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Author Topic: Klonopin (clonazepam) to Ativan (lorazepam)  (Read 666 times)

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Offline Bcollinsix

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Klonopin (clonazepam) to Ativan (lorazepam)
« on: December 22, 2013, 01:40:52 AM »
I've been on klonopin for about 3 months (1mg 3x a day) and it hasn't done much for my nerves so my doctor is going prescribe me Ativan.

Has klonopin not really work for anyone else?

Also, what should I expect from Ativan? I'm looking for something to really chill me out.
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Offline insights

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #1 on: December 22, 2013, 07:23:55 AM »
Has klonopin not really work for anyone else?

Sure, it happens. Everyone's biology is a little different.

Quote
Also, what should I expect from Ativan? I'm looking for something to really chill me out.

Ativan is a slightly less potent benzodiazepine (BZD) than Klonopin, but it does have the advantage of being a BZD that your brain is used to as it is a natural constituent of food. Whether this actually increases its effectiveness in your case remains to be seen, however.

Is there a reason why your anxiety is being treated with BZDs and not antidepressants? While they are usually very effective, BZDs can be risky primary anti anxiety drugs because doctors are becoming increasingly reluctant to prescribe them so getting prescriptions may become hard to get in the future. Even if your doctor is happy to do so them s/he could be taken out by the proverbial bus tomorrow and the replacement may not be as willing.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Bcollinsix

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #2 on: December 22, 2013, 11:47:13 AM »
Thanks for your reply insights. I'm not worried about the future, I'll deal with it when it happens.  I am on 50mg of Zoloft and have been for 4 months but it hasn't helped my nerves. My doctor told me to increase it to 75mg once and all that did was give me a major headache.
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Offline insights

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #3 on: December 22, 2013, 04:17:47 PM »
I am on 50mg of Zoloft and have been for 4 months but it hasn't helped my nerves. My doctor told me to increase it to 75mg once and all that did was give me a major headache.

To get any benefit you will need to increase the dose, 50mg is the low end of the therapeutic range with most needing 100-150mg for good results. Headaches are a relatively common temporary side-effect when first taking Zoloft or increasing the dose. If you can't get past that then you should consider switching to another antidepressant such as Celexa (citalopram) or Lexapro (escitalopram). Switching from one SSRI to another is easy with usually only moderate side-effects for a few days.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Bcollinsix

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #4 on: December 22, 2013, 07:44:21 PM »
Thanks for the advice. My doctor doesn't want to increase the dosage of Zoloft because I'm also taking an anti-psychotic med and could develop serotonin syndrome. So I don't know I have been feeling sort of depress/ suicidal so maybe that's the route I should take.  My sister says raising the dosage of an anti-depressant won't exactly remove my suicidal thinking, which I agree. So I don't know. I see my psychiatrist on jan. 3 so I guess I'll talk to her about it then. Thanks again.
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Offline insights

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #5 on: December 22, 2013, 10:39:09 PM »
My doctor doesn't want to increase the dosage of Zoloft because I'm also taking an anti-psychotic med and could develop serotonin syndrome.

Okay, but there isn't much point in taking the Zoloft at what seems to be an ineffective dose. If you're doing okay on the anti psychotic then it is probably best left alone and the Zoloft switched to an antidepressant with low serotonin activity such as mirtazapine (Remeron) or nortriptyline (Aventyl, Pamelor). As mirtazapine is very prone to pooping-out nortriptyline is likely to be the better long term bet.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Bcollinsix

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #6 on: December 22, 2013, 11:47:22 PM »
You may be right. I'm also taking remeron 30mg for sleep. I don't really know the dosage for its anti depressant properties but thanks. I'll talk to my doctor about it.
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Offline insights

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #7 on: December 23, 2013, 12:04:39 AM »
I'm also taking remeron 30mg for sleep.

In which case you could add the sedating tricyclic antidepressant doxepin (Deptran, Sinequan) to the list of meds with low serotonin activity. It is sometimes prescribed at low doses for insomnia but it is a pretty good antidepressant which is probably under prescribed because of the sedation.

Quote
I don't really know the dosage for its anti depressant properties

The usual therapeutic range is 15-45mg. However, as per my previous post, Remeron is prone to pooping-out fairly quickly, often within a couple of months.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Bcollinsix

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #8 on: December 23, 2013, 12:29:33 AM »
Ok thanks. I really trust my doctor and I have a really good relationship with her so I'll see what she says.
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Offline laineyk

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #9 on: December 23, 2013, 03:40:49 PM »
I just switched from clonazepam to Xanax a couple days ago, because kloni made me more washed out and not great fro the anxiety...for me that is. Xanax works better, again , for me at this time
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Offline AncientMelody

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #10 on: December 23, 2013, 04:44:41 PM »
It's uncommon, but benzodiazepines can cause increased depressive symptoms, so that may be something to consider. The klonipin itself may have been doing that. Just make sure you discuss that with your doctor. Good luck!
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Offline Bcollinsix

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #11 on: December 23, 2013, 08:10:06 PM »
Thanks everyone.
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Offline Jlandd

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #12 on: December 25, 2013, 01:04:21 PM »
  When I was prescribed Klonopin (by a general practitioner) a few years ago, because I wasn't getting enough help from the dose of Effexor I was on and the Ativans "as needed" which was only during an *episode*, it made me feel too strange mentally and added depressive symptoms that weren't there, as AncientMelody mentioned.  And I'll echo insights (both he and AncientMelody are wonderfully helpful with their solid info and advice) that it's best to get the non-benzodiazepine medications dialed in the best they can be first and use the benzodiazepines to fill in the gap until that point is reached and then backing it off to a lesser role when you can.

  Ativan has been a very positive thing for me.  Has the right amount of helpfulness with less downside, and naturally YMMV (your milage may vary  :  )   ).  When I was in that awful twilight zone between meds, of needing to find the right new one and amount of it, I was taking it daily and up to 2 mg for a few months at the worst time and 1 on the bookends of that for a while.  It was totally dependent on what I felt I needed, and the prescribing psychiatrist assured me that I shouldn't worry about the amount or time on it, that in the grand scheme of things it was still not a high dose or a long period to be taking it daily, regardless of the negative stories one reads on the net, simply because I needed it.  We were still getting a bead on the anti-anxiety med target.  What was the alternative?   The goal has been to not rely on them but use them with this strategy, but not to stop taking them or take too little just because I was having my concerns.  In fact, he stressed that the fact I was concerned and had always taken the minimum as infrequently as possible was a sign to be confident I would be OK with using it more aggressively for a while, whatever that was.  What happened was that he took me off what I had been on as a change from the 150 of Effexor (and I had spent a year hopefully trying everything else under the sun, which now I wish I hadn't done, but it was under another psychiatrist's advice) and put me back on it, on a path toward 300, much to my dismay (and I was certain it was the wrong move), which I've been at now for about two months (starting at 37.5 in July).  And sure enough, about two weeks ago I found I didn't wake up at 4am needing an Ativan anymore, and then didn't really need one later either.  He's been insistent I stay taking a tiny amount, .333, then .25, just to have the bases covered as far as withdrawal.

  But getting the SSRI/SNRI choice and then dosage right (totally based on judgement and guesswork, not tests, even with the best doctors) as the priority and using Ativan as needed, even if that means daily until that goal is reached, was really the key for me.  And think months instead of weeks.  You'll be a fortunate one if your body reaches its proper state with the proper med and dose within a month and it might be three.  To be honest I'm not crazy about some of the side effects of being on so high a dose of Effexor, but I have to admit that it's the first time in two years that I've been as functional as this, so I'm gratefully going with it for now.

  Best of luck to you in your journey for relief  :  )  Everyone responds to these things so differently.  If you like your doctor and psychiatrist and have confidence in their judgement give their strategies all the time they say to to work.

Have a good holiday and may this year have you feeling the best you have ever felt.

J
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Offline Bcollinsix

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #13 on: December 25, 2013, 06:43:59 PM »
Thanks a lot j. I hope the New Year brings you great joy and relief as well.
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Offline anxiousartist

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Re: Klonopin (clonazepam) to Ativan (lorazepam)
« Reply #14 on: December 25, 2013, 07:52:23 PM »
I've been cutting back on my dose of clonazepam .25mg a month. I was taking 1mg a day, but I'm only taking .5mg this month.

I'm cutting back on my dose because I've found the less I take bzd the better they work when I really need them to work.

BZD's have really improved my life. I'm not afraid of doing things I want to do because of BZDs.

I've learned I just need to be disciplined and not take them unless I really really need them.

I haven't really experienced any withdrawl symptoms cutting back .25mg a month,

But I modulate any withdrawl symptoms I do experience with exercise.
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I'm working on being happy with what I can do, rather than sad for what I cannot do

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