clonazepam tolerance

[joe504]

I have been taking clonazepam 0.5 mg b.i.d. for about a year now.  It seems that I have built a tolerance to the medication, and now I'm worried because I've heard that this dosage is the most effective for panic disorder / anxiety.  I will talk to my doctor about this but wanted to know if anyone had any insight or suggestions.  I've heard of the option of combining an SSRI with the clonazepam.  Anyway, I would appreciate any feedback.  Thanks.

~Joe

[joe504]

please, some help

[Luisitosax]

yes, in fact any dose above 1 mg is begining to be in the high dose range (10mg of diazepam=0.5mg clonazepam). You have to try to stay in your dose of 0.5mg bid and search for another option that reinforce the treatment. I would not suggest a SSRI for you because I think your main symptom is anxiety. Some SSRI even make anxiety worse. maybe you have to look for some meditation, exercise, relaxation techniques, yoga, etc.
There are several supplements that can be useful for anxiety (magnesium, niacinamide, inositol, 5-htp, some herbs like valerian, passionflower, linden), Do some google research or talk with your Dr about this. Eventually if you increase your clonazepam dosage, you will develop tolerance in the future (addiction).

Good luck and there is hope. I have been treated for anxiety with a combination of chemical and natural sources with success.

[joe504]

bump

[Ryan7591]

Joe,

1 milligram is the absolute minimum effective dosage, and that figure was derived from the average female build of 5'8", 120 lbs.

Also, if you are taking generic Clonazepam (instead of brand Klonopin), has the pharmacy supplied a different brand recently? There is an allowable +/- 20% deviation with this drug, and it's legal. This is more than sufficient enough to cause problems. The TEVA and PurePac brands in particular have been reported to have QC issues. If you have good insurance, ask the doctor to write "brand necessary", and try Klonopin.

Tolerance does not occur to the anti-panic effect of Clonazepam at dosages under 4 milligrams daily. Chances are more likely than not that your current dosage of 1 milligram is only marginally effective (once the above is ruled out). You could speak with the doctor about raising it, and there are a few ways to do it:

(1) 1 milligram, b.i.d.
(2) 0.5 mg, t.i.d. or q.i.d.

or:

It could be augmented with a sedating Tricyclic antidepressant, such as Sinequan. 25 - 50 mg, q.h.s. should be adequate. This can be raised to 75 mg if needed. I would not combine Clonazepam with an SSRI, as they can be overly stimulating and negate the actions of Clonazepam.

Speak with the doctor (and check to see if the pharmacy has switched generic brands recently).

~Ryan

[joe504]

Ryan,

Thanks a lot for the feedback.  I have never heard of Sinequan but did some research and found that it seems to be an idea.  Also, I should have mentioned that some days are worse than others, like with anything I guess.  I'm wondering if I can continue taking the clonazepam 0.5mg b.i.d. and perhaps an "as needed" drug when I feel the panic is overwhelming.  I'm not sure that this is suggested or an option, but it seems that more days than not my panic / anxiety is manageable. ( i.e. 1-2 occurrences per week ).

Thanks for your time and efforts,

Joe

[abby10]

You wrote a post saying to ignore what I say, that you had NOT built a tolerance for klonopin.

[abby10]

Joe why are you IGNORING me??????