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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by paulbwell on November 30, 2004, at 21:55:09
Hi Babblers,
On my visit to my new PcDoc yesterday, he fails to renew my Clonazapam script. I have been on 2-6mgs a day for near 2 years. He started me on Imipramine 1 month ago (150mgs-now) for Depression and second line ADHD treatment, to replace the Ritalin I had been taking (dont PcDocs love to avoid SCH 2 meds)Now heres the problem, he perscribes me 250mcgs BID of Xanax! to replace my 2-6mgs BID TID of Clonaz for the past 2 years!
I asked this guy 3! times if the cross over, and dosage change would be ok, and 3 times he assures me it would.Now I know Alprazolam and Clonazepam are considered on many Benzo tables to be of equal strength, or in fact many conversion tables list Clonaz 250mcgs=500mcgs of Alpraz.
Well one things for sure, he's given me 60 250mcg tabs of Alprazolam and I'll take what I require to control my symptoms, If I run out sooner than he's expecting me to, I'll be on that PH telling him so.
Maybe it'll help my anxiety better than the Clono, that was becoming ineffective after 2 years, even at 6mgs taken a dose. But i worry about the low dose he's given me.
Advice? feedback? on change of compounds and dosage please
Cheers
Posted by JACJ on November 30, 2004, at 22:13:59
In reply to HELP: DOC TAKES MY KLONO GIVES ME XANAX, posted by paulbwell on November 30, 2004, at 21:55:09
> Hi Babblers,
> On my visit to my new PcDoc yesterday, he fails to renew my Clonazapam script. I have been on 2-6mgs a day for near 2 years. He started me on Imipramine 1 month ago (150mgs-now) for Depression and second line ADHD treatment, to replace the Ritalin I had been taking (dont PcDocs love to avoid SCH 2 meds)
>
> Now heres the problem, he perscribes me 250mcgs BID of Xanax! to replace my 2-6mgs BID TID of Clonaz for the past 2 years!
> I asked this guy 3! times if the cross over, and dosage change would be ok, and 3 times he assures me it would.
>
> Now I know Alprazolam and Clonazepam are considered on many Benzo tables to be of equal strength, or in fact many conversion tables list Clonaz 250mcgs=500mcgs of Alpraz.
>
> Well one things for sure, he's given me 60 250mcg tabs of Alprazolam and I'll take what I require to control my symptoms, If I run out sooner than he's expecting me to, I'll be on that PH telling him so.
>
> Maybe it'll help my anxiety better than the Clono, that was becoming ineffective after 2 years, even at 6mgs taken a dose. But i worry about the low dose he's given me.
>
> Advice? feedback? on change of compounds and dosage please
>
> CheersHi,
I am wondering why he switched you? Also, I feel you have reach tolerance with Klonopin. Tolerance is where you don't feel the effects anymore from the drug and you have to keep raising the doseage. Benzos are not meant to be given long term. The max. time is several weeks. It really makes me mad when docs just pull people off the drug or switch them overnight. This is a total shock to the CNS. Did he give you a switch over schedule to follow? Did he mention tolerence?
Posted by paulbwell on November 30, 2004, at 22:44:59
In reply to Re: HELP: DOC TAKES MY KLONO GIVES ME XANAX, posted by JACJ on November 30, 2004, at 22:13:59
> > Hi Babblers,
> > On my visit to my new PcDoc yesterday, he fails to renew my Clonazapam script. I have been on 2-6mgs a day for near 2 years. He started me on Imipramine 1 month ago (150mgs-now) for Depression and second line ADHD treatment, to replace the Ritalin I had been taking (dont PcDocs love to avoid SCH 2 meds)
> >
> > Now heres the problem, he perscribes me 250mcgs BID of Xanax! to replace my 2-6mgs BID TID of Clonaz for the past 2 years!
> > I asked this guy 3! times if the cross over, and dosage change would be ok, and 3 times he assures me it would.
> >
> > Now I know Alprazolam and Clonazepam are considered on many Benzo tables to be of equal strength, or in fact many conversion tables list Clonaz 250mcgs=500mcgs of Alpraz.
> >
> > Well one things for sure, he's given me 60 250mcg tabs of Alprazolam and I'll take what I require to control my symptoms, If I run out sooner than he's expecting me to, I'll be on that PH telling him so.
> >
> > Maybe it'll help my anxiety better than the Clono, that was becoming ineffective after 2 years, even at 6mgs taken a dose. But i worry about the low dose he's given me.
> >
> > Advice? feedback? on change of compounds and dosage please
> >
> > Cheers
>
>
>
> Hi,
> I am wondering why he switched you? Also, I feel you have reach tolerance with Klonopin. Tolerance is where you don't feel the effects anymore from the drug and you have to keep raising the doseage. Benzos are not meant to be given long term. The max. time is several weeks. It really makes me mad when docs just pull people off the drug or switch them overnight. This is a total shock to the CNS. Did he give you a switch over schedule to follow? Did he mention tolerence?
>Hi Jacj, he switched me because he received my notes from a PsyDoc I had seen earlier this year, who had me on 250mcgs of Xanax BID
I may have reached Tolerance. It was not really effective for me anymore, and I was really just taking it for maintaince maybe, or cause I *thought* it was still controlling, helping my symptoms, even thought It caused major over-secretion of Saliva, and I felt It nudged my mood to the low side.
You say Benzo's are not ment for long term use? I'm guessing you are from the UK? with their stronger anti-Benzo trend.
A swithoover schedule you ask?
He did not, I think he just though the Imipramine I have been on for 1 month would take care of my sever GAD, and the Alprazolam tabs he said "I'm happy to give you the xanax to take for Panic Attacks" cause that dose was in my Psy file.Tolerance?
Nope again. I think if I had been on 10mgs of Xanax a day he would think it would be ok to Cold-Turkey it, once an SSRI or AD kicked in.I really think I know more about meds than most of the Psy and Pc Docs I have seen, and often wish I lived in Thailand or Mexico where I could buy any Benzo or Stim or AD I wanted OTC, but no I live in a country where two drugs are available freely, Booze and Pot-both of which I can't tolerate unfortunatly, althought theres Codeine-which I did enjoy.
I hope he raises the Xanax or gives me or another benzo possibly, or I may be running to the ER one night-EEK.
I hope my CNS stands up to this.
Cheers
Posted by Paul Smith on November 30, 2004, at 23:03:17
In reply to HELP: DOC TAKES MY KLONO GIVES ME XANAX, posted by paulbwell on November 30, 2004, at 21:55:09
If you are benzo dependent then you will need to take Xanax doses more often to avoid interdose withdrawals. I have done direct crossovers between benzos before. You may feel strange a few days due to that but probably not any longer. Benzos are all very similar to one another.
Posted by paulbwell on December 1, 2004, at 4:02:40
In reply to Re: HELP: DOC TAKES MY KLONO GIVES ME XANAX, posted by Paul Smith on November 30, 2004, at 23:03:17
> If you are benzo dependent then you will need to take Xanax doses more often to avoid interdose withdrawals. I have done direct crossovers between benzos before. You may feel strange a few days due to that but probably not any longer. Benzos are all very similar to one another.
Hold on Paul Smith
"Benzos are all very similar to one another"
What about their different potencies?
10mgs Valium=.5 or.25mgs Clonazepam= 1mg Ativan=.5mgs Alprazolam?
Wot about the different binding affinities of Klon and Alpra?
Posted by JACJ on December 1, 2004, at 6:35:17
In reply to Re: HELP: DOC TAKES MY KLONO GIVES ME XANAX, posted by paulbwell on December 1, 2004, at 4:02:40
I hope you don't mind me giving an answer to your question. BTW, I am not from the UK. I have just done alot of research and talk with alot of experts on benzo addiction and use.
There have been studies that have shown that
certain benzodiazepines have a higher binding
affinity to these receptors than others.
Binding affinity refers to how tightly a given
substance will bind to a corresponding
receptor. All of these drugs do have in fact a
fairly high binding affinity for these
receptors. Anyway Valium has a fairly high
binding affinity as compared to others in its
class, while drugs such as klonopin, xanax, and
ativan have extremely high binding affinities
for the benzodiazepine receptor. This is what
makes them so addictive. It is also why these
drugs come in lower doses than valium. It is
because they are higher in potency and less of
the drug is needed to achieve a therapeutic
effect.
Posted by Paul Smith on December 1, 2004, at 14:18:08
In reply to Re: HELP: DOC TAKES MY KLONO GIVES ME XANAX, posted by JACJ on December 1, 2004, at 6:35:17
I hope you don't mind me giving an answer to your question. BTW, I am not from the UK. I have just done alot of research and talk with alot of experts on benzo addiction and use.
There have been studies that have shown that
certain benzodiazepines have a higher binding
affinity to these receptors than others.
Binding affinity refers to how tightly a given
substance will bind to a corresponding
receptor. All of these drugs do have in fact a
fairly high binding affinity for these
receptors. Anyway Valium has a fairly high
binding affinity as compared to others in its
class, while drugs such as klonopin, xanax, and
ativan have extremely high binding affinities
for the benzodiazepine receptor. This is what
makes them so addictive. It is also why these
drugs come in lower doses than valium. It is
because they are higher in potency and less of
the drug is needed to achieve a therapeutic
effect.Thanks for answering. :-) I will ad that i have taken several different benzos and found them interchangeable.
Posted by paulbwell on December 1, 2004, at 15:50:30
In reply to Re: HELP: DOC TAKES MY KLONO GIVES ME XANAX, posted by Paul Smith on December 1, 2004, at 14:18:08
> I hope you don't mind me giving an answer to your question. BTW, I am not from the UK. I have just done alot of research and talk with alot of experts on benzo addiction and use.
>
>
> There have been studies that have shown that
> certain benzodiazepines have a higher binding
> affinity to these receptors than others.
> Binding affinity refers to how tightly a given
> substance will bind to a corresponding
> receptor. All of these drugs do have in fact a
> fairly high binding affinity for these
> receptors. Anyway Valium has a fairly high
> binding affinity as compared to others in its
> class, while drugs such as klonopin, xanax, and
> ativan have extremely high binding affinities
> for the benzodiazepine receptor. This is what
> makes them so addictive. It is also why these
> drugs come in lower doses than valium. It is
> because they are higher in potency and less of
> the drug is needed to achieve a therapeutic
> effect.
>
> Thanks for answering. :-) I will ad that i have taken several different benzos and found them interchangeable.
>Thanks JackJ,
But I know this already, the different dosages and binding capabilities of the said benzos. But my worry was, I know Clonazapam, being a longer acting Benzo, will often not show any significant withdrawal symptoms for days, or longer, then bang. My concern was with the substantially lower dose of Alprazolam, (and It's different, If any, binding capabilities to the Gaba receptors) being given to me, with It being of similar strength to Klono, and what effect, if any, this may have.
Paul Smith
Hi paul, I would like to know If you have switched these two said Benzos, and what doses of different benzos you have taken, after each other.Do I need to worry? after all Xanax is the leading Anxiety Med, and maybe it would be just as effective as my previous higher dose of Klono at a lower dose?
and with the coverage of the Imipramine, perhaps that will help? and do more than just make me gain 6kgs in one month!Cheers JackJ and Paul
Posted by Laree on December 1, 2004, at 20:16:58
In reply to Re: JackJ:PSMITH DOC TAKES MY KLONO GIVES ME XANAX, posted by paulbwell on December 1, 2004, at 15:50:30
> Do I need to worry? after all Xanax is the leading Anxiety Med, and maybe it would be just as effective as my previous higher dose of Klono at a lower dose?
> and with the coverage of the Imipramine, perhaps that will help? and do more than just make me gain 6kgs in one month!
>
> Cheers JackJ and Paul
Hello! Question--what was the Klonopin originally rx'ed for--Panic Attacks/Disorder, GAD, social anxiety...?
Anyway, if the Klonopin was becoming ineffective I say it's prob. a good idea to switch to Xanax (or similar alternative) for a while, at least. If the new med doesn't work out for you, perhaps enough time will have passed & the tolerance you developed to Klonopin will have dissipated significantly, and thus if you were to get back on it you'd probably have a "fresh(er)" start again.
Best,
L.
Posted by paulbwell on December 1, 2004, at 21:38:48
In reply to Re: JackJ:PSMITH DOC TAKES MY KLONO GIVES ME XANAX » paulbwell, posted by Laree on December 1, 2004, at 20:16:58
> > Do I need to worry? after all Xanax is the leading Anxiety Med, and maybe it would be just as effective as my previous higher dose of Klono at a lower dose?
> > and with the coverage of the Imipramine, perhaps that will help? and do more than just make me gain 6kgs in one month!
> >
> > Cheers JackJ and Paul
>
>
> Hello! Question--what was the Klonopin originally rx'ed for--Panic Attacks/Disorder, GAD, social anxiety...?
> Anyway, if the Klonopin was becoming ineffective I say it's prob. a good idea to switch to Xanax (or similar alternative) for a while, at least. If the new med doesn't work out for you, perhaps enough time will have passed & the tolerance you developed to Klonopin will have dissipated significantly, and thus if you were to get back on it you'd probably have a "fresh(er)" start again.
> Best,
> L.
>
>
>
> Hi L
The Clonazepam was originally scripted near 2 years ago because, I asked for it basically,and was very surprised when the doc gave me 2mg tabs bid-tid.I had been on Xanax, (for sever GAD), and It was too much for my Benzo-virgin Gaba recepters to handle, as it caused euphoria and a hangover. I also knew Clono to be longer acting and thought this to be better,.
>
Cheers
This is the end of the thread.
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