My doc won't let me have klonopin

[lilie]

This ativan runs out of my system so quickly that sometimes it's like it's not helping at all. My pdoc won't give me klonopin because she says it stays in the system too long and theres greater potential for abuse. I'd just like something that works for a decent amount of time. Should I dump her or is there some good way of telling her that the ativan just isn't cutting it?

Lilie

[groovyone]

I'm not sure if I'm understanding what your doc is trying to convey.  I don't think there is any correlation between the longer lasting effect of a benzo and abuse.  In fact, I would think there might be more of an abuse potential if the drug wasn't working as well as it should as someone might be more tempted to pop a pill more often than prescribed.

I would simply be honest and say that you don't feel the Ativan is working for you and why.  Or, maybe a dosage adjustment is in order? You don't say how much you are taking and when. 

Karen

[chimpmaster]

Ok, im going to take a guess here that your dr is either a GP or a more mature member of the medical community.

The reason I say this is that the info provided to GP's now a days is very much pro short acting benzos, primarily due to the legal issues that have arisen with constant valium use since the 60's.

Bottom line is, for most people, klonopin and valium are less addictive and more suited to regular use, despite their long acting nature.  You drop a pill in the afternoon and sometimes still feel it in the morning.

Atvian and xanax are often presctibed in response to anxiety and panic attacks which is why they are more likely to cause dependence, not to mention that with repeated dosing the half life can drop to 4 hrs.

So essentially with constant use of ther short acting benzos, you more commonly need regular dosing, and are more likely to become psychologically dependent as you take them in respone to an activity rather than to prevent it.

A lot of modern psychiatrists are moving back to valium and klonopin for constant anxiety issues.

[lei]

my experience, and my docs' opinions, match groovy and chimp's suggestions.

on xanax (short acting) i was on a rollercoaster, ever needing more, and living by the dosing clock.

on the longer acting benzos i don't feel that way, and am able to go about life in a more stable fashion. in fact with valium i've been tapering nicely.

hopefully your doc will be more flexible. if not, i'm all for shopping around. good luck and aloha.

[Jemini]

Klonopin is extremely potent compared to other benzos (10-40 times as potent as most benzos, along with Xanax and Halcion), and since it's half life is about half as long as that of Valium (diazepam) and because it is an anti-convulsant benzo, it is typically very hard to withdraw from after exposure for more than a month. The longer one's been on it, the more dependent the brain becomes, particularly with the anti-convulsant effects, and so breaking the dependency becomes a very difficult process, even compared to the other benzos. Psychiatrists specializing in benzo addiction and detox facilities will often transition people from Klonopin to Valium so as to have a drug that is easier to taper off of without ill effects due to ups and downs in the blood level.

The pinned topic has a lot of info, including a link to a paper on dependence. Here's a chart of benzo speed of elimination and potency:

http://www.benzo.org.uk/manual/bzcha01.htm#4

Current guidelines warn about physical dependency that occurs in *all* people if Klonopin is prescribed for more than 4 weeks; in much of Europe benzos are considered more dangerous than heroin. I sometimes wish my doctors had never agreed to my suggestion for the prescription. "Um, OK, let's try Klonopin, since you say it's worked for you in the past." Cut to 5 years later, as I am still trying to break free of the drug and regain my memory and clarity. Doctors should know better than this, but research shows that many don't.

[robotlove29]

Klonopin is extremely potent compared to other benzos (10-40 times as potent as most benzos, along with Xanax and Halcion), and since it's half life is about half as long as that of Valium (diazepam) and because it is an anti-convulsant benzo, it is typically very hard to withdraw from after exposure for more than a month. The longer one's been on it, the more dependent the brain becomes, particularly with the anti-convulsant effects, and so breaking the dependency becomes a very difficult process, even compared to the other benzos. Psychiatrists specializing in benzo addiction and detox facilities will often transition people from Klonopin to Valium so as to have a drug that is easier to taper off of without ill effects due to ups and downs in the blood level.

The pinned topic has a lot of info, including a link to a paper on dependence. Here's a chart of benzo speed of elimination and potency:

http://www.benzo.org.uk/manual/bzcha01.htm#4

Current guidelines warn about physical dependency that occurs in *all* people if Klonopin is prescribed for more than 4 weeks; in much of Europe benzos are considered more dangerous than heroin. I sometimes wish my doctors had never agreed to my suggestion for the prescription. "Um, OK, let's try Klonopin, since you say it's worked for you in the past." Cut to 5 years later, as I am still trying to break free of the drug and regain my memory and clarity. Doctors should know better than this, but research shows that many don't.

<{POST_SNAPBACK}>

Really? 

I thought Xanax was the most potent?  I know it has a MUCH shorter half life than Klon, but I thought it was stronger which is why it is usually prescribed as an emergency med or med for bad panic attacks......hmmm.......

[lei]

I thought Xanax was the most potent?  I know it has a MUCH shorter half life than Klon, but I thought it was stronger which is why it is usually prescribed as an emergency med or med for bad panic attacks......hmmm.......

yeah exactly, potent doesn't necessarily = longer lasting. while i prefer valium's endurance and ease of taper (i'm down yet another 2.5, yay!), in a sudden and extreme new crisis i'd rather pop a xanax.

[Jemini]

Xanax and Klonopin have the same "strength" when comparing benzos apples to apples, but different benzos of course work in slightly different ways, being different molecules. Klonopin, unlike Xanax, is an anti-convulsant, and has a longer half-life.

[Bianca]

I got rx Klonopin today.  I had to go to my GP for it.  My pdoc wouldn't rx it.  We both know that its my anxiety that causes depression and still she wouldn't budge.

[lei]

congratulations, Bianca.

may your quality of life be improved with this.

please keep us posted.

aloha

[2utopian]

After reading this thread, I think I need another Klonopin!  I have been taking Klonopin 1.0 mg/3 times a day since 1996.  At night I take 10 mg. of Temazapam and occasionally 30 mg. of Flurazapam.  I forget, did someone mention something about memory loss?

[Bianca]

Lei, do you take klonopin?  If so whats your dose.  My doc wanted to start me off at .1mg.  I was like wtf?  I had tried .25 and .5 before.  Once I said that he said I'll rx 1mg.  I figured I could split it up.  After the appt I took just .25mg and then 3 hours later took another .25mg.  I wanted to see how it would feel with the smaller dose and then add more to it.  I think I'll take .5 before bed tonight and see if it helps me sleep.  Any input?

[lei]

Lei, do you take klonopin?  If so whats your dose.  My doc wanted to start me off at .1mg.  I was like wtf?  I had tried .25 and .5 before.  Once I said that he said I'll rx 1mg.  I figured I could split it up.  After the appt I took just .25mg and then 3 hours later took another .25mg.  I wanted to see how it would feel with the smaller dose and then add more to it.  I think I'll take .5 before bed tonight and see if it helps me sleep.  Any input?

<{POST_SNAPBACK}>

Bianca, i take (and prefer, and am currently tapering) valium. but i have taken klonopin as well as xanax and just appreciate how a benzo can make a world of difference for many.

good therapy has helped me tremendously too, but i couldn't have functioned well enough to get there, or anywhere else, without the right meds.

in terms of dosage everyone is different. a quality pill cutter is your friend, so you can find the smallest amount that works for you. like everyone else here i'm not a doctor but it sounds like you're starting with small dosages, which is sensible. what did your doc prescribe? hopefully you'll be able to do that much or less, but let him know if it's not working. and us, too, we care.

[Bianca]

He rx me 1mg after I said .1mg was not enough.  He is my GP b/c my damn pdoc wouldn't rx it.  I don't think he specified how to take it but I figure .5mg before bed should be good.  I think if I need to take it in the am I'll go with .25mg since I don't want to get sleepy. 

[lei]

He rx me 1mg after I said .1mg was not enough.  He is my GP b/c my damn pdoc wouldn't rx it.  I don't think he specified how to take it but I figure .5mg before bed should be good.  I think if I need to take it in the am I'll go with .25mg since I don't want to get sleepy. 

<{POST_SNAPBACK}>

i'd never heard of anyone getting .1mg pills...

but anyway, though again your plan sounds reasonable, what is actually printed on the bottle, i.e. "1 pill once a day" (unusual for klonopin i think) or "1/2 pill as needed", etc?

[Bianca]

It just said take as directed with no instructions.  lol

I took .5 mg before bed and I passed out without my sleeping pill.  That made me very happy.  I also could still feel the effects when I woke up this am.  I popped a .25mg around 10am and I'll pop another .25mg around 3pm.

Seem reasonable?

[lei]

sounds great -- good coverage with minimal dosage. again i'm no doc but if this is what he "directed" (lol) and it works for you, hooray

[Bianca]

He didn't driect me thats the proble.  I think I'm doing pretty good at it.  .5mg knocks me out so I know I can't take that much during the day.  Since I took that .25mg at 10am I've been kinda feeling tired and a bit spaced out. weird

[Jemini]

Klonopin's elimination is slow enough that you're supposedly feeling the accumulation of the past day or two, but many people find that there are ups and downs from dose to dose. To minimize this, it can be good to spread doses evenly across either 16 waking hours or 24 hours if insomnia is one problem. So 3 doses would either be every 6 hours starting when you wake up, or every 8 hours, one on waking, one before sleeping, and one in the middle. 7am, 3pm, 11 pm, or whatever your schedule is.

One advantage to maintaining as even a level as possible is that you don't start learning to do certain things at that time of day when you're very relaxed and other things at the time when you're more awake because the sedative aspect of Klonopin is lower. On your schedule, you'd be making yourself less sharp until evening, when you would start waking from the Klonopin and might be inclined to keep going and not calm down to sleep.

Does this make any sense?

[Bianca]

Yes it does but what am I suppose to do, not take it during the day at all? I am taking it 5 hours apart.  10am, 3pm and 8pm.  By 10pm ish I'm ready to hit the hay

[lei]

just my doctors' opinions, and from my own experience.

everyone is different. certain times of day or night and certain situations might require more peak potency. and, some people eliminate it very quickly, while others don't.

if you're not sure what to do, or if you've found a way to divide that 1mg to live better but are not sure it's an okay plan, ask your doc. my hunch is he'll be okay with your plan, but you'll probably feel better confirming it. like, "the bottle says 'as directed', can you remind me what that means?" or "the bottle says 'as directed' and [the schedule that works for you] is working for me, is that okay?"

my unofficial opinion is that if someone is sticking to 1mg/day and dividing it so neatly and keeping such careful track, it's probably not a concern.

but call the doc. may you live well, breathe deeply, and have this resolved soon

[Bianca]

Thanks for all your help! 

[lei]

you're welcome  B)

[HyperInHell]

Do what I did. Find a new pdoc.

[Bianca]

I have an appt with my current pdoc in 12 days.  I'm going to have to tell her I went behind her back and got klonopin.  I bet she won't be happy.  If she isn't then when I see my GP early Jan I'll ask for a new referral.  Hopefully she won't be too upste.  So tell me whats the best way you all dose.  I am taking .5mg before bed, wake up and take .25mg (6:30am) , its now almost 12pm, should I take another .25mg or wait until later....

B

[Jemini]

Space it out evenly, or skew it towards nighttime for help sleeping, and pay attention to how it affects you. No one can tell you how you'll react.

[Bianca]

I guess I was more so wondering if .5mg puts me to sleep at night then it will probably do that to me at work as well...

[Jemini]

No. Asleep is asleep. It's not like a sedative, though it has some "sedative effect".

GABA, the primary neurotransmitter affected by Klonopin, plays a strong role in regulating the levels of all transmitters and thereby affecting electical levels and general arousal. Anxiety is one form of over-arousal of the brain, or it might be better to say anxiety is one thing that can cause over-arousal of the brain. Nerves are firing more frequently. This can lead to more competing thoughts, push someone towards seizure activity, and can be experienced as a higher noise level. Not audible noise (though this can happen), but just a background mental and emotional noise level.

When we go to sleep, many transmitter levels change and lower arousal in the brain. Melatonin is thought to be a primary hormone/transmitter regulating this process. It lowers sensory input levels like a volume knob, slows electrical brain wave patterns so that thoughts are slower and gradually become more harmonious with the rest of the brain. If anxiety or high noise levels in the brain are contributing to trouble sleeping, Klonopin can make an enormous difference. It doesn't knock you out at all (at the right dosage levels), but it allows melatonin to do its thing better at night. (While you sleep, melatonin is metabolised and used to produce serotonin, which is one way sleep is very directly implicated with depression.)

Taking Klonopin in the day may make you slightly less active mentally, but it shouldn't make you sleepy. Mileage does vary though. In particularly, if you're chronically not getting enough sleep and only your anxieties or sense of responsibility is keeping you up and about, Klonopin may make you more likely to cave in and catch up on sleep you actually need, and so could make you sleepier in the daytime in that sense.

Am I making sense or rambling?

[Bianca]

You're making alot of sense.  I'm gonna try the .5mg and see how it works today.

Thanks a bunch!

[Jemini]

If you really went on this without a psychiatrist's approval, you owe it to yourself to read up on the difficulties associated with getting off benzos. Klonopin is particularly hard to kick, and it's not fun. Many doctors don't worry their patients about this (I've had a couple doctors who had no idea how serious the dependency issue is).

There's info about this in a sticky-posted topic.

[Bianca]

Yeah I've read alot about it.  But what else can I try for my anxiety?  I took 1mg today and I feel fine.I am notifying my pdoc next Tues when I see her.  I'm sure she won't be happy but I haven't slept so good.

[Breeze]

But what else can I try for my anxiety?

Well, are you in talk therapy? Do you meditate? Do you exercise regularly? Have you looked into alternative ways to cope with your anxiety?

Your p-doc may have been doing you a favor. Jemini is right on the money - this is a very tough med to come off of.  I have quit smoking and I have had to go cold turkey without klonopin for a few days. The smoking was easier.

Breeze

[Jemini]

Best thing for anxiety is (sincerely) a combination of

- proper sleep

- good nutrition

- daily exercize (doesn't mean a workout, just getting physically active)

- talking out or writing out the things you're anxious about (or less verbal creative stuff, particularly if you have no idea what you're anxious about)

- taking steps to address the causes of anxiety

If anxiety is debilitating, these things will help but may be hard to do, in which case a pill may help reduce the anxiety but you need to then get on these things, especially the last two, ASAP.

There are also a lot of specific foods that help with anxiety. Adjusting your diet can help. I keep sending people to http://www.whfoods.com

The Path To Tranquility, by the Dalai Lama, lives up to its title.

[Bianca]

I have been seeing the same tdoc for years over my pdoc.  She is great.  She was the one who suggested klonopin.  She said she had many agorophobes and others with similar disorders and then completely came out of their shell.  This anxiety comes when when I was a young shild and it went undiagnosed until now being 30.  I grew up as an athlete but that still didn't help the anxiety situations.  I think if I can take one or two klonopin a day I should be fine.  I do NOT have an addictive personaltiy.  I quit ADs and other things cold turkey with no side effects at all.

[Breeze]

I do NOT have an addictive personality.  I quit ADs and other things cold turkey with no side effects at all.

I don't have an addictive personality either. But coming off of Klonopin, cold turkey, was one of the worst things I have been through. I don't care how strong you are, what your resolve is, or what your history is: this stuff is highly addictive and it's a bear to come off of. And I am still on it - very carefully.

Breeze

[Libby]

I have been seeing the same tdoc for years over my pdoc.  She is great.  She was the one who suggested klonopin. 

It's completely inappropriate for a therapist to suggest medications. 

[Bianca]

I know... she was speaking in reference to patients she has seen over years and seen the progress they have made.  I'd almost rather her word over the pdoc.  The pdoc she's you in like 5 min and pushes you out the door.  My tdoc spends a full hour and we discuss everything that is going on.

[Jemini]

Hold on -- it's completely inappropriate for a therapist to suggest medications, but it's appropriate for people who you've never met to suggest medications on the internet? I've had so many people tell me what meds to try, and half the topics here seem to be all about people suggesting medications to each other.

[Breeze]

Hold on -- it's completely inappropriate for a therapist to suggest medications, but it's appropriate for people who you've never met to suggest medications on the internet? I've had so many people tell me what meds to try, and half the topics here seem to be all about people suggesting medications to each other.

That is a little different. I mean really. Here, at least I try and suggest to people (like you) what is working for me so that they can research it. NOT go to your p-doc and say "hey someone on the Internet said this would be good" vs your T-doc who is someone you are paying to see.

This is wonky.

Breeze

[groovyone]

Hold on -- it's completely inappropriate for a therapist to suggest medications, but it's appropriate for people who you've never met to suggest medications on the internet? I've had so many people tell me what meds to try, and half the topics here seem to be all about people suggesting medications to each other.

<{POST_SNAPBACK}>

Yeah.  And we are not professionals.  Granted, neither is she...at least not medically speaking...or who knows? Maybe she is and we just don't know? How many degrees does she have on her wall, Bianca? And in what disciplines?

Okay, I'm being silly.

I'm going to speak in defense of the therapist as I'm sure she was just trying to be helpful.  Personally speaking, I know my therapist would never make recommendations about meds because she just does not have the knowledge.  When I blather on about what I know of them that's the end of the conversation.  For her, she's not interested.  She keeps track of what I'm taking but she realizes it's not part of what she does.  Maybe for other threrapists, there is more of an interest in the pharmaceutical profile of their patients/clients.

But I've never been a therapist...don't know all the ins and outs of the job.

And for what it's worth, if it could be helpful then why not discuss it in therapy? Even it it is about meds? Maybe I'm just really open minded about therapy...I don't know.

Okay...going off on tangent.

Karen

[lei]

prescribing is not the same as talking about.

one of the best sessions i ever had was when i was talking about my meds and my therapist responded how the more i'm healed the less i'll need them. and it's been true. the basis of our relationship is trust, and i can talk to him about anything, thank goodness.

i also don't see a problem with "some of my patients with this condition find this useful, but you can talk to dr. B about if it's right for you." he also suggests yoga and books and massages and salt baths and things that may or may not help.

furthermore my prescribing DO has actually asked me how my therapist feels about our med plan.    not that he'd follow him blindly, but because he knows i spent an hour or more each week with him for a year so he really knows me, and he really knows his stuff in general, and it would simply be food for thought. and i like that they would work together, with my permission.

i didn't quite finish my PhD in clinical psych but -- short of prescribing -- i've never heard of a sacred line of this nature. i've talked to my therapist about my vagina, i've had to talk to my gynecologist about my meds, i'm one person with a lot going on, it's okay.

[Bianca]

She was just telling me about a few patients she saw one in specific who was agoraphobe after she started taking klonopin she's actually a normal person and now travels.  Now that to me sounds very promising

[Jemini]

What?

[Bianca]

Anyway, I had an interview today.  About 1.5 hours before I took 1mg klonopin.  Man was I just feeling great.  Not nervous at all.  I can win these people over so easily

[Breeze]

Yeah it's pesky me again.

About 1.5 hours before I took 1mg klonopin.

That seems like a pretty high dose for just starting out with Klonopin. And what are you going to do when you get the job? How much will you require then?

Those of use who have been on this med, again, know it's addictive quality You don'tseem very aware of this, and are almost giddy that your interview was cake because of the klonopin. At least that what it sounds like.

Maybe you actually deserve the job.

Breeze

[Jemini]

Well just to say, I had the same experience with Klonopin, When I went on it, EVERYTHING was better from day one. I could focus better, organize things, was more outgoing and social, and really my social life took off and my work performance improved. For a while. After a year or more, I was occasionally getting into very anxious hyper states because I'd missed a single .5 mg dose (I was on 1.5-2.0 mg for most of the last 5 years). I'd be impossible to calm down, and would not be able to stop conversations or get to sleep. At work I wasn't so focused anymore, and anxieties were creeping in the corners of my mind, but when I took my pills very dilligently at the exact times of day, I was basically OK. 18 months later, panic attacks had returned, I was very anxious, plus I'd drifted into deep depression over my job (which was itself extremely isolating and not a good work situation for other reasons). I was prescribed some other meds at this point, but the Klonopin wasn't stopping the anxiety and worry anymore, and doctors wouldn't increase my dosage, saying I'd been on it too long and they were worried I "might become addicted". Well, in fact, I'd become physically dependent and built up a resistance to the anti-anxiety effects, as will happen within a few months to a year for most people. Now, almost off the damn pills finally, I am worried about things but I have adjusted my lifestyle significantly since I started Klonopin 5 years ago, and am physically healthier too, so no panic attacks yet. I'm socially isolating, but part of this is lack of money and only working with one other person, and I am finding it easier to connect and be, if not outgoing, emotionally connecting and in good humor with people when I do go out. I've got a lot to re-learn without the drug I think, but I'd much rather learn it than deal with Klonopin further at this point.

[Bianca]

Thanks for the input guys.  Saw the pdoc today and she said she would not rx me klonopin.  I'm dropping Cymbalta down from 90mg to 60mg.  Then in Mid Feb I'm going to taper off and back on to Prozac.

[Libby]

Thanks for the input guys.

[Libby]

Just scrolled back and saw this:

Hold on -- it's completely inappropriate for a therapist to suggest medications, but it's appropriate for people who you've never met to suggest medications on the internet? I've had so many people tell me what meds to try, and half the topics here seem to be all about people suggesting medications to each other.

Hello?

[Bianca]

Thanks for the input guys.  Saw the pdoc today and she said she would not rx me klonopin.  I'm dropping Cymbalta down from 90mg to 60mg.  Then in Mid Feb I'm going to taper off and back on to Prozac.

<{POST_SNAPBACK}>

What are you doing about the Klonopin?  Why the change back to Prozac?  Is the Cymbalta too activating?

<{POST_SNAPBACK}>

Well I'll see if my GP will refille my rx.  I don't think what he rx me will last the 30 days.  Maybe just a few short.  I'm going to get a referral to another pdoc to see what they think.  I don't think the Cymbalta is making me feel that great.  I'm at least dropping from 90 to 60mg since I'm taking the k now.  We only upped it to get rid of the anxiety I still had.

[Bianca]

I love my tdoc.  She has been telling me to try k for a while and she was right.  It works wonders for me.

[Guest FrannyNZooey]

Wow, when I read your part about taking the 1mg prior to job interview, how great feeling.

Just took me back to time when very rough, took on some exta summer courses at Purdue for program I was running. Thought I was going to do it, after the worse period of my life happen.

Because I had to, I could not stop.

And I was still managing my 1 mg of Klonopin, you went so quickly from doing that, to not.

Well guess about 3+ years later still on 1 mg of Klonopin at bedtime. I am no longer wanting to fight.

More happen in life, bam, bam, bam, and I kind of gave up last summer. Last Fall on therapy even.

Klonopin, is so draining, depressing, but Hell got to leave to go talk to make change.

I want to change to valium, maybe Lexapro 10 mg will work better again.

Just be Careful.  Even wonders cease to work.

Aly

[Bianca]

Hi Aly,

I'm kinda confused about what you wrote maybe its just me

[Guest FrannyNZooey]

You started saying you were taking .5@ bedtime, and dividing the other half in .25 doses BID during day.

Shortly later read of job interview and your taking the whole 1 mg prior.

Just seem like big warning flag, and took me back to my start with Klonopin, but I kept with the dividing plan in beginning years.

Then Hell just needed for bed. I never needed to increase either, probably since was too much for me at start.

Just very draining drug, it causes depression amongst many after first big sigh of relief, which it did to me. the depression hangs, relief does not come back, at least not for me.

Hope that made more sense.

Just really read up on it as suggested by others.

As, said I really need to make move to get off of it.

I have tried to cut dose in half at bedtime, but toss turn so much till middle night, dawn, take other half. Why believe Valium would help to get me off, this, since seems too hard for me on own.

Just lot of other not so good things going on for me.

But most likely they would have been, and would be handled better without Klonopin as it is "working" for me now.

Sorry if I rambled too much without enough detail of me in last post.

But this is about Klonopin.

And hopefully explain my experience with it.

Aly

[Breeze]

Well I'll see if my GP will refille my rx.  I don't think what he rx me will last the 30 days.  Maybe just a few short.

And NOW you aren't even getting through the FIRST MONTH on what you were prescribed. I guess we are all wrong though.

Breeze

[Guest FrannyNZooey]

Well I'll see if my GP will refille my rx.  I don't think what he rx me will last the 30 days.  Maybe just a few short.

And NOW you aren't even getting through the FIRST MONTH on what you were prescribed. I guess we are all wrong though.

Breeze

<{POST_SNAPBACK}>

Had to hop on your post Breeze. I just got done reading Jemini's thread on Klonopin. This drug is so serious. It really brought such emotion to me, real emotion that I have been trying to block out for quite a while now.

As Breeze know's also I have use alcohol in past also, after being on Klonopin. It was not me. So many things were not. This stuff should have warning "Beware, can change you and your Life".

Yeah, at first it was all good, till it all comes falling down. And it will, and Klonopin, surely just like that glass of wine, or cosmo martinni is not going to pick it all up again.

I did always have my rx make it, if anything when real down had extra because forgot to take, due to passing out. I know that is quite lovely.

Like Jemini, I do not want to me around the noise, but I do want to be around, just around.

We only got one shot at this great journey, and I think we do need to be more of a true participant in it.

That means taking responsibility for our getting the right help we need.

So, tomorrow Breeze, promise calling doctor, therapist, prior to leaving for shopping, and while in car.

I will leave messages everywhere, till I have an appointment!

Love, Aly

[lei]

just in case i confused anyone, i posted something, but deleted it because i feel it will be more appropriate in another thread. please never mind. aloha.

[robotlove29]

Just scrolled back and saw this:

Hold on -- it's completely inappropriate for a therapist to suggest medications, but it's appropriate for people who you've never met to suggest medications on the internet? I've had so many people tell me what meds to try, and half the topics here seem to be all about people suggesting medications to each other.

Hello?  A therapist is a paid professional with standards and guidelines for ethical behavior.  Part of what they're paid for is to have clear, ethical BOUNDARIES.  It is not a therapist's place to recommend meds.  Period.  Too many therapists have wavering boundaries and narcissistic tendencies, and these qualities ultimately damage their clients.

<{POST_SNAPBACK}>

I just wanted to say that I WANT my therapist to suggest meds.  I mean, she sees me twice a week so she knows pretty much every little thing thats going on inside my brain.  I find her suggestions are pretty right on the money too.  She works with my Pdoc to try and help me the best they can.  In anyway, it's ultimately up to myself and my Pdoc what meds I take, so I don't see the harm in these recommendations.  Additionally, like I said, thus far she's been right on the money more than once.  Oh yeah, and I do post on these boards and constantly ask for anecdotal experiences with meds AND even ask for recommendations.  That's why I'm here!  I don't know, maybe I'm just rambling, but I still think that in the end it's up to Pdoc and me so I feel like all the stuff I absorb on these boards have helped make my problems much better then they would've been if I were on my own......just my 2 cents.....

[Bianca]

I don't know I fee really good on the klonopin and I've decreased my Cymbalta.  The Cymbalta was starting to incr my bp.  I figure if I knock back to 60mg from 90mg I should be ok.  Then I may do the big switch back to prozac and can get off the klonopin all together.  There are times when I don't take it and I feel just fine.  I've basically bumped up to .5 mg whenever I do take it.  I take it before bed and when I wake up.  I have another interview tomorrow so I think this time I will just take .5mg.  The 1mg made me feel fine.  I just get so freaked out on interviews and stuff like that, that for once I wanted to feel calm, cool and collective.

[lei]

robotlove,

yeah that's what i was trying to say in post 42. but you did it more eloquently. thank you.

and i still haven't found any professional reference to this alleged boundary, short of prescribing, which is of course another story (unless someone's tdoc is also an MD. which is sometimes the case!)

[Libby]

Just scrolled back and saw this:

Hold on -- it's completely inappropriate for a therapist to suggest medications, but it's appropriate for people who you've never met to suggest medications on the internet? I've had so many people tell me what meds to try, and half the topics here seem to be all about people suggesting medications to each other.

Hello?

[Bianca]

I don't agree that they always have to work together.... my tdoc knows my life my pdoc doesn't.  tdoc has seen many individuals on a very regular bassis and always see's how the meds are working.  pdoc maybe once a month maybe twice a year and they push you out the door in 15 min

It drives me nuts.  Everytime I suggest anything she always disagrees urgh...

[Jemini]

Libby, what is your hang-up with therapists sharing their knowledge about meds? It's not like you can then just go take whatever they recommend without a psychiatrist, and therapists often know a lot about medications. You make it sound like psychiatrists are all-knowing beings and everyone else should have no opinion about meds.

[Penny Century]

Yeah I've read alot about it.  But what else can I try for my anxiety?  I took 1mg today and I feel fine.I am notifying my pdoc next Tues when I see her.  I'm sure she won't be happy but I haven't slept so good.

there are actually a lot of other options out there for anxiety other than klonopin and benzos in general.

firstly, many people do well on specific SSRIs, paxil for instance, helps a lot of people with generalized anxiety.  so can lexapro.  (whereas some people find prozac too activating and find it doesn't help with anxiety... of course everyone is different and prozac helps some people, etc.)

also, a lot of doctors use low dose antipsychotics for anxiety.  many people find a low dose of somethign like seroquel or risperdal to be just as effective as a benzo, but without the tolerance and addiction issues of benzos. 

some doctors and patients find neurontin to help with anxiety, some use beta blockers...

i am not anti benzo use... but there are MANY other options out there for anxiety, the list is much much longer than what i've written above.  MUCH longer. 

I don't know I fee really good on the klonopin ...  There are times when I don't take it and I feel just fine.  I've basically bumped up to .5 mg whenever I do take it.  I take it before bed and when I wake up.  I have another interview tomorrow so I think this time I will just take .5mg.  The 1mg made me feel fine.  I just get so freaked out on interviews and stuff like that, that for once I wanted to feel calm, cool and collective.

It just said take as directed with no instructions.  lol

I took .5 mg before bed and I passed out without my sleeping pill.  That made me very happy.  I also could still feel the effects when I woke up this am.  I popped a .25mg around 10am and I'll pop another .25mg around 3pm.

Seem reasonable?

there are a couple of things going on here that are setting of penny warning alarms.

if you are having a hard time establishing a good dynamic with your pdoc, by all means seek out a different psychiatrist.  but it's not a good idea to go behind your pdoc's back and to get another doctor to rx a med that he/she refuses to give you.  it is unfair to you and to your doctor.  you may disagree with your pdoc's decision, but he didn't do it to be mean, he did it because that is what he thought was best for your health.  it is not in your best interest to hide medications from your pdoc, and it is not in your best interest to get psyc meds from your gp.

as you mentioned, you gp clearly did not fully understand klonopin if he did not give you instructions on how to use it. 

finding the correct dosage of a medication is something you do in conjuction with your doctor, not by "popping" different doses until you find what you think feels right.

one of the reasons why some doctors do not like to rx meds like klonopin is because people build up a tolerance to it.  by essentially self-medicating and experimenting with different dosages, you are increasing your risk of building up a tolerance.  if .5 mg was what you were rx'd, then you should take .5.  deciding to double your dose increases the risk that .5 will no longer work for you and you will need 1 mg every time. 

also, if you mess with your dose like this, and run out before your next refill, you run the risk of going into withdrawl.  benzo withdrawl isn't something you can just tough out that sucks.  it can be dangerous.  this is why when people go off of benzos they slowly taper down, because comming off benzos doesn't just cause rebound anxiety, it can also cause serious physical problems like tremors or even seizures. 

i'm not trying to tell you that klonopin isn't the right medication for you. 

but the way that you are going about taking it is not healthy at all.  you need to work out the amount you take and how often in conjuction with a psychiatrist. 

[Bianca]

I did tell my pdoc that I was rx it.  I am also seeing a new pdoc this sat am.  I was written 1mg pills.  I would suspect that meant take 1mg before bed.  I decided to split it up.  I don't see anything wrong with splitting the dose.  One at night and one in the am...

[Breeze]

I don't agree that they always have to work together.... my tdoc knows my life my pdoc doesn't.

Well then it will be much harder to get anywhere. If you want to get better, and I assume you do, then I would think you would WANT them to work together. Especially if you have the arrangement of seeing your p-doc for only 15 minutes. If your p-doc and your t-doc had a working relationship, concerning you, then you might get somewhere faster.

As it is, and it has been stated here, you are calling your own shots. Unless you have been to med school, this is a really dangerous and bad idea.

But it's your life and ultimately up to you.

Breeze

[Libby]

Libby, what is your hang-up with therapists sharing their knowledge about meds? It's not like you can then just go take whatever they recommend without a psychiatrist, and therapists often know a lot about medications. You make it sound like psychiatrists are all-knowing beings and everyone else should have no opinion about meds.

Jemini, if you don't get it, you don't get it.  I already explained.

[Bianca]

I don't agree that they always have to work together.... my tdoc knows my life my pdoc doesn't.

Well then it will be much harder to get anywhere. If you want to get better, and I assume you do, then I would think you would WANT them to work together. Especially if you have the arrangement of seeing your p-doc for only 15 minutes. If your p-doc and your t-doc had a working relationship, concerning you, then you might get somewhere faster.

As it is, and it has been stated here, you are calling your own shots. Unless you have been to med school, this is a really dangerous and bad idea.

But it's your life and ultimately up to you.

Breeze

<{POST_SNAPBACK}>

My pdoc didn't really respect my tdoc's opinions.  And she would not regardless of how well it helped me to rx it.  She'd rather me just keep having panic attacks and not help me

I went and saw another pdoc who was the first one I ever saw which was 1.5 years ago.  He spent about 1 hour and 15 min with me going through what had all happened since he last saw me.  I did drop my Cymbalta down to 60mg from 90mg and I feel the same.  My pdoc suggested that would be fine and if I still wasn't ok with Cymbalta that she wanted me to taper down at the ned of Jan.  The new pdoc felt that I was fine.  I'm not depressed hence the meds are working.  I also felt that by decreasing the C from 90 - 60 that would lessen the effect on increasing my bp.  So he decided that I do need to be on Klonopin and that he wanted me to take it on a regular basis for the next month and then to come back in and discuss how I felt.  Before I was really taking it slow with the dosing and on the weekends I wasn't even taking it.  I had withdrawal symptoms at all

[groovyone]

Bianca, I think what Breeze was more concerned about is that no professional has still given you proper instruction on how to take your Klonopin and that's not really helpful or wise to you.  Patient directed pill taking is not always the best solution unless the drug has actually been prescribed prn.  From what we've read here, it doesn't sound like it has as you have come back here repeatedly asking how to take the drug.

I guess I just don't understand how so much attention could be paid to the Cymbalta and yet the Klonopin should be taken "on a regular basis" but with no mg dosages given.  I'm sorry but that is either irresponsible, illogical or both.

Forgive me if I am sounding firm but it just comes from a place of concern.

Karen 

[Bianca]

You must have miss read my post.  I decided with my old pdoc that I'm decreasing Cymbalta from 90mg to 60mg b/c I'm eventually going to get off it unless the 60mg feels good.  I go in for surgery next week so I'm not starting anything until the healing process is over.  I went to see my new pdoc who I had seen over 1.5 years ago.  He's right by my house and that makes more sense to me.  He did write the rx on Monday the 26th.  Take .5 mg before bed and .5mg around noon ish.

So he did give me an actually dosage on how to take it.  I'm not self medicating.  The one who didn't give directions was the GP not pdoc.  I went to the pdco for the refill so he could tell me what and how to take it.

B

[groovyone]

You must have miss read my post.

[Libby]

So he decided that I do need to be on Klonopin and that he wanted me to take it on a regular basis for the next month and then to come back in and discuss how I felt.  Before I was really taking it slow with the dosing and on the weekends I wasn't even taking it.  I had withdrawal symptoms at all

Actually, you said that you had increased from 1mg per day to 1.5mg per day in the first week--in case you forgot.

[solstar]

my doc won't prescribe any benzos

[Bianca]

I did increase but it was only b/c I had interviews.  And OMFG it helped.  I got offered the best job possible just a few hours after the interview.  I guess the 3/4 before me didn't impress them enough.  But now I'm regularly on .5mg before bed time and .5mg about 12 hours later. 

I actually don't have to discontinue my meds for surgery.  The only thinkg I have to stop is the klonopin b/c they're going to be giving me valium.. so I'll still have something sismilar in my system.  Wish me luck, surgery is tomorrow in the afternoon

[Jemini]

Good luck!

[Libby]

Wish me luck, surgery is tomorrow in the afternoon

Best wishes with your surgery!  When will you be able to check in with us?  If I don't know, I might worry!

[lei]

hey Bianca,

good luck from here too.

i recently went through major surgery. i got to take my last valium the night before and they gave me verced (sp?) which is another benzo, through my IV, before/during/after until i could be on valium again.

docs can be so different. the first ob/gyn wanted me to suddenly stop my valium 48 hours before (my DO threw a fit about that) but the good one i found understood. i was glad i worked it all out with her in advance, and that the hospital staff was ready for panic attacks and stuff.

breathe deep, keep us posted. swift healing and much aloha. 

[Bianca]

Made it thourgh surgery great.  I stopped taking the klonopin a day before and just started back up on it yesterday.  Man the drugs they gave me for suregery were focking awesome.  It took me an hour to wake up and when I finally did it was like I was on a coke high that lasted for a log time.  I couldn't stop talking to the nurse... I felt so good.  :rofl:

[Bianca]

So when I was off the K for at least a week I never got an withdrawal effects.  Is that normal or does it take longer?

[groovyone]

So when I was off the K for at least a week I never got an withdrawal effects.

[Bianca]

I've been on it for over 2 months now.... I guess at that point it was about 2 months

Who's the guy in your sig.  I use to watch those videos all the time and for the life of me I can't remember what it was