Klonopin and xanax, subsititution.

I have been takig klnopin and xanax on and off for years. I was previously on 1mg klonopin, and then my dose was increased to 2mg/day plus upto 1 mg more if needed. As this was not helping for breakthrough anxeity and social/panic  disorder i was prescribed 0.5mg niravam t taking an average of 0.5mg/day(not everyday) for a month; and due to recent stressful events 1mg/ day on average(but not daily) , never taking more than needed. during this time whenver i took the niravam, i reduced my daily klonopin dose by an equivalent amount reducing my daily dose of klonopin to 1mg. I am concerned about my dependence on niravam, and i do not want it to increase, as it has helped me and i do not wish to continue taking this since i feel that my tolerance is growing and it isnt helping anymore whilst causing negative side effects like rebound panic and lethargy. I wanted to ask if i would be able to substitute the niravam mg for mg with extra klonopin (prescribed) , so as to replace the need for the niravam in terms of preventing panic attacks. Thanks you so much for your help.

[M4Y0U]

Hello there,

I think it would be a good idea to go with Klonopin only since if you take the Nivaram on and off you could be suffering from withdrawal symptoms. Once you have built a dependence to Niravam which have a half-life of 10.7–15.8 hours it doesn't take long to suffer from withdrawal symptoms that you describe as rebound anxiety and lethargy.

But please note that i don't think it's a good idea to use benzodiazepines ( Klonopin or Niravam in your case ) as a long term treatment and my suggestion would be to try a long term treatment with a anti-depressant like a SSRI ( Lexapro ) or SNRI ( Cymbalta , Effexor ). I know some will use Klonopin as a long term treatment but you must know that one drug does not fit to everyone. That's why i am giving you this suggestion as an alternative treatment and then after engaging in with an anti-depressant treatment you can gradually stop taking Klonopin as the anti-depressant takes effect. Note that it's something that must be monitored closely by your doctor.

Some other alternative treatments include physical activity, healthy diet and suppluments ( vitamins B complex is suggested )  and even natural anxiety medications like Gamma-aminobutyric Acid (GABA)  , Theanine , Seredyn,  passionflower (Passiflora incarnata) herb,  valerian (Valeriana officinalis), Kava.

Talk therapy is always a logical choice too.

Best regards,
M4

[joglocc]

Thanks very much for your advice; i may have not clearly explained my situation and soages in this cases. I  have being taking klonopin for the most part for years in doses carying from 0.5mg to 2mg daily, and have taken breaks from it. Unfortunately im very sensitive to medication and cannot tolerate even a small dose of SSRIs, tricyclics, buspar, and other medications for anxiety. Ive also been advised not to take herbal supplements by my doctor in addition to the medication.
Im not sure if I made it was but I was taking the klonopin at a 2mg/day dose(plus 1mg if needed), and then in addition the niravam for extreme anxiety/ panic attacks (to be taken only  as needed 1-2 tablets 0.5mg max twice a day); during this time my dosage and need for klonopin reduced to avg 1mg/day, taken daily. for the last 2 months, i have taken the niravam around 3-4 times a week, making sure that when i did take it i would skip my dose of klonopin to avoid increased tolerance to both meds.
I wanted to know specifically if i substituted the niravam with an equivalent dose of klonopin (under su pervision), if i would still suffer further withdrawal or anxiety, or would i be able to minize it? I got to University, and I dont want any hiccups before Christmas holiday. Since the niravam had served its purpose, and is innefective now, i would simply be going back to my regimen 2 months prior to this. Any further thoughts and insight would be greatly appreciated.

[M4Y0U]

2mg Klonopin daily + 1mg seems to be good to me. You must know something about using Klonopin as a long term treatment and it is that you actually build a tolerance to the drug. So you need to increase dose to get the same relief and this is why is it usually suggested as a short-term treatment. It have an extremely long half-life of 18–50 hours and it's another reason to avoid excessive dose increases.

One thing you can try to talk with your doctor is maybe asking for another benzodiazepine named Bromazepam. It have a quick onset and a short half-life. If you think that Niravam is not effective for you. One drug does not fit all. Please note that i'm giving you this suggestion only because you mentioned that you cannot tolerate long term treatment of anti-depressants.

Remember to my advice about alternative treatments that might help you too in my last post. There's not a magic pill that will leave you anxiety free, they can mask the symptoms but they doesn't cure the problem to the root.

Please consider that i'm not a doctor and those are all issues that you should talk with your doctor.

Best of luck,
M4

[M4Y0U]

Thanks for clarifying that up Ryan.

I have good experience with Brozamepam that's why i suggested it if he would still want to take 2 benzos. And you are right it is very cheap, i pay 13$ for 40.

I know people use Klonopin for long term treatment but i just think it's wrong to use a benzo for long term use that's why.

Anyway thanks for clarifying. I think i will change my mind about Klonopin and long term treatment. There just just so many warnings around about benzos and long term use...