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LifeGoesOn

Clonazepam / Klonopin Long-term Use

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Posted

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Background:

I have suffered from insomnia (due to being bipolar) for many many years, but my most recent episodes started about four months ago when I was taking only an anti-depressant which spun me up into a manic state, along with the insomnia that comes with it. I suffered through it for awhile, and finally asked my pdoc what could be done. He prescribed Ambien, which had no apparent effect. Later that week, the decision was made to stop the anti-depressant immediately, and the insomnia continued. He prescribed clonazepam (Klonopin) to help with it, and although it didn't help me get to sleep, once I got there, I at least stayed asleep for 4 or 5 hours. He added Seroquel to the mix, which helps me get to sleep. I have been sleeping well 90% of the time for the last two months.

I was concerned about the long-term use of benzodiazepines having been on them for 9 weeks, and wanted to know if I could sleep through the night with only the Seroquel. I skipped taking it for 48 hours, without contacting my pdoc first. (Yeah, bad idea, I know.)

First night went OK, I was up late and got maybe 5 hours of sleep (a friend's band was performing, and I stayed out later than usual). I felt like garbage the next day, which I attributed to being out late, Second night, up until almost midnight, awake at 3am, stayed in bed until 7 but didn't get any more sleep. The next day, I felt even worse than the day before, and I think I was experiencing some mild benzo withdrawal symptoms (increased anxiety, depression, fatigue, slight hand tremors).

Last night, I resumed taking my regular dose of clonazepam and today I feel OK (had the usual hangover), but I'm used to that.

I see my pdoc a week from Monday. I'm going to ask him what his long-term plan for treating my insomnia is, and whether he sees me being on benzodiazepines for the long term.

In the meantime, I'd like to know from your experiences - is it common for someone to become physically dependent on clonazepam after daily use for 9 weeks? Could I be physically dependent and experiencing rebound insomnia? Are there any other options that you have found helpful? (Ambien doesn't work for me, and I cannot tolerate trazedone).

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Posted

everyone's body is different and will react to klonopin and klonopin withdraw differently. you, by what symptoms you described, probably had some level of physical benzo dependence.

if you're on it long-term and that's the plan, then why is dependence a problem necessarily? sure, it's not a good thing, but if you're on it anyway for years the only problem i can see is that you'll need higher amounts for the same effect. i was up to a whopping 6mg at one point!!! i weaned down to 2mg and then (bad me) stopped it cold turkey without consulting my pdoc, because i just didn't feel any withdraw.

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Posted

My wife has been taking benzos for quite some time now. I think over a year. She was taking Xanax as needed, I think around 2mg a day at the most. She likely used about 20mg a month, or less. At first, when I found out she was taking them, I will admit, I freaked a little. I knew about the dependency issues after doing research when my doc gave me Xanax as well. At the time I was pretty anti-meds.

Since taking the Xanax myself and only using it short term, I know that they can be a great help when you truly need them. I honestly don't think I could have made it through my start up on Zoloft with some kind of help. It was that bad. I also don't worry so much about my wife taking them anymore. She uses them responsibly and is aware of dependency issues. She only takes them as needed and when she is having a panic attack. Her doctor is well aware of the use and I'm sure would tell her of any concerns of misuse or self medication.

That being said, I think if you REALLY need the benzos and your doc is safe about letting you use them for a longer period of time, then so be it. For some people they really are the difference between daily anxiety and panic, and having a life they can actually live. When it comes to anxiety, and especially panic attacks, they are very good for that. Also, many people take them each night to help them sleep. My wife has epilepsy too, and many epileptics take them as needed for a long while until their seizures are better controlled. They can often times help to calm you down, thus avoiding the stress that triggers seizures for many people.

I think it's just about reward vs. risk. If you think they greatly improve your sleep and quality of life, then it's fairly worth it to utilize them I would think. It's all up to you and doctor. As long as your comfortable with it and so is your doc, then there shouldn't be a problem. Also you can come off of benzos even after long term use. It just takes time and slowly weaning yourself down. On top of that, not everyone who takes them develops an addiction. Just try not to worry so much about the "what if's" if it's helping you live a better life.

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Posted

I've been on narcotic anxiety meds (klonopin and now valium) for a very long time (10 years almost). Most of that time I was on Klonopin and I never got addicted to it. That's really the biggest thing you should be concerned about. Addiction to these particular meds is very high.

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Posted

To tell you the truth I hate Clonazepam while it reduces my anxiety all the while I

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Posted (edited)

Hi LifeGoesOn,

The big issues about Benzodiazepine addiction and physical dependence hit the press in the 1980's When Valium first hit the market in the early 70's (even before that) it was given out like sweets to people at the drop of hat. They became know as 'mothers little helpers' also the Rollings Stnes coined that phase in one of their songs called Mothers Little Helpers'.

There was a massive program and various organisations set up to deal with the growing problem of Benzo Addiction which was a real social problem. In my workplace we delt with addiction and dependency to many drugs- street drugs and a big client group on Valium and other benzo's.

So yes you do get a physical and psychological dependency and build up a tolerence and this is well documentated. Just go online and search benzo addiction and you will get all the information you need from professional bodies.

Now you have to take a sensible attidute to short term use of benzdiazepines and low doses usage. Most doctors will only let you use Benzos on a short term basis (in the UK max is 4 weeks), unless you need them for epilepsy or other neurological disorders.

The withdrawal effects after long term use are not pretty, and it is only when you stop taking them for good, and usually after up to 2 months that you are hit by these withdrawal s as the benzo leave you fattly tisses and other organs that it has been deposited in. Now I am not one for scare tatics, I only warn people to be careful are sparingly with the usage, they are addictive and no doctor has ever said they are not, nor any research.

So don't worry , just be aware , and careful and consult your Doc on these issues.

Best Wishes

Jim Bow

Edited by jimbow15

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Posted

The most clonanazapam I was on was 3mgs a day. Am I addicted to it? No, dependant yes maybe. I don't enjoy taking it or any benzo. But they have really made a change and I am able to to do a LOT more. I've gone through periods where I would have panic attacks all day long. I've also used the milder ativan, and a few times at the same time. Of course lowered doses of each. When I feel tollerance of clonazapam building, I switch back to ativan for a little while. 5 yrs before C I took only ativan, then tried the C and decided it worked much better. It also seems to help with stability a bit along with the other meds I take. I'm BP as well. Clonazapam is very popular amoung those with BP. It can also help a bit in slowing racing thoughts. Maybe not on it's own, but in a combo of other BP meds.

As far as seroquel, I sleep pretty good with just that. Better when I'm on clonazapam, less so on ativan.

Right now, I'm down to 75mg from 300 at one time till I got to my target dose of 300mgs of lamictal (moodstabilizer) for a few months after. Then slowly titrated down.

If any "prescribed" med, monitored by your doc, improves your quality of life, whats the problem?

Of course this is entirely up to you and your Pdoc.

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Posted

Hi Neo,

I agree in general terms with you excellent response. The question was more about addiction/tolerence/dependency. The nature of benzodiazepines and the way they act on the brain and filtered in the body tissues is different from other SSRI/ADs. The mechanism is different.

I can only talk from expereince of long term users, and here we are talking about people who have been on high doses for up to 40 years of their life. A really good tapering program, often up to one year works for them. It is when you stop Benzos completely and they start leaving you body, fattly tissues ans various organs that is the problem. The side effects of withdrawal are from these bodily systems which have got used to having this drug in that system.

Any perscribed drug is monitored by the Doctor and it is his responsibility to give you guidence and support no matter what med you are on. So the term addiction is applied to benzodiazpines by professional doctors and researches because of the nature of this drug and it long term impact on people who try to withdraw.

You are right when you talk about quality of life and I believe the same applies to SSRI/ADs. I take 40mg of Citalopram. When you stop taking ADs, you may have a return of the original symptoms and it may be that this is only withdrawal effects and not necessarily the depression.

I had a real problem with Diazepam useage over a long period and I went through hell getting off them, I was forced by an unsympathetic GP to come off. He told me 'you won't be getting any more of these. I changed Doctors and we worked using a tapering plan over a year. I still got bad withdrawal effects.

Best Wishes

Jim Bow

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Posted

I would love to be on just an AD for anxiety, but unfortuntaly ADs and BP don't always mix. Not an option for me anyway, and maybe not for LifeGoesOn.

I'm NOT a big fan of benzos or pushing them, thats not for me to decide, but sometimes ya gotta do what ya gotta do.

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Posted

I have been taking clonazepam for about 8 years. The original Rx was for 1m/daily as needed. Well, I need it everyday, and always have. There have been very, very few occasions when I actually have taken an entire mg., and most days .5mg is quite sufficient. On weekends, I can do with .25mg to get me through.

Am I worried about addiction/dependency? Nahhhh! I am under close pdoc supervision, and she sees no prob with up to 1mg/day. I have already advised her that if I should ever feel the need to go over 2mg/day, I'd like to discuss alternatives to this med. Definitely .25mg does not do for me what it used to. But, for me and the pdoc up to 1mg daily is not a problem.

Am I psychological addicted or physically dependent on this med at this dosage? Well, I just don't know. What I do know is that it's improved my quality of life for a long time, and I see no need to give it up.

Deepster

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Posted

I have been taking clonazepam for about 8 years. The original Rx was for 1m/daily as needed. Well, I need it everyday, and always have. There have been very, very few occasions when I actually have taken an entire mg., and most days .5mg is quite sufficient. On weekends, I can do with .25mg to get me through.

Am I worried about addiction/dependency? Nahhhh! I am under close pdoc supervision, and she sees no prob with up to 1mg/day. I have already advised her that if I should ever feel the need to go over 2mg/day, I'd like to discuss alternatives to this med. Definitely .25mg does not do for me what it used to. But, for me and the pdoc up to 1mg daily is not a problem.

Am I psychological addicted or physically dependent on this med at this dosage? Well, I just don't know. What I do know is that it's improved my quality of life for a long time, and I see no need to give it up.

Deepster

The problem that I've encountered over the last five years is that it sneaks up on you and you don't realize how

much you've mentally deteriorated over that time. Save your brain and don't take this product !

Here I sit unemployed because I'm not as sharp as I used to be.

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Posted

The problem that I've encountered over the last five years is that it sneaks up on you and you don't realize how

much you've mentally deteriorated over that time. Save your brain and don't take this product !

Here I sit unemployed because I'm not as sharp as I used to be.

There are plenty of meds for MI out there that slow your mental functioning. And a lot of them you don't come back from after long term use. Clonazepam/Klonopin isn't unique in that at all.

My best friend used 1.5mg/day for a year then stopped. She said it was way easier than quitting cigs, for example.

I take .5mg 3 x day. I couldn't function without it. If I ever (Please!) get to the point I don't need meds, I'll deal with any possible dependency then. Realistically, if I can and must deal with everything this illness throws at me, coming off clonazepam is not going to scare me.

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Posted

Obviously, Klonopin use/withdrawal varies from person to person, but I think there's also an experience factor tied in.

For me, I have quit chewing/snuff several times and it is aweful; not matter how you try to do it. The depression, the agitiation, the anxiety; it's miserable.

I am Type 2 BP and I used to cycle rapidly. The calmest episode I ever had was a mixed episode; depression and agitiation all rolled into one. I was generally only calm when I was seriously depressed; but there was always that agitation hanging around. I never had many hypo-manic phases; my mania was always hypermania (extremely agitated). I went through that for five months before being properly diagnosed.

I'm on 1.5mgs of Klonopin, but was placed on it before I was properly diagnosed and it didn't help the cycling. It calmed me down a little, but it made the depressive stages much worse.

I have been on Klonopin for six months and will be coming off of it soon. I was worried at first, but then I reminded myself how horrible my BP issues were. I am going to come off of them slowly; my pdoc and I have a good tapering schedule. I know that there will be rough periods, but I'll get through them. We're going to up my Neurontin as well, which will really help.

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Posted

Ooh - I read this thread with trepidation.

I have just increased my Valdoxan to 50mg and for the last 2 days have woken late and still feel extremely tired. When I take my Valdoxan at night, I also take .5 Clonazepam and 2.5 Zyprexa.

Last night I decided to halve my Clonazpem and I have woken today feeling slightly better.

I believe this med has a long half life? I probably wont know the true SE from reducing for a few days?

My Pdoc suggested weeks ago that I could do this if I felt too 'zonked' during the day and now I am nervous about the possible outcome - but I have to get off it eventually and I think the higher level of Valdoxan has improved my anxiety and am now willing to see what happens.

Tez :shocked:

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Posted

Trazodone is another option for sleep. At its lowest levels (50mg) its a potent sleep aid (though you'll need more eventually) and at higher doses (300mg) its an antidepressant/anti-anxiety drug.

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Posted

I was on clonazepam for 10 years. I started out at .5 mg and then ended up taking 4 mg in the last years. I went into hospital and they decided that I shouldn't be on it anymore. They cut me off cold turkey (very dangeous) and put me on Seroquel. I realised after I was on off it that it had been making me depressed. Now I am taking .5 mg just to make my body happy because the withdrawal was very bad. So I guess that is what happens when you take it long term ... you keep needing more.

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Posted

Benzo's are bad umkay?! I take 1mg of clonazepam daily and was on up to 3mg, was on 5mg of valium before I changed. This is the only way I've found to combat my anxiety and depression....I really don't understand why this is.... I was on effexor for over 5 years which was fantastic, before it washed out and became as useful as taking a cough lolly for a sore throat. I currently take a combo of 30mg of Avanza at night and 1mg of clonazepam split to .5mg in the morning and night. I think that in this day and age I'm a bit disappointed that doctor's really haven't progressed much in their research over the years, although Im glad that they aren't willing to cut someone's skull open to check out what causes depression or anxiety anymore. Rant over!

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