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well i been taking 1.5 mg of clonazepam a day for the last week and i really don't see a differnce at all. i still feel horrible driving and today i went to wal-mart to get my prescription filled and it was really hard driving there going inside and driving back. no panicPanic disorder Panic disorder with agoraphobia attacks but ALOT of anticipitory anxiety. it's got me bummed out.
so my questions are:
1. is taking .75 BID the same as taking .5 TID? i been taking it .75 morning and night. i figured it would be better .75 twiceTwice-a-day a day because taking one .5 in the morning didn't do much for me and that 2 more doses like that would just keep me feeling the same with a littleLittle noses decongestant Little tummys bump in feeling less anxiety after i took my 2nd pill.
2. i know it hasn't been two weeks, and hasn't leveled out in my plama yet, but it has been a week and i expected to have some better relief by now. i'm thinking 1mg BID might be what i need. i will not go over this amount ever. i dont' care. even if i have to try an SSRI or something. i know my K dosage isn't right and is suppose to mask symptoms, but my anticipitory anxiety is bad. when i even think about going out in the city i get worried. i just want to feel pretty much as ease or have some relief while i continue therapy etc... this is how i felt when i took nothing at all last time when i was desensitizing by myself. the only exception is the attacks are less severe. these stories of people finding their dose and going on with life for 11 years like pam have me wondering what is going on with me.
as per are last correspondence, i think being a guy, with a history of alcohol abuse, i might need a larger dose. i know it would mean a longer weaning schedule down the road, but who cares, let's get well and worry about tomorrow tomorrow. right? i'm just afraid that if 1.5 isn't doing much, what is another .5 gonna really do for me? unless i'm dosing it wrong. let mek now TID or BID or hopefully not but qid?
"1. is taking .75 BID the same as taking .5 TID? i been taking it .75 morning and night. i figured it would be better .75 twice a day because taking one .5 in the morning didn't do much for me and that 2 more doses like that would just keep me feeling the same with a little bump in feeling less anxiety after i took my 2nd pill."
Nope. When Klonopin is dosed twice daily, the accumulation level in the plasma is 1.5 times that of steady-state. When Klonopin is dosed three times daily, the accumulation level is 3 times that of steady-state. What does this mean? That the steady-state plasma concentration would be higher if the Klonopin were dosed 0.5 mg, t.i.d. as opposed to 0.75 mg, b.i.d. The plasma level would be roughly 5 ng/mL greater, which means the efficacy would also be greater.
Take 0.5 mg three times daily (every eight hours). It is far more effective to utilize your 1.5 milligrams in this manner. Give it a full two weeks to reach steady-state before drawing any conclusions. You should also secure the approval from your doctor to take it three times daily.
"2. i know it hasn't been two weeks, and hasn't leveled out in my plama yet, but it has been a week and i expected to have some better relief by now. i'm thinking 1mg BID might be what i need. i will not go over this amount ever. i dont' care. even if i have to try an SSRI or something."
The Clonazepam plasma concentration is not high enough. See above. If 0.5 mg, t.i.d. is ineffective, the next step is to add an additional 0.5 mg daily, making the dosing schedule
0.5 mg, q.i.d. Again, this is more effective than taking the Klonopin twice daily. When Klonopin is dosed four times daily, the accumulation level is 6 times that of steady-state. The steady-state plasma level is increased by roughly 10 ng/mL compared to b.i.d. dosing. Again, the efficacy is increased.
"a few docs and people i know and even the psyc. nurse told me straight up that even 2mg. a day isn't excessive. she said it was nothing at all."
2 milligrams is not excessive by any means. Dosages of 4 mg and below are fine.
Ultimately, I think your maintenance dosage will end up in the 2-3 mg range. 0.5 mg, q.i.d. should work quite well. Keep in mind that everytime you change the dose, a two-week assessment period should follow before drawing any conclusions.
The beauty of dosing Klonopin four times daily is the ease of discontinuning it when the time comes.
thanks man. i got the doc's approval before i did anything. especially with my past of abuse of alcohol. i'm very careful. do i need to switch or taper due to the last 7 days of .75 bid? or just start taking it .5 tid right away? i don't see a problem at all with just .5 tid. i wouldn't think i'd have any withdrawl effect at all.
again very helpful. this might mean a whole lot of difference. and of course i'll give it 2-3 weeks before any other change, if need be. i'm trying my best here to keep it as low as possible. some discomfort is tolerable, but a nervous wreck isn't when on a med that should keep you calmer. knew something was wrong here.
later bud....jay
p.s. i own a graphic company so if you need your drag car all done up and decaled holler at me....
^quote____________________________________________________________________
Nope. When Klonopin is dosed twice daily, the accumulation level in the plasma is 1.5 times that of steady-state. When Klonopin is dosed three times daily, the accumulation level is 3 times that of steady-state. What does this mean? That the steady-state plasma concentration would be higher if the Klonopin were dosed 0.5 mg, t.i.d. as opposed to 0.75 mg, b.i.d. The plasma level would be roughly 5 ng/mL greater, which means the efficacy would also be greater.
Take 0.5 mg three times daily (every eight hours). It is far more effective to utilize your 1.5 milligrams in this manner. Give it a full two weeks to reach steady-state before drawing any conclusions. You should also secure the approval from your doctor to take it three times daily.
"2. i know it hasn't been two weeks, and hasn't leveled out in my plama yet, but it has been a week and i expected to have some better relief by now. i'm thinking 1mg BID might be what i need. i will not go over this amount ever. i dont' care. even if i have to try an SSRI or something."
^quote_____________________________________________________________________
The Clonazepam plasma concentration is not high enough. See above. If 0.5 mg, t.i.d. is ineffective, the next step is to add an additional 0.5 mg daily, making the dosing schedule
0.5 mg, q.i.d. Again, this is more effective than taking the Klonopin twice daily. When Klonopin is dosed four times daily, the accumulation level is 6 times that of steady-state. The steady-state plasma level is increased by roughly 10 ng/mL compared to b.i.d. dosing. Again, the efficacy is increased.
"a few docs and people i know and even the psyc. nurse told me straight up that even 2mg. a day isn't excessive. she said it was nothing at all."
^quote_____________________________________________________________________
2 milligrams is not excessive by any means. Dosages of 4 mg and below are fine.
Ultimately, I think your maintenance dosage will end up in the 2-3 mg range. 0.5 mg, q.i.d. should work quite well. Keep in mind that everytime you change the dose, a two-week assessment period should follow before drawing any conclusions.
The beauty of dosing Klonopin four times daily is the ease of discontinuning it when the time comes.
Ryan
again very helpful. this might mean a whole lot of difference. and of course i'll give it 2-3 weeks before any other change, if need be. i'm trying my best here to keep it as low as possible. some discomfort is tolerable, but a nervous wreck isn't when on a med that should keep you calmer. knew something was wrong here.
later bud....jay
p.s. i own a graphic company so if you need your drag car all done up and decaled holler at me....