Hi, I am a 73 year old woman. I have had bipolar disorder most of my life , successfully in good control past 20 yearts, except for breakthroughs in high stress or physical Illinois periods. My psychiatrist treats me with low dose mirtazipine (REMERON) 15 mg and each night klonopin ( a regular dose, pretty much same range for 20 years) for sleep. If I lose sleep, I get into trouble. Cannot take any SSRIs or typical antidepressants because I get worse. Have had panic attacks and school phobia since age 5. Function life. BA, two advanced degrees and two major professions, so don't let my difficulties stop me from living.

I also developed vertigo/vestibular disorder in 1999, and it has come and gone since then, with one 8 year remission, but in 2011, I had a three month severe episode with daily vertigo, motion sickness (first time ever) . Have great otoneurologist and all tests over years show both central and peripheral components of my vestibular disorder, left side triggered with cervical components adding in in 2011, with that three month episode. Had Vestibular Therapy, two rounds then. It helped me that I am an SLP by profession so I had an understanding of what I was dealing with. In 2011, I took klonopin, during day, .5mg twice , PRN so I could eventually drive and go to PT and stay in life.

Then this past August 22, 2016, I tripped and flipped through air, landing on my head, /forehead and had huge goose-egg hematoma, scraped off right side of my face. In early days concern about losing sight in right eye and front teeth were resolved and both ok. I still have hematoma, that won't go down past size it is now..and it is exactly two weeks since concussion. I have no cognitive/language changes, had a normal neuro this past week and neuro gave me script for PT for balance .....yet again.

Right now, I have been home resting since first week, I was not alone, and had to visit at least 6 doctors to rule out other issues with eye and teeth and skin infections.

Thankfully, no headaches to write home about. I have taken no daytime klonopin since the fall, but yesterday, when I took a short drive to test out my driving and being out, I was ok driving short distance, but had all the vestibular symptoms, minus the vertigo, once I had to walk to and be in the two stores.

I was lightheaded, on edge of anxiety/panic, felt shaky, and couldn't wait to finish and get home. The day after my 24/7 company left, I was climbing my stairs at home, and was so short of breath, I had to sit down. Called cardio who knows me well, and he felt it was clearly, panic because I was now alone again.

So, today, with my reduced but not gone (size of walnut in shell) hematoma, I plan to take two more short drives. I think I will take the .5 mg. klonopin since I believe the feelings once I leave car are PCS/vestibular/anxiety/agoraphobia/panic issues and taking the klonopin when I go out first few times may be helpful. I am nowhere nearly as bad, brain and vestibular wise as I was in the three month episode in 2011. The neuro said it was a miracle that I had a normal neuro exam and only needed to deal with vestibular/balance once again. If I make it today, I will take a short trip to an AA meeting tomorrow (no alcohol for over 26 years and I don't smoke at all either)...then on Friday, a bit longer drive to get my hair colored and cut, at which time I think I will take .5 mg to get through that...I start Pt on September 14th, thinking that would give me some re-entry time. I am listening to my body. Fortunately, I can watch movies, read, and do some screen time and it doesn't affect me..I guess having had the vestibular disorder for so many yeare has taught me how to listen to what is going on. I had been in remission from all vestibular issues for past three years, so this isn't helping, but it could have been so much worse, since my head and face took whole impact on the concrete

No fractures, even on follow up CT five days after fall, since hematoma still so large...my whole face turned black and right eye was swollen shut.

So just looking for support. Anyone have hematoma that took longer than three weeks to go away? Also, any experience with klonopin, (.5) helping get out and drive and not have the agoraphobic/vestibular/anxiety issues while in stores???

Thanks.....Love this website, and have been reading a lot of posts and searched for as much as I can on the klonopin and hematoma issues.

My nighttime dose of klonopin has remained stable for about 20 years. I take 1 mg. four nights a week, and 1 and 1/4 mg three nights a week only increasing for periods when I lose too much sleep on this schedule. My monthly totals are under 40 mgs. for past three years, with my goal being to reduce to 1 mg. nightly. Psychiatrist has managed to keep me off mood stabilizers for all these years and what was once full blow bipolar disorder is now bipolar II with agitation /anxiety as my hypomanic symptoms

I am struggling to process the volume of information you posted to find the main points. I guess it is "So just looking for support. Anyone have hematoma that took longer than three weeks to go away? Also, any experience with klonopin, (.5) helping get out and drive and not have the agoraphobic/vestibular/anxiety issues while in stores???"

Is your hematoma on you face by your eye or inside the skull ?

My mom get hematomas. They can take 6 weeks or longer to go away. When they finally start to turn yellow, it is a good sign. The vascular structure needs to slowly rebuild so it can carry away the old blood.

I was on klonopin before bed for almost 2 years. What do you take it for ? What happens if you do not take it ?
I took it to help my body settle down and stop twitching so I could sleep. Now, I take gabapentin.

Have you tried any supplements ? The Vitamins sticky at the top has a good regimen. Read the first post and the update at post 46 or so.

I take 100 mgs of 5-HTP and 200 mgs of L-Theanine each morning instead of taking and SSRI. You may be serotonin deficient. 5-HTP helps to raise serotonin levels. Some need up to 500 mgs of 5-HTP.

Have you ever had a good full hormone assessment by a specialist who works with bio-identical hormones ? It may just change your life for the better. I know many for whom it did. The specialists are more common now but here is a referral list that may help and a good source for bio-identical hormones if you do not have a good compounding lab near you. Request A Free Practitioner Referral - Women's International Pharmacy | Compounding Pharmacy | Bioidentical Hormone Therapy | Custom Prescriptions | Thyroid | BHRT |

So, ask your psych if you can try gabapentin before bed. I had to take 1200 mgs at first but now take on 600 mgs.

I suggest you try to limit going out during busy times until you have more time going out when it is not busy. Busyness and the chaos can be a struggle in the early stages.

My best to you.

Thanks Mark...yes, hematoma question main. On face above brow, so not inside brain.....Six weeks gives me a reference for it to go always so thanks. The dermatologist said it could take weeks to resolve...it reduced, then was spongy/hard and yellow but past few days has turned purple, not smaller so maybe that is a good sign.

No gabapentin. I have a great psychiatrist who was head of our psychiatry department at our hospital for many years. I have seen him every four or five weeks for over twenty years. He doesn't want me to change any of the meds I take that have helped for over 20 years. So recently, he told me (as did my regular neuro) to take .5mg klonopin if a I experience the vestibular/anxiety/panic symptoms, which I only got when I first drove yesterday.

Have had full hormone workups...I do have diabetes, but in perfect control since I got it with no meds, just diet and exercise. Again, psychiatrist wants me to take no supplements that aren't warranted by tests showing problems.With my bipolar disorder being so well controlled, adding something unknown with my sensitivity to anything new, isn't needed at present. I have little to no pain, other than the severely sprained wrist. I have taken no narcotics either in over 20 yeare and have had hip replacement with severe pain before and still no pain meds other than Tylenol, which I do take and keep to about 1000 to 1500 mg a day PRN. I have had all tests for neuropathy and do have that, radiculopathy and osteoarthritis , poly, and need nothing for pain....maybe meditation and relaxation have helped me with pain issues. Hopefully no need for Neurontin.

Thanks...mostly looking for support here. Hematoma help. Now I realize it can take much longer than two to three weeks to resolve. Heading out now to drive to two places and see how that goes.

I can't use SSRIs anyhow with bipolar, just the atypical antidepressant REMERON. Most of my life especially for first five years after I stopped drinking, I would go 4 or 5 days with no sleep, trigger a mania/agitation/anxiety episode...AA said throw away any "pills" you were on. I did and wanted to die when I got this psychiatrist twenty years ago, but I know what I am like with no meds at least, since I did that first five years sober, but depressed, panic, agoraphobic, anxious. NOw I pretty much have a normal sleep /wake cycle with this protocol and it has worked for over twenty years. No trouble sleeping with this PCS. Vestibular disorder symptoms back though with anxiety and sensitivities being out. Good idea to avoid busy time. Worst wil be this Friday . Drive is about 5 miles local streets from my house so should be able to handle it. Can't drive above 40-45 miles per hour anyhow because of my primary vestibular disorder.

The regimen in the Vitamins was prescribed to me by my first psychiatrist about 35 years ago. He wanted to get my brain healthy before adding meds. He got my brain working so go, I did not need him any longer.

Then, a trauma in 1998 caused a need again. I had a psych and neuro. The neuro prescribed the klonopin. The new psych was fabulous, especially once we got the klonopin switch to gabapentin figured out.

I hated the daytime dopeyness when I took klonopin. I even tried caffeine to overcome that daytime struggle but my psych read me the riot act when I told him. That is when he switched me to gabapentin.

It sounds like you need to focus on moderating stimulation. Taking a klonopin before driving can have an effect on your driving. Hope you stay safe.

Are you massaging your hematoma ? Some say it helps.

I just have one observation here, about your Remeron use.
This drug can cause liver toxicity over time, and when the liver gets affected, the blood clotting factors may be reduced.

One sign of liver damage is impaired blood clotting. So if you haven't had a liver panel run yet, I'd get that done.

Also when you have your next blood draw make sure they evaluate your platelet status.

Mirtazapine

Klonopin also has some uncommon effects on platelets and the liver. Taking both Klonopin and Remeron may be additive in this regard..and not yet visible to you until you had your injury with bleeding.

Thanks for input!

Glad your regimen is working for you, Mark! .5 mg was perfect and I ran my errands with minimum vestibular activity...lights, noises, store, crowds..ok. Now time to rest.

Yes, I have liver functions tested every three months and have for over twenty years, and before that on at least twice yearly basis. Endocrinologist does that. Psychiatrist is aware of Remeron and liver. I am on 15 mg. a starting dose, since therapeutic doses trigger hypomania...so not on 30 or 45mg. They actually made depression and agitation worse. Thanks for the input. Taking it all in.

Mrs. D...I will remember to bring up liver and platelet status next round of blood work. I was off Aspirin and Vascepa for about a week and then went back on. Vascepa is a prescription fish oil with one of the Omega elements out (the one that raises LDLs). My triglycerides went from 633 to 155 on Vascepa alone!!


Thanks again. Great input....Thankfully we look at these element every three months, but just had my bloodwork done week before the accident and was on my way to the endocrinologist to get results. LOL. So will ask him in two weeks if he wants to repeat any bloodwork, including any hormonal workups. I have no Thyroid so we always have to monitor my Synthroid levels regularly. I actually alternate two different doses to keep my TSH in normal range.