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Re: klonopin 0.5 » Cam W.

Posted by Elizabeth on December 14, 2001, at 13:16:17

In reply to Re: klonopin 0.5, posted by Cam W. on December 13, 2001, at 22:06:45

> > Because the AUC remains fixed, right?
> • Yes, the AUC for the individual.

Of course.

> • Diazepam (Valium™), BTW whose main metabolite is oxazepam (Serax™ t1/2 = 5-15h), as well as the first benzodiazepine developed, chlordiazepoxide (Librium™), chlorazepate (Tranxene™), and flurazepam (Dalmane™) all have longer half-lives than clonazepam. Their half-lives are all on the order of 100h (including active metabolites).

Yes, exactly. (What about nordiazepam, BTW?)

> • For the record, although it's not used much anymore (due to hangover effect), flurazepam is still one of the best hypnotics for those who have trouble staying asleep.

Benzos aren't very good in general for chronic insomnia, though -- they tend to stop working after a while. What I'd like to see is a longer-acting variation on Ambien. As it is, I need 40 mg of Ambien each night to get a full, relatively uninterrupted night of sleep (20 mg at bedtime, another 20 when I wake up 4 or 5 hours later).

> Chlorazepate is wonderful for those with schizophrenia who have daytime anxiety problems, when nothing else works.

That's the one I think I'd want to try if I were going to take benzos around-the-clock. (Why schizophrenia in particular, out of curiosity?)

> Chlordiazepoxide is still used during alcohol withdrawl (to help prevent DTs, I believe), as well being used to help a person to adjust to a life without booze (although there are some addiction concerns that I think are sometimes overstated, especially in those who are motivated to stop drinking).

Librium is the benzo that you don't feel, even more so than Klonopin. I've talked to some people about this, including a couple of alcoholics: it's not particularly sedating, you don't feel it kick in, but it covers for benzo or alcohol withdrawal very well. As such, I think it probably has very little abuse potential.

> And Valium is Valium is Valium; it still is good, in a Prozac sense, to help wean those off of the shorter acting benzos.

But isn't Valium pretty short-acting (despite its long half-life and those of its active metabolites)?

> • The person I am referring to is being treated only with lithium for bipolar I (600mg Duralith qhs - sustained release); otherwise, perfectly functional.

Klonopin is something of a mood stabilizer too (although I didn't realize it was at that low a dose).

> This person has tried a couple times to stop the clonazepam, but the anxiety always came back. The doc and I had shook our heads over this a few times.

Yeah, with something like that, I'd wonder if the person had a problem metabolizing the drug, or something like that.

> But hey, if it works, it works (I think that some of the anxiety may be psychological, but this person is holding a respectable, high paying job, and is good at it).

By "psychological" you mean nonspecific/related to expectation effects, right? (Isn't anxiety in general "psychological?")

> You would never guess that mania almost destroyed this person's life.

I hope that one day someone will say something like that about me (substitute "depression" for "mania").





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