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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 83 to 107 of 107. Go back in thread:
Posted by notfred on August 30, 2006, at 21:24:11
In reply to Re: Psychopharmacology of addicting drugs, posted by bassman on August 28, 2006, at 13:19:48
I've never become tolerant of any benzo I've taken except Ativan
Same here, mostly Ativan for over 20 years. I have never had to increase the dose. I became tolerant to the euphoria quite quickly but otherwise 1 mg Ativan is effective today as it
was decades ago. Some days I take none, some days 1 and some days 2.
Posted by Squiggles on August 31, 2006, at 7:15:52
In reply to Re: Psychopharmacology of addicting drugs, posted by notfred on August 30, 2006, at 21:24:11
> I've never become tolerant of any benzo I've taken except Ativan
>
>
> Same here, mostly Ativan for over 20 years. I have never had to increase the dose. I became tolerant to the euphoria quite quickly but otherwise 1 mg Ativan is effective today as it
> was decades ago. Some days I take none, some days 1 and some days 2.
Well, i'll be darned; i am mystified;i thought at least only clonazepam belonged in an interface
between benzodiazepines and anti-convulsants.Does anybody know what is going on? Is it
possible that taking the benzo EVERY single
day makes the difference in addiction?Squiggles
Posted by Phillipa on August 31, 2006, at 18:23:31
In reply to Clonazepam dosing » notfred, posted by Squiggles on August 31, 2006, at 7:15:52
This thread is so long I've forgotten a lot of it but Squiggles did you say you had to up your dose? I thought you were just asking if that's what happens over time. If a person is an abuser he /she will probably want some type of high. I'd think then they'd choose alchohol, cocaine, or another illegal substance? Love Phillipa
Posted by Squiggles on August 31, 2006, at 19:51:37
In reply to Re: Clonazepam dosing » Squiggles, posted by Phillipa on August 31, 2006, at 18:23:31
> This thread is so long I've forgotten a lot of it but Squiggles did you say you had to up your dose? I thought you were just asking if that's what happens over time. If a person is an abuser he /she will probably want some type of high. I'd think then they'd choose alchohol, cocaine, or another illegal substance? Love Phillipa
No! I don't want to raise my dose; the first
time my dr. raised the dose, i put up a fuss;
but he saw something i did not i guess.No-- my question is why do other benzos
require an increase at shorter intervals,
because of tolerance, and clonazepam does
not? Was there a change in the chemical
structure of clonazepam -- it's just strange
that it is so unique in this sense.Squiggles
Posted by Phillipa on August 31, 2006, at 20:12:15
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on August 31, 2006, at 19:51:37
Thanks, I think valium is the same? Love Phillipa again.
Posted by notfred on September 1, 2006, at 14:29:09
In reply to Clonazepam dosing » notfred, posted by Squiggles on August 31, 2006, at 7:15:52
>
> Does anybody know what is going on? Is it
> possible that taking the benzo EVERY single
> day makes the difference in addiction?
>
> Squiggles
>
Yes, addiction and dependance are worlds a part; they are no where near the same thing.Everyone will become dependent to some degree
if they take benzos every day for an extended period. If I take Atavin for maybe a month every day I become dependant, though mild. It is not an issue unless I am stupid and go cold turkey.Addiction is perhaps the difference between someone who has 2 beers every night and and an
alcoholic.Addiction always carries serious negative consequences. Despite these serious consequences
the drug/meds use continue and increases.You might want to do some google searches on this, ie "Addiction vs Dependance" as there is lots of info on what the difference between them.
Posted by bassman on September 1, 2006, at 14:50:12
In reply to Re: Clonazepam dosing, posted by notfred on September 1, 2006, at 14:29:09
Exactly. We all become dependent on benzos in the same sense that a diabetic is dependent on insulin...stop taking them abruptly and you'll be very uncomfortable. Addiction is active drug-seeking behavior. Good idea to search it if unclear about the difference. As I mentioned before, I'm surprised about trouble withdrawing from Klonopin...in fact it is the benzo docs in the US often have a person switch to from other benzos before withdrawing. I find particularly easy to withdraw from...
Posted by Squiggles on September 1, 2006, at 16:31:47
In reply to Re: Clonazepam dosing, posted by bassman on September 1, 2006, at 14:50:12
The discussion is starting to get circular;
i feel that i am taking up too much time
on this recurring subject. I have my ideas
about the linguistic distinction you make,
and I do not think that your perspective,
possibly shared by social workers, correlates with
biochemistry-- which is where it's at.So bring on the chemists, if you want
another round. :-)Squiggles
Posted by Squiggles on September 1, 2006, at 17:11:34
In reply to Re: Clonazepam dosing » bassman, posted by Squiggles on September 1, 2006, at 16:31:47
On second thought, let's put
the whole thing in vitro :-).Bye
Squiggles
Posted by notfred on September 1, 2006, at 17:15:13
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on August 31, 2006, at 19:51:37
> No-- my question is why do other benzos
> require an increase at shorter intervals,
> because of tolerance, and clonazepam does
> not? Was there a change in the chemical
> structure of clonazepam -- it's just strange
> that it is so unique in this sense.
>
> Squiggleslength of action I think. For someone who requires
every day doses of a benzo, it is going to take more for the benzos with shorter 1/2 lives. More frequent doses and higher doses to get to an average level in the body that will control anxiety.Peaks and valleys in levels are really hard on those who have constant anxiety. The longer acting
benzos (Val, Clonazepam) are better suited if one needs a benzo every day; after a few doses levels
are constant. Any change in levels happens slowly.
Posted by Squiggles on September 1, 2006, at 17:21:47
In reply to Re: Clonazepam dosing, posted by notfred on September 1, 2006, at 17:15:13
>
> length of action I think. For someone who requires
> every day doses of a benzo, it is going to take more for the benzos with shorter 1/2 lives. More frequent doses and higher doses to get to an average level in the body that will control anxiety.
>
> Peaks and valleys in levels are really hard on those who have constant anxiety. The longer acting
> benzos (Val, Clonazepam) are better suited if one needs a benzo every day; after a few doses levels
> are constant. Any change in levels happens slowly.
>
>
>
>No, that's not it -
Squiggles
Posted by bassman on September 1, 2006, at 17:46:31
In reply to Re: Clonazepam dosing » bassman, posted by Squiggles on September 1, 2006, at 16:31:47
My Ph.D. is in chemistry. :>}Really. But you're right, we're getting nowhere fast. Sorry for the last post.
Posted by Phillipa on September 1, 2006, at 21:14:31
In reply to Re: Clonazepam dosing, posted by bassman on September 1, 2006, at 17:46:31
Squiggles what exactly are you looking for? I think all meds are tolerant ad's included and all thake withdrawal except lucky people. Maybe the type of med you need effects withdrawal as ad's I just stop. Benzos I require per all pdocs. Love Phillipa
Posted by Squiggles on September 2, 2006, at 8:10:18
In reply to Re: Clonazepam dosing, posted by Phillipa on September 1, 2006, at 21:14:31
> Squiggles what exactly are you looking for? I think all meds are tolerant ad's included and all thake withdrawal except lucky people. Maybe the type of med you need effects withdrawal as ad's I just stop. Benzos I require per all pdocs. Love Phillipa
Phillipa, i don't quite understand your message--
maybe it's early.What am i looking for? The answer to the question
"what is different about clonazepam" -- is there
a history of the chemical manufacture of benzos
that might shed light on this question. I am
convinced by my experience that this is not a benzo like all the others. This does not mean
i have any intentions of changing my prescription,
or anything in my treatment with it.
Posted by Squiggles on September 2, 2006, at 8:17:04
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on September 2, 2006, at 8:10:18
Is clonazepam unique? (i'm searching)
here is one article:
A unique effect of clonazepam on frontal lobe seizure control.
* Obeid T,
* Awada A,
* Sayes N,
* Mousali Y,
* Harris C.Neurology Sections, King Khalid and King Fahad National Guard Hospitals, Jeddah, Kingdom of Saudi Arabia.
In a 16-year-old female, clonazepam (CZP) changed randomly occurring intractable tonic seizures of frontal lobe origin to a few sleep seizures when used as an adjunctive therapy. The significance of this change in the seizure pattern is discussed with an explanation of possible pathophysiologic mechanism. Copyright 1999 BEA Trading Ltd.
PMID: 10600586 [PubMed - indexed for MEDLINE]
Posted by Squiggles on September 2, 2006, at 8:17:20
In reply to Re: Clonazepam dosing » Phillipa, posted by Squiggles on September 2, 2006, at 8:10:18
Is clonazepam unique? (i'm searching)
here is one article:
A unique effect of clonazepam on frontal lobe seizure control.
* Obeid T,
* Awada A,
* Sayes N,
* Mousali Y,
* Harris C.Neurology Sections, King Khalid and King Fahad National Guard Hospitals, Jeddah, Kingdom of Saudi Arabia.
In a 16-year-old female, clonazepam (CZP) changed randomly occurring intractable tonic seizures of frontal lobe origin to a few sleep seizures when used as an adjunctive therapy. The significance of this change in the seizure pattern is discussed with an explanation of possible pathophysiologic mechanism. Copyright 1999 BEA Trading Ltd.
PMID: 10600586 [PubMed - indexed for MEDLINE]
Posted by Squiggles on September 2, 2006, at 8:36:37
In reply to Re: Clonazepam dosing » Squiggles, posted by Squiggles on September 2, 2006, at 8:17:20
My apologies for hitting the button twice
on my previous post.
i need more coffee - if Dr. Bob or his
assistants wich to remove it, please do
so.I found many article under the key words
clonazepam unique
in the PubMed selections - various reasons
from pharmacological structure to interaction
with benzo receptors are cited.This one is from a therapeutic point of view
and comes from Dr. G. Chouinard - Montreal
of all places (what a small world), discussing
the advantage of using clonazepam in bipolar
disorder and other psychiatric disorders,
as it seem to reduce the need for
neuroleptics. It is stated that even without
lithium, K (clonazepam) by itself can reduce
the manic state.I would like to cite my own experience not long
ago, when i took a corrupted (low, or counterfeit or whatever) dose of lithium. Over
six months the symptoms of manic depression
arose for the first time in 25 years. I was
able to correct this at the most suicidal and
agitated depression phase, by switching to another pharmacy and the old lithium.I would like to point out, that at the time of
this incident i had never stopped taking the
regular dose of clonazepam.You might consider the pharmacological import of that according to anyone understaning its
significance. Perhaps an increase in K would
have confirmed Dr. Chouinard's hypothesis.Here is the abstract:
The use of benzodiazepines in the treatment of manic-depressive illness.
* Chouinard G.
Clinical Psychopharmacology Unit, Allan Memorial Institute, Royal Victoria Hospital, Montreal, Canada.
The benzodiazepine clonazepam was approved for the treatment of epilepsy in 1976. To study its use in acute mania, the author compared clonazepam with lithium in a crossover trial. Clonazepam proved more effective than lithium in controlling the symptoms of mania and caused fewer manifestations of parkinsonism. Associated side effects included ataxia, drowsiness, and behavioral changes. No treatment-emergent depression was observed. Neither clonazepam nor any other benzodiazepine is recommended in schizoaffective or schizophrenic disorders because of the high risk of dependence in those patients, in contrast to manic-depressives. For the maintenance treatment of bipolar disorder, lithium is recommended as the initial agent, with L-tryptophan added if concomitant medication is needed. Clonazepam can then be added as the anticonvulsant, if necessary. In the treatment of acute mania, clonazepam is recommended for the first week of treatment, and lithium is added in the beginning of the second week, thus avoiding the use of neuroleptics.
PMID: 2903143 [PubMed - indexed for MEDLINE]
Squiggles
Posted by SLS on September 2, 2006, at 9:05:38
In reply to Re: Clonazepam dosing » Squiggles, posted by Squiggles on September 2, 2006, at 8:36:37
I experienced a manic reaction to antidepressant medication while taking Ativan 2mg concurrently for sleep. The addition of lithium did not help much. The addition of Klonopin did.
Klonopin is unique among benzodiazepines in that it exerts serotonergic effects (as does lithium). The exact mechanisms remain obscure.
- Scott
Posted by Squiggles on September 2, 2006, at 9:13:27
In reply to Re: Clonazepam dosing » Squiggles, posted by SLS on September 2, 2006, at 9:05:38
> I experienced a manic reaction to antidepressant medication while taking Ativan 2mg concurrently for sleep. The addition of lithium did not help much. The addition of Klonopin did.
It is one thing to add lithium to a manic
reaction (what was the dose? 200mg, 300mg, 600mg?); there is threshold for pharmacological
action in all drugs; If Klonopin helped, on top
of the Ativan dose, that may have been enough.
Furthermore, a "manic reaction to an antidepressant" may have infact been a transient
agitation, and not part of the bipolar spectrum
kept under wraps for years with a full dose of
lithium and 1.50mg clonazepam (along with Synthroid).
>
> Klonopin is unique among benzodiazepines in that it exerts serotonergic effects (as does lithium). The exact mechanisms remain obscure.I think i came across that in the PubMed series -
again how much and for what condition would this
be significant and is it comparable to a full
lithium dose 900-1200 for bipolar? Just about anything you eat contains some serotonin.Squiggles
>
>
> - Scott
Posted by SLS on September 2, 2006, at 9:18:45
In reply to Re: Clonazepam dosing » SLS, posted by Squiggles on September 2, 2006, at 9:13:27
Forget it.
- Scott
Posted by Squiggles on September 3, 2006, at 7:46:15
In reply to Re: Clonazepam dosing » Squiggles, posted by SLS on September 2, 2006, at 9:18:45
Lowering of seizure threshold:
Here is an article suggesting the prevention
of seizure in K w/d and tolerance through.
K is found to lower the seizure threshold, thus
increasing the probability of seizure in
withdrawal:-------------
Tolerance and withdrawal to anticonvulsant action of clonazepam: role of nitric oxide.* Gupta N,
* Bhargava VK,
* Pandhi P.Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
The use of clonazepam in the long-term treatment of epilepsy is greatly inhibited by its capacity to induce tolerance and dependence. A means of preventing or minimizing the tolerance and dependence inducing properties is required. Here the role of nitric oxide in preventing the development of tolerance and withdrawal hyperexcitability was studied. In Wistar rats, clonazepam at a dose of 0.25 mg/kg i.p. twice daily produced tolerance to its anticonvulsant action in 28 days. After sudden cessation of therapy it produced hyperexcitability. Tolerance was shown by a decrease in seizure threshold to near control value while withdrawal hyperexcitability was evidenced by a significant decrease in seizure threshold below the control value. L-Arginine (a donor of nitric oxide) and N omega-nitro-L-arginine (an inhibitor of nitric oxide synthase) were given in doses of 150 mg/kg and 8 mg/kg, respectively on day 1, 3, 7, 14, 21 and 28 with clonazepam. Withdrawal hyperexcitability was seen on day 1, 2 and 4 after cessation of drug therapy. Electroshock was used as a model of epilepsy and seizure thresholds were determined by an up and down method of Kimball et al. L-Arginine was found to inhibit the development tolerance as well as withdrawal hyperexcitability when administered with clonazepam while N omega-L-arginine did not prevent either the development of tolerance or withdrawal hyperexcitability in the electroshock model. In the PTZ model, however, L-arginine had no effect on the anticonvulsant action and withdrawal hyperexcitability while inhibition of nitric oxide synthesis prevented withdrawal hyperexcitability in PTZ-induced seizures.
PMID: 10939034 [PubMed - indexed for MEDLINE]
Posted by Squiggles on September 3, 2006, at 8:07:39
In reply to Re: Clonazepam dosing » SLS, posted by Squiggles on September 3, 2006, at 7:46:15
This will be my last message, because there
are so many articles pointing to K as being
seizure-inducing upon discontinuation, possibly
more than other benzos, at lower dosages.
You can search for yourselves on this topic.
It might stand to common sense that a drug
made especially for convulsions, will upon
stopping produce convulsions, but dose may
override that, i don't know. Certainly,
valium had a different w/d effect (of another
horror but not encephelic) for me. This
article below shows the need for caution,
but even here, a much slower and perhaps
adjuncted withdrawal schedule is needed
for K.Squiggles
---------------------
Comment in:
Psychiatr J Univ Ott. 1990 Mar;15(1):64.
Seizure in gradual clonazepam withdrawal.* Wong T,
* Tiessen E.Convulsions from abrupt clonazepam withdrawal in patients with a seizure history or concurrent neuroleptic use have been described in the literature. This is a report of a patient without these precipitating factors developing seizure despite "gradual" reduction of clonazepam by .5 mg every 4 days. The possibility of clonazepam withdrawal seizures should be kept in mind even in patients not considered at risk for developing seizures. Clonazepam cessation should be more gradual, even slower than .5 mg every 4 days.
PMID: 2508139 [PubMed - indexed for MEDLINE]
Posted by SLS on September 3, 2006, at 9:02:49
In reply to Re: Clonazepam dosing » Squiggles, posted by Squiggles on September 3, 2006, at 8:07:39
> This will be my last message, because there
> are so many articles pointing to K as being
> seizure-inducing upon discontinuation, possibly
> more than other benzos, at lower dosages.
> You can search for yourselves on this topic.
> It might stand to common sense that a drug
> made especially for convulsions, will upon
> stopping produce convulsions, but dose may
> override that, i don't know. Certainly,
> valium had a different w/d effect (of another
> horror but not encephelic) for me. This
> article below shows the need for caution,
> but even here, a much slower and perhaps
> adjuncted withdrawal schedule is needed
> for K.
I would have to agree with you. I think your conclusion is well supported. My own experience with withdrawal from clonazepam was that it was far more hellish than with lorazepam. It including lightening-bolt sensations in the head that never occured with lorazepam withdrawal. There is so much more, but I can't recount in words the differences. I would imagine that a crossover to valium or using some sort of support like an anticonvulsant might make sense. I have seen Depakote suggested as an implement to be used in benzodiazepine withdrawal.
- Scott
Posted by Squiggles on September 3, 2006, at 9:10:22
In reply to Re: Clonazepam dosing, posted by SLS on September 3, 2006, at 9:02:49
sp. [encephelic]) should read 'encephalic';
> I would have to agree with you. I think your conclusion is well supported. My own experience with withdrawal from clonazepam was that it was far more hellish than with lorazepam. It including lightening-bolt sensations in the head that never occured with lorazepam withdrawal. There is so much more, but I can't recount in words the differences. I would imagine that a crossover to valium or using some sort of support like an anticonvulsant might make sense. I have seen Depakote suggested as an implement to be used in benzodiazepine withdrawal.
>
>
> - Scott
>Thank you for the feedback Scott; as i understand
it you got off K without extra adjunct help;
that suggests that you may not have needed it
all your life; perhaps epileptic people do, or
maybe even bipolars, but i suspect that many
people take it all their life because they cannot
get off it (like me), putting a curve in the
journal interpretations.Time will tell in scientific circles; to
quote a struggling benzo man, "the truth will
out."Take care
Squiggles
Posted by rfs on September 3, 2006, at 17:27:33
In reply to Re: What does taking a benzo actually feel like? » Meri-Tuuli, posted by Colleen D. on August 25, 2006, at 18:05:41
> Hi!
>
> Taking Xanax for me is like having a glass or two of wine, but without the feeling of overall relaxation of the muscles throughout my body. Drinking alcohol gives me a rubbery feeling and a definite lack of coordination.
>
> I currently take less clonazepam than was originally prescribed. .5mg at bedtime and .5mg in the morning. It's been a miracle for my symptoms of OCD, GAD and SP.
>
> I'm sad to hear it is not more easily available for you. After researching benzos and deciding clonazepam was probably the med for me, I asked my doctor and he didn't balk at prescribing it. So, perhaps you could do some more reading on them, take some notes and and go in as if you have made an informed decision on what you want and maybe...
>
> Good luck!
>
> Colleen
>
> p.s. Where in the UK are you? My mom is Irish and all of our relatives are in Yorkshire.
Hi I have been taking Benzos on and off for 11 years. Xanax at times made me feel slightly high and I could tell when it was leaving my system. I now take klonopin(Clonazepam)All it does is remove the anxiety. I can think clearer in stressful/anxious situations. I would say if you had a minor pain, and took an aspirin, the pain would go away but other then that, you would not feel any different. Also, many times I am entering a situation that I know normally makes me anxious. Just knowing I have the klonopin with me helps. They found that when people could self administer pain meds (Highly addictive) they took less then when they had to wait for someone to provide them. I think anxiety and pain are more complicated then we realize. For myself I have the anxiety situation to worry about, and I also have "how bad the anxiety itself will be or look to others. I also use benzos when I fly. The more I fly the less anxious I become, because Since I have experienced all the bumps and mnoise before, I know it is just a normal part of flying. I feel they have made a world of difference in my life along withA/D.
Ray
This is the end of the thread.
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