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I broke down and finally went through with it thoroughly to see a Tdoc then a Pdoc last year and since then have tried quite a few different meds for my Dx (see signature below).

Just a few months back my Pdoc went on maternity leave (while I was just given the Buspar to try) and was assigned another Pdoc while she was away. When it was time to go back I went in and told him what issues I was having with the Buspar and he Rx'd me the Clonazepam (0.5mg 3x daily) to try. It did work for awhile. My regular Pdoc came back, she seen what I was on and pretty much said she didn't like the idea of anyone being on it & how it was addicting, etc. She asked me if it helped, I said "Yes" (was too afraid at the time to say that it worked well for awhile but not as much anymore in fear she would change it to some other Rx) and she also asked if it helped with my sleep as well, of which I said "No" (because it didn't) and she gave me the 15mg daily of the Mirtazapine for sleep. Found out that 15mg makes me way too groggy the next day, so I just take a sliver of it each night (probably a mg or 2) and it works great like that.

But back to the main issue at hand, the Clonazepam... it worked for awhile but not-so much now, but I am afraid to bring it up to her. I don't know what I should say to her, I've just been telling myself that I'll go in and act like everything's hunky-dory and working great but I hate that I am feeling the way I do (luckily not as bad but still).

What should I do?

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I think it is best that you are honest. You don't want to get into a situation where you say nothing but take more than you are prescribed and run out before the month is up. That would really be bad and would throw up a red flag to your doctor. Better to be honest. If she takes you off it, it really isn't a big deal if it isn't working. Is it? Why do you want to stay on a med that is no longer working?

She may surprise you and up the dose, but if she already is anti-benzo then be prepared to be given an antidepressant or antihistamine to combat the anxiety.

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I definitely don't want to go back to useless antidepressants after finding something that actually helps and I don't mind being on such a helpful substance. So I'd prefer to stick with what's working even if it requires larger doses.

I still have been only taking it as Rx'd, I haven't ever tried upping the dose myself to see if it would help. I don't want to end up running out & needing 1 or throw up any red flags. I just don't do things like that.

That's the thing- it did work for awhile, life felt pretty normal. Had ups and downs but they would've been worse without it & definitely not as often as before.

The last time I went in she did also Rx me the Mirtazapine for sleep (which is also an Antidepressant). Though I can't take it as fully Rx'd, 15mg just makes me way too groggy and lethargic the next day.

 

 

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I agree with jt.  Be honest with your pdoc (psychiatrist).  I would not go in and act as if nothing is wrong.  If the klonopin isn't working anymore, maybe you could ask to try to wean down off of it (with pdoc's approval), so eventually you would not need it anymore.  If it doesn't work, why take it?

Also, does your pdoc know about the mirtazipine and cutting the dose every night?

 

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The reason I would like to stick with it is because it did in fact work, still does but just not as effective as before. As I am sure you know a tolerance is built to this drug so it does require larger doses over time, that's the issue. That's why I want to continue taking it but at a possibly higher dose as per common practice. That's what worries me concerning communicating my issue with the Pdoc and her perceived feelings over this type of drug.

I haven't seen her yet since the Rx of Mirtazapine to let her know I have been having to cut the dose. Though I don't know if I should worry about bringing that up, I figured out what helps me sleep which was the sole purpose of that Rx.

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Well, if you aren't honest and she does not up the dose, then you will build more tolerance and the drug will be useless. You really have no choice but to be honest. No sense taking a med that's not fully working.

As to the mirtazapine, you do realize that the daytime sedation goes away after a week or two? In essence, you build a tolerance to the really strong sedation, but it still works to sedate you at night. It's a good med that I also take. I can even take it during the day now because I'm used to it.

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As I am sure you know a tolerance is built to this drug so it does require larger doses over time,

You're right, tolerances can be built.  But that can happen with any med.

I have been on klonopin at a total of 1 mg a day (0.5 AM/0.5 PM) for a long time.  People don't always build up tolerances, needing more and more over time (to an extreme amount).  You might need an increase at times, but it doesn't mean you'll continually need an increase.  There comes a point where you don't need that increase.  Every one is different thought, YMMV.

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I take 2mg of clonopin nightly. I don't feel any difference if I take them or not.  My pdoc had me start taking them on my last mania. Not sure why.

 

That has happened to me ... where I thought a med wasn't doing anything/making no difference.  Then I went off of it, got worse, and realized that it was helping.  I just hadn't realized it.

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I am on 2mg Xanax, 1mg PRN, and have been at that dosage since 2006. I haven't had to raise it. While it is true that some people do have to raise their dose, your experience is not universal.

I'm just a little concerned about sweeping generalizations about benzos.

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  • 6 months later...

I'm back. Still alive and still a guinea pig.

A few med changes since I posted last- all in my signature (I think I have it updated with everything, will have to check sometime).

Have had a few health issues since February (ear- can't hear & pain & pressure in left side of face & neck, and a couple of random outbreak of hives) have seen a lot of doctors since February over these & of course all diagnosis' and the meds they gave to deal with it (steroids, antibiotics, antihistamines, etc) and have been super irritable.

Had to cancel my February appt with my Pdoc because I didn't feel well (with the whole ear thing) and just didn't want to deal with it. So they rescheduled it for today (3/30).

NOTE: I HATE Dr appt's or really anything to do with Dr's. And I told this to my Tdoc during our first few sessions. Though I no longer see her,as I told her that anything Dr related gives me horrible anxiety and I didn't need therapy as I know what's wrong with me and laid out my plan to her, that I have my own forms of therapy that if I can just get past the anxiety and get out of the house then I can start on my own path. I know what I use to be able to go out and do and enjoy it... I don't enjoy sitting in a room with someone just talking about it, seems to bring more anxiety for me.

 

Went in & told my Pdoc what has been going on- the ear thing and how it's elevated my anxiety and panic attacks. I finally got a referral in February for the Ear, Nose, Throat Clinic but they are backlogged until the end of May... so have to deal with the whole ear thing until then. And then when I broke out in hives for no reason (2x so far) it got worse, as when it spread to my face & my face swelled up, I freaked out about possible asphyxiation trying to get to Urgent Care as fast as I could. And how I have had it with Dr visits lately, that I just can't handle it anymore and need a break. So instead of seeing her every month she has given me every 2 months now.

Told her that the Effexor wasn't working at all. And that (from I believe the steroids that) my Remeron is no longer really helping with my sleep either. And my Klonopin helps a little but not as much as it use to. So she Rx'd me Neurotin 100mg 2x daily, And said that it wasn't FDA approved for anxiety but it has showed to work. She said she reviewed my file and that I have "supposedly" been on everything she can think of and if this doesn't work she doesn't know what else to do, that we might have to get a 2nd opinion on this. I dunno what to do if this doesn't work, as she made it sound like I am just crazy.

 

I took my 1st Neurotin a few hours ago and can notice a mood lift but that's about it (Pdoc did say she was starting me on a low dose). But with my whole ear thing (it's really annoying- deaf, numb, pressure, pain on the whole left side) it might be cutting into the effects of the Neurotin.... I dunno.

 

Well that's what's been going on with me lately. 1 day I may feel alive.

 

Edited by Mud
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I am sorry about your ear.  That sounds rough.  I would probably feel like you do like with that issue causing increased anxiety and panic attacks.

Can you call and ask to be put on a cancellation list?  May is a ways away.  I think it is worth a try.

 

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I can really relate to being nervous about asking to increase doses and the mine field that Benzos have become with some of our doctors.  I think you have to be honest (All the time) with the doctors or you will not be getting their best.  The first Benzo I took was valium and I started at ah... 1 mg?  or it might have been 1/2.   Anyway it did nothing.  1 mg and 2 mg did nothing.  It only started to be noticeable at 5 mg and that was not anything like ZAM I'm vegged out and I can be on fire and not care it was just a subtle calmness type of thing.   As in I'm spazing out having a pani attack and I took a 5 and gradually the "whats that?!?!   Buuuurrrrr" crap with the heart pounding just suddenly was a problem.  I mean a subtle change that I had to pinch myself.  I really was having a panic attack.  Right?  (In the middle of one thats NOT a question) anyway I was having some pretty serious crap and I ended up asking if I could go up to 10mg if needed and I mostly just had it available as I rarely went that high.  My point is that some people need a different dose to have it do anything.  In my case it seems like I get zero reaction to starter doses of anything.

Oh!  And the point is you really have to sit down with the doctor and paint an accurate picture of whats going on.   If your so spun up you can't drive to work and there is a drug that only sorta works and your on the starter dose?   Thats why drugs have these wide ranges. 

Oh!  Forgot the most important point.  If you get stuck with a doctor that is totally freaked out about Benzos read the current stuff on it good or bad and made up you mind that she is right or you disagree.  Then talk about this.  The worst case is you try getting a second opinion.   And from my experience this is a VERY important option.   I was on narcotics for months and months to dial down the pain from some urgical clips that migrated into my bladder.   OUCH!  And it took a different doctor with an open mind to ponder the concept that i was really in pain and not looking for excuses to take narcotics (Which make me spew)  

Edited by HAL9000
Weezer music is rocking my fingers into doing typos
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And it took a different doctor with an open mind to ponder the concept that i was really in pain and not looking for excuses to take narcotics

Yes, ^this.  Hal is right ... sometimes a different DR with an open mind sees things differently, and they can figure things out that no one else could before.

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