Xanax, Ativan, Klonopin

[dbsub9]

Hi,
  
  Everytime I ask my doctor a question I never seem to get a straight answer.  It could be our language barrier but who knows.  Anyway,  I've been on Xanax since 1999.  My dose has increased over time and it's now at 4.5mg/day.  My doctor told me that klonopin is weaker than Xanax and Ativan. I would like to switch to Ativan since I was given it in the hospital and it worked great.  I have had three grand mal seizures since being on xanax.  It's hard for me to imagine a life without benzos.  My doc old me that xanax and ativan are stronger than klonopin but klonopin can be strong at higher doses.  I'm slowly decreasing my xanax dose before I switch but I would just like advice as to what is a good benzo to switch to after being on xanax as long as I have.

Thanks,
Dan

[heartfluttersflyawayplz]

please be carefull tapering off xanax, it can cause the seizures, i take ativan when nedded it does work great but i take only now and than like once every 3-6 months its not a long term drug neither is xanax , cant belive your dr has you on it at such a high dose, klonopin is a great long term drug, i took it for a short while and it was good, there is a guy on here his name is ryan under rca i think he knows all about these meds and can tell how to taper off the med saftey, i will look and see if i fine his name than you need to leave him a note , belive me he knows what hes talking about . hang loose let me see .

[heartfluttersflyawayplz]

me again his name is rca7591 look him up, go to next page you will see him there click on his name take you to his page , or maybe he will pop in here and see your post, but listen to him hes not a dr but hes awesome. good luck Barbara

[RCA7591]

"I've been on Xanax since 1999.  My dose has increased over time and it's now at 4.5mg/day."

^quote

Not good. Xanax in intended for as-needed or short-term use only (less than four months). Prolonged use of Xanax is associated with the development of tolerance and loss of efficacy. The drug is simply too short-acting to use in the management of anxiety disorders. The maximum daily dosage is never to exceed 4 mg.

"My doctor told me that klonopin is weaker than Xanax and Ativan"

^quote

From a therapeutic perspective, Klonopin is twice as potent as Xanax, and four times more potent than Ativan. From a withdrawal perspective, Klonopin and Xanax are equal in potency, and both are twice as potent as Ativan.

Ativan and Xanax are designed for as-needed or short-term use only, and Klonopin is indicated for use over the long-term. Klonopin is a maintenance drug, and it does not lose its efficacy over the long-term.

4.5 mg of Xanax is equal to 2.25 mg of Klonopin for clinical purposes. If you are intending to withdrawal from the Klonopin, then the dosage would be equal to that of Xanax (4.5 mg).

The main issue when making a transition from a short-acting Benzodiazepine such as Ativan or Xanax, to a long-acting Benzodiazepine such as Klonopin - are the differences in their half-lives. Ativan and Xanax do no accumulate due to their short half-lives (12 hours and 6 hours respectively), and these agents work instantly. Klonopin (when dosed at a minimum of twice daily) accumulates (builds up in the system). It accumulates due to its prolonged 50-hour half-life. In other words, by the time you take the next dose, there is still Klonopin remaining in your system that hasn't been eliminated. The second dose overlaps the first one, and this process continues with repeated dosing. After two weeks of repeated dosing, Klonopin reaches steady-state, and, at that time, will replace Xanax. After an additional two weeks, Klonopin accumulates to 1.5 times that of steady-state. At this point, no further accumulation takes place, and the blood plasma level is held at a consistent level. Provided the drug is take daily, there will always be a "reserve" in the body. This is why Klonopin is twice as potent in comparison to Xanax from a therapeutic perspective. Xanax doesn't accumulate, and Klonopin does.

Thus, when making the transition from Xanax to Klonopin, the Klonopin will not instantly replace the Xanax. The process takes two weeks, as Klonopin must accumulate. It is for this reason that the Xanax should not be abruptly discontinued (there would be nothing to replace it during the two week period). Generally speaking, it is better to step the Klonopin in while simultaneously stepping the Xanax out (particularly at high dosages). This will prevent or minimize withdrawal phenomena.

Despite the fact that Klonopin is twice as potent as Xanax from a therapeutic perspective, it is usually wise to implement Klonopin at the same dosage as Xanax (4.5 mg of Xanax to 4.5 mg of Klonopin). The rationale behind this is to reestablish efficacy that was lost due to Xanax tolerance.

Ryan

[xanweaner]

You're received some excellent information. I'm concerned by reading your post about your history of seizures.

Have you considered finding another physician to manage you? It seems that you would benefit from this, as you're having a communication breakdown with your current one.

Good luck to you as you do your xanax taper, and please be careful

[tinkerbell7]

TEST QUESTION:  WHICH BENZO IS PREFERRED IN THE ELDERLY BECAUSE IT IS LEAST LIKELY TP ACCUMULATE WITH REPEATED DOSING?  VALIUM, KLONOPIN, ATIVAN, PRO SOM
TEST QUESTION: PT. IS 49 YRS OLD, BEEN TAKING TRANQUILIZERS 10 YEARS, CAN'T REMEMBER THE NAME, STATES IT HAS A MINT-LIKE AFTERTASTE.  IS IT CHLORAL HYDRATE, MEPROBAMATE, PARALDEHYDE, OR  ETHCHLORVYNOL

[scarred2deathat29]

It is imperative and important that you either go into inpatient detox or ween yourself off. I know from experience. My last psy, who by the way is a quack, from the very beginning put me on 6mg of xanx a day. I did that for two months and was so out of it that my friends and family didnt even recognize me. I quit cold turkey and for a week i had electric shocks, major jerks, the deepest emotional turmoil i ever experienced in my life. I wanted to kill myself. On top of that i didnt sleep for a week. A WHOLE WEEK! I made an emergency appt with a doctor and was trembling so badly I couldnt even write. I started to ween myself to 3mg a day and now see another psy. She still has me weening off at 3mg a day, than next time she will probably start having me take .5 3x a day for a month or two and so on. Im going on 6months on being on it. After reading a lot of personal experiences and research I was furious that this doctor(he was in his 70's so very old school in his thinking) put me and started me on 6mg per day. So you must ween yourself off under a doctors supervision or go into detox. I know of many people who had to do inpatient detox to get off cause the side effects are so bad! I would recommend that no one start this Xanax. Its a VERY BAD DRUG!