Horrible heartburn? Lorazepam to Clonazepam

My psychiatrist thought that switching from lorazepam to clonazepam would be a good thing for me to do yesterday. However, as soon as I took clonazepam, I got HORRIBLE heartburn. I took Pepcid, tums, sipped on hot water, used a heating pad, and everything else I could think of but it was still the most intense heartburn I might’ve ever had. This morning, I still feel the heartburn a bit in my chest and strongly in my back (which hurts more when I swallow).

My doctor is telling me it’s a coincidence but I didn’t do anything differently yesterday other than take clonazepam instead of lorazepam at night. Could heartburn be a side effect? Is it likely to be not as bad today? I’m terrified to take another dose but my doctor is pushing me to do so.

Please let me know if anyone has had similar experiences and if the heartburn could just be from switching benzos and not a side effect of clonazepam that is likely to stay.

Thank you!

Hi goldendood,

We cannot deduce your unique medical circumstances or when symptoms will come and go, but the crossover approach your doctor prescribed has, in my opinion, a very high risk of increased withdrawal symptom severity.

Did your doctor give you an Ashton equivalent dose of clonazepam to replace your lorazepam?

Did your doctor mention that it takes 5-9 days on average of regularly dosing clonazepam for it to reach full strength?

Did your doctor mention that lorazepam will likely be eliminated by your body much faster than the clonazepam will build to full strength?

These are important details in my opinion to consider before doing a crossover, much less a sudden crossover, from a short-acting benzo to a long-acting benzo. Maybe your doctor's claim of coincidence is such, or maybe you're experiencing increased withdrawal symptoms from a significant drop in blood serum levels of GABAa agonists when making the sudden switch that you were prescribed. I am inclined to think the latter is more likely.

I suggest learning more about clonazepam and lorazepam, and considering looking before leaping before making further drug or dosage adjustments; just my suggestion. Your doctor may not have the expertise necessary to guide you safely through this course of medications. I also suggest that unless your symptoms are extremely debilitating, to hold at your clonazepam dose and wait the 10+ days it will take for your nervous system to stabilize after such rocky ride.

I hope the pharmacokenetic properties of clonazepam will be a benefit to you on your taper; they have been for mine though I didn't take a cross. I think if you can get through this rough transition you will be dosing a more convenient medication.

Please let us know if there's any way we can help. 

Thank you so much for your response! I wasn’t aware of the timespan that it takes clonazepam to reach full effectiveness.

I am currently in the hospital dealing some severe anxiety and nausea, and the crossover is actually an updose (about double) from the dose of lorazepam I was taking. So far today I’ve felt (other than the heartburn) calmer so I’m hoping that stays. A psychiatrist should be coming by on Monday and I’ll be sure to ask them about the crossover more specifically. I’ve definitely expressed concern about potential withdrawal, but they said that if someone came in suffering from lorazepam withdrawal, they would give them clonazepam and then wean off from there.

I didn’t have much time to learn about clonazepam since it wasn’t really my decision to switch or not, but I’m trying to learn a lot now and be ready with questions when I can talk to the psychiatrist again. I am definitely skeptical about anything surrounding benzos being a coincidence.

Did you ever experience heartburn or indigestion from the clonazepam?

Thank you so much for your response - I always really value your input slownsteady!

Hi goldendood,

I'm sorry to hear that you've needed hospital care.

I have heard of doctors doing radical updoses presumably to try to make up for the problems caused by a sudden short-to-long benzo crossover. I personally think it's a terrible solution that not only doesn't work to fully cover the patients physical dependency needs during the cross, but it also forces a radical increase in dosage during a drug trial that can result in significantly increased side-effects, dependence, and a prolonged taper. I'm very sorry this was done to you.

Yes, I've had indigestion from glutamate overload unrelated to benzos, and I've had indigestion caused by overly rapid reduction of benzos; they feel the same in my experience. I do not think this reaction is specific to clonazepam, but rather specific to a decrease in GABA agonist blood serum levels after becoming physically dependent. I think it's hard to digest when the body is overstimulated with glutamate.

I hope your psychiatrist will take your concerns and symptoms seriously and make sure that you have more gradual drug or dosage changes going forward.

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Let us know if there's any way we can help.