Question:
Does anyone know the dose equivalence for Xanax and Klonopin? I mean, is .5 mg of Xanax equal to .5 mg of Klonopin or is .5 mg of Xanax equal to 1 mg of Klonopin? Also, does anyone have enough experience with both medicaitons to know which one is better at staving off panic attacks? Sandy
Response:
Does anyone know the dose equivalence for Xanax and Klonopin? I mean, is 5 mg of Xanax equal to .5 mg of Klonopin or is .5 mg of Xanax equal to 1 mg of Klonopin? Also, does anyone have enough experience with both medicaitons to know which one is better at staving off panic attacks?
According to a chart in Panic Disorder/The Medical Point of View by Kernodle… Xanax 0.5mg = Valium 5mg Ativan 1mg = Valium 5mg Klonopin 0.25 = Valium 5mg Tranxene 7.5mg = Valium 5mg So, it looks like Klonopin is twice as strong – probably because it is considered long acting as opposed to short acting (Xanax). I take both but have been on each alone and prefer Xanax even with the multiple dosings and possible breakthru anxiety. I also was on a VERY low dose of K, so that might have made my opinion biased. Both should work to *stave off* attacks if taken as prevention and not *as needed*. By that I mean, if you need meds daily – might as well get on a dosing schedule and stick with it rather than white knuckle it til needed. Mileage varies – I take it daily on schedule, others do fine as needed. Only you and your doc can decide what is best for you. — Gwen On the other hand…. …….you have different fingers. (remove ** to Email)
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<much snipped for space The short acting SSRIs may have a "withdrawl" effect but this doesnt represent the same mechanism as dependence and it is avoided by simply giving one dosage of a long acting SSRI at the time one wishes to discontinue the meds.
This is not the pattern we have seen emerging here from people taking Paxil nor, unless I am mistaken, that shown in the published studies that are starting to appear. There is an inevitable honeymoon period when a new medication is introduced, during which it is hailed as a wonder of the age. ISTR that heroin was once regarded as non-addictive… I rather suspect that SSRIs are going to fall in that middle ground where most medications wind-up and that talk of the dependency problem associated with benzos as a reason for prescribing SSRIs will evaporate as more experience with the latter comes to light. — Gary Cooper
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My doctor just prescribed Klonopin for night time use to replace trazadone in addition to the 4 mgs of Xanax I take during the day. The trazadone is apparently contributing to my arrhythmias I have been experiencing recently. I was taking the trazadone to quell the horrible nighttime panic attacks I sometimes have which do not respond to Xanax. My doc is a big fan of Xanax and even tells me I can take a Xanax with a Klonopin at bedtime. Since my session was so short I forgot to ask him if I need to taper off the trazadone or can just give it up and go right to the Klonopin. My answer to your question is some docs do prescribe them together and my question is–do you think I should taper off the trazadone of just go for broke? The reason he prescribed both is because Klonopin has a longer half life and is much more likely to last me through the night than Xanax alone. Don’t know if this helps or hinders. I mean well. I’m just old and tired. Marilyn "He who throw’s dirt loses ground"
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My doctor just prescribed Klonopin for night time use to replace trazadone in addition to the 4 mgs of Xanax I take during the day. The trazadone is apparently contributing to my arrhythmias I have been experiencing recently. I was taking the trazadone to quell the horrible nighttime panic attacks I sometimes have which do not respond to Xanax. My doc is a big fan of Xanax and even tells me I can take a Xanax with a Klonopin at bedtime.
<snipped for space I just had to reply to this one. I also had horrible nighttime panic attacks. I would wake up *soaked* with sweat, and sometimes my extremities would be numb or asleep (probably due to blood pressure spike during the PA??). Anyway, this was happening while I was on a .5 Xanax dosage 2X per day. My pdoc switched me to .5 mg Klonopin in AM and 1 mg Klonopin PM and I havent had *any* nightime panic attacks. my days have also been very good. I do miss the euphoric feeling I got from Xanax though. IMHO, I wouldn’t worry about stopping the Tranzedone cold turkey, as long as you are taking another benzo in its place. Good luck, Rich
Response:
Does anyone know the dose equivalence for Xanax and Klonopin? I mean, is .5 mg of Xanax equal to .5 mg of Klonopin or is .5 mg of Xanax equal to 1 mg of Klonopin? Also, does anyone have enough experience with both medicaitons to know which one is better at staving off panic attacks?
According to an interesting equivalence chart that I found on the web, the Klonopin is twice as effective per mg. (e.g. .5 mg Xanax = .25 Klonopin) But Xanax reaches peak plasma level in 1-2 hours and the Klonopin does so in 1-4 hours, so K is a little slower acting in the average person. Xanax half life is only 9 – 20 hours and Klonopin is 19-60 hours all depending on the individual, and age of the individual. (IMHO, I don’t think either drug lasts as long as stated above, so half life must not be at a theraputic level… will someone explain "half life" for some of us?) My personal experience with both drugs doesn’t totally agree with the above, I happen to believe that Xanax and Klonopin dosage are about equivalent exactly (e.g. .5 mg X = .5 mg K)…. I’m talking about the ability of the drug to block anxiety / pa, not the amount of time the drug lasts. I do believe, and have experienced that K lasts much longer than X. Keep in mind everyone reacts to drugs differently, so YMMV. If your are interested in where I got this information the address is http://uhs.bsd.uchicago.edu/~bhsiung/tips/bzd.html and it shows equiv of many benzo’s including Time to Peak Plasma Level and Half Life. Take the information for what its worth. Take care, Rich
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Sounds like this post was for me <s. You said several things that interested me. First I want to say that it’s great that you have a physician who is willing to work with you like this. I live in Ohio. Is Ohio against Benzodiazepines (sp)? You stated that you take both Klonopin AND Xanax, but are on a very low dose of Klonopin. Would you mind sharing exactly how you are taking your medications and in what doses AND how taking both helps
you? Well, without getting into MY complicating dosing – I kinda got *stuck* with K as a shrink gave me no other choice and I didn’t know a good doc. Xanax had worked for me – but he wouldn’t give me any and got me onto a low dose of K. As it is now I take about 2mgs of Xanax a day and 1 of K. This has dropped from the starting of 4 of X and 2.5 of K. Now I take the largest dose of K in the morning and use Xanax during the day with some K at bedtime. I don’t know that I would make a good *case*, would prefer to be on just one and hopefully will be one day again, maybe not. I much prefer a GP over a shrink – they did nothing but mess me up. But that is just my experience and contacts. Xanax does work faster, but K seems to last longer – so is a personal choice – some hate multiple dosing. I don’t know what your dose is on K, but it could be too low like when I took it. You can contact me privately if you want to know more. — Gwen On the other hand…. …….you have different fingers. (remove ** to Email)
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The short acting SSRIs may have a "withdrawl" effect but this doesnt represent the same mechanism as dependence and it is avoided by simply giving one dosage of a long acting SSRI at the time one wishes to discontinue the meds.
This is not what my pdoc told me. I take Paxil, and my body is dependent on it. There was a post not too long ago from someone whose prescription had run out. She ended up passing out on the street! We have not yet heard about SRI abuse/addiction, but I bet those stories will come soon. Lori from SF Madness takes its toll. Please have change.
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There is no definite answer to the question which one works best. It all depends on your individual biochemistry and tolerance. Klonipin has worked for me, but then again I have not tried xanax. I am told (by my very capable doctor) that klonipin is longer lasting and xanax tends to have an in/out effect with more withdrawal and craving, but again, there is no hard and fast answer.
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You are right, Gary….my own doctor gave me a copy of The Journal of Clinical Psychiatry titled Antidepressant Discontinuation Syndrome: Update on Seratonin Reuptake Inhibitors. (What a mouthful!) Anyways, I read thru this thing, 8 articles describing this very thing and had been going thru it at the time. Scary stuff and something all docs should be aware of (IMO) as the AD’s are being pushed as non-addictive. This is a 1997 publication from the summer – so very recent news. And I didn’t find anything that could *simply* make this avoidable.
Thanks for the confirmation of that, Gwen 
While I know that many here have been greatly helped by them, I worry about the way SSRIs are being prescribed willy nilly, while there are such quasi-moralistic postures struck about benzodiazepines. IMNSHO, I think there is some *appalling* science going on in certain sectors of the medical profession with regard to this issue :/ — Gary Cooper
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While I know that many here have been greatly helped by them, I worry about the way SSRIs are being prescribed willy nilly, while there are such quasi-moralistic postures struck about benzodiazepines. IMNSHO, I think there is some *appalling* science going on in certain sectors of the medical profession with regard to this issue :/
Hi Gary, I’m with you on this one one hundred percent. I recently saw some appalling stastics regarding the prescribing of SSRI’s for children aged 4-11. They presecription rate has went up over three hundred percent in the past year! IMO, the drug companies are marketing these drugs VERY aggressively. I just got my subscription of "Health" magazine and of a variety of other mags I subscribe to. Almost every single magazine had an ad pushing Prozac!!!! The left page was a little, pitiful wilted xmas tree and the caption was "Without Prozac". The right hand page (facing) was a large, green perky decorated tree….the caption "With Prozac". Personally, I think it is abhorent to market a drug to the public in this manner. All I see is drug companies with "visions of dollar signs dancing thru their heads"…and a public buying into it all en masse (along with the docs). The benzos are just not "sexy" and they are not enough of a profit maker for the drug companies……so they don’t typically even get mentioned to the docs….except all the "bad" things about them and how much better the SSRI’s are for your patients. And all of you out there who are doing well on SSRI’s and "really" do need them….don’t get mad about this post. I really do agree that for some folks they work very well with few side effects….but I do not believe that you folks are the majority. Especially for PD…depression is another animal entirely. (yes, this hits a nerve with me <G) Jen, <stepping down from soapbox
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I’m with you on this one one hundred percent. I recently saw some appalling stastics regarding the prescribing of SSRI’s for children aged 4-11. They presecription rate has went up over three hundred percent in the past year!
That’s terrifying, Jen 
IMO, the drug companies are marketing these drugs VERY aggressively. I just got my subscription of "Health" magazine and of a variety of other mags I subscribe to. Almost every single magazine had an ad pushing Prozac!!!!
<snipped to save space Personally, I think it is abhorent to market a drug to the public in this manner.
Over here that kind of advertising hasn’t been allowed – I’m not sure whether this is changing but I *hope* not and I fail to see the point, anyway. What’s one supposed to do, badger one’s doctor for the brand of choice? That might work with pantyhose or sparkplugs but it hardly applies to medications, I’d have thought :/ All I see is drug companies with "visions of dollar signs dancing thru their heads"…and a public buying into it all en masse (along with the docs). The benzos are just not "sexy" and they are not enough of a profit maker for the drug companies……so they don’t typically even get mentioned to the docs….except all the "bad" things about them and how much better the SSRI’s are for your patients.
We’ve had intimations of this in the past – and from qualified doctors too. I’d add that another thing counting against benzos is that they are old news and out of patent, so there’s little money to be made, compared with SSRIs. It seems to me that the original impetus against benzos came from the ‘jogging generation’ of neo-puritan doctors – the people who, having realised that the fight against major diseases had ground to a halt since the 1950s, threw the onus of responsibility onto the patients via ‘preventative medicine,’ encouraged a million and one bogus ‘healthy living’ scams and adopted an attitude to anything with even the remost potential to be enjoyed much as a strict Calvinist would feel about a striptease. At root we are seeing the same twisted behaviour in the *wicked* refusal to prescribe sufficient morphine in terminal cases on the absurd grounds that it is ‘addictive’. As with most revolutions, the good intentions soon turn to fuel for despotism and, IMO, that’s what we’re seeing now. I’d add that MDs are being egged-on in this respect by the legions of barely educated ‘therapists’, ‘counsellors’ and ‘psychologists’ – all of whom have their own non-meds axes to grind. And all of you out there who are doing well on SSRI’s and "really" do need them….don’t get mad about this post. I really do agree that for some folks they work very well with few side effects….but I do not believe that you folks are the majority. Especially for PD…depression is another animal entirely.
I think it’s fair to say that antidepressants *do* work for people withg anxiety and even anxiety without depression. However, it strikes me as very strange medicine to prescribe a powerful, expensive medication with less history and greater potential for complications as a treatment first resort. (yes, this hits a nerve with me <G)
And with me — Gary Cooper
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IMO, the drug companies are marketing these drugs VERY aggressively. I just got my subscription of "Health" magazine and of a variety of other mags I subscribe to. Almost every single magazine had an ad pushing Prozac!!!! Personally, I think it is abhorent to market a drug to the public in this manner.
~ Snipper at work ~ I am really quite curious how the benzos got the bad rap. I seriously doubt it was the drug companies, why would they shoot themselves in the foot like that? I think it may have more to do with patents running out and most stuff like Xanax and Klonopin going generic while the SSRI’s are still brand name only. Think it was the work of behavior therapists that knocked the benzos, as many times they work better than the 100 dollar/50 minute hour.
Yes, those years I spent, unhappily married to the pharmaceutical rep, confirm your patents running out theory. How about this one, my R is really having a hard time repairing from the car accident. He was next to impossible to live with up until several days ago, couldn’t sleep, rippling back pains following his PT. He does take Zoloft 50 mg. a day for depression. However, his doctor added 10 mg. amitriptyline for the pain and sleep, but I got a husband I could live with back again! Now, when I take mine, I make sure he takes his at the same time! I just added that bit as so many are mentioning mixing meds in this thread. I also made mental note of the fact that newer is not necessarily more effective, but is more expensive! … Tasha … ~8)
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