Author Topic: proton pump inhibitors during klonopin withdrawal?  (Read 1969 times)

[Buddie]

proton pump inhibitors during klonopin withdrawal?
« on: July 05, 2011, 12:24:59 am »
I was first put on Klonopin for anxiety/insomnia caused by stomach problems.  A little over a month ago, they put me on Prevacid for a few weeks (30 mg) and then switched me over to something called Dexilant (60 mg).  I take that in the mornings and my Klonopin at night.

They've run all the tests and I don't actually seem to have any clear "big" problems (no visible GERD after an endoscopy).  I go back to see the GI doctor on the 14th.  Will I have problems if I have to come off the PPI during my Klonopin taper?  Should I tell the GI doctor about the K taper and see if I can wait to get off those until after I'm healed from Klonopin?

Any advice would be appreciated.
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[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #1 on: July 05, 2011, 01:15:38 am »
I don't know of any reason not to stopping taking an unnecessary medication, ajm523.   ;)  Some people who taper off a benzo do experience various gastro-intestinal problems, including nausea, but that's just normal withdrawal.  If you don't have GERD, I think you'd be better off not taking Dexilant. 
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[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #2 on: July 05, 2011, 01:25:48 am »
Yeah, the GI doctor just wanted me on it until I could see him again and he'd run all the tests for H Pylori, etc.  I'll see what he says, and then if he wants me off it, we'll go from there.

I was just wondering because I heard antacids could interfere with benzo absorption, and wondered if it would make a difference if I went off it mid-taper.
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[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #3 on: July 05, 2011, 01:29:04 am »
Some members have reported problems starting a PPI while tapering but never from stopping one.  At least not that I have read.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #4 on: July 08, 2011, 12:51:19 am »
From what I've read along the way, PPI's - especially omeprazole (prilosec) interfere with the clearance of benzos via the liver in the body and extend the 1/2 life.  Here is an example of one of the things I've found:

AbstractThe proton pump inhibitors (PPIs) are the most effective antisecretory agents used to treat acid-related disorders. As such, they are frequently prescribed for patients who are concurrently using other medications. PPIs may interact with other drugs through numerous mechanisms. The most important include competitive inhibition of hepatic cytochrome P (CYP) 450 enzymes involved in drug metabolism, and alteration of the absorption of other drugs via changes in gastric pH levels. Poor metabolizers, who lack CYP2C19, may be particularly predisposed to drug interactions. Although the potential for drug interactions is high, few clinically significant interactions have been reported for the PPIs. Nevertheless, caution is indicated when certain drugs are co-prescribed with these agents. The incidence of clinically significant drug interactions increases proportionately with the number of drugs taken and with the age of the patient. The drug interaction with the greatest clinical importance is the reduction in benzodiazepine clearance by omeprazole.

So, IMO and from what I've read, c/t-ing your dose of Prilosec (I don't about other PPI's) would diminish the amount of Benzos, as well as the 1/2 life, in your body.

I'd be careful.

Sara

Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #5 on: July 08, 2011, 12:58:00 am »
Yeah, I seem to remember seeing that somewhere too, I was looking into it a little bit today.  I'm staying on it until I see the doctor anyway, and then when I go to see him, if he tells me to come off it, I'll mention to him that I'm tapering Klonopin.  It sounds like it may be best to at least wait until a couple weeks after I'm off the K to worry about getting off the PPI.  At that point, it should be there are undetectable levels of it in my body anyway and so it shouldn't bother me too much...?  I have no idea how benzo-wise the GI doc is, so we'll see.  I think the Dexilant is similiar to lansoprazole (Prevacid) and I don't have a lot of the Dexilant left, but I do still have some of the lansoprazole so if I need to stay on PPI's until after my taper is over I should be okay.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #6 on: August 09, 2011, 09:11:44 pm »
I forgot to update this after I went to the GI doctor a few weeks ago, but I can't stop thinking about it today...as I now realize I'm stuck on another drug I'm going to eventually have to deal with getting off of...and am not sure how it's going to affect my benzo recovery.

My doctor told me to stay on the Dexilant until mid-October.  He said that from the symptoms I described I had an acidic stomach.  But then I started reading stuff and realized I could have the exact opposite -- low stomach acid, in which case the Dexilant is just making my problem worse.  I haven't been feeling increasingly worse from continuing to take it -- my nausea and GI symptoms seem to come and go more in the patterns of benzo withdrawal than anything else.

I got scared though because I was trying to do research on the Internet and I found some other benzo forum or something where someone said that being on a PPI could increase your risk of protracted symptoms or something?!  I do understand that the PPI increases the benzo blood levels/decreases the half life, but I figured if I stayed on it the whole taper (I'm due to be done tapering on the 25th) that it wasn't that huge of a deal.

I was planning on staying on the PPI until at least several weeks out from my last dose, then depending on how I'm feeling maybe try to research tapering from it then, or possibly just staying on it until October like the doctor wants.  I've been on PPIs for just over two months now...first Prevacid and then Dexilant.

Anyone on here take a PPI throughout their taper?  Did you feel it slowed your healing down?  I feel like I might try going a day without it several weeks after jumping and see if I feel better/worse...and if it's worse just go back on it obviously...what does everyone think?

Edited to add: I'm 21, and I know low stomach acid is more common in older people, but I'm not sure if that affects anything or not...
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[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #7 on: August 09, 2011, 09:18:46 pm »
I was on a PPI all through my taper and afterward.  I don't think it affected my healing.

Your GI doc says he "thinks" you have an acidic stomach?  He didn't do a test to find out for sure? 
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[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #8 on: August 09, 2011, 09:33:12 pm »
I had a ton of tests done -- endoscopy, CT scan, blood tests, you name it.  All of them came back normal.  He said the only conclusion by my symptoms (I'd been having recurrent nausea especially after eating and some heartburn, the belching problem/hiccups, some IBS-like symptoms...this was all before starting my taper) was that I had an acidic stomach.  The PPI has seemed to make those symptoms go away except for the occasional issue due to Klonopin withdrawal, but I'm not sure what to think.  Some of this started while on the Klonopin, but I'd been getting recurrent stomach viruses about every 3 weeks for several months before I even touched Klonopin.

Maybe I DON'T have an acidic stomach -- that's why I'd kind of like to try to get off the PPI -- but I guess I should wait until several weeks post-taper to try so it doesn't effect the Klonopin levels/half-life and make K withdrawals worse?
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: proton pump inhibitors during klonopin withdrawal?
« Reply #9 on: August 09, 2011, 09:46:45 pm »
I just read somewhere too that a normal endoscopy doesn't mean you don't have reflux -- it just means it hasn't done any damage yet.  That seems to make sense...

I think I'm just going to wait until I feel like I'm mostly healed from the Klonopin to worry about this/see what my doctor says in October...I think I'm just overthinking this one a little because I don't fully trust doctors anymore because of the whole Klonopin mess!
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.