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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Laree on April 29, 2005, at 0:23:47
Hey guys,
I am rx'ed 1 mg./day of Klonopin and have been unable to function on most days on that dose. I have found I do beautifully when I take 2 mg./day, and have not noticed any nasty side effects from that dose (@2mg.).
My pdoc has been reluctant to up my dose at all, it was a struggle to get him to up it to 1 mg./day, he just wants to try and augment it with Gabitril or Neurontin or other drugs I've tried, cannot afford, haven't worked, and given me nasty side effects. I am on Lexapro and it works best for depression for me but does not seem to quell this all-permeating anxiety whatsoever.
Eventually I do want to taper down on the Klonopin, but I cannot afford counseling regularly right now and the attitude of my pdoc is, I think, fueling my anxiety & panic further. I am always petrified that I won't have enough medicine, relief, etc...and usually, that is exactly the case, and then I am up the creek without a paddle...
I even panic just thinking about calling the office -- I have to call tomorrow to get my next month's supply, yet they had to rx me some extra the last few days to get me by because I told them I had run out. I did not talk to my pdoc personally at that time. I am scared to death that my prescription will be denied me b/c I asked for (NEEDED) a few extra pills this month; however, I have been on Klonopin for many months -- isn't it a medical liability to just yank a patient off of Klonopin like that b/c of the withdrawal effects??Any advice/input would be greatly appreciated!
--L.
Posted by Phil on April 29, 2005, at 11:31:24
In reply to KLONOPIN, insufficient dose, S.O.S.!!!, posted by Laree on April 29, 2005, at 0:23:47
Laree...Your doc sounds like, hmmm what's the word? Idiot. Yeah, that's it.
Just my opinion after years on Klonopin. 2 mg is not a large dose and it works for you. Can he explain his reasoning? It's safer than his other suggestions, IMHO.Good luck with Dr. Benzophobe.
~ ~
Phil~
ps...This reminds me of people who live w/ severe pain and doctors won't prescribe meds that fully address it. GRRRRR!!
Posted by Phillipa on April 29, 2005, at 19:13:36
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!! » Laree, posted by Phil on April 29, 2005, at 11:31:24
I agree. He sounds like he's a young [forgive me Matt84] psych doc who thinks the new AD's will stop anxiety. Can you find another one? When I had a young pdoc he tried to stop a 35yr hx of nonabused benzo use by me almost overnight. I ended up in a neurologist's office shaking and unable to speak with an elevated BP. I was afraid I'd have a stroke. He told me to find a new pdoc who wasn't benzo phobic and RX's the needed med for me until I found another one. The one I have now is much older, almost ready to retire and she's not afraid of benzos. Fondly, Phillipa
Posted by anneL on April 30, 2005, at 0:38:12
In reply to KLONOPIN, insufficient dose, S.O.S.!!!, posted by Laree on April 29, 2005, at 0:23:47
One should never be afraid to discuss the need for a higher dose of medication with one's doctor. 2 mg. a day of Klonopin is well within the regularly prescribed doses. Be assertive and tell your doctor that you need a prescription for 2 mg. a day so that you are not anxious about running out. There should be no reason to "beg" for this. How about your primary care physician? My primary care doc rx's my Klonopin. Do you have a mail order pharmacy - part of your prescription benefits where the doc writes a 90 day Rx with 3 refills? Getting monthly scripts for maintenance medications is expensive and time-consuming. Stick to your guns and tell the doc what makes you function best. If he refuses, pleasantly get your 30 days Rx for 1 mg. tablets then find a new doc fast! :anneL
Posted by reefer on April 30, 2005, at 9:47:18
In reply to KLONOPIN, insufficient dose, S.O.S.!!!, posted by Laree on April 29, 2005, at 0:23:47
Ask your pdoc if you can up the dosage while you get on something else for the anxiety that needs a few weeks to take effect. If you call every hour about how anxious you feel he/she will give up and let you up the dose. Don't be shy to call your doc.. Just harass until you get what you need!
Posted by River1924 on April 30, 2005, at 17:06:07
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!!, posted by reefer on April 30, 2005, at 9:47:18
1. Gawd, I feel lucky. I live an hour and half from John Marshall who wrote "Social Phobia" and I made an appointment and got what I needed. Once I was adjusted at four milligrams, I switched to a pdoc who was closer and haven't had a problem since them. John Marshall suggested cognitive-behavioral therapy and that was helpful but, once he got to know me, he said I'd probably be on klonopin my whole life. For awhile that bothered me, but then I lower my dose and RECALL why I wanted it to begin with.
2. Some docs just have prejudices. Once doctor said that since I wanted to try ritalin for depression that she might as well give cocaine. A female friend insists docs are less likely to listen to them seriously. Don't take it personally. Use your intuition. Can you work with this p-doc?
3. I work at a nursing home and residents that would profit from an anxiety med are put on anti-psychotics. The rationale is that anti-anxiety meds have a potential to cause falls and there are legal reasons p-docs get in the HABIT of not prescribing anti-anxiety meds. (My guess is the anti-psychotics may cause just as many falls but the drug companies haven't done that research so the docs are legally responsible.) Ask him why he is so reluctant to prescribe a higher dose if the current one isn't working? Is there a real reason? Drug books certainly don't limit the potential doseages at 1 milligram.
4. Anxiety meds WERE over prescribed in the 1970's. The stigma has continued but, somehow, more recent research that say they are needed and effective for some people has not been driven into docs heads.
5. Docs are unlikely to prescribe addictive drugs (by that I simply mean, drugs that require a long time to wean oneself off) to individuals that 1) don't have a diagnosis of an anxiety disorder and 2) have a history (or family history) of drug and alcohol misuse. Make sure your doc understands the depth of your anxiety. DON'T PLAY WITH DOSEAGES WITH A NEW DOC. He will think you a risky patient. Find checklists in books about anxiety disorder and get to know the lingo. Just don't say you are anxious. Give him a list of symptoms and fancy words that point to the problem.
6. Your perception of his dislike of your suggestion to raise the dose may be/could be part of your anxiety disorder. Social anxiety makes you think the worst of every social interaction. I can't think of one but a workbook on cognitive-behavioral therapy might help reaccess the resistance YOU have to push for the care you need now. You are worth it. Make sure he knows it. Be as strong and as you can muster. You are worth it and you deserve decent treatment.
Good Luck and Peace, River.
If nothing else, have him read the posting from here. If he isn't insulted, you may have the conversation and prescription you need from your doc.
Posted by Chairman_MAO on May 2, 2005, at 9:59:36
In reply to KLONOPIN, insufficient dose, S.O.S.!!!, posted by Laree on April 29, 2005, at 0:23:47
If your doctor is willing to prescribe 1mg and not 2mg, get a new doctor ASAP. There is no "legal" difference or whatever he is worried about with controlled substances, and 1mg/day simply is not enough for many people. 2mg/day is quite standard, and many, many people with anxiety disorders feel well on 2mg/day, so it does not surprise me that you do, as well. Why he wants to "augment" it with medications that have virtually no proven efficacy treating anxiety disorders I do not know. The fewer individual drugs the better; why load you up with Neurontin or gabitril (which is EXTREMELY hard to titrate up to an effective dose without being tore up for days) in addition to Klonopin when you could just take more Klonopin? 2mg/day is still a low dose; most people with social phobia seem to like it around 4mg/day.
Posted by wendy0006 on May 4, 2005, at 15:17:28
In reply to KLONOPIN, insufficient dose, S.O.S.!!!, posted by Laree on April 29, 2005, at 0:23:47
I switched doctors so many times trying to find one that would take my anxiety seriously and, as the other posters have said, they tell you the antipsychotics will deal with it. Ha! Or Buspar - no help for bad anxiety. I get 1.5 mg from my pain dr for Restless Leg Syndrome. there are also some online drs for scrips
wendy
Posted by notfeelingthebest on May 4, 2005, at 22:37:50
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!!, posted by wendy0006 on May 4, 2005, at 15:17:28
Where do you guys live that you cant get this stuff? Ive been on the stuff for a year and when i decided to take a break... NO. It wasnt "withdrawal," it was a return to the old days and it sucked.
Im prescribed 4mg a day, but I need 6 to 8 on days when I need to perform so I have to take like 2 on down days in order to save up.
I cant believe your doctor is such a wanker that he wont give you more than 1 mg a day. I take mine all in one dose - 8mg in the morning - not because I think its fun, but because Im desperate and its the only thing that works. I barely even notice it anyway. I feel best when I can take 6 to 8 for a few days in a row so it really builds up in my system.
As a matter of interest, try searching for one convincing success story from any SSRI, and then read all of the positive feed back from people taking benzos.
Compare what youve read to what your moron doctor is telling you will happen once you take his alternate selection.
Posted by wendy0006 on May 5, 2005, at 7:55:28
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!!, posted by notfeelingthebest on May 4, 2005, at 22:37:50
Lucky you!! Could you talk to the psychs here in atlanta? I have been able to get a hold of the benzos I need sometimes - but you are absolutely right about the ads - i think they just stop working. i wish the drs could suffer from your anxiety for a day and they would change their mind. I've quit work now, but even when I asked to get benzos so I could make it through the day, they said no - so I sit here on disability.
Jealous!! wendy
Posted by Chairman_MAO on May 5, 2005, at 17:08:24
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!!, posted by notfeelingthebest on May 4, 2005, at 22:37:50
I am actually starting to think that for many people, SSRIs are NOCEBOs for anxiety. That is, not only do they not have any benefit, they make it worse, then the doctor ups the dose when the patient complains of additional anxiety. It's some sort of [pe]rever[t]se[d] conditioning. It's sick stuff. Leave it to the US to turn some of the safest drugs known to man--the benzodiazepines--into demons.
Posted by pro_social_soon on May 9, 2005, at 6:45:59
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!! » Laree, posted by Chairman_MAO on May 2, 2005, at 9:59:36
> If your doctor is willing to prescribe 1mg and not 2mg, get a new doctor ASAP. There is no "legal" difference or whatever he is worried about with controlled substances, and 1mg/day simply is not enough for many people. 2mg/day is quite standard, and many, many people with anxiety disorders feel well on 2mg/day, so it does not surprise me that you do, as well. Why he wants to "augment" it with medications that have virtually no proven efficacy treating anxiety disorders I do not know. The fewer individual drugs the better; why load you up with Neurontin or gabitril (which is EXTREMELY hard to titrate up to an effective dose without being tore up for days) in addition to Klonopin when you could just take more Klonopin? 2mg/day is still a low dose; most people with social phobia seem to like it around 4mg/day.
For me even 20mg doesn't work. No social anti-anxiety effect, no sleepines/drowsiness, nothing.
Posted by Declan on May 9, 2005, at 22:49:03
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!! » Chairman_MAO, posted by pro_social_soon on May 9, 2005, at 6:45:59
Hi prosocial, do you know why that is? I don't remember/know what you're on.
Declan
Posted by Paul Smith on May 10, 2005, at 0:40:24
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!! » Chairman_MAO, posted by pro_social_soon on May 9, 2005, at 6:45:59
For me even 20mg doesn't work. No social anti-anxiety effect, no sleepines/drowsiness, nothing.
That is the problem, tolerance. The drugs quit working, you need more and more to get the same effect, but if you try and discontinue, withdrawal effects typically last about 18 months according to an addictionologist I spoke with today. theseeffects are usually much wrose than the original condition. I`m not "benzo phobic" but this happens a lot. Am on them myself, 40 mgs of Valium which is losing it`s efficiency. So I have two choices, get the dose upped or taper off and suffer for a year, probably longer. Some seem to not have this experience though and I am glad for them. In may case, you are basically screwed.
Posted by Declan on May 10, 2005, at 0:58:52
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!!, posted by Paul Smith on May 10, 2005, at 0:40:24
Too right, the effects of the endless withdrawal are much worse than the original condition. At least you eventually sort out that you are no longer as worried by whatever it was.
Declan
Posted by River1924 on May 10, 2005, at 1:40:23
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!!, posted by Declan on May 10, 2005, at 0:58:52
I've been on 2-4mg (sometimes I lower it or raise it according to the enviroment) for several years and have never had to increase the dose. I had no trouble getting off ativan in the past but klonipin is stronger (for me) and I think it would take some time to quit. But I take it for a reason and suffer no ill effects so I plan to take it for the rest of my life. Peace, River.
Posted by ed_uk on May 10, 2005, at 5:19:02
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!!, posted by Paul Smith on May 10, 2005, at 0:40:24
Hi,
>Valium which is losing it`s efficiency......
It may loose its effectiveness in treating your anxiety but it will still prevent you from suffering withdrawal symptoms. I think you should stay at the same dose of Valium and find an additional way of treating your anxiety.
Regards,
Ed.
Posted by Phillipa on May 10, 2005, at 16:20:51
In reply to Re: KLONOPIN, insufficient dose, S.O.S.!!! » Paul Smith, posted by ed_uk on May 10, 2005, at 5:19:02
Thanks Ed! They had me scared as it seems the same thing is happening with the l5mg of valium. But, I did take an additional 5mg at bedtime for a couple of weeks, and since I ran out of the old Rx I don't feel any different back on the l5mg. Fondly, Phillipa O
Posted by university on May 16, 2005, at 0:34:05
In reply to KLONOPIN, insufficient dose, S.O.S.!!!, posted by Laree on April 29, 2005, at 0:23:47
> Hey guys,
> I am rx'ed 1 mg./day of Klonopin and have been unable to function on most days on that dose. I have found I do beautifully when I take 2 mg./day, and have not noticed any nasty side effects from that dose (@2mg.).
> My pdoc has been reluctant to up my dose at all, it was a struggle to get him to up it to 1 mg./day, he just wants to try and augment it with Gabitril or Neurontin or other drugs I've tried, cannot afford, haven't worked, and given me nasty side effects. I am on Lexapro and it works best for depression for me but does not seem to quell this all-permeating anxiety whatsoever.
> Eventually I do want to taper down on the Klonopin, but I cannot afford counseling regularly right now and the attitude of my pdoc is, I think, fueling my anxiety & panic further. I am always petrified that I won't have enough medicine, relief, etc...and usually, that is exactly the case, and then I am up the creek without a paddle...
> I even panic just thinking about calling the office -- I have to call tomorrow to get my next month's supply, yet they had to rx me some extra the last few days to get me by because I told them I had run out. I did not talk to my pdoc personally at that time. I am scared to death that my prescription will be denied me b/c I asked for (NEEDED) a few extra pills this month; however, I have been on Klonopin for many months -- isn't it a medical liability to just yank a patient off of Klonopin like that b/c of the withdrawal effects??
>
> Any advice/input would be greatly appreciated!
> --L.
1mg/day of clonazepam is not that much; the maximum daily dose for seizure control is 20mg, I believe, FYI.Do you take the clon. sublingually? Doing so not only hastens its absorption, but (I *think), would *increase* its absorption (relative to oral administration, via which (again, I think) some of the drug is destroyed in the gut...
This is the end of the thread.
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