Posted by Ritch on March 15, 2005, at 0:14:36
In reply to Klono not nearly as effective as X? (Oth. Benzos?), posted by cache-monkey on March 14, 2005, at 14:18:42
> Hey all,
>
> I had a panic attack in early January. Full-blown. Prior, I had been suffering from GAD and cyclothymia/soft BP. I had been using Xanax 0.25 prn before Jan, and immediately after the panic attack I started taking Xanax at 1-1.5 mg/day.
>
> About 10 days later, my p-doc switched me to Klonopin, which makes sense from a number of perspectives. (Longer half-life => theoretically less rebound anxiety, less addiction potential.) The first two weeks, due to some stressful on-site job interviews, I started Klonopin at 1 mg/day (divided up over the day) and took Xanax at about 1 mg/day while on-site. While home, I'd go off Xanax and feel alright, but still with a lot of anxiety.
>
> I went up to 1.5 mg/day on the Klonopin a couple weeks ago and haven't taken any Xanax for about 3+ weeks. My anxiety gradually worsened and neared panic status again last week. I also have been feeling very slowed down (that might be a consequence of upping my Lithium to 900 mg/day -- that's the only other drug I'm on right now.) Finally, I broke down and took a Xanax (0.25 mg) and boom anxiety gone.
>
> So it seems that 1.5 mg/day of Klonopin is not nearly as effective as a slightly lesser amount of Xanax. My understanding was that they are supposed to be about equivalent in terms of dosages (0.5 mg X = 0.5 mg K).
>
> Is it the case that it just varies between individuals? I.e., for some is Xanax just more effective at a comparable dose? Is a bezo just a benzo?
>
> I'm a little averse to going up further on the Klonopin and would like to consider switching benzos with my p-doc. I'm thinking of Xanax XR, but am worried about the eventual taper, which I think is harder with Xanax. How about Ativan? Valium?
>
> [Alternatively, some of my anxiety might be attributable to being in a "mixed state". I'm having trouble getting the Lithium to a therapeutic dose due to thirst and tiredness, so adding Depakote is another possibility...]
>
> Any advice would be greatly appreciated.
>
> Thanks,
> cache-monkey
>I'd feel averse to increasing K as well beyond 1.5mg. I would consider switching to Ativan a try (since it is also an effective antimanic like K), and just keep some Xanax on hand PRN if it doesn't work out. If a lot of your anx. is rooted in mixed bipolar, then Depakote would be a good add.. I've found a mix of benzo + Depakote + gabapentin to work rather well for anxious bipolar mixed stuff.
poster:Ritch
thread:470912
URL: http://www.dr-bob.org/babble/20050312/msgs/471162.html