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Need help - Paradoxical reaction to Ativan


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I was tapering down on ativan. Just cutting very little every day. I haven't been on it very long. I was down to less than 0.125 and then one night I ended up having hypnotic jerks, burning, muscle cramping, pain, irregular heart rhythms. But... understand I also been having some nerve issues before that. Possibly from short term use of mirtazapine not sure. It just doesn't make sense. Now when I increased the dose to where it was before 0.5 it causes anxiety. Is this from withdrawal? 

 

So, last night I switched over to klonopin.. did have a little burning but no anxiety. I am assuming this will happen with this one as well and maybe I have a week before it does cause these issues.

 

The problem is I am now nowhere mentally able do be doing this now. Ive hit a very bad low. Is it possible to just stay on the klonopin 0.25 till I get into the right place or will I start to have problems in a short amount of time as well. Or should I start right away decreasing the klonopoin over the next few weeks.

 

One thing to note, I don't metabolize Ativan normally.. did one of those genesite tests and one of the enzyme markers was irregular for Ativan. Where Klonopin is longer acting and I metabolize it correctly.

 

Really need your help.. I'm about to go to an inpatient facility for this.

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I'm not sure you were paradoxical, it sounds more like you were tapering too quickly and experienced some intense symptoms.  Am I missing something?

 

We can't know if you're going to run into problems on the Klonopin, you may stabilize and do fine on it so try not to worry right now because you know that only makes you feel worse.  I'd give the Klonopin some time and not plan on tapering anymore right now if you do get stable, I can see you're not in a good state of mind.

 

I guess you've taken Klonopin before since you had it on hand, did you react the same way as you did with Ativan in the past?

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Hi! Thank you so much for your reply!

 

Well I thought it was a paradoxical reaction because I reinstated to a larger dose cause it freaked me out and it didn't help anything. I also had only been on Ativan for 3 weeks tops..  - so was suprised when I had that reaction.

 

I have taken klonopin about 6 years ago and tapered off of it - it was tough but never had that experience.

 

Okay so I will stay at 0.25 Klonopin for a week? Should I do a couple weeks? I got off of klonopin by doing 10% decreases each month.

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I didn't taper but I've read many members say that going back up in dose after an event doesn't seem to help, its like once your body goes into withdrawal mode it's difficult to get it back out, many will have to go to a higher dose.

 

I'd stay with the Klonopin for a week yes, mostly to help you feel a little more confident before you reduce again.  I should mention that members will report that no two tapering experiences are the same meaning each time we withdraw we react differently so even though you've done this before with Klonopin you might want to be prepared to feel differently this time. 

 

As for amount to taper, just pay attention to your symptoms and record them to help you make decisions when and how to cut each time, let your body guide you.

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Thank you so much for your response!

 

Something interesting as well... I did the Genesite report and I don't metabolize lorazepam correctly... (which I think I stated about) but also it says lower doses effect me like higher doses. So Im assuming I will go into some bad withdrawal from the lorazepam in 3 more days? yesterday was my first day without the lorazepam.

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I don't know anything about Genesite but I've seen members mention it.  I doubt you'll feel withdrawal from the Ativan if you've got the Klonopin on board but I could be wrong, I'd appreciate hearing from you how you're doing so I'll know going forward.  Sorry, but you're my test case for this.  :)
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So just an update: (oh yeah and I was taking gabapentin as well.. )

 

Feb 17 - Stopped Gabapentin (was taking only 200mg at night for a few weeks) - Had weird physical anxiety symptoms once I took the ativan (0.25).. so stupidly I took an additional 0.5 cause I freaked out  and felt increase in burning etc- was able to sleep but felt anxious all day

 

Feb 18 - took 0.25 Ativan was going to give it one more shot- felt the same physical symptoms and weird anxiety an hour after after so panicked and took the 0.25 Klonopin in the middle of night. I have a prescription to cross over too - slept ok

 

Feb 19 - 0.25 Klonopin - Felt very anxious all night.. with increasing heart rates.. did smoke some medical merijuana and it helped

 

Feb 20 - Just took 0.25 Klonopin earlier this evening... will see how tonight goes. 

Note: After I took it.. about 15 mins/30 I had some pin pricks which did go away but anxiety has seemed to lessen.

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Thanks for the timeline, I hope you'll try not to updose when you feel odd sensations, I've read from other members that updosing often doesn't seem to ease the symptoms.
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Hey Pamster -

 

If I had to quickly get off Klonopin... How quickly could I do it so I was safe?

I'm currently at 0.25 klonopin after going from 0.25 ativan + 200 Gabapentin 4 days ago.  Was on Ativan for 3 weeks.

 

I'm pretty positive benzos are causing my neuropathic pain.

 

Thanks

 

 

 

 

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Just to be clear, you're no longer on the Ativan or the Gabapentin, right?

 

You can taper the Klonopin as slowly or as quickly as you want to, how quickly did you taper the Klonopin the last time and was it tolerable?  You might expect symptoms to be a little more intense this time around, many members report greater difficulty tapering off after repeated cessations. 

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Yes Im completely off the ativan and gabapentin.

Last time I did 5-10% cuts once a month. It took over a year. :( 

I also started at 1.5mg Klonopin though.

 

If I cut it to 0.125 will that be too large of a cut? I thought its recommended 10%. But how can I do 10% on such a small dose?

 

Then I would have to hold for a month... and cut that dose in half and hold for a month and jump?

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Yes, the recommendation is 5-10% but this is determined by your symptoms.  If you feel awful then make smaller reductions, if you feel okay, you can make them larger.  I have a feeling that you're going to need to take this slow given your previous experience and how you've been feeling lately.  I know your use was for a short time but your body looks to be dependent so it might be time to accept this may take awhile.

 

I'm assuming you have the .5 mg pill, I can see where it's going to be difficult to cut, would you consider getting a jewelers scale and weighing your dose?  How do you typically cut your pills, do you use a pill cutter or a razor blade? 

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I've just been using a pill cutter, but thats not going to make the smaller cuts.

 

So you recommend a jewelers scale? Are they accurate?

 

I also feel like my doctor isn't going to be helpful with switching me to smaller pills.

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The member who did this method is really great for helping members work through weighing their doses, it looks like a great system so take a look at if it appeals to you I'll give him a shout.  He made his own capsules but you can omit that step if you'd rather just take the powder. 

 

Dry Taper Math

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Pamster - I am also on a very high dose of zoloft that I want to reduce as well (not get off). I have found Zoloft to be even harder reducing then Klonopin - probably because I have been on zoloft for a very long time. Do you think I should reduce zoloft first for one month and then then the next month reduce the Klonopin and go back and forth? Or should I complete the Klonopin taper first and then reduce Zoloft or do Zoloft first and then Klonopin.
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When tapering to reduce or stop a benzo it is very important that you not go up in dose according to difficult symptoms from day to day.  Your symptoms were almost certainly just ordinary withdrawal symptoms.  It is normal when tapering and getting to lower doses, to experience withdrawal.  Going back up in dose usually is not effective.  This has nothing to do with being paradoxical.  It is just the nature of benzos and messing with the dose.  You need to accept symptoms will happen.  It is not usual to have a totally symptom free taper.  However, it does happen sometimes for sure.  Tapering from benzos more than once often leads to more difficult tapers each time.  The first time can be okay, the next time not so much.  Your best plan is to taper not more than 10% each 2 weeks or so (with Klonopin), as it can take days for symptoms to appear and more days for them to go away again.  There is not a sure thing that withdrawal symptoms will actually go away, so sometimes just a lessening of symptoms us as good as it gets.  If you reduce a lesser amount, you are more likely to be able to function with less symptoms.  Going faster with larger reductions is not the goal and will not get you symptom free faster.

 

You were on other meds.  They also affected your symptoms.  It is not possible to say which and when caused the symptoms.  But it is safe to say a rapid benzo reduction played a big role.

 

As for the AD taper to lower dose..it's up to you.  Many keep the AD as they taper benzos.  The AD can make it easier to get off the benzos.  Benzos usually go first, then other meds one at a time. 

 

Please do not go back and forth, tapering one a bit then the other.  Very confusing to your central nervous system. 

 

 

 

 

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I agree with Healing64, most will taper the benzo first and my recommendation would to wait until you're completely healed from the Klonopin withdrawal before attempting the Zoloft.
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