I'm having some severe troubles with somnolence / hypersomnia, and am still waiting for the final diagnosis regarding my sleep study. In the meantime, we've decided to correct the situation regardless of the official outcome, cause I've obviously have symtoms that are making my life very difficult. I've switched from 3mg of Klonopin per day to 2mg 2x's per day of Xanax XR to see if that doesn't help. So far, I just feel more tiered than before. I'm now just starting on day #2, and I know that I still have to give it a fair shot. Does anyone have any input on this? Also, I feel more social and general anxiety than before, meaning that probably I'll need a higher dosage of the Xanax XR in the long run. I'd love for any experiences or comments (and I love back and forth discussions - if I or you question something, please feel free to respond, as that's the point of a conversation)! :) One more thing, for those of you who know me, this is just one of several steps that are going to be taken. One of the other steps taking once the benzo of choice is determined, we'll then start to eliminate all of the "sort of" working meds, and upping the dosage of the less sedating working med (dropping 300mg Ultram, 225mg Lyrica, the higher dosage of Pristiq 100mg down to 50mg, and upping the Methadone 30mg up to what is needed, something that has doesn't sedate me much at all, and works by far and away the best for the fibro pain)! Thank god!! The psychiatrist wasn't willing to in the past, but now is all for it. According to him, I've proven over time that I have an extremely low addictive personality profile, rare for also having PTSD, and he's had a number of very bad experiences very recently. Also, hopefully, we'll be saying an almost total good-bye to Abilify (rarely taken as it is), as the Minipress has been working wonders for the C-PTSD!
Xanax xr vs. klonopin, or really any benzo, which has the most effective and least sleepy profile?
- 26 Aug 2010 by jk13
- klonopin, xanax, xanax xr, narcolepsy, anxiety, panic disorder, drowsiness, sleep disorders, sleep
Added 26 Aug 2010:
Ok, so far they know that I've got very mild sleep apnea at night, partially due to the narcotics (methadone slows the breathing considerably, thus less oxygen), but aren't sure if I have multiple sleep disorders yet. I'm going to get a special pillow and give it a try, sleeping on the side... I hate the idea of the mask thing!!!!! I'm stubborn like that... They aren't sure if it's causing the sleep attacks... but the meds plus that make it plausible,
Added 27 Aug 2010:
ok, so this evening, I started to have major panic attacks and irritability even after taking the second dosage of 2mg Xanax XR. Called the doctor, and he told me that he wasn't going to increase the drug, and to go back to the Klonopin. It's strange how different people have such a variety of reactions to mind type meds. Anyways, I have an appointment this next Thursday, and will ask about Valium as an option (I severely doubt that he'll want to try it, due to the fact that the conversion would be 60mg). The Xanax just didn't carry the weight that the 3mg of Klonopin had for me. On top of it all, ultimately the Xanax also made me equally tiered, in a very different way though. Klonopin feels more relaxing and smooth vs. the Xanax for me felt more relaxed in a slightly stimulated way... very hard to explain. Oh well. If the doctor wants to give the Valium a try, I'll definitely post it, but for now, step 2 is to get rid of the 225mg of Lyrica. Will be going down 75mg per week. Apparently regardless if I feel withdrawals or not, there's a possibility for seizures. So... that's that. Lyrica is the one drug that I take that I literally feel nothing from. No benefit, no negative. Just nothing, and expensive. But for a long time, was told to take it.
Added 1 Sep 2010:
just realized that the updates should really be posted up here vs. on the comments, so here it is again.....
Just an update:
Ok, so, I talked to my psychiatrist durring my appointment yesterday about switching from the current 3mg of Klonopin over to Valium, something that I've heard allot of good things about, and according to him, I'd have to be dosed way to high, putting me in a situation setting me up for addiction. According to the good old wikipedia, I guess that 0.5mg of Klonopin = 10mg of Valium, so... that would put me at 60mg of Valium per day, and that's too high of a starting dose for my psychiatrist. Also, the higher the dose, the higher the level of side effects associated with the drug, thus, the higher the abuse potential. So, I guess Klonopin is the one for me as of now. He also pointed out that Klonopin is more or less (according to him - and I'm sure that many would disagree with a portion of this statement), a better and more potent version of valium with fewer side effects.
So... the plan continues as before, to take the meds that don't do a whole lot of good out of my routine. I'm currently down to 75mg of Lyrica from the original 225mg. Once that ones out of the way, then comes the Tramadol, and we'll have to discuss how we want to approach it. Last time I spoke with him about my concerns regarding the discontinuing of Tramadol, he seemed to think that it wouldn't be a problem, this time, he seemed to be more in tune with my concern with the SNRI - and how it has an almost immediate action, thus potentially making it more problematic. Also, regarding the Opioid action, we'll have to figure out how much we want to increase the Methadone to contradict the withdrawal as well as replace it as a pain killer. Tramadol has helped with the pain, so we'll figure all of this out on September 14th, on the next scheduled appointment.
Added 7 Sep 2010:
ok, so... when I went down to 75mg of Lyrica, we had a delay. Apparently, the Lyrica was helping my anxiety considerably, and started to have some major anxiety issues resurface along with minor pain. The last thing that I want to do is add another medication or up the benzo, so we switched the Pristiq at 100mg over to Cymbalta at 90mg per day, and presto! Anxiety gone, as well as most of the pain! I requested to stop the Lyrica, and will have to wait for a response from the doc. (he knows more than I do, and I'm having him be part of the process, every step of the way) Also, it turns out the I have very minor sleep apnea, probably caused by my medications, and we still don't have a clear answer as to the cause of the sleep problem, although, decreasing the Lyrica so far has helped quite a bit!
26 Aug 2010
Hi JK, Have you tried Valium? I hear it has benefits as far as muscle pain goes. I haven't tried it... yet, but I am thinking about switching from Xanax to valium. Other people on this site have recommended valium.
Just a thought buddy.
4 mgs of Xanax a day seems like a high dosage to me, but what the hell do I know...
26 Aug 2010
Hi there jk13. Sweetlemon stole my answer! She does that often. I'm very happy to hear you're getting off the Ultram and upping the dose of methadone as needed. Ultram (in my experience) doesn't help much with pain and is still addicting even though it's technically a non opiate. So if you need around the clock opiate pain control, methadone is your best defense. But extremely difficult to kick. As far as the benzo, sweetlemon is right about the valium. For me personally, it's helped the most and lasts the longest without too much of a "benzo hangover" feeling. You know, once you get your meds all figured out, you'll be pleasantly surprised how productive and happy you can be. It's just so darn frustrating getting there! But over the years (and I don't know why) if my pain is under control, I don't need anti depressants.
For the longest time, my docs thought chronic pain (if not too severe) wouldn't necessarily cause depression. Wrong! And depression is just as debilitating as physical pain. I'm happy to hear your docs are seeing the real you and a good relationship has been forged. It is vital for a good recovery and figuring out the proper meds you need and being trusted to stick to the dosage. So many doctors are apprehensive about prescribing these meds to people. That is the best thing you have going for you. Too many people are scamming good doctors. I can't imagine what it must feel like to lose a good doctor because I wasn't trusted with my meds. But my time has come as well. It's been months since I needed an increase in my dosage. And until my back is properly fixed, medication is my only option. It sounds to me like it's just a matter of time until you get the right meds and dosages. And I would certainly bring up valium as an option with your doctor. Good luck to you my friend. Have a nice day and be sure and keep us posted on your progress!
26 Aug 2010
Hi jk, I am starting toget familiar with where you want to be with your meds., that is why I was happy to hear there are some changes already. Now, just like the first time you asked for an open opinion... you know the rest. The only thing I can argue about xanax, is that it actually brings some type of "high" with it. I know people who say they have lost whole days and only remember bits and pieces of what happened. The only other thing about xanax is it has such a short half life. If you take xanax every day for six months or so, you can take in in the morning and if you miss your evening dose, by eight o'clock at night you are already starting to have muscle spasm and tension headaches. Valium is OK, but it is the generics that bother me. Stay away from the mylan, they can be eaten like candy with no real help. They have other generics of valium that work better. Now personally I would rather take klonopin, I take that 2mgs. twice a day.
I haven't had to adjust the dose for years and as you know I take Methadone for chronic pain. When you reach your "comfort zone" with the methadone you will know. You won't be so sleepy you can't keep your head up, you should be able to do all routine activities without any problem. You may need to consider using either Lyrica or neurotin (Gabapentin) Nerve pain is entirely different. anyhow, that is my two cents (ok four) Let me know how things are going until you get to your next doctors appointment. Fall Queen
4 Oct 2010
You mentioned somewhere near the top that have the meds not make you too sleepy during the day was important to you, or something to that effect. That being the case, you should probably leave the Valium alone. Its half-life is waaay longer than either Xanax or Klonopin, and I've never met anybody that doesn't feel sluggish during the day because of it. Also, if your main issue is panic attacks, as opposed to just straight anxiety (*without* panic attacks), Klonopin will almost certainly work better for you than Xanax.
As for dosage, someone said 4mg/day Xanax was a lot . . . nobody can say that without taking into account the tolerance level you've built up to the drug. For sure, if someone takes no benzos at all, and you give them 4mg Xanax, they'll probably pass out . . . but after being on it for a couple of years, it can take 2mg bars to do what 0.5mg did at the beginning . . . which is why the PDR specifies a Rx dose range up to 10mg/day of the drug.
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