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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
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.
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.
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.
Thanks,
BRC
Posted by anxiety_free on October 3, 2004, at 14:28:36
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.
>
> 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.
>
> 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.
>
> Thanks,
>
> BRCHi! I take 4mgs, but I take "booster" benzos as well...ativan works particularly well for both sleep and anxiety, so its a two time winner. My shrink plops in a few extra klonopin each month for "as needed" (read: calm DOWN) use. I like the ativan better...librium is good, too.
Posted by Cmatt on October 4, 2004, at 2:19:58
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.
>
> 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.
================================================Yes, Klonopin can be used at higher doses if truely need be, but I wouldn't jump the gun, but at the same time I don't know your situation or what meds you have tried before.
If you haven't used a Tricylic antidepressant, you can ask the doctor about generic Elavil, or Imprimine (spelling ?). If you haven't tried Elavil, that might be an option due to it's deep sedating effect which wears off in a week or two. If you are sensitive to meds, you may even want to try like 5mg Elavil ( 1/2 of a 10mg pill)just to see how the drug makes you feel. Take at bedtime which you would likely do.
If you go with a tricylic, ask for the lowest dosage the drug can be prescribed, and then if need be, the dose can be raised as needed. Plus side, generic tricylics are much cheaper than the Paxil, Zoloft, the other SSRI'S ...ect.
I have used most of the anti-depressants on the market (USA), and a few benzo's. Many
anti-depressants just didn't set with me. I can tolerate Elavil and Nortriptyline fairly well. I am a 9 year veterian of a generalized anxiety disorder, and Elavil did quite well for me. I believe tricylics can also be useful for OCD as well.Since you have made it around two years with the dosage of Klonopin you are using, in my opinion and experience I would not up the Klonopin dosage before giveing a tricylic antidepressant a try. If tricylic's aren't for you, then SSRI's are an option if you can use SSRI's, but I personally would ask about trying a tricylic first.
Best of luck,
Cmatt
> 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.
>
> Thanks,
>
> BRC
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
Posted by Jasmineneroli on October 6, 2004, at 23:17:25
In reply to Re: Anyone take more than 4mg of Klonopin daily? » BRC, posted by Ame Sans Vie on October 6, 2004, at 3:14:49
Hi BRC: So glad you found Ame Sans Vie. I recently advised another poster to "page" Michael on a question about benzo doses!!!!
Michael has definitely "been around the block" with his illnesses and is worth listening to!
As a Klonopin fan myself, I'm happy to read of your success - hope your Pdoc is as open-minded as Michael's! Good luck :)
JasP.S. : To MICHAEL
....it's so good to see you back here and sounding so well! I've been mostly away from the board until about the past 6 weeks and was wondering where & how you were.
You are on a lot of benzo meds, along with some stimulants. Would you say that your disorders are rooted in GABA and Dopamine dysfunction?? Because the "cure" seems to address those areas.
I'm asking, because my daughter has ADD & anxiety, depression of the dysthmic type, with anhedonia, plus what maybe dx'd as social anxiety. I was wondering what you'd recommend for her..she's currently on Celexa 20mg and it's just not cutting it anymore. Lots of scattered thinking, unfocussed & memory loss, insomnia, worrying and anxiety, irritability, can't get up in the am, or get going. Can't complete a task. Easily overwhelmed. I'm worried about her :(.
Appreciate your input.Very happy to be talking to you again!
Warm wishes
Jas
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