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Anxiety Community
This patient support community is for discussions relating to generalized anxiety, anxiety and eating, anxiety and sleeping, mood swings, and phobias.
Anxiety problems
by Soonerdean, Jun 13, 2007 12:00AM
What is a good med for anxiety? This is causing me lots of problems. Thanks in advance for any help.
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I've tried paxil - and it was awful! Couldn't get past the 2or3 days - i was flying higher than a kite! Never again for me.
you have to try a few to see what works for you, unfortunately it sometimes takes days to know - although with the paxil i knew right away!
Good luck
--end quote--
There is a world of difference between Ativan and Klonopin, but they are both Benzodiazepines, which means there is a risk of dependency and tolerance with both of them.
Ativan is dispensed temporarily, for the short term relief of anxiety. It has a half-life between 6-8 hours, which means that the drug wears off quickly. Tolerance is proportional to the half-life (the shorter the half-life, the greater the rebound and chance of tolerance). Ativan peaks in the blood rapidly, but never reaches steady-state, as the half-life is too short. Since it never reaches steady-state (unless dosed three times daily, it is useless for the management of long-term disorders.
Klonopin is indicated for the long-term treatment of anxiety disorders, and carries a 50 hour half-life. That means in 50 hours, the drug reaches 1/2 of steady-state if dosed twice daily (with steady-state being the therapeutic level). Since the half-life is so long, the odds of developing a tolerance to the effects is extremely rare. Steady-state is reached within two weeks. Onset of action is slow, so it's not a good PRN drug unless it is used sublingually (under the tongue).
Both cause physiological and psychological dependency or tolerance, but it occurs faster with Ativan. Both must be discontinued very gradually. Ativan typically quits working after 4 months of continuous use, while Klonopin can be effective for decades without the need to increase the dose.
Benzodiazepines also have indications in epilepsy (they lower the convulsive threshold), and Klonopin was specifically developed for the treatment of certain seizure disorders. Since seizure disorders are a chronic ailment, Klonopin was developed by Roche in 1976 as a long-term treatment option.
It was specifically designed to provide long lasting coverage. Klonopin was used off-label in the 80's for the treatment of panic disorder, and was officialy approved by the FDA in 1998 for the treatment of panic disorder DSM-IV, 22 years after its invention.
So, in short, "Klonopin is not just like Ativan"
-Ryan