So I've been on clonazepam for almost 3 years now, I take .5mg three times a day for pretty serious anxiety/panic attacks. I Know it's not meant to be a long acting drug but it's a life saver. I've been on the same dose for almost 2 years now and its not working nearly as well as it was, honestly to feel the effects and have a steady day without panic attacks I need to take 1mg three times a day. I usually do, I know it's not my dose but sometimes I have no choice which leaves me out of meds 1-2 weeks early every month and I spend that time pretty much freaking out and not leaving my house. I have a Doctors appointment on Monday and I'm going to ask for a dosage increase, just wanted your guys opinions on how to go about that without sounding like a drug addict. I don't take them to get high, but just to feel normal. I feel like 2 years is long enough to uo my dosage because of my tolerance being so much higher now. ANYWAY, any advice or opinions would seriously help, thanks!
Benzos Taking .5mg Klonopin 3x a day, asking Pdoc for increase
- Thread starter DylanS4C
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Been there, done that.
My advice: Don't increase your benzo dosage past 1.5 mgs of Klonopin (your tolerance to its beneficial effects will just rapidly rise to match your dose again), and instead try to round out your meds with something that isn't as insanely addictive - Gabapentin (or preferably Pregabalin), various antidepressants you haven't tried yet, low-dose antipsychotics...
EnlightenedOne1
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All Dr.s are different but I would just tell him/her that you've been on the same dosage for so long that it has become ineffective and you feel you need a dosage increase.
I'm currently on a taper from 4mgs of Clonazepam (down to 2.5-3mgs per day), so I can identify with your situation.
I've only been on a year and my taper is 8 months long so prepare yourself if you ever plan on coming off. Gabapentin is also an alternative, albeit that has some unique wd symptoms and becomes ineffective after a few days of use IME. I actually just tapered of f of 3,200mgs of Gabapentin daily to nothing, and the wd is not welcoming.
I'm currently on a taper from 4mgs of Clonazepam (down to 2.5-3mgs per day), so I can identify with your situation.
I've only been on a year and my taper is 8 months long so prepare yourself if you ever plan on coming off. Gabapentin is also an alternative, albeit that has some unique wd symptoms and becomes ineffective after a few days of use IME. I actually just tapered of f of 3,200mgs of Gabapentin daily to nothing, and the wd is not welcoming.
cannablissss
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My doctor lowered my Klonopin from 1mg twice a day to 1mg once a day to .5 to nothing at all. I used to be on Xanax until she yanked me off of that too. Now I'm just on 900mg of Neurontin a day.
I would just tell her your dose isn't as helpful as it was when you started off and describe some effects you're experiencing.
I would just tell her your dose isn't as helpful as it was when you started off and describe some effects you're experiencing.
hatrix
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I'm in pretty much the exact same situation, except with diazepam.
I've been taking it for 3-4 years now, at 5mg 3x daily for most of that timespan (it's been increased once by a different doctor I had after about half a year of being on it). I need an increase myself, but I'm afraid if I ask that he may want to suddenly taper me down or stop prescribing it all together...
He never has a problem refilling it though, I go in every 2-3 months for more refills. Gives it without even asking about my anxiety or anything. Maybe being straightforward is a good idea.
I've been taking it for 3-4 years now, at 5mg 3x daily for most of that timespan (it's been increased once by a different doctor I had after about half a year of being on it). I need an increase myself, but I'm afraid if I ask that he may want to suddenly taper me down or stop prescribing it all together...
He never has a problem refilling it though, I go in every 2-3 months for more refills. Gives it without even asking about my anxiety or anything. Maybe being straightforward is a good idea.
pbuilder
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I would advice against increasing your dose. Long term benzo usage makes the initial anxiety problems much much worse, and is damaging your gaba system permanently. Long term benzo use is linked to alzheimers and other neurodegenerative diseases, and doctors have begun drastically reducing the amount they prescribe benzos because of this. Eventually i think they will be phased out entirely. The last thing you want to do is increase your dose because eventually you may be taken off them, and you will be in even more trouble. You should really consider trying to slowly taper yourself off them, in the long run you will thank yourself. Benzo addiction sucks, i know it myself.
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I take Klonopin and I'm entirely unworried about alzheimers which I don't think will happen to me or damaging my GABA system which I don't think will happen either.
Both MAY happen, but neither is set in stone and I don't think it's fair to tell people what they can and can't take so I don't think they should be phased out and honestly I doubt they will.
Even if they stop being used medically people will find them on the street.
I don't think he should increase his dose either cause I use the same dose as him except usually in one shot, and I feel fine.
Having taken Klonopin for 11 years and being able to get off without any side effects I found the addiction to be overrated in terms of it's horrors at least for me even though I know I am probably that 1 in 10,000 case who was able to so easily stop.
Now I use a low dose...usually about 1.5mgs, 4 or 5 days a week and abstain 2-3 days a week.
I've never noticed a single negative side effect other than sometimes sleeping a bit worse if I take too much which I am careful to no longer do or getting a little tired if i take too much so I try not to or just drink some coffee if that happens.
No one has ever PROVEN that the majority or even half of the majority of people who use benzos longterm will necessarily ever get these sorts of problems.
Some will, some wont, and there's no clear way of knowing how many will or won't, but then again, all drugs have negative health effects.
I think everyone should be free to make their own choices, but I don't lose sleep over using Klonopin a few days a week that's for sure.
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pbuilder
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I'm not forcing or taking away anyones choice to do anything. That is simply my advice based off experience, my opinion, which that person can take or leave.
http://www.psychiatryadvisor.com/al...nes-alzheimers-dementia-death/article/443262/
https://www.psychologytoday.com/blo...s-the-troubling-facts-risks-and-history-minor
You're one of the lucky few who don't get long lasting paws from benzos that are the worst and most terrifying withdrawal symptoms I've ever experienced. Benzos are massively over prescribed without patients being made aware of the long term side effects and addiction.
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Benzodiazepines won't be "phased out" unless another just-as-effective drug class is developed to replace them. And what drug class would that be? I can't think of any class of drug that's as fast & effective as benzodiazepines are when it comes to anxiolytic properties, combined with a good safety profile.
pbuilder
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They already are being phased out as far as prescriptions for anxiety go. They may have a good safety profile in the short term, but mountains of evidence is coming to light about how terrible they are in the long term.
Of course in emergency and hospital situations they will still be used, but getting them scripted for anything other then short term is becoming rarer and rarer.
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I don't really see any problem with using them long-term on a PRN basis, honestly. Of course a structured long-term regiment that involves consuming benzodiazepines every single day is not a good idea, simply because it involves becoming physically dependent on a drug (never a good idea if you can help it because there may come a period of time when you don't have access to the drug, for whatever reason), but that's a problem with prescribing practice, not the drug itself. Benzodiazepines usually have few side effects too, esp. when compared to the candidates for their "replacement" like anti-depressants or anti-psychotics. It's been around in clinical practice for a long time and it still gets defended quite a bit in medical literature, in fact the pharmacology textbook I own states that when most people who adjust their dose of benzodiazepines change their dose voluntarily, they adjust downwards, not upwards, based on studies done on the topic...hardly indicative of an addictive substance.
As far as whether they cause dementia or not, well, that link doesn't seem to be clearly established to me. If you're truly worried about something like that, perhaps just consume aspirin every day, as that's linked to the reduction in risk of developing Alzheimers, due to some speculation about the effect of inflammation in the development of the disease...then you'll be both reducing your risk and raising your risk simultaneously, so you'll be about even! Isn't that how this risk stuff works lol
Plus, how is the effect of the patient's overall health weighed against the increase in risk? I assume they went to the doctor because something was wrong with them originally, and there seems to be a connection between poor mental health and poor physical health, esp. for people who suffer from chronic insomnia etc
As far as whether they cause dementia or not, well, that link doesn't seem to be clearly established to me. If you're truly worried about something like that, perhaps just consume aspirin every day, as that's linked to the reduction in risk of developing Alzheimers, due to some speculation about the effect of inflammation in the development of the disease...then you'll be both reducing your risk and raising your risk simultaneously, so you'll be about even! Isn't that how this risk stuff works lol
Plus, how is the effect of the patient's overall health weighed against the increase in risk? I assume they went to the doctor because something was wrong with them originally, and there seems to be a connection between poor mental health and poor physical health, esp. for people who suffer from chronic insomnia etc