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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 Talbot on March 18, 2006, at 4:32:10
The clonazepam has helped by general anxiety about 80-90%. I’m still having “breakthrough” panic attacks, with all the nasty side effects (choking/gagging, feelings of impending doom, sweating, etc.) I was taking clonazepam 1mg morning, 0.5 mg afternoon, and 0.5 mg evening. My pdoc thought upping the dose may help, so now I’m on 1mg morning, 1mg afternoon, and 1mg evening. Is this considered a high dose? Funny, but I don’t feel sedated at all, just calmer. Guess that’s the way these things are supposed to work. Any thoughts on the increase in clonazepam?
Posted by bassman on March 18, 2006, at 8:10:24
In reply to Klonopin adjustment, posted by Talbot on March 18, 2006, at 4:32:10
I had to back off 1 mg Klonopin/day because it was making me depressed (at 1.5 mg, the dose the pdoc suggested starting at, I was in a stupor). I'm a big man, 6'2" tall and 200 lbs-but a 120 female friend of mine takes 6 mg Klonopin a day and isn't sedated! My point: everyone is different. I have panic disorder and if the 3 mg Klonopin is working and even your doc is happy, stay with it-panic is so awful. Yes, the 3 mg's is a relatively high dose-according to the manufacturer, the clinical trials showed that 1 mg was optimal. But some people need more for the same effect, for sure. Good luck-I've been in Panic Hell more times than I need to in one lifetime...so I'm really empathetic.
Posted by Maxime on March 18, 2006, at 9:16:04
In reply to Klonopin adjustment, posted by Talbot on March 18, 2006, at 4:32:10
Hi
For anxiety you shouldn't have to go higher than 4 mg. People with epilepsy take up to 20 mg a day so you are safe. I was taking 4 mg at night and now I am at 3.5. I am trying to reduce in the hopes that it will help my depression.
So nope, you are not taking too much.
Maxime
> The clonazepam has helped by general anxiety about 80-90%. I’m still having “breakthrough” panic attacks, with all the nasty side effects (choking/gagging, feelings of impending doom, sweating, etc.) I was taking clonazepam 1mg morning, 0.5 mg afternoon, and 0.5 mg evening. My pdoc thought upping the dose may help, so now I’m on 1mg morning, 1mg afternoon, and 1mg evening. Is this considered a high dose? Funny, but I don’t feel sedated at all, just calmer. Guess that’s the way these things are supposed to work. Any thoughts on the increase in clonazepam?
Posted by Talbot on March 18, 2006, at 11:48:02
In reply to Re: Klonopin adjustment » Talbot, posted by Maxime on March 18, 2006, at 9:16:04
Yes, I'm beginning to see the pattern of "your mileage may vary!!" I'll post an update in a couple of weeks and see if the increased dosage does the trick.
As always, thank you all for your insight.
Posted by RobertDavid on March 18, 2006, at 12:28:41
In reply to Re: Klonopin adjustment, posted by Talbot on March 18, 2006, at 11:48:02
I take 2mgs of klonopin daily at bedtime. I've been taking it for 12 years. It's about 80% effective for my social and generalized anxiety. I was up to 3mgs once, but 2 seems to work as well with fewer sedative side effects. Everyone is different, but it seems the typical range of dosing is 1 to 4 mgs a day with some going above and below that dose.
I believe if you get a positive response to klonopin it's trial and error with both the dose, the time of day you take it whether or not to split doses.
For me once a day at bedtime works all day just fine. Some seem to like spliting dose. Others take more at bedtime with a smaller dose in the morning. I haven't heard many that take it 3 times a day, but hey, what works works.
Anyway, of all the many drugs I've tried it's worked the best for me. Again, fine tuning the dose is the key.
Posted by Kon on March 18, 2006, at 18:45:34
In reply to Klonopin adjustment, posted by Talbot on March 18, 2006, at 4:32:10
My philosophy with benzos is that if needed to improve anti-anxiety effects and no side-effects are seen with increased dose...then go for it. I'm kind in a similar situation where my effective dosage has almost doubled over the span of about 4 years of usage but have found no side-effect with increased dose. I see no problem with upping dose (except that I might need to pay more attention to tapering should I need to discontinue due to unacceptable side-effects.). I've wondered if I have a ceiling dose that I would be unwilling to climb even without noticeabe side-effects...I'm not sure but I probably don't have one as long as it worked well without side-effects or unless my doc forced me to stop or change the drug or I found an alternative that worked even better.
Posted by Phillipa on March 18, 2006, at 20:15:02
In reply to Re: Klonopin adjustment » Talbot, posted by Kon on March 18, 2006, at 18:45:34
Klonopin was very depressing for me. Fondly, Phillipa
Posted by Talbot on March 21, 2006, at 18:49:21
In reply to Re: Klonopin adjustment, posted by Phillipa on March 18, 2006, at 20:15:02
If I'm having a real bad day with more stress/anxiety than usual, I notice that if I take my recommended dose, BUT break the pill in half, it seems to work much quicker. I'm assuming this is because it can be metabolized quicker in the GI tract. Would this be similar to as how letting a table dissolve under your tongue seems to work quicker?
Also, by using either method mentioned above, would this alter the half-life of the clonazepam (and make it poop out quicker)?
Posted by yxibow on March 21, 2006, at 21:33:28
In reply to Re: Klonopin adjustment, posted by Talbot on March 21, 2006, at 18:49:21
> If I'm having a real bad day with more stress/anxiety than usual, I notice that if I take my recommended dose, BUT break the pill in half, it seems to work much quicker. I'm assuming this is because it can be metabolized quicker in the GI tract. Would this be similar to as how letting a table dissolve under your tongue seems to work quicker?
>
> Also, by using either method mentioned above, would this alter the half-life of the clonazepam (and make it poop out quicker)?No, the half life is determined by the circulation in the bloodstream. It seems that you, if this is possible, since benzodiazepine tablets are generally not sustained or delayed release (except Restoril and I'm not even sure there, its just a drug delivery shell for messy powder), have possibly altered some sort of release in the binding powder of the medication.
All that is changed, if it isn't a placebo effect, or sheer luck, is the "time to peak plasma level."
( http://www.dr-bob.org/tips/bzd.html )
- J
Posted by Talbot on March 21, 2006, at 22:57:02
In reply to Re: Klonopin adjustment » Talbot, posted by yxibow on March 21, 2006, at 21:33:28
Thanks for the reply. I thought it might just be in my head, but that helped clear it up. Glad to have people like you around!!
This is the end of the thread.
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