I have a strong family history of anxiety
and depression. I am a 57 year old professional male.
1). I have been on Clonazepam for a sleep disorder for ~~15 years.
I have never had a sleep study. My sleep disorder is pretty simple. In spite of how physically tired I am I cannot turn my mind off at night. Sometimes I am thinking about work projects but often it seems anxiety related . It is typically a mixture of both. I am somewhat OCD, like many successful people. I can occasionally get so focused on a minor-major issue until I have to get it off my plate before I move on.
But those that know me well would not tell you my OCD traits really interfere with my life.
My dosage of Clonazepam has never changed. I have not required a higher dose.
I sleep very well with Clonazepam, I feel very rested each morning and do not feel hung over.
2). I have probably had mild anxiety and depression most of my adult life but not to the point that it has interfered with personal relationships (Happily married to the same wonderful women for 25 years with no infidelity) ,work, enjoyment of hobbies, etc. In my profession I am considered by my peers as one of the best at what I do. I teach academic courses and seminars for colleagues, etc.
When the Columbine shooting occurred, I lived 45 minutes from the school. I had a severe panic
attack. A friend of mine was a physician. I called him and he prescribed Ativan. I was on this for a few weeks and all seemed well.
When 9-11 occurred I had a very severe panic attack and once again started using Ativan.
My father had mild anxiety most of his adult life. As he got older it became worse and worse and ultimately he was put on a small daily dose of Valium. (1960'-70's) This helped him tremendously. He died in 1974 of an M.I.
As I am getting older my Anxiety seems to also be getting worse and more frequent. There are some days when I do not take any Ativan. On bad days I will take two under my tongue and I calm down within 15 minutes and can continue to function at a very high level.
3). We do not have any family history of addictive disorders.
4). Right now I sleep well on the Clonazepam ( again for almost 15 years w/o a change in dosage). The anxiety I have is becoming a nuisance but again I am capable of functioning at a very high level.
My question is should I continue the status quo? It seems to be working well. If it ain't broke don't fix it???????
Or should I try medications like cymbalta, Efexor, Luvox?
I have had a knee replacement and both ankles reconstructed due to years of sports activities. So I have to watch my weight very closely. I am on a long term low carb eating pattern ( not a diet) and my main form of exercise is bicycling, elliptical and walking.
So I do not want to take anything that will make me gain weight.
I would appreciate any and all suggestions.