Rivotril (clonazepam)

I use Rivotril (clonazepam) to help with the generalised anxiety that comes with Depression. It's an odd choice of medications. As far as I can tell,

• Rivotril does NOT stop me from having Depression episodes, and

• It does not alleviate any of the symptoms of the Depression episodes when I get them (though this could be because I have learned to cope peacefully with my depression symptoms without meds)

• Rivotril does not seem to make me come out of the Depression episodes any faster, though it may delay my entry into a Depression episode by a day or two (though this is hard to tell).

• Rivotril does NOT stop me from having Manic episodes, but because it is a tranquilizer, it may make me less prone to high anger manic episodes (though this could also be because I have learned how to deal with mania years ago).

• Because my mania episodes have been milder than they used to be, it's hard to tell if the Rivotril makes me less hyper and capable of doing things. Though it might be doing so.

In short, Rivotril does not help with any of the negative Depression related issues, and it may actively hinder the positive Mania related symptoms.

So why bother taking it?

Because whether I like it or not, I'm always in a low level hyper / anxious mood. The Rivotril makes me calmer, allows me to focus better and get a bit more done, and allows me to deal with people better.

None of it is life altering - it's more like a 5-20% boost on my daily activities. But it's enough that I think it's worth taking.

I also think I like the slightly sedative effect - it's nice to NOT feel hyperactive and pulled in many directions all the time. Which also strengthens the idea that depression is a failure of the brain to properly handle messaging rather than a sadness issue.

I take 0.5 mg at about 7 am the morning and 0.5 mg again about 5-6 pm in the afternoon, though the exact times can be fuzzy.

Mentally, there isn't a huge change - things just feel a bit calmer. Coordination, on the other hand, suffers a bit. The meds kick in within 15-30 minutes, and for the next 2-4 hours I tend to have some minor physical coordination issues. I might stagger a bit while walking, or my balance will not be perfect, but it's a nuisance rather than problem. I can still drive - in fact, if I'm actively focusing on what I'm doing I don't have coordination issues.

In addition to the coordination issues, actually doing stuff can feel a bit harder, as if the muscles are working harder or being grumpy to react. Again, it's not a deal breaker, but it can be noticeable. If you're athletic, you might notice a drop in your performance for a bit while you get used to it.

Rivotril DOES make you sleepy, so I suggest that you also plan to drink 2-8 cups of coffee a day to counteract the effect, perhaps including one after taking your afternoon meds.

I also occasionally get cramps in my calves and feet at night while I'm sleeping, enough to wake me up.

If you're a guy, Rivotril does make it harder to cum, and sometimes to get erect, though paradoxically it makes me pretty darned horny. I would suspect this effect would vary from person to person, so you'll need to see what it does to you.

Taken all together (even the effects on sex), the side effects are minor enough that I don't feel as if they are bothersome. But note that I'm taking 0.5 mg doses at a time.

My biggest bugbear is that the tablets are 2mg, so I have to cut them in 4 pieces to get the .5 mg. Even with a tablet cutter, this is a royal pain in the ass. Very often, instead of quarters, I end up with three pieces and a small piece to throw away (you don't get any real ill effects if the sizes aren't exactly ). Having to cut up the tablets is also a headache if you have to go out in the afternoon and you need to carry your meds with you. My solution has been to wrap (the very tiny piece of tablet), in cling wrap and stuff that in my wallet.

Finally, be careful about taking more than the 0.5 mg dose at a time without your psych's okay. There was a two week period when I slowly crept the dosage up to taking 2.0 mg a day, taking quarter tablets four times a day (or two half tablets 1.0 mg at a time). It does feel kinda nice and I did spend the time walking around slightly high and mellow. It's kinda addictive. But I also felt like a zombie with somewhat slower thought processes and slower physical responses and arms and legs that felt heavier. It eventually became unpleasant, like too much of a good thing. Yeah, don't do this.

Rivotril is currently my go to medicine, even though it's useless for Depression.

If all else fails, try Rivotril (clonazepam). 1/2 mg morning and 1/2 mg afternoon. For me, it stops the panic attacks and dramatically improves my functionality while I'm depressed. And I don't seem to get resistant to it. Early days yet (two months into using it since the beginning of Sep 19), but if it is still working in February 2020, I'll update this post.

Caveats:

1. It makes me sleepy. If I'm active, I'm fine with no coordination problems. But if I sit for more than about 5 minutes I pretty much always fall asleep. My response has been to drink coffee constantly, so I'm up to 5-8 cups per day and drinking it as late as 9 pm at night.

2. There seems to be a coordination problem when standing. I drift when I walk, and at home I frequently crash into walls as navigate the turns in my house. As problems go, it's minor so I don't really pay attention to it. Fine coordination, like writing or handicraft don't seem to be affected. Driving isn't affected.

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