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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 53. This is the beginning of the thread.
Posted by AndyD on January 1, 2004, at 10:55:25
Hey all,
Please do not take this post as boasting, but as hope. In addition, I would like to ask some questions. I have been on klonopoin for almost 4 months. Started at .25mg 2x a day, but still wasnt free from my agoraphobia. Not totally. My area increased but still with mediocre amounts of anxiety. Panic attacks were very infrequent and very mild. Found a Harvard study that said less that 1mg a day was not effective....so I jumped up to .5mg 2x a day. Within 1 week I felt very different. I went to Texas for Christmas, I live in Kentucky, with not so much as an anxious moment, well maybe one between Nashville and Memphis, its a lonely road, but it never amounted to anything. Question: Has anyone been on this stuff for long periods of time with any negative effects. I read conflicting reports.
Thanks
Andy
Posted by Maxime on January 1, 2004, at 16:29:15
In reply to Long Term Klonopin Usage, posted by AndyD on January 1, 2004, at 10:55:25
Hi Andy. I have been on various dosages of Klonopin since 1997 anywhere from .25 mg up to 3 mg. Not only does it help anxiety it also has anti-depressant properties to it. I take it for bipolar illness as a mood stabiliser.
So in MY case, no ill effects that I can see or felt.
Maxime
Posted by AntiTrust on January 1, 2004, at 17:43:39
In reply to Long Term Klonopin Usage, posted by AndyD on January 1, 2004, at 10:55:25
Hello Andy,
I know of a person that has been on Kolonpin 2mg 3x daily as needed for 3 years. works great, but with it being a triplicate script in my state, one screw up and a missed doctor visit for a new script....just by 2 days....major I mean MAJOR PAINIC returned....I could go into details but wont, I think if you have experienced panic and how it all feels you know!!!!
Posted by Viridis on January 1, 2004, at 20:36:38
In reply to Long Term Klonopin Usage, posted by AndyD on January 1, 2004, at 10:55:25
I've been on it for 2 1/2 years (1 mg/day) with excellent results, no side effects, and no need to increase the dose. My pdoc is very careful with benzos, but really likes Klonopin for anxiety/panic patients because he says that this is a common pattern -- many people can stay on it for years at the same dose and still achieve the same results.
Of course, if you do go off it, it must be done gradually. I can accept that, given the high benefit:risk ratio.
Posted by Siraris on January 2, 2004, at 4:57:45
In reply to Re: Long Term Klonopin Usage, posted by Viridis on January 1, 2004, at 20:36:38
I have been on Klonopin, 1 - 1.5 mg's for 7 years. It has honestly saved my life. I would most likely be suicidal if I wasn't taking this drug, as I would be having panic attacks all the time. I tried weaning off for fears of it causing cognitive issues, and when I dropped .5 mg I started having panic again. I went back up to 1 mg and the next day I literally woke up and almost felt like dancing around the house I felt so good. I found myself singing and I feel great.
Klonopin is a life saver... let's just hope it doesn't cause something like infertility or sudden death at age 45 :P
Posted by psychlover on January 3, 2004, at 21:06:21
In reply to Re: Long Term Klonopin Usage, posted by Siraris on January 2, 2004, at 4:57:45
I have been taking Klonopin for almost a year for panic attacks. I started on 1 mg, then 0.5 mg for a long time, now .25 for the last few months. It has helped tremendously with the panic attacks -- I was free of attacks at 0.5, but I wanted to decrease my dosage because of concern for long-term adverse side effects, esp. re: cognitive ability. I really don't know if this stuff is good for you in the long-term....
Posted by ian24 on January 4, 2004, at 0:18:01
In reply to Re: Long Term Klonopin Usage, posted by Siraris on January 2, 2004, at 4:57:45
I have been on it for a year and a half. I think the cog stuff is just while you are on it. I mean I know people who drink and smoke pot every day so I am not worried about it. Plus, I think benzos have been around for 50 years. They are addicting but not brain damaging or else they would have found out by the time valiuim turned 50
Posted by cubbybear on January 4, 2004, at 2:15:37
In reply to Re: Long Term Klonopin Usage, posted by ian24 on January 4, 2004, at 0:18:01
>Plus, I think benzos have been around for 50 years. They are addicting but not brain damaging or else they would have found out by the time valiuim turned 50
Hello Ian,
If I'm not mistaken, the first benzo drug, Librium, made its debut in 1963 and valium came around sometime after that. A number of discussions have flared on this board about the use of the word "addicting". I nearly blew up in a GP's face when I told her that I was weaning off Klonopin, and she brazenly thundered, "You're going to get addicted!" Absolute B.S.
I'd venture that the preferred phrase for this class of drugs would be "inducing tolerance or dependency." There *is* a big difference.
Posted by psychlover on January 4, 2004, at 2:50:25
In reply to Re: Long Term Klonopin Usage, posted by ian24 on January 4, 2004, at 0:18:01
> I think the cog stuff is just while you are on it.
I wonder if that is true with long-term usage as well. I would think it might have a lasting effect on different receptors.
> I mean I know people who drink and smoke pot every day so I am not worried about it.
Yeah, but I think those people usually look the worse for wear, don't you think? I hope Klonopin doesn't do that to me! ;-)
> Plus, I think benzos have been around for 50 years. They are addicting but not brain damaging or else they would have found out by the time valiuim turned 50
I would like to know if anyone *does* have sources on the long-term effects on cognitive functioning.
Posted by Siraris on January 4, 2004, at 4:18:26
In reply to Re: Long Term Klonopin Usage » ian24, posted by psychlover on January 4, 2004, at 2:50:25
I have been on Klonopin for 7 years, max 1 mg. It is a life saver, and I would not be here today if it wasn't for it. I have never read anything on long term effects, nor has anyone I have ever talked to ever said there were long term cognitive effects.
I have been having issues with memory recall for a while, but I don't know if it is Klonopin or not. My Pdoc has said in 40 years he has never had anyone with any real cognitive problems from Klonopin. I think it is more of me hyperfocusing that my memory is not pristine, amonghst other factors.
As for it's addictiveness, if you wean off it, you can get off any drug. I tried getting off to see what kind of cognitive effects it would have on my memory, and even after dropping half a mg I started having panic attacks again. Anyone who has said they have issues getting off, and state their symptoms, they are symptoms of having panic attacks again, not withdrawl symptoms.
Posted by psychlover on January 4, 2004, at 13:04:10
In reply to Re: Long Term Klonopin Usage, posted by Siraris on January 4, 2004, at 4:18:26
> I have been having issues with memory recall for a while, but I don't know if it is Klonopin or not.
My neurologist said that Klonopin inhibits the formation of new memories (because it increases GABA, I believe), hence the short-term recall problems.
> I tried getting off to see what kind of cognitive effects it would have on my memory, and even after dropping half a mg I started having panic attacks again.
Same thing happened to me, but I stuck it out through the panic attacks, so I am now down to 0.25 mg a day. I still get anxious though sometimes and think I am going to have a panic attack. Not a perfect solution for me.
>Anyone who has said they have issues getting off, and state their symptoms, they are symptoms of having panic attacks again, not withdrawl symptoms.
My psychiatrist told me the exact opposite, that they were in fact withdrawal reactions. This does not mean Klonopin is addictive however. This just means that your body becomes habituated to a certain amount in your body and reacts when that substance is no longer available.
Posted by Kon on January 4, 2004, at 17:41:27
In reply to Re: Long Term Klonopin Usage » Siraris, posted by psychlover on January 4, 2004, at 13:04:10
> My neurologist said that Klonopin inhibits the formation of new memories (because it increases GABA, I believe), hence the short-term recall problems.
A review of this topic can be found at the following link:
http://www.benzo.org.uk/ashtox.htm
See "Impairment of Memory" section.
Despite these potential side-effects with some benzos in some subjects, other researchers argue that the balance of studies suggest klonopin (clonazepam) is still one of the most effective and safe medications for anxiety. The alternatives (SSRIs or some MAOIs like Nardil)have far more side-effects (including potential memory problems)and dependecy/withdrawl problems (SSRIs). So Prof. Ashton's recommendation of replacing benzos with SSRIs doesn't make sense since quite a bit of data exists suggesting that SSRIs have (on the average) a poorer side-effect profile than benzos and are arguably less effective for anxiety.
>Anyone who has said they have issues getting off, and state their symptoms, they are symptoms of having panic attacks again, not withdrawl symptoms.
It's very hard to tell. It's probably a combination of both. Withdrawl symptoms (including anxiety) have been shown to occur even in normal subjects (with no previous history of anxiety/depression)following discontinuation of benzos. This is pretty convincing evidence that anxiety can be due to withdrawl. The problem is that the same can be said with SSRIs and arguably to a greater degree. See WHO and UK data in "social audit".
Posted by Viridis on January 5, 2004, at 1:11:01
In reply to Re: Long Term Klonopin Usage, posted by Kon on January 4, 2004, at 17:41:27
My memory and cognition are infinitely more severely impaired when I'm very anxious and/or depressed than when I'm on a benzo like Klonopin. I'm also much less functional on SSRIs etc. Klonopin (and Xanax) just make me feel normal, period. I did have a little sleepiness and short-term memory loss at the very beginning, but this disappeared very quickly.
As for withdrawal -- it's the same old thing -- is the anxiety that you feel when you go off a benzo really any worse than what you experienced before? I went off Klonopin a few times early on, but when my pdoc asked if the "withdrawal" was worse than what I'd experienced prior to its use, honestly I couldn't say yes (I doubt it was -- I think I was just back to my previous mental state).
I'd never advocate that a long-term user of these meds stop suddenly (this could actually be dangerous), and I don't doubt that withdrawal can be very real. I just wonder how many ex-benzo users really went through serious withdrawal, and how many simply forgot how badly off they were before using these meds.
Posted by psychlover on January 5, 2004, at 1:15:24
In reply to Re: Long Term Klonopin Usage, posted by Viridis on January 5, 2004, at 1:11:01
I just read something about how people who are taking benzos (like Klonopin) for panic attack (like I am) don't try and make behavioral changes (I guess that means get specific therapy) to address their panic disorder and rely instead on the meds. I for one have been almost panic free on Klonopin, esp. before I lowered my dose, and I have not gone for therapy specifically to treat the panic.
Anyone else with the same experience?
Posted by nobodyz on January 5, 2004, at 2:07:51
In reply to Re: Long Term Klonopin Usage, posted by psychlover on January 5, 2004, at 1:15:24
Since the question has been asked a few times above, I offer this link:
http://www.cwhn.ca/resources/kickers/benzo.htmlHaving done that, I would like to say that while it is quite possible to find scary information regarding Klonopin, it's also possible to find scary information regarding ANY prescribed substance. I will say that I have taken this medication at very low doses for around 15 years and have done so primarily as a result of having tried over 18 other meds with doctor help in that time and never found one that worked as well with as few a number of side effects. Truth is, anything can be harmful when it is not natural to our physique. It really is a matter of making oneself into an informed consumer. The choice, once informed, is then ours and it's important to weigh carefully and to also remember that medicine is considered a "practice".
Posted by zeugma on January 5, 2004, at 2:51:08
In reply to Re: Long Term Klonopin Usage, posted by psychlover on January 5, 2004, at 1:15:24
> I just read something about how people who are taking benzos (like Klonopin) for panic attack (like I am) don't try and make behavioral changes (I guess that means get specific therapy) to address their panic disorder and rely instead on the meds. I for one have been almost panic free on Klonopin, esp. before I lowered my dose, and I have not gone for therapy specifically to treat the panic.
>When I was undergoing CBT I was experiencing numerous periods of increased anxiety, and CBT dogma (as expressed in David Burns's book "Feeling Good" (which my therapist asked me to buy after the first session)) says that benzodiazepines make it too easy for anxiety sufferers because they do not have to "face their fears" while on the meds. Burns instead touts SSRI's as a non-addicting adjunct to therapy that won't interfere with the CBT process.
Well, whether SSRI's are "addicting" or not is a matter of terminology: I have seen people go through withdrawals on SSRI's that looked nasty, caused a lot of missed work, and were protracted over a period of months. AND they don't seem to work as well!
The irony is that if I had Klonopin at the time the therapy itself would have been a lot more productive. Burns makes it sound in his book that people on benzos are like junkies living only for their next high, completely indifferent to whatever 'issues' they had previously as the next dose of drug fills their veins. I still need to work out my issues, and what is more I am actually more aware of them than ever, because I'm less likely to become anxious over trivial things. I think that people with severe anxiety need medication to get through the therapeutic process, and that people like Burns don't understand that severe anxiety is no more the product of a bad 'cognitive schema' than severe depression is.
> Anyone else with the same experience?
Posted by Mr. Scott on January 5, 2004, at 22:37:02
In reply to Re: Long Term Klonopin Usage » psychlover, posted by zeugma on January 5, 2004, at 2:51:08
In My Experience...
SSRI withdrawal is easily managed. Benzodiazepines induce physical dependence and a degree of tolerance, although some of the anti-anxiety effect stays forever. They clearly worsen memory, but so does depression and anxiety so it can be complicated. I have taken them on and off for over a decade. My good friend has taken klonopin specifically for 10 years. He swears by it, and believes he would be dead without it. At the same time he is in a lot of emotional pain, his memory is terrible, and he still seems highly anxious to me despite having his brain a bit foggy. I didn't know him before hand though and says he was 10 times worse!
I think they are like all medicines. Some good and some bad effects.
Scott
Posted by psychlover on January 5, 2004, at 23:03:45
In reply to Re: Long Term Klonopin Usage, posted by Mr. Scott on January 5, 2004, at 22:37:02
Yeah, my mom has been on Klonopin (she was on Xanax before that) for like 10-15 years, and her memory is awful, she can never find the word she is looking for, and she feels like she is becoming senile (she is only 56). It is sad to see really, which is why I want to get off this med if I can. I mean, she doesnt have panic attacks anymore, but she still is too phobic to drive (she stopped abruptly about 15 years ago). So I am sure it has helped, but not completely, and not without significant cost.
Posted by Siraris on January 6, 2004, at 2:04:41
In reply to Re: Long Term Klonopin Usage, posted by Mr. Scott on January 5, 2004, at 22:37:02
What pisses me off about the whole situation is I feel the same way as your friend. As I've said a million times I've been taking it for 7 years, and I don't know whether it's anxiety or the meds. I tried dropping .5 mg and I felt like crap and didn't see any improved cognition for that week or so.
Mr Scott - Your Mom, although 56, is most likely experiencing menapause and old age. That is what is causing her memory issues. My mother has the same thing and has never taken a drug besides tylenol. It's just age, I'm sorry to say its what we have to look forward to. But trust me, if it's the meds, they are only contributing slightly to the other major problems that she is having.
Posted by rutt on January 6, 2004, at 15:45:49
In reply to Re: Long Term Klonopin Usage » psychlover, posted by zeugma on January 5, 2004, at 2:51:08
> > I just read something about how people who are taking benzos (like Klonopin) for panic attack (like I am) don't try and make behavioral changes (I guess that means get specific therapy) to address their panic disorder and rely instead on the meds. I for one have been almost panic free on Klonopin, esp. before I lowered my dose, and I have not gone for therapy specifically to treat the panic.
> >
>
> When I was undergoing CBT I was experiencing numerous periods of increased anxiety, and CBT dogma (as expressed in David Burns's book "Feeling Good" (which my therapist asked me to buy after the first session)) says that benzodiazepines make it too easy for anxiety sufferers because they do not have to "face their fears" while on the meds. Burns instead touts SSRI's as a non-addicting adjunct to therapy that won't interfere with the CBT process.
>
> Well, whether SSRI's are "addicting" or not is a matter of terminology: I have seen people go through withdrawals on SSRI's that looked nasty, caused a lot of missed work, and were protracted over a period of months. AND they don't seem to work as well!
>
> The irony is that if I had Klonopin at the time the therapy itself would have been a lot more productive. Burns makes it sound in his book that people on benzos are like junkies living only for their next high, completely indifferent to whatever 'issues' they had previously as the next dose of drug fills their veins. I still need to work out my issues, and what is more I am actually more aware of them than ever, because I'm less likely to become anxious over trivial things. I think that people with severe anxiety need medication to get through the therapeutic process, and that people like Burns don't understand that severe anxiety is no more the product of a bad 'cognitive schema' than severe depression is.
>
>
> > Anyone else with the same experience?
>
> Hi zeugma,
I started my CBT therapy while on klonopin. I definately believe that the klonopin helped my therapy for panic attacks, and high anxiety in that I needed my panic to stop before I could effectively absorb CBT. I haven't really had any luck with ssri's. Many sources say that the best treatment for panic and anxiety are a combination of a benzo- and CBT. Once the CBT is absorbed, the benzo can be tapered. This is highly individual of course.
best wishes
>
Posted by psychlover on January 6, 2004, at 16:25:47
In reply to Re: Long Term Klonopin Usage, posted by rutt on January 6, 2004, at 15:45:49
To you folks who discussed the use of Klonopin during CBT therapy:
I am wondering if the CBT therapy actually made a difference for you. Were you able to get off your meds or reduce the dose at all? Did it have any effect on you at all?
Thanks!
Posted by ian24 on January 6, 2004, at 18:24:14
In reply to Re: Long Term Klonopin Usage, posted by Mr. Scott on January 5, 2004, at 22:37:02
Mr Scott and someone else have judged that their friens and Mother have terrible memory problems and that it is due to benzodiazapine use. How do you know it wasn't alcohol or an ssri or anything? You don't .
Posted by zeugma on January 6, 2004, at 18:25:48
In reply to Re: Long Term Klonopin Usage, posted by rutt on January 6, 2004, at 15:45:49
Hi rutt,
I intuitively felt that the strategy of using a benzo in conjunction with CBT would work well, but I could not get either my pdoc or my CBT therapist to see it that way. My anxiety skyrocketed during the therapy, to the point where I actually made a plan to hospitalize myself if my fears became so intense that i'd be tempted to kill myself just to be rid of them. And my pdoc was dismissive of my anxiety and told me the issues were merely 'psychological.' It still leaves a bitter taste in my mouth. I discontinued the CBT because it was not causing my anxiety to go down and I had to find another way to get on with my life. My pdoc relented and wrote me a script for Klonopin after my neuropsychologist called him advising a change of course.
It's still a little bitter for me. I got a letter from my CBT therapist a few days ago, where she expressed the opinion that i terminated therapy too soon. Not quite- i terminated therapy before i had the chance to see my life collapse from excess anxiety. She knew that I was taking Klonopin because I told her in our last conversation. It's obvious that i have serious social anxiety issues (she agreed with my diagnosis by the way) and a small amount of Klonopin (.25 mg/day) isn't going to make them all go away. What infuriated me was that the treatment wasn't coordinated properly, and I attribute this to misconceptions about the nature of anxiety on the part of both CBT therapists (at least certain ones) and psychiatrists (at least my psychiatrist, and many others too I suspect).
So now I'm feeling a lot better than when I was struggling through CBT therapy, but trying to muddle through on my own. Anxiety is my case has been pretty unremitting through my entire life (I'm in my middle thirties), more unremitting than depression in fact, because I can recall being anxious as a child, before I became depressed. Recent research suggests that this is typical of the most chronic depressions.
i don't know, after this experience, if I will ever go back to CBT. I have been in therapy of one form or another for virtually all my life, and on balance it has done FAR more harm than good. And that is a generous estimate.
z
Posted by Siraris on January 6, 2004, at 18:48:00
In reply to Did CBT help you overcome panic attacks?, posted by psychlover on January 6, 2004, at 16:25:47
I did 7 sessions of CBT, and it helped at the time, but I wasn't really experiencing that much panic. I had gone an entire year at college beforehand literally never feeling any sort of panic the entire year. I went to CBT to try and clear things up so I could get off my medication.
This winter is when my anxiety came back FULL force and really reared it's head. Unfortunatly I thought it would subside, and didn't call my CBT right away and when I finally did she is on medical leave until the 20th of Janruary.
I am hoping I don't have to call her though. I am going to look into and persue NLP and see how that works. I've heard it works really well (There was something on dateline about it the other day). Hypnosis is proven to work, and I think it could really help in my situation.
Posted by utopizen on January 6, 2004, at 21:04:53
In reply to Re: Long Term Klonopin Usage, posted by Mr. Scott on January 5, 2004, at 22:37:02
It seems so simple I don't know why I never thought of it before, I guess b/c Klonopin was just something I envied for like 2 years until I finally saw a doc that would prescribe it- but my p-doc suggested switching to Xanax or Valium for my social anxiety, given that the Klonopin's effects on my social anxiety only really lasted for a few months.
I have a very good memory, so I can't say Klonopin ever affected it at all... in fact, benzos will increase your IQ if you have a clinically signifigant degree of anxiety to begin with. I tried to explain this to my p-doc, but he gave me a funny look and thought I meant that Klonopin was some smart drug. But I browsed the American Textbook of Psychopharmacology, and it said the same thing I tried to explain to him. Anxiety itself can impair intelligence, memory, and generally make you ridiculious. Anyone who has an anxiety disorder knows this as common sense.
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