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How much is too much Clonazepam?
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How much is too much Clonazepam?

My psychiatrist had me on 5 1mg Clonazepam to be stretched out over the day, an extra thrown in for Panic Attacks.
(normal dose is 4 per day) I was given it for two things, the tremors I get from the Lamictal and also the generalized anxiety. I lost my health insurance and couldn't afford the $180 visit to the Pdoc. So, I now go to the local Health Department where they doctor won't prescribe me that amount and is starting to wean me down to 2 a day.
She is a GP and doesn't know much about BP disorder. She thinks the dose it too high - I think the Pdoc had a reason for giving it to me, or do you think possibly that doctors give patients addictive drugs just to keep them coming back?
I wonder if anyone else was on this high a dose?
I hope I can get some responses...
Thanks all.
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11 Comments Post a Comment
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585414_tn?1288944902
I take 2.5 mg. a day. I am not sure what is considered a dose that would be considered beyond what is workable but I do know that any conclusive decisions about psychiatric medications should be made by a psychiatrist. Perhaps you could find a form of coverage that would pay for a psychiatrist. I will post the link to IL centers as they could help with that:
http://www.ilru.org/html/publications/directory/index.html
I believe other agencies could as well. I definitely know that doctors and psychiatrists do not  prescribe any medications that have the potential of addiction without considering that because there are specific forms that they must complete as regards any medication that is a controlled substance and any of those prescriptions are specifically monitored by the FDA. In fact in some situations it can be the opposite as some psychiatrists that other people have seen that I know will not prescribe benzodiazepenes (of which Klonopin is one) at all. Dosages tend to vary with the only concern that is general by doctors or psychiatrists is  if a person builds up a tolerance to it. Regardless of dosage its best any specific decisions be made by a psychiatrist who has more specific clinical knowledge than a GP.
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1134609_tn?1269275800
Honestly, that is quite a bit of Klonopin, I am wondering why your shrink gave you so much. I mean, when I was started on Klonopin, I was given 1 mg a day and it worked well. We jumped up to 1.5mgs, but it really wasn't warranted. I wasn't having panic attacks; I was having full blown, agitated-mania. The Klonopin didn't put a dent into them at the time because I wasn't diagnosed as BP. Once I was placed on BP medications, I started to wonder if I needed the Klonopin at all. We debated about coming off of it, but I experienced a nasty relapse last month, so it really hasn't been an option. It's a Catch-22, the Klonopin may be dragging my depressive episodes lower, but getting off of it and going through withdrawals could cause some serious issues.

I could see why your new doc would want to get you down to around 2 mgs a day; that's a more standard dosage. And, honestly, as you come down and the levels in your blood stabilizes, the better the medication will work. Plus, coming down from higher doses isn't as bad as coming off of those last few. If the withdrawals get worse, ask him to put you on Neurontin as it will help out a lot. It's a lot like the benzos, but much milder. Be careful with asking for more of the Klonopin; shrinks will view is as addictive and drug seeking behavior. I am having that problem with my shrink right now. I have never abused my Klonopin, but I asked her it we could up the dose to 2mgs this last week, to help me deal with nicotine withdrawals. She was very indignant about it and refused to do so. I also have a script for Ativan to take as needed and I do so rarely, but I have been taking more of it (1-2mgs a week) to deal with my increasing anxiety levels. It's more addictive than the Klonopin, so I figured that this would be a good move; she disagreed. And, I don't take an Ativan until I am really a wreck..

The funny thing is, nicotine is considered to be one of the most addictive drugs on the planet; way more so than the benzos and even cocaine. I am having a terrible time giving up chew. She has never spoken to me like a drug abuser and it was disconcerting this time around... Funny thing is, I have been barely functional over the last month and a half, but when I was up and running last fall, she offered to increase the Klonopin level.

Also, I agree with ILADVOCATE; find a shrink and do it quick. Although I think that coming down to a lower dose of Klonopin may be good for you in the long run, a GP doesn't know enough about the benzos to do so safely. Virtually all of my mental illness problems have been exacerbated by the fact that I was seeing GPs and GNPs. They just don't understand the medication or the illness enough to treat it effectively... A good shrink will know that the best way to wean off of Klonopin is to use Valium. Replace the initial daily dose you want to come off of with Valium and then cut the Valium out slowly. There's no such thing as coming off of a benzo too slowly, believe me.
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1134609_tn?1269275800
Also, a shrink isn't going to hook you on a medication to keep you coming back..They have a reason for putting you on those high doses.. My history is pretty nasty, in terms of hospitalizations, and my shrink will honestly do anything she can to keep me from heading back down there. For me, it generally comes down to becoming suicidal or taking a small pill; the pill wins every time. Your doc might feel the same way.
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Avatar_f_tn
I take two 1 mg doses of clonazepam a day and that make me tired.  If four is what helps you then you should take it.  I'm just curious if it makes you drowsy.  That dose of 4 mg would knock me out.
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222267_tn?1253305810
I take 4 mg a day and i'm fine.  It's just what I need.  If I needed more, I could ask for more for a short amount of time.
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1221258_tn?1267546029
Nothing makes me sleep except Ambien, and although I know it's not right, my doctor (the Health Dept. GP ) cut me off completely. I have a friend that got sublingual Ambien and gave it to me (said it tastes horrible and switched back to her regular Ambien ) Now I sleep like a baby and what a change it makes in my daily energy level!!. ( I'd been on Ambien for 3 years for sleep ) The klonopin does not make me sleepy at all.
I have agreed to go down to 3 daily Haven't had any problems yet, as we are going down 1/4 mg. week.
I am not going to tell her about the Ambien as she will also see it as drug seeking.
My friend who is a social worker told me that people who get large amounts of Klonopin each month, sometimes sell it on the street. Perhaps that's another reason she is uneasy about keeping me on that much. This is by someone who works with the homeless and also uses the health department, they don't like giving you anything that would be used as a "street drug". Their mind set is different than that of a psychiatrist.
My psychiatrist upped me to the 5mg ( 4 4 x day, and 1 as needed for panic attacks)
because of hand tremors starting after I started Lamictal and also complaints of anxiety and panic attacks. I'm not sure who is right or wrong and why.
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1134609_tn?1269275800
There is a hesitance to give out the benzos, for the very reason that you described. I know several people who are prescribed Xanax, runs out of it in two weeks but manages to find it on the streets..  

I am surprised that your doc wouldn't give you Ambien, but will give you large doses of Klonopin; that just sounds strange to me. I mean, if the Klonopin isn't helping you sleep, but the Ambien does, they should just cut you a script. But, then again, I have a friend who is having problems with Zyprexa winding him up too tight and his pdoc won't give him anything for it; not even to sleep.
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Avatar_n_tn
4mg like 2mgs b.i.d. and then 1 extra PRN for Panic Attacks 1mg Klonopin isn't that Much it is a high dose anything above 3-4mgs is a high dose of clonazepam (Klonopin). The shrink would've out weighted the pros and cons of doing that and if the 5mg daily helped I don't see why not.  Theirs always a problem with abuse, dependence, and more commonly tolerance to benzodiazepines like Xanax and Klonopin at higher doses, and yes people with say 4 mgs may just take half and sell the other half. But the maximum dose for Klonopin is decided by your psychiatrist generally the highest I see is 6mgs 2mg pill t.i.d. three times daily, P.S. b.i.d. is twice daily and PRN just means "as needed": common for pain medicines like Vicodin 1 every 4-6 hours PRN pain "as need for pain". Take care, God bless, and yeah the best way to wean of any benzodiazepine is first to get the equivalent to Valium (Diazepam) which is the longest acting Benzo, and then reduce very, very slowly Diazepam comes in 2mg, 5mg, and 10mg tablets so you can decrease by 1mg or half of the 2mg tablet so yeah the best Shrinks will do that and add like Neurontin (Gabapentin). although Clonazepam itself is a long acting benzo just like Valium.  so the GP, is doing an okay job reducing it but from 5mg to 2mg is a little to much.. I would suggest to do it by 0.25mg every week or so, depending on how you feel and to switch to Valium and have a Rx of either Ativan or Valium just in case, benzodiazepine withdrawal is horrible and very dangerous can cause seizures so Ativan or Valium is used to prevent and treat Benzodiazepine withdrawal...
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Avatar_n_tn
The reason for the Rx of Ativan is just in case the reducing is to fast for your body and you just feel horrible or have a seizure taking 1mg-2mg of Ativan just help a lot with that.. or 10mg of Valium depends on the doctor usually the will switch you completely to Valium and order like 30 pills of the 1mg or 2mg Ativan just in case you have troubles to take as needed. if you continue to have anxiety or panic attacks they will add either Vistaril (Hydroxyzine) and/or Buspar, sometimes Gabapentin too. Just depends on the severity of withdrawal and how fast, and your medical history and the doctor that is prescribing the medicines. If you feel like you just had a Seizure go to the ER immediately don not wait you can have more.. and they can wean you off in the hospital via I.V. with Diazepam, Ativan, and/or Clonazepam. and they have many tools, they can even add Phenobarbital and Anticonvulsants if you are having seizures.
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Avatar_f_tn
I looked it up on my iPod PDR Micromedex and it is 0.25 to 4mg is the dosing range. I take 0.5mg every night to sleep. It is primarily for panic disorder (anxiety) and seizure disorder.
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Avatar_f_tn
Valium has a 12 - 15 hour half life while Klonopin has a 30 - 50 hour half life. It is the longest lasting benzo.
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