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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Laree on February 24, 2005, at 22:04:42
My pdoc (very) reluctantly rx'ed a low dose of Klonopin for me months ago(which worked like a dream at first), but it has recently lost it's effectiveness for me and I feel a need to keep raising the dose to alleviate the panic & severe, penetrating, constant anxiety I experience. Thus, I have run out of my rx early this month and am feeling completely scared and screwed.
Also, I believe the more Klonopin I take the more irritable and down I feel--yet I am constantly panicky because my dose seems to be insufficient.
My pdoc refuses to raise the dosage.
I am currently (and have been for over a year) on Lexapro for seasonal aff. depression & anxiety.
I have also been on Adderall for about 2 years total now, rx'ed by the same pdoc.
I am incredibly scared right now--
the thought of even suggesting perhaps Xanax XR to my pdoc (for a break from the tolerance to Klonopin) brings on panicky thoughts! I know I must call tomorrow as I do not have an appointment for over a month and I need help ASAP, but what can I do? Maybe go to my regular MD instead?! Please help!!--LB
Posted by snapper on February 24, 2005, at 23:13:10
In reply to Klonopin probs., Xanax XR??, posted by Laree on February 24, 2005, at 22:04:42
> My pdoc (very) reluctantly rx'ed a low dose of Klonopin for me months ago(which worked like a dream at first), but it has recently lost it's effectiveness for me and I feel a need to keep raising the dose to alleviate the panic & severe, penetrating, constant anxiety I experience. Thus, I have run out of my rx early this month and am feeling completely scared and screwed.
> Also, I believe the more Klonopin I take the more irritable and down I feel--yet I am constantly panicky because my dose seems to be insufficient.
> My pdoc refuses to raise the dosage.
> I am currently (and have been for over a year) on Lexapro for seasonal aff. depression & anxiety.
> I have also been on Adderall for about 2 years total now, rx'ed by the same pdoc.
> I am incredibly scared right now--
> the thought of even suggesting perhaps Xanax XR to my pdoc (for a break from the tolerance to Klonopin) brings on panicky thoughts! I know I must call tomorrow as I do not have an appointment for over a month and I need help ASAP, but what can I do? Maybe go to my regular MD instead?! Please help!!
>
> --LBHey LB, sorry to hear of your misery. I know constant anxiety SUCKS! However how much Adderall are you taking per day?
snapper
Posted by Phillipa on February 24, 2005, at 23:54:29
In reply to Re: Klonopin probs., Xanax XR??, posted by snapper on February 24, 2005, at 23:13:10
I know the feeling of horrible anxiety. For me xanax worked better than klonopin. Call your doc in the am, and see if either of them will rx it for you. Fondly, Phillipa
Posted by SLS on February 25, 2005, at 7:24:10
In reply to Klonopin probs., Xanax XR??, posted by Laree on February 24, 2005, at 22:04:42
> I am incredibly scared right now--
> the thought of even suggesting perhaps Xanax XR to my pdoc (for a break from the tolerance to Klonopin)Everyone reacts so differently to these drugs. Most people seem to find a dosage of Klonopin for which they don't develop a tolerance. However, since you are dissatisfied with it for other reasons, perhaps now is a good time to change. Xanax is a good drug. You might want to present to your doctor that you would like a trial of Xanax such that if it doesn't help you can return to Klonopin. Try not to give your doctor an opportunity to move away from benzodiazepines.
Just a thought.
I would be very interested to know how you progress.
- Scott
Posted by Spriggy on February 25, 2005, at 12:19:43
In reply to Re: Klonopin probs., Xanax XR?? » Laree, posted by SLS on February 25, 2005, at 7:24:10
I've been on both Klonopin and Xanex. I think Xanex may work a little better as well- more instant results but leaves my body faster.The pdoc that just prescribed me Klonopin told me that you would have to take around 2-4 mg's of it a day to really become addicted so if you were below that amount, I wouldn't be too concerned.
Although I suppose it's different for everyone.Another thought- I have the same issues with anxiety/panicky and Lexapro made me 100 x's worse. How long have you been on that?
Posted by SLS on February 25, 2005, at 12:28:58
In reply to Re: Klonopin probs., Xanax XR??, posted by Spriggy on February 25, 2005, at 12:19:43
Hi Spriggy.
> The pdoc that just prescribed me Klonopin told me that you would have to take around 2-4 mg's of it a day to really become addicted
What does your doctor mean by "addicted".
- Scott
Posted by Spriggy on February 25, 2005, at 17:02:18
In reply to Re: Klonopin probs., Xanax XR?? » Spriggy, posted by SLS on February 25, 2005, at 12:28:58
Scott,
Well, I asked him if Klonopin would be habit forming for me.. I was concerned about becoming "dependent" on it (not abusing it since I don't really have substance abuse issues).
He assured me that taking .25 mg's only 2 times a day for a few months would not be a cause for concern.Does that make sense?
Posted by Phillipa on February 25, 2005, at 17:26:15
In reply to Re: Klonopin probs., Xanax XR??, posted by Spriggy on February 25, 2005, at 17:02:18
Yes that makes sense. That is a very low dose and you would probably not have any problem with stopping the med. Probably just cut the dose in half for a while, then a quarter, and stop. Fondly, Phillipa
Posted by awatts on February 25, 2005, at 20:12:50
In reply to Re: Klonopin probs., Xanax XR??, posted by Spriggy on February 25, 2005, at 17:02:18
>
> Scott,
> Well, I asked him if Klonopin would be habit forming for me.. I was concerned about becoming "dependent" on it (not abusing it since I don't really have substance abuse issues).
> He assured me that taking .25 mg's only 2 times a day for a few months would not be a cause for concern.
>
> Does that make sense?Yes, it sounds like a good plan. However, if it is still helping you after a few months, consider staying on the drug. That's a low dose for most folks, but plenty for some. 0.25 mg x 2 is all I need now. I have a friend who does best on only 0.125 mg x 2 of Klonopin.
Many people are on 2 or more mgs a day, and maybe some of them actually need that much. However, as I said in this group before, I think most people on Klonopin for anxiety take too much and then complain about side effects.
Posted by SLS on February 26, 2005, at 6:39:00
In reply to Re: Klonopin probs., Xanax XR??, posted by Spriggy on February 25, 2005, at 17:02:18
>
> Scott,
> Well, I asked him if Klonopin would be habit forming for me.. I was concerned about becoming "dependent" on it (not abusing it since I don't really have substance abuse issues).
> He assured me that taking .25 mg's only 2 times a day for a few months would not be a cause for concern.
>
> Does that make sense?
No.First of all, if you have run out of alternatives, and Klonopin works, then I think Klonopin is indicated. If 0.50mg of Klonopin continues to work, then you take 0.50mg. If you need 4.0mg a day, then you take 4.0mg, or else suffer. The decisions you make will involve many considerations that are unique to you and your illness. I'm not telling you what to do.
I do not consider your doctor's decision to exclude higher dosages of Klonopin simply because it is "habit forming" to be valid. Physiological dependence on a drug is not exclusively the domain of the benzodiazepines. Just ask anyone who has tried to discontinue an SSRI or Effexor. There are also many, non-psychiatric drugs for which this is equally true. Taking any amount of Klonopin for more than two weeks will probably produce some degree of phsysiological dependence for which a withdrawal syndrome will appear should you discontinue it abruptly and without a taper schedule. Of course, the taper from 4.0mg would take much longer. It is difficult to predict the magnitude of withdrawal symptoms at any dosage.
I am not recommending that you take 4.0mg of Klonopin. I am recommending that you use Klonopin as a tool to your advantage. What your doctor wants for you to do might be exactly the right thing to do to accomplish this. It might be the best use of this drug. However, I don't think that increasing the dosage if necessary should be excluded from consideration. Plenty of people have discontinued Klonopin using a taper schedule. I have done it myself. The first time, I tried to get off of it without a well planned taper schedule. It was not fun. I experienced the same thing with Ativan. Since then, I have had no trouble discontinuing benzodiazepines.
What I WOULD do if I were in your position would be to ask as many people as you can how difficult a time they had discontinuing Klonopin. Start a new thread here on Psycho-Babble. It will most likely be redirected to the new Withdrawal board, but at least it will catch some attention. It is my concern that Klonopin is more difficult than other benzodiazepine to discontinue. That is my impression, but I don't know for sure. However, if you suffer from a condition for which chronic treatment is necessary, this issue is moot. Klonopin, used at dosages of 2.0mg and greater, has completely changed the lives of many people for the better.
- Scott
Posted by Laree on February 26, 2005, at 23:37:58
In reply to Re: Klonopin probs., Xanax XR?? » Laree, posted by SLS on February 25, 2005, at 7:24:10
Scott,
My pdoc gave me more Klonopin until I see him next month (I saw one of his PA's on Friday) but she seemed completely huffy as soon as I mentioned Xanax XR as a possibility and basically said they weren't going to give me Xanax. I was on the immediate-release version a few years ago from a different dr., and I don't see how the XR version would be so much different than the Klonopin, except perhaps giving me more stability, possibly less irritability?
I am frustrated because my pdoc added Neurontin to the Klonopin, which I refuse to take because of the potential weight gain factor (I suffered with eating disorders for years). The PA had talked to him on the phone so she just gave me the message--I was not able to voice this concern to him. Anyway, I was on it once, before the ed's, and it made me dopey, tired, and gain weight...nooo way. But until next month, this seems to be the "plan"...Hopefully I can taper the K a bit and still function, because I won't go on Neurontin again, I know what it does to me.
I'd be inclined to think my pdoc is benzo-phobic, but I hear him rx'ing Ativan and Xanax for other patients. I am 22, yet have no history of drug/alcohol abuse...I would just love to feel on an "even keel" again!
any suggestions?
thanks!
--LB> > I am incredibly scared right now--
> > the thought of even suggesting perhaps Xanax XR to my pdoc (for a break from the tolerance to Klonopin)
>
> Everyone reacts so differently to these drugs. Most people seem to find a dosage of Klonopin for which they don't develop a tolerance. However, since you are dissatisfied with it for other reasons, perhaps now is a good time to change. Xanax is a good drug. You might want to present to your doctor that you would like a trial of Xanax such that if it doesn't help you can return to Klonopin. Try not to give your doctor an opportunity to move away from benzodiazepines.
>
> Just a thought.
>
> I would be very interested to know how you progress.
>
>
> - Scott
>
Posted by Phillipa on February 26, 2005, at 23:51:06
In reply to Re: Klonopin probs., Xanax XR??, posted by Laree on February 26, 2005, at 23:37:58
I have heard that the XR version causes breakthrough anxiety, and sometimes needs to be supplemented with the short acting version. Fondly, Phillipa
Posted by SLS on February 27, 2005, at 8:33:13
In reply to Klonopin probs., Xanax XR??, posted by Laree on February 24, 2005, at 22:04:42
Hi.
Has your doctor given you a specific diagnosis?
Do you ever experience true panic attacks (a state of absolute fright that includes racing heart, palpitations, shaking, sweaty hands, hyperventilation, etc.) Is your anxiety dependant on the situation like social anxiety or is it there always?
> My pdoc gave me more Klonopin until I see him next month (I saw one of his PA's on Friday) but she seemed completely huffy as soon as I mentioned Xanax XR as a possibility and basically said they weren't going to give me Xanax.
I know one person whom does very well with Xanax to help treat her schizoaffective disorder. It helps to keep her to sleep and prevents her from becoming manic. She takes it every day at the same dosage. You would not think for a minute that she abuses it. For her, Klonopin did more harm than good. In some ways the two drugs are very different and "feel" different.
> I am frustrated because my pdoc added Neurontin to the Klonopin, which I refuse to take because of the potential weight gain factor (I suffered with eating disorders for years).
I might be forgetful at the moment, but I don't remember anyone complaining of weight gain with Neurontin. Of course, almost anything is possible with these drugs at the level of the individual. It doesn't seem to be pervasive, though. How much weight did you gain. How long did you take it for? Did it help the anxiety at all?
It would be helpful to know what you have taken in the past. Which treatments helped and which treatments hurt?
- Scott
Posted by Laree on February 28, 2005, at 18:02:21
In reply to Re: Klonopin probs., Xanax XR?? » Laree, posted by SLS on February 27, 2005, at 8:33:13
Dear Scott,
My d/x = Panic attacks as well as generalized anxiety.
(You asked):
> Do you ever experience true panic attacks (a state of absolute fright that includes racing heart, palpitations, shaking, sweaty hands, hyperventilation, etc.) Is your anxiety dependant on the situation like social anxiety or is it there always?--Yes. The racing heart/palpitations especially-I get chest pains sometimes, too. Often I have trouble trying to breathe normally during an episode and (involuntarily) begin taking short hollow frantic gasps of air and feel as if I cannot catch my breath. The anxiety remains quite constant, is usually present when I wake up or soon thereafter, and can last all day.
(You asked):
> I might be forgetful at the moment, but I don't remember anyone complaining of weight gain with Neurontin. Of course, almost anything is possible with these drugs at the level of the individual. It doesn't seem to be pervasive, though. How much weight did you gain. How long did you take it for? Did it help the anxiety at all?--I cannot say exactly how much weight I gained, it was many years ago when I was in high school. I took it for at least a few months. However, it made me feel extemely lethargic and foggy. I have heard many accounts of people gaining weight while on it as well. And the thought of the possibility of Neurontin doing that tells me it's not right for me for this problem because it would perpetuate the eating disorder tendencies that are still (unfortunately) with me that I am trying to work on.
(You asked):
> It would be helpful to know what you have taken in the past. Which treatments helped and which treatments hurt?--The panic is a relatively new (chronic) occurance, I've probably been suffering steadily for about 6 or 7 months now. I did suffer with generalized anxiety a few years back as well, and that was when I was put on Xanax (by a diff. dr.).
It worked quite well but I remember it often made me feel tired much of the time after I took a dose. Klonopin only makes me feel that way occasionally.
I have taken Valium for other conditions and it made me tired and exacerbated my depression to an intolerable degree.
I took Ativan for about a month, and I remember it feeling quite "smooth", but I also recall being irritable while on it. Klonopin seems to have that effect on me sometimes as well. Are you familiar with that reaction to the K, by any chance?
Do you know if depression could possibly be helped by Xanax vs. being potentially furthered by Klonopin??
Also, approximately how long does it take for .25 mg of Klonopin to work, do you know? Thanks!!--L.B.
Posted by empty inside on March 3, 2005, at 22:38:56
In reply to Re: Klonopin probs., Xanax XR??, posted by Laree on February 28, 2005, at 18:02:21
> --I cannot say exactly how much weight I gained, it was many years ago when I was in high school. I took it for at least a few months. However, it made me feel extemely lethargic and foggy. I have heard many accounts of people gaining weight while on it as well. And the thought of the possibility of Neurontin doing that tells me it's not right for me for this problem because it would perpetuate the eating disorder tendencies that are still (unfortunately) with me that I am trying to work on.>>That is very strange... I was an inpatient in an eating disorders hospital for almost 3 months and while there was on 600mg Neurontin at night. I also knew of several girls on it as well -- one of them I was very close to and she took it like 3 times a day! And neither of us gained any weight (despite that we were meant to). After discharge, I stayed on the Neurontin. This was almost a year ago/ My weight has been in the 75-80 range the entire year since then, with a brief hospital re-feeding boosting it to 85, still on 600mg every night. And this is despite severe bulimia being added into the mix of what was already anorexia. I binge/purge several times a day. I find it hard to believe Neurontin causes weight gain. ????
> Also, approximately how long does it take for .25 mg of Klonopin to work, do you know? Thanks!!<
0.25mg? As in one quarter of a mg? That is a very small dosage/ you might not notice anything at all/ I'm told I'm on a very low dosage of Klonopin and it is 2mg in the day if needed, and 4mg in the evening. It's rfairly fast-acting though, if that is the info you're after, though I'd say Ativan works faster. Klonopin takes about 30min to kick in for me.>>
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