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I'm currently taking 1mg of klonopin. Im seeing a new pdoc who bumped it down from 1.5. It wasn't really doing anything at 1.5 and so nothing at 1 either.

I'd like to switch to xanax. Mainly BC I hear its stronger than klonopin by reviews.

How hard will it be to convince the pdoc to switch? I think my issue here is he knows I've smoked weed in the past so I don't want him to think I'm a drug seeker. I really just need it for anxiety.

Thoughts?

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Xanax isn't really stronger; it's faster acting so it may *seem* stronger as the effect takes hold more quickly than klonopin, but it is also has a shorter duration than Klonopin. In *general* Xanax is considered an "emergency" med to help impede an oncoming anxiety attack or taken before a normally panic-inducing activity to prevent a panic attack. Klonopin is *generally* used to treat long term anxiety and is prescribed to people with a variety of anxiety disorders that cause them to maintain a high level of anxiety much of the time.

 

That said, I've seen xanax prescribed long term and klonopin short term. It all depends upon how your body responds to each med and what your treatment goals are. I can't remember who it is (hope they chime in) but I know of at least one person on these forums who has taken xanax for years for a long term anxiety issue.

 

Xanax is known to create a psychological dependence (and physical, but psych is more common) while on the other hand, klonopin is known to create a physical dependence vs. psych. IMPORTANT: these are just generalities, NOT sure-fire issues. Coming off either benzo can be difficult.

 

If your dose isn't currently working and your former does was also not working, did your new pdoc tell you why he reduced the dosage? Is he trying to take you off the klonopin entirely? Has he prescribed anything new? It would seem more logical to increase your dosage if lower doses weren't working. 

 

As for "convincing" him, I wouldn't approach it that way. Think of it more as working with him to find a solution for your anxiety issues. I'd start by asking why the reduced klonopin (if you don't already know) and then ask what your other options are. If he doesn't mention xanax, ask about it. It's not drug seeking if you are trying to find the right med for your anxiety. If he says no, it's perfectly acceptable to ask why.

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Sometimes it helps to let the doc know your symptoms and that the current med isn't being effective and asking what other recommendations they have that might work better instead of asking for a specific drug by name.

 

You have a lot of depression meds in your signature for OCD and social phobia. Are they all being useful? I wonder if it's time to consider whether you need all of them (the answer might be "Hell yeah, this is the first time we've had a cocktail that's worked."). Just a thought.

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Thanks CrankyMe and Wooster.

I know why he lowered my klonopin dose, I think. I seem to be flat and slow.

I've been treated for depression in the past for several lengthy episodes of depression. We've just never thought about getting off the ssri's and I'm not currently (clinically) depressed.

The lexapro is an anti anxiety SSRI I believe.

I guess its anxiety or be slower.

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CrankyMe did a great job of detailing the differences b/t Klonopin and Xanax.  I took Xanax for many years.  When things got really bad, I was taking 6 mg of Xanax a day and still anxious.  I switched to Klonopin and have been much happier with it as it is longer lasting.  I hadn't noticed it making me flat, but every one is different.

 

I like Wooster's advice of describing your symptoms and letting your doc pick the med.  That will give him/her the message that you are looking for symptom relief, not a high.

 

I wonder if something could be done with your Saphris dosage as that could be slowing you down a bit.

 

I hope you find something that works.

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CrankyMe, well said.

Here's my opinion.

 

I was taking Xanax 0.5mg twice a day with 2 0.5mg tabs for emergencies (dentists, clowns, y'know...) and easily switched to Klonopin 0.5mg twice a day, but my pdoc (who I switched to after the old pdoc retired, he changed the Luvox to Lexapro and he's much more useful and kinder than the old one) put in a mid-afternoon dose but I don't take it very often. My pdoc knows this. Honesty is important in the relationship. (My old pdoc would make me give him extra leftover meds at appointments, but this one says to keep it just in case. Yes, my old pdoc was err. different, and an ass. He retired.)

 

Xanax kicks anxiety really fast. Some people get euphoria at first, even with low doses. I was just loopy on day 1, then adjusted. It is a higher abuse potential than other benzos and has a bad stigma, unfortunately. It's a better PRN drug than a medication you take the same time daily, as it has a short half life and fast kick in. I never got dependent on it, and I didn't have trouble lowering doses except a bit more anxiety for the first couple days, but nothing serious. Both of my pdocs know of my hard drug abuse in the past.

 

Klonopin is longer acting, doesn't have the Xanax 'zing'. Ativan is a decent PRN if you need one, the sublingual tabs work quick (Hint: If your insurance doesn't cover sublinguals, regular ativan can go under the tongue, it just tastes really bad). Discuss options with your pdoc. What about 1mg Klonopin and one dose of a PRN benzo? This is an idea, I can't prescribe and wouldn't if I could! Wellbutrin can cause some pretty nasty anxiety. It floored me, fucking Wellbutrin. It can help the flatness, but if it causes anxiety, well..

 

My pdoc did see me as being "jumpier" and upped my Lexapro to 30mg from 20mg, and proposed the Klonopin change, which I agreed with. I enjoy being able to discuss meds with my pdoc at great length. Try this with yours. You know yourself best.

 

Eliminating unhelpful meds can help. If you haven't tried CBT or DBT, I'd recommend them. CBT is better for anxiety, DBT is great for just plain life. Dr David Burns's CBT (Feeling Good Workbook) workbook helped me a lot. There are DBT workbooks, flash cards (I have "Retrain your brain" cards) You may still need meds, but that's not a big deal. Therapy can help you cope. A tdoc or a group therapy setting is also an option.

 

Wow, have I rambled on.. If lexapro isn't working, there is the possibility of Luvox which is older, similar to prozac chemically, but when I added it to Xanax, holy CRAP, what a difference.

 

You have lots of options. And lots of good minds here with great suggestions.

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