Klonopin... started last night-first morning I didn't feel groggy

Discussion in 'Fibromyalgia Main Forum' started by suzyloon, Jul 13, 2005.

  1. suzyloon

    suzyloon New Member

    Hey everyone,

    Went to my first visit with new PCP yesterday. Brought the article about Klonopin, she kinda said that is only one person's opinion and that Klonopin IS ADDICTIVE. However she did prescribe it to me which is GOOD.

    Took it for the first time yesterday and this morning I could get out of bed for work and didn't feel totally drugged for the first 5 hours of the day...

    Why is this? What does Klonopin do that helps so much? Does it mean I have sleep disorder and it helps with my REM sleep?

    I can't believe how much better and more alert I feel. Not to mention it helps my anxiety. I sooo wish doctors weren't so afraid of giving patients these kind of drugs. I understand on one hand but am afraid she will cut me off when it comes to the next refill. She gave me 15 days worth.

    Does anyone else feel Klonopin helps so much?

    I am amazed. Didn't get a diagnosis, but I go to Rheumie next week.

    Thanks to everyone on this site!

    Suzy
  2. lvjesus

    lvjesus Member

    but have to add here that my PCP did not want to prescribe it either, but the rhuemy did. I put that in another post titled "Addictive drugs, give me a break" so maybe that is you too.

    If not, check it out.

    Sonya
  3. Mikie

    Mikie Moderator

    Klonopin stops the slight state of seizure in our brains and allows us to get into a slight state of coma, which is sleep. The article explains this and also debunks the addiction myth. There are two articles on Klonopin in our Library. If you do a search on Cheney in the Library, use the one from the third page and not the shorter version on Page 1.

    Love, Mikie
  4. natyrone

    natyrone New Member

    Klonopin was one of a handful of things Dr. Lapp started me on following our meeting 2 years ago. I never saw any benefits from it, so a couple of months ago I stopped taking it, and nothing changed. I was always afraid to go off of it because of the way Dr. Lapp described its benefits. He had me taking so many different things that it was hard to tell what was working and what wasn't. Turns out that NADH was the only thing that worked at all really.
  5. PVLady

    PVLady New Member

    I sure hope your doctor does not refuse to give you a refill if this works for you.

    If so, you may want to look for another doctor to help. It is so sad some doctors are not open to learning more about fibro and the work other doctors have done.

  6. Mikie

    Mikie Moderator

    A CFIDS expert. Anyone can become addicted to anything, including chocolate, vomiting, shopping, and sex. A lot of people mistake tolerance and physical dependence with addiction. I'm not saying that one could never become addicted to Klonopin; I heard of one case where someone did develop a psychological addiction to it. I'm just saying that Dr. Cheney believes it is not, in and of itself, an addictive medication.

    I will go get his article in which he calls Klonopin addiction a myth. Many docs are afraid of addiction to this drug, but most of the time, it is physical dependence, and not psychological addiction, which they are talking about. There is a difference and Cheney does a good job explaining the difference.

    Love, Mikie


    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."









  7. foxglove9922

    foxglove9922 New Member

    Hi Suzy,

    I too experienced immediate results with Klonopin. It has been a large stepping stone in my progress. So happy to hear that this has also been beneficial for you.

    best wishes.............foxglove
  8. Mikie

    Mikie Moderator

    Many, many people, including docs, do not know the distinction between physical dependence and true psychological addiction. Many drugs can make us physically dependent and we must slowly wean off of them when we want to stop taking them.

    Psychological addiction involves drug seeking behavior, taking more and more of a substance to achieve a type of high, and a willingness to do anything to get the drug when the high wears off.

    Most on Klonopin reach an ideal dose and many have been taking the same dose for years. We are physically dependent on it but not addicted to it.

    As I said, anyone can become addicted to just about anything, and I'm not saying someone couldn't become addicted to Klonopin. It's just that many docs know that it produces physical dependence and this leads them to believe it is addictive.

    Every drug has its side effects and Klonopin is no different. Every drug does not work for everyone. Klonopin has been a God send to me and many here, but if one has addiction problems, it might not be a good idea. I suggest taking Dr. Cheney's article in and discussing it with one's own doc.

    Love, Mikie
  9. lurkernomore

    lurkernomore New Member

    Klonopin addict, maybe that is what I would have to declare myself. Because I was put on Klonopin years before I had ever heard of fibromyalgia for what my neuro called a benign familial tremor. I have it so badly that I was refused a haircut. My head and body shook that badly. And I was not even thirty years old at the time.

    So years have gone by and I have remained on Klonopin and have no desire to go off the med. There is a lot ot be said for having some quality of life and the ability to do things as simple as write my name, control my hand movements to feed myself, etc.

    It really saddens me that Klonopin has gotten such a bad rap and I have no doubt that there will always be someone who will abuse anything. But Klonopin gave me back my life so people no longer stare and ask me if I have Parkinson's. And as unbelievably rude as it sounds, trust me, they did that before!
  10. Mikie

    Mikie Moderator

    You are taking a medication which helps your condition. The fact that you have no desire to go off of it does not indicate addiction.

    I take it for insomnia, severe sensory overload, anxiety/panic attacks, muscle spasms, and tinnitus. It also helps with my pain. Why in the world would I want to stop taking it and return to these miserable symptoms?

    I've been on the same dose for several years and it is still working fine for me. I will continue to take it until I no longer need it.

    I am so happy for you that it works so well to control your symptoms too. I dated a man with Parkinsons's and I know how hard it is to contend with this disease.

    Love, Mikie
  11. Mikie

    Mikie Moderator

    Many will build up a tolerance to a med and need to take more and more to achieve the same results. This is physical tolerance and not psychological addiction. That stopping a drug causes withdrawal symptoms is also not psychological addiction.

    The dictionary definition of addiction doesn't go far enough. Addicts will steal from family members, forge prescriptions, see multiple docs for prescriptions, and try to buy street drugs, even prescription drugs on the street which were stolen. An addict will steal his or her grandmother's drug which she needs for her own health. This all falls under the area of "drug seeking behavior."

    Even those with chronic pain will develop tolerance and physical dependence. This doesn't equate to psychological addiction. It is only when one takes more and more of a drug to achieve some kind of pleasureable high that it gets into the psychological addiction area.

    This doesn't mean that we should ignore the physical dependence and tolerance. Tolerance, especially, can become a problem when a patient needs a very high dose to continue receiving pain relief.

    The body produces pain to let us know something is amiss. With FMS, the pain doesn't serve the purpose of survival. It's just pain. When we give the body a pain med, it will produce even more pain in a frantic effort to let us know something is wrong. The body doesn't know that this pain is not helpful to us; it just keeps producing more and more like the faithful alert system it is. This is how tolerance develops. That is why docs may switch drugs from time to time.

    We need to carefully weigh the potential risks (all drugs have them) versus the potential benefits and make informed decisions with our docs. I don't like having to take Klonopin, but the alternatives are worse. If Dr. Cheney is right, the Klonopin is protecting the neurons in my brain from premature death.

    Love, Mikie
  12. Mikie

    Mikie Moderator

    That one rule fits all. When one says Klonopin is addictive, one IS saying one rule fits all; i.e., everyone who takes it is addicted. Benzos, like opiods, do carry a risk of addiction, according to the patient info included with them, and perhaps this is a better way to phrase it. It's a risk, not a certainty.

    To be honest with you, I am a lot more concerned about the long-term effects of taking a drug which alters brain chemistry. No one knows for sure what decades of use of these meds will produce. Again, one has to balance the potential risks versus the potential benefits.

    You are certainly entitled to your opinion that Klonopin is addictive just as I am entitled to believe that, in and of itself, it is not. This question comes up from time to time and there is always someone who is convinced that Klonopin is addictive. Anyone who feels that way has the option of not taking it.

    We can agree to disagee on this issue.

    Love, Mikie


  13. jandog

    jandog New Member

    I started on the Klonopine about 6 months ago - and i finally get a good night's sleep with out the tossing and turning - still wake up in pain from the Fibro and arthritis but at least i'm not so tired all day. My Dr. worries about the addiction to the pain meds. - i take 5-6 Percocet 5mg. daily along with Soma - to get throught the day. I take in the AM before work - then none till i get home- 5 hours later - i drive about 75 to 125 miles daily for work doing Life ins. exams - so need the pain meds the rest of the day. But Dr. makes me feel like i take too much! - but gives anyway
  14. tanyasue

    tanyasue New Member

    I have been on klonopin for over 8 years now. It is because of anxiety. I used to take 2-3 (.05mg) 4 times a day. Now I take 1/4-1/2 pill as need for anxiety, and I now use it for sensory overload-because in my experience sensory overload sends me straight to a horrible anxiety attack.

    I discussed the addiction thing with my psychiatrist, because I know there are street addicts. Anyway, he pointed out that I have gone down in the amount I take.

    I think there are some addicts, they are those who take it for the wrong reasons and not following the directions.

    Addicts are people who ABUSE medication, not whose bodies are used to it. Big difference. HUGE.

    Tanya Sue
  15. lurkernomore

    lurkernomore New Member

    That I have just today checked to see if any of my posts had been replied to. It has been a little crazy around here and I am not feeling...well, need I even go into all that?

    But I thank you for understanding my use and appreciation of Klonopin and why I will not ever give it up. As for the Parkinson-like tremors, I have noticed that the very worst thing a person can do is to mention them to me. This makes me self-conscious and the next thing I know, the tremors are worse than before. I don't know why, but I really feel resentment when people mention them to me.
  16. Mikie

    Mikie Moderator

    People can be so thoughtless. I'm so glad the Klonopin has helped you.

    Klonopin does carry a risk of addiction for someone who is predisposed to become addicted to it--just like alcohol carries a risk to alcoholics. Not everyone who takes a drink or drinks socially will become an alcoholic.

    Seems to me that it's often the docs who are afraid of everything being addictive and having addicts for patients. What puzzles me, though, is that there are so many docs who do not know the difference between tolerance, physical dependence, and psychological addiction. Of all people, doctors should be aware of the distinctions.

    I wish none of us ever had to take drugs; they all have potential side effects. When we do need drugs, however, I am happy that there are some, like Klonopin, which are so effective.

    I hope the Klonopin continues to help you and I'm glad it's been such a God send for you.

    Love, Mikie
  17. razorqueen

    razorqueen Member

    My doctor has no problem giving it to me. In fact I asked if he could increase my dosage at bedtime to 1.5mg instead of 1mg, as I haven't been sleeping as well. I've had a VERY stressful summer and there was a couple of wks I had to take .5mg during the day , under the tongue(thanks for that idea, mikie:)) to settle the turning and tightness I felt in my stomach. I normal never need to take it during the day. Don't need to anymore either. But it helps with my sleep, and we all know how important sleep is!
  18. Rosiebud

    Rosiebud New Member

    I wish it had. I researched here before asking my doctor for it and he and myself were quite happy for me to take it.

    Rosie