The Best Drug for ME/CFS? The Other Side of Klonopin: A Patient's Story and A Survey

Klonopin (Clonazepam) may be the most commonly used drug in chronic fatigue syndrome (ME/CFS). Dr. Cheney hailed its use, putting the drug in the 'neuroprotector' column because its ability to reduce sensory nervous overload gave the brain, he thought, a chance to rest and rejuvenate itself. Dr. Bell agreed about its value, stating "For years I have said that Clonazepam is perhaps the most useful medication in chronic fatigue syndrome".

Indeed, studies have shown that the brains of ME/CFS patients have difficulty ignoring innocuous stimuli and some researchers believe that 'central sensitization' - a kind of central nervous system hyperactivity - is present in ME/CFS.

Klonopin's effectiveness as a sleep aid and calming agent is clear but its potential negative effects have been less well-reported. The problem is that taking Klonopin over time can, like all benzodiazepines, result in tolerance (the drug is not effective at the original dose any more), dependence (inability to stop the medication without side effects) and, in rare cases, addiction. Wikipedia reports that something called 'benzodiazepine withdrawl syndrome' 0ccurs in about a third of people treated with Klonopin (clonazepam) for longer than four weeks.

Benzodiazepine withdrawal is considered more hazardous than withdrawal from opiates and benzodiazepine withdrawal syndrome can result in anxiety, irritability, insomnia, sensory disturbances, headache, nausea, thoughts of suicide, etc. and even in very rare cases, seizures. Ironically, some the symptoms of benzodiazepine tolerance such as anxiety and thoughts of suicide can lead uninformed doctors to increase a patients dose.

Dr. Cheney and Klonopin


Dr. Cheney's 2001 view of Klonopin (http://www.prohealth.com/library/showarticle.cfm?libid=8021) , well elucidated in a report from Carol Sieverling, (not reviewed by Dr. Cheney but which he accepted for publication), has dominated the ME/CFS literature on the web. (It is the first item that comes up using a Google Search for Klonopin and chronic fatigue syndrome. The Phoenix Rising page on Klonopin, which also shows up high on search results, which is partly based on that article, has presented Klonopin in an almost wholly positive light up until now.) In fact, after reading Dr. Cheney's recommendations Gabby's doctor, who had CFS, himself, used Klonopin personally with success.

In this report Dr. Cheney was leery about calling Klonopin 'habituating' or stating that it could cause 'dependence' or withdrawal symptoms. (Dependence occurs when coming off a drug results in side effects). He felt ME/CFS patients with healthy brains could easily come off the drug but stated that if their brain was still injured coming off it could cause "all hell to break loose". He didn't feel that was a sign of 'dependence' - a relatively common occurrence with long-term use of benzodiazepenes -but instead meant the patient should still be on the drug.

"When a CFIDS patient who is still experiencing the underlying mechanisms of brain injury goes off Klonopin, there is a burst of excess neural firing and cell death. That’s the havoc we hear about that is mistakenly called withdrawal."

Dr. Cheney suggested doubling the dose during severe relapses and felt the only downside of too high of a dose of Klonopin would be to impact one's in ability to function, which would be 'inconvenient' but would actually put them into a 'healing state'. According to Carol Sieverling he stated that "You may feel like a zombie, but your brain is protected and your neurons are not getting fried. "
Gabby's Experience


Gabby (Nielk on the Phoenix Rising Forums) had a different experience. She agreed to her doctor's recommendation that she up her dose (to 3 mgs/night), only to find her old symptoms worsening over time and new ones (high blood pressure) appearing. Her withdrawl from 8 years of high-dose Klonopin use ultimately landed her in a month-long stay at a detox clinic in Florida. As Klonopin slowly washed out of her system Gabby's pain, fatigue, blood pressure, mood and sleep symptoms improved.
Not a "Do Not Use Klonopin" Blog


The intent of this blog is not to have people not use Klonopin or to get off it if they are using it. Klonopin works very well for some patients; it may, in fact, be the most prescribed drug for chronic fatigue syndrome. All of our physician commentators pointed out that different patients react differenty to drugs and Dr. Klimas pointed out that low doses can have markedly different effects from high doses.

The intent is provide some balance to what up until now has been the almost universally positive information present on Phoenix Rising (and other websites) and to make patients aware of warning signs so that they can avoid Gabby's situation.

In order to provide some perspective we asked three experienced physicians (Dr's Bateman, Lapp and Klimas) to comment on her story. A general theme emerged from their comments….all use the drug conservatively and warned about long-term use. Several noted that Gabby's higher than normal dose, and her very negative reaction were not typical.
GABBY'S STORY: KLONOPIN USE AND WITHDRAWAL


Klonopin is an anti-seizure medication that is in the Benzodiazepine family of drugs. In addition, its uses include a mood stabilizer, a tranquilizer and a sleep medication.

Patients who suffer from ME/CFS are often prescribed Klonopin to help with their insomnia and with their “neurological wired symptoms”.
Klonopin: How it works


Klonopin is a central nervous system (cns) depressant. It enhances GABA which is a neurotransmitter in the brain and tells neurons to slow down or stop firing. As a consequence, the brain’s output of excitatory neurotransmitters, including norepinephrine, serotonin, acetyl choline and dopamine, is reduced. These neurotransmitters are necessary for normal alertness, memory, muscle tone and co-ordination, emotional responses, endocrine gland secretion, heart rate and blood pressure control.

Klonopin comes with a warning to be used only as a short term treatment. Long term treatment may cause dependency and tolerance for its users. In fact, researching this drug, I found out that a third of the people taking it long term – meaning six weeks or longer, become dependent/tolerant to it. After 6 months of use this number jumps to 50% of users.

Klonopin, as well as all Benzodiazepine drugs have a very difficult and dangerous withdrawal course.
My story of Klonopin use as an ME/CFS patient:


I have been ill with ME for the past 10 years. Gradually, my symptoms worsened and I had to stop working and go on disability. I developed severe insomnia and had a sleep study taken in a hospital setting. The results of the study showed that I had many alpha wave intrusions. My doctor said that this is consistent with a CFS diagnosis which shows “neurotoxicity” of the brain. I was told that Klonopin is the most effective treatment for this and that my insomnia needed to be treated in an effectual way because sleep is the most important treatment for this illness.

I started taking Klonopin about 8 years ago. At first it was working well as far as my sleep was concerned. After a while, I became tolerant to the dose and my doctor increased it in order for it to continue working. This had to be done a number of times in order for it to remain effective.

Six years ago, I started reading about the dangers of Klonopin and Benzodiazepine drugs in general. I refused to increase my dosage which had been at the time 3 mg a night. Because I had become tolerant to the drug it was not working for me any longer. My doctor prescribed Ambien for sleep.

I was kept on my Klonopin dose of 3 mg a night because I could not reduce it in a safe way. Throughout the years I had tried at different points to slowly taper off with no success.
My problem with Klonopin Use


This past year has been my worst year yet as far as my ME/CFS is concerned. I had spent most of my year bed bound. I was in constant chronic pain. My headaches were severe and left me non-functional. I was not sleeping well and it was rare that I could get out of the house. I became depressed about my situation.

The past few months I had a new symptom of feeling edgy and my blood pressure, which has been low all the years of my illness, had increased to a high level. I started to look into these symptoms and found that one could suffer from symptoms of withdrawal from Klonopin just by remaining on a current dosage.

By then, besides feeling very edgy, I had become depressed too. I asked my doctor to help me taper off of the Klonopin. He tried by giving me Viibrid,a new medication which is an SSRI in addition to a 5HT1A receptor partial antagonist. He said that I need to build up my dosage of Viibryd in order to have a “safe” taper of the Klonopin. This didn’t work for me at all. I had a bad reaction to the Viibryd or maybe it was the combination of the Viibryd and Klonopin. I fell into a very dark, deep depression where I became suicidal. This feeling continued even though I had discontinued the Viibryd.

Another doctor tried to help me by prescribing Valium in order to help me withdraw from the Klonopin which backfired on me too. I had a paradox reaction to the Valium. In lieu of calming me, it increased my anxiety. I had to discontinue its use.

At this point, I felt totally stuck. I was suicidal. I knew that it was caused by the Klonopin but, even great doctors could not help me withdraw from Klonopin.

I now know that I was not alone in this position of no return with Klonopin. There are other patients suffering from ME/CFS who have been on long term Klonopin and found themselves in this same corner and ended their lives! This is not a subject to be taken lightly.
My recovery from Klonopin Use


I was fortunate that, with the grace of God, I was given a name of a doctor who specialized in addiction.

My family flew me down to Florida to meet him and he right away put me in a medical detox/rehab facility. I stayed there as an inpatient for 31 days. The first two weeks were sheer torture. They took away my Klonopin and Ambien the first day and substituted it with the medication Tranxene which is an older medication with a longer half life.

My health and blood pressure had to be monitored very closely. I learned there that high blood pressure is a landmark withdrawal symptom of Benzodiazapine withdrawal. I remembered that the past few months I had been suffering from high blood pressure which meant that as I thought, I had been in a state of Klonopin withdrawal all this time.

The detox/rehab facility did a great job monitoring me closely and administrating blood pressure reducing medications as needed. I needed another two weeks for rehabilitation.

Today, two weeks out of the facility, I feel like I have been given a second chance in life. I feel so much better. The only medication I am on is Trileptal which has no danger of becoming addictive. Even though I still suffer from some withdrawal symptoms which might continue for another six months to two years, I feel like a new person. I am not bed bound and my constant pain has been alleviated.

My ongoing withdrawal symptoms from KlonopinThe withdrawal symptoms still persisting include; sweating, nausea, agitation, lack of concentration, sensitivity to sound and touch, pins and needles and numbness.

These will hopefully diminish as time goes on.

Most people will not need such a “fast detox” like I went through. The slower one can taper off these Benzodiazepine medications, the safer it is. I did not have the “luxury” of time at hand. I was on a fast course to death and needed a quick fix to save my life.

I feel compelled to “tell my story” in order to help others and warn them of the very real possible dangers of starting on the road of Klonopin consumption.

I wish someone had warned me before I took my first dose of this dangerous drug.​

Used or using Klonopin or other benzodiazepines? Let us know how you did. Please take the Phoenix Rising Klonopin/Benzodiazepine Survey here


Dr. Klimas' Comments


It is a compelling story. I would think it's well worth publishing, with the comments that note that her dosage was significantly higher than typical dosing and that her story demonstrates something often seen in medicine , that drugs at a low dose can have a completely different and sometimes opposite effect that the same drug binding to the same receptor at a high concentration. The biology has to do with low affinity and high affinity receptor binding - much like the low dose naltrexone vs high dose naltrexone having quite different biologic effects.

Of course at the high dosing you also run the risk of a host of other toxic side effects, and with the valium derivatives increased fatigue, less restorative sleep and slower cognition. I won't say I don't prescribe them, but I try not to, and always at the lowest possible dose.

The other take home point here is the utility of a detox unit to get a patient with a long and potentially dangerous drug list down to a simpler regimen, allows one to see how many of the symptoms are an accumulation of side effects, and what is the baseline illness. It can be life saving in the case of patients with severe depression side effects to regimens that are meant to help, but are in fact doing harm.

And finally, its important to understand that every individual metabolizes and responds to medications differently, and the clinician needs to know if unexpected things are happening, None of us want to do harm, but trying to help often involves trying a number of different approaches, one at a time to see if it is safe and has some effectiveness.​

Dr. Bateman's Comments


Clonazepam is definitely a "double edged sword". It calms the central nervous system (CNS) but has habituating properties. Because people with CFS may have central sensitivity, reducing the dose (once habituated) can be very difficult, causing markedly amplified withdrawal symptoms. I also think most don't realize that the long half life of this drug causes pervasive effects on daytime fatigue, cognition and sometimes mood. For this reason I prescribe it sparingly and generally don't exceed 1 mg at bed.

Clonazepam, like any other drug, it neither Evil nor Good. One must simply learn about how the drug works and use it with expert guidance.

It's also good to remember that for every drug there is a range of response. For one it may be a great solution and for someone else a disaster.​

Dr. Lapp's Comments


The story is worth printing because it points out the problems of using Klonopin (or benzodiazepines) for long periods of time.

There are a couple points to make:

1. It was an ominous sign when tolerance developed, and it would have been prudent to taper off Klonopin at that time.

2. I generally do not recommend night-time doses of Klonopin greater than 2mg, because too high a dose of Klonopin can actually interfere with sleep rather than help.

3. Please recognize that this patient was atypical in her response to medications such as Viibryd and diazepam. Most patients can be withdrawn from Klonopin without such difficulty.

4. The use of Tranxene is the accepted method of withdrawal. Please note that Tranxene is SHORT acting. Thus a short-acting drug is substituted for a long acting one, and then the Tranxene must be withdrawn.

If you decide to publish this story, please make it clear that some individuals MAY have such difficulty withdrawing from benzodiazepines, but she had unique issues.​

Survey



Search




Support Phoenix Rising






(Why not support Ph0enix Rising with a $5 , $10, $15, $20 or more monthly 'subscription'. Click on the Subscribe button and look on the right hand side of the page for options :))​
View the Post on the Blog
 

Comments

Klonopin/clonazepam for many is the only long-term palliative treatment until such time as disease treatments are available. Gabby’s unrealistic expectations of the drug were partly the fault of the doctor but also Gabby for not being responsible and researching this herself.
Klonopin is not a specific treatment for insomnia and neither Dr Cheney or Dr Bell prescribe it as such, so the elevation of the dose was one issue, but that’s not all. Gabby then made the problem worse by taking an ill-advised SSRI and getting suicidally depressed - a known side effect of SSRI’s. If Gabby had done any research she would have also found Dr Cheney’s article explaining the dangers of taking SSRI’s and stimulants in ME/CFS.
That's a bit overly harsh on Gabby. It is doctors and not us who are "supposed" to be the drug experts. Many would think the opposite and think it wasnt being responsible if one was going against doctors advice and questioning it.

Unfortunately the situation is that it is the case, that we do need to be researching drugs before we start taking them as most doctors dont know what is best for complicated patients such as ourselves. A doctor who really wants to help us, may also end up trying things on us which wouldnt be usually done.

/It turns out that the real issue was 6 years of Ambien!
, a seriously dangerous drug which can cause severe reactions, induce suicidal ideation and high blood pressure, and which should never ever be mixed with such a high dose of Klonopin! If anyone took that much they would end up bedridden too. The CFS doctors consulted at the beginning of the article stated that her negative reaction was not a typical reaction to Klonopin. There’s a lot not adding up here. It was more like a typical reaction to some very serious Ambien side effects compounded by too much Klonopin. Why didn’t the CFS doctors commenting on the story figure that out?
I'd query the Ambien too. Ive heard some horrific Ambien cases and know of someone who almost died due to how that drug affected their brain.

also turns out that Gabby has not actually been diagnosed with ME/CFS, she relied on a sleep specialist saying her sleep study results were consistent with CFS but she did not mention whether she actually met the 2003 Canadian criteria, or just the CDC definition, before taking that dangerous drug combination for too many years. It’s a reasonable question to ask when she appears to have done no research on the disease in 10 years.
You've read much into her post that others including myself didnt see. Just cause she had sleep study results consistant to ME/CFS, it dont mean she wasnt diagnosed. So that is jumping to a huge conclusion to say that she only probably has the CDC definition of CFS from that.


Klonopin is a very safe long term palliative treatment for ME/CFS patients who need it but this is actually a story about the dangers of Ambien mixed with other medications! The title of this story is false, its AMBIEN, and the additional comments on the story by the three CFS doctors are unusually alarmist and worrying for anyone who relies on Klonopin to survive this DD. Do Klimas, Bateman, or Lapp actually use the Canadian criteria or do they just conform to the CDC definition?

Klonopin is recommended in the Canadian consensus criteria and has been safely used by many patients for over 10 years to alleviate muscle pain, sensory overload, anxiety, “aid” sleep or improve the rest you get when you can’t sleep, and a little extra to reduce the impact of post-exertional relapse. I have experienced that relief on 2mg a night for 8 years, and I'm alert enough to see that this story you have set up is deliberately misleading.

I can't believe this "scare story" because of the fallacious reasoning - the classic misdirection, appeal to authority, and the emotional manipulation. Its fearmongering and its dishonest. The question Cort is why are you doing this? And for who?
I too thought Cort was being a bit harsh on this drug eg the title and the biased view with just telling someones horror story and not having a good balance there of maybe also sharing another persons postive experience of it.. thou he did then bring the balance up a bit more by adding the other ME/CFS specialists views and asking them... I was very glad he did that as that helped to correct the balance issue some. (thanks cort for doing that).

I too worried that some who this drug may of helped may of been completely put off by PR seeming to support this drug is bad. (not all will be well enough to read the whole lot so may not get to see what the experts said at the bottom).

From the title, it sounded the drug was completely at fault when there were so many other factors at fault in this story (Gabby not being one of them) esp the way the doctor prescribed... I hope you come to ssee you arent being fair to Gabby by blaming her for doctor error and for maybe a slightly biased article.

Cort said he wanted to provide a balanced view to the community.. if that was so, both a positive and negative personal stories should of been presented. He thought people werent hearing this other side of things here so obviously I dont think he's realised how badly some of us have been harrassed at PR in shocking ways due to having postive experiences with this drug .

There was also much sensible debate on the bad and good of this drug in the forums here in the past with the postive and negative experiences being shared in an unbiased way. This thou is certainly one kind of hot topic.

(I was very badly harrassed and targeted and bailed up in PR chat over it in a threatening way in the past, just from sharing my more positive experience of this drug on the forums. Some have taken their negative experiences out on others who have had more postive ones. This hasnt happened thou the past few months so maybe the ones doing that got banned?).

Maybe the truer message of this isnt this drug is "bad" (which seemed to be the original intent of this thread to some of us) but rather that we all need to take care with all drugs and maybe should be doing a little research ourselves if possible before taking ANYTHING. We always cant trust that doctors are going to know what is best for us and be always doing the right thing. Not all of us thou are well enough to be doing our own research... and no ones ever at fault for not knowing something that their doctors should know.

Nielk.. Im so so glad to hear you are doing better now. Thanks for letting Cort share your story.
 
By co-incidence, I just posted a new thread on alternative anti-anxiety supplements that I have tested and found work. See here:

http://forums.phoenixrising.me/index.php?threads/completely-eliminated-my-severe-anxiety-symptoms-with-three-supplements.18369/

Perhaps these supplements will be useful for others here. They have no risk of withdrawal symptoms or dependence.
 
Klonopin/clonazepam for many is the only long-term palliative treatment until such time as disease treatments are available. Gabby’s unrealistic expectations of the drug were partly the fault of the doctor but also Gabby for not being responsible and researching this herself.

Klonopin is not a specific treatment for insomnia and neither Dr Cheney or Dr Bell prescribe it as such, so the elevation of the dose was one issue, but that’s not all. Gabby then made the problem worse by taking an ill-advised SSRI and getting suicidally depressed - a known side effect of SSRI’s. If Gabby had done any research she would have also found Dr Cheney’s article explaining the dangers of taking SSRI’s and stimulants in ME/CFS.

It then turns out that the real issue was 6 years of Ambien, a seriously dangerous drug which can cause severe reactions, induce suicidal ideation and high blood pressure, and which should never ever be mixed with such a high dose of Klonopin. The CFS doctors consulted at the beginning of the article stated that her negative reaction was not a typical reaction to Klonopin. There’s a lot not adding up here. It was more like a typical reaction to some very serious Ambien side effects compounded by too much Klonopin. Why didn’t the CFS doctors commenting on the story figure that out? A little fearmongering perhaps?

It also turns out that Gabby has not actually been diagnosed with ME/CFS, she relied on a sleep specialist saying her sleep study results were consistent with CFS but she did not mention whether she actually met the 2003 Canadian criteria, or just the CDC definition, before taking that dangerous drug combination for too many years. It’s a reasonable question to ask when she appears to have done no research on the disease in 10 years.

Gabby then survived being put through the severe stress of sudden withdrawal from two drugs, for the prize of symptoms that are indistinguishable from moderate/severe ME/CFS. I’m questioning how does a patient with such severe ME/CFS survive the physical stress of abrupt withdrawal without suffering a serious relapse? Why is no-one questioning Trileptal, a dangerous drug with serious side effects that is not recommended for ME/CFS patients?

Klonopin is a very safe long term palliative treatment for those who need it but this is actually a story about the dangers of Ambien mixed with other medications! The title of this story is false and the additional comments on the story by the three CFS doctors are unusually alarmist and worrying for anyone who relies on Klonopin to survive this DD. That survey fits in nicely with the fearmongering drummed up by this misleading story.

Klonopin is recommended in the Canadian consensus criteria and has been safely used by many patients for over 10 years. Do Klimas, Bateman, or Lapp actually use the Canadian criteria or do they just conform to the CDC definition?

I don’t trust this article because of its obvious use of fallacious reasoning: classic misdirection, and appeal to authority. The real question Cort is why are you doing this?

“Clonazepam is perhaps the most useful medication in chronic fatigue syndrome” according to the experts.
I think blaming a patient for following a doctors advice is a bit much! Most people do that unquestionably. I know that Gabby's seen at least one well known ME/CFS physician - I hope she doesn't mind my saying that - so you can throw the misdiagnosis idea out.

Gabby's problems did not begin with withdrawal at all; if you look at her post again you can see that she began experiencing new symptoms (high blood pressure) and her own symptoms got worse while on the medication; in fact it was these new symptoms and increased old symptoms which prompted her to try and get off the drug which she tried to do several times.

Klonopin may very well be a safe and palliative medication for many people with chronic fatigue syndrome - as I pointed out in the introduction, the problem is that some people don't do well on it either because they just don't well on it or they have become tolerant to it and there's nothing about that side of Klonopin on the web. Pointing out the potential dangers of long term high dose Klonopin use is not fearmongering - its being appropriately cautious. This is a complex subject - there are no simple answers...

The doctors were brought in so that they could provide an objective viewpoint and so that Gabby's story wouldn't appear alarmist, actually. I told them I realized that Klonopin is a valuable drug and that I'd want to throw the baby out with the bathwater, so to speak, asked for their opinions.....

In order to get as good a take on the effects of Klonopin we also did added a survey....I'm not sure how much more objectivity we can impart to this process.
Cort, I do think your contention that the internet only has positive things to say about klonopin is gravely mistaken. It is true that it has been portrayed positively in the ME/CFS community specifically, but not in medicine generally.

Starting in the early 1990s, it became fashionable to demonize all benzodiazepines as the latest horror story of drug addiction. Guidelines urging primary care doctors to never prescribe benzos for longer than four weeks became commonplace in many countries. Coincidentally, this was the same time that Prozac was invented and promoted as the long-term cure for almost every mental malady, from depression and anxiety to overeating and shyness. And of course, Prozac was once alleged to be the cure for ME/CFS.

At this time, SSRIs were new discoveries and very expensive, and benzodiazepines were going off patent and cheap. The fact is, true addiction to benzos (drug abuse for a high, escalating doses) is quite rare, though dependency is common and the withdrawal process can take a lot longer than with most drugs.

See this article in the Psychiatric Times "The religion of benzodiazepines" http://www.psychiatrictimes.com/print/article/10168/54151

"Despite a sharp decline in the prescription of benzodiazepines during the past decade, reservations about their use have continued to escalate. . . . Data from . . . diverse sources . . . suggest that (1) the risks of overuse, dependence, and addiction with benzodiazepines are low in relation to the massive exposure in our society; (2) benzodiazepine addiction can occur when doses within the clinical range are taken regularly over about 6 months; (3) many patients continue to derive benefit from long-term treatment with benzodiazepines; and (4) attitudes strongly against the use of these drugs may be depriving many anxious patients of appropriate treatment."4
My contention focused on information on Klonopin and ME/CFS, not Klonopin and other benzodiazepines in general. There's plenty of information on benzodiazepine problems in general. If you do a google or bing search for Klonopin and CFS you'll see sites, Phoenix Rising is one of them, that say little about problems that can occur with high-dose long term use. The Cheney piece on Prohealth has almost a 1,000 votes; nothing in that piece suggests that longterm use of high dose Klonopin can cause someones symptoms to worsen; if I was a doctor using that article - as Gabby's doctor did - I would probably do what he did - which was to up her dose when she felt worse. It was to provide more perspective on Klonopin use in ME/CFS specifically that this piece was done.
 
There are several good forums out there which are specifically for people withdrawing from benzodiazepines, such as BenzoBuddies. It doesn't let you run a search if you're not a member, but it's easy to run a search by putting "klonopin site:benzobuddies.org" into Google (without the quotation marks). I'm having a quick look, and it appears that there are people who have developed problems even if they were on a low dose. There are other similar websites out there.

There are definitely a huge number of people who find out the hard way how addictive benzodiazepines can be, and who also find that they get very poor or no support from their doctors. It's definitely not scaremongering, Nielk is far from being a one-off, and I fully approve of discussing the risks openly. It's also sensible to discuss the risks from similar drugs, such as other sleep meds (Ambien is a lot more dangerous than is generally known, for instance), opioids and anti-epileptics.

I have always kept benzodiazepines for occasional use only, although I did once take temazepam for a week, and discovered that this is too long for me, it sets off rebound insomnia afterwards - I now use it for a maximum of three days in a row. But I had a horrendous time of it coming off gabapentin, both during the taper and for several months afterwards, where again it turns out that it's known that it's addictive, but doctors don't like to acknowledge it (and certainly never warned me). I also had a week of withdrawal one time after being on co-codamol for a month, although it hadn't happened the previous time I was on co-codamol and tramadol for a month (in both cases, the pain was severe enough that I had no choice), and again found that the doctors were hopeless, assuring me vaguely that co-codamol wasn't addictive. I would never dream of taking something known to be as addictive as benzodiazepines long-term.
 
My contention focused on information on Klonopin and ME/CFS, not Klonopin and other benzodiazepines in general. There's plenty of information on benzodiazepine problems in general. If you do a google or bing search for Klonopin and CFS you'll see sites, Phoenix Rising is one of them, that say little about problems that can occur with high-dose long term use. The Cheney piece on Prohealth has almost a 1,000 votes; nothing in that piece suggests that longterm use of high dose Klonopin can cause someones symptoms to worsen; if I was a doctor using that article - as Gabby's doctor did - I would probably do what he did - which was to up her dose when she felt worse. It was to provide more perspective on Klonopin use in ME/CFS specifically that this piece was done.
I agree with you that Cheney's glowing post set the stage for a lot of false expectations. Other ME/CFS doctors have simply stated that klonopin can be useful and is frequently prescribed for the conditions.

Cheney is somewhat troublesome. He was a colleague of Dr. Peterson's at the time of the original Tahoe outbreak, but the two have long since parted ways. Peterson's approach while hardly conservative is characterized by a focus on rigorous scientific methodology, reluctance to stray from allopathic medicine, and the pursuit of just a few theories of pathogenesis related to viruses and the immune system.

Cheney has delved into and promoted almost every imaginable "theory" for how CFS might be caused and treated, sometimes based on limited evidence but other times based on speculation. I have read pieces by him promoting undenatured whey protein, klonopin, diastolic heart dysfunction, and stem cell treatments. Unfortunately, mere patients cannot distinguish when he is making stuff up and when he is talking about scientific findings.

In the klonopin article you speak of, he strongly asserts that klonopin and neurontin protect the brain from the excitotoxic damage caused by ME/CFS. He implies that if you don't take klonopin, you will suffer more brain damage. There is absolutely no clinical or even in vitro evidence to support these claims. He is just speculating.

In another article, he states that SSRIs and stimulants will damage the brain in CFS patients and patients should always avoid these drugs. More speculation.

The truth is, many doctors agree that klonopin helps CFS patients feel modestly better. Many doctors have also noted that SSRIs and stimulants can help selected patients, modestly. It is not known whether any of these medications alters the long-term cognitive effects of the disease. Most likely, none of them change the underlying brain pathology. It is likely that the expensive studies needed to answer these questions will never be done. There are no reports of dramatic recoveries with any of these medications.
 
Neurontin (gabapentin) protects the brain from the excitotoxic damage caused by ME, does it? I pretty much wrecked a year of my life due to that stuff, and let me tell you, my brain does not feel protected. More like seriously damaged, and I hope it won't be permanent. I had damned good sleep (well, by ME standards) before I took that wretched stuff, and six months after coming off it entirely, my sleep is still not back to how it was before. I'm not familiar with Cheney, I've just seen him mentioned a lot around here, but if he's said that, I'm going to treat him with immense caution. And a failure to warn all patients about the well-documented problems with benzodiazepines, Z-drugs, opioids or anti-epileptics is absolutely shameful.
 
This is from Nancy Henson - a satisfied Klonopin (and Ambien) user who turned things around with Dr. Lapp

I think its very important to STRESS that taking excessive amounts of klonopin is extremely rare. I've had CFS for nearly 30 years and being active in support groups I've know 100s of CFS patients personally. I don't recall anyone taking 3mg of klonopin at bedtime.

What I have heard far too many times was how an ill informed doctor would demand that his CFS patient go off klonopin immediately without tapering off. Can you imagine the agony of going thru that??? That is pure ignorance - and torture for the patient - but it happens very often I'm sorry to say.

So you can't blame the drug - but you can blame the doctors who are not educated about the medication.

This is another piece of evidence of how the bumbling of the CDC has hurt us by not getting doctors educated about the neurological aspects of this disease and the medications that DO help.

My Dr. Lapp was of tremendous help to me. I just wish I'd had known about him from the beginning. I was 15 years into my illness before I was treated by him in 2000. But I did have another good doctor when I first moved to Charlotte in 1997 (I became ill in '84) - Dr. lloyd Bridges - he is so very knowledgeble but was not aware of klonopin's benefits. I've tried to get Dr. Bridges on Co-Cure's Good Dr List, but the last time I checked, he still wasn't on it. Charlotte is a large city and there are so few doctors who know anything about how to treat the symptoms of the disease.

Thanks for all this important information.
 
This is from Nancy Henson - a satisfied Klonopin (and Ambien) user who turned things around with Dr. Lapp

I think its very important to STRESS that taking excessive amounts of klonopin is extremely rare. I've had CFS for nearly 30 years and being active in support groups I've know 100s of CFS patients personally. I don't recall anyone taking 3mg of klonopin at bedtime.

What I have heard far too many times was how an ill informed doctor would demand that his CFS patient go off klonopin immediately without tapering off. Can you imagine the agony of going thru that??? That is pure ignorance - and torture for the patient - but it happens very often I'm sorry to say.

So you can't blame the drug - but you can blame the doctors who are not educated about the medication.

This is another piece of evidence of how the bumbling of the CDC has hurt us by not getting doctors educated about the neurological aspects of this disease and the medications that DO help.

My Dr. Lapp was of tremendous help to me. I just wish I'd had known about him from the beginning. I was 15 years into my illness before I was treated by him in 2000. But I did have another good doctor when I first moved to Charlotte in 1997 (I became ill in '84) - Dr. lloyd Bridges - he is so very knowledgeble but was not aware of klonopin's benefits. I've tried to get Dr. Bridges on Co-Cure's Good Dr List, but the last time I checked, he still wasn't on it. Charlotte is a large city and there are so few doctors who know anything about how to treat the symptoms of the disease.

Thanks for all this important information.
And more from Nancy

Yes, I would imagine that of the sicker patients - like those that Cheney treats - may need higher doses but the average seem to be on the same as my dosage of 2 mg per day. I divide mine up across the day. 1/2 twice a day with 1mg at bedtime or 1/2 4x/day with the last at bedtime. I also take ambien. And there's another example. Some claim that ambien is not good because you need more and more and more. I've been on that for about 15 years and I've actually reduced from 10mg to 5mg at bedtime. But that's because some of the meds I take now that I wasn't on 15 years ago, also make me sleepy and help me stay asleep so I no longer need the larger dose... with the primary one being neuropathy (idiopathic as I do not have diabetes).

I think this is another example of how important it is for the treating doctor to understand this disease and the meds we take
 
This is from Nancy Henson - a satisfied Klonopin (and Ambien) user who turned things around with Dr. Lapp

I think its very important to STRESS that taking excessive amounts of klonopin is extremely rare. I've had CFS for nearly 30 years and being active in support groups I've know 100s of CFS patients personally. I don't recall anyone taking 3mg of klonopin at bedtime.

What I have heard far too many times was how an ill informed doctor would demand that his CFS patient go off klonopin immediately without tapering off. Can you imagine the agony of going thru that??? That is pure ignorance - and torture for the patient - but it happens very often I'm sorry to say.

So you can't blame the drug - but you can blame the doctors who are not educated about the medication.

This is another piece of evidence of how the bumbling of the CDC has hurt us by not getting doctors educated about the neurological aspects of this disease and the medications that DO help.

My Dr. Lapp was of tremendous help to me. I just wish I'd had known about him from the beginning. I was 15 years into my illness before I was treated by him in 2000. But I did have another good doctor when I first moved to Charlotte in 1997 (I became ill in '84) - Dr. lloyd Bridges - he is so very knowledgeble but was not aware of klonopin's benefits. I've tried to get Dr. Bridges on Co-Cure's Good Dr List, but the last time I checked, he still wasn't on it. Charlotte is a large city and there are so few doctors who know anything about how to treat the symptoms of the disease.

Thanks for all this important information.
And more from Nancy

Yes, I would imagine that of the sicker patients - like those that Cheney treats - may need higher doses but the average seem to be on the same as my dosage of 2 mg per day. I divide mine up across the day. 1/2 twice a day with 1mg at bedtime or 1/2 4x/day with the last at bedtime. I also take ambien. And there's another example. Some claim that ambien is not good because you need more and more and more. I've been on that for about 15 years and I've actually reduced from 10mg to 5mg at bedtime. But that's because some of the meds I take now that I wasn't on 15 years ago, also make me sleepy and help me stay asleep so I no longer need the larger dose... with the primary one being neuropathy (idiopathic as I do not have diabetes).

I think this is another example of how important it is for the treating doctor to understand this disease and the meds we take
One key point that I think we need reminding of is that both Klonopin and Ambien are in no way a CURE for Chronic Fatigue Syndrome or for that matter for anything else. What they basically do is "mask" the problems. When they work, there is definitely a great benefit to the quality of life of ye patient. Certainly a patient who has insomnia and takes these medications for a good sleep, they will feel much better but it's just a band-aide. I don't believe that any doctor contends that by taking these medications, one is "curing" ME/CFS.

I am not sure why one would think that taking 2mg of Klonopin a day with the addition of Ambien is average and fine whereas 3mg a day is a "very large dose".

If one reads Dr. Cheney's interview about the "Klonopin Myths", he advises that CFS patients should start by taking .5mg in the morning and 3 to 4 times that amount in the evening. Moreover, he stresses that when one is in a crash, they should easily double that dosage. That would amount to 5mg a day.

"Nancy" is very fortunate that this dose is working well for her and I'm sure there are many patients out there who see the same benefit. I was that patient a few years ago.

The problem begins for some of us when this drug starts "turning on you" and this happens to many out there.

I personally have seen this and heard of many cases where this has happened.

There is no way that I know of to predict when and to whom this is going to happen to. I never thought that this will happen to me. For a while, it worked great for me. I had no previous problem with becoming so tolerant to a medication that I could not comfortably taper off of it and I had been on many medications before.

If Nancy and others like her will just keep this in mind so that if God forbid they start showing signs of dependence, they will take heed and seek out help to taper off of it, then I would have done what I accomplished to do by publicizing my story.
 
Calathea,

You did not say whether you were a ME/CFS patient or not? Since you mentioned sleep problems, I'm guessing you are. Disturbed and unrefreshing sleep is an important marker for ME/CFS.

After detoxing did your sleep go back to an acceptable state? Did your ME/CFS symptoms improve? Other than not being addicted to Temazepam, what has improved or changed?

Had you become addicted to Temazepam, what would have been the worst outcome? What would have been the harm withdrawing from it a year from now? A decade from now? Or thirty years from now? Other than improved sleep for the duration, that is.

Are you on disability or do you still work? I ask this question because when on disability the necessity for sleep becomes much less urgent. People who must follow a daily schedule of work would find it extremely hard, if not torturous, to find any quality of life on two or three hours of fractured sleep per night.

According to the UN forced wakefulness as a form of torture is banned by international treaty. Verified consequences of continuous wakefulness include hallucination, psychosis, suicidal ideation, and sometimes irreparable depression and PTSD.

I wonder how your detox would compare to going an indefinite period with little or no sleep? For example, going a month getting two hours sleep per night. While trying to hold down a job. Along with your other ME/CFS symptoms. Two really bad choices. But choices that people like me have had to make.

As I have said exhaustively, there are very, very few alternatives. There are no effective treatments for ME/CFS. If there were we wouldn't be reading this now. We would all be getting infusions of Ampligen or Rituximab or whatever. None of that works now. There is hope, that's about it.

Like Cort, you stated that you aren't anti-benzo. You, Cort, Gabby just want "doctors to be very, very careful" when prescribing. But we know the doctors are not going to grasp the fine print of such an oblique, nuanced statement. A doctor simply cannot predict when Ms. Nielk is going to have a horrendous neurological reaction. They are simply going to stop giving them to patients who need them. That has already started to happen.

As for "benzo.buddies", I don't believe most stories submitted by admitted drug addicts on a web forum. The excuse "I didn't know" and the "doctor gave them to me" among that group is simply not compelling. I have been around enough alcoholics and drug addicts to know how they rationalize. They are probably not admitting their own role in experimention and getting high with such drugs, probably starting at a very early age. Probably using drugs at school, stolen from parents, buying on the illegal market, etc..

A reasonable doctor should expect his patients to know about the potential for benzo habituation. What do Jimi Hendrix, Janis Joplin, Jim Morrison, Kurt Cobain, Heath Ledger have in common? It is simply impossible for a senscient not to know about the dangers of drug abuse, overdose. A patient would have to be living in a cave to not know this. Which is why I question those who claim "the doctor said it wasn't addictive."

Back in the 70s, my mother told us the stories of Judy Garland and Marilyn Monroe, "who killed themselves with those pills." Of course back then it was barbituates. They knew then, and everybody knows now. You cannot be alive and not know these obvious facts. It defies common sense.

As I have exhaustively stated there are no alternatives to drugs like Klonopin. There are no effective treatments for ME/CFS. Cort and the blogger Gabby are well-meaning, but they are effectively pouring diesel fuel into the drinking water. It has effectively polluted the lifeline for the rest of us. If these drugs don't agree you shouldn't take them. Blogging or promoting questionable web sites just makes it difficult for those who are truly ill, and have no choice but to use them to get through each day.
 
Calathea,

You did not say whether you were a ME/CFS patient or not? Since you mentioned sleep problems, I'm guessing you are. Disturbed and unrefreshing sleep is an important marker for ME/CFS.

After detoxing did your sleep go back to an acceptable state? Did your ME/CFS symptoms improve? Other than not being addicted to Temazepam, what has improved or changed?

Had you become addicted to Temazepam, what would have been the worst outcome? What would have been the harm withdrawing from it a year from now? A decade from now? Or thirty years from now? Other than improved sleep for the duration, that is.

Are you on disability or do you still work? I ask this question because when on disability the necessity for sleep becomes much less urgent. People who must follow a daily schedule of work would find it extremely hard, if not torturous, to find any quality of life on two or three hours of fractured sleep per night.

According to the UN forced wakefulness as a form of torture is banned by international treaty. Verified consequences of continuous wakefulness include hallucination, psychosis, suicidal ideation, and sometimes irreparable depression and PTSD.

I wonder how your detox would compare to going an indefinite period with little or no sleep? For example, going a month getting two hours sleep per night. While trying to hold down a job. Along with your other ME/CFS symptoms. Two really bad choices. But choices that people like me have had to make.

As I have said exhaustively, there are very, very few alternatives. There are no effective treatments for ME/CFS. If there were we wouldn't be reading this now. We would all be getting infusions of Ampligen or Rituximab or whatever. None of that works now. There is hope, that's about it.

Like Cort, you stated that you aren't anti-benzo. You, Cort, Gabby just want "doctors to be very, very careful" when prescribing. But we know the doctors are not going to grasp the fine print of such an oblique, nuanced statement. A doctor simply cannot predict when Ms. Nielk is going to have a horrendous neurological reaction. They are simply going to stop giving them to patients who need them. That has already started to happen.

As for "benzo.buddies", I don't believe most stories submitted by admitted drug addicts on a web forum. The excuse "I didn't know" and the "doctor gave them to me" among that group is simply not compelling. I have been around enough alcoholics and drug addicts to know how they rationalize. They are probably not admitting their own role in experimention and getting high with such drugs, probably starting at a very early age. Probably using drugs at school, stolen from parents, buying on the illegal market, etc..

A reasonable doctor should expect his patients to know about the potential for benzo habituation. What do Jimi Hendrix, Janis Joplin, Jim Morrison, Kurt Cobain, Heath Ledger have in common? It is simply impossible for a senscient not to know about the dangers of drug abuse, overdose. A patient would have to be living in a cave to not know this. Which is why I question those who claim "the doctor said it wasn't addictive."

Back in the 70s, my mother told us the stories of Judy Garland and Marilyn Monroe, "who killed themselves with those pills." Of course back then it was barbituates. They knew then, and everybody knows now. You cannot be alive and not know these obvious facts. It defies common sense.

As I have exhaustively stated there are no alternatives to drugs like Klonopin. There are no effective treatments for ME/CFS. Cort and the blogger Gabby are well-meaning, but they are effectively pouring diesel fuel into the drinking water. It has effectively polluted the lifeline for the rest of us. If these drugs don't agree you shouldn't take them. Blogging or promoting questionable web sites just makes it difficult for those who are truly ill, and have no choice but to use them to get through each day.
Valcyte has helped me alot and antivirals in general taking me from a 3 out of 10 to an 8 and i have only been on valcyte for 3 months with a few more months to go with hopefully more improvement. There are others who also who have made alot of improvement with antivirals, so dont know how u can say there is nothing out there.
 
My contention focused on information on Klonopin and ME/CFS, not Klonopin and other benzodiazepines in general. There's plenty of information on benzodiazepine problems in general. If you do a google or bing search for Klonopin and CFS you'll see sites, Phoenix Rising is one of them, that say little about problems that can occur with high-dose long term use. The Cheney piece on Prohealth has almost a 1,000 votes; nothing in that piece suggests that longterm use of high dose Klonopin can cause someones symptoms to worsen; if I was a doctor using that article - as Gabby's doctor did - I would probably do what he did - which was to up her dose when she felt worse. It was to provide more perspective on Klonopin use in ME/CFS specifically that this piece was done.
I agree with you that Cheney's glowing post set the stage for a lot of false expectations. Other ME/CFS doctors have simply stated that klonopin can be useful and is frequently prescribed for the conditions.

Cheney is somewhat troublesome. He was a colleague of Dr. Peterson's at the time of the original Tahoe outbreak, but the two have long since parted ways. Peterson's approach while hardly conservative is characterized by a focus on rigorous scientific methodology, reluctance to stray from allopathic medicine, and the pursuit of just a few theories of pathogenesis related to viruses and the immune system.

Cheney has delved into and promoted almost every imaginable "theory" for how CFS might be caused and treated, sometimes based on limited evidence but other times based on speculation. I have read pieces by him promoting undenatured whey protein, klonopin, diastolic heart dysfunction, and stem cell treatments. Unfortunately, mere patients cannot distinguish when he is making stuff up and when he is talking about scientific findings.

In the klonopin article you speak of, he strongly asserts that klonopin and neurontin protect the brain from the excitotoxic damage caused by ME/CFS. He implies that if you don't take klonopin, you will suffer more brain damage. There is absolutely no clinical or even in vitro evidence to support these claims. He is just speculating.

In another article, he states that SSRIs and stimulants will damage the brain in CFS patients and patients should always avoid these drugs. More speculation.

The truth is, many doctors agree that klonopin helps CFS patients feel modestly better. Many doctors have also noted that SSRIs and stimulants can help selected patients, modestly. It is not known whether any of these medications alters the long-term cognitive effects of the disease. Most likely, none of them change the underlying brain pathology. It is likely that the expensive studies needed to answer these questions will never be done. There are no reports of dramatic recoveries with any of these medications.
All of the ME/CFS specialist docs do that. Every idea that comes along, they glom on to it and say what a wonderful discovery it is. Cheney is just a little more imaginative than most.

I haven't met any patients who have taken stimulants or anti-depressants and been "helped" by them. Mostly just the opposite.
 
Calathea,

You did not say whether you were a ME/CFS patient or not? Since you mentioned sleep problems, I'm guessing you are. Disturbed and unrefreshing sleep is an important marker for ME/CFS.

After detoxing did your sleep go back to an acceptable state? Did your ME/CFS symptoms improve? Other than not being addicted to Temazepam, what has improved or changed?

Had you become addicted to Temazepam, what would have been the worst outcome? What would have been the harm withdrawing from it a year from now? A decade from now? Or thirty years from now? Other than improved sleep for the duration, that is.

Are you on disability or do you still work? I ask this question because when on disability the necessity for sleep becomes much less urgent. People who must follow a daily schedule of work would find it extremely hard, if not torturous, to find any quality of life on two or three hours of fractured sleep per night.

According to the UN forced wakefulness as a form of torture is banned by international treaty. Verified consequences of continuous wakefulness include hallucination, psychosis, suicidal ideation, and sometimes irreparable depression and PTSD.

I wonder how your detox would compare to going an indefinite period with little or no sleep? For example, going a month getting two hours sleep per night. While trying to hold down a job. Along with your other ME/CFS symptoms. Two really bad choices. But choices that people like me have had to make.

As I have said exhaustively, there are very, very few alternatives. There are no effective treatments for ME/CFS. If there were we wouldn't be reading this now. We would all be getting infusions of Ampligen or Rituximab or whatever. None of that works now. There is hope, that's about it.

Like Cort, you stated that you aren't anti-benzo. You, Cort, Gabby just want "doctors to be very, very careful" when prescribing. But we know the doctors are not going to grasp the fine print of such an oblique, nuanced statement. A doctor simply cannot predict when Ms. Nielk is going to have a horrendous neurological reaction. They are simply going to stop giving them to patients who need them. That has already started to happen.

As for "benzo.buddies", I don't believe most stories submitted by admitted drug addicts on a web forum. The excuse "I didn't know" and the "doctor gave them to me" among that group is simply not compelling. I have been around enough alcoholics and drug addicts to know how they rationalize. They are probably not admitting their own role in experimention and getting high with such drugs, probably starting at a very early age. Probably using drugs at school, stolen from parents, buying on the illegal market, etc..

A reasonable doctor should expect his patients to know about the potential for benzo habituation. What do Jimi Hendrix, Janis Joplin, Jim Morrison, Kurt Cobain, Heath Ledger have in common? It is simply impossible for a senscient not to know about the dangers of drug abuse, overdose. A patient would have to be living in a cave to not know this. Which is why I question those who claim "the doctor said it wasn't addictive."

Back in the 70s, my mother told us the stories of Judy Garland and Marilyn Monroe, "who killed themselves with those pills." Of course back then it was barbituates. They knew then, and everybody knows now. You cannot be alive and not know these obvious facts. It defies common sense.

As I have exhaustively stated there are no alternatives to drugs like Klonopin. There are no effective treatments for ME/CFS. Cort and the blogger Gabby are well-meaning, but they are effectively pouring diesel fuel into the drinking water. It has effectively polluted the lifeline for the rest of us. If these drugs don't agree you shouldn't take them. Blogging or promoting questionable web sites just makes it difficult for those who are truly ill, and have no choice but to use them to get through each day.
Valcyte has helped me alot and antivirals in general taking me from a 3 out of 10 to an 8 and i have only been on valcyte for 3 months with a few more months to go with hopefully more improvement. There are others who also who have made alot of improvement with antivirals, so dont know how u can say there is nothing out there.
Honestly, Heapsreal, I'm really happy you feel better. I wish I could find something like that....and I swear I would never take any Klonopin, Valium or Temazepam every again.
 
I havent sorted my sleep yet but if i can maintain or improve i will look at getting off sleep meds. I think there are treatments out there for some, depends if the issues can be found, with me it was obviously the herpes viruses like ebv/cmv. Just have to keep looking, hopefully get lucky and something will raise its head, sometimes i think it can be multiple things which makes it even harder.
 
Cort.. Im glad you have set up that survey with the doses to find out how much most with ME/CFS are taking so we can really see what is happening out there in the real world as far as it comes to us. Thanks.
'
Thanks - we have 86 responses so far - so we're getting some good information on this...The more the better...I haven't looked much at the pattern of responses - I want to wait until the survey is about finished...
 
My contention focused on information on Klonopin and ME/CFS, not Klonopin and other benzodiazepines in general. There's plenty of information on benzodiazepine problems in general. If you do a google or bing search for Klonopin and CFS you'll see sites, Phoenix Rising is one of them, that say little about problems that can occur with high-dose long term use. The Cheney piece on Prohealth has almost a 1,000 votes; nothing in that piece suggests that longterm use of high dose Klonopin can cause someones symptoms to worsen; if I was a doctor using that article - as Gabby's doctor did - I would probably do what he did - which was to up her dose when she felt worse. It was to provide more perspective on Klonopin use in ME/CFS specifically that this piece was done.
I agree with you that Cheney's glowing post set the stage for a lot of false expectations. Other ME/CFS doctors have simply stated that klonopin can be useful and is frequently prescribed for the conditions.

Cheney is somewhat troublesome. He was a colleague of Dr. Peterson's at the time of the original Tahoe outbreak, but the two have long since parted ways. Peterson's approach while hardly conservative is characterized by a focus on rigorous scientific methodology, reluctance to stray from allopathic medicine, and the pursuit of just a few theories of pathogenesis related to viruses and the immune system.

Cheney has delved into and promoted almost every imaginable "theory" for how CFS might be caused and treated, sometimes based on limited evidence but other times based on speculation. I have read pieces by him promoting undenatured whey protein, klonopin, diastolic heart dysfunction, and stem cell treatments. Unfortunately, mere patients cannot distinguish when he is making stuff up and when he is talking about scientific findings.

In the klonopin article you speak of, he strongly asserts that klonopin and neurontin protect the brain from the excitotoxic damage caused by ME/CFS. He implies that if you don't take klonopin, you will suffer more brain damage. There is absolutely no clinical or even in vitro evidence to support these claims. He is just speculating.

In another article, he states that SSRIs and stimulants will damage the brain in CFS patients and patients should always avoid these drugs. More speculation.

The truth is, many doctors agree that klonopin helps CFS patients feel modestly better. Many doctors have also noted that SSRIs and stimulants can help selected patients, modestly. It is not known whether any of these medications alters the long-term cognitive effects of the disease. Most likely, none of them change the underlying brain pathology. It is likely that the expensive studies needed to answer these questions will never be done. There are no reports of dramatic recoveries with any of these medications.
Thanks - by the way I tried to edit my comment...in an earlier comment it appeared that I was referring to benzodiazepines in general - my mistake.
 
Calathea,
As I have exhaustively stated there are no alternatives to drugs like Klonopin. There are no effective treatments for ME/CFS. Cort and the blogger Gabby are well-meaning, but they are effectively pouring diesel fuel into the drinking water. It has effectively polluted the lifeline for the rest of us. If these drugs don't agree you shouldn't take them. Blogging or promoting questionable web sites just makes it difficult for those who are truly ill, and have no choice but to use them to get through each day.
MishMash I understand your concern and it is true that negative stories tend to stick in our minds more than positive stories. I really do think the survey is going to be very helpful in this area. I haven't looked at the results but I imagine some people will do very well on Klonopin - after all Dr. Bell stated at one point that its the best drug he's used for ME/CFS - and then there will be those who wouldn't touch it again with a 10 foot pole.

I imagine that if we took at poll of people using all sorts of prescription drugs we'd find a similar pattern....I know people who are functioning due to beta blockers and others who felt like they were going to kick the bucket because of them..
 
I'm surprised and dismayed at the level of hostility exhibited by some of the posts on this thread, because it is (fortunately) so rare for this forum.

I'm guessing this topic is so controversial due to society's self-righteous and judgemental attitudes towards drug addiction. After all, drug addiction is merely a moral failing, lack of discipline, and proof of laziness. All mortal sins, to be sure.

After years of 12-step meetings, attempting to recover from being harmed by my father's addiction to alchohol, I have learned it is never appropriate for me to say, "You should do X", or "You should never do X". It is appropriate, and sometimes helpful for other people, to say, "This is what happened to me."

It is unreasonable to expect sick people to do their own medical research, though many of us have been forced to. This is what doctors are very well paid to do. I wish more of them would actually do it, because I am tired of trying to be my own doctor.

Despite doctors spouting platitudes like "You are the captian of your ship", refusing to follow the doctor's prescriptions, thus being labeled 'non-compliant', is a tricky business, potentially leading to denial of needed treatment by passive-agressive doctors. At least one doctor has threatened to withhold Imitrex, a common migraine medication, if I didn't "get the blood pressure under control". In fact, my BP is generally only high at the doctor's office, a fact they refuse to acknowledge. For me, lower BP is associated with being sicker, and I have never observed Imitrex to raise my BP.

Neilk, thankyou for posting your story. I found nothing in the original post suggesting that no one should ever take klonopin. Making us aware of potential severe problems is entirely appropriate. I'm glad to read that you are recovering from what appears to be yet another example of iatrogenic harm.
 
I too thought Cort was being a bit harsh on this drug eg the title and the biased view with just telling someones horror story and not having a good balance there of maybe also sharing another persons postive experience of it.. thou he did then bring the balance up a bit more by adding the other ME/CFS specialists views and asking them... I was very glad he did that as that helped to correct the balance issue some. (thanks cort for doing that).

I too worried that some who this drug may of helped may of been completely put off by PR seeming to support this drug is bad. (not all will be well enough to read the whole lot so may not get to see what the experts said at the bottom).

From the title, it sounded the drug was completely at fault when there were so many other factors at fault in this story (Gabby not being one of them) esp the way the doctor prescribed... I hope you come to ssee you arent being fair to Gabby by blaming her for doctor error and for maybe a slightly biased article.

Cort said he wanted to provide a balanced view to the community.. if that was so, both a positive and negative personal stories should of been presented. He thought people werent hearing this other side of things here so obviously I dont think he's realised how badly some of us have been harrassed at PR in shocking ways due to having postive experiences with this drug .

There was also much sensible debate on the bad and good of this drug in the forums here in the past with the postive and negative experiences being shared in an unbiased way. This thou is certainly one kind of hot topic.

(I was very badly harrassed and targeted and bailed up in PR chat over it in a threatening way in the past, just from sharing my more positive experience of this drug on the forums. Some have taken their negative experiences out on others who have had more postive ones. This hasnt happened thou the past few months so maybe the ones doing that got banned?).

Maybe the truer message of this isnt this drug is "bad" (which seemed to be the original intent of this thread to some of us) but rather that we all need to take care with all drugs and maybe should be doing a little research ourselves if possible before taking ANYTHING. We always cant trust that doctors are going to know what is best for us and be always doing the right thing. Not all of us thou are well enough to be doing our own research... and no ones ever at fault for not knowing something that their doctors should know.

Nielk.. Im so so glad to hear you are doing better now. Thanks for letting Cort share your story.
I think if you'll go back and look at the piece, though, you'll see that the positive aspects of Klonopin were clearly stated in the beginning of the piece...as they are on the website.....and the major thrust of the article was that more information needs to be present on the potential downside of particularly longterm, high dose Klonopin use. Given the situation Gabby fell into that kind of information clearly needs to be present on chronic fatigue syndrome websites...

Yes the title was provocative..and many of them are..I want to point out that the 3 physicians we contacted view and use the drug more conservatively than was suggested in the Prohealth post Perhaps the title was too provocative or perhaps it wasn't (I'm kind of back and forth on that myself; it was a question I had from the beginning)) but it helped get this discussion going and that's a good thing....

Klonopin (Clonazepam) may be the most commonly used drug in chronic fatigue syndrome (ME/CFS). Dr. Cheney hailed its use, putting the drug in the 'neuroprotector' column because its ability to reduce sensory nervous overload gave the brain, he thought, a chance to rest and rejuvenate itself. Dr. Bell agreed about its value, stating "For years I have said that Clonazepam is perhaps the most useful medication in chronic fatigue syndrome".

Indeed, studies have shown that the brains of ME/CFS patients have difficulty ignoring innocuous stimuli and some researchers believe that 'central sensitization' - a kind of central nervous system hyperactivity - is present in ME/CFS.

Klonopin's effectiveness as a sleep aid and calming agent is clear but its potential negative effects have been less well-reported.
 
MishMash,

You say:

There are no effective treatments for ME/CFS. If there were we wouldn't be reading this now. We would all be getting infusions of Ampligen or Rituximab or whatever. None of that works now. There is hope, that's about it.
Have you tried all the treatments that various patients here report as having helped them? Even if you have, all you can say is that none of those treatments have helped you. There are many more treatment options than the few you have listed. True, no one has found a "cure" that works in the majority of patients, but there are many treatments that have helped a good percentage--including the antivirals that Heaps has written about.

I have also been helped considerably by a combination of different treatments--including low doses of klonopin--...and yes I have been diagnosed according to the international criteria for ME.

Sushi