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If I have a paradoxical reaction to one benzo (klonopin), does that mean I will have one with a different benzo?

I have been taking 1mg of klonopin 3x a day for panic/anxiety disorder for about a week. I feel it helps with the anxiety (driving, people touching me, doing new things) but it does not calm me down when I feel panicky in fact I have been more panicky since I have started taking it.

Category: Psychiatrist

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Thanks for using for posting your query.
If you have an idiosyncratic reaction to one benzodiazepine, then its likely that you may have a similar reaction with other benzodiazepines as well. However, I would still advise you to persist with Klonopin for another 15 days, if its not a big trouble. Seven days is too short a period to comment on its efficacy.
Secondly, it would be wise to try taking Propranolol instead of taking another benzodiazepine. It acts well in anxiety disorders. Also, you may consider changing the antidepressant from pristiq to paroxetine which is even more effective.
Hope this helps. If you have any further query, do let me know.
Kind regards,
Dr. Srikanth Reddy MD

Patient replied :

I have been on klonopin for about a month now, we have been rasing the dose, and each time the efficacy falls short and the side effects (close family have noticed personality changes and spaceyness) rise. I will not stop taking pristiq because it has put my sever major double depression into full remission without any side effects.
I do agree with my 2 other psychiatrists (sleep and previous) that benzos are the appropriate medication for my particular situation since I cannot add another ssri without risking serotonin syndrome.
What I want to know is that if changing from one klonopin to another benzodiazapine (like xanax or ativan) would carry along the same paradoxical reaction. I have been on ativan but it was not dosed properly, and it did not carry with it paradoxical reactions.

As mentioned in my first reply, yes, as a class all the benzodiazepines share some common side-effects and the idiosyncratic reaction can also be there. As also mentioned in my first reply propranolol is a good treatment option for such anxiety disorders and dont have the side-effects inherent with benzodiazepines.
Kind regards,
Dr. Srikanth Reddy MD

Dr. Srikanth Reddy
Category: Sexologist
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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