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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 93. This is the beginning of the thread.
Posted by joe schmoe on December 8, 2012, at 14:26:40
I would be interested in hearing from anyone who has taken clonazepam for a long time (years, over a decade in my case) and decided/tried to taper off it.
I don't feel like it's helping me anymore, and I don't want to go down the road of increasing the dosage. I generally take either 1.5 mg or 2 mg a day, depending on stress levels. But frankly it doesn't seem to be protecting me from those surreal panic moments when I make eye contact at work under anything but the most relaxed of circumstances. So why stay on it? I suspect it is contributing to my depression, and probably my memory problems as well (though that could also be middle age).
Anyway, just starting to explore the topic of tapering off klonopin and it seems like most people who do, haven't taken it very long (by my standards). Anybody here take it for 5 or 10 years and get off it? How long did it take? Did you use the diazepam/Valium/Ashton method, or just (somehow) trim clonazepam into tiny enough pieces for a smooth taper?
I want to see what life is like off this med now. I suspect it will resemble what life is like on it, but hopefully with more mental acuity and less depression.
Posted by SLS on December 8, 2012, at 15:17:35
In reply to 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on December 8, 2012, at 14:26:40
Hi Joe.
I was on Klonopin for less than a year, but the withdrawal effects were hellish. I really didn't know how to go about tapering it back then, though. It was worse than Ativan withdrawal. I felt lightening bolts going off in my head. They were so bad, I swear I could see them. I have had a relatively easy time discontinuing Ativan using a flexible dosing strategy. I used decreasingly small amounts of Ativan as a PRN whenever the withdrawal symptoms appeared.
There are some reports of the successful discontinuation of benzodiazepines using Trileptal (oxcarbazepine). It is also being studied for treating alcohol withdrawal syndrome. Trileptal is not addictive.
http://www.ncbi.nlm.nih.gov/pubmed/18821451
http://www.ncbi.nlm.nih.gov/pubmed/16109591
- Scott
Posted by Hugh on December 8, 2012, at 15:32:53
In reply to 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on December 8, 2012, at 14:26:40
You might want to check out BenzoBuddies, but that site can be awfully depressing because so many people who post there have benzo horror stories. Someone on Psycho-Babble, I think Jono, posted that about one-third of people who taper off benzos have a really hard time, about one-third have some problems, but nothing too bad, and about one-third have no problems. Here's a case study about someone who used niacinamide to help him get off of clonazepam. It probably wouldn't be wise to taper as quickly as he did.
Posted by Phillipa on December 8, 2012, at 17:43:33
In reply to 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on December 8, 2012, at 14:26:40
Give it try either you will or will not require the klonopin. I also am tolerant to benzos and find that cutting down on them at this point doesn't make a difference. Try valium in the wean. Longer half life. Phillipa
Posted by gadchik on December 9, 2012, at 7:18:38
In reply to Re: 10+ years of Klonopin, poop out, tapering? » joe schmoe, posted by Phillipa on December 8, 2012, at 17:43:33
http://www.europeanneuropsychopharmacology.com/article/S0924-977X%2896%2900381-1/abstract
I found this interesting, using melatonin to help benzo withdrawal or to lower your benzo dose. Some lower their dose twice a week for several weeks, then 3x a week for several weeks, and so on,and have had success. Good luck to you.
Posted by AnnaKarenina on December 9, 2012, at 9:35:29
In reply to Re: 10+ years of Klonopin, poop out, tapering? » joe schmoe, posted by Phillipa on December 8, 2012, at 17:43:33
Congratulations on the attempt, wishing you success. I've not required much if any increase in benzos over many years, and dispute the whole idea of hairy withdrawal. My theory is to literally chip away ... go really, really slow.
It's perfectly intelligent to suspect Klonopin/clonazepam of those effects (affects?) ... and who knows, you may decide to stay at some low dose. It's all a big experiment.
FWIW, a meds expert said, Ativan is for getting you to sleep, Klono for staying there. Of course, Klonopin has other uses.
Posted by herpills on December 9, 2012, at 9:40:05
In reply to 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on December 8, 2012, at 14:26:40
I took Klonopin daily for about 5 years. My dose was 1mg/day with a couple times where I was on 1.5mg/day for a month or so. The first time I went off it my doctor decided I should be taken off of it and deal with my anxiety through therapy. I was also taking Lamictal and Geodon at the time.
I followed my doctors instructions and tapered off o.25mg every week. I thought this seemed like a fast taper but I went along with it. The taper itself wasn't too bad. It was a couple weeks later after my last dose when I started having problems. Anxiety was bad, but even worse was the severe depression I experienced. About 3 months after my last dose I found myself at a new primary care office explaining how bad I felt and that I thought the Klonopin withdrawal was at least partially responsible for how I felt. The doctor made no attempt to differentiate whether my symptoms were due to the withdrawal or to my own mental health issues I was already dealing with. I was labeled a doctor shopper and put on Seroquel. I continued to deteriorate and ended up in the hospital, inpatient for a week. When I told a doctor in the hospital I thought the Klonopin withdrawal was responsible for how I felt, he simply looked at me and said "not possible"
Well they put me back on Klonopin anyway and now I was on a higher dose than I was before. A couple of months after my hospitalization I was able to lower the dose back to 1mg/day. I stayed a this dose again for about 18 months.
I then felt everything that you are describing, that it was no longer effective/I had developed a tolerance, that it was making my mood worse. I was back with a pdoc at this point, and I discussed how I felt about continuing Klonopin. There was some discussion about Neurontin or Lyrica, but somehow at the end of the appointment I ended up with a script for Ativan 1mg/day. So...I'm still on a benzo, which makes me concerned a little because of my past experiences. I will say I am doing better on the Ativan although I think I might need to raise the dose to 1.5mg/day.
My best advice to anyone about to start a taper is to make sure you have access to the drug you are tapering off of in case you get debilitating withdrawals and need to resume at a lower dose until you feel better. In my case I was in a situation where I was forced to change doctors (the mental health clinic where I was going deemed me "stable" and discharged me...) and the new doctor refused to prescribe me the Klonopin.
I truly believe my hospitalization could have been prevented.
In summary, go slow, be prepared for the worst, but maybe it will not be as bad for you as it was for me. Good luck. herpills
Posted by neuroscience on December 9, 2012, at 10:14:22
In reply to 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on December 8, 2012, at 14:26:40
> I would be interested in hearing from anyone who has taken clonazepam for a long time (years, over a decade in my case) and decided/tried to taper off it.
>
> I don't feel like it's helping me anymore, and I don't want to go down the road of increasing the dosage. I generally take either 1.5 mg or 2 mg a day, depending on stress levels. But frankly it doesn't seem to be protecting me from those surreal panic moments when I make eye contact at work under anything but the most relaxed of circumstances. So why stay on it? I suspect it is contributing to my depression, and probably my memory problems as well (though that could also be middle age).
>
> Anyway, just starting to explore the topic of tapering off klonopin and it seems like most people who do, haven't taken it very long (by my standards). Anybody here take it for 5 or 10 years and get off it? How long did it take? Did you use the diazepam/Valium/Ashton method, or just (somehow) trim clonazepam into tiny enough pieces for a smooth taper?
>
> I want to see what life is like off this med now. I suspect it will resemble what life is like on it, but hopefully with more mental acuity and less depression.You could try and stay on it but with a higher dose if possible.
Posted by jono_in_adelaide on December 10, 2012, at 22:11:35
In reply to 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on December 8, 2012, at 14:26:40
Cut it back by 0.25mg at a time, and let your body be the one to determine how long you leave between reductions
I'd suggest between 2 and 4 weeks, favouring the latter, there isnt any inidiate rush to discontinue the med, and there is evdience that people who discontinue more slowly do bettwr.
If you arnt already taking an antidepressant for your panic disorder, then start..... sertaline (Zoloft) is a good one, start off at 25mg per day for a week, then 50mg per day, then 100mg per day. You can go upto 200mg per day if you need to. This treatment isnt habit forming and there is no tolorance. If sertaline isnt effective, mirtazapine 30mg at bedtime would be well worth a shot, it is a powerful antidepressant and antianxiety agent, and again isnt habit forming.
Posted by joe schmoe on February 10, 2013, at 19:42:40
In reply to 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on December 8, 2012, at 14:26:40
Well a few days ago I continued the gradual taper down to .25 mg AM/.125 mg PM (daily baseline of 1 mg/1mg clonazepam).
Starting to get some really unpleasant withdrawal effects. Had some bad social anxiety at .25/.25 but at .25/.125 I really have started getting weird symptoms like tingling and numb hands when I wake up, stiff neck, the runs, sweating, racing heartbeat etc.
No fun. Drinking alcohol helps in the evenings to some extent. Not recommended I know, but, I need some relief now and then.
Also am very sensitive to stimuli now, every sound seems too loud. On the plus side, sexual sensation is greatly enhanced.
Posted by herpills on February 17, 2013, at 7:30:14
In reply to Re: 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on February 10, 2013, at 19:42:40
Thank you for sharing your update. I had what you are experiencing in regards to being sensitive to sound, with things sounding louder. Actually sometimes things that are loud would also sound muffled to me.Which do you find more bothersome, the mental withdrawal symptoms like social anxiety, or the more physical withdrawal symptoms?
Good luck your taper and let us know how it goes, herpills
Posted by joe schmoe on February 18, 2013, at 16:37:20
In reply to Re: 10+ years of Klonopin, poop out, tapering? » joe schmoe, posted by herpills on February 17, 2013, at 7:30:14
> Which do you find more bothersome, the mental withdrawal symptoms like social anxiety, or the more physical withdrawal symptoms?
Depends on where I am. If I am alone at home, the physical symptoms are what bother me. If I am in a social situation (like work) the anxiety is of more concern.
Posted by joe schmoe on February 18, 2013, at 17:00:53
In reply to Re: 10+ years of Klonopin, poop out, tapering? » herpills, posted by joe schmoe on February 18, 2013, at 16:37:20
I should add I just had an unsettling experience at the store, I forgot my PIN number for my debit card.
Never done that before. I am sure it is related to the clonazepam taper (down to .125 AM / .125 PM as of Saturday). Hitting some turbulence.... I am hoping to reduce to none AM / .125 PM in a week and a half or so, and then a week and a half after that, to be done.
My memory is definitely not what it used to be. But is it middle age, or a decade of klonopin?
Posted by joe schmoe on February 22, 2013, at 6:48:28
In reply to Re: 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on February 18, 2013, at 17:00:53
Been at .125/.125 for a week. Very unpleasant. My chest/ribcage muscles were so tight yesterday that it hurt to yawn. My neck often tightens up when I am trying to go to sleep as part of some kind of anxiety attack. Have trouble getting to sleep and I wake up early, resulting in an increasing sleep debt. Minor sensory disturbances are frequent and often make me wonder if I really heard something or not.
Drinking alcohol in the evening gives some relief for a while. It hits me a lot harder than it used to, so I am getting convinced of the benzo/alcohol cross tolerance thing.
I think I will stay at this dosage for longer than I planned, until the unpleasant effects are reduced. I have a feeling that lowering the dosage now would be extremely unpleasant.
Posted by herpills on February 23, 2013, at 8:53:24
In reply to Re: 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on February 22, 2013, at 6:48:28
Yes Joe I agree you should stay at that dose for awhile. Feel better. herpills
Posted by gadchik on February 28, 2013, at 8:19:02
In reply to Re: 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on February 22, 2013, at 6:48:28
Joe, Have you tried a small amt of melatonin to help get your sleep back on track? A pharmacist told me I could try a small dose to help with that when Ive tried(been unsuccessful) to lower my klonopin dose.
Posted by joe schmoe on February 28, 2013, at 16:35:11
In reply to Re: 10+ years of Klonopin, poop out, tapering?, posted by gadchik on February 28, 2013, at 8:19:02
> Joe, Have you tried a small amt of melatonin to help get your sleep back on track? A pharmacist told me I could try a small dose to help with that when Ive tried(been unsuccessful) to lower my klonopin dose.
No. That's an interesting idea, it never occurred to me.
I haven't taken melatonin in a very long time. I seem to recall that the best dose was around 300 mcg, which was hard to find since most of the doses sold were 3 mg or more. Supposedly a dose of 3 mg would be so large that it would cause paradoxical effects and actually result in insomnia.
Have you taken it? If so what dose did you try and did it work?
Posted by gadchik on February 28, 2013, at 17:17:22
In reply to Re: melatonin for insomnia » gadchik, posted by joe schmoe on February 28, 2013, at 16:35:11
Joe, I have a bottle of it, however,Ive never taken one! I didnt taper my klonopin,so I really didnt need it. I have a panic response the first time I take any new medicine,so I was afraid to take it when I did try to taper. But supposedly it helps people with sleep when tapering off a benzo. I have a friend who takes melatonin every night,loves it. She's not on any psych meds though.
Posted by joe schmoe on March 1, 2013, at 7:00:40
In reply to Re: 10+ years of Klonopin, poop out, tapering? » joe schmoe, posted by herpills on February 17, 2013, at 7:30:14
Last night I decided to lower my dose again, so I didn't take my evening dose. So now I am at 0.125 mg in the morning and that's it.
Usually there is a three day delay before I feel a dosage reduction but last night I felt it immediately as I got weird sensations in my head, tight neck, little anxiety attacks etc as I lay in bed trying to get to sleep.
I am sure it will only get more fun in the next few days.
Weird effects continue. I have gone from a great increase in libido and sexual sensation at first, to virtual sexual anesthesia lately, during this taper. Very strange. Makes me wonder where I will end up.
Posted by gadchik on March 1, 2013, at 10:23:32
In reply to Re: 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on March 1, 2013, at 7:00:40
I admire you for continuing on, I know it must be very difficult. I cannot stand the feeling of lowering my dose of k. Maybe one day, I can
Posted by joe schmoe on March 1, 2013, at 16:29:21
In reply to Re: 10+ years of Klonopin, poop out, tapering? » joe schmoe, posted by gadchik on March 1, 2013, at 10:23:32
Today my lips alternated between numb and tingling. I was in a store looking at melatonin bottles and jumped when a store employee behind me asked if I needed help. I also have heard a high pitched whine all day anytime the background noise was low (work is often quiet as a tomb, so I heard it a lot).
Klonopin withdrawal is like a box of chocolates, you never know what symptom or sensory distortion you'll get next. At this point I just shake my head and laugh at the ridiculous parade of symptoms. At least the sheer variety and randomness of them is somewhat entertaining.
The worst ones I think are the weird panic sensations when I am trying to go to sleep, it feels like I am about to have a seizure. At least I imagine that is what it feels like, since I have never had one to my knowledge. At work I have had severe anxiety, inability to look people in the eye for very long without my neck muscles stiffening and trembling etc. but I tell myself they probably can't tell, and even if they can, who cares. Lots of strange people at work, I'm no weirder than the rest of them.
Posted by joe schmoe on March 1, 2013, at 16:31:16
In reply to Re: melatonin for insomnia » joe schmoe, posted by gadchik on February 28, 2013, at 17:17:22
I got some melatonin at the store, 1 mg tablets, I plan to break them in half.
Tonight will be interesting.
Posted by gadchik on March 1, 2013, at 16:41:10
In reply to Re: melatonin for insomnia » gadchik, posted by joe schmoe on March 1, 2013, at 16:31:16
I sure hope you do not have too much trouble tonight,although, as you said, you never know what you may get. Please let me know if there is any relief with the melatonin on board.
Posted by phidippus on March 1, 2013, at 19:43:23
In reply to Re: 10+ years of Klonopin, poop out, tapering?, posted by joe schmoe on February 22, 2013, at 6:48:28
You've probably accrued some tolerance, which would mean you need to up your dose a little.
Drinking will help anxiety, as alcohol agonizes GABA receptors, plus it is an NMDA antagonist. Unfortunately, alcohol is not the best medicine, as its side effects can be devastating.
The best way to treat anxiety is with an SSRI or other antidepressant. ADs treat the root of the problem, where as benzodiazapines throw a blanket over the fire.
Eric
Posted by joe schmoe on March 1, 2013, at 19:55:58
In reply to Re: 10+ years of Klonopin, poop out, tapering? » joe schmoe, posted by phidippus on March 1, 2013, at 19:43:23
> You've probably accrued some tolerance, which would mean you need to up your dose a little.
>
> Drinking will help anxiety, as alcohol agonizes GABA receptors, plus it is an NMDA antagonist. Unfortunately, alcohol is not the best medicine, as its side effects can be devastating.
>
> The best way to treat anxiety is with an SSRI or other antidepressant. ADs treat the root of the problem, where as benzodiazapines throw a blanket over the fire.
>
> EricWell I am putting it to the test, since I am already on an SSRI (have been for almost as long as clonazepam). We'll see how I fare off clonazepam. I am not convinced that an SSRI can handle the kind of massive, altered-state social anxiety I have in the times it matters most, like job interviews. But I plan to take clonazepam and Inderal for such occasions as needed anyway.
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