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Medical Forum / General / Pharmacy / July 2007

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Clonazepam questions after 4 years

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JustAsking - 17 Jul 2007 23:37 GMT
Hello, my doctor put me on Clonazepam (1mg pills) for anxiety about 4
years ago.  Besides Toprol XL for my blood pressure this is the only
medications that I am taking.  My doc told me to take a 1/2 to 1 pill
of Clon as needed and that I can chew them so they start to work
faster.

Since then, I have been taking 1mg dosages off and on, just as she
prescribed (I've read on some websites that you should take it
constantly on a regular basis, but I know this medicine is used for
various treatments so I figured "as needed" may be acceptable when
taking for the minor anxiety issues that I have.)

It has really helped me with my anxiety, but I want to ween myself off
of it as I have found myself relying on taking it a lot more often,
whereas before I could handle the same stress levels just fine without
it (I would only take it when the stress was really turned up).

There were times at the beginning of 2007 where I was taking 1mg every
week day (not on weekends) due to my crazy work schedule and what I
now know was too much caffeine in the morning.  Even though I may be
tempted to take a pill during the day, I've been holding back as much
as possible and I'm back to taking it more on an "as needed" basis (I
would guess approx 3 times/week).  To me, this is still more than when
I started the med and would like to cut back, if not get off of it
period !

I have a few questions about all of this:

1) This may be tough to answer not knowing my full usage for the past
4 years, but knowing what you do know, would you consider my usage to
be normal, heavy, light, nothing to be concerned about or ???

2) My doctor told me that I could chew it - I know that this means the
effects will be felt sooner, but I'm curious if that also means it
will not last as long or be spread out as evenly throughout the day.
Is this true?

3) Do I have to worry about anything since I've been taking this
medicine (even though not regularly) for 4 years?  Or does that only
apply to those who take it on an every day basis?

Since I do not take it regularly, I cannot say exactly how much I have
been taking since I started, but I am still concerned with withdrawal
effects.  I have never taken more than 1mg/day, and there were times
where I went weeks without taking it at all.  At the same time there
were also times where I was taking it daily (as mentioned before).  My
concern however is that I have been taking it for 4 years, which
sounds like a lot to me now that I think about it!

If I would have to guess, I would say that I have averaged around 2mg
to 4mg a week since being on this medicine, perhaps a bit higher bc of
the times where I was taking it daily.

4) Is this enough to be concerned with having bad withdrawals if I
quit cold turkey?

5) Are there physhological problems that I should be concerned about
when quiting?  I have gone days and weeks before without taking this
medicine and never appeared to have any issues, but I have been taking
it more regularly these past couple of months (3 to 4 times/week) so I
am more concerned.

6) I was told by my doctor at one point that I can also take this at
night (complying with all dosage rules of course) if I am having a
hard time sleeping.   Is this a good idea and if I do that, will I
still feel the effects the next morning?

7) Finally, I was prescribed this medicine instead of Xanax bc it has
more of a long term effect and the effects do not "spike" as much as
Xanax.  Any comments or experiences with that?  (it's not that I want
to start Xanax, but I've always been curious about the differences
between the two besides what I have read on the net).

THANKS in adv for any help and advice!   I would appreciate any other
information if you care to share!
Doug Laidlaw - 22 Jul 2007 18:24 GMT
> Hello, my doctor put me on Clonazepam (1mg pills) for anxiety about 4
> years ago.  Besides Toprol XL for my blood pressure this is the only
[quoted text clipped - 71 lines]
> THANKS in adv for any help and advice!   I would appreciate any other
> information if you care to share!

My wife is a pharmacist, so I can answer in part.

Clonazepam is a benzodiazepine, of the same chemical family as Valium.
These can be habit-forming, and it is best to get off them if you can.  I
went off Valium suddenly and had an epileptic fit.  If possible, go back to
your doctor.  There should be plenty of consumer information on the Web.
The Australian consumer information for Clonazepam in PDF format is at:

http://www.roche-australia.com/downloads/rivotril-cmi.cfm

I am not qualified to make any recommendation.

As for chewing the tablets, it is my understanding that only special
slow-release capsules are released more evenly.  Their contents are in
little coloured balls.  Anything "enteric coated" is designed not to be
released until it reaches your intestines, and has a coating resistant to
the stomach's digestive juices.  A drug marked as slow release or enteric
coated should be swallowed whole.  Anything else can be chewed if you can
stand the taste.  But you should be able to accept your doctor's advice on
this.  If you can't get back to your doctor, ask a pharmacist.  They have
books with all that kind of info, when the drug peaks in your bloodstream,
etc.

We in Australia have the advantage of a good Health Benefits scheme (so
far!)  I know that it is sometimes impractical to consult a doctor, but if
you can, please do.  Otherwise speak to a qualified pharmacist.  They are
not just salesmen/girls.  They are trained to know the answers to the kinds
of questions you are asking.  In addition, they are trained to pick up
incompatibilities between different drugs.  For that reason, it is
advisable to use the one pharmacist as much as possible.  Your profile will
be on their computer, and any clashes should be picked up.  If your profile
is in bits all over town and the Web, that is impossible.

I won't speculate on comparing clonazepam with Xanax.  You may find some
info at http://www.mentalmeds.org/ - written by a person whose own problem
was depression.

HTH,

Doug.
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I grow old, always learning new things.
-Solon, Greek lawgiver, 6th c. B.C.

 
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