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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 47 to 71 of 71. Go back in thread:
Posted by comftnumb on January 16, 2003, at 2:07:51
In reply to Re: klonopin vs clonazepam » Bob, posted by proud mary on January 15, 2003, at 15:56:14
I'm not sure exactly why doctors would prefer klonopin to xanax but here is a possible reason:
Xanax has a much shorter average half-life (12hrs) than Klonopin (34hours). Xanax is considered a short-acting benzo while Klonopin is considered long-acting. Short-acting benzos are associated with more rebound anxiety and withdrawal reaction, therefore harder to get off of.
For a list of benzos, see http://www.sdh.sk.ca/rxfiles/acrobat/Cht-Psyc-Benzodiazepines.pdf
PS Make sure you have adobe acrobat reader installed. It's freeware.
Posted by lostsailor on January 16, 2003, at 10:44:45
In reply to Re: klonopin vs xanax » proud mary, posted by comftnumb on January 16, 2003, at 2:07:51
I think I can help a bit here. I am a person that has suffered from GAD and Panic Disorder now for about 7 years and has remained on benzodiazapines virtually continuously for all of those years.
Basically, the family of this medication can be broken down into three main categories depending on the "half-life " of the medication and are at times divided even further. 1) Short acting benzos--xanax and ativan are decent examples. 2) mid-length--Klonopin and 3)long-lasting--valium.
During the past years the ssris and newer meds have not totally alleviated my panic and anxiety prob, though they have helped. Also, while marketed as a salvation and alternative to benzos there is now evidence of a withdrawal syndrome
similar to the benzo family.
I began taking a Prozac and a low dose of xanax as needed in the mid 1990s as directed by my primary care doc. While somewhat helpful I needed a dose that my doc thought indicated a referral to a psychiatrist for work up and consult was in order.
It was then that the words Panic Disorder changed from my description of just the attacks.Dr M (e.g., my shrink), explained that while xanax is a great med for short-term issues klonopin was a better choice b/c it lasts in your body longer, produces less of a "euphoric" feeling and in general is more politically correct to prescribe. I was also started on paxil and stopped prozac.
While klonopin did help it was not as effective as xanax and it "seemed" that it intensified depressive feelings so we agreed that xnanx was perhaps the better choice for me at the time.
A year or two later, I began to despise carrying xanax everywhere I went. When a "short-acting" benzo wears off, you know it (xanax is like the american express card of the benzo family "don't leave home without it") and asked to go back on klonopin again. And again klonopin "seemed" to cause an increase in feelings of depression but did lessen the amount of daily doses I required.
Being sick of carrying xanax and not having great results with klonopin, doc suggested trying Valium, which proved to be effective.
During the interim, doc and I discussed benzo addiction (which I was terrified of) and Dependence. Doc emphatically emphasized that the distinction is made by the method of use and "drug seeking behavior" in the eyes of the clinician. While it was true that I was physically dependent on benzos he stressed, to help minimize my fears, that addiction--per say--would mean A) using the drug in a fashion to get high B) elevation in the dose required C) the method of obtaining the drug...calling for refills with the excuse of losing them, dog eating, finding other docs to write duplicate scripts, ect or buying them in the street.
I now switch for valium when doing "well" with panic and needing to take it only twice a day which is great and switch to xanax (taken 3 or 4 times a day) when panic is very elevated until it is back in control for a while and then switch back to valium again.
I also take an ssri or ssnri at all times and a mood stabilizer. For many, esp. those with prior or coexisting abuse of drugs or alcohol, the benzo family can be tragic if misused. For others, myself inc, they are a blessing that I cant describe for I would rather be dependent on a benzo than have panic attacks galore. I guess I feel bad that there are such stereotypes involved with this medication family and feel sorry for those who have docs that withhold an effective treatment option due to political corrective ness
Posted by proud mary on January 20, 2003, at 15:29:00
In reply to Re: klonopin vs xanax, posted by lostsailor on January 16, 2003, at 10:44:45
No, I agree with you completely, Lost. I can relate to the politically correct deal because I have no trouble whatsoever getting klonopin (clonazapam) from my pdoc (even when I was in the public health system, although they did screen a bit better than my private pdoc does) but asking about xanax seemed to set off bells of alarm and terror in the whole department. my Klonopin has worked well for me and I even got to the point where I didn't carry it with me all the time (a fact that impressed my therapist). But in the old days, I wouldn't have gotten caught DEAD without it (or I guess I thought I WOULD die)...it's SO WONDERFUL to find people who understand what it's like and what I have gone through/am going through! I am still having a bit of trouble navigating the whole message board thing, so if my messages turn up in odd places, that's why....
keep writing so I can keep reading....Mary
Posted by lostsailor on January 22, 2003, at 10:27:31
In reply to Re: klonopin vs xanax » lostsailor, posted by proud mary on January 20, 2003, at 15:29:00
Congrads, my friend.
Like your therapist, I am happy for you, too. Being back on xanax is a bit of a drag but also part of the ebb and flow. I am just so thankful for a doc that works with me not mostly for my insur company. Our goal is to get me back on Valium as soon as the panic waves break and might even try Librium for the first time. What is funny, though, is when first giving me valium he said "boy it's been a while since I wrote for this"...with the Librium, he said I'm not sure if I have ever written this other that for acute alcohol withdrawal...(he's only prop. in his mid forties...lol)
Post back when you have some time. You seem to have it down. I found this right away.
"See you soon"
~Tony
Posted by cares4 on October 12, 2003, at 22:54:59
In reply to Re: Benzos - Dr. Bob - too contoversial ?, posted by me on August 8, 1999, at 11:10:20
I had my first panic attack 2 1/2 years ago, since then I still have daily anxiety and usually full panic attacks at least twice a week. I take Lexapro 1.5 tab at night, and ativan as needed, which I need one every night just to sleep. On bad days i take them twice a day, some days only at bed time. My question is I am 32, have a stressful life, but will I suffer from this anxiety forever? I have tried several different antidepressents and usually they caused me anxiety, so this Lexapro seems to be the best. I can't do anything without having a panic attack, I can't go out w/friend, to school plays, to concerts, anything where I feel I can't get out without being obvious, just there mere thought of having an attack, seems to cause one. I am 32 and I can't stand this anymore. I feel one coming on now. I can't afford psychotherapy, I tried it once and it didn't do anything for my anxiety anyway. Do you think me taking ativan for this long is safe? I have heart palpations, chest pains, daily headaches, and dizziness, I have to wonder if the medicine is doing this, or if the stress I am under is causing it. The doctor says I am probably stressed, but I think the extreme stress for 3 years could be damaging to my body. I dont' know, I just wish I understood, what has happened to make me have panic attacks, and will they ever stop?
Posted by Pattisun on October 13, 2003, at 15:03:53
In reply to Re: low dose benzos controversy, posted by Greg on August 9, 1999, at 21:47:53
I have been taking Klonopin (generic) since 1995. I get terrible panic attacks. Initially my dose was 3-4mg/day but I've lived quite normally on a dosage of 2-3 .50 mg per day. Cognitive therapy was very helpful and got me out in the world and stopped all the emergency room trips, but it did not get rid of my attacks. I've had doctors insist that I get off the Klonopin and it's not been bad--actually nothing at all compared to what I went through getting off of Paxil for instance--however, when I'm off the panic attacks return.
For me, to live a normal life and be able to get out and live life like the majority of people, I have to have something to keep my panic attacks at bay.
I am thankful for the majority of my doctors who have been merciful and understanding and let me continue on this medication.
Pattisun
Posted by hockeygirlcanada on October 14, 2003, at 5:36:21
In reply to Re: Benzos since 95, living a full life, posted by Pattisun on October 13, 2003, at 15:03:53
Hi,
I have been on Klonopin as well since 97 and have been through over 10 anti-depressants (currently starting parnate) but klonopin was the only thing that has allowed me to get through life since then. Even childbirth! And yes, I was allowed to take it during pregnancy, my son was not addicted, and is very healthy. I too have had to use more at certain times, especially while changing meds, but I have always been able to return to an as needed dose of up to 2 mg a day.
My doctors said if you weigh the negatives against the positives, there is no need to stop taking it. THere is no significant scientifically evidence that it is physically harmful to your body, according to my psychiatrist. So, I would not worry about using it, unless you find that you keep needing more and build up a tolerance, but from reading here, and my own personal experiences, the chances of that are unlikely,
all the best, good luck..
Posted by MamaB on October 14, 2003, at 13:56:58
In reply to Re: Benzos since 95, living a full life, posted by hockeygirlcanada on October 14, 2003, at 5:36:21
No, benzodiazapines are not physically harmful. However you are right about the tolerance. However both doctor and patient walk a fine line with benzos. The physicians that I know generally will generally allow only ONE increase in dose.
I struggle with the whole issue as I am a healed/reformed alcoholic (AA does not like me, nor me them!) I have not had a drink for 24 years, but you just go to a new physician, and tell him/her that and you are an ex-alcoholic! You had better NEVER try and get a prescription for a benzo (or painkillers for that matter!!
I have excellent rapport with a fine doctor who knows my history well. On two occasions in the past 24 years it has been neccessary for me to take painkillers, and once a benzo for a pre-op. I was given 6 tablets of the pain killer both times and my husband kept the pills. I had no problems taking the benzo pre-op.
So I guess it depends on the individual and how well he or she works with the physician.
Posted by MamaB on October 14, 2003, at 14:18:42
In reply to Re: Benzos since 95, living a full life, posted by MamaB on October 14, 2003, at 13:56:58
If you doubt the addiction problem or if you just want to be informed, check out this site:
Posted by ian24 on October 14, 2003, at 16:39:13
In reply to Re: Benzos since 95, living a full life, posted by Pattisun on October 13, 2003, at 15:03:53
I agree I have taken Klonopin and it means the difference between being able to or not being able to deal with people at work. I am also in AA. I have 6 years sobriety and the big book says we are not doctors! That is what anyone in AA must learn before they dispense opinion on meds. The book says mind your own beeswax on that , it's between Me and God. Also I have taken zanaz for a year, stopped it then a year later too Klonopin. I never had a drink nor did I abuse my meds .
Posted by Pattisun on October 14, 2003, at 18:30:38
In reply to Re: Benzos since 95, living a full life, posted by MamaB on October 14, 2003, at 14:18:42
> If you doubt the addiction problem or if you just want to be informed, check out this site:
>
> http://www.xanaxaddiction.info/news-1.htmThanks for the info. I don't doubt the addition problem. I graduated HS in 74 and grew up in the pill popping, dope smoking crowd. I have 15 & 19 yr old sons. I keep my medications under tight control and would NEVER give them out to anyone. I have a lot of pain meds too but I don't like to take them (except the Ibuprofen) because I am scared of the potential addiction. But some days I just can't make it through without the meds. I mostly depend on my epidural and trigger point injection at the pain clinic and try my best to stay pill free. It's a scary thing and it's a shame, I guess it's human nature to want to get "stoned"????????
Take care....
Posted by amy_oz on October 14, 2003, at 23:44:02
In reply to Re: Benzos - Dr. Bob - too contoversial ?, posted by cares4 on October 12, 2003, at 22:54:59
Hi,
It is possible to stop having panic attacks. The problem is once you're in the cycle is how to come out again. Have you tried behaviour therapy for the panic attacks? I worked with an axiety therapist for my panic attack problems. THe way it works is that you slowly, carefully and deliberately place yourself in an environment that induces panic attacks. You do this with the therapist with you. (like they do with phobias) You then gradually build on this and over time you can gain confidence about triggering situations.Another thing to note is that you can't have a full blown panic attack if you are breathing properly. Learn how to breathe through your diaphragm. each breath you take breathe out for slighlty longer than the breath in.
When you have an attack try walking at the same pace as normal breathing and try and get your breathing to match using the technique I just mentioned. It does take some practice. Also try singing as you are doing it as singing forces you to breathe more steadily (thats if you know how to sing!)
It took me one month to stop having panic attacks and I was entirely symptom free with out medication.
This may not be enough for everyone so.....
Other medications to try are the atypical antipsychotics, They work really well for anxiety and are very safe at low doses over a few years. Zyprexa and Seroquel are good.
Good luck
Amy
Posted by femlite on October 15, 2003, at 9:50:41
In reply to Re: Benzos re: abuse, posted by Pattisun on October 14, 2003, at 18:30:38
I didnt read the article and i dont think I want to.
I think it would be more fair to say Its just human nature to want to avoid pain.
Perceptions of pain can vary and an objective standard is important.
My daughter thinks its pain ful to do the dishes.
I think so sometimes too. But as an adult, Ive acclimated myself to the notion that life is not pain free.
I think my daughter may be ADD. When shes a little older and manafestations of that pain (the pain of "dysfunction") surface, of course it would be inhuman and cruel for me to then say, life is painful, deal with it.
Young people lack guidance and need it desperately. Life without it can be hell, and they are too young to know why. They just react in a very human way, kill the pain.
my 2 bits
> > If you doubt the addiction problem or if you just want to be informed, check out this site:
> >
> > http://www.xanaxaddiction.info/news-1.htm
>
> Thanks for the info. I don't doubt the addition problem. I graduated HS in 74 and grew up in the pill popping, dope smoking crowd. I have 15 & 19 yr old sons. I keep my medications under tight control and would NEVER give them out to anyone. I have a lot of pain meds too but I don't like to take them (except the Ibuprofen) because I am scared of the potential addiction. But some days I just can't make it through without the meds. I mostly depend on my epidural and trigger point injection at the pain clinic and try my best to stay pill free. It's a scary thing and it's a shame, I guess it's human nature to want to get "stoned"????????
>
> Take care....
Posted by Kristine29 on October 22, 2003, at 1:44:59
In reply to Re: klonopin vs xanax, posted by lostsailor on January 16, 2003, at 10:44:45
I just had some questions.
I have BiPolar Disorder, with panic attacks that go away for a while then come back, real bad.I suffer from Severe Depression also, and take Zoloft 200mg.(lower dosage wouldn't work for me.)
I used to take mood stabilizers Trileptal & Geodone.I've Heard of Lithium?But, I would like to know which are the best mood stabilizers with someone with Bipolar disorder. For panic attacks I've taken Klonopin or Xanax, but I only take it when very necessary. I also want to know about Valium?
Posted by Kristine29 on October 22, 2003, at 2:03:32
In reply to Re: klonopin vs xanax, posted by Kristine29 on October 22, 2003, at 1:44:59
Another thing I wanted to say is I need Ambien to sleep, if not I can stay awake days and nights in a row.(so disruptive-I know it's the manic-depressive thing (bipolar disorder). What complicates things more is that I suffer from chronic pain and when I try to get out of the house, to work, or run errands, or do chores around the house, I oftentimes cannot make it through the day, because the pain in my back and intercostal muscle spasms that I have since 7 epidural shots at once when I gave birth(once) and two Major car accidents in a row, I was in a wheelchair, then with a cane and now without, but the pain makes me feel suicidal at times. I just ran out of medical insurance here in Texas, things are real tough. Please someone give me a little advice.
Posted by Viridis on October 25, 2003, at 1:21:37
In reply to Re: klonopin vs xanax, posted by Kristine29 on October 22, 2003, at 1:44:59
Based on my experience (and that of my pdoc) I'd vote for Klonopin. It's great for anxiety and has some mood-stabilizing qualities, and for most people doesn't seem to induce tolerance nearly as often as some other benzodiazepines do. Xanax is very helpful for panic attacks, but I've found that even taking it occasionally, I've built tolerance to it that requires a higher dose (even though I only take it rarely). Klonopin, on the other hand, keeps working for anxiety and mood stabilization at the same dosage that I started with a couple of years ago. My pdoc says he's seen this pattern with other patients, and prefers to prescribe Klonopin for regular use.
I've tried Valium and really dislike it -- for me, Klonopin is much better, although it took a week or two to get used to it (the side effects were minor, though, and now I have no side effects at all).
Posted by ian24 on October 25, 2003, at 23:52:27
In reply to Re: klonopin vs xanax » Kristine29, posted by Viridis on October 25, 2003, at 1:21:37
It's also very important to remeber that the reason we have a hard time coming off of it is because we suffer from anxiety and without anxiety meds the anxiety comes back > I know that it is physically dpenednce or addictive but I think my point is proabbly still valid
Posted by genetta on March 30, 2004, at 20:07:12
In reply to Re: klonopin vs xanax » Kristine29, posted by Viridis on October 25, 2003, at 1:21:37
hi every one ive read almost of yalls stories.i have a few questions of my own? im bi polar and very depressed and also have panic attack... wow what a combo uh. i have been taking xanax for almot 1 yr and a half now my shrink on my first vist took me off of them and put me on kolopin. but it makes me very sleepy, thats a problem cause im a mom of 4 . the xanax never made me sleepy it just melloed me out.i would really like to have some feed back please---- genetta
Posted by Joy on March 31, 2004, at 9:46:39
In reply to Re: klonopin vs xanax, posted by genetta on March 30, 2004, at 20:07:12
Hi Genetta,
My pdoc has me on Xanax. He claims Klonopin causes or adds to depression. I have taken Xanax for a long time without any problems. I don't take much. It helps me sleep and calms me down. My husband had been on Klonopin for PTST after heart attack. It helped, but he prefers Xanax also. I'd stick with the Xanax.
Regards,
Joy
Posted by genetta on March 31, 2004, at 20:24:12
In reply to Re: klonopin vs xanax » genetta, posted by Joy on March 31, 2004, at 9:46:39
thanks joy. i went back to my dr today and she gave me back my xanax... im glad about that...
Posted by Holly Vaughn on April 9, 2004, at 16:42:01
In reply to Re: klonopin vs xanax » genetta, posted by Joy on March 31, 2004, at 9:46:39
Hi I am happy to have stumbled onto this message board. It's nice to see such supportive ppl. I am 29 and have been struggling with the idea of starting to take an anti-depressant for over a year. My doctor first prescribed paxil and it sat in my cupboard all this time. I am scared. I've heard terrible things about withdrawl and addiction and I'm also afraid to be on something for life. I don't feel like I am really depressed but I struggle with anxiety and insomnia. Lately, I've been having heart pain and the Dr. ran a bunch of tests (which all came out fine) and he told me I need to start the drugs. I asked him for atavan or xanax because they seem less "permanant" but he refused saying they are only for people with sudden trauma like death in the family or divorce but for me, someone struggling just to get by with "normal" life (single parenthood, work overload), I need the constant stuff. Then he perscribed lorazapam in place of the paxil, saying there are less side-effects.
I'm at the brink of beginning the drug therapy. I keep thinking I should just keep trying to tough it out and soon, everything will be back to normal but I think my stressing is causing me physical harm and undue mental anguish and if I could only take the anti-depressants for a little while- a year maybe- to get myself settled, that would be great. Am I way off here?
Thanks for listening to a probably very old and tired story,
Holly
Posted by Holly Vaughn on April 9, 2004, at 16:54:38
In reply to Lorazapam vs. Paxil vs. xanax vs. nothing, posted by Holly Vaughn on April 9, 2004, at 16:42:01
I'm sorry. In my post I should have put LEXAPRO in place of lorazepam (which is of course the generic for ativan). I hope that makes more sense
holly
> Hi I am happy to have stumbled onto this message board. It's nice to see such supportive ppl. I am 29 and have been struggling with the idea of starting to take an anti-depressant for over a year. My doctor first prescribed paxil and it sat in my cupboard all this time. I am scared. I've heard terrible things about withdrawl and addiction and I'm also afraid to be on something for life. I don't feel like I am really depressed but I struggle with anxiety and insomnia. Lately, I've been having heart pain and the Dr. ran a bunch of tests (which all came out fine) and he told me I need to start the drugs. I asked him for atavan or xanax because they seem less "permanant" but he refused saying they are only for people with sudden trauma like death in the family or divorce but for me, someone struggling just to get by with "normal" life (single parenthood, work overload), I need the constant stuff. Then he perscribed lorazapam in place of the paxil, saying there are less side-effects.
> I'm at the brink of beginning the drug therapy. I keep thinking I should just keep trying to tough it out and soon, everything will be back to normal but I think my stressing is causing me physical harm and undue mental anguish and if I could only take the anti-depressants for a little while- a year maybe- to get myself settled, that would be great. Am I way off here?
> Thanks for listening to a probably very old and tired story,
> Holly
Posted by Pattisun on April 9, 2004, at 17:43:09
In reply to Lorazapam vs. Paxil vs. xanax vs. nothing, posted by Holly Vaughn on April 9, 2004, at 16:42:01
Hi Holly,
Your doctor probably picked a good SSRI for you to start with (Lexapro). I went through a one year withdrawal on Paxil (took Prozac to finally wean me completely off).
I now am taking Celexa and doing much better. I didn't realize how stressed/depressed I really was until I started on the Celexa. My husband called me a "regular social butterfly" the other night--I didn't realize that I was tending to not answer my phone and only talk to my kids and not do much else.
Celexa/Lexapro is "supposed" to have the least side effects of the SSRIs.
Give it a try (I always start out a little less than what the doctor suggests, and then raise my dose at my own pace--it's my body and my comfort level).
Let us know how it goes. Good luck to you.
Patti
Posted by genetta on April 11, 2004, at 18:35:54
In reply to Re: Lorazapam vs. Paxil vs. xanax vs. nothing, posted by Pattisun on April 9, 2004, at 17:43:09
im a very deperssed 26 yr old.thier was no really bad bad trauma in my life. but just had alot going on at one time to cause me to kinda of loose control. ive been taking xanax for over a yr and it does me good, i can handle most of everything... im also a mother of 4 kids so of course thats rough but thats a daily part of life .. i wish everyone best of luck with thier depression and thier meds.. genetta
Posted by Holly Vaughn on April 12, 2004, at 12:56:17
In reply to Re: Lorazapam vs. Paxil vs. xanax vs. nothing, posted by Pattisun on April 9, 2004, at 17:43:09
thanks Patti, i hope it works as well for me
This is the end of the thread.
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