![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Guy on April 12, 2004, at 19:02:26
I am trying to decide if I should ask my pdoc to let me try clonazepam alone for my (major)anxiety disorder. My worst problem is insomnia and sleep-related anxiety. I tried clonazepam in the past at 1 mg per day, but it stopped working for sleep after a few months. Now I'm wondering if I should have increased the dose to 3 or 4 mg. I have heard that dose is common for anxiety disorders and that many people remain on a stable dose for years and years. My fear is that it would just poop out again, leaving me stuck on the higher dose. I don't understand people who say benzos can't be used for sleep. What good is a med if it doesn't let you sleep?
Posted by Sad Panda on April 12, 2004, at 21:06:03
In reply to Long-term clonazepam, posted by Guy on April 12, 2004, at 19:02:26
> I am trying to decide if I should ask my pdoc to let me try clonazepam alone for my (major)anxiety disorder. My worst problem is insomnia and sleep-related anxiety. I tried clonazepam in the past at 1 mg per day, but it stopped working for sleep after a few months. Now I'm wondering if I should have increased the dose to 3 or 4 mg. I have heard that dose is common for anxiety disorders and that many people remain on a stable dose for years and years. My fear is that it would just poop out again, leaving me stuck on the higher dose. I don't understand people who say benzos can't be used for sleep. What good is a med if it doesn't let you sleep?
>
>You can't use Benzos for sleep long term because they give a very poor quality sleep & make sleep patterns worse.
You are far better off using one of the sedating AD's like Mirtazapine, Trimpiramine or Doxepin as they produce quality sleep & improve sleep paterns. You could still use clonazepam during the day for anxiety, long term use would depend on how you react to them.
Cheers,
Panda.
Posted by cubbybear on April 13, 2004, at 3:52:34
In reply to Re: Long-term clonazepam » Guy, posted by Sad Panda on April 12, 2004, at 21:06:03
> > I am trying to decide if I should ask my pdoc to let me try clonazepam alone for my (major)anxiety disorder. My worst problem is insomnia and sleep-related anxiety. I tried clonazepam in the past at 1 mg per day, but it stopped working for sleep after a few months. Now I'm wondering if I should have increased the dose to 3 or 4 mg. I have heard that dose is common for anxiety disorders and that many people remain on a stable dose for years and years. My fear is that it would just poop out again, leaving me stuck on the higher dose. I don't understand people who say benzos can't be used for sleep. What good is a med if it doesn't let you sleep?
> >
> >
>
> You can't use Benzos for sleep long term because they give a very poor quality sleep & make sleep patterns worse.
>
> You are far better off using one of the sedating AD's like Mirtazapine, Trimpiramine or Doxepin as they produce quality sleep & improve sleep paterns. You could still use clonazepam during the day for anxiety, long term use would depend on how you react to them.
>
> Cheers,
> Panda.In my experience, the quality of sleep seemed unchanged and definitely improved in quantity while I was taking Klonopin. It helped my depression-related sleep disorder a lot, and continued doing so for many months after I started taking it at 4 mg./day.
Benzo drugs commonly lose efficacy as hypnotics and the dose has to be increased, but I was lucky since this did not happen with me. If anything, I continued reaping the benefits of Klonopin throughout my taper down to zero. Maybe my case is unusual, but I definitely feel that Guy should try using Klonopin at perhaps the 2.0-2.5 mg. level to see how this dosage affects insomnia. His problem is anxiety and insomnia, not depression.
>
Posted by Keith Talent on April 13, 2004, at 3:54:56
In reply to Re: Long-term clonazepam » Guy, posted by Sad Panda on April 12, 2004, at 21:06:03
I think clonazepam's half-life is too long for it to be used to make you go to sleep. You might want to try something like zolpidem or zopiclone as required for sleep and clonazepam twice a day long term for anxiety.
Posted by Ame Sans Vie on April 13, 2004, at 7:50:58
In reply to Re: Long-term clonazepam, posted by Keith Talent on April 13, 2004, at 3:54:56
I agree with Keith -- the newer non-benzodiazepine sleep-aids (i.e. zolpidem [Ambien], zopiclone [Sonata], and zaleplon [Imovane]) have much less great a propensity to lose their hypnotic effect, even taken every night.
Mirtazapine, TCAs, etc. are OK options, but they quickly lose their hypnotic effects as well as it is attributed to anticholinergic/antihistaminic activity. You could get very similar results with Benadryl.
Posted by Sad Panda on April 13, 2004, at 9:30:09
In reply to Re: Long-term clonazepam, posted by Ame Sans Vie on April 13, 2004, at 7:50:58
> Mirtazapine, TCAs, etc. are OK options, but they quickly lose their hypnotic effects as well as it is attributed to anticholinergic/antihistaminic activity. You could get very similar results with Benadryl.
>I don't think so. Benadryl is extremely weak compared to Remeron, Doxepin, Trimipramine, etc. for Histamine blockade. These drugs are also potent 5-HT2A blockers which are proven to improve sleep quality in several sleep studies.
Cheers,
Panda.
Posted by judy1 on April 15, 2004, at 17:35:14
In reply to Long-term clonazepam, posted by Guy on April 12, 2004, at 19:02:26
I've taken 6mg of klonopin a day (2mg tid) for about 7 years to treat panic disorder. I have never increased my dose in that time (but have decreased it on occasion). In the absence of panic attacks which typically occurred at night, the quality of my sleep was greatly improved. I would think that once your anxiety was under control, your sleep would improve. My ex-pdoc who specializes in anxiety disorders, typically uses 4mg klonopin daily for GAD and has patients who have been on steady doses of benzos for *decades*
take care, judy
Posted by andyboy on April 21, 2004, at 20:48:55
In reply to Re: Long-term clonazepam » Guy, posted by judy1 on April 15, 2004, at 17:35:14
Hi Judy,
May it be possible for me to contact you via email regarding your long term use of Klono? Seeing that all other meds have done nothing for me- I may be in it for the long haul. I am at andyboy775@hotmail.com. I hope this does not break the terms and conditions of the board. If so I do apologize.
Andy
> I've taken 6mg of klonopin a day (2mg tid) for about 7 years to treat panic disorder. I have never increased my dose in that time (but have decreased it on occasion). In the absence of panic attacks which typically occurred at night, the quality of my sleep was greatly improved. I would think that once your anxiety was under control, your sleep would improve. My ex-pdoc who specializes in anxiety disorders, typically uses 4mg klonopin daily for GAD and has patients who have been on steady doses of benzos for *decades*
> take care, judy
This is the end of the 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.