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#705893 - 05/28/08 06:40 PM Withdrawl from Klonopin - Input Please?
alexandrea alexandrea Newbie Registered: 07/25/07 Posts: 43	I am on a low dose .75 mg nightly which was perscribed to me about 9 months ago to control panic attacks. It has been working quite well but I am now thinking about starting a family and would want to taper from this drug. I am concerned about the resurgence of panic attacks and mostly what to expect when tapering. Anyone have exp. going off a low dose of this medication that can inform me of how it went? Thanks in advance for your input :-)
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#705906 - 05/28/08 07:07 PM Re: Withdrawl from Klonopin - Input Please? [Re: alexandrea]
Cooly Cooly Board Addict Registered: 02/08/05 Posts: 394	That's not a low dose. I would tell your doctor exactly what you've told this board "I want to start a family....", and I'm sure he'll readily get you off of Klonopin (safely-hopefully) If you don't want to go that route, then you can Ashton Manual for benzo withdrawal.... http://www.benzo.org.uk/manual/ Edited by Cooly (05/28/08 07:08 PM)
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#705969 - 05/28/08 10:26 PM Re: Withdrawl from Klonopin - Input Please? [Re: Cooly]
WingsOfWax WingsOfWax Journeyman Registered: 05/22/08 Posts: 77	While it may not be a low dose, it certainly isn't a high dose either, so don't worry too much. You will be alright, if you do a slow taper. Good luck.
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#705984 - 05/28/08 11:12 PM Re: Withdrawl from Klonopin - Input Please? [Re: alexandrea]
jehza1 jehza1 Veteran Registered: 02/28/08 Posts: 537 Loc: Southwest US	Originally Posted By: alexandrea I am on a low dose .75 mg nightly which was perscribed to me about 9 months ago to control panic attacks. It has been working quite well but I am now thinking about starting a family and would want to taper from this drug. I am concerned about the resurgence of panic attacks and mostly what to expect when tapering. Anyone have exp. going off a low dose of this medication that can inform me of how it went? Thanks in advance for your input :-) Yes, I tapered off 1mg, and it took about six months before I felt normal again (except that normal was admittedly somehow different). You are going to have to be tenacious and do it slowly. I quit using benzos for the same reason (pregnancy), and it was hard, but I had also been taking one benzo or another for the better part of a decade. At the end of my third trimester, I went back on Zoloft, as I was declining from the anxiety. I would give your mind and body at least a year before trying to get pregnant. IMO, of course, as others seem to withdrawl with relatively few problems. _________________________ The average pencil is seven inches long, with just a half-inch eraser - in case you thought optimism was dead.
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#706158 - 05/29/08 10:00 AM Re: Withdrawl from Klonopin - Input Please? [Re: alexandrea]
JokerOwling JokerOwling Pooh-Bah Registered: 07/14/07 Posts: 1214 Loc: here at the moment	Nitrazepam(Mogadon) is a great med to help come off Clonazepam.Its closely related but feels quite different.If you take the Nitrazepam at an adequate dose at night,it will carry you through the next day.Nitrazepam is much less potent and easier to taper off. I have found taking the nitrazepam takes the edge off stopping the clonazepam and allows you to stop it much quicker.Tapering off the nitazepam is much easier and you can stop it much quicker too. Depending on how long you have been taking the clonazepam,it can take weeks or months before you start to notice feeling 'different',which can mean better or worse depending on the underlying condition. _________________________ "A magnesium deficiency may be responsible for more diseases than any other nutrient."-Dr.Norman Shealy,Neurosurgeon&Chronic Pain expert.
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#706166 - 05/29/08 10:11 AM Re: Withdrawl from Klonopin - Input Please? [Re: JokerOwling]
WingsOfWax WingsOfWax Journeyman Registered: 05/22/08 Posts: 77	Some doctors also use barbiturates to replace benzo use, specifically phenobarbital. It prevents seizures, and makes for a more rapid tapering.
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#706173 - 05/29/08 10:29 AM Re: Withdrawl from Klonopin - Input Please? [Re: WingsOfWax]
pugpin pugpin Enthusiast Registered: 02/06/07 Posts: 235	i was on high doses of klonopin after a post partum depression. i first started out at 4mg a day which is ALLOT. even if the dose was high, trust me it was appropriate in my situation and it took that much to even out the anxiety level. after i got situated on an SSRI, i was able to just reduce the dose. i didn't even have to try. i got stuck on .25mg at night for a long time. i did go off the .25mg by cutting the pills in to quarters. i think titration off from meds is a personal thing. you have to set a plan and stick to it all while maintaining your comfort level. the other thing is to work with your doctor however, in many cases doctors don't understand it takes allot longer to titrate off. just depends. i was off klonopin for a long time but i had to go back on when a death in my family brought on a return of my severest symptoms. now i'm okay with taking .25-.5mg PRN. i don't worry about it or feel guilty about it anymore. i think it's great that you want to make sure you are off the klonopin prior to getting pregnant. if you really want this, you will do it. hang in there
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#706177 - 05/29/08 10:36 AM Re: Withdrawl from Klonopin - Input Please? [Re: WingsOfWax]
Strawberry Strawberry GOLDEN EAGLE GRAND Pooh-Bah Registered: 01/29/06 Posts: 5336	Originally Posted By: WingsOfWax Some doctors also use barbiturates to replace benzo use, specifically phenobarbital. It prevents seizures, and makes for a more rapid tapering. yes that may be true( and correct) but don't forget the poster says their thinking about starting a family. so although .75mg Klonopin does not sound like a lot, to a baby it would be. The Ashton manuel has a taper schedule, and I am sure your going to a face to face vist with your doctor if this is a plan. just be honest with you doctor and she should get you something safe to use for the taper. Maybe CBT with another doctor and tapering may work, But for something this important I would give my docotor the complete truth. and good luck to you and your upcoming new family! Attachments Description: _________________________ .
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#706313 - 05/29/08 02:56 PM Re: Withdrawal from Klonopin - Input Please? [Re: JokerOwling]
nephro nephro GRAND Pooh-Bah Registered: 09/04/06 Posts: 8814 Loc: UK, despite the rumours	Originally Posted By: JokerOwling Nitrazepam(Mogadon) is a great med to help come off Clonazepam.Its closely related but feels quite different.If you take the Nitrazepam at an adequate dose at night,it will carry you through the next day.Nitrazepam is much less potent and easier to taper off. I have found taking the nitrazepam takes the edge off stopping the clonazepam and allows you to stop it much quicker.Tapering off the nitazepam is much easier and you can stop it much quicker too. Depending on how long you have been taking the clonazepam,it can take weeks or months before you start to notice feeling 'different',which can mean better or worse depending on the underlying condition. This is the theory behind using diazepam; diazepam has a half-life of up to 200 hours with regular use, and the dose can be taken at night. Stits has quite some experience with benzodiazepines, and says that withdrawal from clonazepam is particularly difficult, despite its relatively long half-life. It has no active metabolites either. Clorazepate dipotassium (Tranxene) is available in extended-release form in some coutries; even the IR form has a half-life of up to 200 hours. Flurazepam (Damlane) and chlordiezepoxide (Librium) are also good candidates for tapering, and doses are high enough for slow withdrawal.
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#706497 - 05/29/08 07:59 PM Re: Withdrawl from Klonopin - Input Please? [Re: alexandrea]
whacker1 whacker1 Journeyman Registered: 01/11/07 Posts: 57 Loc: An allegedly free country	Clonazepam is actually quite easy to taper from. .125mg a month is pretty painless. If a .125mg cut is too much for you , there are a few ways around it. 1. Mix and match it with Librium. A half cap (2.5mg) along with a .125mg cut should be barely noticeable. If you can't handle that then... 2. Buy a gram scale. Crush the 1/4 .5mg tablet piece, and remove a fraction. Bit of a pain, but an easy taper at .03125mg a week. 3. Crush a .125 piece. Mix with lactose, or other bulking agent. Cut mixture into desire fraction. 4. Make an oral solution with suspension syrup such as Ora-Plus/Ora-Blend. Plain old glycerine, as well as propylene glycol, or polyethylene glycol should work as well. _________________________ They don't know nothing about redemption. They don't know nothing about recovery. Some people just ain't the type for marriage and family.
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#706559 - 05/29/08 11:43 PM Re: Withdrawal from Klonopin - Input Please? [Re: nephro]
JokerOwling JokerOwling Pooh-Bah Registered: 07/14/07 Posts: 1214 Loc: here at the moment	Originally Posted By: nephro This is the theory behind using diazepam; diazepam has a half-life of up to 200 hours with regular use, and the dose can be taken at night. Stits has quite some experience with benzodiazepines, and says that withdrawal from clonazepam is particularly difficult, despite its relatively long half-life. It has no active metabolites either. I agree with the diazepam theory,but when it comes to clonazepam the subjective feeling of diazepam doesnt 'cut it'. Because nitrazepam is closely related to clonazepam but less potent,it allows a 'comfortable' experience when swapping over and tapering.Using nitrazepam avoids the 'headache'(and other) subjective feelings that will still be present with almost every other benzo. Regarding the active metabolites of clonazepam,I've seen mixed references,some say no active,and some say it is unknown whether they are active.My experience tells me they are mildly active when it comes to subjective feelings.They may be inactive as far as anti-epileptic qualities though. _________________________ "A magnesium deficiency may be responsible for more diseases than any other nutrient."-Dr.Norman Shealy,Neurosurgeon&Chronic Pain expert.
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#706689 - 05/30/08 08:38 AM Re: Withdrawl from Klonopin - Input Please? [Re: whacker1]
alexandrea alexandrea Newbie Registered: 07/25/07 Posts: 43	Thanks for all the input. I talked to my doctor and she is understanding. She is willing to help me taper and knows my exact situation. I've been on the stuff for less then a year - maybe 9 months? She gave me 2 perscriptions for disolvable tablets in .25 mg's and .125 mg's strength in place of my previous .50's and .25's I plan to start by cutting back .125 per night in exact amount this way. I did this the past 2 nights and so far the most noticeable affects are: I have not slept nearly as well and dreaming more, tired mostly but nothing intolerable. I am going to try 2 .25's and 1 .125 per night until I feel "normal" then cut back to just 2 .25's per night ect, ect... and see what happens. What I don't get is why drs will tell you you can take an SSRI during pregnancy but not a benzo. I had a most awful experience coming off Lexapro after just a few months which inculded hallucination. This is when I switched to Klonopin which has worked wonders without all the crazy side effects. I don't know how an SSRI could not affect a baby.
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#706747 - 05/30/08 10:30 AM Re: Withdrawl from Klonopin - Input Please? [Re: alexandrea]
JokerOwling JokerOwling Pooh-Bah Registered: 07/14/07 Posts: 1214 Loc: here at the moment	Good to hear your dr is understanding alexandrea.Keep us updated if you can. Taking 5-htp or tryptophan can often have the same benefit as SSRI's without the side effects,and often help with tapering from benzos for many people. All the best with starting a family too. _________________________ "A magnesium deficiency may be responsible for more diseases than any other nutrient."-Dr.Norman Shealy,Neurosurgeon&Chronic Pain expert.
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#706749 - 05/30/08 10:33 AM Re: Withdrawl from Klonopin - Input Please? [Re: JokerOwling]
Oxy80 Oxy80 GRAND Pooh-Bah Registered: 03/30/08 Posts: 1903	Of all benzos, I'd say Klonopin has the least severe withdrawals.
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#706830 - 05/30/08 12:46 PM Re: Withdrawal from Klonopin - Input Please? [Re: Oxy80]
nephro nephro GRAND Pooh-Bah Registered: 09/04/06 Posts: 8814 Loc: UK, despite the rumours	The conversion of doses may be what prevents some doctors using diazepam; the Ashton Manual produces plans for using diazepam to withdraw from both nitrazepam and clonazepam due to the longer half-life from active metabolites: http://www.benzo.org.uk/manual/bzsched.htm#s4 http://www.benzo.org.uk/manual/bzsched.htm#s5 The only 'mainstream' benzodiazepine Professor Ashton does not recommend diazepam substitution for is chlordiazepoxide: http://www.benzo.org.uk/manual/bzsched.htm#s11 Again, half-lives and active metabolites account for this reasoning. There's a similar site here: http://www.non-benzodiazepines.org.uk/clonazepam.html But the problem we have in the UK is that 0.5mg is the lowest unit dose of clonazepam available, whereas the availability of 0.125mg and 0.25mg tablets in the US makes much more sense. Regarding L-tryptophan, Chemsynth posted a warning here: http://www.epharmacywatch.com/freeboard/...true#Post703689
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#706886 - 05/30/08 02:25 PM Re: Withdrawal from Klonopin - Input Please? [Re: nephro]
whacker1 whacker1 Journeyman Registered: 01/11/07 Posts: 57 Loc: An allegedly free country	Originally Posted By: nephro But the problem we have in the UK is that 0.5mg is the lowest unit dose of clonazepam available, whereas the availability of 0.125mg and 0.25mg tablets in the US makes much more sense. Regarding L-tryptophan, Chemsynth posted a warning here: Actually, the .125mg and .25mg doses are WAFERS. Unfortunately, they can't be split. OTOH, injectable 1mg Rivotril is availble in the U.K., if I'm not mistaken. If you could find a source of it, it'd be a perfect solution to taper with. Just dilute it with propylene glycol, and measure off tiny fractions each dose. Perfect. _________________________ They don't know nothing about redemption. They don't know nothing about recovery. Some people just ain't the type for marriage and family.
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#706891 - 05/30/08 02:36 PM Re: Withdrawal from Klonopin - Input Please? [Re: whacker1]
nephro nephro GRAND Pooh-Bah Registered: 09/04/06 Posts: 8814 Loc: UK, despite the rumours	Won't the wafers dissolve in liquid to achieve the same effect? We don't use the term 'wafer' in the UK (apart from those sugary crispy rectangles one has typically with iced cream), so I'm not sure. Yet we do have Rivotril injection - clonazepam 1 mg/mL in solvent, for dilution with 1 mL water for injections immediately before injection or as described in hospital protocols. It would be nice dealing with solutions, as they are pretty much infinitely variable in quantity of active drug.
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#706901 - 05/30/08 03:00 PM Re: Withdrawal from Klonopin - Input Please? [Re: nephro]
Oxy80 Oxy80 GRAND Pooh-Bah Registered: 03/30/08 Posts: 1903	I've had both .125mg and .25mg doses when I tapered off of benzos. They have a very pleasant taste which is rather unusual for medications. I found them quite effective as well since my benzo tolerance is nill. I wish I could find a source for either of these wafers.
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#707134 - 05/31/08 12:24 AM Re: Withdrawal from Klonopin - Input Please? [Re: nephro]
JokerOwling JokerOwling Pooh-Bah Registered: 07/14/07 Posts: 1214 Loc: here at the moment	Originally Posted By: nephro the Ashton Manual produces plans for using diazepam to withdraw from both nitrazepam and clonazepam... Regarding L-tryptophan, Chemsynth posted a warning... Firstly,I'm really no fan of Ashton,some of her tips are helpful,but the bulk of her premise I totally disagree with. About the tryptophan,I always use and recommend lower doses and closely monitor ALL reactions.SSRI's have a far worse record,especially concerning suicides. Tryptophan was used(and still is) with great success right up till,you guessed it....Prozac hit the market,then all of a sudden Tryptophan was completely demonized. Basically anyone who reacts negatively to Tryptophan will almost undoubtedly react the same to SSRI's. _________________________ "A magnesium deficiency may be responsible for more diseases than any other nutrient."-Dr.Norman Shealy,Neurosurgeon&Chronic Pain expert.
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#707140 - 05/31/08 01:48 AM Re: Withdrawal from Klonopin - Input Please? [Re: JokerOwling]
nephro nephro GRAND Pooh-Bah Registered: 09/04/06 Posts: 8814 Loc: UK, despite the rumours	What is it you disagree with Professor Ashton about particularly, bearing in mind she has worked with thousands of patients and the guide is a general one; it will work for the majority but not for a small minority? The BNF - one of the world's most respected medical resources - gives these instructions to doctors for patients withdrawing from shorter-acting benzodiazepines: Quote: Transfer patient to equivalent daily dose of diazepam(1) preferably taken at night Reduce diazepam dose every 2–3 weeks in steps of 2 or 2.5 mg; if withdrawal symptoms occur, maintain this dose until symptoms improve Reduce dose further, if necessary in smaller steps;(2) it is better to reduce too slowly rather than too quickly Stop completely; time needed for withdrawal can vary from about 4 weeks to a year or more Counselling may help; beta-blockers should only be tried if other measures fail; antidepressants should be used only where depression or panic disorder co-exist or emerge; avoid antipsychotics (which may aggravate withdrawal symptoms).
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#707146 - 05/31/08 03:40 AM Re: Withdrawal from Klonopin - Input Please? [Re: nephro]
JokerOwling JokerOwling Pooh-Bah Registered: 07/14/07 Posts: 1214 Loc: here at the moment	Originally Posted By: nephro What is it you disagree with Professor Ashton about particularly... My main objection is to the website itself,and making the manual freely available to the public,which in my view,has probably caused more problems than it has helped people.If the manual was only made available to prescribing benzo experienced dr's,I would be ok with it,as those types of dr's know how to interpret the writings. So many people refer to the manual as "the benzo bible",which if they mean can be interpreted a million different ways and causing more problems for the medical naiive,I agree it is a "bible". I've also seen many "self medicating" people get themselves into more trouble because they misinterpreted her work. As far as the diazepam tapering theory,I agree it works in THEORY,but I've seen more people become unnecessarily addicted to diazepam,and many others prolong there ability to stop benzos,as well as others suffer needless withdraw symptoms because of the inability of dr's(or the people themselves,if self medicating) to understand what the subjective feelings are like on different benzos.The equivalancy charts are also EXTREMELY misleading to the benzo naiive. The other issue,which is common to most dr's,is the failure to address the underlying emotional and or nutritional issues before,during and after stopping the tapering process. I'm sure if I was to discuss in person my concerns with Dr Ashton,she would most likely agree with me,and I her.Maybe my post above was wrongly worded to some degree. _________________________ "A magnesium deficiency may be responsible for more diseases than any other nutrient."-Dr.Norman Shealy,Neurosurgeon&Chronic Pain expert.
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#707172 - 05/31/08 07:53 AM Re: Withdrawal from Klonopin - Input Please? [Re: JokerOwling]
whacker1 whacker1 Journeyman Registered: 01/11/07 Posts: 57 Loc: An allegedly free country	Originally Posted By: JokerOwling [quote=nephro].The equivalancy charts are also EXTREMELY misleading to the benzo naiive. What most people , I believe, don't seem to grasp is that her equivalency chart is based upon her estimates for INITIAL CROSSOVER TO DIAZEPAM. If you notice, her tapering plans make pretty large cuts in the following few weeks, after the crossover is complete. Basically, her plan involves using an inflated equivalent of diazepam , for a brief period of time, and then rapid initial reductions. I'd say most of her equivalencies are about 20% too high, and her conversion process is more like 8-10 week period. Secondly, her use of terminal elimation to ascertain the duration of a drugs effects on the CNS, is extremely misleading. I'd say most people read her literature and get the idea that diazepam's therapeutic effects gradually decline at a rate of 50%, every 50 to 200 hours. I'm sorry, but that idea is utter poppycock. The 50 to 200 hour figure is based purely upon the amount of diazepam's metabolites bound to blood proteins, not the amount reaching neuroreceptors in the brain. Lastly, diazepam is towards the top of the pack in terms of abuse potential. Someone is far more likely to develop serious benzo habit with this drug, than say, librium. _________________________ They don't know nothing about redemption. They don't know nothing about recovery. Some people just ain't the type for marriage and family.
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#707174 - 05/31/08 08:00 AM Re: Withdrawal from Klonopin - Input Please? [Re: nephro]
whacker1 whacker1 Journeyman Registered: 01/11/07 Posts: 57 Loc: An allegedly free country	Originally Posted By: nephro Won't the wafers dissolve in liquid to achieve the same effect? They SHOULD. _________________________ They don't know nothing about redemption. They don't know nothing about recovery. Some people just ain't the type for marriage and family.
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#707179 - 05/31/08 08:18 AM Re: Withdrawal from Klonopin - Input Please? [Re: whacker1]
nephro nephro GRAND Pooh-Bah Registered: 09/04/06 Posts: 8814 Loc: UK, despite the rumours	Yes, half-life and duration of action of this drug depend on the amount and time one has been taking it. It should be made clear that a half-life of 200 hours is only possible when the drug has been taken regularly for an extended period. I have always said that chlordiazepoxide may be superior, or even flurazepam, but this sort of thing must be supervised by a specialist. As regards making it public instead of being only available to doctors, that's the nature on the internet I'm afraid. Better it comes from Professor Ashton herself than someone who's seen it, done it or heard it from someone else, and posted it themselves as good as they can remember, with a good splash of their opinion mixed in. Anyone wishing to taper would be best advised to see a specialist, but for various reasons they can't or won't. It would be good to see a few more of these internet-available charts, and compare them. At the bottom of this page: http://www.benzobuddies.org/buddiesguide/tables there is a chart which shows the estimated diazepam equivalencies of a few different charts. Some vary wildly, the clonazepam being the most worrying in my opinion. 0.5mg to 4mg is ridiculous.
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#707187 - 05/31/08 08:33 AM Re: Withdrawal from Klonopin - Input Please? [Re: nephro]
JokerOwling JokerOwling Pooh-Bah Registered: 07/14/07 Posts: 1214 Loc: here at the moment	There are so many variables it can become far too complex for a simple 'chart'.Is the person a male or female? Were they taking for recreational use or medical use? How long was the person taking it? What dosage were they on? Do they have any other underlying health issues? Are they taking other medications?......etc....etc.... I prefer to keep people away from those charts and websites.If dr's find it difficult to deal with,how will a 'self medicating' person who is benzo naiive be able to interpret them? _________________________ "A magnesium deficiency may be responsible for more diseases than any other nutrient."-Dr.Norman Shealy,Neurosurgeon&Chronic Pain expert.
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#707202 - 05/31/08 09:02 AM

Re: Withdrawal from Klonopin - Input Please? [Re: nephro]

whacker1 Offline

Journeyman

Registered: 01/11/07
Posts: 57
Loc: An allegedly free country

Originally Posted By: nephro

Yes, half-life and duration of action of this drug depend on the amount and time one has been taking it. It should be made clear that a half-life of 200 hours is only possible when the drug has been taken regularly for an extended period.

I don't care if you take diazepam 20x a day for 50 years, you will never get a 200 hour half life , at least as far as your neuroreceptors are concerned.

The alpha distribution half life of diazepam, and its chief metabolite , desmethyldiazepam, are far shorter. In a nutshell, what's in the blood is *NOT* an accurate reflection of what's happening in the brai