clonazepam (sleeping/anti-anxiety pill) finally drying my eyes

[ringo]

Hi everyone,

I have been on clonazepam (sleeping/anti-anxiety pill) for some time now, and initially I noticed a lot of improvement in my mood and sleeping without much difference to my eyes.

But in the past week or so, i have noticed increasing dryness, especially upon awakening; I know that particular feeling of dryness from a sleeping pill, I have had it before with other medications like Xanax. My doctor prescribed clonazepam (Ativan, Rivotril) for one more month, and he was at a loss, as dry mouth is listed as a side effect in all anti depressants and most anti-anxiety, anti-psychotic medications usually prescribed for improving sleep and anxiety.

Now I am thinking I should taper off this medication, and I am getting depressed just at the prospect of losing my sleep again.

I thought clonazepam does not affect the eyes that much, but the effect actually seems to be cumulative. Clonazepam belongs to the benzodiazepine gruops of anti-anxiety drugs which have minimal anti-cholinergic effects compared to antihistmaines or antidepressants (by anticholinergic i mean anti-secretion, mainly saliva and tears).

I wonder if I use the pill like 2-3 times a week, would things improve?

I mean-- I can't cry, I can't use any means of venting out my negative emotions related to this disease, I have noone in real life who I can share with or seek advice... and now it turns out I cannot even take pills which a good doctor thinks I should be taking to help me cope psychologically.

This is just another proof that dry eye is directly related to neural (dis)regulation; and another proof that no treatment currently addresses this aspect of the disease. The only thing that upregulates directly neural signalling to some extent are secretagogues (cholinergic medications, the opposite of anticholinergic like the sleeping pills), but even they are not helping much when taking sleeping pills-- seems the effect of the sleeping pill overrides or interferes with the secretagogue action.

I am so puzzled as to how I can tackle this dilemma, and the doctors I have seen-- ophthalmologist, neurologist, psychiatrist, have no clue.

Has anyone done any research on whether there is anything that can help sleep problems/anxiety without drying the eyes?

i know this question has been asked before, and there were lots of answers but may be someone has found something new?

Thank you for any advice,

Dani

[Susie28]

Hi Dani,
I'm so sorry for you. That's really sad! You have found a good medication for your psyche (which is probably broken because of your dry eye problem and now you can't take it anymore BECAUSE OF your dry eyes. That's a vicious circle and that really sucks.
I have no big advice for you (as I'm not well versed in antipsychotic drugs), but perhaps you can try a psychotherapy without medication? This could help a little bit, too. You could talk to a nice therapist about your dry eye problems and I'm sure you can get a lot of advice how to manage your life inspite of having dry eyes.
Have you ever tried autogenous training? it helps me a lot to calm down and to relax. And it's also a great aid for getting some sleep.
I'm so sorry that I can't tell you more, but perhaps it helps a litte...

[ringo]

Thank You Susie,

Thank you for your reply and suggestions ..... but I have tried psychological counseling regarding my sleep problems, but that was not much help.

My anxiety is compounded by other problems related to the disease-- the fact that I am out of work due to my severe dry eye complications, other medical problems, family problems, etc.

As I did not address the insomnia problem for a long time with medications, out of fear that it would worsen my eyes, I developed a very serious problem related to inability to sleep. Now the only thing that helps me sleep a bit is a pill.

I am desperatel hoping I would be able to find something alternative to help with my sleep. It just seems like this eye problem affects absolutely evry aspect of my life and health. Very discouraging.

Anyway,enough of complaining, thank you for the advice, I will try what you suggested regarding the autogenous training-- I do not have any idea what it is?

Thanks,
Dani

[Susie28]

Dear Dani,
I'm so sorry for you. It's so bad that the dry eye problem can cause so many other problems.
Did you really have to quit work because of DES? That's such a pitty! Did you have to work with the computer? Perhaps you can try the computer advice I gave you in the other thread. It really helped me a lot. I would be incapable of working, too, if I would still be working with a small monitor with small fonts.
And yes, try the autogenous training. It's very common in Germany. Its a kind of relaxation technique which can help with very different problems. It can help you falling asleep, it helps you to calm down, it improves your psyche and self confidence. I use it to handle my stressful workaday life - if you can really command the autogenous training you can get to grips with less sleep - than 5-6 hours a day can be enough. I love it.
I learned it in a evening course, there are lots of courses in Germany. I don't know if there's such a wide course offer in your country, too. But you can start with a good book first.
Here is an English link to a side which explains shortly the principle of autogenous training:
http://en.wikipedia.org/wiki/Autogenic_training
I wish you good luck with it! If you learn this technique, I'm quite sure that you can solve some of your problems!

[Rebecca Petris]

Dani, I'm really sorry you're going through this. It's hard when there always seem to be tradeoffs.

Personally I would rate sleep a top, top priority. Almost everything about our mental and physical health depend on getting it. For my own self I would willingly trade off 'some' additional dry eye for sleep IF there were a way to cope. But obviously I'm not the one coping with what you're coping with.

Well sealed moisture chambers are the first thing I think of for incremental relief, but I can't remember, perhaps you already wear these full time?

[Guest]

Is zopiclone available where you are Dani? It's used a lot over here for insomnia, and it is not a benzodiazepine like the clonazepam - perhaps it will help you sleep without drying out your eyes?

Tolerance to benzo's commonly occurs with prolonged use, and they eventually stop working for many people, particularly if they are taken every single night (as opposed to say, only every 2nd or 3rd night).

Whatever you do, fight like mad not to WORRY about not sleeping... that will only make your sleep problems worse. I know that's easier said than done, but try...

Good luck!

[ringo]

Hi everyone,

Thank you so much for all the replies!

Dear Rebecca,

you are right-- I do not consider myself capable of sacrificing my sleep any more just because I am afraid of the effect on my eyes. Without sleep my eyes are bad anyway, but everyhing else is bad too.
Regarding the moisture goggles-- yes, I am wearing them, and mostly in places like cinemas, or when on the computer, and at home. They provide so much relief for me, and save me from the effects of adverse environments.

I wanted to ask you-- summer is coming here, severely cold indoors. Do you have something like goggles for sleeping? I am using a sleeping mask, but I do not think it will save my eyes from thealmighty AC here. when I tried to access the dry eye shop, the site told me my area of residence is not included, or something like that. I need the goggles sent to the UAE.I wonder if you can make the web page available to view/place purchase orders to this area of the world too.
Thank you for your advice-- it reassures me the sacrifice I am making is for a worthy reason after all.

Dear Susie,

Thank you for letting me know about this relaxation tecnique, I will have to research about it, and try it. I will keep in touch and let you know how it works for me.

Dear SAAG,
What you are telling me about benzodiazepines is really alarming; I thought that they just create dependence, but never knew that gradually they lose potency as well with regular use. I think that it will be a good idea for me to try to not use them every day, just like you suggest.

regarding zopiclone-- I had been taking it for around 6 months four years ago, just as my problems were already developing, and I was totally mystified about what is happening to my eyes. Zopiclone was making my mouth very dry and with a taste of metal in it; but it used to make me sleep. However, I still have the suspicion that the long term use of zopiclone at that time contributed to my eye problems. Have you used zopiclone and how do you find it?

Thank you all for the advice-- I just took another benzo pill, and preparing to enjoy some sleep before I wake up to the harsh reality of coping with the dry eyes.

I will keep posting about my progress with this dilemma-- sleep vs. less dryness.

Thanks,
Dani

[Rebecca Petris]

when I tried to access the dry eye shop, the site told me my area of residence is not included, or something like that. I need the goggles sent to the UAE.I wonder if you can make the web page available to view/place purchase orders to this area of the world too.

I am so sorry. The software provider gave a recommendation about certain countries to block a coupla years ago (due to fraud) and I just went with it - but anytime I get a request from a blocked country I turn it back on. I've switched on UAE. Another good site to look at: www.eyeeco.com. (I sell their products but not all of them.) And if there are any other US internet store that won't ship to UAE let me know in case I could somehow facilitate or give them a nudge.

[ringo]

Thank you so much, I will finally be able to expore your shop
I thought that this is something like a default feature which cannot be changed easily, so I never raised the issue.

Does that also mean you can ship products to the UAE?

[Rebecca Petris]

Yes, I ship everywhere. There's a shipping calculator in the shopping cart. I don't have a lot of experience with the middle east - just a handful of shipments to Saudi Arabia and Kuwait. I remember some of those were pretty slow (maybe customs delays) despite being Priority Mail, but they got there in the end.

[Rebecca Petris]

Regarding the moisture goggles-- yes, I am wearing them, and mostly in places like cinemas, or when on the computer, and at home. They provide so much relief for me, and save me from the effects of adverse environments.

When you're going through a particularly hard time with dry eye, I know it isn't much fun to be in moisture chambers but to maximize relief (and prevent spikes) I would really suggest wearing them fulltime for awhile if you're not already. Seems to be more and more decent looking ones coming on the market - slowly. I think what some people are doing is using total protection foam-lined goggles whenever they can and switching to more 'aesthetically pleasing' ones (MEGs, etc) in situations where they're not comfortable wearing goggles. - I was just emailing the other day with a longtime lasik dry eye friend who wears Panoptx pretty much all her waking hours but has MEGs for work meetings. She works at a university and it's hard on the eyes. This is what keeps her stable so it's what she does.

I wanted to ask you-- summer is coming here, severely cold indoors. Do you have something like goggles for sleeping? I am using a sleeping mask, but I do not think it will save my eyes from thealmighty AC here.

Check out Tranquileyes. It's not perfectly suited for everyone and there's some hassle factor + ongoing cost dealing with the foam pads, but it's definitely the workhorse of night protection. In the climate I'm in now, I don't need that much and these days I more typically either use Onyix or a sleep mask but if I were back in Florida in the summer where I used to live, I'd certainly be in Tranquileyes.

[Guest]

Have you used zopiclone and how do you find it?

I've never used anything requiring a prescription for sleep... occasionally I'll take an over-the-counter sleep med, but that's it.

[ringo]

Thank you for your reply Rebecca,

I am interested in Tranquileyes-- however-- you say it is not suited for everyone--why is that?

Also-- how do I find the foam pads where I live?

What is a good alternative that might spare the hassle you were referring to?

Thank you,
Dani

When you're going through a particularly hard time with dry eye, I know it isn't much fun to be in moisture chambers but to maximize relief (and prevent spikes) I would really suggest wearing them fulltime for awhile if you're not already. Seems to be more and more decent looking ones coming on the market - slowly. I think what some people are doing is using total protection foam-lined goggles whenever they can and switching to more 'aesthetically pleasing' ones (MEGs, etc) in situations where they're not comfortable wearing goggles. - I was just emailing the other day with a longtime lasik dry eye friend who wears Panoptx pretty much all her waking hours but has MEGs for work meetings. She works at a university and it's hard on the eyes. This is what keeps her stable so it's what she does.


Check out Tranquileyes. It's not perfectly suited for everyone and there's some hassle factor + ongoing cost dealing with the foam pads, but it's definitely the workhorse of night protection. In the climate I'm in now, I don't need that much and these days I more typically either use Onyix or a sleep mask but if I were back in Florida in the summer where I used to live, I'd certainly be in Tranquileyes.

[ringo]

You are so lucky
i think that i have sensed a cheerful character full of optimism in your posts despite the setback of dry eye.. this kind of attitude to life is probably the best medication for sleep- but unfortunately for me, i have become quite gloomy lately, and also quite scared about the future and about how i am going to sustain my eyes from getting worse the way they were before i was put on all the medications. Doctor told me :be prepared to use medications like these for life.

Also I seem to be mourning the life I had before the disease and the person I was; as well as the life I will never have but could have had, had I not developed this horrible condition. I still can not come to terms with the many ways in which it interferes with every aspect of my life, and I even feel some sort of repressed anger at the disease, which sometimes turns to desperation,, sometimes to resignation, but never to something positive.

I am sure that many of us here feel alike, but still it feels so overwhelmingly lonely at times. For now I have found prayer helps me most of all to regain my perspective, but I admit-- emotionally I feel so tired of coping with this disease on a daily basis, and with all the fears associated.I do not feel that I will get better emotionally until a decent medication is found to treat dry eye.

I came to know phase II of the sirolimus injection for dry eye is complete.But no published source as far as I know cites the actual results, or when will the third phase start.It seems like a very promising treatment.
Anyone have any information on that?
It is also very discouraging that every pipeline drug gets lost down the drain.

Also, for examle my doctor showed me some research which shows that a month of treatment with unpreserved methylprednisone has completely resolved dry eye in a few clinical trials, and patients been followed for 2 years after the treatment had no recurrence of symptoms. Now I keep wondering if those trials took place, with such amazing results, why no doctor ever suggests this course of treatment, and why is not there any unpreserved steroid like this one on the market.

It is so frustrating-- I keep reading or coming across very promising dry eye treatments which are rarely known to doctors.

I am willing to try anything that is at least as safe as (not more dangerous than) the long term antiinflammatory therapy I am on, which is mainly to keep me functional to some extent, plus to prevent the erosions and ulcers from coming back. I think that if that happens again, I will really be on the verge of insanity.

Forgive me for the ranting-- just the bad mood has overtaken me again, and it is 10 am here, have not slept all night until now.

Regards,
Dani

I've never used anything requiring a prescription for sleep... occasionally I'll take an over-the-counter sleep med, but that's it.

[Rebecca Petris]

Than

I am interested in Tranquileyes-- however-- you say it is not suited for everyone--why is that?

Just because everyone is different.

Tranquileyes is in theory the best product because it does the most: physical barrier, moisture seal, pads to help secure eyelids. And in the majority of cases (in my experience) it's the best in practice too. But as with everything about dry eye what works for one does not necessarily work for another. And in my experience people vary greatly in their tolerance of eyewear at night for one thing (what's comfortable depending which way they sleep, etc) and in many other ways such as whether their skin is sensitive and easily indented or prone to edema from added moisture, etc.

Also-- how do I find the foam pads where I live?

Not, I'm afraid! Just have to find a reasonable way to get them from abroad. Check out the UK dry eye retail sites and eyeeco.co.uk. Might have cheaper shipping from there than from the US. I don't know if there are sold yet anywhere else in Europe.

What is a good alternative that might spare the hassle you were referring to?

Personally I am really liking Onyix lately. (or Quartz, that's the same in clear, but I happen to prefer the dark version). No foam, minimal maintenance. When I wear it, I wake up with the inside of it literally dripping. At first I didn't like the 'feel' of the silicone but now I'm fine with it. Depending how I sleep it marks my face a little but it's gone by the time I've showered.