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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Squiggles on April 4, 2006, at 17:19:28
I was prescribed clonazepam about 17 yrs.
ago for anxiety[?] - not severe. I have
written here on other posts my very low
opinion of this drug, esp. given for
anxiety, insomnia and restless leg syndrome.
I am curious, about the dose prescribed for epileptics. In some monographs I see that the dose is 12-20mg, in comparison to 0.5 - 2.0 mg for
anxiolytic purposes. As some many know, respiratory depression is one of the major adverse
effects. I wonder if such high dosages
are not dangerous. How do epileptics deal
with this drug?Squiggles
Posted by blueberry on April 4, 2006, at 19:16:21
In reply to drugs for epilepsy, posted by Squiggles on April 4, 2006, at 17:19:28
Wow, 20mg klonopin?
Some antidepressant monographs showed that they used 3mg during the 1st 2 weeks of antidepressant to counter side effects of jitteriness and insomnia. Even 3mg to me sounds like a lot, not to mention 20mg. Yikes.
My doc says klonopin will soon get FDA approval for unipolar depression. Weird, considering it seems so depressing to many people.
Hey I'm curious. You said you have a low opinion of it for insomnia, anxiety, restless legs. Why is that? I have some but haven't tried it yet. I was going to use it for all the things you mentioned. I take xanax once in a while but I hate its short half life because when it wears off, oh my, anxiety is way worse than it was to begin with.
I know we all respond differently, but I was curious to hear your experiences with it.
Posted by Squiggles on April 4, 2006, at 19:55:24
In reply to Re: drugs for epilepsy » Squiggles, posted by blueberry on April 4, 2006, at 19:16:21
> Wow, 20mg klonopin?
>
> Some antidepressant monographs showed that they used 3mg during the 1st 2 weeks of antidepressant to counter side effects of jitteriness and insomnia. Even 3mg to me sounds like a lot, not to mention 20mg. Yikes.
>
> My doc says klonopin will soon get FDA approval for unipolar depression. Weird, considering it seems so depressing to many people.
>
> Hey I'm curious. You said you have a low opinion of it for insomnia, anxiety, restless legs. Why is that? I have some but haven't tried it yet. I was going to use it for all the things you mentioned. I take xanax once in a while but I hate its short half life because when it wears off, oh my, anxiety is way worse than it was to begin with.
>
> I know we all respond differently, but I was curious to hear your experiences with it.
>
>URLs:
http://www.aesnet.org/Visitors/PatientsPractice/aed/aedtable.cfm?drug=Klonopin
(max dose 20mg)http://neuroland.com/sz/anticon/before_93.htm
(max dose 20 mg)http://www.rxlist.com/cgi/generic/clonaz_wcp.htm
(max dose 20 mg)From the Internet Mewntal health site:
a smaller maintenance dose (10) is recommended:"Dosage:
Must be determined individually according to clinical response and tolerance and depends primarily on the patient's age.
Children:
In order to minimize drowsiness, the initial dose for infants and children (up to 10 years of age or 30 kg) should be between 10 and 30 mcg/kg/day and should not exceed 50 mcg/kg/day given in 2 or 3 divided doses. Dosage should be increased by no more than 250 to 500 mcg every third day until a maintenance dose of 100 to 200 mcg/kg has been reached, unless seizures are controlled or adverse effects preclude further increase. Whenever possible, the daily dose should be divided into 3 equal doses. If doses are not equally divided, the larger dose should be given before retiring.Adults:
The initial adult dose should not exceed 1.5 mg/day divided into 3 doses. Dosage may be increased in increments of 0.5 to 1 mg every 3 days until seizures are adequately controlled or until adverse effects preclude any further increase. Maintenance dosage must be individualized for each patient depending upon response. A recommended adult maintenance dose is 8 to 10 mg/day in 3 divided doses. Dosages in excess of 20 mg/day should be administered with caution.The use of multiple anticonvulsants may result in an increase of depressant adverse effects. This should be borne in mind whenever clonazepam is added to an already existing anticonvulsant regimen.
to top
Supplied0.5 mg:
Each cylindrical, biplane, scored tablet, edges bevelled, contains: Clonazepam 0.5 mg (orange, with {RIVOTRILover0.5} engraved on one face, single-scored on the other with ROCHE above and C below score). Also contains lactose, microcrystalline cellulose, cornstarch, sunset yellow FCF aluminum lake, magnesium stearate.2 mg:
Each cylindrical, biplane, scored tablet, edges bevelled, contains: Clonazepam 2 mg (white, with {ROCHEover2} engraved on one side and cross-scored on the other). Also contains lactose, microcrystalline cellulose, cornstarch, magnesium stearate.Energy: 2.4 kJ (0.6 kcal). Gluten-free, paraben-free, sodium-free, sulfite-free and tartrazine-free. Bottles of 100 and 500. Keep in a tightly closed, light-resistant container. Store at 15 to 30°C.
to top
ResearchThe research information is available separately on Internet Mental Health."
------------
Granted, for the treatment of seizures, most start at 1.5 and increase according to need per day - kind of vague - do they increase and stick
to the increase; do they stop and increase, do
they give as needed?
You say your dr. thinks it may be good for
unipolar depression? Perhaps if you have
anxiety as well, then it may be. All the other disorders you mention are definitely alleviated by
this drug. The problem is that if you forget
one or if you try to get off or reach tolerance,
without your doctor catching that and increasing the dose, the side effects are truly gruesome. For older people I think they may even be fatal.I know that it has its advantages - low
tolerance, but I think that a less potent
benzo under supervision may be an alternative;
heck even alcohol may be better.Squiggles
Posted by med_empowered on April 5, 2006, at 1:18:20
In reply to drugs for epilepsy » blueberry, posted by Squiggles on April 4, 2006, at 19:55:24
klonopin is a weird drug. I mean, I found it helpful for anxiety/agitation, but only to a point; then it helped, but also made me stupid. Its so high-potency that I think its easy to forget that 2mgs/Klonopin (standard dose for a lot of things) is = to about 40mgs/valium, which was the standard dose back in the "Mother's Little Helpers" era (turns out not much changes in psychiatry, after all). I don't get using it for unipolar depression. I read that in Japan they make heavy use of the benzos for all kinds of stuff, with pretty good results but here the emphasis seems to have been on anti depressants and antipsychotics for...well, everything.
One of the cool things about Klonopin is that it seems to help with bipolar disorders and schizoaffective disorders, even where other stuff hasn't helped. On the downside...to me, it seems to have more "issues" than other benzos...personally, I think if they could just make an XR Ativan (ativan doesn't seem to affect mood or cognition), that'd be ideal..a clean, long-lasting drug with more or less neutral effects on everything but the anxiety. Oh well.
Posted by Squiggles on April 5, 2006, at 8:07:18
In reply to klonopin, posted by med_empowered on April 5, 2006, at 1:18:20
I've always wondered whether this drug
is different chemically from other benzos.
Perhaps, as you say, it is only very potent.
If it is so dense, why didn't the manufacturers
prepare the pill in smaller denominations?As for its uses, I don't know that it's best
for bipolars - that would be only the theory
that the same neurological disturbances as
in the epileptic class occur in bipolars.
I don't if that's true. I was given it for
anxiety, if i recall correctly. Had my
thyroxine dose been lower I don't think I
would have had anxiety.In any case, if you do have to withdraw from
it, the size of the pill may be a hurdle, if
not the benzo itself.Squiggles
Posted by Squiggles on April 5, 2006, at 10:19:15
In reply to klonopin, posted by med_empowered on April 5, 2006, at 1:18:20
"Translating research into business"
Here's something interesting I found -
from BRAZIL - no, not the movie. Note
the general prescription for "neurological
disorders" principally epilepsy. I wonder
how many "neurological disorders" this
drug is sold for.---------------------------
"Development and
Nationalization of the
275 Technology for the
Manufacture of Clonazepam
Coordinator:
William Carnicelli
Company:
Alpha Produtos Químicos Ltda.
Approved value:
Phase 1: R$ 70,575 / US$ 70,575
The aim of the proposed project is the develop-
ment of technology for nationalization of the ma-
nufacture of Clonazepam, a product used in the
pharmaceutical industry in the preparation of anti-
convulsive medicines consumed by patients who
have neurological problems, principally epilepsy.
The main manufacturer of these medicines is a
multinational company which practically supplies
the whole market with this specialty in Brazil. The
local manufacture of Clonazepam will enable it to
be offered to national laboratories, in general large
manufacturers of generic medicines and the like,
such as União Química, EMS, Sanval, Medley and
Teuto, among others. The product to be developed
will meet the quality standards of Brazilian, Ameri-
can, European and Japanese pharmacopoeia, allo-
wing therefore for its export, principally to Merco-
sul countries. In its first phase, the project will
conduct a research and development study into the
best route for synthesizing Clonazepam on a labora-
tory scale, followed by its development on a scale of
20 liters. The next stage will be work on a 250 liter
pilot plant, now in the pre-industrial phase.nslating Research into Business *"
-------------
xpdf:/tmp/fichas_inovacao_en.pdf
/Squiggles
Posted by Squiggles on April 5, 2006, at 15:28:50
In reply to klonopin, posted by med_empowered on April 5, 2006, at 1:18:20
There's no doubt of their influence;
I am afraid of my drugs -- whether I am
justified or not I cannot tell. Not only
groups like benzo.org, alt.flame.psychiatry,
but even people and doctors I know personally
seem squeemish about dispensing the right
drugs and right dose. Some think I should
not take drugs at all.I think that has been a real problem in
my treatment. Anyone else have this problem?
How do you deal with it if so?tx
Squiggles
Posted by med_empowered on April 5, 2006, at 15:45:02
In reply to Anti-psychiatry has surpassed Goebbels, posted by Squiggles on April 5, 2006, at 15:28:50
It depends on what you mean by "anti-psychiatry"...some of these people fight for patient's rights, and that's great; I disagree with involuntary medication and stuff like that. BUT then there are people who demonize all meds. I don't think docs should throw pills at people, and I don't think everyone who has mental illness necessarily needs meds, but I do think pills help some people sometimes.
The anti-benzo thing is ridiculous. I mean "benzos are unsafe...take an antipsychotic". Please. That's ridiculous. Part of it I think is $$$--now that there are expensive options to the benzos, I think there's a financial incentive to demonize these (cheap) treatments in favor of newer, more expensive options. Plus, I think psychiatrists themselves sometimes feed this anti-benzo, anti-drugs thing...some docs I've met are crazy anti-benzo...you could be shuddering, shaking with fear in your house, too afraid to leave, and they'd be like "well, here's some zoloft. Give it a month..hope it helps. Bye now!". Please. That's a total disservice to patients.
Good luck.
Posted by Squiggles on April 5, 2006, at 15:54:29
In reply to Re: Anti-psychiatry has surpassed Goebbels, posted by med_empowered on April 5, 2006, at 15:45:02
> It depends on what you mean by "anti-psychiatry"...some of these people fight for patient's rights, and that's great; I disagree with involuntary medication and stuff like that. BUT then there are people who demonize all meds. I don't think docs should throw pills at people, and I don't think everyone who has mental illness necessarily needs meds, but I do think pills help some people sometimes.
>
> The anti-benzo thing is ridiculous. I mean "benzos are unsafe...take an antipsychotic". Please. That's ridiculous. Part of it I think is $$$--now that there are expensive options to the benzos, I think there's a financial incentive to demonize these (cheap) treatments in favor of newer, more expensive options. Plus, I think psychiatrists themselves sometimes feed this anti-benzo, anti-drugs thing...some docs I've met are crazy anti-benzo...you could be shuddering, shaking with fear in your house, too afraid to leave, and they'd be like "well, here's some zoloft. Give it a month..hope it helps. Bye now!". Please. That's a total disservice to patients.
>
> Good luck.
Unfortunately, it's a complicated matter;
it's hard to find a steadfast, knowledgeable
and fearless psychiatric treatment today.
It's true that the drug companies have added
to the complication with the plethora of
drug multiplication for profit.The bottom line, for the patient though
is that uncertainty grows, and where uncertainty
grows, the anti-psychiatry movement sees an
opportunity, and the patient is likely to
suffer from self-medication. I think more
harm is done by the anti-psychiatry movement,
but I am always open to ideas - i am never
sure.Fear is a very powerful tool in propaganda.
And drugs can inspire fear much more than
the "natural" approach to treating mental
illness.Squiggles
Posted by FredPotter on April 5, 2006, at 20:02:24
In reply to Re: Anti-psychiatry has surpassed Goebbels, posted by med_empowered on April 5, 2006, at 15:45:02
I agree with you. I'm lucky. I have an understanding Dr who prescribes me Xanax. My problem is it doesn't work on the worst sort of anxiety that I get. I mean the deep, emotional I've lost my Mommy type. It does work on the jitters, but these are chiefly a sign of withdrawal for me
Posted by Declan on April 5, 2006, at 21:12:18
In reply to Re: Anti-psychiatry has surpassed Goebbels » med_empowered, posted by FredPotter on April 5, 2006, at 20:02:24
Hi Fred
There's a song that goes 'sometimes I feel like a motherless child', which I imagine you know. There's also a great one on Moby's "Play" that repeats again and again 'Why does my heart feel so bad, why does my soul feel so bad?' I find taking benzos is mainly a thing of heading off the withdrawal.
Declan
Posted by FredPotter on April 5, 2006, at 23:05:59
In reply to Re: Anti-psychiatry has surpassed Goebbels » FredPotter, posted by Declan on April 5, 2006, at 21:12:18
Hi Declan yes I know that song, not that I can sing when I'm experiencing the gut-wrenching primal panic of a motherless child. So it seems nothing can help - and yet, why does alcohol work so well? I can't drink any more though. I imagine heroin and GHB would too. I'm confused when I read that the only thing wrong with benzos is people can't get them, like everyone's agreed that they work for anxiety. Well they don't work for mine
Fred
Posted by Squiggles on April 6, 2006, at 8:04:29
In reply to Re: Anti-psychiatry has surpassed Goebbels » Declan, posted by FredPotter on April 5, 2006, at 23:05:59
Sorry to interrupt,
when you use the phrase
"the gut-wrenching primal panic of a motherles child"
are you being metaphorical, or referring to your
experience in a psychoanalytic way?Also, what *does* work for your anxiety if
not benzos? Remember that I am not against
benzos per se, but by the way they are prescribed,
the stupid, greedy preparation of them by
the drug companies, and the lack of research
that physicians seem to get (maybe they're
overwhelmed) in using them properly.Squiggles
Posted by TylerJ on April 6, 2006, at 10:26:44
In reply to Re: Anti-psychiatry has surpassed Goebbels, posted by med_empowered on April 5, 2006, at 15:45:02
>
some docs I've met are crazy anti-benzo...you could be shuddering, shaking with fear in your house, too afraid to leave, and they'd be like "well, here's some zoloft. Give it a month..hope it helps. Bye now!". Please. That's a total disservice to patients.
>
I agree with this. Yea...give it 4-6 wks and it "should" help. Crap, who the hell wants to wait 4-6 wks when they need help NOW!? That's like going to your doc with a severe migraine and he says here's a beta-blocker that should help, but it might take a few weeks.
And, I've never found any of the ssri's that effective against anxiety ( for me anyway ). Some psychiatrists really suck!Tyler
Posted by Squiggles on April 6, 2006, at 13:58:27
In reply to Re: Anti-psychiatry has surpassed Goebbels » med_empowered, posted by TylerJ on April 6, 2006, at 10:26:44
Speaking of benzos - what is the policy
on prescribing clonazepam? Is it prescribed
"as needed" like other benzos, or each day?Squiggles
Posted by Squiggles on April 6, 2006, at 15:23:36
In reply to Anti-psychiatry has surpassed Goebbels » TylerJ, posted by Squiggles on April 6, 2006, at 13:58:27
Well, I'll be darned, take a look at this:
http://www.rxlist.com/cgi/generic/clonaz.htm
So, what's going on? Convenience? Is there a great huge
gap between doctors and pharmacists? Is
there a lack of information exchange? Maybe
I have to go back to my suggestion that
the pharmaceutical companies should run
the medicine show - get them to hire doctors
so that they are directly accountable.Squiggles
Posted by FredPotter on April 6, 2006, at 16:00:50
In reply to Anti-psychiatry has surpassed Goebbels » FredPotter, posted by Squiggles on April 6, 2006, at 8:04:29
There's nothing psychoanalytical about it. It's utterly immediate. A memory of the feeling but not of the event
What works? Nothing
> when you use the phrase
>
> "the gut-wrenching primal panic of a motherles child"
>
> are you being metaphorical, or referring to your
> experience in a psychoanalytic way?
>
> Also, what *does* work for your anxiety if
> not benzos?
Posted by Squiggles on April 6, 2006, at 16:12:15
In reply to Re: Anti-psychiatry has surpassed Goebbels » Squiggles, posted by FredPotter on April 6, 2006, at 16:00:50
> There's nothing psychoanalytical about it. It's utterly immediate. A memory of the feeling but not of the event
That may be so in your case and in the case
of post-traumatic experiences. But in my case,
and in the case of people I know who have gone
through operations, pain, separations, and traumas, the majority tend to forget or supress
if you are a Freudian. People naturally forget
pain and remember pleasure.
>
> What works? NothingI meant for you - are you perpetually anxious
without the aid of medication?-----------
Squiggles
Posted by FredPotter on April 6, 2006, at 19:42:41
In reply to Re: Anti-psychiatry has surpassed Goebbels » FredPotter, posted by Squiggles on April 6, 2006, at 16:12:15
I've often wondered if I have PTSD. Is Xanax any use against PTSD does anybody know? However the accounts I read of PTSD talk of flashbacks of the event. I just relive the feeling not the memory.
Am I anxious all the time? It varies really. I take Xanax but I don't think it works and also Effexor which doesn't do much either. I've tried loads of psychotherapy but it doesn't work. I do however get some comfort from meditation, and Zen stories and haiku. Thanks for your interest Squiggles
Fred
Posted by Squiggles on April 6, 2006, at 20:07:21
In reply to Re: Anti-psychiatry has surpassed Goebbels » Squiggles, posted by FredPotter on April 6, 2006, at 19:42:41
Post-traumatic stress varies in severity
and from person to person.I am very pro-drugs for any kind of
affective disorder or anxiety because i think that
once your physical state becomes habitual,
it is very difficult to reverse without
getting at the source, ie. the physiology
of it. You could say you have a choice
between the high way and the low way.Squiggles
Posted by Squiggles on April 8, 2006, at 11:30:05
In reply to Re: Anti-psychiatry has surpassed Goebbels » Squiggles, posted by FredPotter on April 6, 2006, at 19:42:41
I found a bottle of Xanax (exp. July 06)
and I took one. It has helped my dyspnea
from the li, K, reinstatement.I don't know if there is an underlying
disease caused by reinstating (the slammerino)
but i don't care if i feel better.Darn ant-psychiatrists are puritans; now
i'm too shame-faced to ask my dr. for them.
But it is one thing to use them and another
to misuse them.Squiggles
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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