Wife's klonopin withdrawal

I am posting for my wife .. she was put on Depakote by an "Addiction Specialist" MD here.  Then he wanted her to take Trazadone too.  At first, he was going to switch her from Klonapin to Librium.  I convinced him to leave her on Klonapin as we get it in liquid format from a compounding pharmacy.  And she had a bad experience switching to Valium before.

 

Well, at 600 MG of Depakote for 2 weeks, she was not doing any better... still breathing issues.  Now Depakote caused digestive issues and gaining weight frustrating her more.  Plus visual dots now she sees.  And insomnia if she takes it too close to bedtime.

 

So I cancelled her follow-up appointments with this guy and I am taking her back to her PCP.  Made her quit the Depakote because not doing any good.  Also he told her that she may NEVER be able to get off of Klonapin.  YES SHE WILL I was thinking to myself as he told her that.  He made her more upset... more anxiety with that statement.

 

And he wanted to give her Trazadone?  I know he is trying to help her with here anxiety ... but more drugs?  His goal was complete switch to Depakote ~ 1000 mg/ day + NO Klonapin.  Then quit Depakote quickly.  But I read that it is NOT a substitute.  Still withdrawal effects will be going on after you quit Depakote.

 

Let's see... she takes: Geodon 30MG, 0.375 Clonazapam, 6 mg EMSAM patch, and he puts her on 600 mg Depakote + Trazadone? Said that would be off Klonapin in 2 to 4 weeks the first time we went to see him. And now, on visit #2, he wants to load her up with more drugs.  NO. 

 

I hope all you guys are right. I am having trouble believing that there is no doctor in the 4th largest US city that will remove this drug from her system the correct way.  I guess I am her doctor now.  I am an Engineer... As long as her PCP will give us the liquid Clonazapam (the chemical found in Klonapin), I will get her off of this stuff.  I fired the Addiction Specialist.  He won't be getting any more $$$ from me.

 

She is afraid to cut.  Her main symptoms are "can't take a deep breath"  or yawn... her anxiety is extreme now.  Depakote did not do anything to help her.

 

We started at 0.5 MG.  Now since February, she has only cut down to .375.  I am trying to convince her to drop to .350 mg.  I have read that since she is not becoming "stable"  at the reduced fixed dose, she needs to just CUT like 2% per week until done. Started at 0.5mg and now no better on 0.375mg.  She has never gone back up.  Any relevant experiences/ encouragement/ doing the right thing/ wrong thing would be appreciated.  Thank you, Pat

In my opinion, I would let her hold for awhile. She's been poly-drugged and even though she took depakote for only 2 weeks, she might be withdrawing from that too. Always keep in mind that this isn't a race. You said she hasn't updosed and that is where you get into trouble. Holding is fine if you are experiencing bad symptoms. I've seen many people do it. I'm glad she has you help her. Firing the specialist sounds like a wise move to me.

Hey there,

 

I think it's great that you are really helping out your wife like this.  And I agree about forgetting that doctor.  I mean, telling her that she may never get off of benzos and putting her on more drugs?? 

 

My advice is to absolutely put her 100% in control of her own taper, and if she doesn't want to cut then don't.  Just from what you've described even without the other drugs it's not at all unreasonable that she would need to hold, but man, with all of that other stuff entering and leaving her system it seems to me like she'd really definitely need some extra time to hang where she's at and get stable.

 

Btw, just so you know if you don't, already, the lower the dose (for most) the more difficult the cut.  The Ashton Method involves making 5-10% cuts every 10-14 days (or sometimes longer, but usually no necessary) depending upon the body's response.  That way, the lower you go the smaller the cut.  It's strange, but that's just the way you've got to do it.  And it's also counter intuitive, but a long but forwards moving series of small cuts can actually go much faster than larger cuts that take weeks or months to recover from.  Unfortunately, once you are physically dependant, these drugs just take a really long time to get off of.

 

Best wishes to the both of you.

 

I can give a little technical input, no advice.

 

2 % a week ? Is that from the original dose or the current dose ? I never understood those rules.

It IS possible to taper too slowly.

Klonopin is a drug which can be extremely hard to taper at a very low dose when you come down from a high dose. Nature of the drug. People tend to become hypersensitive to it.

 

I never could do weekly cuts. Except as an interim measure to achieve a lower dose, I basically made much larger cuts and stabilized on those for several weeks.

From a long time ago, I seem to recall that withdrawal symptoms from this drug are supposed to be the worst at the 9th day. Keep in mind, the drug has a very long half life.

The duration of action is not the same as the elimination half life !

 

Tapering is not just about 'GABA receptors'. I wonder how many people get sick from frequent, tiny cuts/jolts. It stands to reason that the various adaptations ('benzodiazepine receptor', GABA upregulation, other neurotransmitters, cAMP, neurosteroids etc.) that occur happen at varying rates/speeds.

 

It's an odd drug. It's a benzodiazepine with strong anticonvulsant action.

It has also serotonergic properties (very complicated), acts on sodium channels and probably glutamate decarboxylase. The serotonergic properties may have something to do with hypersensitivities at low doses.

 

Hydroxyzine (Atarax) also has some serotonergic properties.

 

I don't get Geodon. It's an antipsychotic. Amongst other things, it also affects serotonin.

It doesn't sound like a sleep medication. Often, antipsychotics make 'benzo withdrawal' worse.

Emsam is selegiline. It seems to act mostly on dopamine except in women taking oral contraceptives.

 

It's really hard to say how all this stuff is interacting and working together. Poly-drugging is usually a bad idea.

 

From clonazepam tapering, I recognize the breathing and trembling issue.

Clonazepam often causes depersonalization.

 

The last time I tapered this drug successfully I went from 1 mg to 0.5 mg for two weeks, then from 0.5 mg to 0.25 mg to 0 mg in two weeks. No in-between doses. At the lower dose it was definitely a psychoactive drug, with some near-psychedelic properties. Rather unpleasant, but doable. Things got better when I was off the drug. Sadly, I can't do that now anymore.

 

In my own experience this drug doesn't always have the same effect. That she destabilized unexpectedly at 0.5 mg doesn't surprise me. When tapering this drug, staying for long at a low dose or tapering very slowly can make people very sick. That's my impression.

 

I don't see how the 2-5 % taper a month is doable under these circumstances. I'm really not sure if tiny weekly cuts are the right thing to do. What else ? I don't know. True healing will probably only occur after she has withdrawn from the drug.

It's not a surprise that all of this makes her anxious.

Since she is unstable it is worth considering if there is a way to get her off Klonopin much faster. At that dose, the phrase 'cold turkey' hardly applies. Nevertheless, I am far from sure if a sudden discontinuation is the right thing to do given her current state.

I don't have any real answers, if you can find a way around it that could be great.

 

She was allergic to Valium. Have you considered Tranxene (related to Valium) or a different benzodiazepine ?

 

For me, taking it slow and not getting on any drugs unless I have to are the keys for me getting off of Klonopin.  The antiseizure meds did me more harm than good and I am now glad I didn't try more of them.  By the way, I'm doing titration using Rice Milk to come off of the Klonopin.

 

Sincerely,

 

fg

I agree, fg!  I'm cutting .01 mg (clonazapam) every 5 days and it's working.  I'm down to .1!  I think slow is key!  Hope you're doing well.

That's great, Emily!

 

fg

What a jackass to tell her that! Yes she can! I would have to agree with what others have said about holding for awhile. I'm at .625 from 6mg Klonopin. It's been hard to cut does small now without mixing them up into a solution which I'm too lazy to do, and I don't think it's anymore accurate. If she is suffering I think she should hold till she feels ready to cut again; even if it's 4 weeks from now. Maybe if she experiences a leveling off it will give her more confidence to push forward. I myself have taken this way to do it. I almost need that small window of normalcy to continue. As far as the extra drugs go I think it will only prolong things as it will just be another tax on the liver.

Thank you for all the advice guys... I really appreciate it.  Have not posted in a while because a lot has been happening.  I will be so glad when she is off Klonapin and HEALED UP from effects of it.

 

She is still the same.  Went to ER with chest pain/ arm pain.  Stayed in hospital a day and heart checked out fine.  They gave her Ativan IV twice while she was there.  1 MG.  Immediate relief from anxiety and most symptoms except she said the underlying "breathing awareness" is still there.  She is delusional with the breathing issue to the point where she observes others breathing and then becomes concerned that she is not breathing correctly.  Makes no sense to me. 

 

She is diagnosed  with "a Bipolar with psychotic features" according to her last Psychiatrist.  The new one is continuing in the old treatment.  So I wonder if she really is sick.  Or if the Geodon and Klonapin are muddying the waters of correct diagnosis.  Low dose of Geodon seems to agree with her.  But high doses of atypical antipsychotic drugs (Geodon, Seroquel, etc) are like a chemical straight jacket... makes the person very flat and slow... I hate that effect.  She is pretty normal on the low dose and it does cut her anxiety level and probably not nearly as toxic as benzodiazapines.  I may not be right about that... but from what I have observed in her, seems to be the case.  For now, she is staying on the Geodon.

 

After hospital she is on .5 mg again of Klonapin.  Using tablets again. 

 

She has quit Emsam for now... so only on 2 drugs. (!)  Seems the correct course is eliminate the Klonapin first.. if she ever can.  Then the Geodon... maybe go back to the Emsam if she needs an antidepressant.  It is the best one out there with 0 side effects.  And known to increase HGH levels.  A good drug... She is on natural HRT too. 

 

 

I can give a little technical input, no advice.

 

2 % a week ? Is that from the original dose or the current dose ? I never understood those rules.

It IS possible to taper too slowly.

Klonopin is a drug which can be extremely hard to taper at a very low dose when you come down from a high dose. Nature of the drug. People tend to become hypersensitive to it.

 

I never could do weekly cuts. Except as an interim measure to achieve a lower dose, I basically made much larger cuts and stabilized on those for several weeks.

From a long time ago, I seem to recall that withdrawal symptoms from this drug are supposed to be the worst at the 9th day. Keep in mind, the drug has a very long half life.

The duration of action is not the same as the elimination half life !

 

Tapering is not just about 'GABA receptors'. I wonder how many people get sick from frequent, tiny cuts/jolts. It stands to reason that the various adaptations ('benzodiazepine receptor', GABA upregulation, other neurotransmitters, cAMP, neurosteroids etc.) that occur happen at varying rates/speeds.

 

It's an odd drug. It's a benzodiazepine with strong anticonvulsant action.

It has also serotonergic properties (very complicated), acts on sodium channels and probably glutamate decarboxylase. The serotonergic properties may have something to do with hypersensitivities at low doses.

 

Hydroxyzine (Atarax) also has some serotonergic properties.

 

I don't get Geodon. It's an antipsychotic. Amongst other things, it also affects serotonin.

It doesn't sound like a sleep medication. Often, antipsychotics make 'benzo withdrawal' worse.

Emsam is selegiline. It seems to act mostly on dopamine except in women taking oral contraceptives.

 

It's really hard to say how all this stuff is interacting and working together. Poly-drugging is usually a bad idea.

 

From clonazepam tapering, I recognize the breathing and trembling issue.

Clonazepam often causes depersonalization.

 

The last time I tapered this drug successfully I went from 1 mg to 0.5 mg for two weeks, then from 0.5 mg to 0.25 mg to 0 mg in two weeks. No in-between doses. At the lower dose it was definitely a psychoactive drug, with some near-psychedelic properties. Rather unpleasant, but doable. Things got better when I was off the drug. Sadly, I can't do that now anymore.

 

In my own experience this drug doesn't always have the same effect. That she destabilized unexpectedly at 0.5 mg doesn't surprise me. When tapering this drug, staying for long at a low dose or tapering very slowly can make people very sick. That's my impression.

 

I don't see how the 2-5 % taper a month is doable under these circumstances. I'm really not sure if tiny weekly cuts are the right thing to do. What else ? I don't know. True healing will probably only occur after she has withdrawn from the drug.

It's not a surprise that all of this makes her anxious.

Since she is unstable it is worth considering if there is a way to get her off Klonopin much faster. At that dose, the phrase 'cold turkey' hardly applies. Nevertheless, I am far from sure if a sudden discontinuation is the right thing to do given her current state.

I don't have any real answers, if you can find a way around it that could be great.

 

She was allergic to Valium. Have you considered Tranxene (related to Valium) or a different benzodiazepine ?

I want to reiterate what others have said, props to you for standing by your wife. I can not tell you how important and valued it is for someone going through this to have the support of their spouse/partner. Doctos are generally ignorant about this (what a travesty to their profession) and see the anxiety and other issues as underlying, which they could be in some cases but also could simply and purely be related to w/d of some sort - either tolerance, interdose, or reduction of dose.

Your wife's situation is complex in that she has been exposed to multiple psychotropics and unfortunately, Ashton does not address this issue in her publication. 

 

I encourage you to incorporate additional sources of information with respect to the multiple medications that your wife is on. I found out the hard way that my benzo dependency was only part of the equation in my history of being exposed to multiple psychotropics. 

 

A good starting point is The Icarus Project's "Harm Reduction Guide to Getting off of Psychotropics" - this is especially important information for those who have been exposed to multiple psychotropics.  If you have any questions, please feel free to contact me.  I wish you and your wife all the best.  Hugs, Klonkers

 

 

 

 

 

Liberty,

Thanks for the information... she is still having lots of suffocating feeling... her Psychiatrist gave her Buspar ... 30 MG.  Seemed to help at first.  But she is insane with all this WD.  She will not shut up about her breathing problems.... she is hyperfocused on here bodily functions and image.  Can't read... or focus on this site.  Her Psychiatrist moved her Klonapin back up to .5 MG.  I give up. I got into a fight with her Psychiatrist about Klonapin. 

Either she is insane.

Or her doctor is right (Bipolar disorder with GAD and needs Klonapin to control it)

Or she has tolerance WD and is suffering needlessly.

I am growing weary of all of this.  I told her that I will NOT go to the doc with her anymore.  I don't like the Psychiatrist.  I told her that she will be like this FOREVER if she does not get off of Klonapin.  She needs to tell her Psychiatrist to switch her to Librium and then cut... just to see if all this BS is caused by Klonapin.

She is hitting me on the arm right now and telling me to tell you to "be sure and tell him that I can feel myself breath" .  She cannot sit still and she is driving me crazy too. 

Hi Dian,

I also had the "forced" breathing. It's scary as hell. You feel like you will stop breathing if you don't think about it. It is a symptom of the drug or withdrawal, and it does go away. Keep convincing her that her body will breath. She will not stop breathing. It doesn't work like that. I even made my husband watch me sleep for a while because I thought I'd stop breathing in my sleep. You don't. She will be fine, but she does need to get off the drug. At least I did. Her mind and her body are playing tricks on her. If she can practice meditation and progressive relaxation that will help. She needs to consciously convince herself she won't stop breathing. It's hard to understand if you're not going through it, but it is very scary. I'm a college educated, intelligent person but those drugs had me thinking very irrationally.

 

Keep reassuring her. Panic can create that feeling as well, and it can become a scary cycle where you convince yourself that you will stop breathing. She can absolutely get through this. I did. I'm fully recovered from everything the drug did to me.

Your wife's situation is complex in that she has been exposed to multiple psychotropics and unfortunately, Ashton does not address this issue in her publication. 

 

I encourage you to incorporate additional sources of information with respect to the multiple medications that your wife is on. I found out the hard way that my benzo dependency was only part of the equation in my history of being exposed to multiple psychotropics. 

 

A good starting point is The Icarus Project's "Harm Reduction Guide to Getting off of Psychotropics" - this is especially important information for those who have been exposed to multiple psychotropics.  If you have any questions, please feel free to contact me.  I wish you and your wife all the best.  Hugs, Klonkers

Yes Liberty... still having trouble here.  She is listening to her doctor and becoming worse... updosing on Geodon and Klonapin.  Last time, she told her "get off of the Klonapin if you insist."  She wanted to put her in mental hospital again.  I washed my hands of her for a while.  But now, I am getting engaged with her condition again. 

Last week, I she started having the swallowing tick again... Geodon caused this before.  She now I have convinced her to cutit out of her routine gradually.  Down to 40 mg per day now(down from 60). 

Now I am trying to convince her to get off of Klonapin first.  At least Geodon helps her sleep and once it kicks in, she feels much better.  So I am thinking- keep on the Geodon for a while until Klonapin is gone.  Then start going down on it.  I want her off of the Klonapin ASAP.  She has been suffering long enough.  She has a Trileptal and Depakote prescription.  So I think I will have her cut to .25 mg Klonapin this week and if she has any seizure activity, add some Depakote or Trileptal and Clonadine.  I am getting her off the way her doctor said to do it. Every other day on .5.  Then .25 ... then .25 every other day for a week then quit.  That's the way the Psychiatrists tell you to get off of them.  Then of course, you will be so full of WD anxiety that most will re-instate at a higher dose.  So I am hoping that Depakote and Clonadine will get her through it. 

She will not get off at her own comfort level rate with the liquid like we tried before.  So I will just have to tell her what to do.  She is very med compliant thanks to Psychiatrists pounding the point home.

Wish me luck... and pray for us!  Thanks