My experiences with Klonopin (1 mg every day)

[soManyProblems]

About 6 months ago, my anxiety was really bad. I had two bad panic attacks two days in a row, which was unusual. My agoraphobia was so severe that I didn't plan to go to work or even buy groceries in the foreseeable future. I knew I needed to do those things eventually, but I was living in this awful panicked state where it was hard to imagine how I would ever go to work or the grocery store again.

I called my psychiatrist on the phone, and he gave me permission to start using Klonopin (clonazepam) on a chronic and continuous basis. I already had a bottle which I was using as needed. He told me to take 0.5 mg when I woke up and 0.5 mg 8 hours later, for a total of 1 mg per day of Klonopin.

For the first 6 weeks, it was like utopia. My anxiety was down 90%, my nausea was down 90%. My acne even got significantly better. I gained weight, I caught up with responsibilities at my job. I cleaned my bedroom. I took two trips out of state (only about 110 miles), but they were the least terrifying trips I had taken in my whole life. I have always hated traveling, I even hated field trips in elementary school.

Then after 6 weeks, I had my first panic attack on Klonopin, and it was a bad one. That immediately eroded my confidence and abolished some of the placebo effect.

Now I have been on 1 mg per day of Klonopin for the past 6 months, and I think it is still helping, but I am honestly not sure. I have definitely gained some tolerance.

My psychiatrist (the one who writes my prescriptions) is very opposed to giving me a higher dose of Klonopin, but a number of psychiatrists whom I know socially say that I clearly respond very well to Klonopin, and it is time to up the dose to combat tolerance. Klonopin tolerance is not infinite, it does not grow without bound. They say that maybe I would be stable and happy on 2 mg per day.

I have very mixed feelings. My sister is an oncologist, and she is strongly against the idea of me using more Klonopin. I feel like if I take more than 1 mg per day, I will probably be stuck on it for the rest of my life. But I have certainly had anxiety for my whole life, and I really don't foresee it going away ever.

Is anyone else on chronic and continuous benzodiazepines? What drug and what dose? How do you feel about it?

[djfreon]

Hi. I have been on 3mg of kpin as needed for about two years now. I take 1mg everyday and 2 as needed for panic attacks. You have to not only take it, you have to believe in it. Manage it through different methods like meditation and breathing exercise. But the kpin will calm your nerves.I do believe that 2 more milligrams as needed would give you more piece of mind even if you don't take it, as I have done.

[soManyProblems]

My psychiatrist used to prescribe 0.5 mg as needed, but once I started using Klonopin every day (6 months ago) he strongly urged me to very, very rarely exceed my routine dose. I would definitely like the freedom to take extra rescue doses for above-average anxiety and panic. As it is, I am only allowed to take extra during rare and severe emergencies.

[guyleecocoa]

I have been off and on ativan for 3 years now...was off 6 months ago but back on now for the past 6. I take 3 mg per day. 1 mg in the am and 2 at night. My Dr just switched me to Klonopin .5 every 8 hours. Im tired but the night time anxiety is awful again. So after asking him about the dose he said he was out of the office foto the e.r. omg they put me back on the ativan and now Im out of it til tomorrow when I see my Dr again. Im horribly anxious...should I take a Klonopin to to relax even if it just helps a little??

[Dahila]

yes, it will help on top of ativan. Calm down you get the meds tomorrow. I am on klonopin aka clonazepam 0.5 once a day, the time is to me to decide. I am on it for over 8 months and I do not need to up it. with such small doses you will be ok for years.
Ativan does help, but after years on it , I do not like it. I feel like zombie after that

[GeneAllen]

Klonopin works well. I don't get the take as needed idea though. Get a routine of taking the same amount everyday, stick with that. Xanax is as needed drug, as it pees out fast. Klonopin stays in longer and works best this way. I began on three, knocked back to one, then added a half this year. I do Effexor xr as well. As anxiety settles and I know when that happens I cut back again, and have eliminated Effexor xr for years. Effexor (non XR) does nothing for me. I've been taking this regimen many years. Well since you were in second grade anyway. The idea is to incorporate meditation therapy, CBT, as well as hypnotherapy, or brainwave technology as you can as well. As you begin to feel better you will know when you can cut back. I don't recommend bedtime benzo use, only during very difficult times then schedule them mid afternoon as you get some balance. I avoided all medications for 30 years, scared the hell out of me, then went to a neurologist/psyschiatrist and he said would you like your life back? I said yes, he then gave me these pills. I reluctantly took them, and can say my life and the quality of it was as never before.

Peace

[Dahila]

Klonopin works well. I don't get the take as needed idea though. Get a routine of taking the same amount everyday, stick with that. Xanax is as needed drug, as it pees out fast. Klonopin stays in longer and works best this way. I began on three, knocked back to one, then added a half this year. I do Effexor xr as well. As anxiety settles and I know when that happens I cut back again, and have eliminated Effexor xr for years. Effexor (non XR) does nothing for me. I've been taking this regimen many years. Well since you were in second grade anyway. The idea is to incorporate meditation therapy, CBT, as well as hypnotherapy, or brainwave technology as you can as well. As you begin to feel better you will know when you can cut back. I don't recommend bedtime benzo use, only during very difficult times then schedule them mid afternoon as you get some balance. I avoided all medications for 30 years, scared the hell out of me, then went to a neurologist/psyschiatrist and he said would you like your life back? I said yes, he then gave me these pills. I reluctantly took them, and can say my life and the quality of it was as never before.


Peace
This is exactly what happened to me. Now I know that I am alive again, even enjoying the life :))

[Kabukicho]

I am currently dealing with increased tolerance to Xanax, and am going to try to get my pdoc to switch me to Klonopin. I am getting rebound anxiety during the day from the Xanax and it isn't working great for its original purpose anymore (sleep.)

Benzodiazepenes are the ONLY drug out of the MANY I have tried that have done ANYTHING for my anxiety, so I wholly support their use. I just don't know what the right type / dose is for me.

And tolerance / withdrawal is scary.

[Ritch]

Benzo's for me can provide a huge relief from symptoms and are a good idea in the short term, but as you are discovering you build tolerance and their effect is less noticeable over prolonged periods. I can appreciate not wanting to stop benzo's because they make life easier, but having to increase the doses/swap to another when does it stop?

I'm not condoning the use of them as I was dependent on them for over a year, but they only address the symptoms for a limited period of time and do not address the causes in anyway shape or form.

Drugs do not treat anxiety, they treat the symptoms of it. Unfortunately society pushes drugs in our face as quick solutions but sometimes we have to do the hard things to reap the rewards.

My advice would be to continue to use them for a short while longer, but in the meantime practice techniques such as meditation to help you deal with the anxiety and also get some therapy that will put in a much better position to cope when you come off of them

[soManyProblems]

Kabukicho, how much Xanax do you take? How many mg and how many times per day?

In general, longer-acting benzos like Klonopin are better for continuous and every day use.

Regarding tolerance: Drug tolerance is a natural physiologic response to repeated drug use, it is not inherently "bad", and it is not infinite. Gaining tolerance does not mean you are using too much of the drug, it is just a thing that happens. People may need one or two benzo dose increases because of tolerance, but they will not need infinite dose increases. People often get the wrong idea about tolerance because of what opioid addicts go through. Opioids are rather unusual drugs because the level of tolerance that is possible is extremely high. Heroin addicts, when given free and unlimited heroin, will usually max out at 50-fold tolerance. That means they take 50 times more heroin than novice users. People in severe pain (e.g. from terminal cancer) often have even higher opioid tolerance, sometimes more than 100-fold.

Opioids are an exceptional case, and benzodiazepines are not opioids. Benzodiazepine tolerance grows much more slowly and hits a ceiling much sooner.

Benzodiazepine tolerance can actually be a good thing, especially for anxiety sufferers. Benzos make many people drowsy for the first few days, but tolerance to the drowsiness sets in much faster than tolerance to the anxiety relief. This is a boon for anxiety sufferers who want to be functional during the day and drive safely, but this is a bad thing for insomniacs.

[Ritch]

Kabukicho, how much Xanax do you take? How many mg and how many times per day?

In general, longer-acting benzos like Klonopin are better for continuous and every day use.

Regarding tolerance: Drug tolerance is a natural physiologic response to repeated drug use, it is not inherently "bad", and it is not infinite. Gaining tolerance does not mean you are using too much of the drug, it is just a thing that happens. People may need one or two benzo dose increases because of tolerance, but they will not need infinite dose increases. People often get the wrong idea about tolerance because of what opioid addicts go through. Opioids are rather unusual drugs because the level of tolerance that is possible is extremely high. Heroin addicts, when given free and unlimited heroin, will usually max out at 50-fold tolerance. That means they take 50 times more heroin than novice users. People in severe pain (e.g. from terminal cancer) often have even higher opioid tolerance, sometimes more than 100-fold.

Opioids are an exceptional case, and benzodiazepines are not opioids. Benzodiazepine tolerance grows much more slowly and hits a ceiling much sooner.

Benzodiazepine tolerance can actually be a good thing, especially for anxiety sufferers. Benzos make many people drowsy for the first few days, but tolerance to the drowsiness sets in much faster than tolerance to the anxiety relief. This is a boon for anxiety sufferers who want to be functional during the day and drive safely, but this is a bad thing for insomniacs.

But they are addictive, can cause withdrawal symptoms and are recommended to be used short term which is probably why the doc is hesitant to up the dose. Also they had to keep swapping and uping the dose of valium/lorazepam for me as I became very tolerant very quickly. Is not better to treat a condition than mask the symptoms? According to the royal college of psychiatrists 4/10 become addicted.

I'm not saying you are right or that I am right...... just debating :)



http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/benzodiazepines.aspx

[soManyProblems]

The fact sheet that you linked is extremely biased, and although it has the seal of the Royal College of Psychiatrists, I think you would find that the majority of psychiatrists in that College would have major issues with the fact sheet if asked to review it.

Here is the biggest issue: They use a very outdated and unscientific definition for "addiction". That fact sheet very unambiguously uses the word "addiction" to mean dependence, i.e. the state of having withdrawal when you abruptly discontinue the drug. The medical doctors who treat actual addiction almost universally frown on this blatant misuse of the term "addiction". Addiction is a disease characterized by a lack of behavioral control over drug use. Addicts cannot make a logical decision about whether to use the drug, they are out of control. You will find that people dependent on benzodiazepines are fully in control of their actions, and they make the entirely logical choice to continue using the drugs to avoid withdrawal. Cocaine addicts often say things like, "I saw the white powder on the mirror, and before I knew what was happening I had snorted two large lines." You just don't hear that from the people dependent on benzodiazepines.

Here is the second issue: Dependence is not a terrible evil that must be avoided at all costs. The fact sheet makes it sound that way. Dependence is a predictable consequence of benzodiazepine use, and it can be mitigated by slowly tapering off the medication. A great example is epileptic patients: Many epileptic patients take very high doses of benzodiazepines, up to 20 mg per day of Klonopin. They are severely dependent, and they would have very unpleasant withdrawal if they stopped abruptly. They are not addicted. Also, they are receiving a benefit from the drug: they are free from seizures. Seizures are extremely unpleasant, and they can even be fatal. Avoiding seizures is clearly a huge benefit. And what are the costs? Well, Klonopin costs a few dollars a month, it is generic. They are dependent - is that a cost? Is their dependence a cost at all? Only if they need to taper off the medication.

The drugs used to treat high blood pressure are another good example. Nearly all high blood pressure drugs cause dependence and withdrawal. The withdrawal can even be fatal, it can cause a hypertensive crisis and a stroke. Does this mean we should avoid these drugs? Not at all. Having high blood pressure is very bad for you, it increases your risk of heart attack, stroke, heart failure, kidney disease, and a host of other diseases. Treating high blood pressure is very important, and the fact that these patients almost universally become dependent on the drugs is an acceptable trade-off.

If you search PubMed or survey psychiatrists, you will find that there are a huge number of reputable psychiatrists who believe that every day benzodiazepine use is the best treatment option for some patients with anxiety. Will it cause dependence? In many cases yes, but that is an acceptable trade-off.

Tolerance and dependence are not bad in and of themselves. Withdrawal can be mitigated or avoided by tapering slowly. Many people who have "long-term benzodiazepine withdrawal" may not be experiencing withdrawal at all, they may be experiencing an anxiety disorder. In most cases, it is an anxiety disorder they have had their entire life. There are numerous scientific papers which examine cases of "long-term benzodiazepine withdrawal" and find that the "withdrawal symptoms" are basically identical to the symptoms the patient experienced before starting drug treatment. Restarting benzodiazepines is not the only way to treat these patients (many of whom are averse to that prospect), you can also treat them successfully with SSRIs, CBT, meditation, and talk therapy. Why should talk therapy cure "long-term benzodiazepine withdrawal"? It doesn't, it cures anxiety, and that is what the patient was actually feeling.

[soManyProblems]

Perhaps the most obvious case of hypocrisy in that "fact sheet" is that it universally rejects the idea of using benzodiazepines continuously and long-term on the grounds that this causes withdrawal, but it wholeheartedly supports the idea of using SSRIs.

Do SSRIs cause dependence and withdrawal? Hmm, let's check this forum... YES! SSRIs can cause terrible withdrawal, and there are tons of people right on this forum who can tell you about it. There are also tons of scientific papers on it.

[Ritch]

Thank you for sharing :) Like I said I wasn't say who was write or wrong just curious.

as you stated therapy etc does not cure benzo withdrawal it cures anxiety, it makes you wonder why society just wants to have a pill that treats symptoms thrown at them instead of therapy which can actually treat the disorder.