my shrink might change my benzos??

[jimgreg]

i thought this would be the best place to ask this at??

i go to my shrink tommrow to get meds..the last time i seen him he needed to get my records..so he said i,l alter ur meds then too..well the only one he can touch will be the xanax..im on methadone also for pain management.. been on these both the same time 5 yrs...before the xanax and methadone was on klonpin 4 mgs aday for 12 yrs for panic attacks.....

what is the ratio  if he changes me to klonpin..i take between 2.5- 3.0  mgs aday...but the script is for 1 mg 4 aday.. but the gpdoc told me to only use the 4 mgs only when needed sop i wouldnt be hooked on the 4mg,all the time..i avg  3 mgs aday....

SO WHAT WOULD HE HAVE TO DO IN THIS CASE TO MAKE NO WITHDRAWLS..AND THE TOPS ON KLONPIN IS 4 MGS DAILY...I KNOW THE 1/2 LIFE OF XANAX IS 11.2 HRS...........THE KLONPIN VARRIES BETWEEN 36------AND 100 HRS  1/2  LIFE.....CAN YOU TELL ME WHAT HE WOULD HAVE TO DO TO MAKE THIS SWITCH????????    he said he wouldnt put me in harms way..or hurt me even......thanks  james

[TysonRed]

In my experience klonopin and xanax are about the same mg for mg, but klonopin never worked nearly as good as xanax did. I actually found that xanax xr worked the best for anxiety without having any signifigant side effects like drowsiness. So what is the reason that your doc wants to switch your meds up? Are you planning on quitting the benzos or just not getting the relief you need? I was taking benzos for about 4-5yrs on and off, I tried basicly everyone of the main ones. I personally never had too hard of a time coming off of them for some odd reason, besides it messed with my sleep. Obviously when you do switch you should really try and get by with the least amount possible and not worry so much about what exactly is the equivalent dose. The key is what works the best for you and finding that lowest effective dose. Im sure you know but I have to add that somewhere over 90% of methadone related overdoses are due to mixing benzo's in, so be really careful. I know you've been taking them both for a long time so Im not gonna preach about it, but just be aware and stick to the lowest effective dose. Im not sure if any of this helps, I was on methadone for years, along with benzos and various other opiates, it took me a long time to make it out. Anyways I hope everything goes well, good luck and take care.

[OKnotOK]

Shrinks generally hate benzos. They have a point -- they're addictive, and after long-term use, can be tricky to wean from. Most handbooks recommend them for two weeks, maximum, including taper.

You've done your own research, which is always wise. Punch "benzodiazepines  conversion" into a search engine, and go with the U.K. site, where you'll find tapering info as well.

I can tell you that Klonopin (a.k.a. Rivotril; generic name clonazepam) is 10x the strength of Valium, so 1mg K = 10mg V. No shrink (or GP, for that matter, although there are exceptions) is going to be comfortable with a patient taking the equivalent of 30-40mg of Valium a day, but he's inherited a case where that's your dosage.

I think he's going to go with something like this: Hold you at 3mg K, with an eye to a long taper (both K and V are used to get people off the shorter-acting benzos, so expect -- demand, if necessary- to stay on K at the present dose. He can't just pull the plug; the seizure risk is too high, so don't worry about it. There's a decent chance you can argue for a bait-and-switch: taper off the Xanax while holding the K at the present dose. When you're off the X, he'll probably want to reduce the K slowly. Bring printouts from the site if necessary, expressing your concern about moving too fast. This is all in his Desk Manual.

I have experience with taking long-term benzos (still am) from a GP. Addiction Specialists and shrinks are appalled, but since they help me (even though my resistance to these drugs is phenomenal) with insomnia, they shrug and say, "You're going to have a hard time coming off them, if you even can."

They're right. For people who have the time and money, it starts with a 28-day in-house rehab, with a gradual switch to Imovane (which is so similar to benzos, it's just a technicality to separate them) or phenobarbital. Sleep disruptions can persist for a long time, but who wants to be chained to doctors and drugs forever?

Don't worry, though -- it would be clear-cut malpractice to cut you off entirely. Good luck and let us know how it goes.