Just wanting to add, it kicks in for me within about 1 hour and the relief lasts approximately 8 hours. Hi cwake, the "as needed" this is my opinion means take as prescribed, OR if you do not feel panicky one day, or half that day, then don't take it if you don't need it. It also means Do NOT go over the prescribed amount, in your case never take more than one tablet twice a day. You are most def allowed to take the prescribed dose of one tab twice a day.
Don't let your mother know you are taking klonopin unless you are a minor and she must know what is being prescribed to you. This is none of her concern, yet gently telling her that you know she loves you and is concerned about you taking this medication, but that you have confidence in the doctor who prescribed it for you. And forget about your mother's comments or guilting you into not taking the medication. If you are over the age of 18, then your health is your business. Its great if your parents pay for your insurance, but it's still truly not their business to criticize you when you "Do what the doctor told you to do"!
Be kind, but be firm with your mom. She loves you, this I'm just certain of. If you are having panic attacks daily I had them every day for a few years then take your klonopin as prescribed, twice a day. Just don't take more than that. Best wishes, and maybe if you explain to your mom just what a panic attack feels like, maybe she would understand just WHY you need that medication.
Good luck, and let us know if you talk to your mom. I take Klonopin as needed up to twice a day. Because klonopin has such a long half life stays in the system for a long time I take one pill in the morning and only if necessary in the evening. The one a day holds me pretty will unless I have a bad day and my anxiety or fear becomes noticeable so then I take the second. I am prescribed 3x daily no prn.. Prn just means take when needed, so you are basically prescribed 2pills a day as needed, not to exceed that amount, meaning if u take the 2, and want to take another u are not taking them right!!
Klonopin has worked best for me, I have been on xanax, ativan, valium which I hated the valium made me sluggish all the x never wanted to do anything!! The ativan and xanax work pretty quick, meaning when u take it you don't have to wait very long for it to work, that was the up side, but the down side is they wear off quick and if u have really bad anxiety in my opinion your likely to abuse simply cause of the fact that they are in you possesion and your brain might just say man I still have alot left and I am feeling anxious after the first one wore if and find yourself taking another, with that being said you will get youself in trouble, addiction wise as well as running out before the next script is do, trust me been there done that!!!
I found that u might have to wait a little longer for the klonopin to kick in, but it stays works in your system longer then xanax and ativan etc Usually around 8hrs from what the doc told me.. So if I am taking 3 and they work for 8hrs I am covered around the clock!! In my opinion, just take them when u are at your worst! You are not forced into having to take both if u don't need them not saying u don't but if u have a good day and only need on just take the one!!
Also Klonopin is a med. That u cannot just stop ct, u can have a seizure etc Not trying to scare u just given u facts, if there comes a time u don't want them anymore tell your doctor and taper off slowly so u have no issues!!! Hope that helped some. Indeed it only works about hours for me: I understand that it has a "very long half-life" but it so does methadone. That doesn't mean methadone's analgesic properties are felt for the entire half-life.
Xanax only works for about hours for me. With Klonopin, I feel the same as you, 3x dosing would be perfect for me but I would have to call my doctor and somehow convince him that it's necessary, which always scares me. I'm always afraid that a doc won't understand and that they'll take it as me drug-seeking or whatever. Thanks for the comment.
I most definitely am not taking more than 2 per day. It's usually one in the morning and one in the evening like between 8 and I'd prefer to get by only taking one, but without it, my anger bouts, obsessive thoughts, and general uneasiness returns. I'm hesitant to ask because I don't want to bother him like I used to in the past. I only see him quarterly so I'd have to set an appt with him.
You can probably get a question like this to him through his nurse, who will also relay the answer. If not, it's worth an appt. What exactly should I ask? I would like to ask if he would be willing to allow TID prn, that kind of stuff usually hasn't required an appointment in the past. I think I know what he means by as needed.
Take up to two if I have to. But seeing as klonopin is hard for me to judge taking as an "as needed" med, maybe I need to let him know this. Exactly what it says. If you know that say the upcoming day is going to be a high stress one, you'd take one say upon awakening. It as Laurie suggested a long half life and can be in your system as long as anywhere from 18 to 45 hours. It can take from one to four hours for a person to begin to feel the drug work. Best of wishes, pledge. Hi cwake forget to let u no the way I take mine is around 7am, 4pm, and then right before bed!!
Good luck get back to me if u have any other?? Hi cwake, you will know when you need to take one, as when your anger, or obsessions start to rear their awful heads. It's best not to take them "in case" you might need the med, unless you are sure that you will be in a position that will set off the feelings. Some people have no problem getting off of the Klonopin with it's long half life, yet others who have addictive tendencies, have a difficult time getting off of them.
Having addictive tendencies does NOT mean that you are an addict, just means that you have the genes that tend to make it easier to become addicted. People like that can become addicts, but if you are aware of your abilities, that may not pertain to you. I was prescribed this prn. Or twice a day. I took one the second evening that I had them. I could not tell you much about anything after that. But for many BZs, half life turns out to be a poor measure of how long the patient feels the effects of the medication.
Consider immediate release alprazolam: For example, diazepam Valium has a long half-life 26 to 50 hours , but because of its higher lipophilicity, it crosses the blood brain barrier more quickly than lorazepam half life of 10 hours and actually has a shorter duration of action clinically. The long half-life of diazepam can, however, become burdensome because it gradually accumulates in the fatty tissue and then can slowly cause more side effects when dosed long term for chronic anxiety Sheehan and Raj, ibid.
BZs are rendered inactive by metabolism in the liver. This has two important implications for clinicians: Potent inhibitors of the PA4 enzyme like fluoxetine Prozac , fluvoxamine Luvox , and certain oral contraceptives can increase the plasma level of alprazolam and several other BZs, requiring dose reduction in some cases. When switching from one BZ to another, refer to the dosage equivalence information in the table below. A rule of thumb is to use lorazepam as the standard.
We are all tempted to use medications as a PRN for good reason: On the other hand, a standing dose of a long acting medication, like clonazepam, is sometimes the best option, especially when you are starting treatment with a very anxious patient. This will predictably relieve symptoms and prevent clockwatching for the next dose. Another important but often overlooked downside to using PRN dosing is that this may adversely affect cognitive behavioral therapy CBT. The specific goal of CBT is to allow the patient to become more comfortable with sensations and emotions related to panic attacks and confront their automatic thoughts about how dangerous these feelings are.
In general, we recommend prescribing BZs as standing doses rather than PRN or not prescribing them at all with patients who are undergoing CBT psychotherapy for panic. In most cases, BZs have a benign side effect profile. Patients often resist taking BZs during the day when they most need them because they fear sedation, but you can reassure them that this side effect is usually mild and goes away within a few days. All BZs cause physiological dependence if a patient takes a high enough dose for several weeks.
Serious withdrawal symptoms, such as delirium tremens or seizures, are very rare among patients who have taken therapeutic doses of BZs without adding alcohol or illicit drugs. The side effect situation is more worrisome among the elderly, who are at higher risk of falls Woolcott JC et al, Arch Intern Med ; Consider tapering BZs in your patients from time to time to rule out the presence of occult side effects.
How do you taper most successfully? BZ tapers are most successful in patients with lower baseline levels of anxiety, who have been on lower daily doses for fewer months. Regardless of the patient, the best way to taper is very, very slowly—it often takes five to six weeks but may take months. For example, one published slow-taper program for alprazolam recommends reducing the daily dose by 0.
Oxford University Press; Most patients appreciate it if you write out the schedule in detail. Consider CBT during tapering for patients who have difficulty tolerating tapering and are motivated. Special thanks to Kate Salvatore, MD for her input on this article. This article originally appeared in: Click on the image to learn more or subscribe today!
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