Full Version: klonopin withdrawal
I have been on Klonopin (clonazepam) for years. Always 1 mg/day. Originally prescribed by a psychiatrist for dealing with chronic anxiety. I want to get off it, because I think at this point, in addition to keeping anxiety at bay, it "thickens" brain functioning, taps my energy, and lowers my spirit. But after being off it for 4-6 days I become outrageously anxious, agitated, etc. More than I can stand. I have read at Web forums that it is harder to shake than heroin. I wouldn't know about heroin, never having taken it, never having wanted to. Does anyone out there have experience with getting off Klonopin? Or does anyone have ideas as to how I might shake it? I would be ever grateful for any help.[FONT=Arial][SIZE=1][COLOR=gray]
Please take a look at the the pinned thread about general benzo discontinuation for a safe tapering schedule
QUOTE (hoosier @ Nov 16 2005, 03:50 PM)
I have been on Klonopin (clonazepam) for years. Always 1 mg/day. Originally prescribed by a psychiatrist for dealing with chronic anxiety. I want to get off it, because I think at this point, in addition to keeping anxiety at bay, it "thickens" brain functioning, taps my energy, and lowers my spirit. But after being off it for 4-6 days I become outrageously anxious, agitated, etc. More than I can stand. I have read at Web forums that it is harder to shake than heroin. I wouldn't know about heroin, never having taken it, never having wanted to. Does anyone out there have experience with getting off Klonopin? Or does anyone have ideas as to how I might shake it? I would be ever grateful for any help.[FONT=Arial][SIZE=1][COLOR=gray]
I had a hellish time getting off benzos. 95% of people CANNOT quit cold turkey or stop unaided. In fact it can be life-threatening to try to stop taking a benzo. Klonopin is a benzo and they ALL have the same withdrawals. If you are addicted.
The one drug that helped me get over my benzo addiction was a drug used to treat bipolar mania episodes called Zyprexa. It knocks 'em out cold, and destroys the episode. Naturally any drug that can end a manic episode is pretty potent.
I was dating someone who was bipolar and he saw the incredible difficulty I was having and pure suffering I was enduring trying to quit benzos. Like you I had outrageous, uncontrollable anxiety, mental confusion and agitation + insomia.
The insomia was the thing that made him give me a few pills.
Considering the living hell I was enduring the effect of the Zyprexa was like a magic spell. It immediately shut down everything. 45 minutes after taking it I was sound asleep for the FIRST time in 2 months. After 2 months of not being able to sleep 1 real night, and periods of not sleeping at all for several days, just being able to sleep alone was a godsend.
The next day I was not groggy. I felt fine unlike my bipolar who would barely be able to function for a few days after taking 1 dose.
I knew it wasn't over so I watched what happened. As the Zyprexa gradually and completely left my system the withdrawal symptoms came back and soon I was back to my almost sleepless night.
At that point I took another Zyprexa and once again I was asleep in 45mins. After seeing how it worked I begged my partner to give me all he could spare.
I took one at bedtime to ensure I slept. After such a long time of NOT sleeping all I wanted to do was sleep 1 full night.
I kept this up for 30 days.
Over the thirty days the effect of the Zyprexa lessoned to the point that around the 30th. day. It didn't put me to sleep or affect me at all.
I spent the next day in dread. Fearing that after the Zyprexa left my system the benzo withdrawal would start again, but it didn't.
Instead while I lay awake in my bed that night wondering how I ever was so stupid as to let this happen to me, I drifted off to sleep. I drifted off to sleep without the help of any medication for the first time in 15yrs. WOW.
Over the next few days I watched for signs of the return of the anxiety and mental chaos. It also to was gone.
I observed myself and asked those who knew me if they had noticed any changes in me like not being as aware or sharp as before. All said, no negative changes. In fact you're starting to look better.
I don't know the exact mechanics, but the initial powerful sleep inducing properties of Zyprexa were able to deal with the effects of benzo withdrawal. Zyprexa is how I escaped the seeming endless agony of benzo withrawal.
Unless you have a bipolar friend, I don't know how you can get Zyprexa, but if you can. It should be a powerful ally in your quest.
I'm sure someone here can help you out.
Good luck.
Since I've been asked (elsewhere) to respond, I'll add my thoughts.
There are many ways to skin a cat, so this is only my approach and I'm not questioning any other advice on the topic. I will emphatically agree with others from what I've read and before that what I went through that stopping Klonopin cold is very disturbing and potentially dangerous. What I've read added something I never would have guessed, which is that stopping cold can precipitate symptoms that persist far longer than the taper period. It's such a shock to the system.
Decreasing by 10% per week seems to work well (this is from _Your Drug May Be Your Problem_, by Breggin and someone). That book even recommends that you might repeat the 10% taper on the last 10%. So for example, lets say you started on 100 mg of Blissexa -- you would do 90 mg for a week, 80 mg for a week, and so on, until you hit 10 mg, and then would do 9, 8, 8, 6... I think this is useful in approaching Klonopin. This is one of those drugs, fortunately, where you can cut it up with a razor or pill-cutter. The main thing is the taper. I probably will reduce my final doses as .5 (current dose), .375, .25, nada, spread over 2 doses daily (so, cutting .5 mg pills into quarters), but this is because I've been tapering off for many months already and am used to the process. I'd maxed out at 2 mg. Some people are on 10 mg or more.
The second point is to extend the one week periods if you are experiencing uncomfortable withdrawal. What you want is to be unable to distinguish the difference between the amount you're taking now and the amount you were taking when you last reduced it.
Point three is to really work on understanding the issues that give rise to your symptoms for which you went on the drug. You will need to work on these, but you don't actually need to solve them all to be drug-free. Simply being aware of what causes panic, anxiety, emotional noise, etc and having some sense of what you can keep learning to do better to get these a bit more under control can prevent the physiological effects from running away on their own.
Point four: get onto a healthy diet (doesn't need to be a permanent lifestyle change; relax), and if you start experiencing anxiety or emotional disturbance or shakiness or whatever, see if a very healthy meal takes the edge off before you go rushing to re-up the dosage of the benzo. If it doesn't work, you can always take another pill.
Point five: share your plan with a doctor or therapist. Get someone on your side with this. This will allow you to backtrack as you see how things go, but you do want someone who agrees with you that functioning well without the drug is a good goal.
My final point is more complex and lengthy, but may really affect the long-term outcome of breaking any drug addiction. It has to do with the esoteric topics of contextual dependence and homeostasis. You are withdrawing not only from a physical and a psychological dependency, but from a combination of the two. This is why people who have been on a drug longer require a longer taper period, even though they may be at the same physical level of dependency in terms of dosage.
Contextual dependence is what it sounds like -- a (in some cases physical) drug dependence that is stronger in certain contexts. Many people are familiar with addiction triggers as a common example. You quit smoking for several years and then you enter a pool hall and immediately find yourself bumming smokes as if you'd never quit. The phenomenon goes deeper than mere psychological addiction. Many Vietnam veterans acquired heroin addictions while in service -- a serious physical dependency -- and yet confounded conventional wisdom when their addictions disappeared on returning to the U.S. (not to overgeneralize, but this was observed by many vets). Such addictions can be re-triggered later, but the fact that the typical effects of physical withdrawal can be so minimized shows just how important context is. Part of the explanation for this is homeostasis.
Homeostasis is the body's (and mind's) ongoing attempt to maintain a consistent baseline state. It plays a major role in any addiction, as the habitual use of a drug becomes part of one's baseline, and the brain will therefore work to maintain the level of the drug. Chaning tolerance to a drug is also an aspect of homeostasis.
The curious connection between homeostasis and contextual dependency is that the brain adapts to specific functioning in specific contexts. So for example you might write every day for years with your morning coffee and become a better writer while caffeinated than not, even though you can perform equally complex or creative tasks in the evening without caffeine. Or you used to always drink beer when playing pool, and now it seems as if you actually play *better* when you've got a buzz on than not. This isn't all about drugs -- most people are better at different tasks at different times of day, and this too is because of a shifting context, which has some basis in physiology as levels of hormones, transmitters, blood sugar, etc. change throughout our natural cycles. It's as if distinct activities have "tuned" themselves to certain physiological states.
What is the relevance of all this? If you have been on Klonopin for one month, you probably can taper off of it in a couple weeks, as there is a limited amount of context in which you've developed the dependency. But if you've been on it for 3 years, you've adapted many more behaviours and routines to the state of being on the drug. You will need to re-adapt to a larger set of contexts without the drug. Context here includes a range of moods, social situations, cognitive states, etc.
So what's the advice? Definitely expect a taper period proportional to the lperiod you've been on the drug. Also be mindful of what may be triggers and of whether you're re-introducing yourself to a range of experiences gradually, or sort of holing-up in some neutral safe zone while you get off the drug (in which case you may feel as if you've adjusted just fine until some time after you've been off the drug you put yourself back into some situation you had needed the drug to cope with, and wham! you experience full-blown withdrawal symptoms). From my experience, I would recommend getting out, trying to do a range of things, and generally testing your limits a bit so that you can feel the adjustment taking place, but also staying away as much as possible from things you know are triggers as these may make you feel like you're derailing. You are making an adjustment to your biochemistry. Just like you shouldn't call your embittered ex when you'd had too much to drink, you shouldn't put yourself in equally precarious situations when you are coming off a drug.
I also agree that benzos, like all drugs, can impair aspects of the brain's normal functioning. I've experienced a return of sensory awareness and greater clarity and memory as I've gone off the drug, which is ironic because in the period I was on Klonopin I was eventually prescribed additional medications for these symtoms. (And a couple times prescribed medications for the side-effects of those medications.)
That's everything I know about it, except for thoughts on alcohol which I won't share here as they're too potentially complicated and controversial. Hope it's all useful.
There are many ways to skin a cat, so this is only my approach and I'm not questioning any other advice on the topic. I will emphatically agree with others from what I've read and before that what I went through that stopping Klonopin cold is very disturbing and potentially dangerous. What I've read added something I never would have guessed, which is that stopping cold can precipitate symptoms that persist far longer than the taper period. It's such a shock to the system.
Decreasing by 10% per week seems to work well (this is from _Your Drug May Be Your Problem_, by Breggin and someone). That book even recommends that you might repeat the 10% taper on the last 10%. So for example, lets say you started on 100 mg of Blissexa -- you would do 90 mg for a week, 80 mg for a week, and so on, until you hit 10 mg, and then would do 9, 8, 8, 6... I think this is useful in approaching Klonopin. This is one of those drugs, fortunately, where you can cut it up with a razor or pill-cutter. The main thing is the taper. I probably will reduce my final doses as .5 (current dose), .375, .25, nada, spread over 2 doses daily (so, cutting .5 mg pills into quarters), but this is because I've been tapering off for many months already and am used to the process. I'd maxed out at 2 mg. Some people are on 10 mg or more.
The second point is to extend the one week periods if you are experiencing uncomfortable withdrawal. What you want is to be unable to distinguish the difference between the amount you're taking now and the amount you were taking when you last reduced it.
Point three is to really work on understanding the issues that give rise to your symptoms for which you went on the drug. You will need to work on these, but you don't actually need to solve them all to be drug-free. Simply being aware of what causes panic, anxiety, emotional noise, etc and having some sense of what you can keep learning to do better to get these a bit more under control can prevent the physiological effects from running away on their own.
Point four: get onto a healthy diet (doesn't need to be a permanent lifestyle change; relax), and if you start experiencing anxiety or emotional disturbance or shakiness or whatever, see if a very healthy meal takes the edge off before you go rushing to re-up the dosage of the benzo. If it doesn't work, you can always take another pill.
Point five: share your plan with a doctor or therapist. Get someone on your side with this. This will allow you to backtrack as you see how things go, but you do want someone who agrees with you that functioning well without the drug is a good goal.
My final point is more complex and lengthy, but may really affect the long-term outcome of breaking any drug addiction. It has to do with the esoteric topics of contextual dependence and homeostasis. You are withdrawing not only from a physical and a psychological dependency, but from a combination of the two. This is why people who have been on a drug longer require a longer taper period, even though they may be at the same physical level of dependency in terms of dosage.
Contextual dependence is what it sounds like -- a (in some cases physical) drug dependence that is stronger in certain contexts. Many people are familiar with addiction triggers as a common example. You quit smoking for several years and then you enter a pool hall and immediately find yourself bumming smokes as if you'd never quit. The phenomenon goes deeper than mere psychological addiction. Many Vietnam veterans acquired heroin addictions while in service -- a serious physical dependency -- and yet confounded conventional wisdom when their addictions disappeared on returning to the U.S. (not to overgeneralize, but this was observed by many vets). Such addictions can be re-triggered later, but the fact that the typical effects of physical withdrawal can be so minimized shows just how important context is. Part of the explanation for this is homeostasis.
Homeostasis is the body's (and mind's) ongoing attempt to maintain a consistent baseline state. It plays a major role in any addiction, as the habitual use of a drug becomes part of one's baseline, and the brain will therefore work to maintain the level of the drug. Chaning tolerance to a drug is also an aspect of homeostasis.
The curious connection between homeostasis and contextual dependency is that the brain adapts to specific functioning in specific contexts. So for example you might write every day for years with your morning coffee and become a better writer while caffeinated than not, even though you can perform equally complex or creative tasks in the evening without caffeine. Or you used to always drink beer when playing pool, and now it seems as if you actually play *better* when you've got a buzz on than not. This isn't all about drugs -- most people are better at different tasks at different times of day, and this too is because of a shifting context, which has some basis in physiology as levels of hormones, transmitters, blood sugar, etc. change throughout our natural cycles. It's as if distinct activities have "tuned" themselves to certain physiological states.
What is the relevance of all this? If you have been on Klonopin for one month, you probably can taper off of it in a couple weeks, as there is a limited amount of context in which you've developed the dependency. But if you've been on it for 3 years, you've adapted many more behaviours and routines to the state of being on the drug. You will need to re-adapt to a larger set of contexts without the drug. Context here includes a range of moods, social situations, cognitive states, etc.
So what's the advice? Definitely expect a taper period proportional to the lperiod you've been on the drug. Also be mindful of what may be triggers and of whether you're re-introducing yourself to a range of experiences gradually, or sort of holing-up in some neutral safe zone while you get off the drug (in which case you may feel as if you've adjusted just fine until some time after you've been off the drug you put yourself back into some situation you had needed the drug to cope with, and wham! you experience full-blown withdrawal symptoms). From my experience, I would recommend getting out, trying to do a range of things, and generally testing your limits a bit so that you can feel the adjustment taking place, but also staying away as much as possible from things you know are triggers as these may make you feel like you're derailing. You are making an adjustment to your biochemistry. Just like you shouldn't call your embittered ex when you'd had too much to drink, you shouldn't put yourself in equally precarious situations when you are coming off a drug.
I also agree that benzos, like all drugs, can impair aspects of the brain's normal functioning. I've experienced a return of sensory awareness and greater clarity and memory as I've gone off the drug, which is ironic because in the period I was on Klonopin I was eventually prescribed additional medications for these symtoms. (And a couple times prescribed medications for the side-effects of those medications.)
That's everything I know about it, except for thoughts on alcohol which I won't share here as they're too potentially complicated and controversial. Hope it's all useful.
hoosier, I can't emphasize jemini's point #5 the most. Please do this with a qualified medical professional. Do not attempt to do this on your own.
And a bipolar friend is not the only way for you to obtain Zyprexa. If you work with a proper medical doctor and it is determined that using that medication is right for you he can easialy write you a script. In fact, medication swapping or sharing is not something that is advocated here. A patient's scripts are their own. It's just plain irresponsible to pass them out to someone else.
Karen
And a bipolar friend is not the only way for you to obtain Zyprexa. If you work with a proper medical doctor and it is determined that using that medication is right for you he can easialy write you a script. In fact, medication swapping or sharing is not something that is advocated here. A patient's scripts are their own. It's just plain irresponsible to pass them out to someone else.
Karen
The only caveat here is that finding a doctor who both makes a living writing prescriptions AND is agreeable to helping you get off of medications can be difficult. This is widely written about and not only by those who question pychiatric medication. I'm not arguing one way or the other right here, but simply saying it is easier said than done to get off your meds with the full help of a psychiatrist. Still, you are much better off if you can do this. The problems with going it alone include:
- Permanently damaging the trust in a relationship with your current pdoc or future pdocs who may want access to your treatment record. Non-compliance.
- Being unaware of the risks and effects of withdrawal. You can learn a lot on your own (and so should pdocs), but it's better to be able to work through the adjustments with someone who understands fully the effects of the drug and its withdrawal, including not just the most common ones.
- Inability to change horses mid-stream should you yourself decide that going off the drug is not working. You want to be able to try other medications, or slow or reverse the taper if needed.
- This may seem small or large to you, but you'll have no medical record explaning how well or badly you managed to adjust to not being on the medication. Often diagnoses are made based on how people react to medications or how they function without medications. Sadly.
- Permanently damaging the trust in a relationship with your current pdoc or future pdocs who may want access to your treatment record. Non-compliance.
- Being unaware of the risks and effects of withdrawal. You can learn a lot on your own (and so should pdocs), but it's better to be able to work through the adjustments with someone who understands fully the effects of the drug and its withdrawal, including not just the most common ones.
- Inability to change horses mid-stream should you yourself decide that going off the drug is not working. You want to be able to try other medications, or slow or reverse the taper if needed.
- This may seem small or large to you, but you'll have no medical record explaning how well or badly you managed to adjust to not being on the medication. Often diagnoses are made based on how people react to medications or how they function without medications. Sadly.
Oh I didn't mention nutrition. Vitamin B6, magnesium, manganese, omega-3 fatty acids, and adequate protein do a load of good for you mentally. I've found them helpful with Klonopin withdrawal, but also the more I learn about it the more I think maintaining FDA levels may be more effective than any meds for dealing with anxiety and other things for which benzos are prescribed.
B6
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=108
Magnesium
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=75
Manganese
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=77
Omega 3s
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=84
Protein
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=92
Check your diet:
http://www.whfoods.com/foodadvisor.php
I haven't got all my info from this site, but they're pretty comprehensive. One thing they don't elaborate on is that benzos and other meds deplete the body of some of these very nutrients, though I haven't uncovered anything that definitively goes into how severe this impact may be.
B6
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=108
Magnesium
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=75
Manganese
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=77
Omega 3s
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=84
Protein
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=92
Check your diet:
http://www.whfoods.com/foodadvisor.php
I haven't got all my info from this site, but they're pretty comprehensive. One thing they don't elaborate on is that benzos and other meds deplete the body of some of these very nutrients, though I haven't uncovered anything that definitively goes into how severe this impact may be.
You have gotten some great advice here. Follow it to the best of your ability and realize that everyone is different... so make sure you try to use the info that helps YOU.
I've been on 4 mgs. a day for 8 years. (I know.... I know.... but I didn't know about the dangers). Recently I went off it cold turkey because I ran out (I know.... I know.... I was SO scared.... but had no choice). I'm back on it now.... but I can honestly say that it almost killed me. Very, very literally. I went to the ER.... but they were complete asses and had the attitude of "Well, you got yourself into this problem... now get yourself out." They wouldn't prescribe anything or even rehydrate my body (I was SEVERELY dehydrated and malnourished from not being able to eat and drink..... this was after two and a half weeks off of klonopin).
You SHOULD be able to get off of 1 mg. But everyone says that the last little bit is the toughest.... to get COMPLETELY off it. But please, please.... BE KIND TO YOURSELF. Don't make yourself feel worse when you realize how difficult it is to come off it!
Some tips (from my personal experience).... but remember.... EVERYONE IS DIFFERENT.
* Taper SLOWLY..... there is really no such thing as TOO slowly. And remember that it takes 5-7 days (for most people) to see how the lack of klonopin is making them feel. In other words.... don't decrease the dose and then two days later think, "well, I feel okay..... my body must be adapting". NO..... you won't know for about a week how you are really feeling!
* Try to continue to eat and drink regularly.... even if it's very small amounts. Especially get enough protein.... your body needs the amino acids to start to produce the correct neurotransmitters.
* GABA (an amino acid) and Valerian (an herb) help some people feel more relaxed and make things easier.
* It most likely WILL profoundly effect your sleep.... so let yourself sleep WHENEVER you are able.... your body needs rest.
* Keep things like lights and noises and even voices (people talking to you) to a minimum. You'll be super sensitive to them.
And like I said.... most importantly...... be kind to yourself!!!
I wish you all the best.
I've been on 4 mgs. a day for 8 years. (I know.... I know.... but I didn't know about the dangers). Recently I went off it cold turkey because I ran out (I know.... I know.... I was SO scared.... but had no choice). I'm back on it now.... but I can honestly say that it almost killed me. Very, very literally. I went to the ER.... but they were complete asses and had the attitude of "Well, you got yourself into this problem... now get yourself out." They wouldn't prescribe anything or even rehydrate my body (I was SEVERELY dehydrated and malnourished from not being able to eat and drink..... this was after two and a half weeks off of klonopin).
You SHOULD be able to get off of 1 mg. But everyone says that the last little bit is the toughest.... to get COMPLETELY off it. But please, please.... BE KIND TO YOURSELF. Don't make yourself feel worse when you realize how difficult it is to come off it!
Some tips (from my personal experience).... but remember.... EVERYONE IS DIFFERENT.
* Taper SLOWLY..... there is really no such thing as TOO slowly. And remember that it takes 5-7 days (for most people) to see how the lack of klonopin is making them feel. In other words.... don't decrease the dose and then two days later think, "well, I feel okay..... my body must be adapting". NO..... you won't know for about a week how you are really feeling!
* Try to continue to eat and drink regularly.... even if it's very small amounts. Especially get enough protein.... your body needs the amino acids to start to produce the correct neurotransmitters.
* GABA (an amino acid) and Valerian (an herb) help some people feel more relaxed and make things easier.
* It most likely WILL profoundly effect your sleep.... so let yourself sleep WHENEVER you are able.... your body needs rest.
* Keep things like lights and noises and even voices (people talking to you) to a minimum. You'll be super sensitive to them.
And like I said.... most importantly...... be kind to yourself!!!
I wish you all the best.
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