Posted by alan on August 30, 2002, at 1:15:57
In reply to Question for Alan others, correct dose: 2 benzos, posted by hildi on August 29, 2002, at 13:29:41
> I am just starting Klonopin and Ativan- I may try xanax later (instead of ativan)if I don't have good luck with this duo.
> I know some of you also take a long and a short-acting benzo. So, my question is: Do I take the klonopin at night, or the shorter acting benzo (ativan, for me) at night, or is this vise-versa?
> Which is least likely to cause day-time drowsieness?
> Hildi
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For klon, which has a *theraputic* half-life of around 12 - 20hrs, you probably would want to try it in two seperate doses. Start with one half of a .5mg tablet (.025mg) at night and one either when you awake or perhaps later in the AM if it makes you drowsy to take it on awakening.Remember that it will take a week or so for the drowsiness to go away after start-up. Then adjust your dose upwards by adding .025 at night if you feel that klon is not yet handling your symptoms. Keep working upwards by adding .025 in the AM until the overall dose is .5 at night and .5 in the AM. That is a pretty median dose. It is what I take but many need twice that or more. You won't know until you get there.
After you've made an assessment if klon is going to have more benefits than side effect(drowsiness, clumsiness, and mild depression are the 3 that come to mind if the dose is too high for you or if you simply can't tolerate it) then one can add ativan. If klon isn't covering your symptoms while you are starting it up, one can always take ativan PRN for breakthrough anxiety or panic.
Adding ativan (theraputic half-life around 6-8 hrs) should come in 3 equal doses starting with .5mg at night, same on awakening, same at dinner. Increase as - or if needed.
This is the way I did it in order to achieve as steady a state blood level as possible. Of course the real trick is to do this according to how it feels to you. The klon may be fine at half the dose I mentioned and then the ativan may be adjusted to a slightly lower dose too. You may want to space the doses further apart than I - especially if you feel too drowsy - your body may metabolise the med slower or faster than I. It takes a little time to work out the nuances of it without getting too sleepy in order to for instance drive safely.
Another alternative is to use the klon after you find a theraputic level and just add ativan PRN for breakthrough anxiety and panic. This has worked well for me in cases of situational anxiety, phobia, etc.
Since individual responses vary, drowsyness may be more promenent with either ativan or klonopin.
If you have any questions about what I've said, please ask! It may be a little confusing...
Best,
Alan
poster:alan
thread:118149
URL: http://www.dr-bob.org/babble/20020829/msgs/118183.html