OK, I need the scoop on Klonopin

[chinacat]

Firt the basics---I am BPII, with ADD, and huge anxiety issues, especially rught now when my life is in pieces.

I was put on Klonopin a coule of years ago, it works OKL, but one day (another story) I discovered (while trying to get someone --anyone--to see me at an ER) I took 15 1mg.(TOTAL==15 miligrams all in one dose) and actually felt not much at all. Right now, my doc has me on 1mg. AM and 1 mg. PM--to "Keep a fire from starting, rather than put one out" he says, which seems to make sense--

BUT--

Lets face it--2 mg a day of Klonopin is like an asprin to me. I once, briefly was on Xanax, and after 4 days, missed 2 days--and promptly had the most incredibly awful withdrawal I have ever even seen any one have--like my skin was coming off from the inside. That was at a relatiovely low dose.

So--tomorow, off to the pdoc. who ONLY manages my meds, no talking, please--but we gotta talk, cause I am eating Klonopin right now like a madwoman, just to keep from killing someone or being toted offby the men in the coats when the neighbors hear the screams.

I have never really taken anything else--well ,Atavan for a dental appt--what a joke--and years ago, Librium, which they gave all "women of a certain age". Basically I seem to have a HUGE tolerance for benzo's, and I need something, NOW. Back on Xanax, and just never miss one? More Klonopin, so I don't run out before the month is over? VALIUM??? A Large rubber mallett?

I know our mmileage may vary, but I need some suggestions to take to the good doc inthe AM--HELP!!

china

[Sensation]

Wellbutrin is a stimulant and causes anxiety in a lot of people.

Adderall is also a stimulant which keeps you wired and alert all day.

These two medicines will render your klonipan useless.

What do you take for BIPolar? May I suggest lamictal.

[Penny Century]

i agree you need something more than benzos here.

(now i'll go into personal experience time here, YMMV, feel free to ignore the specific meds, but think about the idea of adding another AC or a AP to your mix.)

personally, i i use lyrica (pregabalin) to help with anxiety. in the EU it's approved for GAD, in the US it's only for neuropathic pain and seizures. but you have pain and i bet you can get it through insurance. it's a slow taper med. effective dosage is between 300-600mg, usually taken TID, but some do BID.

another option is to add in a low dose of an antipsychotic.

ask yourself "is this anxiety or agitation?"

a low dose of abilify worked wonders on calming the roaring in my head... of course it causes agitation in other people. risperdal in low doses can also help. any of them can, just with some you have to worry about the blood sugar issue. as far as i know abilify and geodon are neutral on blood sugar.

talk to your doctor.

i'm not saying ditch the klonopin, but it sounds like you need something in addition to tegretol to help with your mood stabilization.

[null0trooper]

I was also thinking an AP, maybe even a "major tranq" (Haldol and company) might be temporarily useful ...

but the old hard-line APs are more likely than the AAPs to turn Adderall into a waste of organic matter.

So, "What Penny said."

Wellbutrin is a stimulant and causes anxiety in a lot of people.

As many times as it's referred to as a "stimulating anti-depressant," it still is not a stimulant. In people with ADD

but not GAD (nor major depression with anxiety) it is a fairly good anxiolytic. The more-stimulating TCAs

(also NOT stimulants: Norpramin, Vivactil, and company) are likewise effective.

Adderall is also a stimulant which keeps you wired and alert all day.

Adderall is a Schedule 2 stimulant, and in Chinacat's case is prescribed for ADD. Again, for ADHD in the

absence of manic agitation or comorbid anxiety disorder it is well-documented as a calming agent. Do you really

think a sane parent would give a hyperactive kid something to make him more wired for more of the day?

These two medicines will render your klonopan useless.

It's not unusual for people to be prescribed klonopin when Wellbutrin is one of the few antidepressants that works

but is causing increased anxiety and irritability. It's there to take the edge off the WB. They work mainly through

different mechanisms anyway.

If you have depression and GAD, and are taking WB with your SSRI/benzo combination in order to get your sex life

back... well, that's one of the trade-offs. That actually highlights a difference between bupropion and amphetamine -

the latter does anything BUT help guys "get it up." And it's not like anxiety and sex are foreign concepts to each

other.

[Dee]

My script is for up to 4 mg a day prn, but I have the ok for 5, while we are working out an AD approach for anxiety. I have taken 8 mg. I think I am pretty tolerant as well to benzos which is why I need an alternate solution. You may be like me. The pharmacist said don't take more than 2 mg at one time.

I'm a bit confused about Klonopin actually, because I read somewhere on the PI sheet (which I can't find) or somewhere that the daily max dose is 20 mg, so maybe this isn't as extreme as it seems to us? I am more familiar with other benzos.

VE, AM, CNS, other brainiacs?

[Penny Century]

I'm a bit confused about Klonopin actually, because I read somewhere on the PI sheet (which I can't find) or somewhere that the daily max dose is 20 mg, so maybe this isn't as extreme as it seems to us? I am more familiar with other benzos.

20mg is the max dose for seizure disorders.

the max recommended dose for panic/anxiety is 4mg, but individual doctors may go higher than this if it is not effective.

[Dee]

I'm a bit confused about Klonopin actually, because I read somewhere on the PI sheet (which I can't find) or somewhere that the daily max dose is 20 mg, so maybe this isn't as extreme as it seems to us? I am more familiar with other benzos.

20mg is the max dose for seizure disorders.

the max recommended dose for panic/anxiety is 4mg, but individual doctors may go higher than this if it is not effective.

So in the (very) temporary case, while working out an alternate solution, it won't kill us?

[Penny Century]

I'm a bit confused about Klonopin actually, because I read somewhere on the PI sheet (which I can't find) or somewhere that the daily max dose is 20 mg, so maybe this isn't as extreme as it seems to us? I am more familiar with other benzos.

20mg is the max dose for seizure disorders.

the max recommended dose for panic/anxiety is 4mg, but individual doctors may go higher than this if it is not effective.

So in the (very) temporary case, while working out an alternate solution, it won't kill us?

Rx List Klonopin Indications and Dosage

Adults: The initial dose for adults with panic disorder is 0.25 mg bid. An increase to the target dose for most patients of 1 mg/day may be made after 3 days. The recommended dose of 1 mg/day is based on the results from a fixed dose study in which the optimal effect was seen at 1 mg/day. Higher doses of 2, 3 and 4 mg/day in that study were less effective than the 1 mg/day dose and were associated with more adverse effects. Nevertheless, it is possible that some individual patients may benefit from doses of up to a maximum dose of 4 mg/day, and in those instances,the dose may be increased in increments of 0.125 to 0.25 mg bid every 3 days until panic disorder is controlled or until side effects make further increases undesired. To reduce the inconvenience of somnolence, administration of one dose at bedtime may be desirable.

Treatment should be discontinued gradually, with a decrease of 0.125 mg bid every 3 days, until the drug is completely withdrawn.

There is no body of evidence available to answer the question of how long the patient treated with clonazepam should remain on it. Therefore, the physician who elects to use Klonopin for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.

(Using quotes here to back up what I'm going to say)

Klonopin is supposed to be a short-term solution. But there are a lot of us here who have been on it for years. 4mg is the recommended top dose, but not the MAX MAX dose if your doctor says it's ok to go above 4mg.

It is, and please no one run off and test this theory, hard to over dose on just klonopin alone. (you need some other CNS depressant thrown in the mix.)

4mg of klonopin, 6mg of klonopin, these are all safe as long as you are following your doctor's instructions.

which you are.

*gives Dee a good patient certificate*

(and i mean this, you are being a good patient, following your doctor's orders and doing research.)

penny

[Dee]

Thank you Penny. I was actually concerned that this seemed excess. You put my mind at ease.

[Sensation]

I was also thinking an AP, maybe even a "major tranq" (Haldol and company) might be temporarily useful ...

but the old hard-line APs are more likely than the AAPs to turn Adderall into a waste of organic matter.

So, "What Penny said."

Wellbutrin is a stimulant and causes anxiety in a lot of people.

As many times as it's referred to as a "stimulating anti-depressant," it still is not a stimulant. In people with ADD

but not GAD (nor major depression with anxiety) it is a fairly good anxiolytic. The more-stimulating TCAs

(also NOT stimulants: Norpramin, Vivactil, and company) are likewise effective.

Adderall is also a stimulant which keeps you wired and alert all day.

Adderall is a Schedule 2 stimulant, and in Chinacat's case is prescribed for ADD. Again, for ADHD in the

absence of manic agitation or comorbid anxiety disorder it is well-documented as a calming agent. Do you really

think a sane parent would give a hyperactive kid something to make him more wired for more of the day?

These two medicines will render your klonopan useless.

It's not unusual for people to be prescribed klonopin when Wellbutrin is one of the few antidepressants that works

but is causing increased anxiety and irritability. It's there to take the edge off the WB. They work mainly through

different mechanisms anyway.

If you have depression and GAD, and are taking WB with your SSRI/benzo combination in order to get your sex life

back... well, that's one of the trade-offs. That actually highlights a difference between bupropion and amphetamine -

the latter does anything BUT help guys "get it up." And it's not like anxiety and sex are foreign concepts to each

other.

Deep *sigh*

Is it possible for people to have diferent viewpoints.

I have been on both of these meds and they were both stimulants. Wellbutrin is one of the active AD's which causes anxiety in a lot of people. And on top of that taking adderal (speed) will keep you wired.

And please stop dissecting my posts as if you are teaching me something.

[Velvet Elvis]

You can't have opinions on facts.

Well. I guess you could go around protesting that 2+2 = 5, but it wouldn't do you a whole lot of good in terms of the rest of the world.

[Sensation]

There were no facts in this thread just opinions based on experience.

Leave it alone, you can't know everything.

[mrsloony]

I have found the addition of lithium to be very calming. at first a very low dose as an AD then recently dx'd bp2 and increased lithium. seems to help other calming meds work better too- including klonopin and seroquel. ( warning though- there is a fine line between calming and exhausted which i contunue to struggle with- I'm not nearly so anxious , i'm just soooo tired all the time. I guess its a trade off.

( by the way- nice to see you again china- seems like its been awhile since i have.

mrs l

[Breeze]

I didn't read all the replies because I am sick of "YMMV". God. Can't we come up with something new? Jerod has been gone how long now?

China: I have been on Klonopin forever. I am on 2 mgs. and it's plenty. It depends on your anxiety level. While that might sound funny and stupid, it isn't. Because I have been where you are too: "Too Flipped Out for Words" (We could use that)

Anyway. I am on a blood pressure med and nuerontin to s l o w me down after a long day. I no longer need to pop extra klonopin. I take all of my meds before bed now and not throughout the day. The key? I changed my life.

• You have to take days off. Just for you days. This is imperative. Everything else goes.
  
  
• Exercise: I swim and do yoga. Every day I spend an hour doing something
  
  
• I don't go places that will inspire a melt down.
  
  
• I see my p-doc and we talk
  
  
• I have learned to create boundaries and say no.
  
  
• I have done a lot of reading on the subject. You have to change your life. It takes time, but it does work.
  

Also pm me if you are interested in EMDR. I have heard through the vine you might be, and I have done this many times.

Hope you feel better.

Breeze

[chinacat]

Dear Sensation, your comment," And on top of that taking adderal (speed) will keep you wired." is a lovely but way too generalized statement.

My final comment--Adderall may keep YOU wired, but it does NOT keep EVERYONE who takes it wired. For me and other ADD folks, it keeps us normal and focused and able to get from point A to Point B.

As for the Klonopin this whole thread got so out of control I no longer care, and am reqlly quite sorry I even asked.

Have a nice day

china

[Sensation]

Dear Sensation, your comment," And on top of that taking adderal (speed) will keep you wired." is a lovely but way too generalized statement.

My final comment--Adderall may keep YOU wired, but it does NOT keep EVERYONE who takes it wired. For me and other ADD folks, it keeps us normal and focused and able to get from point A to Point B.

As for the Klonopin this whole thread got so out of control I no longer care, and am reqlly quite sorry I even asked.

Have a nice day

china

Chinacat,

You asked for suggestions in your post. And then comeback and critique said suggestions. I WAS SIMPLY GIVING MY EXPERIENCE I DIDNT SAY IT WAS LAW, AND I DID NOT IMPLY THAT YOU HAD THE SAME EXACT SYMPTOMS. Re-read my post, it says that "I" have been on both meds and this is how they affected me. Then my next post said the responses were from our experiences. just forget it, yall are a trip.

[Sensation]

We have a mod who asks for help about their medicine and they get 3 mods to help them figure out their cocktail an shut out anyone else who says different all within one day. I put up shit day after day and barely get 1 or 2 responses, man fuck this preferential bullshit. And this is what it is bullshit.

[december_brigette]

Hi,

to comment about another member's post. breeze wrote :

I didn't read all the replies because I am sick of "YMMV". God. Can't we come up with something new? Jerod has been gone how long now?

my internet spying indicates that:

1. jerod is still alive.

2. jerod did not invent "YMMV."

db

[Dweii]

chinacat: Just wondering how your appointment went?

[Velvet Elvis]

We have a mod who asks for help about their medicine and they get 3 mods to help them figure out their cocktail an shut out anyone else who says different all within one day. I put up shit day after day and barely get 1 or 2 responses, man fuck this preferential bullshit. And this is what it is bullshit.

Your post would probobly have gotten more responses if you'd finished it. The more you say the more there is for people to respond to. You made a post asking about a couple meds and literately ended it in mid-sentence. Nobody answered your question because you never finished asking it.

The more detailed your post the better your chances of getting a decent reply. If you can't be bothered to write even 100 words, why should anyone be bothered to respond?

Mods answer posts because it's their job and I beat them if they don't. Nobody was beaten for failing to answer the post that you ended in medias res because they are not psychic.

Ditto with correcting facts. Research skills and command of facts is a key consideration for selecting mods, particularly on the med boards. If you don't want to be corrected, don't say stuff that's wrong. Simple enough.

[cache-monkey]

I realize that this thread has gone totally OT, and that chinacat has effectively cut it loose.

But, chinacat: If you still happen to read this, did this mad tolerance to benzos start recently (i.e. post-Tegretol) or has it been an going thing? I guess what I'm driving at is that you may want to consider the Tegretol effect. You may be fully aware of this already, so apologies if this is old news.

Anwyay Tegretol's induction of your liver enzymes (CYP 3A4) is giong to increase the clearance of pretty much every benzo (other than Ativan). Depending on the dose of Tegretol, this can be as much as 50%. Meaning that your 2 mg of Klonopin might be effectively 1 mg. And also of relevance: the half-life will something like 15 hours instead of 30. So there is a greater chance of inter-dose rebound anxiety if you're taking it all at night.

Good luck,

cache-monkey