What is the real difference between Klonopin & Valium?

Discussion in 'Fibromyalgia Main Forum' started by forfink, Jul 10, 2006.

  1. forfink

    forfink New Member

    Just looking for some expert advice from someone who has been through this route. I have spoken to my MD and he feels valium really isn't that different, between the 2 drugs.
    Have been on low dose valium 2mg. when I get really sore for 20 years!!! Would I feel the difference if I switched to Klonopin, do you think? Love to hear your input.....
    [This Message was Edited on 07/10/2006]
  2. TXFMmom

    TXFMmom New Member

    Valium is a sedative and anti-anxiety drug.

    It helps prevent seizures.

    Klonapin cuts down on myoclonic movement, restless leg, and sedates, but THE HALF LIFE OF IT IS MUCH, MUCH, MUCH SHORTER.

    A small dose of Valium, because of its' half life can still be on board for several days.
  3. forfink

    forfink New Member

  4. StephieBee

    StephieBee New Member

    I have taken both of these drugs. I am currently on Valium for anxiety. I have been taking it for about 3 years now and I am in no way physically or mentally addicted. Valium can be taken in larger doses for use as a muscle relaxant. It is mostly used as a sedative though.

    Klonopin I was prescribed to for a brief time after I had exceeded the highest dose of Xanax (BTW is very addictive!). No matter how much I took it did not work for me. On the other hand, I have seen others take it and pass out or black out. For me, a placebo probably would have worked better.

    IMO, I believe that the Klonopin is much more addictive than Valium. But you could always try the Klonopin and see if it works better for you. Its worth a shot!

    Take Care,
    Stephanie
  5. forfink

    forfink New Member

    I was also told that Valium interfered with the stage 4 sleep . My MD just didn't seem to feel that there was a big enough difference to change me over to Klonopin.

    I know valium has a sedating affect and can make you more tired. If Klonopin is in the same family of drugs wouldn't you think Klonopin would also make you tired?
  6. mariee

    mariee Member

    I did a brief search on these 3 drugs...and they are all benzodiazapines.
    Klonipinis clonazepam
    Ativan is lorazapam
    and
    Valium is Diazapam.

    All are central nervous system suppressants...used for anxiety and seizures primarily...and for many other purposes according to various docs.


    They differ in the chemical makeup...so their half lives are different. Each drug stays in your system for different periods of time.
    My pharmacist is the best person for info on these drugs.

    You can google "benzodiazapines" and get lots of info.

    Good luck.
    Marie
  7. Mikie

    Mikie Moderator

    I always hate it when I see people post about how "addictive" a med is. There is a lot of confusion, even among docs, regarding psychological addiction versus physical dependence and/or tolerance.

    With psychological addiction, a person gets a high from taking a drug. He or she must take larger and larger doses to achieve the same high. He or she will display addictive behavior and will forge prescriptions, lie, cheat, and steal to get high. I'm not saying this hasn't happend to those of us on these meds, but it is rare.

    What does happen is that our bodies will develop tolerance over time to the drug and we will need a higher dose for the drug to work, not to get high. Most of us do not get high from our meds. We can also develop physical dependence on our drugs and if we ever need to stop taking them, we will need to very slowly wean off to avoid rebound side effects. Neither tolerance nor dependence equate to psychological addiction.

    This, like many things we discuss here, can be a matter of semantics but it is inaccurate to use the word, addiction, when one is speaking of tolerance or dependence. When we take drugs, we must perform due diligence and weigh the potential benefits versus the potential risks. We need good data in order to make an informed decision. Fear of addiction is always a valid fear, but it is important to understand the difference between psychological addiction and tolerance and dependence.

    Love, Mikie
  8. twerp

    twerp New Member

    The Dr. had me on Valium at first, but then switched me to Klonopin, as he said it is less sedating.

    I've been taking Klonopin now for several years, with no loss in effectiveness. It works well for me.

    Hugs,
    Twerp
  9. StephieBee

    StephieBee New Member

    I stated that Klonopin and Xanax are very addictive because they are more widely abused that Valium. They are both much stronger benzos with most people. The few like me that Klonopin did not work for are the exception. Most doctors I know do not want you to develop any type of addiction or dependance because one day you will have to come off of them. So if your tolerance gets too high (like my case with the Xanax), doctors that will prescribe you such high doeses are hard to come by.

    I just wanted to clarify what I meant by "addiction".

    Take Care,
    Stephanie
  10. Mikie

    Mikie Moderator

    Addiction does not occur with these drugs. One can become addicted to almost anything. But if docs are reluctant to prescribe because a drug is more prone to tolerance, that isn't psychological addiction. If tolerance is equated with addiction, it makes it impossible for one to make an informed decision. That is the only reason for the distinction.

    Tolerance is a bona-fide reason to reject a med or to use it with caution. This isn't just an effort to nit pick and it's more than just semantics. The difference between addiction and tolerance is important. Unfortunately, many docs use "addiction" when they are talking about tolerance. So many people here are underserved by docs who are afraid to prescribe meds which our illnesses necessitate, especially pain meds.

    Again, it is vitally important to perform due diligence but it is also vitally important to differentiate between psychological addiction, tolerance, and dependence. I don't like being dependent on Klonopin but it is the lesser of two evils. Having my brain in a state of seizure all the time is worse. If I were psychologically addicted to the Klonopin, it would be horrible and I would have to get off of it. As it is, I've been on the same dose for almost five years.

    Love, Mikie
  11. NyroFan

    NyroFan New Member

    Klonopin has a long half life, which means it stays in your bloodstream longer than Valium and Xanax. And before you know it, it is time to take another pill.

    I got one of those printouts from the pharmacy when I picked them up today. For once I was reading them and it said Klonopin was indicated for seizures and panic attacks.

    I do not think many doctors would just write a prescription for anxiety only. Maybe so, what do I know?

    nyrofan
  12. StephieBee

    StephieBee New Member

    I believe that the majority of the people on this board know the differnce between all of them if they are truly educated on this DD. Addiction does occur with benzos often, I have seen it happen to the most innocent people. I personally had a physical addiction to them. I had a high tolerance but when your eyes and eye lids start twitching when you dont have your Xanax, I call that addiction. But Im not saying that it makes you a drug addict.

    Unfortunatly for all of us that suffer from chronic pain, thse doctors will always use the addiction excuse because they want to sway you away from controlled substances IMO so they are not being watched by the government. I wish there was something we could do, but the prescription book is in their hands, not ours.

    I too would prefer to be dependant upon a drug that helps me than suffer like I am now. But at the same time I do not want to end up like the people who took their narcotic use overboard and end up in a detox, puking my brains out and going through withdrawals. Believe me, I know all about this because I see my father who is in more pain than anyone on this board go through severe withdrawals from his methadone when he misses a dose by 20 minutes.

    I do believe we should educate those few who do not know the difference between tolerance and addiction, but I also believe that you should not be rude about someones lack of knowledge on this subject. If you hate when people use the word addiction, instead of complaining, try educating. I would rather have a conversation with someone who is understanding than someone who comes across as a know it all. And Im sorry if this post comes off as hostile, but I am not trying to be. I am speaking from experience and education from college. I hope that you would not hold this against me...I just sensed attitude in your first post.

    Stephanie
  13. Mikie

    Mikie Moderator

    My intention was not to be rude but rather to, as you say, "educate." I prefer to use terms like, "understand the difference." To educate seems to assume that one is speaking to the uneducated. This is simply not the case. Our members are are often more educated on our issues than the medical community. Whether our members are college educated or not does not determine how educated they are when it comes to our illnesses. Many of us have done a lot of research into our illnesses and potential treatments.

    The problems begin with semantics because one may post a phrase and assume that others share the same meaning. That may not be the case, and it often isn't. When one person uses the word, addictive, she may be thinking of physical dependence. That one has withdrawal symptoms does not mean that one is psychologically addicted to a substance. If insulin is withdrawn from a Diabetic, harsh physical symptoms likely will ensue.

    When another person sees "addictive" in relation to a med, she may get a picture of a person who develops a true psychological addiction with just one dose. We all have our own ideas of what addiction means. We need to be on the same page if we are going to use these terms and be able to communicate. My attempt was to define the terms so that we can better understand. You obviously have a different definition for these terms. That is your right. It is also my right to express my opinion. I may have been matter of fact but my intent was never to be rude.

    Love, Mikie
  14. Mikie

    Mikie Moderator

    Here is some info from this website which may help to clear things up. There is more info there related to this subject. Because this article is rather lengthy, I've added bold and italics where the article emphasizes the definations in question.

    Love, Mikie

    *****************************************

    Definitions Related to the
    Use of Opioids for the Treatment of Pain



    The American Academy of Pain Medicine, The American Pain Society and the American Society of Addiction Medicine

    Consensus Document

    BACKGROUND

    Clear terminology is necessary for effective communication regarding medical issues. Scientists, clinicians, regulators and the lay public use disparate definitions of terms related to addiction. These disparities contribute to a misunderstanding of the nature of addiction and the risk of addiction, especially in situations in which opioids are used, or are being considered for use, to manage pain. Confusion regarding the treatment of pain results in unnecessary suffering, economic burdens to society, and inappropriate adverse actions against patients and professionals.

    Many medications, including opioids, play important roles in the treatment of pain. Opioids, however, often have their utilization limited by concerns regarding misuse, addiction and possible diversion for non-medical uses.

    Many medications used in medical practice produce dependence, and some may lead to addiction in vulnerable individuals. The latter medications appear to stimulate brain reward mechanisms; these include opioids, sedatives, stimulants, anxiolytics, some muscle relaxants, and cannabinoids.

    Physical dependence, tolerance and addiction are discrete and different phenomena that are often confused. Since their clinical implications and management differ markedly, it is important that uniform definitions, based on current scientific and clinical understanding, be established in order to promote better care of patients with pain and other conditions where the use of dependence-producing drugs is appropriate, and to encourage appropriate regulatory policies and enforcement strategies.


    RECOMMENDATIONS

    The American Society of Addiction Medicine (ASAM), the American Academy of Pain Medicine (AAPM), and the American Pain Society (APS) recognize the following definitions and recommend their use:

    ADDICTION

    Addiction is a primary, chronic, neurobiologicneurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

    PHYSICAL DEPENDENCE

    Physical dependence is a state of adaptation that often includes tolerance and is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

    In the case of sedative drugs, spontaneous withdrawal may occur with continued use. Tolerance Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug's effects over time.


    DISCUSSION

    Most specialists in pain medicine and addiction medicine agree that patients treated with prolonged opioid therapy usually do develop physical dependence and sometimes develop tolerance, but do not usually develop addictive disorders. However, the actual risk is not known and probably varies with genetic predisposition, among other factors. Addiction, unlike tolerance and physical dependence, is not a predictable drug effect, but represents an idiosyncratic adverse reaction in biologically and psychosocially vulnerable individuals. Most exposures to drugs that can stimulate the brain's reward center do not produce addiction. Addiction is a primary chronic disease and exposure to drugs is only one of the etiologic factors in its development.

    Addiction in the course of opioid therapy of pain can best be assessed after the pain has been brought under adequate control, though this is not always possible. Addiction is recognized by the observation of one or more of its characteristic features: impaired control, craving and compulsive use, and continued use despite negative physical, mental and/or social consequences. An individual's behaviors that may suggest addiction sometimes are simply a reflection of unrelieved pain or other problems unrelated to addiction. Therefore, good clinical judgment must be used in determining whether the pattern of behaviors signals the presence of addiction or reflects a different issue.

    Behaviors suggestive of addiction may include: inability to take medications according to an agreed upon schedule, taking multiple doses together, frequent reports of lost or stolen prescriptions, doctor shopping, isolation from family and friends and/or use of non-prescribed psychoactive drugs in addition to prescribed medications. Other behaviors which may raise concern are the use of analgesic medications for other than analgesic effects, such as sedation, an increase in energy, a decrease in anxiety, or intoxication; non-compliance with recommended non-opioid treatments or evaluations; insistence on rapid-onset formulations/routes of administration; or reports of no relief whatsoever by any non-opioid treatments.

    Adverse consequences of addictive use of medications may include persistent sedation or intoxication due to overuse; increasing functional impairment and other medical complications; psychological manifestations such as irritability, apathy, anxiety or depression; or adverse legal, economic or social consequences. Common and expected side effects of the medications, such as constipation or sedation due to use of prescribed doses, are not viewed as adverse consequences in this context. It should be emphasized that no single event is diagnostic of addictive disorder. Rather, the diagnosis is made in response to a pattern of behavior that usually becomes obvious over time.

    Pseudoaddiction is a term which has been used to describe patient behaviors that may occur when pain is undertreated. Patients with unrelieved pain may become focused on obtaining medications, may "clock watch," and may otherwise seem inappropriately "drug seeking." Even such behaviors as illicit drug use and deception can occur in the patient's efforts to obtain relief. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when pain is effectively treated.

    Physical dependence on and tolerance to prescribed drugs do not constitute sufficient evidence of psychoactive substance use disorder or addiction. They are normal responses that often occur with the persistent use of certain medications. Physical dependence may develop with chronic use of many classes of medications. These include beta blockers, alpha-2 adrenergic agents, corticosteroids, antidepressants and other medications that are not associated with addictive disorders.

    When drugs that induce physical dependence are no longer needed, they should be carefully tapered while monitoring clinical symptoms to avoid withdrawal phenomena and such effects as rebound hyperalgesia. Such tapering, or withdrawal, of medication should not be termed detoxification. At times, anxiety and sweating can be seen in patients who are dependent on sedative drugs, such as alcohol or benzodiazepines, and who continue taking these drugs. This is usually an indication of development of tolerance, though the symptoms may be due to a return of the symptoms of an underlying anxiety disorder, due to the development of a new anxiety disorder related to drug use, or due to true withdrawal symptoms.

    A patient who is physically dependent on opioids may sometimes continue to use these despite resolution of pain only to avoid withdrawal. Such use does not necessarily reflect addiction.

    Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects. For example, in the case of opioids, tolerance usually develops more slowly to analgesia than to respiratory depression, and tolerance to the constipating effects may not occur at all. Tolerance to the analgesic effects of opioids is variable in occurrence but is never absolute; thus, no upper limit to dosage of pure opioid agonists can be established.

    Universal agreement on definitions of addiction, physical dependence and tolerance is critical to the optimization of pain treatment and the management of addictive disorders. While the definitions offered here do not constitute formal diagnostic criteria, it is hoped that they may serve as a basis for the future development of more specific, universally accepted diagnostic guidelines. The definitions and concepts that are offered here have been developed through a consensus process of the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine.
  15. StephieBee

    StephieBee New Member

    Here is another clarification on my part...I agree with you that we can form our own "terms". When I say "educate" I never meant that these people are dumb. All you did was teach them the differeces. Young adults that go to college are getting "educated", but that does not mean they are dumb. Everyone is knowledgable in something. Some people have more knowledge than others. Everyone that knows something was "educated" on the fact and I just want to defend myself by saying that I NEVER called anyone stupid. They just possibly did not know about this. Or in my case, chose different terminology.

    Take Care,
    Stephanie
  16. Mikie

    Mikie Moderator

    No one ever said you called anyone stupid or dumb. My intent was to provide info and nothing more. It is obvious this is upsetting you. You have no need to defend yourself and neither do I. Can we please just let this go as it will only lead to stress and the possibility of this whole thread's being deleted.

    I wish you only the best.

    Love, Mikie
  17. Shannonsparkles

    Shannonsparkles New Member

    Did you say that you use Klonopin occasionally instead of every day?

    I was wondering if you have other sleep meds you can use for the days when you don't use Klonopin? Immovane seems to help somewhat for me, but I'm not supposed to take it every night, so I've been wondering about what else I can take when I can't take Imovane.

    Thanks. :)
  18. pam_d

    pam_d New Member

    I'd still like to know how closely related Klonopin and Valium are, as Forfink asked in the first place...can anyone clarify this for me?

    I am highly intolerant to Valium, Versed, etc. Therefore, I'd be interested in knowing if Klonopin would give me the same reaction. I've never taken Klonopin, but have considered it in the past due to annoying neurological symptoms of FM.

    If anyone knows, please let me know....thanks!!

    Hugs,
    Pam
  19. 1sweetie

    1sweetie New Member

    This is what I have been told:

    Neurologist from Duke: Valium is a dangerous drug. It stays in your body for around 3 days and changes its chemical makeup during that time 3 times. He said at one point it actually changes to another prescribed drug (which he did not identify) and that in his career he has never prescribed it. I have used it in the past and it helps with muscle relaxation as well as anxiety. I have not used it since talking with him though. He scared me.

    Psychiatrist: They are mostly all alike and will give you whatever you want (LOL). She had know idea why the neurologist from Duke said that. This makes me not trust her at all. Wait... she did say Xanax did work faster and was best for panic attacks.

    CFS Doctor: Klonopin works best for us. See all of Mikie's post about Dr. Cheney's recommendation. Klonopin stays in your system longer than Xanax so if you take it for sleep you should sleep longer and deeper. Xanax to me works faster and will put me to sleep ASAP.

    That is my limited personal knowledge of these drugs. I am sure that there is better info from experts. I am having major sensory overload problems so I am sticking with the Klonopin because of info on this board.


  20. pam_d

    pam_d New Member

    ...we can't get back to Forfink's original question. 1sweetie, thanks for your input, though...that came the closest to clarifying things, I appreciate it.

    Carry on, though, with the "addictive" and "non-addictive" debate. I think I should just ask my doctor or perhaps pharmacist about Klonopin and Valium being closely (or not closely) related in terms of drug structure.

    Forfink, if I find out anything further, I'll let you know...

    Hugs,
    Pam
    [This Message was Edited on 07/30/2006]