Posted by Ame Sans Vie on October 6, 2004, at 3:14:49
In reply to Anyone take more than 4mg of Klonopin daily?, posted by BRC on October 3, 2004, at 11:10:37
> Hi, I have been taking 2mg of klonopin in the morning and 2mg at bedtime for about two years now. It works wonders for my anxiety and OCD.
>Hi there! Glad to hear Klonopin works so well for you -- it is definitely a terrific medication. My doctor, in fact, sings its praises so loudly that he prescribes it practically indiscriminately at this point -- all one has to do is ask for it by name (or for something in general to ease stress/anxiety) and he'll happily write out a generous prescription for it. He's quite fond of most of the benzodiazepines, actually, especially Xanax XR (primarily for panic disorder and/or depression) now that he's had adequate experience prescribing it, Tranxene (for low-medium grade stress reactions and occasionally ASD [acute stress disorder]), Ativan (primarily for GAD [generalized anxiety disorder and medication-induced insomnia), Serax or Centrax (for patients who respond to Xanax or Ativan but find them too sedating), Halcion (for increased-sleep-latency insomnia), Restoril (for early-awakening insomnia and general sleep troubles in the elderly). He says he's pretty upset that Paxipam is no longer manufactured, as he normally used it quite a bit in his practice; and as for the hypnotics, he claims not to have had much success with Ambien or Sonata.
One thing I've learned from my current doctor is that benzos can be a bit unique in that dose readjustment (read: _dose increase_) is *very* often necessary anywhere from several days to several *decades* into treatment, and often more than one adjustment will be necessary. You may have guessed from my writing above that I take Klonopin, and have now for around 3.5 or four years. For the record, I have used Klonopin for 3.5 or four years to treat social anxiety disorder, generalized anxiety disorder, panic disorder w/agoraphobia, mild-moderate OCD (by the way, if I'm not mistaken, you're the first person I've come across apart from myself for whom Klonopin has been a successful treatment for OCD -- interesting), and avoidant personality disorder.
> I have been reading in medical books that a theraputic dose to treat anxiety can be up to 6-8mg. I was wondering if anyone takes a dose higher than my 4mg and how does it help your anxiety at those doses.
About one year ago, after three psych hospital stays and more than a dozen different psychiatrists, I had my first appointment with my current psychiatrist who I was shocked to discover actually had a clue when it came to treating "treatment-resistant" disorders of all types. He immediately wrote a prescription for 3mg Klonopin twice daily (6mg total). Prior to that, I had been taking 2mg twice daily for some time.
It worked wonderfully, but I feared I was developing tolerance as my four-week follow-up approached. At that appointment I asked him what this meant, if I should raise the dose, change the timing, etc., and he reassured me that research shows patients treated with benzos for anxiety tend to have to increase their dose one or more times during their treatment before “stabilizing” on a dose. The reason for this is most likely due to a tolerance developing to the calming sedative effects of the drug, which certainly contribute to the anxiolytic effects for most people.
After a few dose adjustments, I'm now happily taking Klonopin 12mg, Xanax XR 9mg, Adderall 120mg, Eldepryl 10mg, Dexalone 120mg, and DL-phenylalanine 1 gram (all this along with various nutritional supplements -- coenzymated B6 [P5P], sublingual B12/B6/folic acid, and Ester-C being the most important). My Klonopin dose still fluctuates occasionally (that is, sometimes I only need 6-9mg daily (that's 2-3mg three times a day).
I'm receiving S.S.I. each month still until I get on my feet, but, insofar as one *can* be, I'd say I'm completely "cured" of all my ailments. There were two years that I literally didn't leave my home due to crippling agoraphobia, but now being in the house all day drives me crazy and I *have* to be doing things -- going to clubs, making friends for the first time in sooo long, etc.
> The reson for asking is I think my body is building up a little tolerence, but I am scared to try anything higher. Wanted to get some people opinions where I can talk to my doctor.
If it's been about two years, I'd say you're definitely due for a dose adjustment – in my personal opinion, 4mg daily is rather low for treating OCD on top of other anxiety disorders and there's certainly no harm in discussing a twice-daily dose of 3-4mg with your doctor, or even changing your dosing schedule to 2mg three times daily. I've always found Klonopin to work better when taken this way, perhaps due to accumulation in the blood.
I hope I gave you some information you can use, and good luck to you! Keep us informed.
~Michael
SAD, GAD, PD, OCD, agoraphobia, dysthymia, MDD, ADD, AvPD
poster:Ame Sans Vie
thread:398508
URL: http://www.dr-bob.org/babble/20041002/msgs/399484.html