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proton pump inhibitors during klonopin withdrawal?


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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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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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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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Some members have reported problems starting a PPI while tapering but never from stopping one.  At least not that I have read.
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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

 

 

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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.
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  • 1 month later...

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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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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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?

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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!

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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...

 

 

That does make sense  :thumbsup:

 

My first upper G.I scope indicated damage, but after six months on a PPI my second scope showed that all the damage from the reflux had healed.  That second scope was described as normal, but I know for a fact that I have reflux, so your statement rings true to me.

 

If the PPI is helping you with your problem then, if I were you, I would continue taking it, and then perhaps try to taper off it once more healing time has elapsed.  You can always switch to something more natural once your body has a chance to heal.  I am now able to take half the dose of my PPI or switch it out for Zantac now that I am further along the path to healing.

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Thanks -- I think I feel better now.  That had been my plan for a while...a gradual taper alternating the PPI with Zantac and stepping down that way...or possibly even waiting to see what the doctor said or whatever.  I think maybe the endoscopy was normal because we caught the reflux very early on, only after a month or two?  I wasn't even worried about it until I read on some other site that PPIs affect the CNS or something -- probably just fear-inducing stories.  I have mostly felt better taking mine as far as being able to eat a lot easier with very few notable exceptions -- those being benzo-induced-nausea waves!

 

Actually I do remember seeing one member on here looking through posts a while back who just waited until he was healed to deal with his PPI -- which I guess should show that healing can occur while on one!  Maybe some mistake the rebound acid symptoms for benzo problems coming back?  Who knows.  I feel better about the whole thing now and that's what matters!  Thanks.

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Beeper, Bevoir --

 

I've read that PPIs can deplete nutrients...I was on a multivitamin start of taper and I went off at somepoint...I'm thinking I had a bad wave and tried to stop the multivitamin to see if that would make things better.  It didn't make it better or worse...so this afternoon I took half of the multivitamin to see if it would rev things up and it didn't.  I'm going to take half tomorrow again since I work and then see if I can't go up to a whole one.  I also saw though that calcium and magnesium are two of the big ones that get lost -- my multivitamin doesn't have much of those -- did either one of you take a calcium/magnesium supplement during taper and if so did it rev up your symptoms?  If not, do you have recommendations for a good one?

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I took a multivitamin all through my taper and didn't notice any ill effects.  They had a pretty small amount of the B vitamins.  I have taken extra Calcium with Magnesium and Vit. D for a couple of years due to osteoporous.  I get a lot of my supplements at Puritan's Pride online.  Hope that helps.
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[13...]

I have Prilosec, but thinking about just water and baking soda.

 

I was on stomach pills for a long time back in 2003-2005.

 

 

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Thanks Beeper.

 

Sigma -- I kind of want to go off of mine, but apparently proton pump inhibitors mess with blood levels of benzos -- i.e. if I stopped it, I'd probably get hit with serious withdrawals.  I just hope my stomach acid isn't getting dangerously low or something, that's my main concern.

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Oh, Beeper, when you say they had a pretty low amount of the B vitamins...oh, now I see what you're talking about, I think.  I was going to say that mine supposedly has 100% DV of B vitamins, but some of these have like 1000%.  Maybe that's why some people's multivitamins rev them up more than others...because some of these have huge doses of B vitamins!  I'm looking on the website you told me about, by the way.
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I hate to be a pain, but with the calcium/magnesium stuff, was it the liquid or the pills?  Some of those pills say to take them 4-5 times daily.  If it was the pills, were you doing that?
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I have Prilosec, but thinking about just water and baking soda.

 

I was on stomach pills for a long time back in 2003-2005.

 

 

 

Sig - I use water and baking soda also!  It tastes pretty nasty - I think I use 1 tsp. in at least 4 o of water up to 3 times a day.  I don't have trouble with sodium (just the opposite, low b/p so my doc told me t make sure I get plenty of salt  :pokey:).  You can always try it once and you'll know how you react - it doesn't rev my sx at all - again, just tastes yucky  :sick:.  I would try to taper the Prilosec though in light of what I've posted and others about it extending the 1/2 life of benzos.

 

Sara :smitten:

 

Sara

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Sara, Sig isn't taking the Prilosec, he just has it...I'm the one who's actually on the PPI but wants to get off...it's 60 mg Dexilant...which is a high dose. 

 

It'd be easier if I could taper down to 30 mg Dexilant and then try to taper using Zantac from there...but my insurance was troublesome writing the 60 mg prescription and I don't see the GI doctor until October and it's impossible to get an appointment with him!  He wants me taking 60 mg of Dexilant at least until then!  I don't think it's safe...I think it's messing up my nutrient absorption and all that and I never had really severe acid reflux to begin with.  I'd feel safe taking 30 mg of Dexilant until I was sure all the Klonopin was out of me and then tapering from there...but I can't get the 30 mg strength!  I don't know if it's safe to open the capsules and empty out half of the granules because it's a delayed release formula...

 

Ugh, I have really been obsessing over this the last few days.  Seriously.  I don't know what to do about it.  I don't know if the Dexilant is making things better or worse but I don't want to start taking it every other day at such a high dosage!

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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.

i've been taking prilosec daily now for the last few years which wouls encompass my entire time on k , and throughout my taper and being benzo free....of course i don't have anything to compare it to but i think i've prpoably hasd a typical wd...i read that they shouldn't be used w/ valium but haven't heard about anything else....if it does extend the half life.. i would think that would be a good thing in wd

 

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It just worries me because some of the side effects (although rarer ones) of PPIs are common withdrawal symptoms: anxiety, insomnia, depression, palpitations.  I keep thinking it's all withdrawal but I have no way of telling...then I did some research and read you can get horrid withdrawals from PPIs too!  Shakes, dizziness, stuff almost as bad as benzo withdrawal!  It makes no sense to me how a stomach med could affect the CNS, but apparently it can...
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like i've said i've been on prilosec for over 3 years, and if i skipped a few days the only sx i noticed was increased heartburn.... and i'm sensitive to medications

 

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