![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 35. This is the beginning of the thread.
Posted by Guy on December 22, 2002, at 0:02:29
I'm finally starting to feel better now that I have stopped taking anti-depressants for my anxiety (severe GAD). I hate AD's with a passion...tried ten different ones and all they do is make me fat, lethargic, impotent and hung over. They don't help my anxiety. I'm now taking 1 mg of clonazepam every night because of my insomnia and profound fear of sleeplessness. (I have anxiety attacks when I can't sleep.) I'm wondering if I can do this for the rest of my life (I'm 48 now). Does clonazepam lose its effectiveness over time? People seem averse to long-term benzo use.
Posted by comftnumb on December 22, 2002, at 0:40:49
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
Just keep taking it as long as it works, and don't let the conservative docs tell you otherwise!!! As long as it works, take it. Who cares if its addictive. The SSRIs are addictive. Look at all the people on this board talking about Effexor/Paxil/Zoloft withdrawal.
The difference between Benzos and SSRIs, the difference docs care about, is you can't overdose on SSRIs. But if you take enough of a benzo, you will get high. That's why Benzos are DEA Schedule IV drugs. I got high on Ativan once: I took 16mg over 12 hours and it turns out the half-life of Ativan is really long so I got wasted. I had terrible cravings for the next 2 days, luckily I didn't take any more. So just be careful not to abuse your benzo and you'll be fine.
Posted by viridis on December 22, 2002, at 4:29:25
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
If clonazepam provides relief from longstanding anxiety and ADs don't, then I'd stick with it unless problems arise. Some people have taken benzos for decades without difficulty, and their long-term safety is well established (much more so than for the newer ADs). People who take benzos for serious anxiety disorders seem to stabilize at a particular dose and stay there (or even reduce the amount voluntarily) over time.
Re: euphoriant effects of benzos: I'd fall asleep before I reached a dose that got me high, so for me at least, there's no incentive for abuse or dose escalation. Klonopin is especially unlikely to induce addictive behavior due to its long half-life, although medical dependency is likely to develop (which means that discontinuation, if necessary, should be done gradually, as is the case with SSRIs etc.).
Posted by gheld on December 22, 2002, at 7:57:08
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
I've had PD on and off, mostly off, for over 40 years and taken benzo's, Librium, Ativan, Xanax and now Klonopin, on and off several times.
I've never found a high in any of them. Only a stupor if I overdosed.
I've discontinued use of them for years at a time as therapy allowed my mind to work without all the "interruptions". When I discontinued them, I'd drop about 25% of my daily dose for maybe a month, as there is a bounce back effect after a week or two, then do it again.
Your body will tell you when it's ready to reduce your intake.
If you look at the side effect profiles of any of the classes of drugs used to treat panic disorder, benzo's come out best by a wide margin. Since they're all generic, physicians don't have salespersons giving them samples and selling them on the benefits of the new SSRI's.
The above all presumes you have anxiety not coupled with depression. I don't think the benzo's, particularly Klonopin, work well for depression.
Posted by HIBA on December 22, 2002, at 8:15:51
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
Long-term benzo is by all means justified in cases of GAD, because it is a chronic condition. If klonopin helps you to cope with this disorder, stick with it and don't waste your time trying another AD. There is not even a single proven antidepressant that is superior to benzos in terms of efficacy. Lack of serious side effects make benzos even superior.
Benzos seldom lose their anxiolytic effectiveness over time, and if it happens, is only minimal. But tolerance to the sedative effects can occur more rapidly. That is why their use as a hypnotics should be discoraged. But when anxiety itself is a causative factor of insomnia, benzos can really be beneficial.
No doc can assure you, that you may be able to stop an AD or Benzo whatever that drug may be, since you are having a chronic condition like diabetis or hypertension. So chose the best for the purpose. And right at this time, there is nothing better than klonopin to treat GAD. Don't get worried over tolerance. Paradoxically, sometimes there will be a reverse tolerance though it is rare. But in my case, it happened once. I began to take 1.5 mg of klonopin a day and after a few months I could decrease it to 1 mg and the same effectiveness maintained. I am not taking klonopin any more because of the benzophobia of my treating physician. But I wish if I could once again stabilized on that benzo.
HIBA
Posted by judy1 on December 22, 2002, at 11:05:13
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
I've taken klonopin for 4+ years and have gone lower at times (like now). I assumed I would take it forever (and the thought doesn't bother me in the least), but I do find that my symptoms wax and wane as does my use of benzos. So be grateful you don't have a benzophobe for a pdoc and that your disorder is under control. take care, judy
Posted by michael73 on December 22, 2002, at 20:21:42
In reply to Re: Clonazepam/Klonopin for life??? » Guy, posted by judy1 on December 22, 2002, at 11:05:13
I took 2mg/day Klonopin for anxiety for 5 years and then quit because I didn't really need it anymore and I thought it may have made me tired. Other than that I never had any problems with it, not even when I quit. The only thing I noticed when I quit was a period of over sensitive smell. Michael73
Posted by Peter S. on December 23, 2002, at 13:38:14
In reply to Re: Clonazepam/Klonopin for life???, posted by michael73 on December 22, 2002, at 20:21:42
I know Klonopin is better for long term use because it's long acting. I was wondering about people's experience with other benzos and if these are also effective for long term use. Specifically Ativan- anybody had good experience with this? Are some benzos better for certain people than others?
Thanks!
Posted by BrittPark on December 23, 2002, at 19:13:51
In reply to Klonopin vs other benzos?, posted by Peter S. on December 23, 2002, at 13:38:14
Different people react differently to different benzos. On the whole however they are equivalent (if taken at equivalent doses) Shorter half-life benzos like ativan or xanax can give a sea-saw kind of anxiolysis.
There is some clinical evidence that xanax is in itself a mild antidepressant. I find it so. There is anecdotal evidence that klonopin can actually produce or worsen depression. I found this to be true for me. Most others don't. My current regime is 1mg klonopin at night, and 4mg xanax during the day. (I'm a hyper metabolizer of almost everything and need to take more for the same effect than most people.) This keeps the worst of my anxiety and phobia at bay.
Hope this helps,
Britt
Posted by Iolite on December 23, 2002, at 20:53:47
In reply to Klonopin vs other benzos?, posted by Peter S. on December 23, 2002, at 13:38:14
> I know Klonopin is better for long term use because it's long acting. I was wondering about people's experience with other benzos and if these are also effective for long term use. Specifically Ativan- anybody had good experience with this? Are some benzos better for certain people than others?
>
> Thanks!Hi! Yes, I took Klonopin for 2 years (with Paxil, Wellbutrin, Zoloft etc. which made me sweat - so I didn't reallly take them as ordered). But the Klonopin 2 mg a day was absolutely necessary at the time because I had cancer of the bladder and would have insane moments of profound anxiety. (I am alone, no family, and was having tremendous difficulty getting to the surgery and chemo sessions too.) Anyway the Klonopin worked extremely well for me during that time period.
Jump 7 years to 9/11/01 when many friends died.. I wound up in a hospital in shock myself, and was put on a slow Ativan IV for 1, then 2, then 3 mg. That was helpful. I was able to walk but not much more! The shaking stopped.
Now over a year later after stabilizing I understand the feelings between what I remem ber of Klonopin, and Ativan. Klonopin affects me in a way that seems more of a sleeping pill, more of a valium feel to it. Whereas Ativan has no effect on me *except* that I no longer feel anxious or quake. Panics come still but they are very mild and mostly teary, and if I REALLY have to, I'll just reach for another Ativan knowing I'm still functional and still able to drive, etc.
As I recall, when the big red neon letters CANCER used to scream at me from my bedroom ceiling, the Klonopin wooziness allowed me to blow them away. Poof. Now if I were to have the same type of panic, I am not so sure the Ativan would be quite so magical!
(I'm no pharma expert so I hope you understand my "babble"... thanks)
Nice chatting,
Iolite
Posted by HIBA on December 23, 2002, at 22:51:59
In reply to Re: Klonopin vs other benzos?, posted by Iolite on December 23, 2002, at 20:53:47
Dear Lolite,
Hope you are fine now, Your message was so great. It shows us how a benzo can help people in times of otherwise uncontrollable anxiety and stress. Nothing can substitute a benzo at this kind of crucial junctures of life. Thanks again for the message.
HIBA
Posted by jimmygold70 on December 25, 2002, at 11:28:16
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
It's not such a bad idea. The thing is - you'll never be able to stop. 1mg is not a high dose. Tolerance develops for most people but with GAD you are less likely to get that.
Posted by john7219 on December 25, 2002, at 20:25:21
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
I have been taking Clonazepam (Klonopin) for about eight years now, and believe it's advisable for you to control your anxiety, as best as possible with as many relaxation techniques you can think of (ie, exercise, meditation, diet, etc), and to limit your dose of clonazepam. It is extremely addictive, and although it's effects seem to not waver over time, it does tend to produce many unusual long term effects such as a form of psychosis, numbing of emotion, effects to your cognitive functioning including memory and sensory impairment.
Posted by Guy on December 25, 2002, at 23:56:12
In reply to Re: Clonazepam/Klonopin for life???, posted by john7219 on December 25, 2002, at 20:25:21
John, would you mind providing me with a bit more information as to what you mean by psychosis? This really concerns me. As for the emotional numbing, I believe it is much worse with the anti-depressants. I have been on Clonazepam for four months now, and have not noticed any numbing...a bit scatter-brained, but that may be my usual anxious self. My shrink says I should be taking more clonazepam--at least 2 mg per day, but I am a worry wart and always try to hold back. How much are you taking? Have you had to increase your dose over the years? Thanks for your feedback.
Posted by john7219 on December 26, 2002, at 0:16:20
In reply to To John, posted by Guy on December 25, 2002, at 23:56:12
At one point in my life I increased from .5mg to 2mg, but this move was'nt necessitated by lack of effect by the drug. The move was to help me cope better with a difficult time. Apparently everyone has a unique "tolerance threshold" which you should strive to discover. Any larger of a dose than this point and you will be over-sedated, any lower and you'll experience either your original condition sypmtoms or withdrawl symptoms, depending on how long your use has been. I'm currently on .25mg/day.
My reference to psychosis is not a clinically qualified observation, however due to my personal experience and the testimony of others, I have concluded that long term use may cause mentally unstable individuals (which is often the case with people prescribed this RX) and a very "difficult time". This drug is what it is, a drug to mask your inner problems, so maybe it's simply a case of masked problems building up to an extent that it reaches the level it could be considered a psychosis.
Posted by Iolite on December 26, 2002, at 2:43:20
In reply to Re: Klonopin vs other benzos? » Iolite, posted by HIBA on December 23, 2002, at 22:51:59
Hi again. Thanks for realizing my message was about how these benzos helped in emergencies and on an ongoing basis. I felt the Klonopin and Ativan were very different but can't explain pharmacologically, only from my own reactions to them. Thanks for your message. Hope you are doing okay now too?
Iolite
Posted by scarlett on December 26, 2002, at 16:01:41
In reply to Re: To John, posted by john7219 on December 26, 2002, at 0:16:20
I have been on clonazapem for almost 11 months now. I take an AD (Prozac) for my main issues (I have OCD)and I was prescribed clonazapem inorder to curb some of the severe anxiety I was experiencing due to circumstances in my life @ that time. I am only on .5mg a day, and I don't know how to go about reducing my dosage so that I don't get w/d symptoms. It's such a small dosage anyway, I have no idea how to go about this. Does anyone have any advice? I feel I am ready to just stick to my therapy and Prozac w/o any other medicine.
Posted by scarlett on December 26, 2002, at 16:03:21
In reply to Re: To John, posted by john7219 on December 26, 2002, at 0:16:20
I have been on clonazapem for almost 11 months now. I take an AD (Prozac) for my main issues (I have OCD)and I was prescribed clonazapem inorder to curb some of the severe anxiety I was experiencing due to circumstances in my life @ that time. I am only on .5mg a day, and I don't know how to go about reducing my dosage so that I don't get w/d symptoms. It's such a small dosage anyway, I have no idea how to go about this. Does anyone have any advice? I feel I am ready to just stick to my therapy and Prozac w/o any other medicine.
Posted by john7219 on December 26, 2002, at 17:02:19
In reply to how do u go about getting off clonazapem safely?, posted by scarlett on December 26, 2002, at 16:03:21
Here is a good website with info
http://www.benzo.org.ukIt seems the method of choice if you have difficulty getting of your original benzo ie; clonazepam, is to slowly switch over to diazepam(valium) and then gradually taper the dosage over a lengthy period of time ie; three months to a year. The reason is valium has a half life three times longer than clonazepam which allows your body to adjust more smoothly to the reducing level in your blood.
Posted by Mr.Scott on December 26, 2002, at 23:16:26
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
If it's truly working for you, just take it. My sense is that it isn't perfect however. The withdrawal isn't so bad but it isn't fun, and can be mimimized quite nicely by switching to tranxene (clorazepate dipotassium) which promptly turns into desmethyldiazepam when mixed with gastric acids. This is truly as close as it gets to a not dependence forming benzos in the US. The half life is over twice that of Klonopin. It binds weakly to receptors, and also doesn't impair cognition and learning as much. At the same time it probably won't kick panic or mania's ass quite like Klonopin will. It is great for GAD however, and Neurologists who use it for seizures believe it keeps its efficacy over the long haul.
Generally I'd say that at least one third of ALL psychiatric drugs will poop out in at least 30% of the the people who take them whether they are benzos, antipsychotics, lithium, anticonvulsants, SSRI's, etc. It's just the way it is. So try to enjoy it while you can and deal with the next step when you have to.
I know where your at...You will not avert a major catastrophe either way.
Scott
Posted by HIBA on December 28, 2002, at 23:59:25
In reply to Re: To John, posted by john7219 on December 26, 2002, at 0:16:20
Hello John,
What kind of psychosis do you think benzos cause? Earlier you carelessly attributed psychosis to long-term benzo intake, which is by no means made any sense and just to those benzo intakers at least in this forum, and surprisingly your later thread confesses psychosis is not a clinically qualified observation. Using benzos in high doses for a considerably long period of time and stopping them ABRUPTLY may cause toxic psychosis in rare cases.(Even this statement is controversial, because of the concommitant use of alcohol) Is this what you mean ? Klonopin is one of the benzos used to treat psychosis, and benzos are sometimes very vital in treating agitation related to psychosis. Librium (Chlordiazepoxide) is found to be very useful in some cases of psychosis, much useful than traditional antipsychotics. Ignoring all these facts will be unfair, especially to a group of medications on which millions rely and find relief. I have never seen a psychosis directly attributable to benzo intake. And those testimonials should be carefully screaned before making any conclusions. Because "sometimes evil is in details". I have heard some benzo horror stories in this forum and when it came to details, it was not benzos which I found to be blamed but the narrators themselves were to blame. Multiple drug using, underlying physical disorders, awkward and abrupt discontinuation of benzos.. there could be many reasons behind each and every benzo horror stories.
And about coming off benzos: A peson will really have a very hard time if he is under untreated severe anxiety disorder. Anxiety can wreck havoc in all departments of life and it often lead to paranoia and depression. And if the person consistently avoiding a medication which will give him back his normal self, it is simply idiotic. Anxiety is often chronic and long-term treatment with medications will be necessary to most of the patients. Denying benzos to such patients will lead them to alcoholism and eventually irreversible psychosis and other physical damages. And long-term benzo therapy is less problematic than long-term antidepressant therapy.
HIBA
Posted by louly on March 3, 2007, at 22:00:29
In reply to Clonazepam/Klonopin for life???, posted by Guy on December 22, 2002, at 0:02:29
I was put on Valium at 19 and tried to get a regular perscription for my anxiety disorder. I also had alcoholism and loved opiates. I stopped drinking, ended up on a low dose of methadone. A lot of the abuse was because of the anxiety. On methadone no psychiatrist ever thought I needed benzos. I even had one doctor who suggested Buspar was all I needed. That crummy drug may work for cartoon characters in the commercials but I learned later it was a joke.
So my life was built around 1.5 mgs of clonazapem a week. I know away around the system and don't tend to listen to doctors when my body knows what it will do and not do. Absolutely no relaxation therapy, I won't learn it, I've been doing instant gratification for too long. I ended up on Klonopin at 4.5 mg, taken regularly and no anxiety problems again, no desire for addictive drugs, outside of optiates as well.
I have had anxiety/agophobic and figure it's not going away and either is the drug. I'm prepared to go down on it at some point.
Posted by bkdog on March 5, 2007, at 6:04:34
In reply to Re: Clonazepam/Klonopin for life???, posted by louly on March 3, 2007, at 22:00:29
FWIW----
I have been on Klonopin / Clonazapam for prolly 15 years or more....
from .5mgs to 2mgs to 4-6mgs currently.......
i think i will be on it FOREVER....
'less i become a zen yoga master or something...
Posted by SandyWeb on March 5, 2007, at 8:26:26
In reply to Re: Clonazepam/Klonopin for life??? » louly, posted by bkdog on March 5, 2007, at 6:04:34
Hi Louly,
I'm taking 3 mg daily of clonazepam. I find it to be much milder than Ativan, but the effects last longer.....so I prefer this benzo over the others. I found Xanax to be so extremely mild that it wasn't even worth taking. But we are all different.
I expect to keep taking an anti-anxiety for the rest of my life. The dose my go up or down, depending on how well I am progressing in my recovery journey, but anxiety has always been a part of my life.....just never to the extreme that it has been for the past 4 years.
I have no problem with being on this med for the rest of my life. If it gives me even a little bit more of a quality of life, I'm all for it!!
Best of luck!
God bless,
Sandy
Posted by johnnyj on March 6, 2007, at 9:34:07
In reply to Re: To John, posted by john7219 on December 26, 2002, at 0:16:20
Hello,
This is a great thread for me right now. I suffer from gad which is affecting my sleep very badly. I noticed you take .25 and that is what I take. I tried taking .5 at night and felt like a zombie the next day and it didn't really help my sleep very much. But, I am new to this drug so I am feeling my way so to speak. I have tried an ssri, luvox, and didn't fair too well.My question is when do you take it? I am searching for a good dose right now and am struggling with timing.
Thank you
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.