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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by becksA on January 15, 2006, at 9:58:34
I have been on all the benzos, and ironically am finally trying one of the most common. It seems to be working out well so far. I have always needed a high dosage of whatever I'm on and the doc has me currently at 1mg 3x daily. He eventually wants to put me at 1.5mg 2x daily. Will that be enough to stay working all day long? What are the half lives/duration of this drug?
For klonopin users, what is your dosage, and what is your dosing schedule?
Thanks
Posted by 4WD on January 15, 2006, at 18:47:12
In reply to Klonopin Dosing Schedule...half life, etc., posted by becksA on January 15, 2006, at 9:58:34
> I have been on all the benzos, and ironically am finally trying one of the most common. It seems to be working out well so far. I have always needed a high dosage of whatever I'm on and the doc has me currently at 1mg 3x daily. He eventually wants to put me at 1.5mg 2x daily. Will that be enough to stay working all day long? What are the half lives/duration of this drug?
>Klonopin is supposed to have a long half life, but for me it wears off pretty quickly. About 5-6 housrs after a dose, I'm anxious again. But then, I take a very small dose (.5 mg) and the anxiety never really goes away, just lessens. The most I've been on was .5mg 3 times a day. I didn't find that the last dose at night added any benefit, since I wasn't scared/anxious at night; it didn't seem to have any effect on how I felt when I woke up in the morning. I mean I didn't wake up less scared by taking a final .5mg at bedtime.
>
It seems to take a while to work also. For me, it takes at least an hour after taking it to feel it. Full effect doesn't come for a couple of hours. Probably I am not taking enough to get the benefits. I'm just too scared to take more. Plus, if I get about 1mg day I get kind of ditsy.Marsha
Posted by RobertDavid on January 15, 2006, at 18:59:18
In reply to Re: Klonopin Dosing Schedule...half life, etc., posted by 4WD on January 15, 2006, at 18:47:12
I take 2mgs once a day at night. After a while I think it builds up in your blood levels and single daily dosing has worked for me. It helps me sleep, then the anti anxiety benefits work through the day. I've taken it 12 years, nothing works better. I think that those that take smaller doses .5 here and there need mulitiple dosing more. When you get up between 1 and 4 mgs (which seems to be the norm range for SAD) single dosing will probably work. I've found the key is to find the right dose that works for you. When i first started taking klonpin I didn't think it was working, but once I got up to 2mgs it really kicked in. I took as much as 3mgs, but it seems that 2 is my majic number. I've played with taking small doses during the day but always go back to single dosing at night. Just my take. Good luck.
Posted by Phillipa on January 15, 2006, at 19:13:14
In reply to Re: Klonopin Dosing Schedule...half life, etc., posted by RobertDavid on January 15, 2006, at 18:59:18
That sounds a lot like valium. Only take it at bestime. And when I was given klonopin a high dose even at bedtime used to leave me very lethargic. Fondly, Phillipa
Posted by becksA on January 15, 2006, at 19:22:53
In reply to Re: Klonopin Dosing Schedule...half life, etc., posted by Phillipa on January 15, 2006, at 19:13:14
Posted by yxibow on January 15, 2006, at 21:13:26
In reply to Klonopin Dosing Schedule...half life, etc., posted by becksA on January 15, 2006, at 9:58:34
> I have been on all the benzos, and ironically am finally trying one of the most common. It seems to be working out well so far. I have always needed a high dosage of whatever I'm on and the doc has me currently at 1mg 3x daily. He eventually wants to put me at 1.5mg 2x daily. Will that be enough to stay working all day long? What are the half lives/duration of this drug?
>
> For klonopin users, what is your dosage, and what is your dosing schedule?
>
> Thanks
In general Klonopin has up to a 16 hour half life in vivo and may even be higher. It sounds like you are a fast metabolizer of it.I used to take it twice daily, with the bulk at night, up to 8 mg a day. I do not recommend going beyond the standard 4mg dosing unless it is absolutely necessary, and you are prepared to adjust your reflexes slowly for things like driving and other important tasks.
I now take Valium at the same schedule although it actually has a 24 hour half life so the overall blood level is the same by this point, the staggered dosing just changes peak points.
Posted by becksA on January 15, 2006, at 23:03:21
In reply to Re: Klonopin Dosing Schedule...half life, etc. » becksA, posted by yxibow on January 15, 2006, at 21:13:26
how do you find valium to differ from klonopin?
Posted by Cairo on January 16, 2006, at 0:11:56
In reply to Klonopin Dosing Schedule...half life, etc., posted by becksA on January 15, 2006, at 9:58:34
I am generally very sensitive to med doses and have always appeared to be a slow metabolizer, but with Klonopin, I find that TID dosing is necessary. Could be due to enzyme induction or something from other meds I take. I take only 0.5mg at night, and 0.125mg in the morning, with occasional 0.125mg in the afternoon if stress is high. Higher doses than that are depressogenic and cognitively I am zonked in the afternoons if I take more in the morning.
Cairo
> I have been on all the benzos, and ironically am finally trying one of the most common. It seems to be working out well so far. I have always needed a high dosage of whatever I'm on and the doc has me currently at 1mg 3x daily. He eventually wants to put me at 1.5mg 2x daily. Will that be enough to stay working all day long? What are the half lives/duration of this drug?
>
> For klonopin users, what is your dosage, and what is your dosing schedule?
>
> Thanks
Posted by yxibow on January 16, 2006, at 2:34:49
In reply to Re: Klonopin Dosing Schedule...half life, etc., posted by becksA on January 15, 2006, at 23:03:21
> how do you find valium to differ from klonopin?
So far its an experiment, its been going for about a month or so. I think it is probably similar, but there may be a slight difference in the "immediacy" that Valium provides -- and also there is the advantage that it has a 24 hour half life so there's less problems with forgetting doses or taking them late I guess. Also it is possible that there is a little less depression, but that's hard to say. A number of people here have experienced more depression with Klonopin, I dont think I have particularly.
The equivalency has been 10mg Valium for 0.5mg Klonopin.
I'm also adding Trileptal, so I may have to increase the Valium because they are both at CYP 450 3A4. Time will tell.
Posted by becksA on January 16, 2006, at 10:26:53
In reply to Re: Klonopin Dosing Schedule...half life, etc. » becksA, posted by yxibow on January 16, 2006, at 2:34:49
Valium is the only benzo now that I have not tried. So we'll see how klonopin works out. like i said, so far so good but it's very early in the process. The main concern for me is causing depression....so knock on wood.
thanks again
Posted by Phillipa on January 16, 2006, at 18:06:15
In reply to Re: Klonopin Dosing Schedule...half life, etc. » becksA, posted by yxibow on January 16, 2006, at 2:34:49
Wow! I don't understand all the lingo at times. But are you saying that trilepal causes you to need higher doses of valium. My old pdoc said trileptal with valium would help with anxiety without raising dose of valium. Fondly, Phillipa
Posted by yxibow on January 17, 2006, at 2:11:05
In reply to Re: Klonopin Dosing Schedule...half life, etc. » yxibow, posted by Phillipa on January 16, 2006, at 18:06:15
> Wow! I don't understand all the lingo at times. But are you saying that trilepal causes you to need higher doses of valium. My old pdoc said trileptal with valium would help with anxiety without raising dose of valium. Fondly, Phillipa
It depends on the person, but the cytochrome P450 (liver elimination system) in the body is very important especially for psychiatric drugs. Trileptal is known as what they call an "inducer" of an important enzyme, 3A4/5, so drugs that you take at the same time such as Seroquel and Valium which metabolize through 3A4, may have to be adjusted, say 10-20% higher than their original dose. That's because Trileptal is reducing their plasma levels, so a higher dose is as if you were taking the previous dose originally, give or take. It inhibits 2C19 which means it raises the plasma level of drugs that metabolize through that one, though I don't know if it is as important as 3A4.
Doctors should be informed about the P450 system -- it really wasn't studied until oh I dunno, the last 10 years or so, and is very important in determining drug interactions. That's why I think that especially if GPs instead of psychopharmacologists are to prescribe psychiatric drugs, they should take CME courses on the P450 system.
cheers
Jay
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