3.5MG of Klonopin a day is not working :(

Hi there_

I did a search and could not find a relevant topic, so i thought i would ask here. Just a brief description of what i'm taking.
After years of zoloft and 1.5 MG a day i taper over a year to 0 zoloft.

On June 20th of this year i had to go back on zoloft 25MG w/ same dose of klonopin (using ativan only during panic.)
July 27th I had to go up to 50MG of zoloft w/ same dose of klonopin and up to 4MG of ativan a day (I was having daily panic attacks at this point).

After a week of this my doctor was not into me taking the 4MG a day, and wanted to up my klonopin since it has a longer half life. She did all the calculation and figured that 3.5 MG of equals the same amount of the combined 4MG of ativan and the 1.5 of klonopin. Since 4MG of ativan is like 2MGs of Klonopin, she added to 2MGs of klonopin to my dose.

OK! now. The problem is, i'm still have break through of panic, even at this high level of benzos. I really thought this would do the trick and knew this dose would be temporary, but the idea (of course) is to block the panic. After a little bit of time with no panic, i would then be put taper down to a lower dose, preferably the original dose.

So, how can this be happening. You give anyone else 3.5 MG of klonopin a day and they wouldnt be able to walk. Me, i still having morning breakthroughs of panic. Benzos always worked in the past for me. They work very well during panic episodes, and i was always able to just use a little ativan during those times and be done with both panic and the drug.

Another side note, is that everything seemed to get worse with the upping of the zoloft. My doc is convinced that this would have happened regardless, and since i've been on up to 100MG at one time of zoloft she didnt see how the zoloft could induce panic. While she has never steered me wrong in the past 6 years, i'm afraid of what she might want to do next. Also, after a horrible week of adjusting to the new dose of zoloft I finally started to feel as if my body was getting used to it. I wonder if it was because i was on the drug in the past and for some reason or another my receptors are not taking to it, or were shocked by the high dose (its been a year at least since i've been on 50MG). Also, when i went for 0-25 I didnt feel so messed up, but 25-50 really got to me....

So i guess this is a complex medication question that starts with klonopin (3.5) a day not holding me. And zoloft rise from 25-50 feeling like it was inducing panic.

Sorry for the ramble, i'm just a little worried and frustrated.

Thanks
Dan

hey nick_

Do you think that it jut might take sometime for it to really get into my blood stream? When i talked to my doctor yesterday (started new dose friday night -- talked to her yesterday) She seemed surprised that i had panic on such a high dose of Klonopin. Yeah, i would never just stop taking anything. After 5 years of medications and stuff, i've felt the wrath of withdrawals. But i'm wondering if there is something else i need, or if i some how poop out on the benzos.

Thanks for the reply nick!
Dan

Hi Dan.  It's me Nick.  Yes, I can say from my own stupidity that klonopin takes some time to get into your system.  The pharmasist told me I should feel somthing within an hour after taking a dose......bull...IMO.  Unless you and me are building up a tolerance (not likely...IMO.), yes, if you take your klonopin exactly as directed, your body will notice it.  Don't take more just to see if they are in fact working becuase they are.  If you take your meds everyday, they do work. And yes, IMO, it does take some time for the body to get used to the meds.  Hey remember, were are all changing the chemicals in our brain to help us at least fuction. But whatever you do, don't stop taking them fast. okay.

Hope this helps a bit.

Nick

Dan

In my humble opinion, your physician has the wrong equivalency calculation.

Klonopin .5mg = 1 mg of Ativan ^{(Reference: Professor C Heather Ashton DM, FRCP)}

You posted " Since 4MG of ativan is like 2MGs of Klonopin, she added to 2MGs of klonopin to my dose."

Maybe I just did not follow those doses you were posting correctly. :)

Take care and I hope you soon get this straightened out.

Hi lyn,

I totally agree, i mean i felt panic and bad on 25 of zoloft, but since the first dose of 50 my life changed. I felt over medicated and the list of side effects, including daily panic, was obvious to me. I dont want to fight her on this, and i actually understand her thinking behind this. She feels that it takes some time for the zoloft to actually take effect and she has seen it work on me before (I was up to 100MG at one point, but the situation was different, and i never felt it did much for my panic -- ugh). While i understand it, i dont think I should feel worse on it. Yeah, maybe some side effects, but daily panic and anxiety, even while taking all that ativan. I mean i felt (it getting less now) but at a constant state of anxiety and panic, that no matter what i took, it really didnt do anything. So yeah, since my increase in zoloft i've been worse than before. I'm a bit frustrated and sad at the same time. I've been with this doctor for a long time and she has really helped me. But now i'm thinking i may have to consider looking for someone else. The problem with this is it took me forever to find her. I went through so many other doctors that i felt no connection with. She has been great and has always taken into account my input and concerns. I think i may have stumped her, as i know she would never intentionally steer me down the wrong path. she makes herself available to me when its an emergancy, and i hope that today will be an indication that maybe the zoloft is really not helping. One of the problems is, even though see believes me, she tends to look at studies ( and not done by the actual pharmaceutical companies, but others and she could not find one study that suggested the increase or inducting of panic. I'm gonna search a bit more :(

Kitt,

Yeah it took me a while to figure it out, but this is how it works. I was already on 1.5MG of klonopin (steady dose for months). During this panic phase i've been take on average 4MGs of Ativan a day. So if .5 of klonopin = 1 of ativan than 2MG of klonopin would equal 4 MGs of Ativan. Now add the already 1.5 klonopin and it equals 3.5. Yeah, i did the math over and over again and it makes sense when you take into account my current (well was current dose of klonopin).

Thanks for looking into it! I was doing the math a bunch as i too was having a hard time figuring out how it work.

thanks Kitt!

Hi Dan.  It's me Nick again.  Hey brother I am glad to hear that you don't increase the Klonopin on your own.  It really does cause A LOT of problems.  It happened to me.  I was on 2 mg a day (2-.5mg tablets). http://www.apotex.ca/products/en/Search.asp?Type=General&SearchText=clo

I thought they were not working and went ahead a took 2 extras a day.  Well guess what?  I ran out of them about a week early. And because they are a controlled substance (here in Canada), (but are NOT considered narcotics) I had to wait and entire week to get a refill.  It was pure hell for a week.  Only after seeing my MD and explaining to him what I did, he increased the dose to 3mg a day only on a verbal contract that I NEVER do anything like that again on any medication or he would give me 3 months notice to find another family doctor (which is really hard to do in Canada at the moment and I have had him since I was 24 and am now 36).  He was really upset and told me that if I ran out again, he would NOT allow and early repeat.  So now I have to count all 180 tablets each refill to make sure that the pharmacy didn't make a mistake (it does happen).

And even when he increased me to 1mg more, I still do this day don't feel anything within an hour of each dose.

I find that for panic attacks, Paxil works for me.  Now anti-depressants DO take several weeks to notice that they are working.  But some people don't like Paxil and Benzo's becuase they are addictive.  IMO, I really don't care if they are addictive as long as I can lead a somewhat normal life.  So please don't feel bad that your on a Benzo.  Don't get me wrong, Benzo's don't cure our anxiety but rather help us cope so that we can at least learn why we have an anxiety problems and use other coping measures like deep breathing (and yes it takes time to learn to do it correct to put yourself asleep) and getting the help you need like talking with others in the same situtation either here or at a support group (but I have found that being in a support group made me feel worse at the end of the day becuase of all the crying you get to see-but if you can handle it-GO FOR IT). 

I also never knew that .5mg = 1mg of Ativan.  Now there is one that you will feel really fast as they dissolve under the tongue.  I had to take two of those just before surgury on my back and I was "out".

In any case, you will be fine.  If you find that you are nervous or anxious and can't wait for your next dose, come here and you will most likely find someone with the same situation.  I do.

Nick

 

Hey Dan.  It's me Nick.  I would definately try what your doctor told you to do.  I know this might sound lame, but I write in a journal everyday and how I feel.  Then I bring my journal to my doctor and he reads it and holds onto it.  If your not shaking like a leaf from anxiety like I do somedays, you may want to consider trying it.  Then you can look back everyday and follow your progress.  No word of a lie, on my frst page of my jornal, my writing looks like "scrible" becuase I was shaking so bad.

I do have one question for you.  Do you find that when you are having a panic attack at night in bed, you sweat really bad or wake up in a cold sweat?  If so, like I did, that's a great time to take the Klonopin (9:00pm) as your doctor said.  It did stop the cold sweats which was the worst for me.

Nick

Hi Dan.  3 days ago I took my Klonapin at 10:00pm EST.  Then I take the rest at 11:00pm and off to bed I go.  One of the things I hated the most was waking up in a cold sweat (I mean like my bed sheets were just clinging to my body-even with the air-conditioner on).  That's when I really new there was something wrong and went to see my MD.  And that's when I was told that I had really bad anxiety after my MD put me through a lot of tests (like blood work, etc.).

Yes, try taking your meds as directed by your MD and it will probably help you through the night.

Hope this helps just a bit.

Nick

Dan, I'm not familiar with Klonopin, but I'm familiar with morning anxiety!  I take Xanax.  When my panic was at it's worst, my doctor also suggested that the Xanax already wore off by the time I woke up.  I then kept a glass of water next to my bed.  AS SOON as I woke up in the morning, I swallowed the Xanax, then just tried to do some deep breathing exercises, all before my feet would even hit the floor.  This seemed to help a lot.  All the best to you, and good luck with your doctor's appointment!  Julie

3.5 mg of Klonopin is quite a lot. Usually this dose is reserved for people with seizures, not A/P disorder. My best (and uneducated) guess is that you built up a tolerance to the Ativan and it simply "ruined" benzos for you. The only alternative would be to taper off very slowly, quit for some period of time, and then begin benzo therapy once again.

I'd suggest you first find a new doctor, then talk to them about what to do.

Best of luck.

I just began seeing a new psychiatrist, she prescribed Atavan 1 mg, no help at all, we tried 2mg, still, nothing, as a matter of fact, it kept me up through the night. She also increased my Zoloft ( which I have been on for 10 years fro chronic depression...) from 100mg to 200 MG, I am going through unemployment for the first time in my life and the anxiety and stress were unmanageable!! I am now on Klonipin 1 mg, still nothing, the good news is that the Zoloft increase has REALLY helped my depression, I was worried b/c I have been on it so long, meanwhile I have never taken a benzodiazapine, and can't seem to find one to control the impeding anxiety..any suggestions??HELP!

Hi Dan. Am amazed at how well you write taking jntonaccount that you are on anhigh dose of klonopin. At my highesf usage f Benzos I was taking .5 Xanax and 1.0 Mg klono. While it did tame my anxiety. It also made me quite forgetful and have a cloudy head making it so hard to concentrate. I do hope you can combine natural coping skills. For me that is paying ofninnthe long run. Good luck!