Posted by mattdds on May 29, 2003, at 6:07:45
In reply to Yet another Klonopin question?, posted by Dragonslayer on May 28, 2003, at 8:24:12
I use K exclusively (0.5 mg bid-tid) with great results. Interestingly, my pdoc recently tried to titrate me up to 0.5 mg qid for residual derealization / depersonalization (anxiety of all types was already completely obliterated, I just had nagging derealization), but it seemed to have a lethargy inducing effect, as you described. So I dropped back down to the 0.5 mg bid. On a bad day, and mainly for prevention, I'll go up to 1.5 mg total daily dose (0.5 mg * 3).
I prefer to take the divided doses throughout the day, because I like enjoy the feeling of a nice bolus of Klonopin "kicking in". I live in Manhattan, and my doc said that it is OK either way; one big dose or two or three divided. The only problem with taking bigger doses all at once, according to him is that you get bigger peaks and valleys, even with steady state pharmacodynamics (K in = K out, at any given moment). I'm pretty sure, if I remember correctly from my pharmacology class, that "steady state" is really NOT that steady with oral dosing, even in drugs with long half lives like Klonopin. That definitely mathces my experience.
I tried taking it all at night, but found I get better anxiety control with divided doses. But for me the AM dose is by far the most important. Thinking about it, this would conceivably give you the best "coverage" for the barrage of any given day's anxiety-provoking events. So again, the main thing is the AM dose.
It's funny - most people take coffee to get up in the morning. I just use the coffee to wash down the Klonopin.
Best
poster:mattdds
thread:229680
URL: http://www.dr-bob.org/babble/20030525/msgs/229891.html