Questions About Klonopin / Librax

[Casey80]

Doctor Gould, Ryan, or anybody else . . .

I have been taking Klonopin (finally) for the last three weeks. I started at .25 b.i.d. for gad, social anxiety, etc. I then moved to .5 b.i.d. after about three days. I am still tired, groggy, etc. I want to know if this should have abated by now?

I also have been diagnosed with IBS and have been prescribed Librax 3x day. I know that the Librax is the lowest dose. My gastro says it is safe to take both together.

Should I lower the Klonopin back down to .25 due to the Librax, or take the Librax as prescribed? I am concerned about over sedation as I am still lethargic now on Klonopin alone. I appreciate any insight.

Thanks . . . Casey

[RCA7591]

Librax contains 5 mg of Librium (Chlordiazepoxide HCl), and 2.5 mg of Clidinium Bromide.

5 mg, TID of Librium is a fairly small dose, until it is combined with Klonopin, that is. You see, both of these Benzodiazepines have a long half-life and accumulate (1.5 times for Klonopin, and 5-10 times for Librium). The two would have an additive effect on one another, and would lead to excessive somnolence (sedation). Therefore, it is generally not suggested that the two agents be used concomitantly for this reason.

A better option would be make your own "customized" form of Librax, using Klonopin instead of Librium. This is accomplished by substituting the Librax for Quarzan 2.5 mg (Clidinium Bromide), twice daily. You would take the Quarzan whenever you take the Klonopin. Here, you have the benefits of a Librax type drug, but with only one Benzodiazepine. This prevents somnolence, or excessive sedation.

You can discuss this option with your doctor.

Best,

Ryan

[RCA7591]

Oops...

Make that 5 mg of Quarzan instead. 5 mg of Quarzan twice daily (taken concomitantly with the Klonopin).

Ryan

[Casey80]

Thanks Ryan. I will discuss this with my doctor. Presently, I have yet to take the Librax at all due to the somnolence I am still feeling with the klonopin right now. Will this abate ? I am on .5 b.i.d. for almost three weeks. Also, do you think this is a good choice for gad, sad, etc. I have noticed the gad calming down, but the somnolence is a pain in the ***.

[RCA7591]

"Will this abate ?"

It should. I can't give you an "X" amount of time, as everyone is individualized. However, if it persists, a dose reduction to 0.25 mg BID can be discussed with the doctor.

Ryan

[Casey80]

Thanks for all of your input. You help many people here on this board and I, speaking for the others you have helped, appreciate it. One last question . . . after reading everything I could on benzos because I tried every SSRI in the world, I decided klonopin was the last ditch effort for the gad and sad. Do you think this was a wise choice and do you know of people who have had success with this as a long term solution? You read all of these anti-benzo people on the net. Thanks again in advance.

Case y

[RCA7591]

"I tried every SSRI in the world, I decided klonopin was the last ditch effort for the gad and sad. Do you think this was a wise choice and do you know of people who have had success with this as a long term solution?"

The SSRI Paxil is the front-line treatment for social phobia, but it doesn't work well for GAD. The Tricyclics may have worked nicely (Elavil, Pamelor, Sinequan), 25 mg t.i.d. However, Klonopin would offer the greatest relief, and it was a good choice in my opinion. Klonopin maintains its efficacy over the long-term provided the daily dosage does not exceed 2 mg total. Dosages greater than 2 mg are associated with tolerance. 2 mg daily or less rarely, if ever, causes tolerance issues. To put it into perspective, at the epilepsy dosage of 10 (TEN) milligrams, the risk of tolerance is 30%. You are only taking one-tenth of that dosage.

As far as the "anti-benzo" crowd, they don't have all of the facts. I wouldn't bother reading any of that nonsense. Most of those horror stories apply to Ativan and Xanax, which are not indicated for the long-term.

Ryan