Invest in ME Conference 12: First Class in Every Way
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Stopping Klonopin and central sensitization

Discussion in 'General Treatment' started by Braz, Mar 25, 2016.

  1. Braz

    Braz

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    Central sensitization is often associated with pain. Klonopin is supposed to help with that. Pain is something that is not my problem.

    I was prescribed this drug and have great difficulty getting off. I've been through a lot, I am in poor health but I think I need to get off.

    Did anyone have to deal with a situation like that, and was there anything that helped ? Or did you need to wait till you were better ?
     
    Last edited: Mar 27, 2016
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  2. geraldt52

    geraldt52 Senior Member

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  3. barbc56

    barbc56 Senior Member

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    @Braz

    Withdraw from any medication like klonopin can be very difficult and needs to be done under a doctors supervision. But it can be done.

    Why do you want to get off klonopin? I was originally given it for RLS as I can't take the usual medications. It has also helped with sensitivities with lights and sounds. It doesn't make me feel drowsy nor drugged which may be dose related. I don't want a "Mommies Little Helper" effect.

    So for me I continue to take it. Your health situation may make it wise to discontinue Klonopin as each of us is different as far as our health needs.

    Good luck!

    Edit next day. Changed grammar mistake.
     
    Last edited: Mar 26, 2016
  4. Braz

    Braz

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    @geraldt52 ,

    I know I have asked a similar question in the past, but this one is a bit different ... I think I've read all those threads.

    @barbc56,

    Unfortunately, I have a GP who knows squat. His knowledges of benzodiazepines in general dates from about 1980 ...
    He tried to help me based on his experiences getting people off antidepressants. He has no experience getting people off benzos. And almost nobody (perhaps with the exception of a few neurologists) has experience getting people off clonazepam. And somewhat recently, after asking him some question and confronting him it turned out that he believes there is an underlying psychiatric problem ...
    Which he hid so well after I switched to this GP ! Somatic issues were not taken seriously. I'm sure many people here can relate.

    For me, this drug has a harsh effect and side effect profile. The worse my health gets, the more these problematic effects come to the fore. And after all those years, an ordinary taper lasts about 6 months ... if all goes well.

    I was prescribed this drug as a muscle relaxant ! Couldn't they have prescribed me some baclofen or something mild ... They just don't know how potent this drug really is. 2 mg a day, once daily ...

    My health continues to deteriorate, which is partly an separate process, partly the effect fo the clonazepam.

    After a request of mine, based on some people's experience with Tranxene on this website I asked my GP for Tranxene. I did try that drug, but it seems to be so short acting ... It's supposed to have a long duration of action.
    Also, weird issues like muscle stiffness, waking up early with an adrenaline rush. And more.
    An earlier switch to diazepam was not successful either, although I decided not to force the issue.

    I'm not sure 'central sensitization' is what really applies to me as it's really not about pain.
    But there has been a lot of chronic stress, somatic complaints and very little sleep of poor quality since about November last year.

    Oh yeah, I took it for about 10 years, although not daily during the first few years. But because of the long half life dependence can catch up with you ...
     
    Last edited: Mar 27, 2016
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  5. caledonia

    caledonia

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    I've been on and off Xanax (alprazolam) twice and Klonopin (clonazepam) once. They are both very addictive. I was not taking that much. (.5mg) It took me 6 months to taper off each time. I was prescribed it for anxiety.

    I did better on Klonopin because it's longer acting. I found out that I have SNPs (genes) that process benzos quickly, so a longer acting benzo works better in that you won't be having rebound anxiety 4 hours after you take it. The half life of Klonopin is more like 8 hours.

    So what I did first is dose it 3 times a day so I was getting an even amount throughout the day. Otherwise I would get rebound anxiety when it wore off.

    Then starting from there I cut back a tiny bit. Then I waited a week. I would have some minor issues with anxiety throughout the week, but invariably at the one week mark, I would get a large dose of rebound anxiety (i.e. panic attack). Once I got through that without increasing the dose, I felt stable. Then when I felt ready, I reduced the dose again.

    I believe it was the Klonopin which depleted melatonin and so ironically screwed up sleep even though it's often prescribed for sleep. So taking 1.5 to 3mg of melatonin at bedtime might be helpful. I had to keep taking the melatonin for another month after being completely off the Klonopin.
     
  6. Butydoc

    Butydoc President

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    Hi Braz,

    There is a good paper by Dr Ashton concerning benzodiazepine withdrawal. Very good place to start. Worked well for me, although took about a year to kick the drug.

    Best,
    Gary
     
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  7. barbc56

    barbc56 Senior Member

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    It's such a complicated issue and frustrating . There are legitimate reasons for taking these medications but trying to find the optimal dosage, a doctor who is knowledgeable and won't go to extremes one way or another is difficult.. Sigh.

    My neurologist prescribed the Klonopin so like you said that makes a difference.

    EDIT I crossed posts with @caledonia and @Butydoc so edited the above. Hopefully it makes sense.

    Again good luck.
     
  8. Braz

    Braz

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    @Butydoc,

    Unfortunately, I don't find the Ashton manual helpful at all. It contains half-truths and 'silly statements'.
    Klonopin/clonazepam is treated as a short acting drug. Her crossover schedules assume that people take it three times a day and she has people switching over gradually. She completely disregards the concept of 'duration of action', and 'half life' would seem to mean long acting ... Diazepam is short to medium acting, while clonazepam is long acting.

    I appreciate your response, though.
     
  9. Braz

    Braz

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    I guess the issue is how to get off ... I just don't see how to do a 'normal' taper under current circumstances.
    Yet, the drug seems to make me sick.
     
  10. caledonia

    caledonia

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    One member here had to go to a detox clinic: http://phoenixrising.me/archives/12200

    I don't know if you saw my post before. I switched to taking it 3 times a day to get a consistent level of the drug in my system. Otherwise you can have in between dose withdrawal symptoms. I would suggest taking the 2mg and dividing it into 3 doses, (not increasing it to 2mg, three times a day :eek:).

    You could probably even divide it into 4 doses if the math worked out easier.

    Also Klonopin depletes melatonin which can screw up sleep. So supplementing with melatonin can help the sleep issues.

    The group http://survivingantidepressants.org/ might be helpful. They help people taper off various psych drugs, including benzos.
     
  11. Thinktank

    Thinktank Senior Member

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    I tapered off clonazepam very slowly using a daily liquid titration schedule. I didn't tolerate diazepam very well so had to stick with clonazepam.

    http://www.benzosupport.org/water_titration.htm

    Using this automated spreadsheat. http://www.benzosupport.org/the_spreadsheet.htm
    Click on "get spreadsheet" to download it.

    Withdrawal is hard and nasty but the method of daily micro cuts has helped me tremendously. I tried the Ashton method first with 10% cuts or more but that threw me into acute withdrawal every time.

    I'm now 3 months off and still suffer really bad but some symptoms start fading and i sleep a bit better. The mental symptoms are the worst.
     
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  12. Braz

    Braz

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    @caledonia,

    (hey, it's very convenient to use the @ , for notifications )

    I had a conversation with her. She was taken off Klonopin in a 'detox center' or whatever you want to call it. They used Tranxene, as I understand taken once a day.

    Actually, I tried Tranxene. While the clonazepam lasts pretty much a full 24 hours, the Tranxene was relatively short acting. Sure, the half life of desmethyldiazepam is long, but the 'duration of action' is short/medium.
    Also, it was weak and there were a few other issues as well. More like a detox drug ...
    It seems that a once-daily formulation is available in the USA, but I actually talked to the local company that manufactures the Tranxene and they stated it was NOT gradual release. It has a peak at about one hour.
    I find it 'peters out' relatively quickly.

    Unfortunately, I can't just split the daily dose during the day. It is a problem drug with a harsh effect and side effect profile. The worse I get, the worse I get. And I have been on it for all those years ... I'm used tot aking it once daily. i guess I'm sensitive to the 'unusual properties' of the drug.

    It depletes melatonin ? I wonder what makes you think that. (source?) Unfortunately, over the past few months my body has been producing way too many stress hormones, including melatonin ... So I have no melatonin deficit, the opposite. Although, the Tranxene seemed to block melatonin production ...
     
  13. Braz

    Braz

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    @Thinktank,

    Aside from all other issues, the liquid version (Roche actually produces 'Rivotril drops') was faster acting, shorter acting, and had a bit different effect.
     
  14. Thinktank

    Thinktank Senior Member

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    Yes, that's possible. The idea of liquid titration though is to taper off from the benzo you are currently using by daily micro deductions. You create your own suspension, nothing premade. Seriously, look it up because that was the only method that got me off clonazepam. Ashton method was just too harsh for me.

    Why do you absolutely want to use tranxene? I don't believe it's very helpful in withdrawal. Steady deductions at your own pace is what works, there's no shortcut to it.
     
  15. caledonia

    caledonia

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    That's interesting that you say the clonazepam lasts 24 hours. Perhaps you have the opposite problem to me - it lasts way longer in the body than it ought to, and you're not clearing it out very fast. The SNP (gene)
    CYP2C19 detoxifies diazepams. https://en.wikipedia.org/wiki/CYP2C19

    Perhaps assisting either Phase I or Phase II detox (not sure which) would be helpful getting the drug to clear out faster and would alleviate side effects.

    Google "name of the drug" and the word "depletes" to find out which drugs deplete which nutrients. That plus personal experience that using melatonin helped.

    Please do check in with the Surviving Antidepressants forum. There will likely be others there who have similar issues to you. You might need to do a 10% progressive taper, similar to what I'm doing for an SSRI.

    My doctor told me one of his patients was on a 5 year taper off a benzo. Some people are just extremely sensitive.
     
  16. Hip

    Hip Senior Member

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    Diazepam has a half life of 32 to 47 hours.

    Clonazepam's half life is 20 to 50 hours, but its effect is shorter, around 8 hours.

    Here is says that that clonazepam's "duration of biological activity is often shorter pharmacokinetic terminal half life".
     
  17. Hip

    Hip Senior Member

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  18. Braz

    Braz

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    @caledonia,

    'Perhaps assisting either Phase I or Phase II detox (not sure which) would be helpful getting the drug' Would you have any suggestions for that ? I doubt you can seriously alter the half life
     
  19. Braz

    Braz

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    @Hip,

    Thanks for that link. However, for me clonazepam lasts about a full day ... ('duration of action')
    I guess the half life is somewhere between 1-2 days.
     
  20. caledonia

    caledonia

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    A quick google search brings up the following information -
    https://www.merckmanuals.com/home/d...to-drugs/genetic-makeup-and-response-to-drugs

    People who clear drugs slowly are called slow acetylators.

    This website explains Phase I and Phase II detox and gives information for supplements for increasing acetylation.
    It also mentions that benzos slow down Phase I detox. So it sounds like some Phase I support would be useful, as well as acetylation support. Vitamin C is helpful for both.

    http://modernherbalmedicine.com/articles/the-low-down-on-liver-detoxification-2.html?page=2
    http://modernherbalmedicine.com/articles/the-low-down-on-liver-detoxification-2.html?page=3

    I don't know if these are the greatest sources of information, but it's a start. My suggestion would be do more research on those terms and see if you can come up with a consensus from a variety of sources, or find a source that seems to be definitive and not some flaky site trying to sell you supplements.

    Then try out the various supplements one a time (so you know what is doing what) and see if they help or not.
     

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