Posted by Anthony Quest on May 4, 2004, at 9:08:42
In reply to I called the pdoc last night, posted by hundredhugs on May 3, 2004, at 7:59:10
I am really sorry that my last two posts didn't post correctly. It was my fault, and I really felt that what I had to say might be important so please indulge me for posting this third response (last two were blank).
Since you were at 4 mg dose instead of 2mg dose a day and you just realized the mistake and you also point out that you are on some other meds for other issues, I think you see your doctor ASAP. If symptoms get worse go to the office or ER without waiting.
I say this because you mention "shaky". This could be just a mild withdrawal. It could also be the beginning of acute severel withdrawal - the type that leads to seizures and can be fatal. Unlike withdrawal from opioids, benzodiazepine withdrawal symptoms are not just unpleasant and hellish but potentially serious and sometimes fatal.
Don't just watch and wait. You could wait and it could be too late.
If your doctor hasn't said not to taper and you are shakey, I would go ahead and resume your Klonopin as prescribed and this time begin with a taper schedule. Klonopin is long acting or medium acting or short acting depending on whom you ask or the source you consult. It's entirely possible your withdrawal is hitting you now, and it could be bad.
Please do something now, just on the chance you could be experiencing a serious medical event. The consequences of being wrong are nothing but being prudent and cautious. Just waiting could end up costing you a lot.
This is also a good reason to always seek professional medical advice and never just rely on internet boards.
While I think what you hear here is better than a lot of what the advice doctors give their patients, there is no way any of us know your past medical history, comorbid conditions, the potential to mix up your 2mg pills with 1 mg.
If you have an underlying seizure disorder problem or are taking another medication that increases the seizure risk, that's all the more reason not to take any chances in not tapering or waiting to see your doctor.
Did your doctor really recommend no tapering from either a 4mg or 2 mg dose? If so, I don't think that is within what is considered general practice. You might want to check with her to make sure there was no misunderstanding but the tapering idea is fairly universal.
You might want to consider a complaint with the State Medical Board. I don't mean this to be a vindictive move on your part, but if you have a physician who simply gets this sort of thing wrong, my experience is you aren't the only one, and the next person may not have this resource to use to find out what they should do.
The State Medical Board hopefully will check her records and make sure she's not endangering others and if not she'll get called in for a informal conference and perhaps given a sanction of continuing medical education in proper prescribing and care of benzodiazepines. There is no way to know though and every state medical board is different.
I just feel that you shouldn't be left wondering what to do. The doctor has a responsibility to you to help and give you as much care and advice as you need in stopping a medication as you need to do it safely.
It does not sound to me as if you got it, and I am upset for you. Of course, I don't have all the facts and if you do and what I say doesn't sound right, just as usual with advice, feel free to take it or leave it.
Anything like elevated pulse, changed blood pressure, or more shakiness, go straight to the ER. Anything like seizures of course means call 911 and don't drive. If this is just mild withdrawal, then I am needlessly being alarmist, but I wouldn't want to take the chance on it.
Anthony
> I called the pdoc last night because I was feeling "drunk", shakey, mentally foggy and nauseated and didn't know if it was my lithium or the klonopine. I was outside alot yesterday and it was hot and I didn't drink as much as usual, but I am on a low dose of lithium. Anyway the call came back that it was probally the klonopine. Before I put a call into her I took what I thought was 1 mg of klonopine, but it was the green tab (2 mg). I then had the horrible relization that i had not been taking 2 mg all this time for at least 2-3 months (or longer), but 4 mg. So I must be doing suprisingly well, to get a little nauseated and shakey a couple times.
>
> My pdoc said that if i wasn't feeling better today she would see me in an emerengcy slot (before thursday on my regular appt). I guess I will wait and see how I feel.
>
> I feel so stupid for making that mistake!
>
> Hundredhugs
poster:Anthony Quest
thread:341997
URL: http://www.dr-bob.org/babble/20040429/msgs/343159.html