Help! should I updose clonazepam due to rifampin? How much?

I've posted about this in "Withdrawal" but got no response so hope that this might be okay to post here.

 

I've been on rifampin for a week and learned that it reduces the effectiveness of benzos.

 

I never would have agreed to take the rifampin if I had known. I'm so close to getting off of the taper that I would have told my doctor that I would wait.

 

I've read that it reduces the effectiveness of many meds as much as 50%.

 

Does anyone know if it's ok to updose to where I'd have less anxiety? The thing is the rifampin itself causes anxiety and can cause suicidal thoughts. I'm assuming that part of the dose I'm taking now is just moving out of my body and not getting to my brain?

 

It seems my doctor should have mentioned this. She didn't mention that my thyroid med would lose effectiveness too.

 

Above all, I don't want to spoil the progress I've made with my taper, but I need to be able to function.

 

Anxiety from rifampin + anxiety from reduced effectiveness of clon. is a double whammy!

 

Hope someone can help. I'm feeling so hopeless  and helpless right now.

If I understand correctly, rifampin is an anti-biotic and AB's certainly can mess a lot of things up, including your digestive system but presumably you need to take the drug for some form of bacterial infection so the benefits outweight the risks.

 

I wouldn't have any idea how to calculate a benzo equivalent for the "extra" anxiety caused by the drug, particularly since I think the bigger effect is coming from your worry about the effect, if that makes any sense.  Personally, I'd work extra hard on learning to lower my anxiety by non-drug means and maybe hold longer before making the next cut.  I can't tell you how many hours I spent trying one thing and another so I could get off lorazepam and then live life without that crutch but it was worth every minute.  I found it most effective to practice whenever I wasn't feeling overly anxious but I started every session with at least 10 minutes of controlled breathing.  I even enrolled in a Tai Chi class and found it very helpful while I was doing it.  Keep trying different techniques and you'll develop a few that work best for you.  Believe me, they come in handy in your post-benzo life, too. 

It is an abx for bartonellosis. The bart is actually a disease that causes anxiety because it is in your brain. Rifampin croses the blood brain barrier. When it's killing the bacteria it's making the anxiety even worse due to toxins from dieoff. So this is not a power of positive thinking thing.

 

Also, Rifampin is unique among antibiotics in that it reduces the effectiveness of other meds. It literally causes them not to work although I don't understand why or how. There's a big long list of the ones it affects including my thyroid med. Some people  have had to double their thyroid med while on the rifampin.

 

So I believe the .1875 mg of clonazepam I'm on now is not really being used. So it's like I've had a large taper.

 

The problem is I don't know how much--maybe 50% according to what I've read, but there's no way to know for sure.

 

I know the clon. is working some because I do feel it kick in a little after I take it.

 

I know it's bad to updose, but isn't it also bad to reduce too much? In effect that's what's happening--I've taken an unplanned, unknown quantity of a cut

 

This is a huge dilemma for me. And MDs are really not knowledgeable about tapers anyway.

 

So it's not the drug only that's increasing anxiety--it's the fact that the clon I'm taking isn't all getting used.

 

I'm just worried about this being a bigger cut than planned. If rifampin really does cut it by half, then I might have gone from .1875 to .09375 mg.

 

Oh, and I'll be on r. for 6 months.

Since you say the Rifampin actually causes other meds not to work ( I presume you found this from a reliable source), your doctor should be taking that into account.  Or maybe you aren't on any other meds?  It qalso occured to me to consult your pharmacist; he/she is an expert in medication interactions.  I doubt that anyone can tell you about updosing to compensate; I'm afraid that's going to be up to you.  Whatever you decide to do, I suggest you make small changes and then wait a while (a week or so) to see if it's helped.  You are kind of doing a lab experiment on yourself and want to control the variables.  Best of luck.

Thanks Beeper--calling it a "lab experiment" is kind of what it feels like.

 

Yes, I did call the pharmacist and he double-checked the list and clonazepam was on it as well as levothyroxine. Since my voluntary taper with clonazepam came up during my office visit and she knew I was on thyroid meds, it seems odd to me that she wouldn't take those into account.

 

Today, I took .25 instead of the .1875 of clon and am surviving. Problem is you start out slow with the rifampin and right now I'm only at 1/4 of the dose I'll work up to so hope it doesn't get any worse.

 

 

 

Could you update on what worked?

Did updosing a little and stop rifampicin help?