Klonopin/Clonzapam (sp)?

[anxiety860]

How much is to much? I am on .5mg. during a horrible anxiety attack i feel it is not enough. I am wondering what are the normal range of dosages for it? .5-2mg? 5mg? I ask because I honestly have no idea... I am going to discuss this with my doctor sooner or later, just thought I would see if anybody on here is taking more than .5mg, or if somebody knew what range was. Thanks

[Paxiled]

Nursegirl gave a great answer, but the question of addiction isn't as simple as it sometimes is made to sound.  Some people are just more likely to become addicted than others.  I've never increased my dosage and I've been on it for more years than I can remember; in fact, I decreased my dosage while I was on Paxil without incident.  But because of a bad time with Paxil I'm just not going to risk quitting the klonopin even though as far as I can tell it's never done much.  When I really need it, I take an extra half.  But there are people who shoot heroin without suffering any of the things we associate with withdrawal, so again, it's not that simple that one can really give an answer other than to play it safe rather than be sorry.

[lifeworthliving]

Thank you so much for your very informative reply! You always give such great support.

My current doc is unaware that I'm taking the klonopin. I have about 150 of 2 mg pills left from my previous doctor, from last time my world came to an end. I'm too scared to ask my doc about benzo, as I fear he would question whether that means I'm at a stage where I'm unable to take care of my child (which is not the case). So for now I'm relying on my klonopin for emergencies.

Anxiety860, sorry for "hijacking" your thread, but hopefully you also got the answers you were looking for.

[nursegirl6572]

Ahhh, the topic of benzos.  It can be a controversial ones.  Certainly many people have very strong opinions about them, both good and bad.

Technically, and "officially", a "short term" course of treatment is considered to be 3 months or less, give or take, but many people will show signs of dependency after only a few weeks of taking a benzo regularly.  

Taking it every other day at a small dose isn't bad, I wouldn't expect you to run into any dependency issues right away.  That being said, even taking it every other day will eventually lead to physical dependence if you're taking it regularly.  

This is why I strongly feel that unless someone is on a benzo that is more appropriate for longer term use (ie Klonopin, Valium), I feel that benzos should be taken only "as needed" to avoid both the issues of tolerance (where you would need a higher and higher dose to maintain the same level of effectiveness) and dependency.  To add, with shorter acting benzos (like Xanax and Ativan), they actually work MUCH better when they're only taken here and there, versus with any kind of regularity.

I've been on an "as needed" dose of Ativan for 23 years.  There have been times, when my panic was out of control, or when I was trudging through the adjustment period of an antidepressant, when I needed the Ativan at higher doses, and daily (sometimes even 2-3 times a day).   There is no question that the Ativan was truly a God send for me during those times.  

Never did I need to take the benzo regularly more than a few months, and what I basically did when I was much better (usually thanks to an antidepressant and therapy) that I didn't NEED the Ativan as much was to slowly taper back down to my "as needed" dose.  I can honestly say that I did fine each time I had to do that (probably 2 or 3 times).  Other than some minimal rebound anxiety, I tolerated the tapering process very well.

Of course, everyone is different, but truly, when these medications are monitored properly, and dosed optimally, they can be a beneficial part of an anxiety treatment plan without causing a lot of extra issues.  It's always best IMO to tread carefully, and when possible, either avoid them or take only the minimal necessary, but I don't want people to FEAR them either.  The meds themselves aren't necessarily inherently bad.

I would really recommend for you both asking about a shorter acting "as needed" benzo, as it seems you both have more of a need for a rescue drug, versus a maintenance drug, which Klonopin more often is.  It CAN be used as a PRN medication, but the shorter acting benzo cousins are better.  Klonopin works a little differently in that it builds in the plasma to achieve maximum efficacy, therefore why it's best if dosed twice or three times daily every day.  Taking it as needed may help to an extent, but you definitely aren't getting the maximum effectiveness out of the Klonopin for sure.

Keep us informed (both of you)!

[lifeworthliving]

Paxiled, in your opinion, how much/often/long do you have to use it before you get addicted? And how long should it be before .5 mg poop out?

[lifeworthliving]

The first time i was put on klonopin, the crazy doc gave me 2 mg three times a day! I was completely stoned, and blacked out at work. Went to work on instinct, and slept the rest of the time. I don't remember much of those weeks, and looking back at emails I sent to my colleagues, I didn't even spell my own first name correctly. Eventually my pharmacist saw which state I was in, and called my doc, who reduced to 3 mg a day. I was hard to eventually withdraw, had to do it really slowly.

Now I take .5 mg as needed, typically every other day. But like you, I don't really feel it's enough.

Be very careful, and good luck!

[Paxiled]

It used to be 1mg twice a day, because klonopin is a long-acting benzo but also takes a bit of time to kick in.  Short acting benzos tend to be better for as-needed use, as they kick in faster and poop out faster.  The problem is, and of course they didn't tell me this when they put me on klonopin, when you take a benzo regularly you get addicted to it and it's very very hard to stop taking.  But there it is.