klonopin vs Ativan vs Xanax
 

I have the MS hug. I have gastro issues that are being handled with meds from another country, but the hug remains. I went to the neuro today and we talked about the benzo drugs. He said Xanax is short term, and best used for like a panic/anxiety thing. it last about 4 hours. quick, easy. Said if I keep waking in the middle of the night with the hug, ativan would be a better choice, since all benzo's offer a muscle relaxer effect and tend to help that hug. Since I report hugs during the day but are much worse at night the Ativan has about an 8 hour half life. He wanted me to try Klonopin which has about a 4 DAY half life. Stable and steady and hangs around.

What are your thoughts on this? Do you prefer one over the other? do you like the way one reacts more than another? Better relief with one vs the other? Im so confused! I want the hug to go away, but stuff with a 4 day half life is wild! I know I know, just stop whining and take my pill..

I have never tried klonopin so I can't comment on that for the hug or anything else. This has been my experience.

Neurontin - Helps me quite a bit. It takes care of the nerve pain in my ribs. I am fortunate that this works for me as long as I don't increase my dosage. (I'm at 900 mg a day).

Baclofen - Gave it a week trial. Did nothing for the hug and made me hungover and grumpy and irritable.

Valium - Is great if you don't mind being knocked out for a few days. Even at 1/4 dose I sleep a lot. Whether I had pain or not I have no clue and it really didn't matter. :D But, I'm a light weight so things effect me easier.

Ativan - Works good for the hug and decreases the spasms. It doesn't get rid of all of it but takes the edge off of the pain. It also keeps you calm during the pain. The good thing is that you can still function on a small dose and yes, it lasts a while. If I take it at night I seems to last me well in to the next day.

Xanax - Did nothing for the pain and I was still well aware of it when I took Xanax. I've only had 2 in my entire life so I don't know if I'd be the best to answer that one. However, like I mentioned, I was still well aware of the pain/discomfort when I took it.

Some other things that help me . . . Ice. I put ice on quite often. It helps the nerve pain as well as the muscles and inflammation caused by the intercostals constantly going in to spasm.

Epsom salt baths - These really help me a lot and recently I started using magnesium cream. (I found some recipes on line and there is one on NT). It really helps a lot. I apply it a few times a day to the rib cage area.

Pressure - For me, applying slight pressure to the area seems to help. My hug is on the left side. I sleep on that side and it just feels so much better. If I switch to the right side, I can feel the pull on the muscles. I have heard of others putting pressure on the area and/or wearing a girdle. :eek: And, I have also heard that for others putting pressure on it makes it worse.

Bras - Go braless if you need to. I only wear one if I leave the house. They just hit right where one of the nerves goes through the ribs. There are many times when I have been out that I have had to loosen my bra.

SalonPas - These are great too and I have used them many times on the hug. They really do work on breakthrough pain as well as other muscular type pain. DD19 loves them.

TENS Unit - This is a tricky one. My TENS unit works great most of the time. BUT, if the area is nervy :eek::eek::eek: OMGoodness!!!! The pain will take your breath away. If you have one, start out slowly before upping the "amps" so that you know whether some of the pain is muscular or nerve.

In the meantime, I hope you feel better. The hug is my constant daily companion. Some days are better than others but it is always there. And, the nerve damage extends in to my stomach causing spasms in my stomach too. It is not fun to deal with but once you find something that works for you, you will feel so much better and much more in control of the pain.

That is one of my issues. I have had a double mastectomy so I NEED my bra to hold in my fake boobies when I go out. it just looks bizaare to see someone with a flat chest. I get stared at.

I am loving the suggestions keep them coming

Can you try a different bra? I read some where that a woman got a bra with a thicker band and it helped her with her hug. I think that was on about.ms.com but I'm not too sure. For me, it seems the thicker band would hurt more as the area it "constricts" is greater.

Also, sometimes heat helps too. I alternate sometimes between the heat and ice. Sometimes the heat just makes it worse. Most of the time, I just use ice.

Additionally, as you know, I have been getting massages. These work if the massage therapist does just a gentle massage. My MT has been able to get the swelling down and most of the muscles loosened. The intercostals are still spastic but it has helped me so much. She dropped her rate for me, I don't know why. She said that she got in to massage therapy to help people and not necessarily make money. So she charges me $20 for a 1/2 hour gentle massage. My PCP, who also has MS, recommended that I start getting these done on a regular basis as the area was so sore and so swollen. It really does help. It took about a month or so before the swelling and muscle spasms went down. She would come once a week. I am now doing better and she comes every other week. By the 2nd week I am so ready for her to come.

I will say though that she came the other day and did a deeper massage in the area. I could tell she was going deeper and was sore that evening. So, I don't think a deep tissue massage would be good. Just a gentle one.

Ahhh grasshoppa....
 

I love Ativan...it centers me and helps me tremendously with my off balance problems.
I only take a dose of .05 (super low) but can take it up to 3 x a day. My only complaint about it is it seems to take a long time to kick in. When I have my anxious, dizzy times; I can pop one and go drive about 1.5-2 hrs later and feel most normal.

Was just given Klonopin to try at 20 mg. Took a half a one and it knocked me on my *****! I was out like a light and felt a bit hungover the next day.
However; taking 1/4 of the pill does help with the pains.
I think Klonopin is one of those drugs you have to get used to. It has some really great qualities for some people with pain that keeps them up at night.
Its worth a try.
You can always tell a doc you don't like it and move on to something else.

when I needed faster releif I stuck my pills under my tongue. they absorb super fast and work faster.

Cant wait to try this pill later. I dont want to take it now or I will be asleep in my soup.

Dej - I have done the sublingual trick too. It usually works within 10 minutes for me. ;) It's a faster way to deal with pain induced anxiety as well as the pain itself.

Klonopin actually comes in wafers in the USA for dissolving in the mouth. Lucky! I asked for the wafers here thinking if I'm on this medication for the burning mouth syndrome, dissolving mouth wafer makes sense, but the wafers aren't available in Canada! :(

I decided to wait till Sunday night to try it, since I have so many things to do this weekend, and simply cant afford the hangover, spoonless affect. I will let you know in a day or two how it works for me.

btw, I found many differences between Canada meds and USA meds. isnt it strange that the same company that makes this stuff only sells this in USA and that in CAnada and or not at all in UK.

If you do sublingual.... use a smaller dose. Under the tongue bypasses the first metabolism by the liver, and hence you will get much more drug in your blood steam using under the tongue.

If you don't want that huge dose, cut back a bit with your dosing.
If you use your regular dose, be careful.

Took my 0.5mg tab and snapped it in half. took it at 10pm so I wouldnt be zzzzzzing at 8pm. it started to work, I got the warm fuzzies, and I turned off the light. I woke up at 12:30 and 1:15 and 2:20 and 3:30 and 5:00 and 6:15 and gave up and got out of bed at 6:30 Is this normal?

maybe I was over tired, over stimulated, or over stressed after a big full weekend. I will try another one tonight. I am a bit hung over today, but it feels like I worked out or something. I am not as bad as I expected.

I hate new meds. I hate old meds. I hate taking any meds!

I take .25 mg some nights along with ambien CR. I still wake up a lot. Last night was one of those nights when i just could not relax and sleep.

Took. another .25 and it was like someone gave me a cup of coffee before bed. At first I was sleepy and able to nod off and then I woke every 45 minutes. it was silly! I need sleep. I rolled over and took a xanax which helped me nod off and stay off for 5 hours. After a long weekend, and then taking this med which keeps me awake I really needed that rest. I will call the MD today and ask if this is what he expected.

The hug is still here, but I dont know how long it is supposed to take for it to go away. This isnt working out like I hoped. :(

(((Dej))) Sorry you almost pulled a klonopin all nighter. May taking it in the a.m. would be better? As for the hug, well . . . you might not like this but it can take up to 12 weeks to calm down after a flare. And, for some of us, it is constant to varying degrees.

I tried something the other night. I put Vicks vapor rub on my rib cage area before going to bed. I don't know what possessed me to do it, other than I was too tired and lazy to go get the magnesium cream I made from the bathroom and the Vicks was right next me in my nightstand. I tried it anyhow and had pretty good results. I woke up yesterday with less muscle spasms in my ribs. I'm going to try it again and see what happens.

I'm glad you called your dr. and hopefully he/she will have another suggestion. Let us know how it is going.:hug:

I started on Klonopin two weeks ago, I take 1/2 of .5 , first thing in morning and second half at noon, no later. Seems to be helping me to relax my tension, and helps with tremors . Going to try to stay on it, as long as it's not causing me any problems. I also take 3 mg of Lunesta everynight.
Kind of worried about my weight, as I am eating constantly. Not sure if it's meds or not.

Dej, I am one of the ones with a constant hug. Some days are worse than others, but it is always there. For some reason, my neuro never refers to it as the hug. Instead he calls it a girdle like symptom. Perhaps he is right. Hug is too nice of a word.

Tricia, I am going to try Vicks. I have never tried magnesium cream. do I need a prescription for it?

You don't need a prescription for the magnesium cream. MrsD mentioned it in her magnesium thread. (Thanks, mrsD!:hug:). Kirkman's is the one she recommended. However, I couldn't justify the $18.50 for 4 oz. cost. So, I searched for a way to make my own using Epsom salt. I have yet to perfect the recipe as mine came out runny. I still used it and it does work well. Yesterday my thighs were a tight mess, so I put some on after I showered and it helped. ;) I was able to make it through a quick grocery shopping trip without any problems.;)

Here's a thread on the cream. I can't remember if a recipe is on there or not but I think Chemar makes her own. (Was that you Chemar? If so, what is your recipe?)

http://neurotalk.psychcentral.com/thread48757.html

The Vicks works fairly well. It does say on the bottle it helps with muscle aches and pains. That's why I decided to just try it. lol Plus, it helps with my nasal congestion from allergies as well. ;):p

Finally heard back from the MD who said to stop taking the klonopin and put me on Ativan. The xanax does ok, but doesnt work nearly long enough. I keep waking up hugged. Its late on Friday and the nurse is trying hard to get a way to get the Rx to me. I told her I cannot/willnot drive the 20 minutes to where she is to have to drive 20 minutes back. its unsafe for me to go to city driving, and I wont risk it. She is trying to get the pharmacy to accept her phone call in, and will mail it to them. She said she would call me back with the results, but so far she hasnt been great about calling me back. I am just happy that we are working to fix this.

so...off to yet another prescription. I am so tired of pills.

I always have to take in a paper copy for a new prescription for my clonazepam. The same was true for my prescription for cough medicine with codeine. Everything else they are able to fax.

The nurse spoke to the pharmacist (a personal friend) who allowed the script to be filled, and the MD will mail the script directly to them. Got a call from my friend at Rite Aid who told me it was ready, come get it. You gotta love some things about a small town. So, tonight I get to try ativan. yum!

Good luck! I took it a few times prior to MRI and did not have any problems with it. It did help relax me, but did not make me sleepy. But then nothing seems to make me sleepy. Ambien CR is not even helping this week:(

well, I got sleepy, but it wasnt impressive sleepy. I did wake several times during the night, but was able to go back to sleep. With the Klonopin I had trouble finding my way back. So...I think I will try this for a few days. The hug did leave me long enough for me to breath a bit.

My hug is weird, in that its positional. Its so much worse when I lay down, or sit in a leaned forward position. When I stand tall it goes away, or at least backs off.

Mine actually bothers me the most when i am standing and the least when i am lying on my left side.

I know what you mean. Mine really bothers me when I lay on my right side. In fact, I can't lay on my side at all now. I've taken to sleeping on my back. I can breathe better that way, too. The hug doesn't really bother me until I lie down. It takes my breath away. I hardly notice it when I'm standing up or sitting up.

i have intentionally checked myself before bed. no hug. I lay down, start to watch TV and 5 mins later, im hugged! once it starts its hard to make it stop. I get up. I sit bolt upright for it to go away, which takes a 1/2 hour or longer. Back to bed. Lay on other side. and sometimes I get hugged, sometimes not. laying on my back or right side is a good bet it will come. laying on my left side puts me face to face with fuzzy Jack and when I snore he puts his dirty fuzzy foot in my mouth. ICK! I find when I lay on my back its worst under my right rib cage. One MD told me I was crazy! that isnt how the hug works. I would have other sx in my legs and torso first. ugh! then another MD told me that is exactly how it works. putting pressure on the area with the lesion can make it fire up. I wish they would all work from the same book.

Isn't that weird. The left side is where I experience the hug. But mine is in my rib cage/back so it does not affect my breathing. I know that Trish mentioned that she feels better at times when she lies on her side too.

Yup! I feel better most of the time when I lay on my left side. There are times though that I have to lay flat on my back, though.

Certain positions irritate it more. If I slouch or semi recline on the couch it irritates it. Sitting too long sometimes causes it to act up more. Sometimes even a simple movement such as a slight twist will cause the nerve to flare and it ripples through my rib cage. I have sometimes wondered if I have a back injury or something. (Queen of Denial Syndrome :D) But, I've had X-rays and an MRI and nothing showed except some mild disc degeneration and a few bone spurs as well as the lesions.

Some people like heat on their hug. I can't tolerate heat on my hug and it makes it worse. (I tried it last night.:eek:) Ice works best for me.

Barb - Once I get the magnesium cream recipe right I'll let you know. Basically it is dissolving Epsom salt with hot water and adding cream to it. It does help and since summer is coming up and it's so hot, I have trouble with the baths. This is my summer alternative. ;)

BTW - Do any of you feel the muscles "moving" with your hug? I get that all the time. It's not necessarily painful but I can always feel movement in there. It's an odd feeling, kind of like when you are pregnant and can feel the baby moving or like gas moving in your stomach. It's the intercostal muscles that are the painful ones. I often feel like the spasms are so bad they move my ribs.

I tried the side position last night and couldn't do it. Flat on my back is the only way I can sleep and breathe. Oh well, at least it's good for my face....maybe it'll pull out any wrinkles that might be forming! :D