# Clonazepam & Sertraline combination therapy



## the big bad i said no!

In regards to my thread in the Depersonalization & Derealization Discussion part of the forum (viewtopic.php?f=1&t=15262) i am going to be posting about my experience taking a combination therapy of Clonazepam & Sertraline (Zoloft). This combination was prescribed by Dr Sierra-Siegert at the Depersonalisation Research Unit at the Maudsley, Kings College London.

Day 1 - So its my first day of taking the combination, and overall i have felt REALLY good, and ive been working!  I have had no anxiety or random panicky feelings which i am normally plagued by. Ive been out around town, to the gym, eating loads of fruit (which for me is very odd) and overall feel very motivated and..... HAPPY!!! My dp/dr symptoms are still present, but are already not as bad as usual and because of the lack of any anxiety or panic feelings i seem to care a lot less about them and its only day one!!
My second clonazepam 0.5mg dose of the day, which i took at about 7pm this evening knocked me out by about 9pm and i slept for about 3 hours and have just woken up! I understand that this is a common side effect and hopefully won't happen every night!
Please reply and let me know if you are interested in me trying to post regularly and keeping you up to date with my progress.. love to all tbbisnx


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## Guest

Yep defo carry on posting


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## the big bad i said no!

Day 3 - Quite tired today, i think its sedation from the clonazepam which will hopefully pass but still absolutely no anxiety or panicy feelings! Dp is still there, but no where near as bad or constant as it has been for years which is amazing. I did randomly fall alseep again today at 5pm and slept for 2 hours but the sleep was very relaxing. Overall so far its just lovely not to feel on edge and out of it constantly!


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## Guest

the big bad i said no! said:


> Day 3 - Quite tired today, i think its sedation from the clonazepam which will hopefully pass but still absolutely no anxiety or panicy feelings! Dp is still there, but no where near as bad or constant as it has been for years which is amazing. I did randomly fall alseep again today at 5pm and slept for 2 hours but the sleep was very relaxing. Overall so far its just lovely not to feel on edge and out of it constantly!


Good to hear  I know what you mean about on-edge, when I try and just relax I have this feeling of really wanting to try and 'think' myself better, like if I don't I will 'forget' how to be.......which apparently is fairly typical, the wanting to fight thing but I have to learn to ignore it. Hope you continue to improve


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## the big bad i said no!

Day 6 - Todays been brilliant! I worked really hard at my job all day with no anxiety or random panic feelings distracting me. I keep having moments where i feel so connected to everything. Like earlier when i went out to the gym, i really felt like i was there, and part of the life that was going on around me! Normally i would have felt isolated, detached, anxious and just want to get out of there (probably wouldn't have even gone out in the first place!). The only problem at the moment is the sedation i feel later in the evening, after around 8pm. I don't need to be in bed until about 1am and its just hard to do anything when you feel so sedated. I have also been getting a bit argumentative and randomly annoyed but i think this is side effects from the Sertraline (Zoloft), as ive felt these side effects before from previous ssri's ive tried and know they will pass. Overall it really is amazing the difference i feel already and its not even a week and once both drugs have eased down a bit and my systems got used to them i reacon this is my way out of DP!!!


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## Guest

Congrats! Gonna try and get me an appointment, I emailed them and they said I just need a referral from my psychatrist and doctor.


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## the big bad i said no!

Yeah, i tried in vein to get a referral from an nhs psychiatrist. So i would recommend, if money allows, to get an appointment at one of the priory hospitals. I made myself an appointment and saw Dr Vik Watts at the Priory Hospital North London, the 1 hour assessment cost about ?120 if i remember correctly, but well worth it as i immediately referred to the DPRU. 
If you do go down this route make sure you get them to refer you to the right department and person as mine was sent wrong and it took a year to get a reply from the DPRU when it should have taken a couple of months if they decide to see you. At the priory they did offer an anti-psychotic medication treatment to which i declined and prescribed me the ssri - lamotrigine combo as i mentioned it to them, but wouldn't prescribe clonazepam long term, that needs to be the DPRU. 
GOOD LUCK! tbbisnx


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## Guest

Well I live in the Channel Islands and we don't have the NHS here so it would be a private referral anyway. Already spoke to DPRU they said that's fine. Thanks for good wishes and please do carry on updating


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## h1021

hello and yes I am very intersted. My doctor just put me on the same combination and wondering if you are seeing more improvement day by day. Today was only day one and I saw little change in the dp. I am new to this forum but have had dp for about 7 months grrrr. Would be interesting to see how both our progress goes since we are on the same meds. 
Thanks so much!!
h1021


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## Guest

I'm thinking its going well as we've not had an update for a bit


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## sk00ts99

Im glad to hear somthing is working for you, but you should be warned, and this has no intent to scare you, that Klonopin is VERY addictive and is almost impossible to get off. My DP is actually from this withdrawal and it is a nightmare. I was in Iraq and hurt my back, started taking tons of vicodin for a few years, then got bad stomach issues. I ended up in the Hospital and the GI Doc prescribed Clonezapam (Klonopin) to help with anxiety and relax smooth muscles in my stomach to keep from cramping. I was on 1.5mgs a day for a little over a month and all I wanted to do was sleep. The doctor advised me to stop taking them, and 2 days later, I began my DP hell. It has gradually gotten better, but still, 6 months later I am still having issues. The moral of this story is watch out with the meds, the yseem great at first, but can become a nightmare later. Just google Klonopin Withdrawlal, or go on youtube an dsearch for it, not too good. Best of luck and God Bless. I only want you to know the "whole" truth.


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## the big bad i said no!

Im not fussed, if and when stopping clonazepam it induces 'dp hell' then im back to where i was. I'm absolutely loving life now for the first time in 5 and a half years! Anxiety from 95% of the time to 0%, panic feelings and panic attacks 75% of the time to 0% and dp/dr complete hell from 100% of the time to about 15% so far and ive only been on the medication for 2 weeks. This combination is being prescribed to me by Dr Sierra-Siegert at the Depersonalisation Research Unit as ive mentioned before and he has explained my dose of clonazepam will not be increased, the chance of complete tolerance and addiction are not that high and im quite happy to take that chance as ive not had much of a life for so long. He also advised that its the combination of the two drugs that helps cure the dp not just the clonazepam to mask it. This comes from the guy that wrote the Cambridge depersonalisation scale and has been studying it for 14 years and also successfully treated people with the clonazepam and ssri combo. 
And by the way, sorry ive not been updating my progress for a while, been loving things so much and been out and about living life that ive not been on the net much! I will update when i can and heres to that last 15% of dp/dr pissing off and me being free! peace.. tbbisnx


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## Guest

Here's to your new dp free life tbbisn!!! *clinks glass*


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## hurricane12

hey how did u get depersonalization?
and im 17 is it safe if i try to take the same meds?
i got my dp from a concussion so i dont know if the meds will even help in my case


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## the big bad i said no!

Hey everyone, sorry its been a while! Im still doing really well on the med combo and havent had to increase my dosage. I really am living my life now more than just experiencing it! I still have moments of dp/dr but they are getting less frequent and it used to be constant, 24/7! My anxiety levels are at 0% and i now never get panicy. I hired a car last weekend and drove to download festival for the day with my gf and brother and didn't have 1 beer, which is something i could have never done before (obviously i wouldnt have been driving before) but i always had to get pissed at events like this, i thought it was to add to the fun but i think it was more to control my dp and make things seem a bit more real. KISS played a storming headline set and i remember every bit which is amazing and i really felt every moment of being there. When finding out i couldn't really drink on clonazepam it bothered me but now i hardly ever drink and don't miss it, as things are feeling real without it! Now just got to give up these damn cigarettes!!!


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## Guest

I am so pleased for you!! Got my own psychiatrist appointment coming up soon and I gave the mental health worker I saw first all the research I had done on these treatments, like info from the kings college dp department and a research paper 'understanding and treating depersonalisation disorder' - see what happens although I have been doing better recently. I lost my grandad yesterday which although really sad, has brought me back down to earth a little. RIP Grandad will miss you so much


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## hurricane12

^^^dam sorry to hear that the last thing u need is to lose loved one especially at hard times like this


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## Guest

hurricane12 said:


> ^^^dam sorry to hear that the last thing u need is to lose loved one especially at hard times like this


Thanks matey, I've come to terms with it and in a way has helped bring me back down to earth a bit............


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## Neil1427

Where is the next page... :lol:

Phasedout24 - Did you follow this up, and how you getting on??

I've been working through mine for 3 years and im on Citalopram which seems to be working. I can fight mine off by ignoring it but do slip back into it. Trying Hypnthearpy next week to give me a little more strength.


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## frustrated

hi i have been put on the same combo about 4 weeks ago i started out on the zoloft with 25 mg and very slowly am working my way up to a higher dosage, it has started to break my DR but not enough for me to be satisfied, i was wondering how many mg did u start on and how many are u on now of the zoloft?


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## hurricane12

i need some meds my dam psychiatrist says i dont need meds stupid doctor
anyway yea what happened im guessing the treatment has really helped you and your out enjoying life instead of being on this forum
but at least give us an update...

are you completly cured yet?


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## goldengirlz

wondering if there's been an update recently...?


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## the big bad i said no!

Hi to all!!! Not been on this site for about 6 months now. Just to recap, my DP/DR was a constant thing for about 5/6 years, constantly seeking medical advice & help and as im sure you can remember. I have now been on the clonazepam & sertraline combo the dp research unit in London prescibed for about 8 months now and life is much better! I still have dr to a certain extent but no dp and am loving every minute!! Im now taking 2.5 mg's of clonazepam & 100mg of sertaline a day and its changed me back to nearly who i was before. I have new friends, a decent, well paid job & still, a loving supportive girlfriend, who i love to bits seeing me through all this. She always said she could see who i really was under this cloud of constant dp/dr and anxiety and now she knows that person. I have feelings, love, emotions and the greatest appretiation for Dr Segert at the Dp research unit who has helped me regain a life i thought i'd lost forever. 
Im sorry for not replying to messages, but in a selfish way i dont really come onto this site ever anymore as it just used to fueled my dp/dr even more, constantly searching for a cure/peace/answers. Just thought i'd let you know there is a light at the end of the tunnel and i love and wish you all well. TBBISN xxx


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## jay2008

It's great to hear you come back and update us on your status. When I read posts like this, it encourages me to put aside my silly fears and ignore the overly negative views on medication on the internet and seek help for my DP.

Thanks!


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## the big bad i said no!

Personally I don't care if i have to take these meds for the rest of my life, to be able to lead a normal life. Clonazepam is a dependance building drug and ive slowly had to increase my dose from 1mg to 2.5 mg over the last 8 months but now i at last haven't built up a tollerance to this dose! Its just about finding the right med & doseage & everyones different. I do feel withdrawl symptoms if i miss a dose but as long as im on it, im me, not some hollow shell that's scared of his own shadow, pactically housebound and loner that feels he's living in a completely different reality to everyone else!


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## utterlyadrift23

Hi there,

I am so glad I came across this post. How do i get prescriptions for this medication? My GP is useless. Hope to hear from someone soon


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## Matt210

utterlyadrift23 said:


> Hi there,
> 
> I am so glad I came across this post. How do i get prescriptions for this medication? My GP is useless. Hope to hear from someone soon


Where are you from? You need to get in with a psychiatrist. Your GP is capable of writing you a prescription for these drugs, but if he is uneducated enough to think that you are hallucinating then you probably don't want to have him as the one monitoring your on psychiatric drugs.

Hopefully he can make a referral for you on to a psychiatrist, or you should find a new GP.


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## utterlyadrift23

Hey matt210,

I had a question. I just read this post about a guy who broke out of the cycle and he says that his DR has pretty much gone. I am almost certain I have intense DR more than DP because nothing looks as it did before I had it. Not that it has changed in shape or form but it's just so hard to explain.

How are you supposed to break out of the cycle when you will be reminded of it while you're awake? Makes no sense....


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## Matt210

utterlyadrift23 said:


> Hey matt210,
> 
> I had a question. I just read this post about a guy who broke out of the cycle and he says that his DR has pretty much gone. I am almost certain I have intense DR more than DP because nothing looks as it did before I had it. Not that it has changed in shape or form but it's just so hard to explain.
> 
> How are you supposed to break out of the cycle when you will be reminded of it while you're awake? Makes no sense....


I know that DR is hard to explain, don't worry - i've been there.

Not sure exactly what you are asking me, but if you are asking me for the 'cure' I couldn't tell you that. What I can tell you is that you have a good chance of getting better. The vast majority of people do get better. But there is no one way to get better. This current thread discusses medication - a combination of an SSRI (which is an anti-depressant that works on anxiety in the long term) and a Benzodiazepine and works on calming you when you get really anxious.

This depends if your DR is anxiety based. Are you feeling extremely anxious and scared right now? Do you have any history of anxiety?

There are plenty of treatment options and it is hit or miss. Some people just have this go away on its own, others use techniques of relaxation and distraction, others do psychotherapy, others learn cognitive-behavioral techniques, others find success with different combinations of medication and/or supplements.

For me I got better pretty much on my own - never took any medication. However after 2 years of feeling better, mine came back worse than ever. So I am currently trying out medication for the first time in my life as this time I have been more anxious than I have ever been in my life (i suffer from an anxiety disorder).

Maybe give me some more details about your history and your feelings and I can try and offer up some suggestions. But everyone is different.

Just remember that you can and likely will get 100% better.


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## utterlyadrift23

Well It all started with a panic attack when I smoked a tiny bit of marijuana in June 2006. I had a massive panic attack which lasted around 14 hours. I thought that once I would fall asleep I would wake up fine...much to my demise I didnt.

I woke up with derealization but no anxiety at all. It was bizarre. It continued for about 4 months and eventually died down. The irony of this is that I recall the day where I said to myself "it has gone". The very same day I was sitting in Mcdonalds, and I had the biggest panic attack and it came back 100x worse, with the added _benefit_ of the intense anxiety. From then forth I had panic attacks very often; once a day almost. At one point I was almost certain that I would end up dying from one of them.

But then it calmed down about 6 months later. I carried on with my life as normal, the level of anxiety and derealization fluctuated. It was when I moved to the South of France, Nice where it actually became bearable. I met my girlfriend there and it was ok. Of course it was too good to be true. The panic attacks had subsided, the level of anxiety was manageable and all that was left was the derealization - I thought that it would also dissapear in time. But then in September 2008, just before I was supposed to drop my sister off to her university I had a huge panic attack again. And it has been really really unbearable since...

The reason I found this forum is because I guess since my girlfriend broke up with me two days ago, the feelings have become far too intense. In the last two weeks of our relationship it was getting progressively worse.....

But I think that's about it. In terms of therapy I was seeing a guy who specialises in psychoanalytical psychiatry but it doesn't seem to be doing much. I tried CBT for a bit (a self help book) and that didn't work either. My level of anxiety is too severe for it to be treated like that. And the way it was induced I suppose makes it a little more difficult to cure it like that. So the only option I am left with is medication...

Over the last two three days I have been reading as much as possible on this forum about all possible routes to recovery and that is where I stand at the moment.


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## Matt210

I just read your introduction on the forums as well so I got a better idea of where you are coming from.

Sounds like you are suffering a great deal of anxiety right now, so that is probably the key to your DP/DR. It is also normal that after a rough life event that your DP/DR would get worse. I also had limited success with CBT, and have never tried psychoanalysis.

It's important not to ONLY treat your symptoms with medication. Seeing a psychiatrist or someone in addition to medication is always the best route to go. But medication sounds like a good idea for you. The most popular route for medication, and probably a good place to start is with what I was talking about and what this thread is talking about: a SSRI and a Benzo. The Benzo is for short term relief - to help you cope with panick attacks and overwhelming feelings of anxiety. It helps immediately after taking it. The SSRI takes 4-6 weeks to start working but the idea is that it will eventually help your anxiety and DP in the long run so you do not need the Benzos anymore.

The two mentioned in this thread are the most common and popular among DP sufferers it seems. Sertraline (trade name Zoloft) and Clonazepam (Klonopin) might be a good place to start. Do your own research though, and talk to your doctor about what the best route is for you. Medication is not the only way to turn, but there is no harm in using medication if you are overwhelmed. 
The medication will not 'screw you up' in the long term. It may have side effects, and you may go through withdrawal symptoms when you stop. But as long as you are seeing a doctor you don't have to worry about medication being dangerous.

Hopefully that information helps. Try not to worry too much, you'll be fine.


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## utterlyadrift23

Thank you ever so information for bothering to reply. Means alot to me that someone I barely even know is willing to give some advice. I just hate my ex for not understanding me, I suppose it's not her fault though...


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## Do.I

I just showed this to my doctor who has agreed to let me try the combination (although on the lowest doses of each. He said not to start the clonazepam for 5 days, so I know where any side effects are coming from. But even today after having taken sertraline in a small dose, I am feeling a little better. So fingers crossed.

Although can someone please help explain the logic behind clonazepam, as my Doctor told me it is for treating epilepsy only.


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## Matt210

Do.I said:


> I just showed this to my doctor who has agreed to let me try the combination (although on the lowest doses of each. He said not to start the clonazepam for 5 days, so I know where any side effects are coming from. But even today after having taken sertraline in a small dose, I am feeling a little better. So fingers crossed.
> 
> Although can someone please help explain the logic behind clonazepam, as my Doctor told me it is for treating epilepsy only.


Clonazepam calms anxiety, and is quite frequently used to treat panic and anxiety. It is also an anti-convulsent so it could be used for epilepsy. Again - I can give you the very non-scientific explanation since I have no idea how to use scientific jargon to explain this. Anyone who is more educated on the topic is free to correct me if I say something incorrect.

Clonazepam is a GABA agonist as far as I understand, which means it increases levels of a neurotransmitter called GABA in your brain. GABA is an inhibitory neurotransmitter which means it stops other neurons from firing - it essentially slows things down in your brain. Epilepsy is actually caused by a flurry of neurotransmitters firing in the brain - which increased levels of GABA is able to inhibit. The idea in treating anxiety is that once again, anxious people have too much activity going on (obviously in different areas of the brain) and GABA is able to calm down the brain activity which is making you anxious.

Once again your doctor is demonstrating how little most doctors know about anything at all really when it comes to mental illness, as Clonazepam is probably as frequently prescribed for anxiety and panic as it is for anything else.

It actually probably would have made more sense to start Clonazepam first, and then the SSRI as Clonazepam will help you with the short term anxiety and panic and Zoloft will help you in the long term. It may take 4-6 weeks before you start feeling the full effects of the Zoloft.

Regardless, this is a combination of meds that works for a lot of people so I wish you good luck!


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## Do.I

Matt210 said:


> Do.I said:
> 
> 
> 
> I just showed this to my doctor who has agreed to let me try the combination (although on the lowest doses of each. He said not to start the clonazepam for 5 days, so I know where any side effects are coming from. But even today after having taken sertraline in a small dose, I am feeling a little better. So fingers crossed.
> 
> Although can someone please help explain the logic behind clonazepam, as my Doctor told me it is for treating epilepsy only.
> 
> 
> 
> Clonazepam calms anxiety, and is quite frequently used to treat panic and anxiety. It is also an anti-convulsent so it could be used for epilepsy. Again - I can give you the very non-scientific explanation since I have no idea how to use scientific jargon to explain this. Anyone who is more educated on the topic is free to correct me if I say something incorrect.
> 
> Clonazepam is a GABA agonist as far as I understand, which means it increases levels of a neurotransmitter called GABA in your brain. GABA is an inhibitory neurotransmitter which means it stops other neurons from firing - it essentially slows things down in your brain. Epilepsy is actually caused by a flurry of neurotransmitters firing in the brain - which increased levels of GABA is able to inhibit. The idea in treating anxiety is that once again, anxious people have too much activity going on (obviously in different areas of the brain) and GABA is able to calm down the brain activity which is making you anxious.
> 
> Once again your doctor is demonstrating how little most doctors know about anything at all really when it comes to mental illness, as Clonazepam is probably as frequently prescribed for anxiety and panic as it is for anything else.
> 
> It actually probably would have made more sense to start Clonazepam first, and then the SSRI as Clonazepam will help you with the short term anxiety and panic and Zoloft will help you in the long term. It may take 4-6 weeks before you start feeling the full effects of the Zoloft.
> 
> Regardless, this is a combination of meds that works for a lot of people so I wish you good luck!
Click to expand...

Thanks for explaining, that makes sense. My doctor actually seems very good. From what I've been reading it is a rarity to have met a doctor who already knew about DP. I think it might just be that in the UK it is supposed to be strictly for Epilepsy, as he went to a book to double check. Also the leaflet in the box only referred to treatment of epilepsy. Honestly I'm not that fussed which order I start taking them in, as long as they help (sorry, I always feel the need to defend anyone who has been helpful, as my doctor certainly has). Anyway, thanks again for the explanation.


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## Matt210

Well i'm glad you found a doctor that helps then. Didn't mean to be judging your doctor, just am consistently annoyed at how little GP's seem to know about anything in general. I suppose you can't blame them as human health is an enormously complex issue, and as GPs they did not specialize in any one particular area. But I often have to wonder what most doctors did in their 10 years of post-secondary education.

Hope you feel better!


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## Do.I

Thanks fellow West Wing fan.

It's Day 2 on both for me, and I think my dose of Clonazepam is nowhere near high enough (0.5mg). I was feeling more awake (not in a no DP sense) with just the sertraline, but after taking the Clonazepam, I get about 5 minutes of being exhausted, and then feel a tiny bit less DP'd for the next 5 or 6 hours. I'm seeing the doctor in a week and will see if he'll up my dose, but I get the impression it could help me a lot if I find the right dosage. So I owe a thank you to the big bad I said no!. I'll see if it improves anymore.


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## davehodgson333

Hi,

I've also just started Sertraline / Clonazepam combination and it's working pretty well!

My GP and Psychiatrist weren't very keen on the idea until I showed them this paper: [search google for 'understanding and treating depersonalisation disorder' - sorry I'm not allowed to post links yet!], along with the Depersonalisation Research Unit's FAQ: [search google for 'depersonalisation research unit faq'] . I'm on 100mg Sertraline and 0.5mg Clonazepam once in the morning and another in the afternoon.

I feel groggy most of the time from the Clonazepam but it's pretty much cleared up the derealisation.

This is just my experience and not backed up by any medical data, but about a year ago, when my derealisation was particularly bad (my short-term memory was in-and-out), I was taking Sertraline, and then had a 10 day course of Temazepam, which is also a benzodiazapine like Clonazepam. The Temazepam/Sertraline combo cleared the derealisation up completely, which then came back two months later. This might be a good thing to try before going onto the Clonazepam; if you can be fixed for a few months by taking a simple sleeping tablet for only a few days, this is much preferable to being constantly on Clonazepam. Sadly the Temazepam doesn't do the trick to anywhere near the same extent for me any more, so it's Clonazepam for me.

Hope that's helpful, and gives hope to those who feel like they're at the end of the line!

Dave


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## Matt210

Do.I said:


> Thanks fellow West Wing fan.
> 
> It's Day 2 on both for me, and I think my dose of Clonazepam is nowhere near high enough (0.5mg). I was feeling more awake (not in a no DP sense) with just the sertraline, but after taking the Clonazepam, I get about 5 minutes of being exhausted, and then feel a tiny bit less DP'd for the next 5 or 6 hours. I'm seeing the doctor in a week and will see if he'll up my dose, but I get the impression it could help me a lot if I find the right dosage. So I owe a thank you to the big bad I said no!. I'll see if it improves anymore.


Clonazepam will have the sedative effect for the first little while, but this will be the first thing you'll build up a tolerance too. Which is good because then you get a few weeks or whatever of the drug calming your anxiety without making you feel drowsy.

Don't be too quick to up your dose. I mean - if 0.5mg is useless for you then you might as well, but if you are finding some relief then up the dose VERY slowly. Clonazepam has a high potential for tolerance and for dependence. In other words - you can't be on it forever, and eventually each dose you take will stop working and you will have to increase again to the point where you can't increase anymore for safety sake and then you are forced with the dilemma of being addicted to a drug that isn't even working for you.

So if you start on 1mg right away, then you'll have built up a tolerance to 1mg by the beginning of April lets say. Whereas if you can find relief from 0.5mg until April when it stops working you can then go up to 1mg at this point. The goal is to NOT have to use the Benzos in the long term - they are a short term solution while your SSRIs or other form of therapy kicks in. So the less Benzos you can take the better.

Don't get me wrong though - Benzos need to be calming your anxiety in the short term to be helping your DP. Don't torture yourself with low doses that aren't working for fear of addiction. Just use them at a level that you can feel comfortable with.


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## Do.I

Matt210 said:


> Do.I said:
> 
> 
> 
> Thanks fellow West Wing fan.
> 
> It's Day 2 on both for me, and I think my dose of Clonazepam is nowhere near high enough (0.5mg). I was feeling more awake (not in a no DP sense) with just the sertraline, but after taking the Clonazepam, I get about 5 minutes of being exhausted, and then feel a tiny bit less DP'd for the next 5 or 6 hours. I'm seeing the doctor in a week and will see if he'll up my dose, but I get the impression it could help me a lot if I find the right dosage. So I owe a thank you to the big bad I said no!. I'll see if it improves anymore.
> 
> 
> 
> Clonazepam will have the sedative effect for the first little while, but this will be the first thing you'll build up a tolerance too. Which is good because then you get a few weeks or whatever of the drug calming your anxiety without making you feel drowsy.
> 
> Don't be too quick to up your dose. I mean - if 0.5mg is useless for you then you might as well, but if you are finding some relief then up the dose VERY slowly. Clonazepam has a high potential for tolerance and for dependence. In other words - you can't be on it forever, and eventually each dose you take will stop working and you will have to increase again to the point where you can't increase anymore for safety sake and then you are forced with the dilemma of being addicted to a drug that isn't even working for you.
> 
> So if you start on 1mg right away, then you'll have built up a tolerance to 1mg by the beginning of April lets say. Whereas if you can find relief from 0.5mg until April when it stops working you can then go up to 1mg at this point. The goal is to NOT have to use the Benzos in the long term - they are a short term solution while your SSRIs or other form of therapy kicks in. So the less Benzos you can take the better.
> 
> Don't get me wrong though - Benzos need to be calming your anxiety in the short term to be helping your DP. Don't torture yourself with low doses that aren't working for fear of addiction. Just use them at a level that you can feel comfortable with.
Click to expand...

Well a few days on with the 0.5mg and its better. I'm still drowsy but I'm feeling happy, less anxious. Still got the twitchy leg, but I can live with that. I have noticed it is better when I combine it with both vitamin B complex and my concentration is better than ever when all those are combined with the caffeine from Red Bull. I'm thinking I should possibly ask for a stimulant like Ritalin in a small dose, because then the anxiety, lack of emotion, and inability to concentrate should all be significantly less severe. The DP is still there, but it is not as daunting. You seem to be very clued up on the pharmacological side of this, so I was wondering if you had any thoughts about this?


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## Matt210

Do.I said:
 

> Well a few days on with the 0.5mg and its better. I'm still drowsy but I'm feeling happy, less anxious. Still got the twitchy leg, but I can live with that. I have noticed it is better when I combine it with both vitamin B complex and my concentration is better than ever when all those are combined with the caffeine from Red Bull. I'm thinking I should possibly ask for a stimulant like Ritalin in a small dose, because then the anxiety, lack of emotion, and inability to concentrate should all be significantly less severe. The DP is still there, but it is not as daunting. You seem to be very clued up on the pharmacological side of this, so I was wondering if you had any thoughts about this?


This is interesting actually, and I honestly can't say I know the answer. Your inability to concentrate likely comes from the anxiety and the benzos and eventually the SSRIs should eventually take care of it (i'm talking in the long term here - nothing immediate). So my immediate gut reaction would be to say no to the stimulant - stick with what you have.

It is interesting that you say that caffeine improves your concentration though. I know that caffeine has been shown to improve attention and concentration, but I would have thought that caffeine would actually counteract the anti-anxiety effects of the Clonazepam, and thus should technically make your particular concentration worse. If you are saying the opposite, then perhaps your theory could be beneficial. Talk to your doctor about it - I am completely clueless when it comes to Ritalin. The only expertise I have are in the drugs I have either taken myself or have explored as options for myself. I took a psychopharmacology course as well which helped, but not enough for me to be offering you advice. Maybe its an option worth exploring - but you'd have to look into drug interactions, and so on and so forth.

I still have a hunch that in the long run your concentration will be helped by the two drugs you are already on, so maybe for now just enjoy your Red Bulls and see where you end up when the SSRIs are at full effect a month or so down the road.


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## midlandsguy27

What dose of sertraline and clonazepam are you currently takeing and is it taking the dp/dr away?


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## midlandsguy27

Is it possible for someone to sticky this post as its an important subject. Reading this have raised my spirits somewhat and i feel that many people will not know of this department


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## wael

i'm also on the combo sertraline & clonazepam. Sertraline is a very useful ssri for me. It feels more "softer" than citalopram, and i have fewer sexual side-effects. But justs a with the citalopram, it helps me with anxiety and obsessive stuff, which results in a less dp/dr state. But it does not take it away. When clonazepam is added im even more functional, but still dp/dr. When i used 75 mg sertraline, the clonazepam isn't really neccesary, but on 50 mg it is.
Funny, but when i was on 75 mg and i tapered my clonazepam i became less anxious. 
Currently im on 50 mg, because i feel that my ssri is helping me but in the same holding me back.(middle of road)
I'm using clonazepam for a couple of months. In the beginning 1/1,5 mg a day, now im just taking .25 a day, but i think that i will go back to 1 mg a day.


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## midlandsguy27

Am on 50mg sertraline Have a doctors appointment on Monday. Would like to ask for Clonazepam. How should I approach the subject? I am in the uk. I need something to brek this cycle of dr.


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## wael

In my case I told that a lot of dp/dr sufferers benefit from clonazepam. If your doc is not to dogmatic you can honestly discuss the subject with him. Don't go pushing, because then you give him/her the feeling you are potential addict. Just try to be rational and give examples of the studies that mention dp/dr relief from clonazepam and that it is perhaps worth trying. 
If he reject to prescripe it you can go on "desperate"tour (perhaps the next appointment). I told i was ordering from the internet or that I could get some from a friend who's mom was suffering from epilepsy. Most of the time they rather describe you clonazepam then some potential dangerous internet drug you will order.
It to you to decide. You can also try to get a second opinion.


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## Do.I

My GP is pretty clueless on DP and I just showed him this thread, and explained that my research suggested that the combination was among the most effective out there.


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## midlandsguy27

What dose of sertraline and clonz are you on? Has it helped?


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## Do.I

I am on 50mg of Sertraline and 0.5mg of Clonazepam, It helps a little, but I think I could do with a stronger dose of clonazepam.


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## Guest

I know when I was deep in the hell of full on DP I didn't care if I had to take like 20 tabletsa day for the rest of my life to get out of it. 
I'm not fully better by any means, however now I personally (and I'm not saying this is correct by any means) see DP as a healing process of the brain - now why would you take tablets to get rid of a healing process? It's not something you can 'cure' because it's not an illness as such but your brain/nervous system being over exhausted. There's no magic pill to rest your brain, the only healer is time IMO. I think the mindset that it's an illness you have to cure is probably what prolongs it to some extent?? And to that end, I believe that the reason clonazepam shows success is because it is a fairly strong benzo and therefore makes you relax somewhat and gives the ol' noggin a break? 
I'm not dissing taking meds at all, I'm on effexor for underlying anxiety myself, but I think that meds are more of a helper (i.e. for underlying anxiety etc) than an actual cure for the DP itself.
Please do feel free to comment or discuss


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## Do.I

You're right. I like the sertraline clonazepam combo, but it is not so much a cure. It merely makes it a little more bearable.


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## Do.I

Just if anyone was wondering how this worked out. Not well would be the answer. When my dosage of sertraline had been raised for a little while the DP actually worsened. My mood lowered and I found myself to be more aggressive. So now it's Escitalopram with the occasional Diazepam for sleep. The latter makes little difference to the DP. It's easier to enjoy a situation, but only a little, and it is still as if I have forgotten how to be happy. Still the most effective SSRI I've tried to date.


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## FoXS

I 've got a question to you ... you all come from America or England, do you?
I'm from Germany and I wonder where can you get those medications so easily?
Have you gone to a doctor who gave you a prescription, or can you get it in a pharmacy / drugstore? 
Because in Germany, you can not buy every chemical medication withou permission!


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## Do.I

In England you need a prescription for those kind of medications.


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## FoXS

so you all go to a doctor for getting rid of DP/DR??


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## Mario

FoXS said:


> so you all go to a doctor for getting rid of DP/DR??


Where else should we go?they are the ones who can prescribe medication.Of course that you can also see a psychologist or a psychoterapist or use an alternative medicine such as acunpuncture,yoga,zen meditation and so on.


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## FoXS

when i was at the doctor, he had been searching for reasons in my body, for example muscle cramps which i should not be able to realize. 
but he hasn't found anything. 
yet i have experienced that deep relaxation can help. I'm on a good way
do you think i should still contact a psychologist, too?


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## melindazcrew6

Wondering if this is still working for you??


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