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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 Guy on September 3, 2004, at 12:59:41
I am currently taking 1.5 mg of clonazepam and 15 mg Remeron before bed and this is working very well for my insomnia and anxiety. My pdoc wants me to take the clon in split doses so I don't experience rebound anxiety, but I have not found this to be a problem so I just keep doing things my way. What I am worried about, though, is tolerance. I know it's pointless to worry about something I can't do anything about, but I nevertheless keep waiting for the other shoe to drop. I love the clonazepam...so few side effects and it really helps me feel almost normal. I just hope and pray it will keep on working. The key for me has always been a good night's sleep.
Posted by Glydin on September 3, 2004, at 13:55:28
In reply to Clonazepam working, but worried it won't last, posted by Guy on September 3, 2004, at 12:59:41
It has worked for three years for me at lower than my starting dose and it is the only RX I use.
How long have you been on?
Tolerance, in most cases, develops in a relatively short span of time from start up, if one is going to develop tolerance and be unable to find a maintance dosing.... and by tolerance are you referring to needing higher and higher doses to achieve the same results? I only ask because there seems to be some confusion with terms associated with meds that have potential properties of physical dependence, addiction, abuse, withdrawal, etc... and what they really mean. I hope you don't take offense that I'm asking you to clarify.
Posted by Guy on September 3, 2004, at 14:26:31
In reply to Re: Clonazepam working, but worried it won't last, posted by Glydin on September 3, 2004, at 13:55:28
Yes, I'm worried about needing higher and higher doses to get the same effect. I'm particularly worried about the med losing its ability to help me sleep. I have read that if insomnia is caused by anxiety, there shouldn't be a problem, whereas if you use the clonazepam to force sleep, tolerance develops rapidly. My anxiety disorder is quite severe, and I should probably be on an even higher dose, but as usual I try to take as little as possible, even if that means more symptoms.
Posted by Jasmineneroli on September 3, 2004, at 16:53:23
In reply to Re: Clonazepam working, but worried it won't last, posted by Guy on September 3, 2004, at 14:26:31
Hi: I've been taking Clonazepam for GAD for just over a year, and like Glydin I've been able to reduce my dose from the original 1 - 2mg per day, as needed, down to .5mg per day (bedtime) with an occasional .25 or .5mg per day, as needed, in times of stress or great demand upon me.
I think it has been well documented (and certainly anecdotal evidence from this site, would bear it out) that tolerance does not seem to develop in those with anxiety. There is however, the possiblity of withdrawal affects once stopped. But this is no different than most other AD or anxiolytic drugs.
Clonazepam has been the ONLY drug to help with the physical symptoms of my anxiety, making me feel "even" and calm. The only part of my GAD that it didn't relieve that much, was the constant worrying, thinking, racing thoughts and focus problems....which varied, depending on what was happening in my life. My doc has now added a very low dose of Celexa (10mg) which has helped with the "thinking to excess". As a result, I'm sleeping better.Like you, insomnia compounds my problems. The one thing that bothers me about the combo is that I feel very lethargic in the am for quite a while.
Good luck with your trial of meds. Unless you feel more anxiety (that's not related to extra stress) and have trouble sleeping again, Clonazepam should'nt be cause for concern.
Take care, Jas
Posted by Philidor on September 3, 2004, at 17:32:23
In reply to Re: Clonazepam working, but worried it won't last, posted by Guy on September 3, 2004, at 14:26:31
First of all, Guy, you really need to chill-out. I mean, talk about irony. You're anxious about taking a drug you're taking for anxiety. (Maybe you should ask your doc for another drug to treat that!)
Ok, all kidding aside. I have been taking clonazepam, 3-4 mg a day, for 8 months now, and it has helped my social anxiety tremendously. (For the first time in my life, for example, if a girl smiles at me, I can actually look her in the eye and SMILE BACK! Do you know how GREAT that is?)
As for your fear of building tolerance, and needing to take more and more----FORGET IT!! Yes, after a time many people do have to raise their dose a bit to get the same effect. This is normal. True even of alcohol, coffee, lots of drugs.
What I think YOU are scared of is ADDICTION!
You think that you will have to raise your dose more and more to get the same effect until you're popping the pills like peanuts and draining your bank account and holding up liquor stores and buying on the street to feed your habit. You will become a JUNKIE!
Well, my friend, it ain't gonna happen. I mean, not unless that's your goal. What will happen is that you will reach the dose level that does the job for you, and stop there. Just like social drinkers who know their limit and stop when they get there.
NOW---what WILL happen after awhile is DEPENDENCE. That's different. It means that you will need to keep taking the drug every day and not stop it suddenly or you could run into trouble. You could have a really bad reaction, in fact.
But that's true of lots of people and lots of drugs! My dad can't suddenly stop taking his blood pressure meds, my mom would become very ill and finally die if she stopped taking her thyroid.
Does that make them junkies? Of course not. But it does make them drug dependent. BFD.
So forget the scare stories and keep taking the clon for just as long as it helps you. Forever, if you like. Many people do.
And if you ever decide you want to quit, you CAN! But you must do it verrrrrrrry slowly. Ask your doctor how.
And I couldn't agree with you more. A restful night's sleep is VITAL to mental and physical well-being. It should do wonders for your anxiety.
So may I make this humble suggestion? Ask your doc to give you Sonata or Ambien to use for sleep, while saving the clon for daytime anxiety. REASON: Those drugs, while close relatives of clonazepam, are designed to enhance the most restful stages of sleep in a way that clonazepam is not.
I'm not a doctor, but I do read a lot by the experts on this stuff and I can back up everything I've told you with the evidence. So I hope you find this helpful. Best of luck!
Phil
Posted by Glydin on September 3, 2004, at 18:44:06
In reply to Re: Clonazepam working, but worried it won't last, posted by Philidor on September 3, 2004, at 17:32:23
I think all the posts, thus far, have excellent very true points. I have decided that if I must be a "lifer", so be it. My quality of life has changed dramatically due to my med -- as in, I actually HAVE a life now. I was extemely agoraphobic and a mess, pretty much covering all symptoms and categories of anxiety.
I can understand your concern about the sleep issues. Benzos have been reported to lose their "sleepiness" producing effects and retain their antianxiety effects. That being said, the point of anxiety causing your sleep problem, Klon should be effective for taking care of the root cause. Also, there are options for sleep meds.
I fully support the approiate use of any benzo for anxiety disorders. They actually work, work for long term, and many of us avoid pitfalls and find them to be pretty close to a miracle. There is alot of negative info out there and caution is required but---- Successful and effective use can be achieved.
Good luck to you.
Posted by Michael Bell on September 5, 2004, at 10:27:53
In reply to Clonazepam working, but worried it won't last, posted by Guy on September 3, 2004, at 12:59:41
Klonopin is the first line of defense against anxiety disorders. Forget what you heard about SSRIs or dependence, etc. The bottom line is this - if a severe anxiety disorder is your primary problem, NOTHING works better than drugs that significantly affect the GABA transmitter system. This is why Klonopin, Nardil, GHB (Xyrem) and Alcohol are, hands down, the most effective substances for anxiety (especially social anxiety and panic attacks, in my case). Though the other transmitter systems are probably involved in some way, it is absolutely clear that people suffering from anxiety have an inefficient GABA system, and those locked into a cycle of social fear have hypersensitive CCK-B receptors as well.
Now, obviously you can't rely on GHB and alcohol as long term treatments (unless you get a script for Xyrem), and Nardil has some pretty serious side effects. So that leaves Klonopin. I've been taking it for about 2 YEARS, and I've never had to go above 1 mg/ day. I've noticed no tolerance whatsoever.
However, Klonopin may lose its effectiveness as a sleep aid, because GABA deficiency is only one possible reason for insomnia. However, the anti-anxiety effect should remain. Some other helpful substances, though not as powerful are: Picamilon, suntheanine, gotu kola, etc.
Good luck.
Posted by anxiety_free on September 5, 2004, at 20:11:07
In reply to Clonazepam working, but worried it won't last, posted by Guy on September 3, 2004, at 12:59:41
> I am currently taking 1.5 mg of clonazepam and 15 mg Remeron before bed and this is working very well for my insomnia and anxiety. My pdoc wants me to take the clon in split doses so I don't experience rebound anxiety, but I have not found this to be a problem so I just keep doing things my way. What I am worried about, though, is tolerance. I know it's pointless to worry about something I can't do anything about, but I nevertheless keep waiting for the other shoe to drop. I love the clonazepam...so few side effects and it really helps me feel almost normal. I just hope and pray it will keep on working. The key for me has always been a good night's sleep.
Hey! Klonopin is GREAT for anxiety, but in terms of sleep...not so much. It works beautifully for a while as a hypnotic, then nothing. My advice is to talk to your doc about a gradual switch of the Klonopin to daytime use (once you can handle it) and the addition of an as-needed sleep aid...there are sooo many, your doc shouldn't have a problem finding a good one for you. I you're worried about addiction to a benzo, here's the lowdown: long-term use makes you DEPENDENT. You will need to either take Klonopin or gradually taper. You won't, however, look like something out of "Valley of the Dolls". Best of luck to you!
Posted by andyboy on September 8, 2004, at 16:45:11
In reply to Klonopin, sleep, posted by anxiety_free on September 5, 2004, at 20:11:07
Hi all...
This has been one of THE MOST comforting Klono threads i have ever come accross. Ive been on 3mg/day (1mg am 2mg pm) for 3+ years now for panic and GAD. It has definitely saved my life!!! I mean I was beginning to just accept panic as a way of life before I started taking it...and like Guy- I too was worried about tolerance and addiction. Obviously outside stressors will somedays cause excess anxiety or stress (kind of like a period i am going thru right now) however- panic never seems on the horizon, and as someone had mentioned above...if I am a lifer- and the Klono keeps me panic free...then how can it be wrong.God Bless
Andy
Posted by Glydin on September 8, 2004, at 22:01:08
In reply to Re: Klonopin, sleep, posted by andyboy on September 8, 2004, at 16:45:11
Good for you, Andy. It has taken me a while to come to peace with this being an issue in my life and to come to terms with what I need to do to treat this annoying, awful "thing". But, there does comes a point you simply have to deal with the "is" of circumstances.
In the grand scheme of things, those of us who find treatments that are effective without falling into a vortex of awful issues dealing with the med itself... well, in the world of mental health and emotional issues, we are the lucky and the blessed.
Keep doing well.
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