Klonopin question

Discussion in 'Fibromyalgia Main Forum' started by goaska29, Aug 18, 2006.

  1. goaska29

    goaska29 New Member

    So I've become accustomed to taking .25mg of clonazepam (generic for klonopin) about 3 times a day. Since then, I've had no tremors or racing thoughts and the fog has seemed to lift a bit.

    My only concern is dependancy. Does anyone else take it this regularly? I usually take it when I wake up, at lunch, and then again at dinner.
  2. Chevy39

    Chevy39 New Member

    My bottle states that I am to take 1 or 2 tablets twice daily as needed for anxiety. But, I actually take it for Restless Leg Syndrome at night. It knocks me out, and that is with breaking the pill in half. After reading that you were taking it 3 times a day, I went back and checked my bottle. No wonder, mine is a 1 MG dosage. As it is, if I take 1/2 of a pill, I can hardly get up to go to work in the morning. I just recently started trying to break it into quarter pieces. Too early to tell. It was prescribed by one Dr. for the anxiety (too strong) and then another Dr. recommended it for my restless leg syndrome.

    My pharmacy puts those warning labels on the medications and this one only states that it "May cause drowsiness" and of course, alcohol could intensify this effect. I have other medications with labels about dependency.
    Hope that helped some.
  3. 69mach1

    69mach1 New Member

    ...spasms...i feel a huge difference if i do not take them...

    my dr told me not to worry about dependancy...

    jodie
  4. BHopeful

    BHopeful New Member

    if soenthing works as is not casuing you side effects, why even worry.

    Do diabetics worry about dependency on insulin. No - they just take it because they can't function without it.

    We're too hard on ourselves with these illnesses.
  5. Mikie

    Mikie Moderator

    Yes, you can develop dependency on Klonopin and if you decide to quit taking it, you will need to very, very slowly wean off. Thing is that you had symptoms and the drug is working, which says that you need it. As long as you need it to stop the overfiring of the brain's neurons, it would seem wise to take it. Dr. Cheney believes that the Klonopin protects the neurons from premature death caused by overfiring.

    Many of us suffer from a slight seizure state which can cuase racing brain, anxiety/panic attacks, muscle spasms, sensory overload, insomnia, RLS, and tinnitus. Klonopin helps many of us with these symptoms.

    I'll go see whether I can pull up Dr. Cheney's article. I post it here often because it is very informative about Klonopin.

    Love, Mikie

    OK, here it is:

    Dr. Paul Cheney Discusses the Benefits of Klonopin
    by Carol Sieverling
    ImmuneSupport.com

    10-12-2001


    Editor’s Note: The following is based on a recent interview conducted by Carol Sieverling with Dr. Paul R. Cheney, M.D., Ph.D., and the article "CFIDS Treatment: The Cheney Clinic’s Strategic Approach" (CFIDS Chronicle, Spring 1995). Dr. Cheney gave permission to share this information, but has not reviewed or edited it.

    Many CFIDS specialists prescribe the drug Klonopin. In the October 1999 issue of The Fibromyalgia Network, nine CFS/FM specialists summarized their most effective treatments, and six included Klonopin. Interestingly, the three who did not are primarily FM specialists.

    Dr. Cheney prescribes Klonopin to address a condition associated with CFIDS called "excitatory neurotoxicity." To explain this condition to patients, he draws a line with "seizure" on the far left and "coma" on the far right. A big dot in the middle represents where healthy people are when awake. A dot somewhat to the right of the middle indicates where healthy people are when asleep – slightly shifted toward coma. He highlights in red the left portion of the line, from seizure to the middle, and labels it "Neurotoxic State" (damaging to the brain). He highlights in blue the right portion of the line, from coma to the middle, and labels it "Healing State."

    In CFIDS, an ongoing injury to the brain shifts patients toward seizure. A dot to the left of the middle, marked "injury," represents the position of CFIDS patients. This puts us in the red "Neurotoxic" zone. When we shift toward seizure, we often experience "sensory overload." It’s as if our brain’s "radar" is too sensitive. Our neurons (nerve cells) are sensing stimuli and firing when they should not. This causes amplification of sensory input. Light, noise, motion and pain are all magnified. At the beginning of their illness, many patients report feeling exhausted, yet also strangely "wired." The "wired" feeling is the slight shift towards seizure that occurs as a result of the excitatory neurotoxicity.

    Cheney frequently uses the term "threshold potential" when discussing excitatory neurotoxicity. (Think of the threshold - bottom - of a doorway. The lower it is, the more accessible it is. When it is at floor level, everything can enter. When it is raised, access is restricted to taller people. If it is too high, no one can enter.) Threshold potential refers to how much stimulus it takes to make neurons fire. If the threshold potential is too low, even slight stimulation is "allowed to enter" and is detected by the neurons. This causes the neurons to fire, resulting in sensory overload. If the threshold is dropped to nothing, all stimuli get through and the neurons fire continuously, resulting in a seizure. If the threshold is raised, only stronger stimuli can make neurons fire. A healthy person’s threshold potential naturally rises at bedtime, promoting sleep. If the threshold potential is too high, you feel drugged or drowsy. If the threshold potential is raised extremely high, coma results.

    Two receptors in the brain, NMDA and GABA, determine the threshold potential. During the waking hours of a healthy person, NMDA and GABA should be equally active. This balances the person in the middle of the seizure/coma continuum. NMDA stimulates, and GABA inhibits. If NMDA increases, one moves toward seizure. If GABA increases, one moves toward coma.

    In CFIDS, NMDA is more activated than GABA, lowering the threshold potential. This causes neurons to fire with very little stimulation, resulting in sensory overload. This condition of excitatory neurotoxicity is dangerous. Dr. Cheney emphasizes that in an attempt to protect itself, the body will eventually kill neurons that fire excessively. He states that brain cell loss can result if this condition isn’t addressed.

    How can the brain be protected against excitatory neurotoxicity? Klonopin. This long acting benzodiazepine has been Dr. Cheney’s most effective drug for CFIDS over the years. He believes that Klonopin and the supplement magnesium may be two of the most important treatments for CFIDS patients because of their neuroprotective qualities. He recommends two or more 0.5 mg tablets of Klonopin at night. Paradoxically, very small doses (usually a quarter to a half a tablet) in the morning and mid-afternoon improve cognitive function and energy. If the daytime dose is low enough, you’ll experience greater clarity and think better. If the daytime dose is too high, you’ll become drowsy. Adjust your dose for maximum benefit, taking as much as possible without drowsiness. Adjust the morning dose first, then take the same amount mid-afternoon if needed, then take three to four times the morning dose at bedtime. Dr. Cheney recommends doubling the dose during severe relapses.

    Dr. Cheney most frequently prescribes the combination of Klonopin and Doxepin, along with the supplement "Magnesium Glycinate Forte." Magnesium Glycinate alone is a good choice for the more budget minded(www.ImmuneSupport.com sells it as "Magnesium Plus".) A common dosage of magnesium is 200 mgs at bedtime. Too much magnesium can cause diarrhea, though glycinate is usually the best tolerated form.

    Cheney prescribes Doxepin in the form of a commercial elixir (10mg/ml). At low doses, this tricyclic antidepressant acts as a very potent antihistamine and immune modulator. Doxepin acts synergistically with Klonopin to assist sleep, and may improve pain. Patients tend to be very sensitive to Doxepin, which can cause morning fog and fatigue if the dose is too high (5 to 10 mg or higher). He recommends starting at two drops a night and gradually increasing the dose until "morning fog" becomes a problem. Most patients can’t tolerate more than half a cc.

    On a handout entitled "Neuroprotection via Threshold Potentials," Cheney lists six substances that can protect the brain. Under the category "NMDA Blockers" Cheney lists:

    1. Parenteral magnesium and taurine (intramuscular injections of magnesium and taurine, usually given with procaine) 2. Histamine blockers (Doxepin Elixir) Under the category "GABA Agonists" (increases GABA) Cheney lists: 3. Klonopin 4. Neurontin 5. Kava Kava 6. Valerian Root

    Klonopin is taken "day and night"; Neurontin "night, or day and night"; kava kava “daytime only”; and valerian “nighttime only.” The first four are by prescription, the last two are herbs. In my limited experience, only certain patients are put on magnesium/taurine injections, and then only for a limited period before switching to oral supplements.

    Many myths abound concerning Klonopin. When asked about these myths, Dr. Cheney shared the following information.

    MYTH NUMBER ONE: THE GENERIC IS JUST AS GOOD.

    When the generic Clonazepam came on the market, many patients switched to it because it was less expensive than Klonopin. Cheney then began hearing that most patients had to take more Clonazepam to get the same effect. Generics aren’t exactly identical to the original products, and with most drugs the slight variations don’t matter. However, most CFIDS patients can tell the difference between Klonopin and its generic form, Clonazepam. Most find Klonopin to be more effective.

    MYTH NUMBER TWO: KLONOPIN IS ADDICTIVE.

    Dr. Cheney was adamant that Klonopin is not addictive. In treating thousands of patients, he has never seen a patient become addicted to Klonopin. He reviewed the definition of addiction, stating that it involves: (1) psychosocial disruption, (2) accelerated use, (3) inappropriate use, and (4) drug seeking behavior.

    Dr. Cheney said a case might be made that Klonopin is habituating. It’s true that it can’t be stopped suddenly. You must taper off of it gradually. However, he was cautious about even calling it habituating. The process of tapering off a drug is not the same thing as withdrawal, a term that implies addiction.

    Dr. Cheney said to keep in mind that Klonopin is given for a physiological problem – excitatory neurotoxicity. It’s prescribed to adjust the threshold potential: to keep neurons from firing inappropriately and being destroyed. He stressed that Klonopin should never be given unless you intend to raise the threshold potential. He stated, "Problems arise when you begin to use benzodiazapines for reasons other than threshold manipulation." However, CFIDS patients have a "threshold potential aberration" and need Klonopin (or something similar) to avoid brain injury. Dr. Cheney has never seen a recovered patient have difficulty coming off Klonopin. He stated, "When you no longer need the drug, coming off it is very easy."

    On the other hand, trouble arises when someone who still has an injured brain tries to come off Klonopin. It’s like a thyroid patient stopping their thyroid medication. Dr. Cheney warned, "All hell breaks loose". However, it’s not because the drug is addicting, and it’s not withdrawal. The condition still exists, and the body lets you know it has a legitimate physical need for the drug. Cheney stated, "When a CFIDS patient who is still experiencing the underlying mechanisms of brain injury goes off Klonopin, there is a burst of excess neural firing and cell death. That’s the havoc we hear about that is mistakenly called withdrawal."

    MYTH NUMBER THREE: KLONOPIN DISRUPTS STAGE 4 SLEEP.

    Dr. Cheney said that he honestly doesn’t understand this concern. He believes Klonopin might disrupt the sleep of people who take it for conditions other than the threshold potential aberration found in CFIDS. He also acknowledged that if you are looking just for drugs to facilitate sleep, Klonopin is certainly not the first one to come to mind, nor should it be used to induce sleep in "ordinary" patients. It’s not a sleep drug per se. However, a large part of the sleep disorder of CFIDS is excitatory neurotoxicity and the resulting shift toward seizure. If you treat this condition with Klonopin, then you have treated a large part of the sleep disorder in CFIDS. Most importantly, he said he simply does not see stage 4 sleep disruption in his patients on Klonopin.

    Towards the end of this discussion on Klonopin, Cheney smiled, and remarked, "But suppose I’m wrong about the brain injury and the threshold potential aberration and the shift toward seizure? What if I’m wrong about your need for Klonopin? I’m absolutely sure I’m right, but what’s the worst case scenario? Do you know what long-term studies on Klonopin have shown? Reduced incidence of Alzheimer’s Disease. Alzheimer’s Disease is a complicated and convoluted way of knocking out your neurons, and Klonopin protects your neurons. Now it’s believed that Klonopin didn’t actually stop Alzheimer’s. It just delayed its onset so long that everyone died of something else before they ever got it - which is to say you won’t get Alzheimer’s. You’ll die of something else first."

    The last question Cheney addressed concerned the dose: what happens if the dose is too high? He said the only down side was that if you took a little too much (we are not talking overdose here) it would shift you toward coma on the continuum. It would shut your brain down to some degree, and thus impact your ability to function. This is inconvenient, but it’s not harmful. In fact, it shifts you into the "healing state" on the continuum. You may feel like a zombie, but your brain is protected and your neurons are not getting fried. However, not being able to function isn’t an option for most of us, so we need to find the maximum dose that doesn’t make us drowsy.

    Dr. Cheney emphasized that Klonopin, Doxepin, and magnesium are very, very good at protecting the brain from cell death due to excess firing. However, they can’t stop the underlying mechanisms of CFIDS that are injuring the brain in the first place.

    Though it can’t stop the underlying mechanisms causing the injury, Klonopin can protect your brain and keep your neurons from being destroyed. Then, as Cheney put it, "When you come out on the other side of this, you’ll have more of your brain left."







    [This Message was Edited on 08/19/2006]
  6. bpmwriter

    bpmwriter New Member


    i'm sure some other klonopin users will chime in but here's my take. dependency in this case means you may need to take higher and higher doses to achieve the same effect, it does not mean you will become an addict. if the drug is becoming less effective, temporarily cut back your dose for a few days then move back to the regular dose. yes, klonopin can be tricky to stop, you get the jerks, you might not sleep well for a few nights, but it's not heroin! if it helps control your symptoms, take it!!
  7. 1sweetie

    1sweetie New Member

    It has helped me so much. It had been prescribed to me for both sleep/RSL and sensory overload.

    I, too, was afraid of taking more medication, especially during the day, but my sensory overload became worse and worse. By listening to Mikie and all the info she knows about Klonopin, I started taking it during the day. I have .5 mg pills and I vary from a 1/4 to a whole pill during the day as I feel I need it. I am prescribed to take as many as 5 .5 mg pills per day if needed. By using Mikie's method, I do not have to use that much medicine.

    I am not concerned about dependency. Without the Klonopin, I may not be here to worry about that issue. I also feel that when my brain does not need it, I can discontinue it gradually. It needs Klonopin desperately now.
  8. lvjesus

    lvjesus Member

    I take .5mg at night for hypersensitivity. I got to the point that I COULD NOT go to any store with flourscents and function AT ALL and that was WITH a hat AND sunglasses.

    I have been taking .5mg once a day for over a year. I have not had to increase and it is still working fine. Not everyone will have to wean off slowly, but it is advisable with ANY med.

    My doctor told me I could quit my 25mg of Elavil cold turkey but after 3 days I had anxiety so bad it was unbearable.

    I went off Klonopin cold turkey for about 3 months but not on purpose. I was out of town for a month and called in for a refill before I left only to find out I had to see the doctor before he would give me more.

    He would not even give me one month's worth for the time I was out of town so I had no choice. I did jerk alot in my sleep. My roommate said I looked like I had Turrets! and of course I did not sleep as well, but that was it.

    Like someone said, it is not heroin or something! I was doing okay by the time I got back so just did not bother going back to the doctor for a new script (because I hate going to the doctor) until the sensitivity started to come back. Now I am back to my .5mg at night.

    If it helps you, take it!!!

    Love,
    Sonya
  9. CockatooMom

    CockatooMom New Member

    I started taking Klonopin (well, the generic) two weeks ago, and I can't tell if it's helping or not!

    It was Rx'd for RLS, myoclonic jerks during sleep, and to help me sleep in general.

    I took the 1 mg tab the sirst night...didn't notice anything different.

    I took the 1 mg tab the second night...noticed I didn't want to get up in the morning, but I was still tossing, turning, and staring at the ceiling.

    Doc told me I could take 2 tabs (2 mg), so I tried that for a few nights...I remember waking up feeling frustrated in the middle of the night that I could not stay asleep.
    But found it even harder to get out of bed in the morning.
    (Thank heavens I'm not working right now.)

    So I went back to 1 mg a night and added a vicoden...still not much difference.

    ANY THOUGHTS?

    I will be calling my doctor Monday morning.

    I also became VERY depressed this week, and now wonder if the klonopin had anything to do with it? Hmmmmm???

    I'm glad it works for many of you. Looks like I will be trying yet another remedy for sleep. (Except for the baseball bat and shot of whisky...ouch!)


    Hugs,
    E
  10. NyroFan

    NyroFan New Member

    goaska29:

    My doc just jumped me up to 4mg. of Klonopin from 3mg.

    I was having involuntary body movements.

    He said it was part of the seizure syndrome I have.

    I have been on 3mg. for years and I was suprised he jacked it up to 4.

    Do I feel better? You better believe it. No more twitching!

    nyrofan
  11. 69mach1

    69mach1 New Member

    if i have to be dependant on this that is ok for me...atleast i can get some sort of sleep at night...i did toss and turn last night...but i think it had something to do w/the wellbutrin still in my system..i had to stop that a couple days ago...

    the dr cheney theory is one that i believe...in...cause when i am w/o theklopin my ears ring...and ring...and the only time i feel like i do not not it ...is when i have my air purifyer on full blastt..

    jodie
  12. Mikie

    Mikie Moderator

    Dependency means that our bodies come to depend on some substance and if it is withdrawn quickly, we may have rebound symptoms.

    Tolerance is when our bodies become used to the substance to the point that we have to increase the dose to achieve the same effect.

    Neither dependence nor tolerance equate to psychological addiction. Dependence and tolerance are physical reactions to meds.

    Hope this helps with some of the confusion.

    Love, Mikie