Jump to content

Klonopin while tapering off Ativan- please advise


[Ni...]

Recommended Posts

Hi,

 

I am new here.  I've suffered from Panic Disorder with GAD and Agoraphobia for about 8 months now.  I had to quit my job and as you can imagine my life has stopped.

I have been taking Ativan for about 8 months.  I am up to 2mg.  I love it, but my new therapist wants to switch me to Klonopin, which makes me nervous.  I just started today.  She wants me to take my usual 2 mg of Ativan daily and 1 mg Klonopin in the morning and 1mg in the evening.  Does this sound like a lot to you? 

Then I am supposed to start tapering off the Ativan.  I am not quite clear on the plan for this, but thought you might have some insight.  Is it ok to go down by .5?  I can't break the pills into .25, but I didn't know if .5 would be too much of a jump.  Does anyone know how long and how much I should be tapering?

Also, since I don't have experience with Klonopin, is this going to make the tapering of Ativan easier?  Does Klonopin work well?  I'm nervous about not being able to have something I can take that will give me immediate relief.  I am wary of long acting benzos, but my therapist feels this is better for controlling my symptoms (which are all physical) and that it will be easier to get off than continuing to up my Ativan dose. 

 

Any advice you can give would be greatly appreciated.  Thanks so much.

Link to comment
Share on other sites

Hi Nicole and welcome, the only advise I can give you is to not take benzo's at all! I was on klonopin for  year and half when I stopped taking them my life ended as I know it, that was two and half years ago. Its been a year and half since my last day of work.

 

Has you Dr given you any indication how long your going to have to take a benzodiazepine?  IMO your looking at a short term fix for what sounds like a long term problem.

 

Best of luck

 

Dave

Link to comment
Share on other sites

Hi Nicole and welcome, the only advise I can give you is to not take benzo's at all! I was on klonopin for  year and half when I stopped taking them my life ended as I know it, that was two and half years ago. Its been a year and half since my last day of work.

 

Has you Dr given you any indication how long your going to have to take a benzodiazepine?  IMO your looking at a short term fix for what sounds like a long term problem.

 

Best of luck

 

Dave

[/quote

 

Hi Dave,

 

Thanks for your reply.  I'm so sorry to hear that you have had a hard time with the benzo's.  What were you taking it for?  Have you tried any SSRI's?  I hope you are feeling better now.

 

I personally have found benzo's to be the only thing that have worked for me and it's been very difficult for me to find a doc. to prescribe them.  My current therapist is using Klonopin to help me get off Ativan.  Then once I have completed my therapy I will try and get off the Klonopin.  I'm only going to be taking it for a max. of 6 months my therapist said.  I don't like taking meds, but I don't have a choice now.  I hope to be med-free one day. 

 

I hope things are going well for you and appreciate your input!

Link to comment
Share on other sites

Hi, Nicole,

 

The medical community seems to think that Klonopin is the "best" benzo. They think it's not as addictive as the others and that it's easier to get off of. Having tried to get off Klonopin and failed (I had to switch to Valium), I can tell you from personal experience that getting off Klonopin is no easier than getting off Ativan. Klonopin has a longer half-life than Ativan, which is a plus, but it's likely that it binds more tightly to the GABA receptors than Ativan, which is a big drawback.

 

Normally, a person wouldn't switch from one benzo to another until it's time to start tapering. It sounds like your therapist is trying to cross you over to Klonopin to taper, but the problem is that she is upping your dose in the meantime. That causes problems with the taper, because your body becomes even more dependent because it's receiving more drug.

 

According to Dr. Heather Ashton, Klonopin is roughly twice as potent as Ativan. So taking 1 mg of Klonopin would be like taking 2 mg of Ativan. In effect, if you are taking 2 mg of Ativan plus 2 mg of Klonopin a day, that is like 3 mg Klonopin. That's a high dose.

 

Nicole, our bodies adjust to the presence of benzo pretty quickly, within a few months' time. After that, the body has compensated, and the benzo no longer has a therapeutic effect. I can't help but wonder if you have become dependent on the Ativan, since you seem to need more and more to get the same effect. This is called reaching tolerance. It's happened to many of us.

 

My personal opinion is that I would not increase the dose. If you are dependent, you will just have to get off that much more benzo. I would consider starting a taper to get off the Ativan now.

 

Ativan is tough to taper because of the small pill size. We recommend cutting no more than 10% of your dose every 1-2 weeks. Switching to Valium allows you to get pills of smaller strengths, so the tapering is easier. According to Dr. Ashton, the equivalent of 2 mg Ativan would be 20 mg Valium. If your therapist will not switch you to Valium, we have a method where you can dissolve the benzo in milk and cut a tiny amount every day. We can help you with the numbers; we call it "titration." You would need a 100ml cylinder. More information is here: http://www.benzobuddies.org/forum/titration-tapers/titration-instructions!/0/

 

Dr. Heather Ashton has a manual for getting off of benzos. You might like to read it. You can find it here:

http://www.benzo.org.uk/manual/index.htm

 

Therese

Link to comment
Share on other sites

Hi, Nicole,

 

The medical community seems to think that Klonopin is the "best" benzo. They think it's not as addictive as the others and that it's easier to get off of. Having tried to get off Klonopin and failed (I had to switch to Valium), I can tell you from personal experience that getting off Klonopin is no easier than getting off Ativan. Klonopin has a longer half-life than Ativan, which is a plus, but it's likely that it binds more tightly to the GABA receptors than Ativan, which is a big drawback.

 

Normally, a person wouldn't switch from one benzo to another until it's time to start tapering. It sounds like your therapist is trying to cross you over to Klonopin to taper, but the problem is that she is upping your dose in the meantime. That causes problems with the taper, because your body becomes even more dependent because it's receiving more drug.

 

According to Dr. Heather Ashton, Klonopin is roughly twice as potent as Ativan. So taking 1 mg of Klonopin would be like taking 2 mg of Ativan. In effect, if you are taking 2 mg of Ativan plus 2 mg of Klonopin a day, that is like 3 mg Klonopin. That's a high dose.

 

Nicole, our bodies adjust to the presence of benzo pretty quickly, within a few months' time. After that, the body has compensated, and the benzo no longer has a therapeutic effect. I can't help but wonder if you have become dependent on the Ativan, since you seem to need more and more to get the same effect. This is called reaching tolerance. It's happened to many of us.

 

My personal opinion is that I would not increase the dose. If you are dependent, you will just have to get off that much more benzo. I would consider starting a taper to get off the Ativan now.

 

Ativan is tough to taper because of the small pill size. We recommend cutting no more than 10% of your dose every 1-2 weeks. Switching to Valium allows you to get pills of smaller strengths, so the tapering is easier. According to Dr. Ashton, the equivalent of 2 mg Ativan would be 20 mg Valium. If your therapist will not switch you to Valium, we have a method where you can dissolve the benzo in milk and cut a tiny amount every day. We can help you with the numbers; we call it "titration." You would need a 100ml cylinder. More information is here: http://www.benzobuddies.org/forum/titration-tapers/titration-instructions!/0/

 

Dr. Heather Ashton has a manual for getting off of benzos. You might like to read it. You can find it here:

http://www.benzo.org.uk/manual/index.htm

 

Therese

 

Hi Therese,

 

Thank you so much for your wonderful post.  The info was great to read.  I can't thank you enough.

 

My therapist's intentions are to have me on Klonopin to help the Ativan taper.  Ultimately she wants me on an SSRI, which I do not want.  For the time being I will continue on the Klonopin while doing therapy with her.  Then I would like to taper off of that once I feel confident with my skills learned from therapy.  We haven't discussed Vallium, but I imagine she prefers Klonopin.  At this point in time I'm not ready to be benzo free.  But she does not want me on the Ativan anymore so that is why she decided on Klonopin.

 

I started to taper from Ativan today.  My usual dose is 2 mg, and I took 1.5 mg. 

 

I agree with what you about her dosing of Klonopin being high- that's mostly why I posted this.  I don't quite understand why she wrote such a high dose since Klonopin is so much stronger than Ativan.  Wouldn't it make more sense to start off with the smallest dose of Klonopin possible to get me through the Ativan taper?  Chances are I will have to up the Klonopin dose at some point just like I have with Ativan so why start so high?  I wanted to see if anyone on this board had any insight into why she would have done that.  At any rate, I didn't take the 2 mg of Klonopin as she prescribed.  I just started off with 1 mg this morning and then the 1.5 mg of Ativan. 

 

I felt pretty weird on the Klonopin.  Not too tired, but more loopy and drugged.  I guess that will wear off, but again makes me concerned what I'd be like on 2 mgs.  I pretty much scheduled nothing this weekend because I thought I'd be a vegetable and I was right.  Maybe tomorrow will be better.  I know my mind is contributing a great deal to this- I really don't like trying new medicines and get hypersensitive about it.

 

If you have any other thoughts please write back- I'm new to this and feeling pretty confused.

 

Thanks again for everything.

Link to comment
Share on other sites

Hi,

 

I guess I am not sure what your therapist is doing by prescribing Klonopin to get you through the Ativan taper, unless she's not explaining herself well. Klonopin and Ativan are essentially the same drug. So she might as well have prescribed you the entire dose in Ativan rather than part in Ativan and part in Klonopin. It's really all the same, except for the half-life. But chemically, it's still doing the same thing in your brain.

 

When a person crosses over from one benzo to another, it is normally done in steps. So you would take half your entire dose in one form (i.e., Ativan) and half in the other form (i.e., Klonopin) for maybe a week or two. Then you switch to all Klonopin. But your therapist is upping your dose during this crossover, which is not typical.

 

Nicole, as far as SSRIs go, as a whole they appear to be quite a bit safer than benzos over the long term. They are not as addictive. If I had to make a choice, I would choose the SSRI.

 

Many doctors are not well informed about benzos. So your therapist is probably just doing what she has been taught. Many of us here were put on benzos by doctors who were not intending to do any harm--but we became chemically dependent taking the stuff just as prescribed by the doctor. People come to online support groups like BenzoBuddies because they cannot find doctors who are willing to admit that benzos are so addictive, and even if they admit this, they have no clue how to get a patient off. Most of them rush the patient through a taper, causing awful symptoms. These patients have to seek outside help to get off these drugs. So I am sure your therapist is doing what she thinks is best; I just think it is misinformed.

 

 

Link to comment
Share on other sites

Hi Nicole & Welcome to Benzo Buddies :)

 

I think Therese has given you some fantastic suggestions and things to further explore.  Like Therese, I especially recommend thoroughly reading Dr. Heather Ashton's work on benzos at http://www.benzo.org.uk/manual/index.htm.  She ran a benzo withdrawal clinic for 12 years and is a leading world expert.  You can download her manual for free.

 

Please read as much as you can and know the very real and very dangerous consequences of benzo use.  I won't go into my story (if you like, you can see my signature line & read the first page of my blog), but I just want to urge you to educate yourself as much as possible!  My own ignorance (and my doctor's) nearly cost me my sanity.  No kidding :(

 

Take Care,

Maggie

Link to comment
Share on other sites

Thanks to all those who responded.  I appreciate all the info and your time.

 

I'll continue to taper my ativan and see how do on the klonopin.  How long will I be on it?  I don't know.  I do know I need to function and start working again so hopefully in time I will get there and then be able to taper off the klonopin.

 

Thanks again.

Link to comment
Share on other sites

×
×
  • Create New...