Benzodiazopenes?

[Matuboo]

Just wondering how many out there have to take benzos for a medical condition?? I started taking Ativan about 6 years ago for panic attacks and anxiety at a relatively low dose, only .5 mg, maybe twice a day.


About two years ago, I started having bad insomnia and lightheadedness, the latter still comes and goes with no known cause (have had heart workups and brain MRI-normal.) My psychiatrist put me on a pretty high dose of Klonopin, 4 mg's per day and that seemed to quell both of these problems, at least, to a fair extent. He actually prescribes 6 mg's per day now, although I only use 3-4 mg's at the most, usually breaking the 2 mg pills in half. Still, I am concerned that I will probably never be able to get off this drug, seeing as though I've been on a high dose for so long. I've heard nightmare stories about people trying to go off, with horrible results. When I asked my pharmacist about this, he said it wasn't a big deal as long as I did a two week taper! I find that hard to believe.:rolleyes:


They do help me sleep, especially when I'm in a lot of pain and they also help with other symptoms but I'm concerned about being on such a high dose for a long period of time. If I was to taper down (or off) what would be the best way to do it? I won't be able to see my psychiatrist again for another 6 weeks or so although I plan on mentioning this to him. Any experiences, feedback or advice would be appreciated, thanks!


M

[Pharmacist.steve]

I am not sure that 2 weeks would be long enough .. the really big problem is cold turkey with benzos. As long as it is an organized taper down.. the problems should be minimual..however... this presumes that the underlying cause of why you are taking the meds don't come back and are intolerable.

[Matuboo]

I am not sure that 2 weeks would be long enough .. the really big problem is cold turkey with benzos. As long as it is an organized taper down.. the problems should be minimual..however... this presumes that the underlying cause of why you are taking the meds don't come back and are intolerable.



There used to be a guy around here (Fred) who would calculate tapers for people, opioids or benzos, although he is long gone. As I recall, the opioid tapers (depending on the drug) were generally a lot shorter than the benzo tapers. For people on high doses, such as myself, the tapers were quite long, sometimes months or longer. This is simply what I recall from memory. I think you're right though, two weeks would not suffice. I would like to get to a point where I only need to take them when I'm symptamatic (lightheadedness or severe anxiety/insomnia.) Don't know if this is a realistic goal but I'd like to try. Thanks for the input Steve. Most people I know that take Klonopin don't take anywhere near what I'm taking, although I have run across a few.

M

[Kathi49]

M,

I'll just add my two cents worth for now. I also take Klonopin .5 mg once a day. I was reading the Ashton Manual that shows Valium is usually used to help with a taper; normally at higher mgs. I talked to my Neurologist about this and she agrees. Then eventually you can come off the Valium. It is supposed to help with any withdrawals. But that is just one way.

Anyway, PharmacistSteve is probably right. I don't think two weeks is long enough either. I would ask your doctor how to go about doing this. But I have heard from others they usually cut by quarters and stay with that for a few weeks or so. And just gradually taper that way. AND...I have also heard it can take many months. How true that is, I really don't know. It is just things I have read from other people. I would really ask the doc and he could tell you how to go about the taper. The key is ORGANIZED taper as PharmacistSteve says. Never, ever stop the benzos cold turkey.

And, yes, you will read all kinds of horror stories and even have the docs tell you it is no big deal. But be careful! I have yet to try to taper and totally come off so I really have no experiences to provide...just things I have been told and have read.

[Matuboo]

M,

I'll just add my two cents worth for now. I also take Klonopin .5 mg once a day. I was reading the Ashton Manual that shows Valium is usually used to help with a taper; normally at higher mgs. I talked to my Neurologist about this and she agrees. Then eventually you can come off the Valium. It is supposed to help with any withdrawals. But that is just one way.

Anyway, PharmacistSteve is probably right. I don't think two weeks is long enough either. I would ask your doctor how to go about doing this. But I have heard from others they usually cut by quarters and stay with that for a few weeks or so. And just gradually taper that way. AND...I have also heard it can take many months. How true that is, I really don't know. It is just things I have read from other people. I would really ask the doc and he could tell you how to go about the taper. The key is ORGANIZED taper as PharmacistSteve says. Never, ever stop the benzos cold turkey.

And, yes, you will read all kinds of horror stories and even have the docs tell you it is no big deal. But be careful! I have yet to try to taper and totally come off so I really have no experiences to provide...just things I have been told and have read.


Well, Valium is a benzo as well but it might have a longer half-life which is why it's used for tapers, don't know for sure. I know Klonopin has a longer half-life than Ativan and tends to work better for my symptoms. I sure wish I was only taking .5 mg per day although from what I've read, most people are in the .5-2 mg a day range. If I remember correctly, I think the key is to spread the doses out and then start taking smaller ones. Too bad we don't have the archives because Fred posted hundreds of Benzo tapers for people. I'll have to Google it and see what I come up with, thanks kath...

M

[Kathi49]

M,

Go the benzo.org site...something like that and the Ashton Manual is there. It is being done in the UK. If nothing else, it does give you the half lives and such. I know what you mean though; I was always afraid to up it and really, it worked pretty well all this time at .5 mg. There were times I must admit, I could have probably used some more but I was just simply afraid to. This is the longest I have ever been on any benzo...and that is my fear. All other times (and other benzos) I could taper off just fine...no problems. PharmacistSteve is probably going to come along and laugh at me because .5 is supposedly nothing. :)

[Matuboo]

M,

Go the benzo.org site...something like that and the Ashton Manual is there. It is being done in the UK. If nothing else, it does give you the half lives and such. I know what you mean though; I was always afraid to up it and really, it worked pretty well all this time at .5 mg. There were times I must admit, I could have probably used some more but I was just simply afraid to. This is the longest I have ever been on any benzo...and that is my fear. All other times (and other benzos) I could taper off just fine...no problems. PharmacistSteve is probably going to come along and laugh at me because .5 is supposedly nothing. :)



Well, as discussed in another thread, everyone is different and some people are more sensative to WD symptoms than others. I tend to fall into the catagory of sensative people, to pain and to emotions, especially anxiety (which is supposed to be the main *demon* in benzo WD's.) However, 4 mg's a day is a big dose and it could be dangerous physically to simply quit, that much I know for sure.


As for your dose, you could probably get away with breaking it in half for a couple of weeks, than into quarters, don't know for sure.:o Glad that level works for you as you are better off as a result, if I miss a dose and leave the house without my Klonopin, I have to come back home and take it, that sucks! Otherwise, my heart starts to race and I get really lightheaded. Often times I forget to take it with me, being so scatter-brained.


At any rate, when I was taking .5 mg's of Ativan per day, I could go a day or two (missing several doses) without any problems. I wouldn't think .5 mg's would cause problems but it's impossible to say for sure.


Thanks for the link....


M

[Kathi49]

M,

Agree! But originally the Klonopin was prescribed for small fiber peripheral neuropathy when nothing else would work! My Neurologist also said I was anxious from the pain and that Neurontin had thrown me into a tizzy (panic attacks) which it did. So, yes, I am overly sensitive to a lot of meds myself.

I haven't tried to taper yet but I can imagine that your heart would race and that you would get lightheaded; that is all part of it from what I have heard.

But really, don't go by anything you read on the Internet and take it to heart or try to do it by yourself without talking to the doc first. I just use this information to formulate my questions. Plus, all you really read is the horror stories. I am certain that other people have had good luck with their tapering...they are just not posting. :)

[Matuboo]

M,

Agree! But originally the Klonopin was prescribed for small fiber peripheral neuropathy when nothing else would work! My Neurologist also said I was anxious from the pain and that Neurontin had thrown me into a tizzy (panic attacks) which it did. So, yes, I am overly sensitive to a lot of meds myself.

I haven't tried to taper yet but I can imagine that your heart would race and that you would get lightheaded; that is all part of it from what I have heard.

But really, don't go by anything you read on the Internet and take it to heart or try to do it by yourself without talking to the doc first. I just use this information to formulate my questions. Plus, all you really read is the horror stories. I am certain that other people have had good luck with their tapering...they are just not posting. :)



No, I woulnd't start anything before calling my doctor, which I may or may not do (taper.) I could probably cut down to 2-3 mg's per day without significant problems, with a lot of drugs, once you get below 50 percent of what you are used to taking, that's when the WD's kick in.


Advice from pharmacists and doctors vary greatly, I've talked to some pharmacists who seem to know everything, I get the feeling they spend a lot of extra time researching, same with doctors. I have a doctor who is willing to sit and answer my questions, this is something I've never had before. Prior to my current PCP and psychiatrist, the physicians I've come across have been dogmatic and curt, always in a hurry to get out of the room.


Yeah, Klonopin is a great drug for a lot of different issues, probably the best all around benzo as it can help with numerous medical issues. The lightheadedness is a horrible feeling, probably a result of increased heart rate.


M

[Scar Tissue]

I take a small dose at night for sleep 1mg. If you do decide to taper off of this drug, could you please post and let us know if it was easy or hard? It would be greatly appreciated, and Best of Luck!;)

[Matuboo]

I take a small dose at night for sleep 1mg. If you do decide to taper off of this drug, could you please post and let us know if it was easy or hard? It would be greatly appreciated, and Best of Luck!;)


I certainly will. I'm more concerned about the long-term side effects than anything else, just because I'm on such a high dose and the fact that if I ever got cut off for any reason (doctor retires or whatever) it would be a bad situation. This paticular doctor seems to be pretty liberal when it comes to prescribing controlled substances. When I told him I was going back to school to take some courses (a few years ago) he asked if I had ADD and offered to RX Adderall for me. A bit odd, especially since I had never mentioned ADD before.


A 1 mg dose at bedtime is certainly reasonable and with your pain issues, I imagine it does help make the nights a little shorter.

[GardeniaGirl]

I have been on methotrexate for over 2 years ago and it makes me into a moody, horrible, mean, anxious, wired nightmare of a person.

BUT -- if I don't take it, the inflammatory pain I feel throughout my body is at suicidal levels 24/7. I'm really not exaggerating on that. That is how bad it is (for me).

About 2 months ago, after trying a number of meds to manage the mood problems, my psychiatrist decided to try Xanax. (0.25mg)

It is the difference between night and day for me. I feel almost like a normal person - the irritability, the anger, the moodiness, the isolation, all of it greatly decreases.

I hate the idea of being dependent on a benzo and I hate the idea that my dose may need to increase over time, but my psychiatrist keeps telling me the benzo is way safer than all the immunosuppressant meds I am on.....and he says if it makes me feel 80% better, then the small problem of long-term dependency on benzos is worth it.

I still don't like feeling like I have to take Xanax in order to feel normal -- but it is the only thing that has helped with the horrible side effects of methotrexate for me.

Valium worked well for me, but my psych explained that it has a long half-life and builds up in the system, and what was happening for me was after 3 or 4 days of taking 5mg Valium per day, I was getting severely depressed. On the xanax, since it clears the system in several hours, this doesn't happen.

[Matuboo]

I have been on methotrexate for over 2 years ago and it makes me into a moody, horrible, mean, anxious, wired nightmare of a person.

BUT -- if I don't take it, the inflammatory pain I feel throughout my body is at suicidal levels 24/7. I'm really not exaggerating on that. That is how bad it is (for me).

About 2 months ago, after trying a number of meds to manage the mood problems, my psychiatrist decided to try Xanax. (0.25mg)

It is the difference between night and day for me. I feel almost like a normal person - the irritability, the anger, the moodiness, the isolation, all of it greatly decreases.

I hate the idea of being dependent on a benzo and I hate the idea that my dose may need to increase over time, but my psychiatrist keeps telling me the benzo is way safer than all the immunosuppressant meds I am on.....and he says if it makes me feel 80% better, then the small problem of long-term dependency on benzos is worth it.

I still don't like feeling like I have to take Xanax in order to feel normal -- but it is the only thing that has helped with the horrible side effects of methotrexate for me.

Valium worked well for me, but my psych explained that it has a long half-life and builds up in the system, and what was happening for me was after 3 or 4 days of taking 5mg Valium per day, I was getting severely depressed. On the xanax, since it clears the system in several hours, this doesn't happen.



Interesting, I've never heard of methotrexate. I'm not positive but I believe 10 mg of Valium is similar in dosage to 1 mg of klonopin although I hate to think of it that way, taking 40 mg of Valium per day!


Any rate, glad you found something that works, .25 mg's of Xanax doesn't sound like a lot but there again, I've never been presribed that paticular drug before except on one occasion and I don't recall the dose.


I can't imagine what it must be like having that kind of pain, I have arthritis but it's relatively mild, not severe at all and certainly not Rheumatoid Arthritis. Most of my pain issues are related to my lower back, fibro and occasional icepick headaches.


M

[Scar Tissue]

Thanks Matubo, and Best of Luck to you!!:)

[Kathi49]

Gardenia Girl,

I understand where you are coming from. Odd, but Flexeril does that to me. I can take just one pill and the very next day I feel irritated, mean and just plain tired...like just don't bother me. And the Medrol Dosepak...oh boy...I can really get on a rage on that but I know why too. :eek:

Okay, back to the benzos...

I tried Neurontin, Lyrica, Cymalta and Elavil when trying to combat the PN. My Neurologist and my PM will NOT prescribe Topomax for various reasons. Anyway, I have a long, long list of the meds I have tried. Of course ALL had SE's; most of which I couldn't tolerate while still trying to work.

So, my Neurologist said I could try Xanax because anxiety can present as a burning sensation. But still I just had it in my hands and feet and pretty bad. I was prescribed Xanax 3 times a day. Well, that was pretty potent and made me tired. But it worked like a charm! I just went back and asked her if there was something else that was similar but I didn't have to take too much of during the day. That is when she switched me to Klonopin and I have been at .5 mg every day for two years.

I know doctors and a lot of people frown on taking them. But I was to the point of whatever worked! I am always hearing, well, there are better meds you can take. But the thing is...I have tried a lot of them. So, if a benzo allows me to function, stay upright, not be out of my mind with dizziness, then so be it. I still maintain they have their place if used responsibly. And the Klonopin truly helped with the neuropathic pain.

Now for the Valium. That was only prescribed for me after surgery and usually only 3 months worth. Never had a problem with it other than sedation. But when recovering from surgery, who cares? LOL I expected sedation and it helped tremendously with spasms. And I was always able to taper off with no problem.

Now, I did NOT take Valium after this second surgery because I was taking the Klonopin and I did not want to throw one benzo at another. However, the ER doc gave me a Valium one day and even my Neurologist said I could take one if the spasms get severe. So far I think I have taken 1/4 of a table of Valium two or three times now. But it is still sitting here for whenever I decided to taper or make the switch.

I really just get by with the Klonopin at .5 mg a day and one Norco 5/325. That's it. The docs say I can up the Norco but I haven't on a regular basis. There are times I have had to for an occipital headache.

Anyway, yep, I still have pain but I don't expect to be painfree either. I just want the edge taken off and still be able to function. If I were to take or up the Norco to the point they say want me to, I would sleep the day away. And I just can't allow that to happen. It would not be a good thing as my muscles would really weaken. But again, I have upped it on occasion when the pain is really bad. And, yes, I fall asleep.

So the bottom line is, just enough to take the edge off, up the Norco on occasion, use heat and ice and a TENS unit and that's about it along with hot baths or showers.

Really, it is the only way I know how to combat it while still remaining upright. I never want to go back to the days of several meds at once just making me sicker and sicker. I may have to. But for now this combo works pretty well.

I did want to add that my mother took Lorazepam for YEARS! And just this last year came off of it without a hitch. But she also wasn't taking a high dosage. My sister takes Xanax and is now down to one a day and feels just fine. When and if she ever decides to come off is up to her. But she says she is feeling much better and Xanax was prescribed for her after her hysterectomy after Effexor did not work.

[Pamster]

I was on klonipin for awhile, a few months, I can't recall how many though, it was in the fall 2005-2006. So I think it was about 6 months. I was having vivid nightmares and had read about the addiction factor and it bothered me because I was taking it at night and I didn't like how it was affecting my sleep with the nightmares. So I tapered off and it was fine, I did have anxiety, but it wasn't nearly as bad as it's been lately.

I now take lorazapam, and worry about what it will be like to taper off of it again, I recall before it was just anxiety as the WD symptom, so hopefully my doctor won't have a problem with letting me stay on it until I get through this bad patch of stress. We're going to be moving and I have been stressing about it and that plus my car are what prompted me to ask for it. In addition to talking to your dr. I would recommend talking to your pharmacist, they helped me recognize I needed to taper off the neurontin I had been taking when my dr. had told me I could just stop taking it.

Keep us posted on how it goes Matuboo. Good luck with whatever you decide to do. :)

[painiac]

I took klonopin 2mg at bedtime for restless leg syndrome for ten years. My primary doc. finally wanted me to switch over to Carbidopa-Levo which is doing a great job. I did a 16 week taper.........reducing by .25 mg q 2 weeks. No problem.

[lobelsteve]

I took klonopin 2mg at bedtime for restless leg syndrome for ten years. My primary doc. finally wanted me to switch over to Carbidopa-Levo which is doing a great job. I did a 16 week taper.........reducing by .25 mg q 2 weeks. No problem.

I think your restless legs will be coming back with a vengeance in the next few weeks. Sinemet has a propensity to tachyphlax itself away. Two good options include Mirapex or Requip.

[painiac]

I hear you and have read the literature. It has been working for three years now.........50/200. My primary has tried to switch me to several other meds with limitted success........lots of breakthrough. A reduction to 25/100 resulted in breakthrough maybe four nights out of seven.

I DO appreciate your input. My doc calls me the queen of paradox. Have a great weekend.