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On low dose of clonazepam. Feeling anxiety. Should I increase the dose of medicine?

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Practicing since : 2003
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i have been on low dose of clonazepam for 5 years went off old XXXXXXX for 6 weeks 3 months ago had to increase my dose to 1mg to feel normal again tried to decrease by .125mg was ok then .25 but anxiety came back and is still there after going back to 1mg for the last week do i need to increase my dose again?
Posted Fri, 30 Nov 2012 in Anxiety and Stress
Answered by Dr. Jonas Sundarakumar 4 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you are going through a difficult time dealing with your anxiety. However, it is not advisable to increase the dose of Clonazepam further. Your recent fluctuating levels of anxiety seems to be due to the erratic levels of benzodiazepines of late. Withdrawal effects or rebound anxiety can sometimes last for weeks together.

Though a further increase may temporarily decrease your anxiety, it will make it even more difficult to come off the medication at a later stage. Moreover 1mg is a significant dose and higher the dose, more are the chances of rebound anxiety.

I would suggest the following:
1) Please wait on this dose for some more time and as your rebound anxiety settles down, you will be able to feel more in control.

2) If your symptoms are very distressing or disabling, then you should consider non-benzodiazepine anti-anxiety medication, which can be taken safely without this risk of habituation and rebound anxiety when coming off them at a later stage. SSRIs are usually effective anti-anxiety agents. There are also certain other medication like Buspirone, Flupentixol, etc. which can also effectively control your anxiety problem. Please discuss these options with your doctor.

3) There are also several psychological techniques and relaxation therapies, for example, progressive muscle relaxation, applied relaxation, biofeedback, etc. which can yield effective and long-lasting results. Additionally, you can also try simple relaxation techniques like XXXXXXX breathing, yoga, etc. which can be quite helpful.
Regular physical exercise helps in relieving both the physical as well as psychological symptoms of anxiety and also helps you stay more functional.

So, please stay motivated and be persistent in your efforts and you will soon be able to overcome your problem.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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