Posted by Viridis on October 9, 2003, at 0:57:29
In reply to Re: BIG differences between benzos? » JaneB, posted by Shawn. T. on October 7, 2003, at 17:11:55
Hi Shawn,
I'm really impressed by your knowledge of benzodiazepine pharmacology, so maybe you'll have some insights into the following situation:
I've been taking 1 mg clonazepam (Klonopin)/day for about 2 1/2 years, and it continues to be effective for anxiety at the same dose. I also have alprazolam (Xanax) available for PRN use, and it worked very well for "breakthrough anxiety" for a long time. However, recently my tolerance to alprazolam seems to have increased dramatically, even though I only take it occasionally.
I asked my pdoc about this and he really couldn't explain it, except to say that he's seen this pattern before, and it seems to be specific to alprazolam. He didn't seem too worried, and just suggested that I take as much alprazolam as I need when I need it, as long as my frequency of use doesn't increase. He did add, though, that this is why he's especially cautious with alprazolam, whereas he has many patients who stay at the same dose of clonazepam for years.
He thinks that cross- tolerance to alprazolam from clonazepam seems unlikely, since the two are structurally quite different.
So, what's so difference between these two benzos, such that one can induce tolerance even with infrequent use, whereas the other just seems to plug away effectively for years at the same dose, used every day?
I realize that there probably isn't a simple answer, but any insights would be appreciated.
poster:Viridis
thread:266360
URL: http://www.dr-bob.org/babble/20031004/msgs/267107.html