I have ddpresion and panic disorder/anxiety. I take Zoloft and Edronax every day (I'm in Australia, not sure if Edronax is avaliable in the US, but it is a noradrenalin reuptake inhibitor) but I find I still often need a tranquilizer. Currently I am on Xanax 1mg three times a day as needed, but I have been wondering if clonazepam (Klonopin might have less risk of habituation/dependence, because of its longer half life?
I have been taking 1mg Klonopin twice daily for panic attacks and GAD. While I am not a doctor, I've heard many physicians say that the lomger the half life, the less adictive the benzodiazepine. Knlonopin takes about an hour for me to set in, so if you want rapid releif, it is probably not your best choice. However, the long half life means you will still feel the effects of the drug the next day.
I am also on Klonopin and I use Xanax as needed. Klonopin stays in your system longer than Xanax. Both are similar medications and both can cause an addiction but you can wean yourself off when needed. Xanax works much faster for me when a panic attack starts. My doctor mentioned taking anti-depressant medication because it's suppose to help with anxiety also. I never tried it but am considering because I don't feel the Klonopin is doing much for me or maybe I need to increase my dosage. I'm on the lowest dose but split the pill so I take 1/2 3 times a day.
Hope this was a little helpful.
Having taken numerous SSRIs, benzodiazepines, etc., over the years, having compared notes with fellow sufferers of anxiety/panic, and having discussed this with my MD, it seems to boil down to the fact that people are very different in the ways they react to any given medication. Each one of us has a unique biochemistry and psychology, which unfortunately makes finding just the right "corrective" drug(s) for each person very complicated.
For example, I was prescribed zoloft for G.A.D. and depression many years ago, but I had my first "out of nowhere" panic attack a couple of hours after taking the first pill - "A paradoxical reaction, severe akathisia," the doctor said, "happens to only a very small number of people" - like me! But other people successfully take zoloft and lessen their panic attacks!
After trying a few more SSRIs, even though I had no more instant panic attacks with any others, I realized that they just weren't the solution to my particular biochemical problems--which really, really disappointed me, knowing others had had great success with SSRIs. They always made me feel unreal, a strange "depersonalization", like I was running myself by remote control.
I've tried almost every benzo there is (valium, ativan, klonopin, etc.), and each one eventually lessened the anxiety but left me with a sort of unpleasant "deadened" feeling--and I didn't seem to sleep well. But by chance, finally, after being prescribed xanax while I was in extreme anxiety over a trauma in my family, I knew that it was the one that clicked with my own particular chemistry. It halted my anxiety attacks fast, it allowed me to sleep deeply, and it actually lasted longer than the usual 4 hours in my system.
Personally, the fact that xanax IS shorter-acting than other benzos is a great plus for my own psychology, because that gives me a greater sense of control over the drug. I tried extended-release xanax and actually hated the feeling that I was "down for the count" for the next 12 hours whether I liked it or not. When I wanted to wake up and be alert, I couldn't with the E-R xanax still slowly releasing into my body.
So I'm back to regular xanax as needed. I don't follow a strict, scheduled daily dosage--I take it in small increments whenever undue anxiety or panic rears its ugly head. I have set a maximum in my pill tray of 2 mg a day, which I can almost always stay within.
It seems that when I have a run of good days and take much less xanax, my tolerance for it "resets". I feel very lucky about that, as I've been taking it for 6 years. I was up to 3 mg per day in January this year when a family member was dying, but I'm back down to about 1.5 mg a day on average now.
I might venture to say that at this point, my body seems to be dependent on varying amounts of xanax for biochemical "correction" (it also lowers my occasional high blood pressure in minutes), but that it is not an escalating addiction for me (thank heavens).
That said, I have a friend who said she once became seriously addicted to xanax, but has taken klonopin daily for years without problem.
We're all different!
Last edited by Vocrinthedes; 05-31-2010 at 07:22 PM.
I dont think I have an addictive personality - I have used diazepam and oxazepam in he past with no issues of dependency, and I dont like the "stoned" feeling strong pain killers give. Also, I would probably use the xanax periodicaly, use it for a few weeks when the symptoms peak, then tail it off when they abate. I need to take the SSRI and the Edronax for depression, so they will always be there in the background as a support - I feel they help my anxiety when it is mild, but not when its severe.
I spoke to my psychiatrist yesterday, and he said that here in Australia, clonazepam isnt generaly used for anxiety, it is only approved for epilepsy, so it looks like its gonna be Xanax.
It sounds like you'll be okay with xanax on an as-needed basis. You've been okay with other benzos, and you seem to know when to back off. Tailing it off if you're not feeling so anxious is a good plan. If you're like me, this should "reset" any tolerance you might build up. Just don't quit it "cold turkey" one day. Also, I'd suggest taking the last few doses near bedtime, so tapering off will have the least effect on your sleep.
I know there are real xanax horror stories out there - in fact, in this very website - but my own impression is that some people's biochemistries seem to get more "hooked" by benzos than others - not their fault, though, poor souls. As I said, we're all different. My MD said that some of his patients on xanax can taper off quickly and have very few problems doing so, while others have to cut back in fractions of milligrams over time. I wonder if maybe it partly has to do with what stress is still going on their lives while they're cutting back.
And all too often, some try to cut back from a very high daily dose (like 4 mg a day for months or years) way too fast! Cutting back should be done in small increments, not suddenly a whole milligram less per day!
My MD and a drug-management psychiatrist have separately told me that most anxiety/panic patients are the least likely to OD on or become seriously addicted to xanax. Putting their explanations together, it seems it's because we typically over-inform ourselves of the dangers of anything we do, we desperately try to stay in control, and we are deeply afraid of damaging ourselves and/or dying.
I have to admit that does sound like me!
PS: It's very interesting how countries with similar cultures can view the same drugs so differently. Klonopin is very widely used for anxiety in the US, whereas many US doctors won't even prescribe the "evil" xanax. I just lost my latest psychologist over that, as he strongly disapproves of xanax, even though the psychiatrist who prescribes for him put me on extended-release xanax! (Those two have more "issues" than I do! I'm out of there!)
Last edited by Vocrinthedes; 05-31-2010 at 10:27 PM.
Reason: improved reply
In Australia, most doctors prescribe diazepam/Valium for anxiety, and use Xanax for panic disorder that hasnt responded to antidepressants, as a last resort. My GP is very much against using Xanax, but my psychiatrist said that if thats what it takes to keep me as a normal, functioning member of society, rather than a recluse with long hair and an overgrown lawn who never leaves the house and all the local kids are scared of, then its a reasonable compromise :-)