What dose clonazepam [Klonopin, rivatril for muscle spasm relief?

Discussion in 'Fibromyalgia Main Forum' started by Jen F, Jun 20, 2003.

  1. Jen F

    Jen F New Member

    What dose do you use to help relax your muscles?

    what was your starting dose?

    I've taken 2 0.5 tablets today and I am in a lot of pain, despite regular tylenol, and mobicox, an antiinflammatory. I also take restoril 30 mg to sleep and I take a small amount of SJW.

    I am having a heck of a time getting the doctors to realize I am serious about my pain being very severe esp at night.

    Did you find it takes a while for clonazepam to work, like a few days on the meds before results?

    Thanks.

    jen
  2. catgal

    catgal New Member

    Hi Jen~~I am 54 and have had FM since my teens, and also have degenerative disc disease, multiple back problems, rheumatoid arthritis, and other ailments.

    My PCP started me out .5mg klonopin at night. The Pain Specialist raised it to 1mg and told me to take a fourth or half mid-morning and mid-afternoon to keep my body relaxed and to keep the severe back spasms down.

    The 1mg klonopin really helped me to get a good night's sleep, to quell the hidden anxiety we all have but don't realize, stopped my restless legs at night, and helped lessen the fibro-fog. However, it just barely took the edge off my pain. It is no substitute for genuine pain relievers. I take 20mgs oxycontin 3x's a day, 10mgs percocet 3x's a day (or as needed), 20 mgs Bextra once a day(an anti-inflammatory for my back) and Soma is the best muscle relaxer I have ever used, and it also has a pain reliever in it. I take it 3x's a day.

    Klonopin is a wonderful drug for alot of things, but I don't find it particular useful for bad pain. It is in the benzo family and not the narcotic family of meds. It will take a tiny bit of the edge off simply by relaxing the muscles & joints/body--but is a poor substitute for a narcotic pain reliever.

    The klonopin worked immediately on me. However, I could not take the generic brand because it knocked me out, left me hung over the next day and unable to wake up or function. So, I take the Name Brand, and it works fine for me with no side affects.

    You are entitled to effective pain relief. If your physician isn't willing to help you--find one that is. There is absolutely no reason--legitimate or legal--for you to suffer in genuine pain.

    Go to the ER over the weekend and get some help. I work at a hospital, and I certainly do not encourage people to lie--but sometimes when real help is denied you--you do what you gotta do. Tell them you have an absessed tooth in the back of your mouth, that you have a dental appointment on Wednesday, and you need a pain reliever to get you by until Wednesday--and then Monday look for a new doctor--one that is knowledgeable about FM and willing to help you.

    Many years ago, I can remember when I was in absolutely unbearable pain, and it was the weekend. I was so desperate that if I'd known how--I would have scored something on the street. I was out of head with pain. So, I went to the ER, told them I had an absessed tooth and had an appointment with my dentist that coming Wednesday--so they gave me enough pain pills to last until that Wednesday. On Monday, I hit the bricks and found me a physician that was willing to work with me.

    Please understand I don't encourage people to lie, but desperation can sometimes force you to do desperate things until you can get legitimate help.

    Best Wishes to you, and I hope you are feeling better ASAP.
    Blessings, Carol....
  3. barny

    barny New Member

    ive taken both of theses ia on a high dose of 2 clonazis anight and 3/4 rivatol a day also anti inflam tablets if u grt right dose it can help if any body has it in there hands may i rec hands straps i brought them from the chemist they work a treat i wear them when the pain starts and it takes it of straight away
    [This Message was Edited on 06/21/2003]
  4. Jen F

    Jen F New Member

    Catgal:

    Perhaps I should clarify. I don't have FMs, at least not the clinical defintion. I have CFS and a muscle strain?& brachial plexus injury? &disk herniation? compounded on DDD and bone spurs and cervical spine stenosis, esp C5-7 which I have just been diagnosed with as per my xrays.

    so I wonder if the stuff you FMers are taking for pain will help me, i figured it would since you guys have the market on PAIN!

    Asked my doctor yesterday for neurontin, but he was not aware of its recent use for neuropathic and myofascial pain.

    I had actually printed out tons of research and helpful information to arm myself and yesterday turned out to be a bit of a disaster -- all the information, including the names and phone, fax numbers of the doctors I wanted to be referred to for pain clinic, osteopathy, and physiatry, disappeared. I got to my docs office and i did not have it. it is nowhere i can find at home. I don't know what could have happened unless i dropped it in the taxi on the way over, i called taxi company but have no response as to yet.

    so, had nothing to show doctor about neurontins use and he wouldn't give me any, but agreed to the klonopin, which is called rivatril here.

    Sorry to hear you've had FM since teens. Where is your DDD?

    Perhaps I should try taking 2 of the 0.5 rivotril at night. I am a little wary since it is in the same benzo family as my sleeping pill restoril which i take at max dose 30 mg.

    Thanks for the info on what your pain specialist said. That is very helpful.

    From what you say, I guess I can't expect it to quell my pain much more.

    I think i need a stronger antiinflamm and a stronger pain med than reg tylenol. The problem is vioxx made me sick [after one great day of no pain, taken with tyl 3 as well] then i tried celebrex and i got an allergic reaction, either to the codeine or the celebrex] so now the doctors don't want to give me any drugs related to codeine, i.e. percoset, or any sulfa drugs as celebrex has some similarities to sulfa drugs. Aslo, added to the mix was flexeril which hardly did a thing for muscle relaxation/pain in me, except helped me sleep better.

    then with the allergic reaction, i had to take an antihistamine. Then I was given demerol and had not so good reaction, including diff swallowing so i had to stop immediately.

    So, now my doctors think I've tried WAY too many drugs, they want me to just take the rivotril they've now prescribed and as little as possible of anyting else, and [it seems to me] be a good little girl and toughen up, I'll feel better soon. Don't worry so much. They're not the ones who may have to wait in ER for 10 hours while in pain, on uncomfortable chairs in very uncomfortable environment with rude reception intake, completely overworked and understaffednurses and doctors and now SARS protocols...

    ER care here in Ontario in my own experience and others I've spoken to can be horrificly unpleasant, due to cutbacks in the gov't a few years ago and continued financial strain. A bunch of hospitals closed down and ERs are often overwhelmed.

    Novemeber I was in the hosp closest to me, couldn't stop vomiting, intense intense abdominal pain - started off mild but during night went to a 15 out of 10, would have shot myslef in the head if i had a gun i couldnot cope. Asked several times for something for pain, wasn't given anything. Had to wait til xrays etc, but even then when given all clear, doc gave nurse a scrip for me for a bowel relaxant, which he called a rx for something to help with pain. Duh...I'm vomiting and cant' keep anyting down!!!!! I asked for it via iv and after another hours agony got it and it took the edge off by relaxing my bowel, but still pain 11 or 12 out of 10 and they discharged me. I was disgusted. Still vomiting every half hour or so. Couldn't walk, had to be taken out in a wheelchair. Give me a break... More to the story, but you get the idea.

    I spoke to a MALE friend of mine who had a similar problem, he said most painful thing he ever experienced, andhe has had bad kidney stone pain, so he knows pain, and they gave him demerol. But me, obviously a hysterical woman, right?

    anyhow, I like your idea about er, though i don't know if i could get away with it, wouldn't they check the teeth? wouldn't they be able to tell? wouldnt' one have a fever?

    How did you get away with it? please tell me. i may have to go to er one of these days if pain gets so severe i just can't cope anymore. the pain has had me in tears, but so far i've just barely managed.

    I am going to take note of what you take for pain and keep in mind for my docs. Though until it's sorted out whether or not I am alergic to codeine, i probably won't be given any similar drugs such as oxycontin.

    But, as soon as my allergic reaction seems to have completely subsided, I do want to try an stronger antiinflammatory, either the celebrex again or the bextra

    I definitely want to check out the Soma, so thanks so much for the info.

    I am taking the name brand of the clonazepam because I too don't want to take any chances. I want to do so with as many drugs as possible right now, but some don't seem to be avail in brand name any more around here. Seems so many ppl order generic that the co's discontinue the brand name, or so the story is from the pharmacist. So the flexeril I tried is not name brand.

    You say: "You are entitled to effective pain relief. If your physician isn't willing to help you--find one that is."

    and that is true, but it is not easy. doctor shortage here, and the few good cfs/fm doctors full up or unavailable right now. so i will have to wait. maybe next week i will see the MD that works at the naturopathic clinic occasionally, maybe he will be cfs and drug friendly. I have an appt on tues with my GP, but don't know if i will even get the referrals I want from him.

    thanks somuch for your very helpful reply, C.

    Jen F.




    barny
    you say you take both

    clonazipam and rivotol

    did you mean rivitril [sp?]? Cause Rivatril or however it's spelled is the brand name of clonazepam so they would be the same thing. Perhaps there is a drug called rivotol that I am unaware of that is not clonazepam?


    When you say you take 2 at night, do you mean 2 of the 0.5 mg dose? I was told the pill also comes in a 2mg pill.

    If so, did you start on that dose right away or work up to it?

    Thanks so much.

    Jen

    PS. Trying to manage this pain is such an involved and exhausting process when not ont eh irght medication!!! I Have to go now and take some supps and phone the taxi company seeif i left my stuff in the cab and then back online to order a chinese pain relief concoction over the net. Yes I am fairly desperate. :)

    Then I have to check the local stores to see who sells back rests and cervical collars cause I think I shall try that. I notice i am worst at night or after using my neck or shoulder or arm a lot, so I think some temporary immobilization may help. Last time at physio he sugg'd the collar and I've also got information on non-operative treatment of degenerative cervical disk disease that recommends rest and immobilization for acute episodes and exacerbations. I know some people who read about the cervical collar will cringe and say no, no, you must exercise it, as did my GP, but my body says no. It needs to rest and heal a bit or it's just going to keep getting severely aggravated. If i sit with good posture and don't move, my pain diminishes to a much more tolerable level. So those of you who think no no don't immobilize, don't worry, would just be for a few days, and I would take collar off to do a few stretches recommended by phsyio. Heck, i might not even be able to stand a collar or find it helpful, it's just what i think is one of the next steps.

    jen
  5. catgal

    catgal New Member

    Hi Jen~~My docs and specialists do not treat me for FM although I have FM/CFS. They treat me for the degenerative disc disease. I have 3 discs completely degenerated; a shattered vertebrae, a herniated disc, bulging discs, narrowing of the disc/spine, nerve damage in the spine, neck, and shoulder area, and several other back problems with long names. Plus, I have rheumatoid arthritis in my hands, neck/shoulder area, osteoarthritis all over my body, and psoriatic arthritis.

    The oxycontin is not codeine, but oxycodone (no tylenol, aspirin, or anything else) and is liver friendly. It is a long-term, timed-release narcotic that comes in 10, 20, 40, 80mgs generally taken 2x's a day. However, I take 20mgs 3x's a day as my back is really screwed up. I also take the 10/325 percocet which is oxycondone with 325mgs tylenol 3x's a day or as needed. Both oxycontin and the 10/325 percocet only come in the Name Brand. For anti-inflammatories--I tried naprosen (naproxen) which ate my stomach up; vioxx which caused stomach bleeding; celebrex which was absolutely worthless to me, and then found Bextra which helps me with both the back inflammation and rheumatoid arthritis inflammation. I take 20mgs once a day right after dinner to avoid stomach upset. It also helps me to sleep. Soma is a high powered muscle relaxer that also contains a pain reliever which sets it apart from other straight muscle relaxers. It is the best muscle relaxer I've found. I take it 3x's a day when not working as it relaxes my body so much I get sleepy. When at work, I break off a fourth to ahalf tablet if needed so I can control the muscle spasms and don't get so sleepy. And, I told you about how I take the klonopin. Some nights when I'm having a really rough go of it, I'll take 2 of the 1mg klonopin and still have no hungover side affects from it.

    I've taken all these for 3 years now. Bare in mind that all these meds I've mentioned have a potential for physical dependency and tolerance. But, they have given me back some quality of life, deminished the pain considerably even though I still have some bad days that nothing seems to help, and they have enabled me to continue working part-time.

    I only lied the one time at the ER to get pain meds because I was going out of my head with pain, and this was before the DDD was found. ER docs are not dentists and most absesses in the back mollars are below the surface and cannot be visually detected. I did rub some red food coloring on the back gum to make it appear irritated. The important thing is that they know you have a dental appointment coming up, and therefore, are just asking for a few pain pills to get by with until your appointment. It is really a last ditch effort made out of desperation when you can get help no other place. However, if you have evidence on file or that you can show them regarding your back problems, they should give you something IF you have an appointment coming up. What they don't want is you coming back to the ER again and again for a repeat performance--they want to know that you have an appointment coming up with a doc who specializes in your medical problem, and that your problem is being taken care of because the ER is not set up for chronic pain problems.

    I would strongly suggest you get a referral to a Pain Specialist. My primary physician fills my meds, but he also refers me to a Pain Specialist every 6 months for a consultation and backup agreement on the meds he is giving me, and it is the Pain Specialist that has been the one to increase my meds; I'm also referred to an Orthopedist who is a back specialist and back surgeon to monitor the progression of the degenerative disc disease and make decisions when or if surgery would help (so far it has been determined surgery would not help me), and I'm referred to a Rheumatologist for my rheumatoid arthritis, osteoarthritis, psoriatic arthritis, and FM/CFS. I have a very good primary physician who likes to cover all the basis while keeping his ass covered in prescribing these types of narcotics and meds. I am also referred to an Asthma/Respiratory Specialist as I was born with severe asthma/allergies and have been diagnosed with "life threatening" asthma which is a rare class of asthma, and my primary physician gives me alot of meds for that based on the consultation with the Asthma specialist.

    I was initially also put in physical therapy, but it only aggrivated my back, so the Orthopedist stopped it. However, it is essential to get some kind of mild exercise and keep the back/body in as good condition as possible so I do some eastern forms of mild exercises called Tai Chi and Qi Qong 3x's a week and go for walks as much as I can. The Tai Chi and Qi Qong videos can be purchase or ordered from any book or video store. These forms are called the "Ballet of Martial Arts". I have developed a library of them because they are so beneficial.

    I also use ThermaCare Heatwraps (the shoulder size) for my neck and back. They last a good 8 hours, stick onto your body, and act like a portable heating pad. The best cream/salve I have found is called Tiger Balm ( a salve)which you rub into the affected area. It helps my back and rheumatoid arthritis. You can get this at Wal-Mart, health stores, or most drug stores. Comes in a round red and gold can.

    I also take long, hot soaks in essential oils, eucalyptus oil, and epsom salts--works wonders on the whole body.

    Back pain is extremely debilitating, and the pain level can go through the roof and make you immobile. So the important thing is to get on some type of pain management to control the pain. It is much harder to take a pain pill and get relief after the pain has a hold on you. That is why the oxycontin is so good--and the 10/325 percocet is for breakthrough or incidental pain as they call it now. The percocet is rapid acting while the oxycontin is long-lasting and time released. It all helps to keep the pain under control.

    I know these good physicians are hard to find, but you just have to keep looking for they are out there. And since I know how desperate you can get with back pain--I sincerely hope you find a good doc soon and get the relief you deserve and are able to regain some quality of life and pain-free days. Blessings to you, Carol....
  6. Jen F

    Jen F New Member

    for all your helpful info. I am doing tiger balm and epsom salt baths and essential oils.

    The doc says percoset is similar to codeine so wouldn't prescribe it, but maybe if I try it, i won't react

    I actually met a lady today who has same problems as me but worse, also on mobicox and she says neurontin helps her the most. the doctor wouldn't give me the neurontin scrip when i asked.

    But i shall keep trying. I also should have some sources of corydalis yan hu suo to try by the end of the week.

    Sorry about your extreme asthma. That must be worrisome!

    My apt and everything else is a disaster, but at least I am making slow headway with figuring out pain management. I hope either the pain reduces soon, or I get a strong pain med that feels good when I take it.

    I have a recommendation for a pain clinic, but i suspect my md may think i'm going over the top. he still thinks i'll be better sooon and maybe he's right, but with the intense pain now, if he can't help me and/or doesn't have much experience controlling this kind of pain, then he really should send me to someone who does. Of course, the easy way out for him will be to suggest I see a psychiatrist. If he tries that as a alternative to pain meds, I wonder if I will be able to not burn my bridges with him, cause I might get pretty angry and agressive.

    that is not to say a psychiatrist wouldn't be helpful...i am actually looking into an option for hypnosis therapy and learning self hypnosis to help with the pain.

    thanks again.

    Jen
  7. Mikie

    Mikie Moderator

    Nor is it a muscle relaxer, per se. It is an antiseizure/antispasmodic drug. While it does appear to disrupt the pain signals in the brain, it is not as effective for pain as opiods.

    Klonopin is usually prescribed for sleep, anxiety, and/or sensory overload. It will help with muscle spasms. The fact that it helps with higher quality sleep helps the pain indirectly.

    If pain is your main problem, you need more than just this drug.

    Love, Mikie
  8. Jen F

    Jen F New Member

    Now, would you please tell my doctor that?!

    Regular tylenol is not enough.

    Problem is I reacted to something, either a sulfa related drug or codeine, so now they dont' want to give me a stronger anti inflamm like Bextra, nor can I try celebrex again just yet, and they decided against percoset because its similar to codeine. Why they didn't give me oxycontin or codone I don't know.

    Fortunatley the rivatril takes the edge off and does help with sleep. It's kinda strange, it's like - I have the pain, but I feel like I might fall asleep anyway.

    I asked for Neurontin and doc said no, but I didn't have all my research with me on how it's recently been used with good results for pain management, esp neuropathic and myofascial pain. I've lost 2 hours of research and print out work. I think I left it in the cab and I've been calling the cab co. for 2 days, but driver's not on while I call and if he got my message didnt' bother to ring me.

    I have found that if I stabilize my neck and practise good posture and don't use my arms much, my pain doesn't get absolutely unbearable.

    I have gp appointment on Tues, I wonder what I should ask for next....whether to try another anti inflamm or codeine, one at a time and see if I get another allergic skin reaction, or whether he would be willing to give me oxycontin - whichever oxy doesn't have codeine. But, I won't hold my breath. He's very reluctant.

    Which is why I am working on back up plans. I am arranging to get a very powerful chinese herb for pain. I know it's helped me with mild back problems before, but the product it was in that I used to have is no longer made, so I must find something new. Secondly I am trying to find options of other gp's to go see. One of which does hypnosis. Thirdly, I will push for referrals to an osteopath, a physiatrist and maybe neurologist.

    thanks for the feedback, Mikie.

    Jen

    p.s. would like a referral to a pain clinic too, but my doc might just laugh. I shall see....[This Message was Edited on 06/22/2003]
  9. 1fibrowife

    1fibrowife New Member

    Mickey was taking Oxycontin for pain and OxyIR for breakthrough pain. It is very expensive!! He had his doctor to prescribe MS Contin and MSIR which is a generic morphine, he says it seems to be working as well as the Oxycontin with no new side effects.
  10. Lynda B.

    Lynda B. New Member

    oxycontin. There are other meds that don't have sulfa (which I am allergic to also) and do not have codeine.

    Lynda B.
  11. Jen F

    Jen F New Member

    but didn't give me any. I'm not sure why. Perhaps concerned about highly addictive qualities of drug?
  12. Mikie

    Mikie Moderator

    It is an antiseizure med. Like Klonopin, it probably works synergystically with other meds, but it will not give adequate pain relief for severe pain.

    A pain specialist is usually most helpful in prescribing pain meds for us unless you happen to have a good doc or PA like Madwolf.

    Love, Mikie