My experiences with Klonopin (1 mg every day)

[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/healthadvic...iazepines.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Here is the biggest issue: They use a very outdated and unscientific definition for "addiction".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.