Clonazepam and Dry Eyes?

[John Doe]

Greetings. I've been on a maintenance dose of Clonazepam @ 3mg/day for 6 years (among other psychiatric meds). I started having crippling panic attacks that left me FUBAR in 2003. Benzos pretty much allowed me to function in a semi-normal state. I started on Ativan and was moved to Clonazepam as part of a cocktail to treat my panic and OCD (obsessive thoughts and compulsive "repetitions").

Recently, I was dx'ed with keratitis, corneal infiltrates and moderate dry eye. I had to use steroid/antibiotic combination drops for about a month, then just plain high powered steroid drops to clear the infiltrates, and am now indefinitely on Restasis cyclosporine drops 2x day and artificial tears for the dry eye. I am seeing a corneal specialist in addition to my ophthalmalogist.

I have read on one of the "shock-and-horror British anti-benzo boards" that dry eyes may be a side effect of tolerance withdrawal to benzos. I have been at my current dose of Clonazepam for over 2 years now. I have breakthrough anxiety from time to time and gastritis, but no other benzo tolerance w/d symptoms. I take my meds as prescribed by my p-doc (and other docs). The issue here is that my regular eye doc (who diagnosed me) and my corneal specialist do not think that my Benzo therapy could cause this. One of them wanted my to get tested for Sjogren's Syndrome and Lupus (even though I'm not having any of the other presenting symptoms) because she couldn't figure out why the steroid/antibiotic combo I was initially put on wasn't working faster. When I brought this issue up to my p-doc, he said "do you feel like you're in withdrawal"? I said no -- but, honestly, how in the hell am I supposed to make that determination? I'm not having any of the so-called "common" benzo withdrawal symptoms, really.

Any of you all out there on benzos have ANY eye problems while taking them (aside from occasional blurred vision)? If so, what did you have to do? Did you have to increase your dose? The latter is not something I am interested in doing at this point.

[Guest Guest_001]

Is it possible that clonazepam has something to do with 'dry eyes' ?

Yes. Probable ? I don't know. The other eye problems ? I don't have a clue.

'tolerance withdrawal'. It is possible to experience withdrawal symptoms due to increased tolerance.

At what time do you take the clonazepam ? There may be peaks and valleys.

I've taken clonazepam myself, and it can cause both 'dry eyes' and 'wet eyes' for lack of a better expression.

Maybe taking the same amount of clonazepam at different times of the day can help.

6 mg is a lot ! I really wouldn't recommend increasing it further for help with your eye problems. Although, with the consent of your pdoc you could briefly try a higher dose to see if it's related.

6 mg is a lot for panic attacks. Yes, you could go higher but where does it end ? IMO, clonazepam is more an epilepsy drug. Check a benzodiazepine equivalence chart, 6 mg clonazepam is equivalent to 120 mg diazepam/valium ! , except for the anticonvulsant effects.

That's all I've got. I've found the people on www.crazymeds.us to be quite knowledgable about meds ! Sometimes, anyway.

[AnneMarie]

Hi. Dry eyes, or xerophthalmia, is a noted side effect of Klonopin which is name brand clonazapam.

From the Prescribing Information Sheet ...

Page 14-15

427 Other Adverse Events Observed During the Premarketing Evaluation of Klonopin in

428 Panic Disorder:

...

473 Vision Disorders: eye irritation, visual disturbance, diplopia, eye twitching, styes, visual

474 field defect, xerophthalmia

As an officially recognized potential side effect, that seems the more likely scenario than withdrawal symptoms. Maybe bring a copy of the PI Sheet to your next doctor appts.

Based just on the PI Sheet info, I'd guess that reducing or switching off Clonazapam is the more logical test than increasing it. What does your pdoc say? Also note that there may be no link between the med and what's up with your eyes.

[John Doe]

'tolerance withdrawal'. It is possible to experience withdrawal symptoms due to increased tolerance.

At what time do you take the clonazepam ? There may be peaks and valleys.

1mg @9 AM, 1mg @ 3PM, 1mg @ 9PM.

6 mg is a lot ! I really wouldn't recommend increasing it further for help with your eye problems. Although, with the consent of your pdoc you could briefly try a higher dose to see if it's related.

6 mg is a lot for panic attacks. Yes, you could go higher but where does it end ? IMO, clonazepam is more an epilepsy drug. Check a benzodiazepine equivalence chart, 6 mg clonazepam is equivalent to 120 mg diazepam/valium ! , except for the anticonvulsant effects.

I only take 3mg a day. I have been on Clonazepam for 6 years. Like I said, I think 3mg/day is high enough and I don't want to go any higher. My last p-doc said 3mg is a "medium" dosage. He was the one that raised my dose from 2mg to 3mg in '08.

Thanks for answering!

[John Doe]

As an officially recognized potential side effect, that seems the more likely scenario than withdrawal symptoms. Maybe bring a copy of the PI Sheet to your next doctor appts.

Based just on the PI Sheet info, I'd guess that reducing or switching off Clonazapam is the more logical test than increasing it. What does your pdoc say? Also note that there may be no link between the med and what's up with your eyes.

Thanks for the information!

I had asked my p-doc about the klonopin/dry eye connection last med check and he said "possible, but not likely". I am also on 40mg of Nexium for gastritis, so I asked my GI doc and he tried reducing the PPI but it didn't improve the condition. That med is aslo known to cause dry eye.

At this point, I will probably ask my p-doc at the next med check if he can temporarily taper me down to a lower dose of Clonazepam and see if that makes any difference in tear production. I am reluctant to go off the benzo completely because it literally is the only med I have been on that has stopped my panic attacks cold. And before I was put on benzo therapy, I would spend entire nights in inexplicable, paroxysmal fear, with insomnia, tachycardia, racing thoughts, depersonalization...the works.

Until then, I'll have to deal with the artificial tears... I will follow your suggestion and bring a copy of that info to the next med check. Also to my next eye doc appt.

[Guest DepressedDood]

Honestly, the SSRI's will give you more dry eye than the benzos.

Do you have any other issues going on to explain your dry eye?

Have you been on any pain meds? Allergy meds?

Did you have LASIK?

What about contacts? I cannot wear my contacts anymore due to dry eye, but 15 years ago when I was younger I could.

Drier eyes as we age is normal.

If you are doing anything more lately to cause you drier eyes, marijuana, cigs, alcohol etc. you might want to consider reducing that.

I take 1mg/day of clonazepam. Have for about 5 years. It is great for panic attacks, etc, and even depression, in my case. Make sure you evaluate all the other things going on with your health/lifestyle before considering the clonaz as the culprit.

Hope any of this helps!