long acting benzos dont last all that long, IMO

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harry4
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   Posted 6/12/2007 4:00 PM (GMT -7)   
some longacting benzos such as clonazepam are promoted to doctors as lasting 24 hours per dose
 
I dont think this is correct, the effective time varies a lot from person to person but, IMO, is seldom longer than 4 hours
 
so if having a very difficult day, a morning and lunchtime dose may be needed
 
dont take again before bed unless you cant get to sleep naturally
 
I am very against a dose daily before bed, as I dont think there will be much help the next day, and it may eventually stop you from being able to fall asleep naturally
 
remember that docs learn from their textbooks and drug company sales reps ,but not from anxiety sufferers


recovered former longtime anxiety and panic attack sufferer and helper of other sufferers  but no training or  qualifications in medicine or psychology, any remarks that may be taken as advice must be confirmed with doctor or other health professional
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Aussieangel
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   Posted 6/12/2007 4:03 PM (GMT -7)   
I agree Harry and today is my switch day from nightly to 3 x a day. I just had my morning one so I'll let you know how it goes.

debaser
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   Posted 6/12/2007 11:18 PM (GMT -7)   
Clonazepam is usually dosed bid, and I know that one dose will last throughout my working day and begin to lose effectiveness as I approach the time for my next dose, which is 8pm. I take them roughly every twelve hours.

I'm not sure what you base your information on, Harry, but these meds have been around so long that I'm not sure it matters what the pharma reps tell doctors. There's a large body of research on the benzodiazepines. Many people do take a smaller dose three times a day. I take a small dose twice a day. It pretty much covers me. People are different and this is in the literature.

"Long-acting" is relative term to be compared to ativan or whatever. Klonopin/Clonazepam lasts a LOT longer than the "short-acting" benzos.

Anyway, you're not qualified to tell people they may need a lunchtime dose if they're having a bad day. That should be up to the doctor, and it's up to the patient to communicate with their doctors if they find themselves having a lot of those bad days.
My Brain: My friend, My enemy: A blog to chronicle my attempt to recover from anxiety/panic disorder
anxietypanicdisorder.blogspot.com/


Howlyncat
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   Posted 6/13/2007 6:59 AM (GMT -7)   
NO one is qualified to give medical advice as per HW rules .......
I hope this thread does not get out of hand ....

LYN
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Howlyncat
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   Posted 6/13/2007 7:00 AM (GMT -7)   
Victoria
I am so glad you are working with your doc in this

LYN
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debaser
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   Posted 6/13/2007 11:40 AM (GMT -7)   
I don't see why it would get out of hand.

If a person is on meds but is still experiencing anxiety that they can't handle, they either need to find some way to relax or talk to their doctor about how they take their medication. It's that simple. And before they talk to their doctors, people should know that there are definite drawbacks to changing the doses of any benzo, short or long.

I actually agree with most of what Harry said, but I don't like how he worded it. And a real long-acting benzo should last quite a bit longer than four hours for just about everyone. They have really long half-lives...the studies are available on the internet. A person would have to have a very unusual metabolism for a therapeutic dose of Klonopin to last such a short time. But I guess it's possible...talk to doctors.
My Brain: My friend, My enemy: A blog to chronicle my attempt to recover from anxiety/panic disorder
anxietypanicdisorder.blogspot.com/


Aussieangel
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   Posted 6/13/2007 3:43 PM (GMT -7)   

debaser you haven't been on clonazepam for long, like any benzo they can end up actually giving you worse symptoms then you started with.

I had been on 2mgs per day for about 8months, at no time did any pdoc say to me do you know that's equivalent to 40mgs of valium. All they did was withdraw me each time I went in hospital usually in less then a week which ended up a nightmare and they' restart me.

Only recently when I was cut back to 1.5mgs I noticed I was getting more anxious during the day and that when I took my dose at night I could fel the difference. Hopefully by taking it during the day in more measured doses it'll work better and it also sets me up for a proper withdrawal.

I use to think clonazepam was a wonder drug, for short periods of time I still do but I don't believe pdocs should be handing it out for long term use.

 

 


ChristianWithHope
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   Posted 6/13/2007 9:35 PM (GMT -7)   
Interestingly I just visited my psychiatrist yesterday. I've been taking 2mg of Xanax before I go to bed for about 6 months now. When things were really bad, I was taking 2mg every 4 hours as needed. They were a huge help.
For the first time in 20 years, I'm sleeping the entire night through. I'm on 200mg of Zoloft plus the 2mg of Xanax before I go to bed.
I specifically asked him about the tolerance issues and if he saw it as an issue that I was still taking the Xanax before bed. He didn't think so...because the Xanax only stays in your system for about 4 hours...so essentially I'm going through "withdrawal" every day. He said I should feel free to back off of it gradually - maybe 0.5 mg every couple of weeks.
But again - everyone matabolizes the chemicals at different rates, so something that works one way for me may not work the same for you. So see your doctor (I sound like a commercial). ; )
The good news is that there are lots of people that go through torturous seasons of anxiety and emerge on the other side wiser and stronger than before. THERE'S REASON TO HOPE! : )
Harry - I don't doubt that you're trying to be helpful, but speaking authoritatively in areas where you're not qualified is just not right.
Be smart folks - listen to your docs, get second opinions if you're not confident in your current treatment and use this forum as place where you can share with others your unique experiences. But don't mess with your medication without first consulting a physician.

debaser
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   Posted 6/13/2007 10:16 PM (GMT -7)   
Right on, C.

But when I was talking about Clonazepam I was referring not to my experience, but to what I've read. There's a significant body of research that strongly suggests there's not a tolerance problem with lower doses of that particular drug. A low dose would be what Roche and the FDA recommend for A/P disorder: .5 mg x2/day. There's a lot of evidence that suggests higher doses are risky in terms of tolerance. 2 mg would be considered a high dose. On my blog there's some links that are pretty interesting, and if you follow them you'll eventually get to the clinical studies I'm referring to. Numbers are numbers. These pills have been around a long time and there's lots of data.

Long story short, I'm not worried about Klonopin/Clonazepam making my symptoms worse. If that happens I'll definitely report it here and in my blog, but I don't think it will just based on the science.
My Brain: My friend, My enemy: A blog to chronicle my attempt to recover from anxiety/panic disorder
anxietypanicdisorder.blogspot.com/


Howlyncat
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   Posted 6/14/2007 5:00 AM (GMT -7)   
I have been taking benzo's for more yrs than I care to say but I am happy to say that I have cut from 3 a day to prn at times and then none at all for so many days
Depends on me I guess and whats going on around me
I take the most when broke out in PG sores or getting TX.........

Lyn
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SarahP
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   Posted 6/14/2007 11:08 AM (GMT -7)   
I'm really interested in why a benzo, specifically Klonopin, shouldn't be used before bed, or as a sleeping aid. My script reads "take twice a day as needed", but my doc said take one before bed. Does it make a difference that I am not taking it for anxiety at night, but for muscle twitching?
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stkitt
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   Posted 6/14/2007 4:06 PM (GMT -7)   

Hello All,

Ha, you thought I was so busy serving on a jury that I would miss this one...........

Sarah, if your physician has told you how he feels you should take your med and you are taking it as prescribed so IMO  I do not believe you should worry about the literature.

I am a long time user of the benzos and I do not know if I could have worked for 26 years without the aid of the meds.

No matter what med your discussing there will be two sides.

I believe at this point the thing to remember is we are all here for support and none of us are professionals.

I wish you peace.

Gentle Hugs.


Respectfully
Kitt
Moderator Anxiety ~ Panic Disorders
Dx: Anxiety/Panic, Depression 
______________________________________________________
"If you doubt you can accomplish something, then you can’t accomplish it. You have to have confidence in your ability, and then be tough enough to follow through.” 
~Rosalyn Carter


Aussieangel
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Date Joined Sep 2006
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   Posted 6/14/2007 4:37 PM (GMT -7)   

I've noticed over the last 2 days that I get edgy when I'm due for my dose. I think for me it's a good indicator that the 24hr life doesn't work for me. I see my pdoc today and if all goes well I 'll go from weekly to fortnightly meetings, I'll ask him then.

 

 


stkitt
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   Posted 6/14/2007 6:55 PM (GMT -7)   
Good for you, I am proud of you for being proactive.  Keep it up and keep posting.  You are family here.  yeah
Respectfully
Kitt
Moderator Anxiety ~ Panic Disorders
Dx: Anxiety/Panic, Depression 
______________________________________________________
"If you doubt you can accomplish something, then you can’t accomplish it. You have to have confidence in your ability, and then be tough enough to follow through.” 
~Rosalyn Carter


debaser
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Date Joined Nov 2006
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   Posted 6/14/2007 11:05 PM (GMT -7)   
I wish I had more time to post, but I have a long day ahead of me tomorrow.

Klonopin's half life is significantly longer than 24 hours, but that doesn't mean that it's therapeutic effects will last that long. The length of the therapeutic effect will vary from individual to individual, but for me it's somewhere in the 12 hour neighborhood. Interestingly, I normally get edgy around dose time, but tonight I was busy and didn't remember to take it on time...I was two and a half hours late. It didn't bother me at all until I noticed that I hadn't taken it! So some of the edginess we're experiencing might be psychological...hard to tell.

To SarahP: I've heard of a LOT of people who take their K dose an hour or so before bedtime, and their doctors told them to do that. In your case with the muscle stuff, that would seem like an entirely appropriate thing to do. What Harry failed to mention is that the sedation effects of benzos tend to go away with time if taking it regularly. That's what the studies say, anyway. If that's true for you then it shouldn't interfere with your natural ability to get to sleep. And if it did, so what? It's not going to mess you up for life if you stopped taking it. Eventually you'd return to normal, I'd think.

I just don't think there's much cause for alarm. While there are bad doctors out there, most of them are very bright and know what they're doing. If they say to take it at night, take it at night. Harry's notion that doctors don't learn from anxiety sufferers is puzzling to me. My doctor asked me questions every time I saw him for a refill, and I imagine that he does that with all his patients. Learning from textbooks? Sure they do, but they learn from their experience just like the rest of us. I've finally learned to trust doctors like I would any other professional. They're not Gods but very few of them are idiots who only learn from textbooks and pharma reps.
My Brain: My friend, My enemy: A blog to chronicle my attempt to recover from anxiety/panic disorder
anxietypanicdisorder.blogspot.com/


Howlyncat
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Date Joined Jan 2005
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   Posted 6/15/2007 3:21 AM (GMT -7)   
Sarah
Ditto to Kitt's post and Debaser Doc's are not God thats for sure BUT for many many yrs they have been treated as such so it is not only their fault sad to say IMHO

THERE has to be EMPATHY with each patient and different measures of TX'x for each patient
We are not a herd of Cattle
    Contribute today to support Healing Well Forums...Donate @
 
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Take my Hand ...I will WALK with you
 
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 God Bless All
 
LYN    
                                  

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