Psycho-Babble Medication Thread 578982

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klonopin build up question

Posted by mrgeek on November 15, 2005, at 14:17:45

I actually have a few questions which all relate to my situation. If anyone has answers for these I would be very grateful. First let me give a quick background.

I was on Klonopin for about 18 months. I started at 1.5 mg/day for the first 6 months and then gradually moved down .5 mg over the last 12 months. At first, it was like a godsend offering me almost complete anxiety relief. I was happy, sociable, and successful. This lasted for about a year. At this time the anti-anxiety effects continued, but I started to become more and more detached or emotionally "numb" to the world around me. I was depressed and became increasingly unhappy with life although I was doing the best I ever had both socially and professionally. I decided to taper off the klonopin. One month after the taper completed I am now back to my old self again. I'm experiencing lots of anxiety again, but virtually no depression even though my life is falling apart around me. But thats another story. Onto my questions and suspicions.

First off, I'm wondering if it's in any way possible that over time the klonopin built up in my bloodstream to an amount that was unnecessarily high, thus having an exagerated effect on me. Seeing how the half life of klonopin is anywhere between 18-50 hours, our days are 24 hours, and most everyone taking it long term is taking the same dosage daily, wouldn't this leave the possiblity of a "build up" in you blood to a dose higher than intended over a sufficiently long period of time?

Of course there may be something fundamental I don't understand about drug metabolism, but using layman logic my conclusion makes sense to me. If this is wrong could someone please explain why?

Now second, granted that my logic is correct--it would seem to make sense that if you are affected by this then you should probably come up with an alternative dosing schedule, as opposed to simply dosing daily at specific times. Does anyone have any experience with this and klonopin?

Thanks in advance for any insight on this!

 

Re: klonopin build up question

Posted by Kon on November 15, 2005, at 18:16:19

In reply to klonopin build up question, posted by mrgeek on November 15, 2005, at 14:17:45


>At first, it was like a godsend offering me almost complete anxiety relief. I was happy, sociable, and successful. This lasted for about a year....First off, I'm wondering if it's in any way possible that over time the klonopin built up in my bloodstream to an amount that was unnecessarily high, thus having an exagerated effect on me.

The klonopin will build up for a few weeks to some steady state level depending on dose, dosing interval, half-life but within about 5 half lives (roughly 2 weeks for klonopin) you will attain this maximum level). Beyond this time, the concentration won't go any higher unless you increase dose or dosing frequency. Since you were getting benefits (without depression) way past this time period, I don't think it has anything to with overly high blood concentrations.

Depression is a known side-effect (in about 10% of subjects) of most benzos (with the possible exception of xanax). When did first notice your signs of depression? Were you taking any other drugs at the time? Anything in your life changed at that time? If not, it may be that you're one of the individuals susceptible to klonopin's depression side-effects.

I"ve been on it for over 3 years prn with no signs of depression.

 

Re: klonopin build up question

Posted by RobertDavid on November 15, 2005, at 22:44:10

In reply to Re: klonopin build up question, posted by Kon on November 15, 2005, at 18:16:19

I take 1.25mgs of klonopin at night. Recently after 10 years of being on klonopin I switched to another med because I suspected the klonopin was agrivating some depression, my moods, making me feel flat and without much zest for life. I got all the way off klonopin and all my previous social and generalized anxiety returned. I was so anxious I couldn't tell if my mood was better or not. The new medicine, Lyrica, didn't work for me at all. Typical of other meds I've tried.

In the past I tried to add several different anti depressants with klonopin, but I seem to be one of those treatment resistent people and all the anti depressants did was give me intolerable side affects (SSRI's, Effexor, Welbutrin, etc.).

Previously I was taking 2mgs klonopin at night. Now 1.25mgs seems to work just as good. My anxiety is 70% under check. I realize that I need this medicine. It works good. Perhaps I'm one of those that it depresses a bit, but my primary problem is anxiety and it works for that.

Both my doctor and I have always felt that I would benefit from an MAOI such as Nardil, especially with my social anxiety, but through the years I've always resisted taking it with it's side affects and food restrictions. My gut tells me an MAOI is the answer to "blend" with klonopin.

But before diving into another anti depressant or Nardil for that matter I have decided to hold out for the approval of EMSAM, the MAOI patch that appears to have a low side affect profile (compared to oral MAOI's) and without food restrictions at the 20mg dose.

After watching this med go through the FDA process for years it appears the final approval will come by the end of next week. If approved, it will probably be available within a few months and I will be first in line to try it. I've talked with Bristol Myers directly who verified this info. If approved, they want to fast track it to the public.

If that combo doesn't work out it's my plan to try klonopin & Nardil or klonopin & Remeron and so on until I find the right blend. I just know that klonopin works for my anxiety, better than anything I've tried. Before taking it I was house bound, after it I own a business and have a life.

I know how you feel about the possible affects it may have on depression/mood. I have always wondered if it was the klonopin or me. Unfortunately figuring this stuff out seems to be trial and error. And after trying to not take klonopin I know I'm sticking with it. It's half the answer for me.

I suppose I'd suggest you consider blending klonopin with an anti depressant as well (as you indicated klonopin did help your anxiety).

Lastly, as far as klonopin goes, I'd recommend paying the price and buying brand. My doctor is real savvy with these meds and does a lot of research for the drug companies. He says with klonopin, if you don't buy brand you can get a 20% variance in potency. Generics are mostly made out of the country.

That means from refil to refil the variance in dose could be 40%. This could have a huge impact in fluctuations in how you feel. Apearantly the fluctuatioin issue is much bigger with drugs that have a long half life like klonopin.

Anyway, I'm certainly not a doctor, this is just my take, but perhaps it's something to think about. Best of luck....

 

Re: klonopin build up question

Posted by mrgeek on November 16, 2005, at 6:06:09

In reply to Re: klonopin build up question, posted by RobertDavid on November 15, 2005, at 22:44:10

Wow, this is great advice from both of you. Thanks a lot.

I should have mentioned but i've also been on pretty much ever SSRI and SNRI on the market and none of them did squat for me...thats when i found Klonopin.

I have always been very interested in how a MAOI such as Nardil would work for me, but I too have always been too worried about the dietary restrictions and side effects to try it. I have not heard of this new patch, but I'm definitely going to be looking into it.

Anyway...thanks again


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