Stuck on Klonopin

[mattie]

@Mary @Learner1 @Stretched @geraldt52
Thanks for all the input. Very helpful. And interesting.
Just ordered a Cortisol profile test.
And iHerb here I come again.

You will almost definitely have to wean yourself off the Klonopin to get decent results from anything else,.

I agree. There is no way around that. Klonopin is definitely working against me right now. Too bad tapering has to be done that slow. That Vodka trial will have to wait .
In the mean time let's hope some of the suggestions here will help a bit during this process.

 

[Thinktank]

I've been in your shoes and seen hell for nearly 2 years.

My advice to you is to updose a little bit to lessen the interdose withdrawal effects and get some sleep.
From there on taper very very slowly using a liquid micro titration schedule. You can choose to stay on clonazepam or crossover to diazepam because it has a longer half-life, i chose to stay on clonazepam.
Every day you drop a microamount of the benzo until you've reached to a very little non-therapeutic dose, small enough to jump. This will take months, for me it took 12 months of tapering.

Schedule:
http://www.benzosupport.org/the_spreadsheet.htm

Example video (there are many more to be found on youtube):
Some people like in the video overcomplicate the process. I only used a blender, water, some measuring cones and 0.5mg clonazepam tablets. Every day a new tablet and toss whatever isn't used.

You can also use milk (if tolerated) to create a more even suspension

This method saved me, i'm nearly 2 years clonazepam-free, there are still lingering symptoms especially a messed up ANS/CNS and cognitive difficulties but it's getting better and sleep has normalized.

Natural products DON'T WORK or have a very little therapeutic effect in benzodiazepine withdrawal syndrome.
First of all don't use any GABAergic products, those will give you little temporary relief but in the end just prolong the withdrawal period. Your GABA-A receptors need to heal by themselves and that takes time.
You can however use stuff to antagonize NMDA receptors like magnesium and upregulate GABA receptors with bacopa monieri. You should also cut out sugar and foods high in glutamate. Stop drinking anything with caffeine.

The Ashton manual explains more about benzodiazepine withdrawal and how to manage it.

Good luck.

 

[Stretched]

@Thinktank ”You can choose to stay on clonazepam or crossover to diazepam because it has a longer half-life, i chose to stay on clonazepam.’

Do you mean just the opposite, ie that Valium has a much shorter half life (6’) than Klonopin (48’) which is the whole premise of the Ashton Manual, referenced above?

 

[Thinktank]

No, diazepam has a longer half life than clonazepam. To avoid interdose withdrawal it's recommended to crossover to a long-acting benzodiazepine like diazepam.

https://www.benzo.org.uk/bzequiv.htm
https://www.benzo.org.uk/bzequiv.htm
Clonazepam 18 - 50 hours
Diazepam 36 - 200 hours

Diazepam [Valium] is one of the most slowly eliminated benzodiazepines. It has a half-life of up to 200 hours, which means that the blood level for each dose falls by only one half in about 8.3 days. The only other benzodiazepines with similar half lives are chlordiazepoxide [Librium], flunitrazepam [Rohypnol] and flurazepam [Dalmane] all of which are converted to a diazepam metabolite in the body. The slow elimination of diazepam allows a smooth, gradual fall in blood level, allowing your body to adjust slowly to a decreasing concentration of the benzodiazepine. With more rapidly eliminated benzodiazepine e.g. lorazepam, (Ativan) (which has a half-life of 10-20 hours) the blood concentration drops rapidly and withdrawal symptoms can occur between doses, because your body has little time to adjust to low concentrations.

 

[Stretched]

No, diazepam has a longer half life than clonazepam. To avoid interdose withdrawal it's recommended to crossover to a long-acting benzodiazepine like diazepam.

https://www.benzo.org.uk/bzequiv.htm
Clonazepam 18 - 50 hours
Diazepam 36 - 200 hours

Okay, fair enough. I had recalled it reversed, sic from long term memory. Too much reading of
technical stuff over years and referencing before checking. ‘Sorry

 

[edawg81]

I feel like im dealing with the same issue. Before my big ME onset i had just gotten off klonopin, i felt great, then i caught a cold and was on a higher dose than before, ME sucks and i still couldn't sleep!

Ive noticed lately although my ME symptoms are worse but my anxiety and sleep problems are better. I am taking ceftin (tapering off) and mc-bar1 via a lyme dr and have been able to sleep some nights with half a nightly dose of klonopin, without payback. I am also on an antiviral and antifungal and suppliments but my guess is the ceftin or mcbar helped with sleep.

Not sure if lyme or bart has to do with my problem, but for me liquid doxepin and klonopin seem to help the most and i take them nightly. When i am in a bind from a bad med reaction or ME flare i updose sparingly, i try not to get too upset about updosing in a crisis.

Hopefully eventually at some point you will get a break and find something that helps with the sleep/anxiety or it will just get better with time. Then you can think about tapering, we all want off these drugs, but ME is terrible so we must think of our sanity first. I did post a thread last year before committing to benzos but I'm glad I did something at the time. I hope you can get some sleep.

 

[Wayne]

So running out of options here...
Must sleep.

Hi Mattie,

Sorry to hear how difficult it is for you to get quality sleep. I'm always looking for things that will improve my sleep, and have found some rather unorthodox things that help me.

Number one on my list is to eat shortly before going to bed. I realize that goes against all the conventional wisdom about how unwise it is to do that, but I consistently sleep FAR better when I schedule my last meal about an hour before retiring. If I want to get a little extra insurance for getting good sleep, I'll make sure that I eat some butter with my last meal--the more I eat, the more effective it is. Don't know why that is, but my best guess is the butyric acid in the butter.

I also generally do better when I restrict my time on the TV and computer in the evenings (though I'm not always very good at that). Since I'm sleeping better these days, I can get away with it more often than in the past. -- Speaking of the past, I took clonazepam for about 10 years, as much as 2 mg/day. I finally got to the point of realizing I needed to get off of it. The impetus for me was that my clonazepam "hangovers" were getting worse with time. It took me over a year to wean off completely, and what helped a lot was using a product called alpha-stim, which helps calm the system down.

Another unconventional thing that helps me these days is having a prescription for Tylenol 4. I believe it has 60 mg of codeine in it, which goes a LONG way toward calming my system down. Interestingly, I only need to take 1/4 to 1/6 of a tablet for it to be effective. Also, I only take it on average of about 1x/week. If I take it too regularly, I can start to feel depressed, and is easy for me to see how I could become "dependent" on it. That happened with clonazepam, and I don't want to ever do that with another drug again. -- I've noticed that when I make a teasel root tea (for Lyme), that I generally sleep better. St. John's wort tincture can also be helpful.

Addressing chronic insomnia is so invididualized, that it's hard to know what will work and what won't. I see you've gone to extraordinarily lengths to find a solution for yourself. One either thing that helps me considerably, of more spiritual or energetic nature, is to sing the HU chant (link in my signature), either outwardly or inwardly. I sort of do it automatically these days when I close my eyes to go to sleep, whether before retiring or in the middle of the night. On the rare occasions where I can't get back to sleep, it at least calms and relaxes me.

Wishing you the best in finding a solution for yourself!

Wayne

 

[TreePerson]

That's interesting @Wayne. I had a very bad patch in the summer and took non-prescription Co-Codamol for the first time which I also find helps sleep. One tablet is 8mg codeine a similar amount to what you describe. In the middle of the night half of one (4mg) plus a paracetamol will sometimes get me back to sleep. I have been taking them a bit too regularly although only at a very low dose.
I also really like butter but have been told that my cholesterol is on the high side. It's very difficult at times working out what takes priority and what to worry about most.

 

[Wayne]

I also really like butter but have been told that my cholesterol is on the high side. It's very difficult at times working out what takes priority and what to worry about most.

Hi @TreePerson,

I used to be concerned about cholesterol and fat consumption, but no longer am (and am truly grateful for that). I feel confident that the dogmatic conclusions surrounding those issues were not in anyway scientifically based. However, I do mostly eat good fats, and this includes the so-called "bad" saturated fats. The Westin Price Foundation has a lot of good information on this.

I currently believe that sugar is a far greater culprit than just about anything else when it comes to clogged arteries. A major problem with sugar is that the liver apparently becomes unable to properly metabolize large amounts of it, and the result is a bad kind of cholesterol being deposited in the body. Supporting the liver with 3-5 grams of Vit. C daily can support the liver in significant ways, and usually prevents the buildup of damaging cholesterol.

I seem to recall that @Mary has found Vitamin C to be effective for her sleep. Below is a link to a good article you may want to check out from the website "Orthomolecular Medicine". -- I believe they also have a good article on that site on how niacin is very effective for reducing cholesterol levels. Unfortunately, while on the site just now, I noticed they didn't have a search feature.

Vitamin C and Cardiovascular Disease

I began to feel so much better overall when I began to eat a higher fat, lower carbohydrate diet. When it comes to deposits of any kind in the arteries,

Getting back to the topic of Klonopin and sleep, DMSO apparently significantly improves the transfer of GABA across the blood brain barrier, and can be very helpful. I know my sleep improved when I started using DMSO regularly. -- I believe my habit of taking DMSO regularly also does a great job in helping keep my arteries clear.

Best, Wayne

 

[Mary]

Hi @Wayne - vitamin C has been helpful to me for sleep and lorazepam withdrawal, along with several other supplements (I've been off of the lorazepam for about 8 months now), here's a link about this: http://forums.phoenixrising.me/inde...p-seriously-ameliorates-excitotoxicity.48768/

Calcium pyruvate and resveratrol are also glutamate scavengers.

Also, I've just started using CBD oil. Initially I tried it at night and middle of the night and it didn't work that well, and left me sort of hungover. But I've switched to taking small doses during the day, and that seems to be much more effective and no bad side effects - e.g., yesterday I took 3 drops after breakfast and the same with lunch, and then 5 with dinner and 3 more before bed. And plan to do the same today. I also am starting gotu kola (it's never-ending!) I'm pretty sensitive to this stuff, we're all different.

re DMSO - how do you use it? do you ingest it or rub it on your skin? Do you mind sharing what specific product you use?

Thanks Wayne!

 

[TreePerson]

Thanks @Wayne. I have followed the arguments in recent years that a high-fat diet may not be so bad after all. And I have tended to subscribe to that view. Nonetheless I was a bit taken aback to find that my cholesterol is high especially as I don't eat loads and I'm not overweight.

It was actually the first time I'd had it tested but as there is emerging evidence that we may not be utilising either glucose or fats properly then I suppose that both those are likely to spike.

I have taken vitamin C for years and I have never eaten much sugar although I do like marmalade! So that's all good.

I don't know anything about DMSO I don't even know what it is! So I will look that up. Thanks so much for your help

 

[Stretched]

I have CAD (atherosclerosis, coronary artery disease), so I keep my numbers low and avoid fats, dairy, etc.

I, too would appreciate some intel on DMSO.

 

[Wayne]

re DMSO - how do you use it? do you ingest it or rub it on your skin? Do you mind sharing what specific product you use?

Hi @Mary, @Stretched, @TreePerson,

I posted fairly extensively this past year over on HR about some of my experiences with DMSO. Here's a link...

POTS Inexplicably Improves After Topical DMSO Applications

Here's a blurb I wrote on DMSO and sleep. It's from my initial post on that thread...

So, within days of liberally applying DMSO topically, I began to 1) wake up feeling much better, 2) noticed much better energy, and 3) noticed my POTS had improved significantly.

So I began to research DMSO more thoroughly online. One thing I discovered was that DMSO has the ability move GABA across the blood brain barrier—something it normally has a hard time doing. I had tried GABA in the past, and found its benefits to be modest at best.

But since I was already doing the DMSO daily, I decided to try GABA again. To my delight, it has really made a notable difference in my quality of sleep. I’ve since learned GABA is not only an important calming neurotransmitter, but that it apparently significantly stimulates human growth hormone (HGH), something I've long felt I was probably low on.
-
In my next post, I’ll try to give some specifics on my own thinking of why I’ve been able to improve as I have, and why I think these improvements may only be the start of even more significant improvements. A lot of my thinking centers around two important characteristics of DMSO: — Improves Circulation, Reduces Inflammation.​

 

[Stretched]

@Wayne Thanks, I’ll check it out

 

[Wayne]

@Wayne Thanks, I’ll check it out

The blurb below is from another post on that same thread. It also might help explain why DMSO can be helpful for some sleep problems...

,,, so I experimented with applying the DMSO to my chest. ... It was during this time of treating my chest cold that I began to notice a new relaxation in my whole body, and a lessening of pressure in my head. This trend continued when I began to apply it liberally to my sore lower back about a month ago.

Since I had read about DMSO's extraordinary ability to reduce intracranial pressure, I assumed that was why I was getting these good results. When I visited my chiropractor (who does energetic treatments) a short while later, he commented on the pressure in my head and skull being far less than at any time since I began to see him.

-​

DMSO: — Improves Circulation, Reduces Inflammation.

​

 

[Mary]

Thanks @Wayne! I've tried a ton of supplements in varying forms, but never DMSO - I will check it out.

 

[keenly]

Severe insomnia since ME onset 2 years ago.

I have been taking Klonopin for sleep now for about 6 months.
0,8 - 1 mg (liquid form called Rivotril) Never increased above 1mg.

It worked well in the first few months. Gave me about 6 hours reasonable sleep. Definitely not enough but a lot better than before.
This got less and less. For the last couple of months it's been more like 3-4 hours of sleep.
Also getting interdose withdrawal symptoms during the day.
This ongoing lack of sleep has made me so much worse.
Currently completely bedbound and after another bad night I barely have the energy to breathe.

I do not want to increase my dosage as I know all too well about the risks, especially if you keep upping the dose. But tapering down is not really an option either because if my sleep will get any worse I am afraid I will not survive for much longer.

Tried all the other stuff. None of it helped.
Other shorter acting benzo's are even worse than Klonopin. I got tolerance on them in just 2 weeks.
same for Ambien (Zolpidem). That stuff also gave me horrible interdose withdrawal.

Had a sleep study done: result: almost no deep sleep.
They put me on Amytriptyline. Did not work. Horrible side effects.
Later tried Trazodone: Did not work either. Again horrible side effects.

Melatonin: No results
Natural stuff does nothing: eg: Valerian, L-Theanine, Gaba, 5HTP, etc. Tried all the supplements ever suggested for sleep on this forum.

Cannabis: cannot tolerate it. Does not help.

Diet: tried them all. I eat like a monk. And no: Bone-broth is not an option.

Sleep hygiene: Been there, done that.
Meditation / MBSR / Relaxation: check.

Sleep or no sleep for me is the difference between being totally bedridden and having a tiny little bit of a life.

I slept like a baby for 43 years. Now virtually every night is pure torture. (daytime too)
This disease is living hell.
I have severe ME and POTS and my health is declining so rapidly it is frightening.

My GP can't help. And the last ME "specialist" I saw did not live up to the Primum non nocere oath.

So running out of options here...
Must sleep.

Circadian rhythm. Block blue light at night.

 

[Stretched]

@mattie
So runningout of options here...Must sleep.

Understood. Insomnia is the pits.

Try to remember that irrespective of our awareness the body will get the minimum sleep it needs.

One other thing that makes a difference for me is exercise, which is hard to do. IAE, a long walk mid-late afternoon helps to calm my system
down for later ease of relaxing. Without it I toss and turn. ...every little bit helps!

 

[keenly]

Blue light NEEDS to be eliminated at night.

 

[zzz]

As I gather you know, @mattie, if you are running into interdose withdrawal reactions with Klonopin, you need to taper off it before things get worse. And as you have noted, this is much easier said than done. One effective method is replacing Klonopin with gabapentin during a taper. Although the two drugs bind to different GABA sites (Klonopin on a site on the GABA(A) receptor, and gabapentin on the GABA(B1a) receptor), both drugs are allosteric modulators, and their similarity in function allows gabapentin to replace Klonopin (and other benzodiazepines) to a large extent, and thereby make tapering easier. Gabapentin itself is helpful for sleep, so there is that benefit too. Although gabapentin can be addictive, especially at higher doses, it is much less addictive than the benzodiazepines (gabapentin is not a controlled drug), and tapering off gabapentin is much easier than tapering off benzodiazepines.

I used gabapentin to successfully titrate my Klonopin dose down from 4 mg/night to 2 mg/night (which seems to be the right dose for me now) in a relatively short time with essentially no problems. I ended up with a gabapentin dose of 200 mg/night, which is fairly small.