Posted by chemist on April 26, 2004, at 15:32:05
In reply to Re: klonopinchemist, posted by Kon on April 26, 2004, at 11:56:36
> > "klonopin is notorious for tolerance at about 6 months"
>
> Unless I missed something in the literature, I've never come across this. In fact, in the Worthington et al. (1998)study "clonazepam alone" dose for panic disorder tended to decrease from 1.53 mg/day at 6 months to 1.22 mg/day at 12 months. The majority of patients tended to maintain same clonazepam dose or decrease dosage over time. Similar data exist for social anxiety disorder. Overall, most of the material I've come across suggests no evidence for tolerance wrt anti-anxiety effects. I'm also interested in knowing where you got the 6 month figure. Any references would be appreciated. Thanks
>
hi kon, the ~3 pages of text i had written for posting strangrly disappeared. there are references (suzuki, several) and the worthington paper (psychopharma bull, 1998) abstract states ``clonazepam doses remained stable over time,'' so i am not sure where the decrease in dose you mention comes from, but i do not have the m.s....the data for clonazepam losing efficacy or reaching therapeutic dose in a short time is well-documented in literature concerning using it in patients with seizures (e.g., the suzuki papers and one by loscher et al., j. pharm. exp. ther. 1996). see rosenberg et al., epilepsia 30:276-285, 1989, for evidence that doubling the dose of clonazepam does not result in increased antiseizure activity. another abstract states ``...tolerance to the antipanic or antiphobic effects of clonazepam...does not occur in panic disorder/agoraphobia; doses also tend to decrease over time,'' (davidson, j. clin. psy. 51A:31-37, 1990). my point - which i think i was quite muddy about - was that tolerance to clonazepam does not appear to emerge quickly and thus dosing must continue upwards until asymptotically hitting the right dose.......as for the 6 month thing, a goof on my part, some internal information from a series of studies i participated in, apologies for the stonewall, but cannot disclose...all the best, chemist
poster:chemist
thread:339715
URL: http://www.dr-bob.org/babble/20040423/msgs/340270.html