Xanax

[ronna1978]

I am a 29 year female. I have been suffering from anxiety and depression for about a year now. My Doc put me on xanax about 4 months ago. I am taking 3mg a day. I recently went to my psych and he told me to quit the xanax because of the addiction, he put me on klonopin and about 2 days after quitting the xanax and switching to the klonopin I was in hell, I passed out, I could not think or remember anything. It was as though I was out of control of my thoughts and body. Went to the emergency room 3 times over the course of 4 days. I would love to know if anyone has had this type of reacton from either the klonopin or xanax withdrawal?    

[RCA7591]

3 mg of Xanax daily is a large dose, equal to 60 mg of Valium.

Here's what happened:

Xanax works immediately, it's onset of action is immediate, the plasma level peaks rapidly, and the drug is eliminated rapidly from the body. Alprazolam carries a half-life of 6 hours, and the duration of action is about 4 hours. Thus, the risk of tolerance is extremely high. At 3 mg, tolerance would occur in four months or less in the majority of cases.

Klonopin works on the principals of steady-state and accumulation. The onset of action is delayed, 45 minutes - 1 hour. For Klonopin to replace Xanax, it must accumulate to steady-state. This is a two-week process. During the transition period, you will undergo Xanax withdrawal, as the Klonopin will not instantaneously replace the Xanax. I call this time frame "the window of vulnerability". The window of vulnerability varies between 3-14 days, with the average being 10 days.

Once the Klonopin reaches steady-state within two weeks, it will replace the Xanax completely. Within one month, it will accumulate to three times that of the steady-state plasma level. This is known as "accumulation", and accumulation prevents or minimizes the risk of tolerance. Thus, Klonopin (a long-acting agent) is ideal for the management of anxiety disorders. Xanax is intended only for p.r.n. use on an infrequent basis. Long-term use of Xanax will lead to tolerance.

The Klonopin should be administered in three daily, divided does of 1 mg, separated 8 hours apart. In your case, it should not be dosed twice daily, as the withdrawal phenomena would be more severe.

If you are not currently taking 1 mg, t.i.d, I would suggest that you speak with the prescribing doctor about implementing this schedule.

Facts that you need to be aware of:

(1) The transition from Xanax to Klonopin will not be smooth. Xanax withdrawal will be precipitated. The withdrawal symptoms will be severe. You must be fully aware of this fact, and you must be prepared to manage the symptoms for up to two weeks.

(2) You must not take any Xanax during the transition period. Taking Xanax concomitantly with Klonopin during the transition phase will prolong the withdrawal, and lessen the efficacy of the Klonopin.

(3) The Klonopin must be dosed three times daily initially.

If anything that I just wrote was not fully disclosed to you, or if the dosing schedule does not mirror that of the one above, you should consult your doctor immediately.

Ryan

[spade22]

Just to add:

klonopin carries a very high risk of "physical dependence" .  Weaning yourself off klonopin can be very tricky and  often is associated with withdrawal phenomena - just look over the last few days of postings in this forum for some examples.