Klonopin weaning - can I get some clarity?

[goddessone]

Let me start by saying I'm not replacing doctor's opinions by looking for medical information on the Internet. Just hoping for some opinions about the differing information my medical professionals and patient information sheet is telling me. Also I'd appreciate it if you could try not to scare the shit out of me, I've got enough anxiety over this already. Thanks.

As my signature shows, I have been on a small dose of klonopin for a few weeks, prescribed to take .25 or .50 mg at bedtime. It helped with my sleep issues and anxiety especially as I was coming off a horrible time with Risperdal. I am not anti benzo nor do I judge anyone who uses them as prescribed. I have a bipolar "mentor" who has walked me through some harrowing times with anti-psychotics as well as metaphorically held my hand when I had just been diagnosed, and she has been on klonopin for years at the same dosage. She even suggested about a year ago I ask my pdoc about a benzo but I never did until my appointment 2 months ago and he actually mentioned it before I did.

Recently I changed pdocs as my former one did not pick up on the Parkinsonism I developed from Ripsperdal as he basically had his nurse talk to me and then would spend 2 minutes writing out a script. The new one saw it right off and took me off it slowly. Between getting off it and the small dose of klonopin he prescribed I felt better than I had in almost a year.

Hope this isn't too long just trying to give some background.

I was concerned about physical dependence and developing tolerance so at about 6 weeks of use I asked my pdoc about it and he said he would not have prescribed it for me "if he was concerned about abuse or addiction." As a note, I asked him about this twice, once at my appointment and once I called the office hoping to speak with him, he called me back but I missed his call. He left a message again saying he wasn't worried about it and if I was concerned, to just "take a couple of days off."

Well, I didn't take it for 2 nights and I did not sleep more than a couple of hours and had some crazy ass dreams. On the third night I took . 25 mgs and slept okay. After the way I felt for the two nights I later decided to ask the pharmacist about it and she said yes I could become dependent and possibly develop tolerance so I should try not to take it every day. I told her I had been at .25 mgs for 2 weeks already and she said I was weaning myself off but I didn't need a long taper, another week at .125 and then off or if I felt more comfortable, another week after that taking it every other day then off. I then looked at the patient info sheet which said to wean off by .125 mgs every 3 days. That seemed really fast and of course conflicted with what my pdoc and pharmacist had said. On the .25 mgs I had a few days with some headaches and I didn't feel I was sleeping as well as normal but nothing major. I then dropped it down to .125 and again other than not sleeping as well and a slight increase in anxiety from time to time, I haven't had any issues. I AM feeling the lack of sleep as I don't sleep through the night or as well.

So now I am at .125, and as I am getting different opinions on what I should do I am confused. I have done my best not to get information off the web other than official medical sites but stupidly I did read some posts on benzo buddies which scared the crap out of me like I was going to have a horrible withdrawal worse than hell and I was surely an addict and benzos are the worst thing in the world and why do docs prescribe them etc etc etc holy shit!!

So, wtf. Do I start taking it every other day? Just some opinions please, I know you're not doctors. Today I have been at .125 for a week and I am trying to decide what to do next. Also I have an appointment with my pdoc in about two weeks.

Thanks.

Edited December 15, 2014 by goddessone

[goddessone]

Sorry that seems really long especially for only my second post. Just confused.

[Wooster]

I just got re-prescribed klonopin for sleep, 0.5mg one or two as needed. The recommendation my pdoc and pharmacist gave me is definitely to take the least amount you need, and "try your best to not take it every night" but balanced against "you really need to get better sleep to try to make everything else better.

 

As your pharmacist said, our bodies do develop physical tolerance and/or dependence if we use this class of medication every day. That's not necessarily a bad thing in and of itself.

 

Benzobuddies tends to, as you have noticed, have a lot of alarmist OMFG YOU'RE GOING TO HAVE THE WORST EXPERIENCE EVER BECAUSE BENZOS ARE HORRID type posts.

 

Benzos have legit uses. Some people develop physical tolerance. Some people abuse them. Some people have a hard time getting off them. That does NOT mean that you will develop these things if you use them responsibly and as prescribed.

 

The PI sheet says 3 days, which does seem a little fast compared to what your pdoc and pharmacist are telling you. It's kinder on one's brain to do a slower taper.

 

Are you trying to get off of it all together? Or come up with a reasonable use schedule?

 

It sounds like you are having a lot of anxiety about your anti-anxiety med.

 

Your pdoc prescribed you a very reasonable dose for sleep. If he was concerned about you misusing the medication, he wouldn't have prescribed it for you. Trust me on that.

 

Several years ago, my pdoc was trying to get me to change from lorazepam to klonopin and I was very reluctant because I had seen a lot of people get addicted and abuse that drug. I am fortunate to not have had addiction issues, but still was concerned. Once I switched over to klonopin, though, I was actually able to get better coverage for my anxiety that lead to more effective therapy/skills development to help manage the anxiety to the point that I tapered off of it completely for about 3 years.

[goddessone]

Hey Wooster

Thanks for your reply. Basically I'd like to get back to using it more PRN during those times when anxiety keeps me from sleeping well, so I don't develop dependence, although I'm pretty sure I've passed that point already. One of the things that led me to crazy boards was looking for rational non sensational stories of people who had successfully tapered off klonopin with minimal trouble. I am concerned about that last drop to zero. I'd like to hear from others, such as yourself, who have tapered off, and how they handled the end. I have read a few posts on here about people starting to skip every third day, then every other day etc. Just not sure how I should handle the end of my taper.

Also you pretty much quoted my husband, " you seem to have a lot of anxiety about your anti-anxiety med." He thinks the klonopin really helps but doesn't like the way I am worried about how to go off it.

Sleep is important. It keeps my anxiety low, keeps depression away and stops my cycling.

Thanks again. Ok, off to try to get back to sleep. I was up getting my usual 2 am glass of water and thought I'd check back here. Your reply has made it easier for me to hopefully drop back to sleep.

[melissaw72]

When I weaned down off klonopin (when I tried to go off of it), I was on a higher dose than you were (at that point it was about 3 mg/day), but to give you a reference it was 0.25 mg down every 2 weeks.  Very slow process.  And then when I was all the way down and off of it, I found I did need it, so I went back up to my current dose of 2 mg/day.  And I have been at that dose for years.  I have tried taking a little more at times (per DRs ok), but it did absolutely nothing for me, so I stayed at 2 mg.

 

So my advice is to take it very slowly.  If you get to the point where you are weaned off, it still might be in your system for a couple/few days, but after that I think you should be able to tell if it is helpful or not.  And then go from there with what you are comfortable with and that your pdoc ok's.

[goddessone]

@ sylvan I like your idea of stretching out the time between doses but I hate to make it less than 48 hours as I'd like to keep the dosage time to evening to see if I can get some relief with sleep. Nervous about stretching it out to 48 hours right off it but I guess I should try it. Or was thinking about skipping every third day or something.

Wooster and Melissaw72: how did you handle the end of your taper? Did you just drop off at .25 mg? Did you increase the time between doses as sylvan did?

@ Melissa - I think I definitely need it but I hate to develop a dependence so I'm trying to deal with things without it. Seriously I miss the calm and the good sleep. Like to keep it to infrequent PRN in the future. I did drop it .25 every two weeks but as I keep repeating it is the end I am unsure of.

Anyhow thanks for your replies while I try to figure out what is best. Yes I sound like a anxious nutcase but ruminating is unfortunately a trait I can't seem to stop practicing. Again - the klonopin helped with that too, dammit!

Wish I could edit that stupid j in the topic line, typos frequently from trying to type on an ipad

Edited November 17, 2014 by goddessone

[Wooster]

Honestly at this point, I don't remember.

 

I think I just went down until I was taking a quarter of a 1mg pill (so 0.25 mg) for a couple weeks then stopped.

 

I didn't have any difficulties with it.

[goddessone]

Thanks Wooster. Think I'm going to try every other day I think as see how I do. Maybe I can't get around some withdrawal symptoms, I don't know. Probably too worried about it.

[Wooster]

What other skills have you learned to manage anxiety when you notice it?

 

Using those on purpose more now might be helpful.

[goddessone]

Deep breathing, mantras, getting some exercise. Try to distract myself. Right now it's difficult because I'm not working and don't have enough to fill up my day. Also unfortunately I can tend to dwell on the negative and the horror stories I stupidly read are stuck in my head.

It feels good just to be able to express it here, which is really what I needed more than opinions on tapering though they were helpful too.

One of my worst traits is I tend to rumanize. The brain just won't stop. I think it is part of being bipolar, hard to shut off the mind and worry at times. Well, a lot of the time. Lamictal helps but doesn't stop it all. I'm trying to keep my meds to just two.

[WinterRosie]

Maybe, if you're looking for a place to spill more than the answers, maybe you'd be well-served by starting a blog here? You can make it as public or as private as you'd like. If you need any help setting it up or have questions the staff can help with that, too.

[Wooster]

With regard to filling up your day, have you considered volunteering somewhere? Or picking up a new, inexpensive hobby?

 

Ruminating is definitely an anxiety thing... not being able to shut off thoughts.

 

 

I wonder if getting a workbook about anxiety and/or cognitive behavioral therapy would help you have some more skills to work with.

[goddessone]

Thanks WinterRosie, I'll consider that. I do feel better since I got some replies here to help with my decisions with the klonopin and to vent my fears.

Wooster I was thinking of volunteering again. Just want to be stable enough to do that. It helped in that past. Have to see how I feel anxiety wise off the med.

Thanks for all your replies and support. I'll quit with this ruminating shit now!

[melissaw72]

 

 Melissaw72: how did you handle the end of your taper? Did you just drop off at .25 mg? Did you increase the time between doses as sylvan did?

 

The end of the taper I did go down to .125 for awhile before stopping.  I kept the times the same though in the day when I took it.  It wasn't long after stopping it that I realized I truly needed it, and I went back on a low dose (for me), of 0.5, 2x/day.  I haven't needed to increase either for years though, so it wasn't like I needed more and more to get the same effect.

[goddessone]

If I knew I'd never have to increase my dosage I'd stay on the .5. After all I'll be taking lamictal til the day I die unless some miracle cure for bipolar should happen. (Laughs blackly)

I do feel so much calmer and sleep well on it. I'm just so confused about what to do. Also concerned I'm going too fast. Started to skip days as of this weekend, well last night, but maybe I should hold at .125 for a little longer.

Edited November 17, 2014 by goddessone