RCA7591

[Jade59]

I have been on Xanax for the last 12yrs, Ativan since 1980 before that and I am interested in weening off this drug and maybe starting Klonipin.  After reading many many posts, this seems to be the way to go I think.  I have had anxiety/depression since my childhood and am at the point where I would prefer to take nothing, but I dont think that's going to happen.  I stopped smoking cigs/weed 7wks ago now, haven't taken an AD for a few years, but since the cigs cessation, I can't sleep and the anxiety is back and I feel so wound up all the time.  I thought stopping smoking was really the answer, but now I am not so sure WHAT the answer is.  My question is, could I just switch over to the Klonipin from the Xanax or would that cause a big w/d problem?  And, am I just switching from one benzo to another.  Would this be beneficial at all?  I have read your posts and appreciate your knowledge.  Thank you so much

[RCA7591]

Xanax isn't indicated for long-term use, let alone 12 years. At this point, tolerance is the largest concern. In all liklihood, the Xanax no longer has a useful benefit. Loss of efficacy would be fairly typical at this point.

What dosage of Xanax are you currently taking daily, and how is the dose divided? (Important).

Klonopin and Xanax are equivalent in potency. Ideally, you would NOT want to reduce the dosage of Xanax, unless the total daily dosage is greater than 2 mg.
What you would do is make a direct transition over to Klonopin.

When making the transition, there is a 3-14 day "window of vulnerability" in which you will undergo Xanax withdrawal. Since Klonopin carries a long half-life, it will not instantaneously replace Xanax. Klonopin reaches steady-state within two weeks, at which time the maximum therapeutic benefits will be obtained. It is important to be prepared for withdrawal phenomena, and to understand that it is typical, and that it will pass within the specified period of time as outlined above. The symptoms are largely those of anxiety, but amplified by a factor of 10. They WILL dissipate.

The main difference between Klonopin and Xanax are their halve-lives. Xanax works immediately, but the effects are not prolonged (4-6 hours), and the drug never accumulates to a steady-state blood level. Klonopin works differently. The onset of action is variable - 45 minutes to 1 hour, and the effects are prolonged (12-18 hours after a single dose). When dosed at least twice daily, it accumulates to a steady-state value in your blood. It is this steady-state value that minimizes or prevents recurring anxiety/panic. Klonopin provides 24-hr coverage against the symptoms of anxiety and panic, where as Xanax does not.

Since you have remained on Xanax for 12 years, the drug is either less effective, or largely ineffective compared to when you first started taking it. Efficacy can be re-established by switching to a dose equivalent of Klonopin. As mentioned, if your Xanax dosage is greater than 2 mg, the Xanax should be reduced to 2 mg daily before attempting to switch to Klonopin.

Ideally, you would want to make the transition before tolerance becomes a severe issue. Tolerance is severe when you are at the point of experiencing withdrawal phenomena, despite taking the Xanax as indicated. Klonopin will prevent the issue of tolerance, and will maintain its efficacy over the long term.

So to answer your question, yes, it would be benefical to switch from Xanax to Klonopin; not only to prevent tolerance and re-establish efficacy, but to provide you with a means of tapering in the future, should the need arise (Xanax is extremely difficult to taper from, due to the short half-life).

You can speak with your doctor about making the transition.

Ryan

[Jade59]

Thank you Ryan, this is as serious as I thought.  I have been taking .05-2mgs at night for sleep and your right, they have stopped working.  Not until I started reading this forum, and your posts specifically, did I realize that Xanax was not made for long term use.  My doctor justs refills my rx every single month and has NEVER educated me.   This is the best information I have ever got.  Thank you so much again.