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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on December 26, 2002, at 9:56:25
In reply to what???????????????, posted by ross c on December 26, 2002, at 9:10:32
If you are having this much troubble withdrawling it could be the sign of a serious underlying medical condition such as depression. I know many people that have had extreme difficulty withdrawling from benzos and others who havn't. It really reflects the nature of your anxity. I do recomend seing a doctor and discussing other options for sleep.
I totally agree with the low dose tricyclic suggestion. Doxipin is very good for chronic insommnia. Good Luck
Linkadge
Posted by viridis on December 26, 2002, at 13:55:59
In reply to The Truth About Clonazepam, posted by john7219 on December 25, 2002, at 23:48:30
This seems to be a recurring theme here, but sensationalizing the issue doesn't help. Of course Klonopin can cause dependence, just like most of the other psychiatric drugs that are prescribed. But the weight of evidence, and the experiences of many others here, indicate that it's a very effective drug with little potential for abuse or true "addiction".
I've been on it daily for about a year and a half. When I started, I discussed my concerns about "addiction" etc. in detail with my psychiatrist. He's a very open and direct guy, and seems quite cautious in prescribing meds, but not afraid to try what he thinks will be best for the patient. He told me that he's rarely seen people with serious anxiety conditions abuse benzos, although he has had a few cases in which he's had to switch to a different class of meds when he detects escalating use of benzos, patients repeatedly "losing" their pills, etc. According to him, this is mainly a problem with Xanax, much less so with Klonopin, and rare in any case.
He told me there was a high likelihood that I would develop medical dependency on K, and that if I decided to discontinue it, I should do so slowly under his supervision. According to him, this is pretty straightforward for most patients (based on his experience, which is quite extensive).
I do feel anxious if I don't take it for a couple of days. I've asked him about this, and his question is "do you feel more anxious than before you started taking it?" My answer is no -- I just feel very uncomfortable (like I did for years, pre-K). So, is this withdrawal, or just a return to my pre-K condition? I'm not sure, but I'm certainly much better off on Klonopin.
I do wonder if some of the "withdrawal" people talk about is just a return to their ground state, and they've simply forgotten how bad it was. Clearly, some people have had very serious withdrawals from Klonopin and other benzos, and I don't mean to diminish these experiences. But it does get difficult to sort out withdrawal from a return to anxiety, at least for me.
One of the nice things about Klonopin is that so far at least, I've been able to stay on a fairly low dose (1 mg/day) and get the same anti-anxiety, anti-panic, antidepressant benefits with no side effects and no need for dose adjustments. Others here have reported similar experiences. This also contradicts the idea that K is "addictive", although I expect that by now I am dependent, just as I would be on long-term therapy with SSRIs, insulin, blood pressure meds, and so on. In any case, it's a small price to pay for the ability to think clearly, function normally, sleep well, and deal with stress appropriately.
Posted by utopizen on December 26, 2002, at 14:21:51
In reply to The Truth About Clonazepam, posted by john7219 on December 25, 2002, at 23:48:30
So you're a drug addict who abuses heroin and cocaine and Klonopin, don't tell your pharmacist or doctor you've grown addicted to it when you go for a refill, and it's the pharmacist's fault for your deceit, not you?
Yeah, I'm glad I have to go leave my doctor for a new one because people who deceive docs and then blame them for not reading into their minds cause people who are honest to their docs not to receive proper treatment when they actually need it.
Posted by utopizen on December 26, 2002, at 14:22:36
In reply to The Truth About Clonazepam, posted by john7219 on December 25, 2002, at 23:48:30
The only truth in this post is that you deceived your doctor, and then turn around to blame him for your deceit.
Posted by comftnumb on December 26, 2002, at 19:37:23
In reply to Re: The Truth About Clonazepam, posted by utopizen on December 26, 2002, at 14:22:36
Klonopin has about 1/3 the half life of Valium, 34 hours for Klonopin vs. 100 hours for Valium. Both are considered to be long-acting benzos. Xanax and Ativan have about 15hour half-lives and are considered short-acting.
Posted by Mr.Scott on December 26, 2002, at 23:36:23
In reply to The Truth About Clonazepam, posted by john7219 on December 25, 2002, at 23:48:30
What is your dosage if I may inquire?
Posted by john7219 on December 27, 2002, at 0:17:06
In reply to Re: The Truth About Clonazepam » john7219, posted by Mr.Scott on December 26, 2002, at 23:36:23
It is .25mg before bedtime currently. About a year ago I dropped to this level from approx. 1mg nightly, with the aid of 150 mg/day Effexor. I wish I could get off clonazepam, but if I decrease slightly from my current dosage level it's a sleepless night for me, which I can barely tolerate. I was initially diagnosed with panic attacks eight years ago, which soon disappeared after treatment, and formed into GAD with secondary depression.
There seems to be a debate about whether, when tapering from clonazepam, the DIFFICULTY one experiences is the original condition resurfacing or actual withdrawl occuring.
Posted by Mr.Scott on December 27, 2002, at 1:25:26
In reply to Re: The Truth About Clonazepam, posted by john7219 on December 27, 2002, at 0:17:06
John,
You gotta trust me on this one... It's not that bad.. You can do three things here to get off the clon if you really want to. 1) Switch to Ambien 10mg while you dump the clon. Expect two weeks of uncomfortabality and be done with it. 2) Switch to 3.75mg of tranxene and taper in the tiniest of increments possible. The half life is over 100 hours and you'll barely notice much of anything. 3) Ditch the clon for some Neurontin 300mg maybe 600 tops and again endure a bit of annoying rebound for a couple weeks.
I guarantee your anxiety about the rebound anxiety itself is contributing to what is making this seem so overwhelming. The last few increments of the drug are always the hardest be it effexor or clonazepam. You just gotta get over the hump and maybe that means finding a doctor who actually reads more than just the drug ads in the journals he/she receives!
You can do this if you want to. Your almost there already..
Scott
Posted by Mr.Scott on December 27, 2002, at 1:38:59
In reply to Re: The Truth About Clonazepam, posted by john7219 on December 27, 2002, at 0:17:06
"There seems to be a debate about whether, when tapering from clonazepam, the DIFFICULTY one experiences is the original condition resurfacing or actual withdrawl occuring."
At that dose, you probably don't 'need' it anymore. But you will definately experience rebound anxiety and insomnia when coming off it. It passes though within 10 days. If after 2 or 3 weeks your not improved, maybe you do need it to take the edge off of either/both the remaining anxiety disorder or the Effexor.
But as I posted before, you can either get off it or find an alternative fairly easily. I've been on and off that stuff for years... The first couple times really had me worried especially Xanax. Clon was a bit easier. Now I know the experience so well, that If I needed clon and then had to come off of it I would navigate it much easier. I used to get so freaked about that stuff, but it's part of the anxiety disorder too. I couldn't stand to feel "off" or "out of control" of my body. God forbid I lose a nights sleep. But everything comes at a price. To pay with two weeks of discomfort for however long it helped you doesn't seem all that bad.
Best of luck on this one.
Scott
Posted by john7219 on December 27, 2002, at 15:33:21
In reply to Re: The Truth About Clonazepam » john7219, posted by Mr.Scott on December 27, 2002, at 1:38:59
Posted by Aadika on December 27, 2002, at 20:46:53
In reply to The Truth About Clonazepam, posted by john7219 on December 25, 2002, at 23:48:30
I have taken high-dose clonazepam (over 5mg / day at times) for well over a year for avoidant personality disorder with NO build-up of tolerance, and have always retained the ability to quit this drug cold turkey with NO withdrawal effects. It may be addictive to some, but there ARE those of us who cannot lead fulfilling lives without the aid of a benzodiazepine. I may be dependent, but I most certainly am not an addict.
Posted by john7219 on December 27, 2002, at 22:12:52
In reply to Re: The Truth About Clonazepam » john7219, posted by Aadika on December 27, 2002, at 20:46:53
Why is there this distinction between physical and/or psychological dependency and addiction. I am medically dependent to Clonazepam, since when I attempt to discontinue use I experience withdrawl symptoms(ie;anxiety,insomnia,tension,etc) which are intolerable if I wish to continue functioning in society. Now some people claim this is merely my prior condition resurfacing, for which I was initially prescribed this Rx. Tell me now, after eight years have passed since initial dosage, I have changed immensely in my perspective on life, I meditate nightly, exercise regularly, studying to be a machinist, maintain a healthy diet, etc, yet, as some people claim, I am still some sort of weak, anxiety ridden drug addict since I'm unable to kick this drug, as apparently so many of you have with such ease! Give me a break people! Take this drug for as long as I have daily at a .5mg level or higher, and attempt to get off, and you will experience severe withdrawl no question about it! Im not trying to be callous, just stating a fact, so don't trivialize my problem by suggesting you've got it under control.
I am DEPENDENT therefore I am ADDICTED.
Posted by viridis on December 28, 2002, at 0:03:10
In reply to Re: The Truth About Clonazepam, posted by john7219 on December 27, 2002, at 22:12:52
I don't think anyone here sees you as a "weak, anxiety ridden drug addict". Obviously, for you, getting off Klonopin is a real problem. Benzos affect some people that way, and it's not a character flaw -- just your physiology and brain chemistry. Some people can just stop taking ADs like Effexor with no problem, others have major withdrawal. Some people can quit smoking cold turkey after years; others (like me) suffered terribly when we tried to quit (it took me about 20 tries before I finally got off cigarettes).
Most people who use benzos are able to discontinue them by gradual tapering, but clearly some have genuine problems, just like with many other medications, psychiatric or otherwise. This doesn't make you an "addict". An addict is someone who craves a substance that is damaging to them, increases the doses to dangerous levels, and so on. You're dependent, and it's no reflection on your integrity or anything else.
Is it possible that the Klonopin actually is helping you, and that's why you still need it? I'm not saying this is the case, but it's something I've wondered about myself after a much shorter duration of use. I can stand going off it, but I feel very anxious -- the problem is, that's the way I was a lot of the time before I started using it, so am I really experiencing withdrawal? I'm not sure. I'm certainly uncomfortable without it.
Anyway, you're not an addict, and I don't think anyone suggested that you were.
Posted by Aadika on December 28, 2002, at 0:31:47
In reply to Re: The Truth About Clonazepam, posted by john7219 on December 27, 2002, at 22:12:52
I must say I agree with Viridis on all counts-- you are NOT a drug addict. And I believe his (her?... sorry, I'm rather new here) definition/distinction between medical dependency and addiction is a great one. And one that I have always believed to be the case since I first started psychotropic medications.
I guess what I'm essentially saying is, chin up--hang in there. For some reason, some people have a much harder time quitting Klonopin than others. Stevie Nicks (of Fleetwood Mac fame), for example, has been quoted as saying that Klonopin was a harder habit for her to kick than cocaine! But I know exactly how you feel-- I had a HELLISH withdrawal from Xanax, even at very low doses. I suppose I just got lucky with Klonopin? Oh well, all I know is that without my Klonopin, I'm house-bound... a recluse. So MD after MD has reevaluated my situation and we've mutually decided that long-term benzodiazepine therapy is best for ME. Whether your "withdrawal" is truly withdrawal or rebound anxiety, I suppose none of us can say for sure. But there ARE very efficacious ways to get off any benzo, and I hope that if you decide to take this route, one of them works for you.
Wishing the best,
~ Aadika
Posted by Mr Cushing on December 28, 2002, at 15:13:45
In reply to The Truth About Clonazepam, posted by john7219 on December 25, 2002, at 23:48:30
"I believe I could go through a year long combined cocaine and heroin binge, while still taking my usual nightly dose of clonazepam of course, walk away from the narcotics, and still be at the pharmacist counter the next day awaiting the refill of my beloved/wretched clonazepam RX!"LOL... you can sure tell when somebody has never had first hand experience of Cocaine or Heroin addiction. Comparing the withdrawal of Clonazepam to Cocaine or Heroin... that's what creates a fool.
I've been taking 1mg of Clonazepam every night now for about 4-5 years, with a period about half way through where I stopped cold turkey for about 4 months.
The withdrawal from this medication was VERY easy to do compared to some of the other drugs that I've had to come off of in my lifetime.
Any of the SSRIs are Hell in withdrawal compared to Clonazepam. And surely, comparing the withdrawals of cocaine to the withdrawals of Clonazepam is like comparing good to evil.
I still use Clonazepam to this day because it is the one drug that I've tried that has very few major side effects and that helps rid me of my anxiety/panic attacks and allows me to sleep a good night's sleep. Try going through about 11 years of Insomnia and then come and tell me how evil this medication is lol...
Posted by john7219 on December 28, 2002, at 18:04:49
In reply to Re: The Truth About Clonazepam, posted by Mr Cushing on December 28, 2002, at 15:13:45
I have experimented on enough occasions with cocaine and crack to have developed an addiction, like so many other unfortunate people. I had no desire to return to the drug to merely get high, I have more restraint than that. On the other hand, I NEED clonazepam to merely function in everyday life, not to get high. There have been reports that Benzodiazepines have a more serious withdrawl issue surrounding them than heroin!
I'd be careful what you say about it, since you are currently using them on a regular basis.
Posted by worrier on December 28, 2002, at 19:46:20
In reply to Re: The Truth About Clonazepam » Mr Cushing, posted by john7219 on December 28, 2002, at 18:04:49
> I have experimented on enough occasions with cocaine and crack to have developed an addiction, like so many other unfortunate people. I had no desire to return to the drug to merely get high, I have more restraint than that. On the other hand, I NEED clonazepam to merely function in everyday life, not to get high. There have been reports that Benzodiazepines have a more serious withdrawl issue surrounding them than heroin!
> I'd be careful what you say about it, since you are currently using them on a regular basis.>I think someone already said this, but has it occurred to you that you need the clonazepam because it is successfully treating your disorder? You said you don't want/need it to get high, just to function normally. So, the problem is what??? I had terrible benzophobia (fear of addiction, viewing myself as weak for needing a drug, etc.). But,as my psychiatrist once asked,"If your dr. told you you had high blood pressure and needed to take a med for it , what would you do?" The answer was obvious. Anxiety/panic disorder is real...why resist the most effective treatment?
Posted by Aadika on December 28, 2002, at 20:03:34
In reply to Re: The Truth About Clonazepam » Mr Cushing, posted by worrier on December 28, 2002, at 19:46:20
Posted by john7219 on December 28, 2002, at 21:23:59
In reply to Re: The Truth About Clonazepam » Mr Cushing, posted by worrier on December 28, 2002, at 19:46:20
I needed it initially about eight years ago, and for probably a few years afterwards to get my head screwed on straight. I don't need it now however, yet I am having great difficulty discontinuing it, on account of it being, ah that's right, ADDICTIVE! What don't you people understand?
Posted by Alan on December 28, 2002, at 21:49:02
In reply to Re: The Truth About Clonazepam, posted by john7219 on December 28, 2002, at 21:23:59
> I needed it initially about eight years ago, and for probably a few years afterwards to get my head screwed on straight. I don't need it now however, yet I am having great difficulty discontinuing it, on account of it being, ah that's right, ADDICTIVE! What don't you people understand?
==============================================Just being the devils advocate. How do know that you do not need it (in the medical sense of the word)?
Or is it perhaps that you are, as we all are from time to time, wrestling with acceptance of the underlying disorder, not acceptance of the medication itself? That may be what the conflict is about? I would like to be off of my medication more than anything but I can not. That constitutes medical dependency to me, not addiction in the strict sense.
The differentiation for my state of mind is crucial if I am able to make any meaningful decisions about being medicated or not. At least that is the way it seems to me. Perhaps I'm wrong in your case.
Maybe you've read this already. I know it has helped me and others:
http://panicdisorder.about.com/library/weekly/aa031997.htm
Best to you,
Alan
Posted by Aadika on December 28, 2002, at 22:06:59
In reply to Re: The Truth About Clonazepam, posted by john7219 on December 28, 2002, at 21:23:59
Are you abusing your medication? Are there negative consequences of taking clonazepam that you forsake in order to get your daily "fix"? Do you compulsively seek out the drug, and continually require increasing dosages? Is your MEDICAL DEPENDENCY on this medication causing significant stress to your social, family, and work life? If not, then you, my friend, are NOT addicted. IMHO, you probably still need this medication every bit as much as a chronic insulin-dependent diabetic needs his insulin.
Posted by Alan on December 28, 2002, at 22:41:33
In reply to Re: The Truth About Clonazepam » john7219, posted by Aadika on December 28, 2002, at 22:06:59
The vast majority of competently diagnosed, perscribed, and managed patients undergoing bzd therapy are helped far more than they are hurt. That's the basic criteria on which the manipulation of bodily systems are determined to have an acceptable cost/benefit ratio.
The term "medical dependency" refers to a situation in which the drug continues to exert a beneficial or even indispensable effect, but there is an acknowledgement that the user is not functional without the drug and cannot abruptly stop taking it.
Tolerance is not required for medical dependency, but it may occur. Most often it occurs to some extent in early use and then the effect of the drgug stabilizes. If tolerance were to continue developing indefinitely, any beneficial effect would rather quickly be outweighed by toxicity. Undoubtedly there are situations where this has happened with many types of drugs, not merely psychotropics, but all it really proves is that there are careless and incompetent doctors just as there are careless and incompetent practitioners of every profession, trade, vocation, etc. It doesn't prove anything special about psychotropics.
The distinctions exist because they reflect the way reality naturally sorts into groups of similar experiences. They're not hard to understand. They're simply inconvenient to certain points of view.
Alan
Posted by john7219 on December 28, 2002, at 23:53:15
In reply to The Truth About Medical Dependency, posted by Alan on December 28, 2002, at 22:41:33
Posted by Guy on December 29, 2002, at 0:30:27
In reply to BENZODIAZEPINES DESTROY LIVES!! (nm), posted by john7219 on December 28, 2002, at 23:53:15
John, most of the people who frequent this board have severe mood disorders. There is clinical evidence to show that what you are saying is false. It seems to me that you are parroting slogans from the anti-benzo fanatics. People who are already suffering from extreme anxiety do not need you here to spread more unfounded panic. If you want to discuss your own experiences, fine, but please do not presume to speak for everyone else. I think your ranting is actually doing more harm than good...you may indeed cause some people to continue to suffer needlessly by scaring them away from medications that help. I've been on more than 10 AD's with terrible results, and I even tried 18 months totally med free while I focused on acupuncture, meditation, relaxation, hypnotism, hot saunas, etc, etc. After several trips to the ER and constant thoughts of suicide, I have finally found some relief in clonazepam. Even if it eventually poops out, that is a chance I am willing to take. Just be very careful with your words--they can be really dangerous.
Posted by HIBA on December 29, 2002, at 1:34:11
In reply to Re: The Truth About Clonazepam » john7219, posted by Mr.Scott on December 27, 2002, at 1:38:59
Dear Mr. Scott,
Why should a person quit clonazepam if it is working for him, only to substitute it with another hard antidepressant (like doxepin as some recommend)...? Do you think it is a fair trade to substitute a benzo with an antidepressant ?
HIBA
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