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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by 3 Beer Effect on March 16, 2002, at 23:44:44
I take 4 mgs of Klonopin per day, 2 at bedtime, 1 at breakfast, & 1 at lunch. However, I seem to be building up a tolerance to it b/c it doesn't seem to work as well anymore for social phobia (i've been on it around 2 months).
I've heard of people who take "drug holidays" from their add stimulants adderall/dex/ritalin etc and in a short amount of time (a week?) without the drug their tolerance is reduced to baseline (zero).
Do drug holidays for benzos work?
MOST IMPORTANTLY, How long would the drug holiday have to be to reduce the tolerance down to baseline (zero)? (I know you can't just stop taking them cold turkey, but Klonopin has a long half life so I was planning a fast taper down to zero).Also, my Provigil 200 mgs has "pooped" out after 2 months. It was never that great in the first place (similar to extended release caffeine without as much anxiety) but now only lasts about 6 hours now before I get extremely tired/sleepy. Do drug holidays work for Provigil, or should I just switch to a real medication like Dexedrine?
(Med Summary: Klonopin 4 mg/day, Provigil 200 mg/day, Lamictal 100 mg at bedtime.)
Thanks,
3 Beers
Posted by JohnX2 on March 17, 2002, at 0:21:51
In reply to Do Drug Holidays for benzo tolerance work?, posted by 3 Beer Effect on March 16, 2002, at 23:44:44
> I take 4 mgs of Klonopin per day, 2 at bedtime, 1 at breakfast, & 1 at lunch. However, I seem to be building up a tolerance to it b/c it doesn't seem to work as well anymore for social phobia (i've been on it around 2 months).
>
> I've heard of people who take "drug holidays" from their add stimulants adderall/dex/ritalin etc and in a short amount of time (a week?) without the drug their tolerance is reduced to baseline (zero).
>
> Do drug holidays for benzos work?
> MOST IMPORTANTLY, How long would the drug holiday have to be to reduce the tolerance down to baseline (zero)? (I know you can't just stop taking them cold turkey, but Klonopin has a long half life so I was planning a fast taper down to zero).
>I used Klonopin to help me with a facial neuralgia (mainly tension headaches). It worked at 2mg and also gave me a sedative/antianxiety effect. This pooped out after a number of months. I had to continually raise the dose to retain the effect (upto 6mg). Once I grew tolerant I never had that antianxiety effect and my sleep patterns were permanently goofed up.
Meanwhile we tried many anticonvulsants to try to treat the issue; most of these experiments were failures. Ultimately I found that Topamax was a suitable replacement for the Klonopin. The Topamax increases conductance at the GabaA receptor as do all the benzodiazepines.
After starting Topamax (which instantly fixed my myofacial pain), I started to taper the Klonopin. I was able to dump 4 of the 6 mg in about 6 weeks.
I got it down to 1 mg and then things got really rough. I threw in the towel and bumped the dose to 2 mg. When I bumped the dose I felt a noticeable anxiolytic effect (as when I started the medicine). This anxiolytic effect quickly wore off after a number of days resuming this 2 mg dose.I used these medicines to help me taper the Klonopin. I believe they may be useful adjuncts to help with withdrawl symptoms:
Topamax 400 mg.
Zyprexa 5mg.
Neurontin 300 mg 3x a day.Without these aids I feel the Klonopin taper would have been much more difficult. The Zyprexa exerts a fairly substantial antianxiety effect and will help with rebound insomnia (you can start this quickly, it works fast). The Neurontin will help with anxiety and any neuropathic tingling (in fact you may want to bail on Klonopin in favor of Neurontin). The topamax as I mentioned works on Gaba a bit like benzos, but I haven't heard of anyone besides me using it for withdrawl (or as a replacement).
While my sleep was goofed up by Klonopin tolerance, these two medicines restored my sleep:
Remeron, Zyprexa.> Also, my Provigil 200 mgs has "pooped" out after 2 months. It was never that great in the first place (similar to extended release caffeine without as much anxiety) but now only lasts about 6 hours now before I get extremely tired/sleepy. Do drug holidays work for Provigil, or should I just switch to a real medication like Dexedrine?
>Just my opinion, I think the dexedrine will make you too anxious while you are dealing with the Klonopin issue.
hope you feel better.
best wishes
John> (Med Summary: Klonopin 4 mg/day, Provigil 200 mg/day, Lamictal 100 mg at bedtime.)
>
> Thanks,
> 3 Beers
Posted by Jackster on March 18, 2002, at 1:35:27
In reply to Re: Do Drug Holidays for benzo tolerance work? » 3 Beer Effect, posted by JohnX2 on March 17, 2002, at 0:21:51
The topamax as I mentioned works on Gaba a bit like benzos, but I haven't heard of anyone besides me using it for withdrawl (or as a replacement).
>John - I read somewhere in a research report about tegretol (anti-convulsant) being used to help with benzo withdrawal. I assume it's similar to topomax?
Jackie
Posted by andyboy on March 18, 2002, at 19:04:29
In reply to Do Drug Holidays for benzo tolerance work?, posted by 3 Beer Effect on March 16, 2002, at 23:44:44
Tolereance of 4mg after only 2 months??????My side effects didnt even go away for 2 months! Are you sure you are not confusing the CNS side effects with the actual theraputic effect? What are you taking the drug for? Now I have proved my case that you cannot make an across the board generalization of the tolerance of benzos. I have been on the same dose of klono (2mg/day) for about a year now and it is still effective as day 1. Dont give up on it yet-wait at least another month I say. All the anti-benzos would have my head for saying that!
Good Luck
Andy
Posted by 3 Beer Effect on March 19, 2002, at 0:22:35
In reply to Re: Do Drug Holidays for benzo tolerance work? » 3 Beer Effect, posted by andyboy on March 18, 2002, at 19:04:29
As proof that tolerance can occur in only a few months----when they give Klonopin to epileptics the anticonvulsant effect wears off at 3 months & the dosage must be upped significantly or a different medication must be used to prevent seizures (from Prentice Hall Nurse's Drug Guide).
I take Klonopin for social phobia/anxiety & insomnia. 2 mg at bedtime, 1 mg breakfast, 1 mg lunch.It is possible that I may be confusing the side effects with the therapeutic effects. When I first started taking it I had short term memory loss, & I was slurring my words when I talked. These 'klonopin studpidity' effects went away but now it doesn't seem to do much of anything, although the anti-anxiety effect is supposed to be the last to go. I can't really tell if it is working or not. I stopped it cold turkey for this last weekend & had no problems except for rebound anxiety before I had to go to work Monday afternoon, so that is when I started taking it again. I think I am just going to take the daytime dose of 2 mg instead of the previous 4 mg/day to help prevent tolerance & skip the 2 mg nightime dose- Klonopin is pretty lousy as a sleeping pill anyways, I think Benadryl works almost as well.
I am not going to give up on it, i'll probably keep taking it for a long time (it curbs any urge of mine to drink alcohol)- But like all psychiatric medications, it has been somewhat dissapointing- I read all these rave reviews about Klonopin & that besides Nardil, Klonopin is the "social phobia gold standard" & its okay but not that great, atleast for me. It doesn't seem to help with social inhibtion, just with social anxiety. I read at high doses (like I am taking) Klonopin is serotogenic & increases confidence, & decreases social inhibition but this never happened (I still wait for girls/women to talk to me instead of the other way around).
(Zoloft & Dexedrine are the only meds i've taken that helped me be confident, and socially disinhibited- but Zoloft made me manic/insomniac, so now I take Lamictal- I plan to switch to long acting dexedrine spansules for both social phobia & ADD at my next psychiatrist visit- I take 200 mg provigil currently which has pooped out at 2 months.)
This is the end of the thread.
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