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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by offsleepmeds on February 28, 2005, at 21:06:41
I am on meds for insomnia and have gradually weened myself to what, compared to what I used to take, are small doses. Now I am on 225 mg per night of Trazodone, 100 mg (down from 800mg, which did not a thing for me!) of Seroquel, and 1.5 grams of Klonopin.
I have weened myself from 3 to 1.5 mg. per night of Klonopin gradually, albeit more quickly than usual withdrawal schedules with the support of the precursor to tryptophan, 5-HTP(50-100 mg per night), 1500 mg GABA per night, and 500 mcg of melatonin.
By tapering off Klonopin, the other meds, and by adding the above--along with the addition of some central nervous system-support minerals during the day, my sleep has improved tremendously. I now experience more REM sleep, can remember my dreams, and feel more rested.
My problem is that I tend to need at least two hours in the morning to really get going.
When I was on 3 whopping mg. of Klonopin per night and was busy tapering my doses of Trazodone and Seroquel, I was able to quite coffee in the morning. Now that I am taking the 'natural' aids to get off of Klonopin, I have to have a cup of coffee in the morning to get going.
Why get off the Klonopin and not continue getting off the Trazodone and Seroquel completely before tackling Klonopin? I have done the research, and finally seen a psychiatrist who has been frank with me about how long it takes to undo what Klonopin does to the brain chemistry. Therefore, I have decided to get off the Klonopin and then proceed getting off the Trazodone and Seroquel.
By the way, yoga, good diet, and better sleep hygiene have helped with everything.
I am mainly concerned with going off of Klonopin safely, and with using the 'natural' adjuncts that I am using in the safest manner.
I welcome your suggestions.
Thanks.
Posted by SLS on February 28, 2005, at 21:06:41
In reply to Going Off Klonopin, posted by offsleepmeds on February 28, 2005, at 18:12:27
Hi.
> I have done the research, and finally seen a psychiatrist who has been frank with me about how long it takes to undo what Klonopin does to the brain chemistry.
What does Klonopin do to brain chemistry?
How long does it take to undo it?
Thanks.
- Scott
Posted by Phillipa on February 28, 2005, at 21:06:41
In reply to Re: Going Off Klonopin » offsleepmeds, posted by SLS on February 28, 2005, at 18:52:44
Yes, what does klonopin do to brain chemistry as i've just recently eliminated it. Fondly, Phillipa
Posted by offsleepmeds on February 28, 2005, at 21:06:41
In reply to Re: Going Off Klonopin, posted by Phillipa on February 28, 2005, at 19:58:37
Klonopin is simply very addictive, with a lot of doctors substituting drugs in the same family with much shorter half lifes for Klonopin as they taper down doses.
Going off it "cold turkey" or without tapering it correctly can causes seizures, hallucinations to the extent that at least one med manual says not to classify anyone as psychotic who has discontinued it for at least one year, terrible nightmares, insomnia, and extreme anxiety.
Posted by Glydin on February 28, 2005, at 22:13:49
In reply to Re: Going Off Klonopin, posted by offsleepmeds on February 28, 2005, at 20:30:36
> Klonopin is simply very addictive.
I do not feel this statement is true for all who use Klonopin long term and routinely. In particular in light of the true definition of dependence versus addiction.
Most studies reveal a lower incidence of true addiction with longer half life benzo's than short acting ones.
I supportive anyone's choice to D/C or continue meds as their individual circumstances and choices deem.
As a long term monotherapy Klonopin user, I feel unsupported and judged when I read this type of blanket statement.
Posted by NealMcCoy on March 1, 2005, at 3:27:21
In reply to Re: Going Off Klonopin » offsleepmeds, posted by Glydin on February 28, 2005, at 22:13:49
Klonopin and other benzos bind to the gaba receptors. The neurotransmiter GABA is the bodies natural tranqueliser and benzodiazipines potentiate the effects of gaba to the receptors.
The reason that benzo's are addictive is that they eventually take over the role of gaba. Over time, the gaba receptors become used to the benzo and no longer attract gaba. When the benzo is discontinued, the nervous system is in a state of excitability because the bodies natural calming system is not working.
That's why it is best to slowly discontinue the benzo by tapering, therefore allowing the receptors to slowly adjust and attract their own gaba.
Posted by NealMcCoy on March 1, 2005, at 3:31:06
In reply to Going Off Klonopin, posted by offsleepmeds on February 28, 2005, at 18:12:27
My suggestion is to wean off the last bit of klonopin very very slowly. I would say that once you get down to .25 mgs, you need to go really slow from there. Klonopin is a very potent benzo and it can take the time for the body and brain to re adjust to it not being there. For now, I would do the following(just my suggestion)
1.5-1.25 for 2 weeks
1.25-1 for 2 weeks
Posted by SLS on March 1, 2005, at 9:34:18
In reply to Re: Going Off Klonopin, posted by NealMcCoy on March 1, 2005, at 3:27:21
Hi.
Benzodiazepines act as a sort of key to unlock the door for GABA to open, allowing chloride ions to enter the neuron. Benzodiazepines actually bind to a separate receptor that is intimately connected to the GABA receptor. The interesting thing about this interaction is that GABA can open the door by itself without the benzodiazepine, but it just takes a lot longer. What's more, GABA acts to help the benzodiazepine find the door lock more quickly. In other words, the benzodiazepine molecule and the GABA molecule act synergistically to amplify the GABA neuronal signal. As GABA signals increase, they act to inhibit or "calm down" excitatory neurons.
- Scott
Posted by Dave Lopan on March 7, 2005, at 17:57:08
In reply to Re: Going Off Klonopin » offsleepmeds, posted by SLS on February 28, 2005, at 18:52:44
> Hi.
>
> > I have done the research, and finally seen a psychiatrist who has been frank with me about how long it takes to undo what Klonopin does to the brain chemistry.
>
> What does Klonopin do to brain chemistry?
>
> How long does it take to undo it?
> Thanks.
>
>
> - ScottSo, what did the frank psychiatrist say?
Posted by SLS on March 17, 2005, at 21:24:30
In reply to Re: Going Off Klonopin, posted by offsleepmeds on February 28, 2005, at 20:30:36
> Klonopin is simply very addictive,
Physiological dependance or the development of tolerance to a drug isn't the same thing as addiction to that drug. Addiction involves having cravings, compulsions, or a psychological need for intoxication. For the addict, they simply find it difficult to discontinue their substance abuse, even in the absence of withdrawal side effects. I believe Klonopin is one of the benzodiazepines least likely for one to become addicted to.
> with a lot of doctors substituting drugs in the same family with much shorter half lifes for Klonopin as they taper down doses.
I am not familiar with this strategy. Perhaps it is effective towards the end of the taper period. I really don't know. Some doctors do just the opposite. For example, someone on Xanax will cross-over to Klonopin and taper from there.
I want to reiterate that addiction and physiological independance are two different things, even though both usually occur concomitantly. Many dictionaries still confuse the two.
- Scott
Posted by reefer on March 21, 2005, at 7:10:37
In reply to Re: Going Off Klonopin, posted by SLS on March 17, 2005, at 21:24:30
Well without being rude. I haven't met any medical professional that would switch you from a long acting to a short acting for tapering. It is well known that withdrawing from a longer acting benzo will give you less of a ride than from a short acting.
Posted by SLS on March 21, 2005, at 8:59:29
In reply to Re: Going Off Klonopin, posted by reefer on March 21, 2005, at 7:10:37
You weren't addressing me, were you?
> Well without being rude. I haven't met any medical professional that would switch you from a long acting to a short acting for tapering. It is well known that withdrawing from a longer acting benzo will give you less of a ride than from a short acting.
- Scott
Posted by reefer on March 27, 2005, at 15:13:49
In reply to Re: Going Off Klonopin » reefer, posted by SLS on March 21, 2005, at 8:59:29
No it was in reply to this:
"Klonopin is simply very addictive, with a lot of doctors substituting drugs in the same family with much shorter half lifes for Klonopin as they taper down doses."
There is no way a doctor with knowledge about benzos would substitute Klonpin with Xanax for tapering because Xanax has a shorter half life. Actually they do exactly the opposite.
Of course there might be other reasons for substituting a longer acting benzo with a shorter acting when withdrawing. If a very rapid withdrawal would be needed in a hospitalized patient for reasons i wont go into.
Posted by kriskraft on April 13, 2005, at 11:34:36
In reply to Going Off Klonopin, posted by offsleepmeds on February 28, 2005, at 18:12:27
I've taken klonopin for so long I've worn it out. It does not control the anxiety any more even if I incresae the dose. I have been on it 3 years and it used to work wonderfully. My doctor says not to exceed 3 mg daily but that doesn't even do any thing. Now that I've tried to cut back life isn't anywhere normal and I have rebound anxiety all day long. I also take remeron 30 mg at bedtime. I feel horrible. What are some substitutes. Do I need detox to get better? I tried buspar and it seemed to make me more jittery and anxious. Dr. tried me on the class of things like abilify and stuff; I felt worse also. help
Posted by Mildred on April 14, 2005, at 5:18:39
In reply to Re: Going Off Klonopin, posted by kriskraft on April 13, 2005, at 11:34:36
I started weaning off of klonopin this week. I was on 1 mg/day for a couple of years - mostly to help me sleep and get through a difficult time in my life. My pdoc told me to start taking 1 mg one day and .5 mg the next day, etc. Today was the second .5mg day for me, and this afternoon I started experiencing . . . well, not sure how to describe it . . . brain zaps? I will forget what I'm saying, gasp, body parts jerk - dropped a load of laundry tonight. Can't keep a thought in my head. Can't remember what I'm doing. Almost like mini seizures.
My questions:
Has anybody else experienced this? Can I expect these nasty episodes to stop soon? Can anybody suggest an easier taper method?
Thank you in advance -
Posted by Spriggy on April 18, 2005, at 15:43:09
In reply to Re: Going Off Klonopin, posted by Mildred on April 14, 2005, at 5:18:39
WHY.. OH WHY... did I come and read here.
I am on Klonopin going on 2 months now and Restoril for sleep.
Now I am scared.
Posted by Lizzyb on May 3, 2005, at 16:38:46
In reply to Re: Going Off Klonopin, posted by offsleepmeds on February 28, 2005, at 20:30:36
> Klonopin is simply very addictive, with a lot of doctors substituting drugs in the same family with much shorter half lifes for Klonopin as they taper down doses.
>
> Going off it "cold turkey" or without tapering it correctly can causes seizures, hallucinations to the extent that at least one med manual says not to classify anyone as psychotic who has discontinued it for at least one year, terrible nightmares, insomnia, and extreme anxiety.Here's what my pdoc ordered, even though I don't agree with it-I have been on .75 xanax and .5 Klonopin for over nine years. I want to get off benzo's. After a bad bout with Seroquel, today my doc said stop all benzo's and take 30mg 2x a day of Phenobarb. Anyone out there have any information on this or used phenobarb to get off benzos? What can I expect? Any information wil be helpful.
Posted by delna on May 4, 2005, at 16:14:56
In reply to With Phenobarb?Re: Going Off Klonopin, posted by Lizzyb on May 3, 2005, at 16:38:46
> Here's what my pdoc ordered, even though I don't agree with it-I have been on .75 xanax and .5 Klonopin for over nine years. I want to get off benzo's. After a bad bout with Seroquel, today my doc said stop all benzo's and take 30mg 2x a day of Phenobarb. Anyone out there have any information on this or used phenobarb to get off benzos? What can I expect? Any information wil be helpful.Hi
I used to take xanax (between 1-3mg) daily but I had to withdraw because I was popping it indiscriminatly during bad times so i was pretty hooked. Anyway I was put on phenobarb to withdraw (I dont remember the dose). I had to go into psych hospital for this but I couldnt bear being there so I discontinued the drug at home (using the phenobarb as directed).
In my experience:
-The xanax was stopped cold
-phenobarb was used to tide over the acute withdwawal phase (10days) starting at a higher dose on day one and titrating down to 0 by the 10th day
-phenobarb knocked me out totally. I couldnt get out of bed.When the phenobarb was removed I started experienceing terrible xanax withdrawal symptoms for at least a month. Panic, anxiety, shaking... the entire lot of symptoms possible. then they slowly became better. (over a couple of months). It was pretty disabling
I mentioned hosptal above as I wanted to add that I was also put on carbamazepine to prevent any seizures and I needed to be monitered.I had a less traumatic experience the second time I got 'addicted' (again!! how pathetic..) This time I was withdrawn from xanax over the course of 10 days without the phenobarb. My anxiety was controlled with olanzapine (I was also delusional at the time which is the reason i was popping xanax in the first place but xanax only made things worse).This was easier because the olanzapine and carbamazepine were continued even after I left hospital (for at least 2 months) so the xanax withdrawal was covered up.
with the first method, nothing was used once the phenobarb was stopped and I really suffered for a good while after that.
I hope this makes sense...i have really been babbling. Also I dont mean to scare you. this was just an honest recount of my experience.
Best of luck
D
Posted by Lizzyb on May 4, 2005, at 17:05:18
In reply to Re: With Phenobarb?Re: Going Off Klonopin » Lizzyb, posted by delna on May 4, 2005, at 16:14:56
Delna-
Wow! Thanks for sharing your experience and your honesty. I kind of had a bad feeling about doing it this way. I got a second opinion from another pdoc and my treatment plan will be to be slowly weaned from xanax first, then once I have stablized from that, I will slowly wean off the Klonopin. No cold turkey w/phenobarb as the other pdoc wanted. He also acted like what he was asking was no big deal. After the fifth day of craziness, I went for a second opinion. Thank goodness I did. See my thread I started below that outlines my short lived nightmare.
I'm so glad you posted your experience! Thank you.
Anyone else out there?
Posted by electricstorm on May 5, 2005, at 0:02:54
In reply to Re: Going Off Klonopin, posted by Mildred on April 14, 2005, at 5:18:39
> I started weaning off of klonopin this week. I was on 1 mg/day for a couple of years - mostly to help me sleep and get through a difficult time in my life. My pdoc told me to start taking 1 mg one day and .5 mg the next day, etc. Today was the second .5mg day for me, and this afternoon I started experiencing . . . well, not sure how to describe it . . . brain zaps? I will forget what I'm saying, gasp, body parts jerk - dropped a load of laundry tonight. Can't keep a thought in my head. Can't remember what I'm doing. Almost like mini seizures.
> My questions:
> Has anybody else experienced this? Can I expect these nasty episodes to stop soon? Can anybody suggest an easier taper method?
> Thank you in advance -If you ask me, you're tapering too quickly. You're decreasing your Klonopin intake by 50% over the course of two days. You've obviously developed a chemical dependence on the drug. It sounds like you're experiencing myoclonic jerks or possibly even some type of seizure activity. Of course, this is impossible to know without knowing more about you and your medical situation. I would suggest that you go back to where you started and taper much more slowly. If not, you risk continued problems, migrains, etc. At the very least, I would speak to my doctor. I speak from personal experience as I made several failed attempts - all under the watchful eye of some of the best doctors I could find - to free myself of .5mg of Klonopin which I took for 11 years. To avoid the seizures and the chronic migrains - which would last 4 or 5 days - here is the taper plan I followed:
It actually turned out to be fairly simple. I cut the .5mg tablet into eights. I then weaned off over a period of eight weeks reducing the amount I took each week by 1/8 of a tablet.
I recognize that there are those who take this drug for anxiety, depression, etc. and that not everyone will suffer the same withdrawal symptons. However, if you happen to suffer from any type of seizure disorder, I believe that special care should be taken when attempting to wean off it.
I hope the above helps.
Posted by Mildred on May 5, 2005, at 7:00:46
In reply to Re: Going Off Klonopin » Mildred, posted by electricstorm on May 5, 2005, at 0:02:54
>> If you ask me, you're tapering too quickly. You're decreasing your Klonopin intake by 50% over the course of two days. You've obviously developed a chemical dependence on the drug. It sounds like you're experiencing myoclonic jerks or possibly even some type of seizure activity. Of course, this is impossible to know without knowing more about you and your medical situation.
I had a seizure disorder as a child - it was diagnosed as petit mal epilepsy, though I am not sure that that was the correct diagnosis. I outgrew the disorder, but the seizures have been brought on from time to time by some medications (which I promptly stopped - or in this case, added back . . .)
>>I would suggest that you go back to where you started and taper much more slowly.
After my disastrous initial attempt, I started cutting the .5 mg tablets into 4 pieces (I had actually only been on .5 mg/day, not 1 mg - I got confused . . . And I had cut down to .25 mg every other day as opposed to .5 mg) For 2 weeks, I took .375 mg (.125 3 times/day), and did fine - except that I am not sleeping at night. Then this Sunday, I cut down to .125 mg twice/day, with no additional negative effects yet. That is the amount I was taking when I had the little seizures, but now I am taking it in 2 doses/day instead of one.
>> At the very least, I would speak to my doctor.
I have been doing all this under the advice of my doctor. He suggested the original taper schedule in the first place. He really doesn't seem to be very helpful when it comes to tapering off drugs. I had a problem with lexapro (ended up back on it), and he just told me that he never heard of anyone having problems when going off of lexapro before.>>I speak from personal experience as I made several failed attempts - all under the watchful eye of some of the best doctors I could find - to free myself of .5mg of Klonopin which I took for 11 years.
Wow, and I thought that was such a small amount and I was on it for a couple of years only - it didn't even occur to me that I would have difficulty discontinuing it. I don't know why it didn't occur to me,though; I am extremely sensitive to meds.
>> It actually turned out to be fairly simple. I cut the .5mg tablet into eights.
You divided your .5 mg tablets into eighths? How did you do that without crumbling the pills? I don't think I can cut these pieces any smaller. I will give it a try, though - I am not looking forward to the next cut, which would be only once/day. I was planning to give this 2 more weeks before doing that. Do you have any suggestions for successfully cutting the tablets into those tiny pieces?
>> I hope the above helps.Thank you so much - yes, that is a tremendous help! I will follow your suggested taper schedule from this point forward - :)
Posted by Chairman_MAO on May 13, 2005, at 11:20:31
In reply to With Phenobarb?Re: Going Off Klonopin, posted by Lizzyb on May 3, 2005, at 16:38:46
It is always preferable to use a drug from the same class for withdrawal purposes. While phenobarb will "cover" for the xanax, it is not the same thing and will likely be a much more unpleasant experience in the long run than if you used, for instance, clonazepam, diazepam, clorazepate, or chlordiazepoxide to detox.
Posted by Lizzyb on May 16, 2005, at 23:03:04
In reply to Re: With Phenobarb?Re: Going Off Klonopin » Lizzyb, posted by Chairman_MAO on May 13, 2005, at 11:20:31
> It is always preferable to use a drug from the same class for withdrawal purposes. While phenobarb will "cover" for the xanax, it is not the same thing and will likely be a much more unpleasant experience in the long run than if you used, for instance, clonazepam, diazepam, clorazepate, or chlordiazepoxide to detox.
Really interesting information. Have you done this? I would like to hear your experience about this or any information you know. Thanks!
This is the end of the thread.
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