Dose - Dr. lowering Clonazepam dose and swim feeling the dose needs readjusted?

[blackdb1]

Swim is RX'ed Alprazolam (xanax) 90 a month as needed by his psych, and given Klonazepam by his Suboxone Dr. as the sub doc is against xanax for long-term anxiety treatment... Swim uses the xanax only when needed for instant relief of panic and prefers the K-pins.

Swim was on K-pin 3x a day, 1mg morning, 1mg afternoon, and 2mgs bedtime. His Dr. just lowered this dose to 1mg morning, 2mg bedtime, therefor cutting out the 2nd dose of the day... This has led swim to not want to leave the house, avoid all social interaction, etc... Swim always used the 1mg in the morning to get his day going and use the other 1mg dose sometime in the afternoon during stressful situations. Now swim does not have that 2nd dose of the day and it has made an impact on swims functioning in the 'real world'!!!

Swim definately prefers the 3x a day regiment over the morning and evening doses he is now on! The thing that swim is confused about is that he started adderall 2 months ago and assumes the Dr. will think that is the cause of this however swim only takes the addys when he has a HARD days work ahead of him and they're ABSOLUTELY NEEDED!!!???

Swim would MUCH RATHER take care of his anxiety issues than his adhd!!! Swim would be willing to come off the adderall if needed to get his k-pins re-adjusted to a comforetable dose!!!

Swim felt "alright" on his previous 3x a day dose but thinks 2mgs 3x a day would be the most effective!!!???

What swims question is, is has anyone ever been through this situation before, or could anyone shed some light on this problem?
Swim thanks all replies greatly in advance!!!

All have a great night and be safe!!! THANKS AGAIN!!! -bdb1-

[blackdb1]

No replies at all??? Swim would REALLY APPRECIATE some info on this!!!

Swim in simple terms is wondering if he tells the doc he thinks 1mg is no longer effective, would the Dr. think swim is becoming addicted to the drug? Swim 100% DOES NOT abuse his meds he just doesn't want to say the wrong thing to the doc and get taken off all together!!!

If swims Dr. is not willing to find a solution to the problem then swim will have to go see his psychiatrist and tell him his Dr. lowered his Klonopin and wondered what they could do, maybe increase the alprazolam dosage???

PLEASE!!! ANY REPLIES ARE GREATLY APPRECIATED!!! -bdb1-

[panic82]

It would be helpful to know how long swiy have been on this med. Also pls note how long swiy has been on alprazolam and the dosage.

From swim's feedback by various expert psychs, clonazepam is most effective as a once a day treatment (usually at bedtime) due to its 30 hour half life. Swim believes that swiy's recent use of amphetamine seems to be throwing the clonazepam off-kilter. The use of adderall should be discontinued if it's causing this breakthough anxiety. It seems that swiy has reached a peak with the clonazepam if 4mg a day is simply "alright."

Talk to your doctor about discontinuing clonazepam all together, especially since swiy has mentioned heightened symptoms of agoraphobia for which clonazepam is not as effective a treatment as alprazolam for this condition.

One benzo should be enough and it seems that long term alprazolam therapy would be a better option for your doctor to consider rather than clonazepam dose escalation. Swiy's GABA receptor may lose sites for the benzos to bind to if using two benzos with clonazepam at such a high dose. Swiy may want to option the drug gabapentin as an adjunct to clonazepam if swiy's doctor does not wish to discontinue clonazepam and push the alprazolam.

[Laudaphun]

Originally Posted by blackdb1

If swims Dr. is not willing to find a solution to the problem then swim will have to go see his psychiatrist and tell him his Dr. lowered his Klonopin and wondered what they could do, maybe increase the alprazolam dosage???

PLEASE!!! ANY REPLIES ARE GREATLY APPRECIATED!!! -bdb1-

Assuming from your last statement, SWIY are still getting alprazolam prescribed from a psych, while being prescribed 3mg clonazepam from your suboxone dr? So, which dr. is prescribing the adderall?

That's something SWIM's marmoset won't do because it can be viewed as by some authority figures as "double-dipping." When dealing with controlled substances, one needs to be careful about stuff like this.

This is something swiy needs to take up with your doctor/doctors It's doubtful that anyone here is going to be able to tell you what to do. It sounds like a lot of different psycho-active substances thrown into the mix in a very close time-frame. Plus with all that, none of us know your medical history, or whatever other meds you are on.

Clonazepam works good for SWIM's marmoset for symptoms of physical anxiety, however in the case of social anxiety alprazolam does a much better job for her. Alprazolam tends to be more habit-forming as well.