Posted by Rick on February 10, 2002, at 4:16:32
In reply to Should I give up on Klonopin? » Rick, posted by JohnQ on February 8, 2002, at 17:43:31
> So clonazepam doesn't work instantly? I've used it on an as-needed basis and I found it to be very disapointing (Most I've tried at once is 1.5mg. Not enough?), although combined with generous amounts of alcohol it was pretty good. How long does it usually take to kick in, or how long did it take for you, Rick? Should I give up on it based on my as-needed experiances, or should I give it an AD-like trial?
Taking Klonopin *regularly* instead of as-needed can make all the difference in the world. And that way it prevents anticipatory anxiety from building, too. Even to the extent that it *does* help on an as-needed basis, it takes a good 45 mins to an hour to have any effect...even more if not taken on an empty stomach.
Daily Klonopin kicked in within days for me, but it doesn't work quite that fast for everyone.
Re the alcohol: In the long run, alcohol will *decrease* Klonopin's efectiveness. And large amounts of alcohol can be dangerous with benzos.
You shouldn't feel doped-up on Klonopin. Don't fall prey to the major mispereption that it works by making you feel inebriated and thus disinhibited. Instead you should feel perfectly sober, except that the anxiety is gone or greatly reduced. (Although it's typical to feel a little sedated the first few days to a week, which then goes away.)
Here are some (rambling) thoughts and personal experiences on how to get the most from daily Klonopin:
Everyone requires different amounts. One thing to remember is to take the Klonopin on an empty stomach whenever possible. I started with 3 mg daily (it's uncommon to need more than that), but quickly discovered that 2 mg actually worked BETTER for me. (I now take only 1 mg...it's common to be able to get by on lower doses over time, despite what benzophobes will tell you.) You just may need to experiment with the amounts and dosing schedule. 2.0 sounds like a good starting daily dose, maybe 1.5. I'd suggest that to begin with, you divide your dose into two or three dosings a day. I always took the biggest dose in the morning, and less in the afternoon. I never have liked taking it at night because I'll feel a litle groggy in the morning, and because I want concentrations to be highest when I'm in social setings. I don't know if insomnia is an issue for you, but once you reach steady-state blood levels, early-in-the-day dosing will still help you sleep at night.
Once you reach steady-state, you can start experimenting with less frequent dosing. Until a year ago, I took 1 mg in the morning and .5 at about 2 pm. Now I'm at 1.0 mg, all first thing in a.m. For the first year, I would often take some about an hour beore an extra-challenging event. This mainly took the form of temporary juggling of the dosing schedule, but it's fine to take an extra .25 - 1.0 occasionally. One thing I personally found is that if I take two doses -- of any size -- less than four hours apart, I get a little sleepy. Same goes if I take more than 1 or 1.25 in any single dose.
You should see at least SOME benefit within a few days, or at least within a 7-10 days. If that doesn't happen, and adjusting the dosage or schedule doesn't help either, than you may one of the 20% who don't respond to Klonopin for SP... OR you may be taking other meds (not necessarily psychotropics) that lower Klonopin levels in the bloodstream. These aren't always listed in the interaction checkers. Some -- but not all -- drugs that are inducers of liver enzyme CYP3A4 can reduce Klonopin levels. Certain over-the-counter supplements, especially those with fiber, can reduce absorption of drugs in general.
I bet you'll end up really glad you started taking Klonopin on a maintenace basis.
Rick
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