Klonopin

Shrinkette recently posted about Klonopin being prescribed at excessively high doses:

When you see a patient taking Klonopin, it's helpful to recall the approximate dose equivalents:Klonopin 0.25 mg is approximately equivalent to Xanax 0.5 mg, or Ativan 1 mg, or Valium 5 mg, or Librium 10 mg. Of course, the kinetics are different, and there is tolerance and so on. But high potency meds can be...highly potent.
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I agree with her completely. Patients are often started out on a dose of Klonopin of .5 mg twice a day, which is probably too high of a starting dose. I think that the primary reason this is done is because .5 mg is the smallest dose that the Klonopin tab comes in (though the orally disintegrating wafers also come in .125 mg and .25 mg strengths).
When I start a patient on Klonopin, I typically have them take 1/2 of a .5 mg tab, twice a day. The manufacturers of clonazepam (Klonopin) really need to come out with a .25 mg tab.