Re: Rivotril WD

Hi all,

 

unfortunately, my story begins long ago.

 

In 2008, to cure the anxiety symptoms caused by the finasteride withdrawal, I was prescribed paroxetine and, already on the first day of intake, I developed PSSD with anesthesia and narrowing of the genitals (which still lasts). After a month of completing a forty-day course of taking paroxetine without a long tapering, the anxiety symptoms returned much stronger than before and included panic attacks, muscle twitching, motor agitation and restlessness, mental confusion, insomnia and so on. I developed, in other words, an AD withdrawal syndrome.

 

An indescribable ordeal began in 2009, with continuous prescriptions of antidepressants and benzodiazepines (citalopram, cymbalta, mirtazapine and Xanax) to contain the continuation of anxious-depressive symptoms. The more antidepressant drugs I took, the worse I was. Extreme anxiety, panic attacks, twitching, confusion and insomnia were joined by tremors in the hands and limbs, shivering, motor restlessness, numbness and mental confusion, photosensitivity to sunlight, tingling along the neck.

 

I solved this vicious circle after a year and a half of suffering by administering high doses of testosterone for six weeks. The extreme anxiety, panic attacks and all other related symptoms disappeared, while the effects on libido and genital sensitivity remained there and continue to this day.

 

For thirteen years, however, I have lived without drugs of any kind. From February 26 to March 19, on the advice of my doctor and believing that it was not dangerous at dosages below 150 mg., I made the colossal mistake, only  for a period of three weeks, of taking trazodone with muscle relaxant and sedative targets (3 days 25mg., then a week 50 mg., then another week 75 mg., and then three days drop to 50 mg. and then stop). I specify, in this regard, that before taking trazodone I had no particular problems of anxiety or depression, but only a difficulty in falling asleep due to work thoughts and so on. Nothing to justify taking an antidepressant. I was really very, very stupid.

 

Within a few days (March 22) I began to experience unusual levels of night and morning anxiety, with restless awakenings around 4.00 o'clock. I had to take again Xanax as needed, but on April 23, more than a month after the suspension of trazodone, the symptomatic crisis worsened and, to extreme anxiety, I got panic attacks with fainting, muscle twitching, tingling, shocks along the head, neck and arms, strong agitation, motor restlessness, dullness and mental confusion, insomnia, photosensitivity to sunlight, difficulty in relieving, intestinal cramps, exhaustion and so on and so forth. I recognize, in short, the same symptoms as in 2009 and a new persistent withdrawal syndrome.

 

To manage the withdrawal crises, a psychiatrist, on may 2022 (about one year ago), prescribed me clonazepam (Rivotril drop - 0,2 mg. at 10.00 and 0,5 mg. at 22.00) . I went from one nightmare to two. In this last year, I've never "stabilized" and was always in very serious trouble with the mix between prolonged trazodone WD symptoms and clonazepam side effects. The latter, however, are prevalent now. Since the first Rivotril drops, I clearly experienced very strong symptoms of depression and fatigue. At that time, I was not tapering and I haven't done any reduction for four months. I've been a stupid to continue to take it, but my state of confusion was very high and I was not able to decide what to do. In this last year, depression increased along with derealization and other paradoxical reactions from clonazepam. It's a very devastating drug for me.

 

On August, 2022 I started to taper clonazepam. I'm continuing it, but it's a very terrible process. My problem is that I feel I have no choice than pursueing, becouse this drug is strongly damaging me. There are a lot of symptoms that come from it and not from trazodone WD: weak and aching muscle of legs, difficulty speaking and coordinating movements, comatose depression, unbearable anxiety, panic attacks, strong derealization, worsening of sexual side effects, burning skin and so on. The longer I take Rivotril, the more my symptoms become intense. I'm suffering too much, whatever I do and far beyond my ability to bear. I no longer feel human. My nervous system is completely destabilized. If I don't taper, I feel a lot of side effects from the drug and, at the same time, the tapering process causes or accentuates my paralizing anxiety, palpitations, breathlesness, mental confusion, depression and so on.

 

A very terrible side is anhedonia. No pleasure or good emotions for anything. In the past I was very outgoing and wellknown in my country, full of cultural and intellectual interests, with a lovable job, an active political and public role and a lot of personal relationships. Now I find it hard to leave my house. It seems to me like a I had a strong brain injury from which it's really impossible to recover.

 

The tapering process has been as follow:

 

August 15 - September 11, 2022 = -10% (from 0,7 to 0,63 mg. per day)

September 12 - October 9, 2022 = -1,6% (from 0,63 to 0,62 mg. per day) - I felt very sick after the first month of reduction

October 10 - November 6, 2022 = -6,5% (from 0,62 to 0,58 mg. per day)

November 7 - December 4, 2022 = -6,9% (from 0,58 to 0,54 mg. per day)

December 11, 2022 - January 1, 2023 = -3,7% (from 0,54 to 0,52 mg. per day)

January 2 - January 29, 2023 = -4,8% (from 0,52 to 0,495 mg. per day)

January 30 - February 26, 2023 = -10,1% (from 0,495 to 0,445 mg. per day)

February 2027 - March 26, 2023 = -12,4% (from 0,445 to 0,39 mg. per day)

March 27 - April 19, 2023 = -5,1% (from 0,39 to 0,37 mg- per day).

 

I'm using a graduated cylinder and dissolving the drops in water, mixing well before drinking. I reduced a lot the morning dose becouse it makes me very derealizated, but during days I'm very anxious and agitated. Many days I can't stand. After three months of taking clonazepam, I lost 17 kg. (from 68 to 51), all my fat mass and some muscle tonicity. I'm skeletal and can't exercise anymore, like before, otherwise I start shaking out of control. At the present moment, I assume 0,05 mg. at 10.00 o'clock and 0,32 at 22.00. Please, help me. I would be infinitely grateful.

 

 

 

 

 

 

No one answers? Should I maybe post on Klonopin Klub 2 to get some advice?

I'm sorry you haven't received a response!  I'm also sorry you've been coping with such intense withdrawal symptoms.  Withdrawal often gets harder as you get down to lower doses.  It becomes even more important then to be flexible about slowing down the taper, making smaller cuts and holding longer between cuts. 

As I understand what you've written you're dosing more than once a day.  How many doses do you take each day?  It's important to keep the dosing as consistent as possible, i.e. same amount at the same time each day. It looks like you are holding about a month between cuts. You may find you need to hold longer but if I were you I would make the reductions smaller - under 5% of your most recent dose. 

If you're taking it twice a day, are you reducing both the morning and nighttime doses or just one? 

 

Hi Brighterday,

 

I am currently taking 0.05 mg. in the morning (10.00 o'clock) and 0.31 mg. at night (22.00 o'clock).

 

I generally reduce the dose a little each week (for example 0,01 mg.), but it also happens that, depending on how I feel, I do it after only three days, or stabilize the same dosage for three weeks. I have never tapered more than a 12.4% reduction in a month. As you can see, there were months where I only reduced by 3.7%. The taper process was absolutely hard from the start. I can't imagine what will be next.

 

At the beginning of my taper (August, 2022), I reduced almost exclusively the morning dose, going from 0.2 mg in eight months. to 0.05 mg. I kept the night dose stable or reduced it slightly for mantaining sleep. Now I'm reducing only the night one, but I'm suffering the pains of hell. The symptoms of my taper are unbearable, but I think they mix with those resulting from previous abrupt discontinuations of finasteride and various antidepressants. I have a very dysregulated nervous system and am really exhausted.

 

The problem is that clonazepam, right from the first drop, causes me severe depression, dysarthria, fatigue and derealization. If I take it, I feel sick, but if I reduce it, I'm worse. How can I think of going on like this? I can't think to stay for long on this drug. It's devastating me. Is there anything that can help benzo WD symptoms?

Did you ever consider a gentle crossover to Valium/Diazepam? You may have quite severe problems with Klonopin! Depression/Anhedonia is a common side effect of all Benzos... but also a typical WD symptom. You might face depression on one benzo and not on the other...

 

But Valium may also make you depressive as an adverse effect or aggravate a clinical depression. So  really be careful about that! A lot of people face depression on Valium...

 

I didn't tolerate Valium in a higher dosage more than 5mg... I reacted paradoxical on it and it made me badly depressive ... also back in 2014... the depression side effect of Valium just stopped when I got down on 1mg... So that's why I chose Klonopin for taper this time..  It didn't make me depressive....

 

Valium is easier to taper down in my opinion... of course WD symptoms of the antidepressants you mentioned could/ are likely to also play a very big role in it!

 

By the way, that was a very very stupid idea from your doctor to substitute you with a benzo for helpng out with the antidepressant WD! That just doesn't work!!!! A benzo is a completely different substance with a completely different mechanism of action, just so different from the mechanism of action of an antidepressant! That won't work! You can substitue a benzo with a benzo or a z-Drug with a benzo.... but not an antidepressant...

 

My doctor did the same to me! Only it was not an antidepressant but Lyrica WD (that was far worse than any benzo WD!!) I was prescribed Ativan for but it just didn't work, didn't help at all! Ativan was a terrible drug for me! I was better on Klonopin than on Ativan..but as desperate as I was I took the Ativan, too,  long enough for chemical dependency to set in.. but it was just paradoxical! Never felt good on Ativan... not in one day!. It made me sad and very restless. Then I raised the dosage more more because it just didn't help me at all.. and then it got more and more paradoxical... I got akasthisia and crying spells...please Never do that (raising dosage)

 

...Well that's how I got on Klonopin and why I had to withdraw one more time... I had never thought that would ever happen to me again!!!!

 

I don't know why doctors just don't know... I don't think there is any psych pills that are not resulting in chemical dependency... and I've learned that antidepressants,  Lyrica and Co are just as bad as benzos and create the same chemical dependency to the same degree with very similiar or same WD symptoms...

I don't know if switching to Valium is a good idea. Maybe it's easier to taper, but I'm afraid to add the severely depressive side effects of diazepam - as far as I understand, you've had them too - with those of coming off Rivotril. Why do you say that I could have serious problems with clonazepam? Perhaps does it leave its persistent mark more than other benzos?

 

To be honest, clonazepam has always made me sick. The same thing happened to me, as you experienced with Ativan. For this reason I am trying to taper him, but with such a dysregulated nervous system I am in great pain. You are right, my doctor was very incompetent and I curse him, but me too, being confused, continued to take the benzo, despite the fact that it gave me severe negative symptoms. Now I am in great difficulty and I think I will never get out, also due to the symptoms of the trazodone WD. They add up to the benzo symptoms and will never send away, I fear. I wonder how I will be able to fight the increase of my akathisia, depression and insomnia for a long time.

 

Fifteen years ago I resolved most of the antidepressants and finasteride WD symptoms with the administration of testosterone. It was a godsend. I was reborn, though not entirely. I was able to have a lot of energy and positive emotions, however. Now I'm like a scared zombie and I know I can't take any medications because my nervous system is too kindled.

 

 

Hi there,

By "serious problems with Rivotril/Klonopin/Clonazepam" I just meant that maybe it's the wrong medication for you,  like paradoxical reaction or too severe side effects...because you say it makes you sick...you know that's why I mentioned a  crossover... sometimes People do much better on another benzo then... so I did with Klonopin instead of Ativan...

 

But I fully understand that you don't want to risk to destabillize you fragile CNS even further by a crossover attempt...and I also absolutely understand that you fear the side effects like depression in Valium! There is a risk!

 

I guess your problem is that you are still in the antidepressant WD and at the same time you try to withdraw the benzo now... so that probably adds up...

 

Maybe some others can chim in with some ideas... and really I don't want to give you stupid advice... only you yourself know and feel what's best for you!

 

PS you should really drink some special energy drinks to gain weight! Doctors may prescribe it or you  can purchase yourself! It's a pharmaceutical product... I mean pharmacies sell it... I drink that stuff, too I buy it for cheaper at Amazon... I drink 5x400kcal a day at the moment! The brain needs a lot lot of energy to heal in WD!!!

Hi Brighterday,

 

I am currently taking 0.05 mg. in the morning (10.00 o'clock) and 0.31 mg. at night (22.00 o'clock).

 

I generally reduce the dose a little each week (for example 0,01 mg.), but it also happens that, depending on how I feel, I do it after only three days, or stabilize the same dosage for three weeks. I have never tapered more than a 12.4% reduction in a month. As you can see, there were months where I only reduced by 3.7%. The taper process was absolutely hard from the start. I can't imagine what will be next.

 

At the beginning of my taper (August, 2022), I reduced almost exclusively the morning dose, going from 0.2 mg in eight months. to 0.05 mg. I kept the night dose stable or reduced it slightly for mantaining sleep. Now I'm reducing only the night one, but I'm suffering the pains of hell. The symptoms of my taper are unbearable, but I think they mix with those resulting from previous abrupt discontinuations of finasteride and various antidepressants. I have a very dysregulated nervous system and am really exhausted.

 

The problem is that clonazepam, right from the first drop, causes me severe depression, dysarthria, fatigue and derealization. If I take it, I feel sick, but if I reduce it, I'm worse. How can I think of going on like this? I can't think to stay for long on this drug. It's devastating me. Is there anything that can help benzo WD symptoms?

 

I think it would help if you modify your taper to help make your WD symptoms less severe.  First of all, it may help to hold for a minimum of two weeks after each cut.  It's probably too rough on your CNS to make cuts more frequently than that.  Second, I would look at your daily doses and try to keep them as consistent as possible with each cut to keep your blood serum levels consistent. So your nighttime dose would remain the same, taken at the same time for two weeks or longer until you make your next cut. Same with your morning dose.

 

Another question is whether it makes sense for you to taper both doses simultaneously (with total cut for the day adding up 5% or less of your most recent dose). Or does it make sense to taper one dose?  For instance if you find taking clonazepam helps you sleep at night you may want to taper the morning dose first. What do you think?

 

Coping with WD symptoms is a bear, no question about it. It brought me to my knees.  I think if you try to adjust your taper it will help.  But developing coping skills, practicing the best self care you can, and learning calming techniques can add up.  The single most helpful thing we know of is distraction - that is, pouring yourself into an activity that absorbs your attention and shifts your focus away from your miserable symptoms.  It sounds simple, maybe too simple, but it's often the best way to get through the rough days of withdrawal.  Of course, there are many other tools too.  Here's a link to a helpful board :Anxiety

 

I encourage you to read Success Stories too.  When you're in the thick of withdrawal, everything often looks awfully bleak and hopeless.  This is what your brain tells you as it scrambles to find equilibrium and heal after benzos.  But the darkness will lift.  You will get there.

 

 

 

Hi Canary,

 

you wrote: "PS you should really drink some special energy drinks to gain weight! Doctors may prescribe it or you  can purchase yourself! It's a pharmaceutical product... I mean pharmacies sell it... I drink that stuff, too I buy it for cheaper at Amazon... I drink 5x400kcal a day at the moment! The brain needs a lot lot of energy to heal in WD!!!".

 

What energy drinks are you referring to? I know that, when you are on WD, you have to be careful with supplements…

Hi Brighterday,

 

I understand that I can't speed my taper too much, but only cutting back by 5% a month and every two weeks extends the time of exposure to a drug that makes me feel very sick. I shudder at the idea of ​​having to take it for years. It's very difficult to manage this situation, becouse, as I said, I can not tolerate clonazepam.  I'm not able to live with all this anxiety, insomnia, depression, derealization, total anhedonia, sexual dysfunctions, etc. It's a not human torture. What I don't understand is how much these problems depend on the side effects of the drug (it gave me some right away) and how much, instead, by the fact that I'm tapering it. Then there is the interference of trazodone WD symptoms. What a mess!

 

You wrote: "For instance if you find taking clonazepam helps you sleep at night you may want to taper the morning dose first. What do you think?".

 

I would not know. I am very afraid of interdose symptoms. What do you think about it? Many mornings I wake up anxious and agitated, other times very depressed. Perhaps I could try shifting the morning dose one hour a day to the night, after having reduced the night dose to 2.5mg. I'm disorientated.

 

I also wonder how much the methylation factors can affect and what we can do to measure and change them.

 

Another question: can excessive histamine production be a problem?

 

BB edit

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Suicide, Self-harm & Threatening Behavior

Another thing I would like to point out is that, sometimes, anxiety symptoms increase after taking the morning dose. It's like it's some kind of paradoxical reaction. I understand very little.

I'm thinking about gradually reducing first the morning dose (0,05 mg.), keeping the evening dose (0,31 mg.) stable, as Brighterday suggests. Do you know people who have been well with this method, without suffering the interdose symptoms?

 

I also had the idea of ​​gradually posponing the morning dose by an hour a day, until I take it all in the evening. Do you have any thoughts on this idea?

55 -  I want to get you more guidance on this - let me ask my team members to weigh in on the best way forward for you. 

Many thanks.

I'm thinking about gradually reducing first the morning dose (0,05 mg.), keeping the evening dose (0,31 mg.) stable, as Brighterday suggests. Do you know people who have been well with this method, without suffering the interdose symptoms?

 

 

Are you currently experiencing interdose withdrawal?

Hi Jelly,

 

It's really hard, for me, to understand what's going on and give you an answer.

 

Generally my state of anxiety and agitation is constant, but it has always been since I started taking clonazepam in constant doses (0.2 mg in the morning + 0.5 mg at night from May to August 2022). I think the withdrawal symptoms from trazodone, at that time, were very strong and still are present. What changed after introducing clonazepam was a marked increase in depression, derealization, anhedonia, sexual dysfunctions, muscle aches and a hemiparesis, as a side effect of the drug. Canary is right, when he says that the benzo served no purpose, except than increasing the damages and create a new addiction. As I mentioned in a previous post, it sometimes happened that, after taking the morning dose, my anxiety symptoms became stronger and more difficult to manage, creating a paradoxical effect.

 

For this reason, I started tapering the drug from August 15, 2022 and there were added various other symptoms, such as burning and sensitization of the skin of the face and body, an even stronger depression (almost a coma in the morning and sometimes during all day), weakness in the legs, tremors , headache, mental confusion and so on.

 

My nervous system is totally dysregulated and the situation is very confused, so it is difficult to say how much the symptoms of anxiety and agitation depend from clonazepam taper and how much from the persistence of trazodone WD symptoms. I can say that, in percentage terms, I decreased the morning dose much more (from 0.2 mg. to 0.05 mg., -75%) than the evening one (from 0.5 mg. to 0.31, -38% ) and, since I started tapering, the situation has always been very difficult, as it was before and even worse. Basically, I've never had windows and don't know what to do. What I do know is that clonazepam has never made me feel well and now, even with sleep, it doesn't work much.

If you react with anxiety after taking your morning dose that -in fact- really sounds like a paradoxical reaction to me! I know this just too well... I had it, too...I had it that way anytime while my failed reinstatement attempt and I had it in the beginning of my (too) rapid Clonazepam taper.. when I started on 2.5mg Klonopin...But it got a lot better then, actually even disappeared when I got lower! At 1.5mg it was actually gone! So maybe it might disappear for you as well if you get lower (I hope)?!

 

May I ask : what seems to bother and stress you out more?! The probably paradoxical reaction to Clonazepam or the WD signs of Clonazepam?

 

The Energy drink(s) I use at the moment is called "Fresubin " (it's a german health product) I don't know about the Supplements included... but I do fine with it !

 

 

It doesn't sound like you're experiencing interdose withdrawal. With interdose withdrawal you'll usually start having withdrawal symptoms some time before your next dose is due and once you take your next dose you'll experience a relief of symptoms.

 

You seemed concerned about tapering your morning dose and suffering from interdose withdrawal. Your morning dose itself is currently fairly low, so with what you're describing I don't think interdose withdrawal will be a problem if you keep tapering your morning dose.

Hi Canary,

 

you wrote: "What seems to bother and stress you out more?! The probably paradoxical reaction to Clonazepam or the WD signs of Clonazepam?".

 

The paradoxical reaction to clonazepam usually consists of an increase in "chemical" anxiety and underlying akathisia, but the WD signs - especially comatose depression, but also tinnitus, leg tremors and more derealization, anhedonia and intrusive thoughts - are very strong and increasingly unbearable.

Hi Jelly,

 

thank you for your answere. I will try to reduce by 0.01 mg. my morning dose (from 0,05 to 0,04) and see what happens, even if it's hard to figure out exactly how to go about it. Perhaps Brighterday will be able to give me some suggestions shortly. One thing is certain: clonazepam itself and its WD symptoms make me sick.

 

I think making your daily dose consistent in terms of dosage and time of day along with making smaller cuts,  and being flexible about how long you hold at a given dose, may help smooth out some of your symptoms.  In your shoes I would start with a reduction in your a.m dose (less than 5% preferably) and leave your night dose as it is until you've tapered off your morning dose completely.  Again, taking the doses at the same time each day.

This is a rough ride for sure, but some tweaks like these can help.

Hi Brighterday,

 

how can I taper 0.04 mg. (morning dose) of 5% with my graduated cylinder? It's equivalent to 0.002 mg! Isn't it too small a dose? In this moment I fill the cylinder up to 40 ml. of water, then I add a drop of clonazepam (=1 mg.) and remove the 60%, drinking 16 ml. (=0.04 mg.). If I make such a small cut (0,002 mg.) once a month, it becomes a very, very long time. I fully understand the valid reasons of your advice and I already feel, in my body, the risks of akathisia, but isn't being exposed to a toxic drug for such a long time just as dangerous? As I explained, clonazepam gives me very strong depressive, cognitive and physical effects...

I think you need to do what you think is best and you're right that it's challenging to know how to reduce when you get to the very low doses.  This thread my be helpful to you: http://www.benzobuddies.org/forum/index.php?topic=275221.0

Hi Brighterday,

 

thank you for the thread.

 

Yesterday I felt very ill and was thinking to switch from clonazepam to diazepam. Rivotril made me sick from the first moment I took it and, most importantly, it has drastically worsened my pudendal neuropathy and sexual dysfunctions. I believe this can depend from the modulation that only clonazepam, among the benzodiazepines, makes on the serotonin receptors (5HT1), as some studies show. I also have difficulty in reducing the drops of this drug down to very small doses (for example, 0,002 mg.). As you know, clonazepam is very potent and concentrated.

 

As I said to Canary, however, I'm really scared to mess my brain again with another change of drug. I don't know if switching to Valium is a good idea. I've read that diazepam can have severely depressive side effects and I fear its introduction does not protect me from the dangerous side effects of stopping clonazepam. Perhaps, however, diazepam shows the advantage of being easier to scale and not hitting the sexual sphere as hard as Rivotril.

 

I don't know what the cases of switching to Valium (Ashton manual) are on Benzo Buddies. I have seen, on other forums, that some people are successful with the switch to diazepam, others are worse off. I think that, may be, the effects of Valium on the sexual sphere could be minor, but I don't want to deceive myself and mess around again, doing worse than now. I need just an opinion or advice.

It's a difficult decision and I understand your worries.  I think you'll get the most helpful input from this group:Valium Support Group and discuss it with members who have firsthand experience with crossing over.