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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by rjlockhart98 on October 14, 2005, at 13:20:47
I take Clonazepam 6mg daily. Yes i know thats alot. My doctor doesnt hasnt moved to Xanax yet, I have been on Ativan 6mg (2mg x 3) and didnt help much.
Klonopin comes on slowly, and takes time to peak effect. When i have panic attacks, it takes up to 15min to reach a effect of calming it down. I have heard Xanax works FAST.
How does Xanax compare since it does have antidepressant properties where i have heard from some sourses. Does it make you in a better mood?
Klonopin all i know is it relieves, but then at the same time depresses me, at doses like 2mg or 3.
Does anyone take Xanax?
Posted by JenStar on October 14, 2005, at 15:50:54
In reply to Klonopin and Xanax, how they differ in effect?, posted by rjlockhart98 on October 14, 2005, at 13:20:47
I take Xanax,and it works very well to calm panic for me. I know it's *supposed* to be addictive, but I've never had issues starting it and then stopping abruptly when I no longer need it. I don't know if it makes a mood better, but since I stop worrying so aggressively, my mind is freed up to focus on more positive things.
What happened with your heart palpitations? I was worried about you! ARe you ok?
JenStar
Posted by med_empowered on October 14, 2005, at 17:54:23
In reply to Re: Klonopin and Xanax, how they differ in effect? » rjlockhart98, posted by JenStar on October 14, 2005, at 15:50:54
hey! Yeah, back in the 80s, in the pre-SSRI years, Xanax was noted to have some helpful anti-depressant effects, so much so that some patients who presented with high level anxiety and low-to-mid level depression were treated with xanax as their primary medication, and antidepressants, if used, were secondary. It also helps to improve mood in some people with schizophrenia, schizoaffective, and bipolar disorder. The problem is dosing; Xanax is great for panic attacks--take one when you're freaking out, you'll feel OK for a couple hours. But..when its used as a long-term maintenance med, the short half-life is a definite problem because people sometimes get anxious in between doses. Also, although any benzo can exacerbate (occasionally cause) psychosis or induce "rage" reactions, xanax and halcion (a benzo sleeping pill related to xanax that's now used very infrequently, and is actually banned in some countries) seem to cause a n unusually large number of reactions, based upon reports filed with the FDA. Plus, withdrawal from xanax can be really hard--some docs switch the patient from xanax to a phenobarbital or xanax-phenobarbital mix and do the taper that way. As for "addition," thats a tricky subject. Yes, all benzos cause physical dependence--studies dating back to the early 60s with librium have shown this. The problem seems to be that xanax, because of its short half life, makes the physical dependence more pronounced; also, because of its fast onset and mood-elevating properties, xanax became the benzo of choice for those abusing RX drugs (especially true among teenagers and 20somethings). In addition...xanax was pushed really hard for a while, so docs tended to prescribe it when another benzo--ativan, valium, librium, klonopin, etc.--would have been much more appropriate. This caused problems b/c patients who would have been better served by long-acting, slower-onset benzos were placed on high-intensity, short-acting, fast-onset xanax...although xanax does appear to cause more problems in the phsycial dependence department (like I said, xanax withdrawal can be pure, unmitigated hell for some people), a large part of the problem was inappropriate prescribing by physicians b/c xanax was the "it" pill for a while. In addition, if you look at sales numbers, in the US xanax was **the** benzo; since so many benzo users were being given xanax, it only makes sense that alot of those who had problems with benzos had problems with xanax. So...I don't really know what to tell you. Some shrinks really hate xanax--a friend of mine, who is in medical school, calls it "the crack of the benzos"--but some GP docs and shrinks still prescribe it pretty regularly. Dosage is highly variable; 2-10+mgs/day. Antidepressant effects are decidedly more robust on the higher end, but I think there is a sort of diminishing-returns effect as the dose is upped. Xanax lacks the "mood-stabilizing" properties that Klonopin (and Ativan) have, so its definitely inappropriate for cases where the patient exhibits (hypo)mania and/or agitation...that said, some schizophrenics benefit from xanax and it helps keep their neuroleptic dose at a minimum. Klonopin is probably the most mood-dampening benzo I've ever taken, except maybe Tranxene (tranxene isn't a mood-stabilizer, but it can cause **severe** depression in some people). So...its not surprising that Klonopin is making you depressed. Plus, your dose is a little high--Klonopin is usually dosed from 1-3, up to 4, mgs/day; in that range, drug-induced apathy, depression, and "paradoxical reactions" are minimal. There is a xanax xr now...I've heard mixed reviews on that one, and I've never taken it so...I'd ask your doc about it. It seems like a marketing ploy to keep xanax popular as docs shift to long-acting benzos like klonopin. One poster noted that Prazepam helps some people with depression; at the very least, it is less likely than klonopin to **cause** depression. Could you try Ativan+Klonopin? I hear you on Klonopin's delayed onset; it makes it ideal for people who take it as a double anxiolytic+mood-stabilizer, but makes things problematic for people who take it as-needed for anxiety. Some people do well with a base Klonopin dose, plus a shorter acting benzo (usually ativan it seems) for anxiety "flare-ups". Ativan is probably the cleanest benzo out there; it doesn't seem to affect mood (positively or negatively) and it doesn't seem to interact with many drugs. Plus, withdrawal is usually easier than with xanax and dependence is much milder than with many other benzos. Librium and Valium would also be options but...doctors tend to either not prescribe those or under-prescribe them (in which case the question must be asked: why bother?). Good luck!
Posted by UgottaHaveHope on October 14, 2005, at 18:44:39
In reply to Re: Klonopin and Xanax, how they differ in effect?, posted by med_empowered on October 14, 2005, at 17:54:23
Xanax acts faster, but Klonopin has a more relaxed effect for a longer period of time. i guess i would have to say its like coke and pepsi. you have to find out which one you like the best. i love klonopin.
Posted by Franz on October 17, 2005, at 15:45:58
In reply to Re: Klonopin and Xanax, how they differ in effect?, posted by med_empowered on October 14, 2005, at 17:54:23
> There is a xanax xr now...I've heard mixed reviews on that one, and I've never taken it so...I'd ask your doc about it. It seems like a marketing ploy to keep xanax popular as docs shift to long-acting benzos like klonopin.
Hi med_empowered,
Do you have links for those reviews?.
I do not think Xanax XR is just marketing. It works as supposed (maybe not so good, but it works), the onset of action is much more soft than in regular Xanax. Also, it lasts more (not 24 hs maybe) and the peak is about half of the dose, e.g. regular 0.25 foa a XR 0.5). XR in my experience is not so mood effective and maybe this is what people miss.
I think both versions have its use.
Thanks
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