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Klonz not helping as much anymore


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Unfortunately, I think I am tolerating the 2mg x2 Daily klonopin prescribed by my pdoc. I've told her that I do not want them anymore because I don't feel they work very well with my anxiety, and am finding myself having to take them everyday (the script says "daily as needed" which confuses me, and I keep forgetting to ask about that) and it only slightly helps. I know I can't take any more than the 4mg daily, don't know what that would do - probably be bad. So what's left? I blacked out on gabapentin so I can't supplement with that anymore.

I asked about Xanax and told her that my mom used to take that. She said no it wouldn't work for me because it doesn't last long and I'd have to keep taking it all the time. She says it's not a good GAD maintenance drug. I've had Ativan before but it was weak sauce. 

Any ideas that I should ask her about next month when I see her again? Valium? I dont know much about valium or the other one (I forget the name of it). But I want the klonz to work, dang it!!!

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It's great that you've found some things that work for you at least some of the time.

There's some really good evidence to support a few different approaches to anxiety, but not generic psychodynamic talk therapy. I'm talking about skill based approaches like CBT, mindfulness based stress reduction, acceptance and commitment therapy, exposure therapy, etc.

There's also a really great book called Master your Panic that I'd recommend checking out from the library if you can't afford to buy a copy.

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Have you tried Buspar?....It does work for some people.....Might be worth asking about, at least.

Some pdocs will also prescribe low dose antipsychotics for anxiety, but I see you're already on Abilify.

Edited by CrazyRedhead
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21 hours ago, CrazyRedhead said:

Have you tried Buspar?....It does work for some people.....Might be worth asking about, at least.

Some pdocs will also prescribe low dose antipsychotics for anxiety, but I see you're already on Abilify.

I've tried Buspar and it didn't do anything at all. It was like a sugar pill. 

When I see my pdoc I'm going to ask her about alternatives to the klonz. I think the name of the one I was forgetting was called "librium' but I need to read up on it, it doesn't sound like one they give you very often.

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I've found Rexulti to be extremely effective at knocking out my generalized anxiety. I still get acute anxiety attacks, but Xanax works for those. Abilify actually upped my acute (situational) anxiety and didn't really touch my generalized anxiety. Rexulti may work as an adjunct, but it's not well studied for that.

Just a thought. I know it's loathsome to start messing with APs.

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I think your doc is right about Xanax.  I had it for quite a while and was unhappy with the way it worked and got to the point where I was afraid of it. I know it works for some people but... I'm not sure how it helps because its a very short lasting very strong drug.  According to my PDoc this combo makes it "popular" for people with addictive problems and thus he is not a big fan of it and when I asked about going back to Valium he seemed much less worried.

Valium is long lasting and in a low dose (for me) it just makes Anxiety seep away and I feel normal.   If the dose is too high its sedating so adjusting the dose in small bits is (I think) a good way to find what helps without it being too much.    Maybe ask about 2mg tabs and be given a little wiggle room on how much to take at a time. 

In my experience 2 didn't seem to do anything.  4 was underwhelming.  6 was good but 8 or 10 was just too strong.   I mean if your having a major panic attack maybe 8 or 10 is a good thing.  Better to be sedated then just totally loosing it.   Anyway PDoc has me on 5 which is a good dose with my makeup.   2 might be right for you or who knows?  The thing is that you have to find the right drug and then the right dose.   The problem with Xanax is that you might get some relief but you might need to be popping them all day in a bad anxiety situiation and thats where you get into trouble.   *And all opinions are just me babbling - I'm not an expert or doctor just a fellow patient.  My 2 cents worth and you can usually find that much change in the couch.

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13 minutes ago, HAL9000 said:

 

Valium is long lasting and in a low dose (for me) it just makes Anxiety seep away and I feel normal.   If the dose is too high its sedating so adjusting the dose in small bits is (I think) a good way to find what helps without it being too much.    Maybe ask about 2mg tabs and be given a little wiggle room on how much to take at a time. 

 My 2 cents worth and you can usually find that much change in the couch.

Thank you for your 2 cents worth, I will ask about that. In the end, it all comes down to relief. I am miserable with anxiety lately and there has to be SOMETHING out there that will work to help take it away without making too much of a mess of everything else. 

25 minutes ago, dtac said:

I've found Rexulti to be extremely effective at knocking out my generalized anxiety. I still get acute anxiety attacks, but Xanax works for those. Abilify actually upped my acute (situational) anxiety and didn't really touch my generalized anxiety. Rexulti may work as an adjunct, but it's not well studied for that.

Just a thought. I know it's loathsome to start messing with APs.

I have never heard of that one before, but I do know that my Abilify is the only AP that has worked for me without side effects.

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17 minutes ago, HAL9000 said:

I think your doc is right about Xanax.  I had it for quite a while and was unhappy with the way it worked and got to the point where I was afraid of it. I know it works for some people but... I'm not sure how it helps because its a very short lasting very strong drug.  According to my PDoc this combo makes it "popular" for people with addictive problems and thus he is not a big fan of it and when I asked about going back to Valium he seemed much less worried.

Valium is long lasting and in a low dose (for me) it just makes Anxiety seep away and I feel normal.   If the dose is too high its sedating so adjusting the dose in small bits is (I think) a good way to find what helps without it being too much.    Maybe ask about 2mg tabs and be given a little wiggle room on how much to take at a time. 

In my experience 2 didn't seem to do anything.  4 was underwhelming.  6 was good but 8 or 10 was just too strong.   I mean if your having a major panic attack maybe 8 or 10 is a good thing.  Better to be sedated then just totally loosing it.   Anyway PDoc has me on 5 which is a good dose with my makeup.   2 might be right for you or who knows?  The thing is that you have to find the right drug and then the right dose.   The problem with Xanax is that you might get some relief but you might need to be popping them all day in a bad anxiety situiation and thats where you get into trouble.   *And all opinions are just me babbling - I'm not an expert or doctor just a fellow patient.  My 2 cents worth and you can usually find that much change in the couch.

I agree with this.

With generalized anxiety, Xanax isn't a good choice because it is a medium-acting benzo. Ativan would fall into the same category. Klonopin and Valium are much longer-acting, so they're preferred to help manage generalized anxiety -- less likely to be abused too. I've taken Valium (up to 40mg) and Klonopin (up to 4mg, not at the same time) for anxiety, and I didn't get much relief from them except at high doses, but I tend to have more acute anxiety issues. Valium and Klonopin also have more muscle relaxant properties that can be beneficial if you're one of those people who tends to tense your muscles up when anxious.

My pdoc calls Xanax "the crack cocaine of benzos" because of how easily people abuse it. I find it to be very powerful, and quite sedating, so even though I'm prescribed 0.5mg PRN, I usually just take 0.25mg unless I'm trying to sleep. I've gone as high as 1mg, and that puts me out and causes retrograde amnesia (unless I'm battling insomnia + anxiety simultaneously.)

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6 minutes ago, dtac said:

I agree with this.

With generalized anxiety, Xanax isn't a good choice because it is a medium-acting benzo. Ativan would fall into the same category. Klonopin and Valium are much longer-acting, so they're preferred to help manage generalized anxiety -- less likely to be abused too. I've taken Valium (up to 40mg) and Klonopin (up to 4mg, not at the same time) for anxiety, and I didn't get much relief from them except at high doses, but I tend to have more acute anxiety issues. Valium and Klonopin also have more muscle relaxant properties that can be beneficial if you're one of those people who tends to tense your muscles up when anxious.

My pdoc calls Xanax "the crack cocaine of benzos" because of how easily people abuse it. I find it to be very powerful, and quite sedating, so even though I'm prescribed 0.5mg PRN, I usually just take 0.25mg unless I'm trying to sleep. I've gone as high as 1mg, and that puts me out and causes retrograde amnesia (unless I'm battling insomnia + anxiety simultaneously.)

I am somewhat relieved to hear that you were able to take 40mg because it shows one size doesn't fit all.  And on a note I didn't mention I think if you gain some tolarence (Spelxed?) the dose needs more wiggle room and you shouldn't be ashamed to bring it up.  The first time around I was on 10mg and that was the dose that just made things "normal"   When I went back on it (After flushing the Xanax) 10mg put me out like a brick to the head. 

I think we have the same or similar doctors because that comment about Xanax being the "Crack Cocaine of Benzos" is close to what my PDoc said about it.   He was in a rare open mood (Talking shop like doctor to doctor stuff) and he went on about the different benzos and which ones he felt good about and why and which ones he thought were "invented to cause more harm then help"

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Oh one thing I really ought to have said was ask about adjusting the dose of what your already taking.   Getting used to a drug at a particular dose if you've taken it regularly is fairly common and its not "addiction" so don't panic if the old dose just underwhelms you.

If (Like me) your saying Xanax doesn't last long enough can I take it more often?  That might be a sign that it doesn't work right for you (Or its the wrong drug to give out for people with my kind of anxiety.  Or its the crack of Benzos and just a stupid drug)  But if what you had "did" work its maybe as simple as going to the next higher dose?

I'm not a doctor but my grandma always said, "Be the squeeky wheel.  Its the one that gets the grease"   or in 21st Century speak "Be proactive about your health care.  If something stops working or you have a problem seek medical help asap"

 

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21 minutes ago, HAL9000 said:

Oh one thing I really ought to have said was ask about adjusting the dose of what your already taking.   Getting used to a drug at a particular dose if you've taken it regularly is fairly common and its not "addiction" so don't panic if the old dose just underwhelms you.

If (Like me) your saying Xanax doesn't last long enough can I take it more often?  That might be a sign that it doesn't work right for you (Or its the wrong drug to give out for people with my kind of anxiety.  Or its the crack of Benzos and just a stupid drug)  But if what you had "did" work its maybe as simple as going to the next higher dose?

I'm not a doctor but my grandma always said, "Be the squeeky wheel.  Its the one that gets the grease"   or in 21st Century speak "Be proactive about your health care.  If something stops working or you have a problem seek medical help asap"

 

That's a good point. I'm already on 4mg klonopin (well, 2mg x2 daily) and I don't think it's a good idea to go any higher, that would just lead to more and more probably. And that's just a flat out waste. But I do tend to have a high tolerance for medications and need higher doses of things. I think it is individualized, but I know pdocs are real careful with benzos and so try not to give more than what they think, text-book-wise, would work. At least in my experience anyway. I could probably take 5mg and it might work, who knows. Maybe I should ask? I'll ask lots of questions. I think I see her in June. I have an online email portal though, is this something that should be discussed in person you think?

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11 minutes ago, Alien Navel Cord said:

I have an online email portal though, is this something that should be discussed in person you think?

IMO, it needs to be discussed in person......Raising benzo doses is a very serious matter to many pdocs.

If you don't have an appointment till June, maybe you could call and ask to get an appointment sooner than that, if the anxiety is really bothering you

 

Edited by CrazyRedhead
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1 minute ago, Alien Navel Cord said:

That's a good point. I'm already on 4mg klonopin (well, 2mg x2 daily) and I don't think it's a good idea to go any higher, that would just lead to more and more probably. And that's just a flat out waste. But I do tend to have a high tolerance for medications and need higher doses of things. I think it is individualized, but I know pdocs are real careful with benzos and so try not to give more than what they think, text-book-wise, would work. At least in my experience anyway. I could probably take 5mg and it might work, who knows. Maybe I should ask? I'll ask lots of questions. I think I see her in June. I have an online email portal though, is this something that should be discussed in person you think?

I too have a cast iron liver or whatever it is that makes it so I take the large doses of drugs for them to be effective.   In my non MI meds I take the Max of several things and in one I keep having to say "Yes, its 2000mg  Its not a typo"  ha.  I worked with a guy who had been in some kind of accident and was busted up pretty bad and has had to take pain meds for a long time.  The doses he takes?   I didn't even know they made them that high.  He functions fine and with the except of a really non functioning limb does all the normal stuff at work.   If you or I took one of his pain pills it would be a rush to the cemetary (I think)   Anyway its not anything to be ashamed of if 2mg x2 times doesn't cut it.   Maybe it needs to be 4mg x3 times or whatever.   Just don't "prescribe" it yourself :lol:

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14 minutes ago, HAL9000 said:

I too have a cast iron liver or whatever it is that makes it so I take the large doses of drugs for them to be effective.   In my non MI meds I take the Max of several things and in one I keep having to say "Yes, its 2000mg  Its not a typo"  ha.  I worked with a guy who had been in some kind of accident and was busted up pretty bad and has had to take pain meds for a long time.  The doses he takes?   I didn't even know they made them that high.  He functions fine and with the except of a really non functioning limb does all the normal stuff at work.   If you or I took one of his pain pills it would be a rush to the cemetary (I think)   Anyway its not anything to be ashamed of if 2mg x2 times doesn't cut it.   Maybe it needs to be 4mg x3 times or whatever.   Just don't "prescribe" it yourself :lol:

Yeah lol I'd be afraid to go over it without my pdoc prescribing it... one time I took too much gabapentin on accident (just an extra pill, nothing major) and had hallucinations. (Then again I was manic and extremely paranoid at the time so I'm not sure what the exact culprit may have been)... 

Yeah some people can be high functioning on higher doses of meds and it works just fine for them. Sounds like I will have to have a serious talk with my pdoc. I do need some relief, I think I'll try to get in for an appointment sooner than I have now.

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