Question about Klonopin?

[The Emperor]

Hello! I was prescribed a bit of clonazapam to help with my anxiety. The actual directions are to take 1/2 or 1 pill of .5mg everyday or as needed. Not very specific I guess. I haaven't been taking it really as a maitenence drug and basically use it "as needed" or when I feel an "as needed" situation may occur. So I've had this RX for about a month now and I have been taking .5mg when I need it, which sucks, honestly, this stuff takes forever to start working. But I usually take it a couple or a few days in a row, then take anywhere from one to three days off it. I haven't had a problem with this yet but. . .

You hear all these stories about this crap and I was wondering if it is likely that I could develop some kind of tolerance to this stuff at this point, or if I will become dependent on it following the same pattern. I would honestly love to take it everyday as maitenence, I really feel that would be beneficial, but I know that isn't the long term solution, also, my Dr. has me on Buspirone, and these are the only two drugs I am taking for my anxiety at this point. There are a few reasons I take days off it, sometimes I experience intense, annoying anxiety during these days and just suffer through it because

1. I don't want to become addicted or dependent on these things

2. I have to take a break every now and then to see if the buspirone seems to have done anything yet, it's only been two weeks

3. Sometimes I wonder if the klonopin makes me irritable, or a little down the next day following ingestion of this pill, does that happen to anyone else?

Anyway, it really works and nothing has helped me so much with the anxiety, though I honestly haven't tried much. But I took one .5mg tablet tonight and I guess I don't feel anxiety, but it doesn't feel the same as it did when I first started taking it. Like it's effects aren't as strong or something. Does that mean I have become used to this dosage and need to up it, or, since I don't really have anxiety, that I have just become used to the effects? I'm not sure. The sedation thing doesn't happen anymore, but I also doen't feel as over all relaxed as I did in the beginning, though little to no breakthrough anxiety.

So if I don't feel anxiety at this dosage and no sedation, is that no anxiety+ no sedation= what it would feel like to be normal? I'm not sure. I just wonder if soon I would have to take more of it. And how likely is it that I will become dependant on these things? They work wonders, that's for sure. Thanks to people who would answer this for me!

[peppermintpatty]

Yer basic disclaimer: I ain't a doctor. Advice you read inthis here column should not be construed as a substitute for medical advice from a certified professional, yadda yadda. Whatever...

With that being said, If you haven't already learned this the hard way (and if you really haven't, then you're in the minority and extremely lucky), you should know that finding the right meds or combination of meds in the right dosages that work for you can be a slow, painfully frustrating process of trial and error. The second thing you should know, if you don't already, is that meds don't always affect people in exactly the same way. So just because klonopin turned me into a newt (it got better) does not mean that it will turn you into a newt. So whatever reactions people describe in their responses here should be taken with a grain of salt.

The dosage of klonopin you're taking is pretty low, and is in fact the same dosage I took when I first started taking it. You could probably double or even triple that dosage and still be within medically accepted therapeutic levels. **This does not mean that you SHOULD double or triple your dosage!!** I'm merely pointing out that it's low.

Klonopin is a benzodiazepene, and your doc is following standard practice when he tells you that you should take it "as needed" as opposed to regularly. Benzos CAN become addictive, and people CAN build a tolerance to them. This does not necessarily mean that YOU will become addicted and/or build up a tolerance. However, I have known some docs to prescribe low doses of benzos for "everyday" use. So I guess it depends on who your doc is. Again, people do not always react to a drug in the same exact way. If he hasn't already, your doc should ask you whether you've had any problems with addiction (drinking, smoking, drugs, whatever) before prescribing benzos, because people with a history of addiction are more likely to become addicted to benzos.

My experience with klonopin has been up and down. As I said, when it was first prescribed to me I was told to take .5 mgs or 1/2 a pill twice a day. (.25 in the morning, .25 in the evening). I'd been doing this for about 6 weeks when I lost my job and health insurance. I tried to get into a research study so that I could at least continue to be seen by a doc. I found one that accepted me, but they told me I had to be completely off meds for 2 weeks before I could start the study. I thought, "I've only been on klonopin for 6 weeks, it's a low dosage, 2 weeks isn't that long, I can kick this cold turkey for that long."

WRONG! I turned into a miserable irritable crybaby. After that experience (and I got rejected from the study on a technicality, so it wasn't even worth it, grr...), I still took klonopin because I had it and I couldn't afford to get other meds with no insurance. But I only took it "as needed" because I was afraid of going through that withdrawal again.

Today, I'm taking klonopin 5 days a week. (.5 mgs or 1 pill in the morning--so it's the same dosage, just taken all at once instead of split up.) I need it to get through work, which of late has become sheer hell for me. I skip it on the weekends. I don't know what would happen if I had to stop cold turkey, and I don't want to find out.

Benzos can have a depressive effect, which is why you might be feeling a little down if you're taking them regularly. This is why people like me who are both anxious AND depressed have a bitch of a time finding the right combo. The antidepressants can make you anxious, and the anti-anxiety meds can make you depressed.

Like you, I find that klonopin takes longer to kick in. I'm also on xanax (.5 mgs as needed), and I find that that kicks in quicker. But it also wears off quicker. So I take my klonopin right before I leave for work so that it kicks in before I get to the office, and I take xanax if/when the shit hits the fan at work so I'm better able to cope with it. No way of predicting how often that happens. I can go an entire week without taking any, and then I might need it 3-4 times in a week.

My pdoc is comfortable with me being on both of these meds because they're relatively low doses and I have no history of addiction (save for that nasty cold turkey episode described above). I've never smoked or touched illegal drugs, and I rarely drink.

I hope that I haven't blathered too much and that my response has been of some help to you. Good luck!

[gizmo]

I'm gonna make the same disclaimer as peppermintpatty: I AIN'T NO DOCTOR. Ok, I feel better.

My father is a recovering alcoholic and drug addict, and when he needed medication for pain, he got a lesson in the difference between addiction, tolerance, and dependance. I cannot tell you the exact story, but I will try to paraphrase best as I can. I hope it will give you some clarity, as it gave my father (and later, myself) the clarity needed to take meds that make us feel better.

Dependance is generally thought of as addiction. In fact, they are two completely seperate entities. Addiction is a mental process. It is a thought-driven process. Dependance is the body's way of becoming used to or needing something. Technically, our bodies are dependant on water. We go through withdrawal symptoms if we go without water (get dehydrated). In this situation, your brain chemicals get used to the medications you intake, and use them to function as normally as possible. When the medications are withdrawn, your brain physically reacts to not having those chemicals by sending out more chemicals, producing a withdrawal symptom. Tolerance is, as said before, the body's way of getting used to the medication, and you needing to use more to get the same effect. Have you ever noticed that you need to turn the shower water hotter, or salt your food more? These are also examples of your body's tolerance ability.

ETA: I guess I should add that the amount of clonazapam you are taking isn't likely to make you become addicted. If you begin to crave a release from reality that only a few klonopins can provide (so you think in your mind) and this happens on a regular basis, then it might be time to have a discussion with your doctor. Otherwise, medication taken as directed is fine.

You are not obligated to stop and check to make sure your meds are working. AD's take weeks and weeks to work, so you may not notice anything happening yet, hence the need for the klonopin.

As for dependancy, see above. If taken as prescribed, and you stop taking them as prescribed, you will be ok.

As for tolerance, I've been on xanax for four years. I started out taking .5 mg, and I take 1 mg as needed now. Because I take zyprexa now, I only take the 1 mg once or twice a week. I take 2mg every night to sleep, because my tolerance level is so low that 2mg slows down the gears enough to put me to sleep when ambien, lunesta, and Seroquel can't.

[debiz]

I am not a doctor either...

I've been on .5mg of Xanax 4 times a day for quite a while. Actually what I do is take it three times a day and then take the last two together at night so I can sleep. I also take Klonopin (.5mg) at bedtime to help me sleep. This is a daily routine for me and not a prn. I do not feel the need to go up on my dosage even though I know I actually need more Xanax a day because it's not cutting it. I am not addicted nor dependent on either one (unless you consider needing to sleep because in the past I was a horrible insomniac). I can go without taking them, but then I just don't sleep.

I don't want to ask my pdoc for higher doses because I don't want to sound addicted so I just put up with the daily anxiety.

[Phoenix_Rising]

Hello to THE EMPORER:

I have taken both klono and xanax over the years. I have been on one or the other of these benzos daily for about 12 years. A few things I know:

1. I have developed tolerances to both meds. The tolerance usually came about when my anxiety was out of control and my current dose just didn't cut it.

2. Klono has a half life of about 24 hours, meaning it stays in your system, helping you feel chilled for quite a while.

3. Klono is not fast-acting (hence your having to wait for results). My experience is that it takes about 30-60 minutes to start acting. But, b/c of its long half life, once it does start working, it stays in your system for a while.

4. I increase/decrease the amount of klono I taken (per my pdoc's instructions) depending on my level of anxiety, agitation and whatever else BPII throws at me.

Like the others have said, I would take this up with your pdoc as tolerance and/or addiction are common concerns.

Best of luck!

Peace,

Phoenix

[The Emperor]

Thanks everyone for replying!!

peppermintpatty- sorry, I don't know how to use that nifty quote function, and that this way of addressing people might be annoying, sorry. Anyhoot, thanks for all the input. It's frustrating, as you said, trying to find the right combo. I am seeing a GP for my issues right now(I know...) and I basically know that the meds I am on are not going to help me as much as others could. I should see a real head doctor for this, and hopefully will one day. I (and my GP) think I have some serious anxiety issues, she was kind enough to RX the klonopin, and then some buspar, which, from what I have read about it, probably isn't going to help my most major issues. So yeah, that trial and errror thing sucks

I thought I was on the smallest dosage they give out. I just don't feel as good as I did when I first started taking it a month ago, and then I was scared of the pill, so I only took 1/2!! Now I take a whole one, and my dr said I could take two, but, again, I am afraid of dependence.

You didn't say too much, I enjoy long posts, and often tend to make them. That sucks about the study and everything. That story freaked me out because I have almost been on this pill that long and am absolutely terrified of the exact thing you described when you suddenly stopped taking it. I smoke like a chimney and have an awful coffee habit. My Dr. knew this. I am afraid of seeing an actualy p-doc because I am afraid they wouldn't be as understanding about my finding klonopin useful. I hear sometimes they are hard to get from dr.s. It's stupid because they help so much!!

susanb- good luck with your med change! That is irritating a lot of the time, to say the least, though I haven't tried that many things, I know it sucks a bit. You are another of the "I think the BuSpar was a placebo" People? I am getting there, though I have only been on it a couple of weeks and just recently got up to 30mg a day, it doesn't do ANYTHING to me! I don't expect anything good but geez, there aren't any side effects either. I'll keep at it as I DO have a lot of generalized anxiety, which it COULD help, but I know there are other things I have anxiety about that it probably won't help, I don't know what this is related to necessarily, but I don't think buspirone is the drug for it. I've heard it is a better drug to augment an SSRI. I didn't tolerate Zoloft well AT ALL and was only on it five days, so my Dr. apparently now doesn't think I should take that class of drugs. I don't know, I bet maybe another brand wouldn't do that to me.

I'm glad I responded to a low dose, I am a small person. Did you start out on a lower dose of Ativan and eventually become tolerant and have to bump it up? I wonder because I am just curious what kind of crap to expect. Thanks for replying!

gizmo your post was very re assuring to me, thank you!!

debitz- I know what you mean about asking for a higher dosage, I was thinking about even just asking if I could adjust mine according to the level of anxiety I am having, because sometimes one works great, and other times not so good. But yeah, I do NOT want to sound like a druggie, I am so afraid of that because I DO NOT want to get these things taken away from me. I cannot imagine a time when I know I WON'T have them around in case I absolutely need them. Knowing they are here is a great comfort. Stupid druggies making it hard for people who need it to get it or even want to ask about it. Ugh.

Phoenix_Rising I like the klonopin, it's the first benzo I have ever taken it and I LOVE how long acting it is. If I take it at 11PM and wake up at 9AM, I don't experience that anxiety attack I get first thing in the morning that makes me want to pass out and throw up and lay down until the shakes go away. It's SOOO much easier with this stuff to get up and take care of my little girl! It's amazing. I am happy I found the klonopin. So I suppose the trade-off is fair, that it takes(for me) about an hour before I feel much relief, but that it helps me, even a little through the next day is pretty cool. Thanks for replying!!

[basketcase]

i to would like to know about it, i have percription for it, took 1 0.5 like few hours ago, i dont feel as bad as i did on valium but still somewhat flat...

[The Emperor]