cross-benzo comparisons

[dancesintherain]

I'm currently taking 0.25mg xanax at 10am, 0.5mg xanax at 3pm, and 1mg klonopin at bedtime.

I think I'd like to switch the xanax out.  I appreciate its effectiveness, but it's almost too effective.  I'm checing my watch at 2pmg waiting for the 3pm dose.  And the same with the 10am.  I feel the need for it too acutely.  I need something that's not quite as quick a fix, I think. I  may change my mind.  

I think I'll need it to be the same drug in am and pm because I had some slurred speech issues when I was taking klonopin at night and taking ativan in the morning.

Trying to get a sense of what to request/ask my pdoc about.  I haven't ever taken valium. 

Klonopin am was stopped once because of excessive sedation, but I wasn't on my current med cocktail, so I don't know if that would be different at all.  

I lean toward asking for Ativan at morning and night and seeing if that's too sedating.

But I'm curious for ideas.

[Iceberg]

I might retry a super low dose (like .25) Klonopin in the Am before Ativan. Ativan is longer acting than Xanax but still doesn’t necessarily provide all day coverage. 

You would probably still need at least three doses if you switched to just Ativan.

Edited January 1, 2020 by Iceberg

[dancesintherain]

43 minutes ago, Iceberg said:

I might retry a super low dose (like .25) Klonopin in the Am before Ativan. Ativan is longer acting than Xanax but still doesn’t necessarily provide all day coverage. 

You would probably still need at least three doses if you switched to just Ativan.

Thanks--I'll talk with her about it.  I was doing 1mg klonopin in am and 1mg klonopin at bedtime, so I have some room to go before I get to the point where I was feeling the excessive sedation.  But my current klonopin tables are 0.5mg, so I could try 0.25 pretty easily.

I've done ativan am and pm before...but I can't remember why we stopped.  Maybe not enough coverage, like your comment suggests could happen? 

[Iceberg]

4 minutes ago, dancesintherain said:

Thanks--I'll talk with her about it.  I was doing 1mg klonopin in am and 1mg klonopin at bedtime, so I have some room to go before I get to the point where I was feeling the excessive sedation.  But my current klonopin tables are 0.5mg, so I could try 0.25 pretty easily.

I've done ativan am and pm before...but I can't remember why we stopped.  Maybe not enough coverage, like your comment suggests could happen? 

Personally I found Valium more on the sedating side @ 10mgs qid. So I had better luck with it than Klonopin for sleep, but not as much for daytime coverage. 

[dancesintherain]

good to know.  klonopin probably makes the most sense for the reason you gave...all-day coverage.  I'll see what my pdoc thinks. 

I don't expect she frequently gets people advocating to going off of xanax because of it being too effective.  it scares me and I feel like longer-lasting coverage makes more sense.

Edited January 1, 2020 by dancesintherain

[Iceberg]

1 hour ago, dancesintherain said:

good to know.  klonopin probably makes the most sense for the reason you gave...all-day coverage.  I'll see what my pdoc thinks. 

I don't expect she frequently gets people advocating to going off of xanax because of it being too effective.  it scares me and I feel like longer-lasting coverage makes more sense.

Based on treatment goals Xanax not lasting long enough is a common concern when picking a benzo, I think it’s a reasonable concern 

[mikl_pls]

Xanax XR could be a possibility. It goes as low as 0.5 mg and can be taken either once or twice daily. Valium at 2 mg qid for me was very smooth, very good for my anxiety, and not remotely sedating (just an iota). You may not even need that much... You could do anywhere from 1/2x2 mg (1 mg) bid to 2 mg qid. It's pretty flexible because 1. it's a tablet, and 2. it has a very long half-life.

Librium is another possibility. It's essentially Valium bit a little dirtier as far as metabolites go. 5 mg is about equivalent to 0.25 mg Xanax, but it's not as quick-acting so may not hit you so hard. It too has a long half-life, so you could take 5-10 mg bid-qid. They're capsules though, so you can't split them. 😕 

Tranxene T-Tabs are another good long-acting option. 3.125 mg bid-tid. Tranxene are tablets so you could go down to 1.5625 mg if needed.

Also, there are Klonopin ODTs which I think are Klonopin Wafers. They go as low as 0.125 mg and could be taken bid-tid if 0.25 mg is too much for you.

 

[dancesintherain]

Thank you both.  Quick question—why the consensus that I’ll need a tiny tiny dose?  I think xanax is the only one where I’ve been this small of a dose.

i know the benefits of going slowly, so I’d probably recommend something low also. But just curious.

[dancesintherain]

Oh right...I asked equivalencies.  I think xanax may be the exception to the norm, now that I think about it.

[dancesintherain]

So my pdoc wants me to try 0.5mg of xanaxXR when I take my medication in the morning to see if it can last long enough for me to feel comfortable with it and still give the anti-anxiety component of the program.  
 

I have permission to switch to klonopin in the am if the xanaxXR is a fail.  

[dancesintherain]

I’m anxious (I recognize it’s ironic) about taking a new anti-anxiety medication.  My pdoc recommended it as being smoother and I could take it once in the morning and likely have it carry me through the day.  I’m starting with 0.5mg but I can take up to 1mg if I need it and it doesn’t make me too drowsy.
 

I don’t get to try it until Saturday morning because t doesn’t come in until tomorrow. Maybe that’s a good thing because it will be a weekend.

ill look to see if there are posts on XanaxXR but would also love if someone who has taken it could chime in

Edited January 9, 2020 by dancesintherain

[Iceberg]

2 hours ago, dancesintherain said:

I’m anxious (I recognize it’s ironic) about taking a new anti-anxiety medication.  My pdoc recommended it as being smoother and I could take it once in the morning and likely have it carry me through the day.  I’m starting with 0.5mg but I can take up to 1mg if I need it and it doesn’t make me too drowsy.
 

I don’t get to try it until Saturday morning because t doesn’t come in until tomorrow. Maybe that’s a good thing because it will be a weekend.

ill look to see if there are posts on XanaxXR but would also love if someone who has taken it could chime in

I had decent luck. As maintaince my doc had me a 1 mg q AM but during a panic-y stretch we bumped it up to 2 mg. Once the anxiety was controlled we went back to one mg cuz the 2 would make me tired. When things subsided I went off it (I was also using Xanax ir PRN) but I’d try it again if need be 

[dancesintherain]

thanks @Iceberg, that helps to hear. 

[Iceberg]

Good luck!

[dancesintherain]

thanks :-)

[dancesintherain]

they're little pentagons!

for unknown reasons, that makes me happy.  Maybe like certain numbers? (february 2nd is my favorite day this year because it's a palindrome - 02/02/2020)

[browri]

So if your goal is to switch to a benzo regimen that is a little less "moreish" (in that you want more and can barely wait for your next dose), you truly would want to consider clonazepam (Klonopin) around the clock. It has one of the longest half-life of the benzos leaving pretty much only diazepam and flurazepam being longer. However, diazepam is broken down into several metabolites and definitely falls into the "moreish" category. My pdoc loves clonazepam for its long half-life and lower propensity to develop a tolerance than something like diazepam. When I'm more panicky than usual, my pdoc has me do 0.25mg with my morning meds, 0.25mg somewhere between noon and 2PM, and then another 0.5mg at bedtime for a total of 1mg in the day. I do sometimes find myself anxiously awaiting the noon dose sometimes, but I don't feel panicky in the mornings and by the afternoon I'm usually not jonesing for the evening dose.

[CrazyRedhead]

I agree with @browri about Klonopin (clonazepam).......I only take it 2x per day (morning and night)......It is a good long-lasting option, IMO.

[notloki]

I get away with just talking Klonopin (clonazepam) once a day, every day and don't get panicky between doses. I take 1 mg and can go to 2 if I want to. Still taking it once a day.