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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by polly on October 5, 2001, at 21:32:18
Can Xanax be taken togerther with Klonopin?
Klonopin for SP, and Xanax for PD and/or quick relief from breakthrough attacks.
Posted by paxvox on October 6, 2001, at 7:16:57
In reply to Xanax and Klonopin together?, posted by polly on October 5, 2001, at 21:32:18
Although both meds are benzodiazepines, they have certain pharmological differences that COULD make their use at the same time effective. Xanax (alprazolam) at .5mg is equivalent to 5mg of Valium. Klonopin (clonazepam) at .25mg is also equivalent to 5mg Valium (diazepam). The main differences between Xanax and Klonopin is their time to peak plasma level, and their half-life in your body. Xanax takes 1-2 hours to reach peak plasma concentrations, and has a half-life (i.e half of the available drug has been metabolised) of 9-20 hours. Klonopin, conversely, has a 1-4 hour peak plasma time but a much longer half-life of 19-60 hours. So, therapeutically speaking, Klonopin would be the main benzo for your condition, and Xanax could be used ONLY when you were having "breakthrough" panic attacks to supplement the benzo effect, but clear your system more quickly. The co-administration of both meds on a daily basis taken chronically seems redundant. Perhaps your Pdoc should pick one and increase the dose level or dose frequency.
PAX
Posted by polly on October 6, 2001, at 10:42:08
In reply to Re: Xanax and Klonopin together? » polly, posted by paxvox on October 6, 2001, at 7:16:57
Thanks PAX -
Then 6 mg of Xanax should be equivalent to 3 mg of Klonopin.> Although both meds are benzodiazepines, they have certain pharmological differences that COULD make their use at the same time effective. Xanax (alprazolam) at .5mg is equivalent to 5mg of Valium. Klonopin (clonazepam) at .25mg is also equivalent to 5mg Valium (diazepam). The main differences between Xanax and Klonopin is their time to peak plasma level, and their half-life in your body. Xanax takes 1-2 hours to reach peak plasma concentrations, and has a half-life (i.e half of the available drug has been metabolised) of 9-20 hours. Klonopin, conversely, has a 1-4 hour peak plasma time but a much longer half-life of 19-60 hours. So, therapeutically speaking, Klonopin would be the main benzo for your condition, and Xanax could be used ONLY when you were having "breakthrough" panic attacks to supplement the benzo effect, but clear your system more quickly. The co-administration of both meds on a daily basis taken chronically seems redundant. Perhaps your Pdoc should pick one and increase the dose level or dose frequency.
>
>
> PAX
Posted by paxvox on October 7, 2001, at 20:20:39
In reply to Re: Xanax and Klonopin together?, posted by polly on October 6, 2001, at 10:42:08
> Thanks PAX -
> Then 6 mg of Xanax should be equivalent to 3 mg of Klonopin.Yes, but as i said, it is really the HALF-LIFES that make these meds differently applicable for combinent use. I don't see a conflict as long as you understand that the two, while similar, have slightly different pharmocology and more significant potency.
PAX
Posted by Alan on October 8, 2001, at 14:12:50
In reply to Xanax and Klonopin together?, posted by polly on October 5, 2001, at 21:32:18
> Can Xanax be taken togerther with Klonopin?
> Klonopin for SP, and Xanax for PD and/or quick relief from breakthrough attacks.I use Klon and ativan (similar to xanax) with Klon at 2MG daily and ativan PRN as much as needed for specific situations that provoke panic (sometimes up to 4 MG for long air travel and sleep needed). The Klon works great to stabilse my mood as the ativan fluctuates in and out of my system. A small dose of neurontin 3X 100MG daily also helps to moderate these fluctuations.
Alan
Posted by kregpark@yahoo.com on October 11, 2001, at 4:18:08
In reply to Re: Xanax and Klonopin together?, posted by Alan on October 8, 2001, at 14:12:50
Several years ago I exchanged a few emails with a
happily married woman who took those two together.
She has panic disorder and went to the Wisconsin
Clinic (University) led by John Marshall, author
of "Social Phobia" (GREAT BOOK!!!).Anyway, after seeing Marshall she changed to
Klonopin low dose (2mg or so) and Xanax sometimes
daily and sometimes prn, I think about 1 mg a day
or less when taken.This was for panic disorder, but she reported
virtual complete remission and lack of any negative
side effects taken some number of years.Some people might do well adding provigil to that combo.
Xanax can be tricky though if you have fast metabolism.
(frequent dosing and rebound anxiety sometimes a problem).kregpark@yahoo.com
http://www.socialfear.com/
> > Can Xanax be taken togerther with Klonopin?
> > Klonopin for SP, and Xanax for PD and/or quick relief from breakthrough attacks.
>
> I use Klon and ativan (similar to xanax) with Klon at 2MG daily and ativan PRN as much as needed for specific situations that provoke panic (sometimes up to 4 MG for long air travel and sleep needed). The Klon works great to stabilse my mood as the ativan fluctuates in and out of my system. A small dose of neurontin 3X 100MG daily also helps to moderate these fluctuations.
>
> Alan
Posted by Britt Park on October 21, 2001, at 17:06:11
In reply to Re: Xanax and Klonopin together? » Alan, posted by kregpark@yahoo.com on October 11, 2001, at 4:18:08
I think (as does my psychiatrist) that there is more difference between xanax and klonopin than just pharmacokinetics. Xanax has been shown (in not terrifically convincing studies) to have antidepressant effects. As far as I know klonopin if anything can produce a slightly depressed mood in some people. For me taking just klonopin for my anxious depressions has not been as effective as taking xanax alone or with klonopin. FWIW.
Britt
Posted by kregpark@yahoo.com on October 22, 2001, at 3:23:07
In reply to Re: Xanax and Klonopin together?, posted by Britt Park on October 21, 2001, at 17:06:11
> I think (as does my psychiatrist) that there is more difference between xanax and klonopin than just pharmacokinetics. Xanax has been shown (in not terrifically convincing studies) to have antidepressant effects. As far as I know klonopin if anything can produce a slightly depressed mood in some people. For me taking just klonopin for my anxious depressions has not been as effective as taking xanax alone or with klonopin. FWIW.
>
> Britt---------
I totally agree Britt, in general those hold true.
Klonopin does induce mild depression for me, and
Xanax does not, in fact in low dose it is mood lifting for me.For SP, Klonopin is extremely effective, Xanax only a bit (statistically).
But for panic and other stuff Xanax often has advantages except for half life.
Posted by judy1 on October 24, 2001, at 23:42:14
In reply to Re: Xanax and Klonopin together? » Britt Park, posted by kregpark@yahoo.com on October 22, 2001, at 3:23:07
I've taken this combo for 4 years- 2mg tid (6mg/day) of klonopin for panic disorder and mood stabilizer and xanax prn (usually about 2mg/day) for breakthrough panic attacks during really stressful times. Together they have totally controlled my panic disorder. Best of luck- Judy
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