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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Lainy on July 21, 2003, at 17:47:56
I was given 3mg of Klonopin daily for anxiety. I quickly (within a month) found that I was taking all 3mg at the same time,(which doc said was okay as long as I didn't go over the 3mg dosage) but to no avail. What was effective at first soon was like eating a piece of candy. Has anyone else had this problem of quickly building up a tolerence to Klonopin? I couldn't even get to sleep on 3mg.
I don't know what to resort to now. I think the next step up is Valium.
BTW, I HATE taking medications and I have a normal high tolerance.
Posted by Janelle on July 21, 2003, at 17:57:14
In reply to Klonopin tolerance, posted by Lainy on July 21, 2003, at 17:47:56
Given that Klonopin is a benzo, and they are known for tolerances to develop, it's possible that you have indeed developed a tolerance for it.
I've been taking Klonopin for MANY years, started with 1 mg/day and now take 2mg/day, one in am and one in pm.
I'm not sure I'd say that I've built up a tolerance to it but rather that because it has a longer half-life than other benzos and acts very gradually and slowly over the course of a day, its effects are more *subtle* in my experience.
I plan to taper off of it eventually and remain on Buspar (another anti-anxiety med but it's not a benzo).
I would just issue the caution that Valium, Xanax and other short-acting benzos are highly addictive, people quickly develop a tolerance to them and have to pop several each day.
Talk to your pdoc about your concerns and good luck 2 u!
Posted by Ame Sans Vie on July 21, 2003, at 19:24:45
In reply to Re: Klonopin tolerance » Lainy, posted by Janelle on July 21, 2003, at 17:57:14
I personally don't believe in tolerance developing so rapidly to benzos. Are you sure you're not confusing the loss of the initial sedation and buzz from the Klonopin with lack of efficacy? That's a very common mistake. For the vast majority of patients on Klonopin, tolerance either never develops, or develops VERY gradually, over a period of years. It may be that the sedating effects have disappeared, which is a *good* thing, but the anxiolytic effects should still be there. Sometimes it takes a few weeks to really notice them. I suggest you give it a chance.
Posted by Lainy on July 21, 2003, at 20:10:24
In reply to Re: Klonopin tolerance, posted by Ame Sans Vie on July 21, 2003, at 19:24:45
I've never felt a "buzz" or any sedation effect while on Klonopin. I was usually waiting to feel "normal" as opposed to how I usually feel.
Posted by Viridis on July 21, 2003, at 21:21:09
In reply to Klonopin tolerance, posted by Lainy on July 21, 2003, at 17:47:56
The pattern with Klonopin for many anxiety patients is that once the optimal dose is achieved, it tends to stay stable for a long time. I wonder if you were ever at "your" dose in the first place, or whether you just felt substantial relief initially (i.e., a big improvement), and now realize you could be doing better? I've done well at 1 mg/day, but my pdoc says that many anxiety patients need "several times" that amount. Apparently, he has a lot of patients who have stayed at the same dose for years, once the right dose was found. Some epileptics take up to 20 mg/day and tolerate it just fine.
Interestingly, I haven't built up a tolerance to Klonopin, yet with Xanax (which used to work for me in very small amounts), I now need to take 2-3X as much to get the same effect. I only take it occasionally and have no problems with it; I just need more when I do take it. I asked my pdoc whether this was likely to represent cross-tolerance from the Klonopin (which I take every day) and he said this was unlikely, given the structural differences between the two. Since I use it fairly rarely and always have extra, he just said I should take as much as I need at a time, and not worry unless I find myself needing it more and more often too (which hasn't been the case). Yet with the Klonopin itself, I haven't noticed any tolerance building.
Posted by River1924 on July 21, 2003, at 22:55:28
In reply to Klonopin tolerance, posted by Lainy on July 21, 2003, at 17:47:56
I'm wondering what your diagnosis is. Do you normally have a "stable" amount of stress and anxiety... or do mood flucuations cause you to have changes in your insomnia and anxiety? Depending on my other meds and the time of year and random mental states, I need more klonipin at times. I usually take between 2 and 4 milligrams but it just depends on internal and external circumstances. Has something been going on lately? Is there any other possible explantion for your increased insomnia and anxiety, etc?
Posted by Lainy on July 22, 2003, at 5:23:58
In reply to Re: Klonopin tolerance » Lainy, posted by River1924 on July 21, 2003, at 22:55:28
My diagnosis is "Adjustment disorder with mixed aniexty and depressed mood." My life has gone from stable and having things "normal" families have to VERY unstable.
Posted by mattdds on July 22, 2003, at 11:25:33
In reply to Klonopin tolerance, posted by Lainy on July 21, 2003, at 17:47:56
Hello,
Do you have panic attacks or severe generalized anxiety (GAD)? It is these two things that benzos have tremendous "staying power" against, from what I have read. Otherwise, tolerance can develop quickly, if they are taken for other problems. Be sure you have a diagnosis nailed down.
What is interesting is that my dad took benzos for many years for the wrong indication (to counteract SE's of asthma meds, which were stimulants), and he quickly developed a rapid tolerance to them and had to take extremely high doses.
On the other hand, I have not seen any decline in the effectiveness of Klonopin over the almost 2 years I've taken it for. But I take it for a different indication - panic disorder and severe GAD. Also, it does feel like I'm taking candy now, as you put it. I don't feel it "kick in" or anything like that. I don't feel any "effects" anymore, other than the fact that I don't get panic attacks and derealization and have normal anxiety levels now.
I've read that tolerance develops faster when benzos are taken for things besides pure anxiety disorders (e.g. sleep), but is less likely to occur if one has pure panic disorder or GAD.
So be sure that you have a correct diagnosis. I believe you said you were taking them for "adjustment disorder" or something like that. Perhaps benzos are simply not for you? They are certainly not for everyone. This may be a problem with your diagnosis / treatment plan, rather than with Klonopin per se.
Best of luck,
Matt
Posted by matthhhh on July 22, 2003, at 16:30:13
In reply to Re: Klonopin tolerance )) River, posted by Lainy on July 22, 2003, at 5:23:58
Ive been on all the ssri's all made me tired. Im thinking about taking klonopin for social anxiety and ocd. Does anyone like this drug compared to the ssri's?
Posted by Viridis on July 23, 2003, at 3:22:31
In reply to Thinking about taking klonopin, posted by matthhhh on July 22, 2003, at 16:30:13
I can't stand SSRIs -- they just make things worse for me and increase my agitation, and this doesn't go away over time. My pdoc confirmed that SSRIs can do that to some people, and simply suggests that I avoid them. But for generalized anxiety, depression (anxiety-based) and panic disorder, Klonopin has been great for me so far, with no side effects past the first week or so and no need for dosage adjustment after two years.
Posted by Lainy on July 23, 2003, at 7:27:54
In reply to Re: Thinking about taking klonopin » matthhhh, posted by Viridis on July 23, 2003, at 3:22:31
Your diagnosis is similar to my own. I have been diagnosed with 'Adjustment disorder with mixed anxiety and depressed mood'. I also have panic attacks.
I was curious as to what your dosage of Klonopin is? I was o 3mg daily...went off and started Tranxene, which is completely noneffective. I going to start back on the Klonopin today. Also, do you take anything else with it?
Posted by Viridis on July 24, 2003, at 0:14:06
In reply to Re: Thinking about taking klonopin Viridis, posted by Lainy on July 23, 2003, at 7:27:54
Hi Lainy,
Well, my situation is a bit complicated, but it finally seems to be under control. My official diagnosis is panic disorder, major depression, and ADD. The pattern with me (and my pdoc agrees) is that I get disorganized, stress out over this, and become severely depressed as a result. In other words, for me anxiety leads to depression, and the anxiety seems to stem largely from my ADD situation.
For years, doctors addressed just the depression aspect of things and gave me meds like SSRIs, Wellbutrin, etc., saying that anxiety is simply a byproduct of depression, so treating the depression is the key. I responded very poorly -- just got more anxious, had more panic attacks, and hated the side effects of the ADs. I became quite convinced that the anxiety led to depression, and finally found a psychiatrist who agreed.
As soon as he started me on Klonopin (1 mg/day), plus Xanax as needed, I felt much better and stopped having panic attacks, severe depression, etc. Once that was stabilized, we addresed the ADD issues, so now I take a small dose of Adderall (10 mg/day), and recently Strattera as well (currently 60 mg/day). That's further improved my focus and mood. I just can't touch SSRIs or everything falls apart.
I'm still using just 1 mg Klonopin, although my pdoc has given me the option of increasing it as needed. But I don't need to, so have declined the offer. If my anxiety flares up, I take a bit of Xanax (once in a while) and that seems to take care of the problem.
Oh, and I take 1200 mg Neurontin/day, but it doesn't seem to do anything for me (good or bad), so I'll probably drop that one quite soon.
I really think Klonopin is the key med, because it allowed me to settle down, think clearly, and rationally work out a drug combination that's appropriate for my situation, with the help of a very good psychiatrist who doesn't just hand out whatever med the drug co. reps are pushing this month.
Posted by Lainy on July 24, 2003, at 8:16:58
In reply to Re: Thinking about taking klonopin Viridis » Lainy, posted by Viridis on July 24, 2003, at 0:14:06
This is the end of the thread.
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