Klonipin, or clonazepam, is a benzodiazepine, used to treat panic attacks and other anxiety disorders, as well as several neurological conditions. Prozac, or fluoxetine, is a serotonin specific reuptake inhibitor, or SSRI. It can be used in the treatment of several psychiatric conditions, among them depression, PTSD and panic disorder. The two medications are used together in several situations where the combination is beneficial.
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Fluoxetine is an energizing medication, useful in particular for treatment of people who have depression along with very low energy and oversleeping, known as hypersomnia, as explained in "Sleep Medicine Pearls." It's often used to treat other types of depression too, where people have difficulty sleeping. When starting treatment with fluoxetine, it can cause irritability, anxiety and insomnia. Clonazepam can be used during the first weeks of treatment to ease these side effects.
Panic disorder is a condition where there are recurrent panic attacks. Symptoms of a panic attack include a rapid heart rate, chest pain, perceived shortness of breath and a feeling of impending death. With long term treatment, fluoxetine can alleviate many of these symptoms. Because of its propensity to cause increased anxiety at the start of treatment, it should be started at a very low dose and increased gradually. Clonazepam is often used in conjunction with fluoxetine, not only at the start of treatment, but on a long term basis. It's used to help relieve panic attacks that occur occasionally despite treatment with fluoxetine. It's usually given on an as-needed basis, meaning it should be taken when the patient experiences a panic attack.
Post Traumatic Stress Disorder
PTSD is a type of anxiety disorder, as explained in "Kaplan and Sadock's Comprehensive Textbook of Psychiatry." Symptoms of Post Traumatic Stress Disorder include hyper-vigilance, which means that the patient is always watching out for people who may harm him, flashbacks, panic attacks, depression and nightmares. Fluoxetine can be used to treat the hyper-reactivity of PTSD, as well as to ease the depression and anxiety. It's often used together with clonazepam, which relieves the anxiety, panic attacks and helps the patients sleep.
- "Sleep Medicine Pearls": Richard B. Berry; 2003
- "Kaplan and Sadock's Comprehensive Textbook of Psychiatry"; Virginia Sadock and Pedro Ruiz; 2009