Benzos Clonazepam fears. Advice needed

[Masa]

Hi guys,

First of all, I am sorry for this long post. It is my first here.

Specific details about DOSAGE and my QUESTIONS are down toward the end of the post.

I have a few questions I hope somebody could help me with. I am an expat in a country where there is still a lot of prejudice toward mental health issues and while treatment is available, it is still very backward, so I rely on the internet for my information here. There is no such thing as “therapy” here. Just meds.

I was first prescribed Xanax about 11 years ago after having one panic attack that quickly turned into severe panic disorder, in which my panic attacks NEVER went away and I really mean NEVER. Back then, between my first panic attack and being prescribed meds, for about 2 months, for 24 hours a day I had one constant panic attack with extreme dizziness, high blood pressure, weird surges of energy inside me, a constant terrible fear of dying, sweats, muscle spasms, racing thoughts and heart pain. I only told my doctor about the dizziness and she thought I had a mid-ear infection. NOTE: I had only started drinking alcohol a few months before this.

Well, one night after drinking with a few friends, I woke up the next afternoon and I seriously thought I was gonna stroke out. I rushed to the ER and the doctor there recognized anxiety/panic attack straight away and gave me a few 0.5mg Xanax and told me to see a psychiatrist.

On hearing it was an anxiety problem instead of a stroke or something like that, my anxiety literally disappeared and I got a great night’s sleep. I was reluctant to taking the Xanax and refused to take it; but the next day when I had another massive attack for no reason, I took one 0.5mg of Xanax and it made me feel like my normal self within 5 minutes. It was like magic. Anyway, I went back to my regular doctor and told her what happened (minus the drinking bit) and she prescribed me with 2mg of Xanax per day. She told me they were good pills and that she was on them too. I didn’t think anything of it at the time, because I just wanted an end to feeling like crap all the time.

So, I started taking 4 a day, got a new job, started to socialize and drink with workmates and this went on for about 4 years. I NEVER went above 2mg of Xanax, NEVER drank more than twice a week, but did black out quite a few times while drinking on Xanax during those four years. I later realized Xanax and drinking was REALLY bad, so I went to a psychiatric hospital and asked to be detoxed from the Xanax.

The doctor put me on 2mg Clonazepam and on 80g of Prozac a day, after diagnosing me with general anxiety, OCD, panic attacks and depression. He said the Prozac would work for all these and that he would slowly taper the dose of Clonazepam. Unfortunately, he stopped practicing medicine for various reasons and referred me to a colleague of his. The new doctor hated benzos (and me) with a vengeance and wanted me off Clonazepam in 14 days. I didn’t think much of the guy either, so after one visit, I switched doctors and got a doctor at the same hospital who gives meds without too much attitude or judgement. He gave me my original prescription of 2mg Clonazepam and on 80g of Prozac a day no questions asked and has been for the last six years or so, which suited me, that is up until a few days ago.

Prozac seems to be a wonder drug for me as it literally starts working on my panic after the first few doses, but I have never really taken it much, just on and off, because I don’t care for the sexual side effects. For the last few years, I continued to binge drink about once a week and take clonazepam but not Prozac.

Fast forward to the last few months, I have become unemployed again, had zero energy and can’t get out of bed. I wasn’t taking Prozac, but when my anxiety and worry got really bad, I started taking Prozac out of hopelessness. The Prozac has helped me greatly with anxiety, but recently I have had zero energy and just can’t be bothered with anything. It’s like I am extremely lazy, but in my head, I feel I am up against something other than just laziness. In the past, I could fight laziness with a bit of action; but recently I have just been so unmotivated and unable to concentrate, I started thinking it might be something chemical that is stopping me from doing anything to change my situation.

For the past 5 years or so, I have taken the 2mg of Clonazepam I am prescribed in one go in the morning or whenever I get up, mostly without Prozac. I don’t like Prozac, but I am really starting to feel that the Clonazepam is making me even more depressed, lazy, sluggish, unable to concentrate and apathetic. I want off the shit.

For the past few days, I have been researching how to taper off Clonazepam and to my shock, I discovered that some people say 2mg of Clonazepam is equivalent to 4 mg of Xanax. I know that’s a shit load of benzo and I am really worried I have developed a monstrous tolerance and dependence on Clonazepam.

So, have I been lying around stoned out of my head without even knowing it all this time? I just thought that was me without anxiety and feeling bad for myself…

Also, is the fact I take 2mg in one go each morning instead of 4 times a day forever increasing the mount of Clonazepam in my body? I wonder how much I have in me, seeing how I have gained 20 kilos in the last 2 years. (I read clonazepam builds up in the fatty cells of the body.)

Yesterday morning, I woke up and took my 20mg of Prozac and a single 0.5 dose of Clonazepam. After six hours, I had a temperature and was getting electric shock sensations in my legs, so I took another 0.5mg and went to sleep. Upon waking, I got into an argument with my girlfriend and got the electric shocks in my head with a spike in blood pressure, so I took another 0.5 and went to sleep for 12 hours.

I am now going to take 0.5mg of Clonazepam each morning, afternoon and evening, so I will be at a total of 1.5mg, instead of 2mg. My current plan is that I will do this for 4 weeks and then go down to 1mg for 8 weeks and then see how I am. Would this be cutting too fast given that I have been on Clonazepam for so long? Am I at risk of seizures? I don’t drink anymore and will start to exercise and eat better. I really want off this fucking drug and to restart my life.

Can someone please give me some advice as to whether the way I plan to taper is safe? Like I said, doctors here are useless.

Thank you all very much and sorry for the long post.

 

[Quere]

The reduction of .5 mg all at once may be very unpleasant. You could try halving the reduction .25 but reduce every two weeks instead of staying at 1.5 for 4 weeks then dropping by a whole .5mg tablet.

If you went cold turkey you would certainly be at risk of seizures but I think you would be safe even while reducing at .5 at a time, I just think a drop of .5 may turn out to be too unpleasant.

Or you can reduce every week but only at a quarter of a pill. The main thing is to start the reduction slowly and reduce by a small amount only. Then you can see how you respond to the reduction and increase/decrease based on that. And before seizures become a problem you will experience a whole lot of other highly uncomfortable symptoms, so the key is too reduce at a rate where the withdrawals are as comfortable as possible.

 

[Masa]

The reduction of .5 mg all at once may be very unpleasant. You could try halving the reduction .25 but reduce every two weeks instead of staying at 1.5 for 4 weeks then dropping by a whole .5mg tablet.

If you went cold turkey you would certainly be at risk of seizures but I think you would be safe even while reducing at .5 at a time, I just think a drop of .5 may turn out to be too unpleasant.

Or you can reduce every week but only at a quarter of a pill. The main thing is to start the reduction slowly and reduce by a small amount only. Then you can see how you respond to the reduction and increase/decrease based on that. And before seizures become a problem you will experience a whole lot of other highly uncomfortable symptoms, so the key is too reduce at a rate where the withdrawals are as comfortable as possible.

Thank you so much for your response!

I just went out to a crowded place for a few hours (after having taken two 0.5mg doses today) and everything was more intensified the minute I left the house: sound, vision, movement. I haven't felt like that in more than 10 years, but I switched off and it went away eventually. Walked around some more and tried to get used to the world on the lower dose. This is only my second day tapering and I am a bit shocked at how much a difference of 0.5 has made so far. I think I will try .25 increments instead as you suggested and just take it slow.

Thank you very much!

 

[Quere]

Thank you so much for your response!

I just went out to a crowded place for a few hours (after having taken two 0.5mg doses today) and everything was more intensified the minute I left the house: sound, vision, movement. I haven't felt like that in more than 10 years, but I switched off and it went away eventually. Walked around some more and tried to get used to the world on the lower dose. This is only my second day tapering and I am a bit shocked at how much a difference of 0.5 has made so far. I think I will try .25 increments instead as you suggested and just take it slow.

Thank you very much!

Yep, sounds good, there's no point going fast if you just end up being too hard on yourself and cave in and go off schedule. Just take it slow, benzo withdrawal is no joke and that goes double for someone who has an anxiety disorder.

Clonazepam is one of the more potent benzodiazepines prescribed for anxiety so although 0.5 doesn't sound like a lot - it is.

So just take it easy, the whole idea with a taper is to reduce at a rate which is as comfortable as possible and reduces the likelihood of severe symptoms, so if it get's really bad, don't tough it out, be kind to yourself and slow down or stay on the same dose for an extra week, as long as you're making progress you are a success

 

[Masa]

Yep, sounds good, there's no point going fast if you just end up being too hard on yourself and cave in and go off schedule. Just take it slow, benzo withdrawal is no joke and that goes double for someone who has an anxiety disorder.

Clonazepam is one of the more potent benzodiazepines prescribed for anxiety so although 0.5 doesn't sound like a lot - it is.

So just take it easy, the whole idea with a taper is to reduce at a rate which is as comfortable as possible and reduces the likelihood of severe symptoms, so if it get's really bad, don't tough it out, be kind to yourself and slow down or stay on the same dose for an extra week, as long as you're making progress you are a success

Thank you so much for your advice and kind words!!!

"as long as you're making progress you are a success." I'll remember this.

 

[Lorne???]

If you’ve been on clono for years I doubt highly it’s the source of your problems. AD’s are horrible, personally, but, it’s your life

If you want I could draw you up a safe and effective taper plan, I am the resident benzo expert.

And clonazepam has too low of a solubility to build up in fatty cells, although it does have a t1/2 of 12-60 hours or so

PM or post back if you want taper help

 

[Lorne???]

Just don’t drop half a mg at a time!

 

[Clear_Rivers]

Wow, your story sounds similar to my own. The country I live in (Canada) has prejudice/negative judgement of people with mental health issues, even though there is supposed "help" here; most of the doctors don't care and will just dismiss you/not listen at all and tell you to go to your family doctor, even if you're suicidal!

Are you in Canada - if so, you might have seen the same doctor that I saw; one that hates benzodiazepines and me, for some reason - the doctor said the only reason he helped me the first time I saw him was because he pitied me; he was substituting for my regular doctor, who decided I should be on Clonazepam instead of Ativan, which I had been on since 2007, but only as needed. My regular doctor thought I should take Clonazepam daily since I have bad panic attacks, social anxiety, and Complex Post-Traumatic Stress Disorder due to being bullied the whole time I was in school (and still am being bullied because I apparently am a freak - I guess because I have Simple-Partial Seizures which involve me having an overwhelming sense of fear - thankfully I don't scream but have a look of terror on my face that I can't control and am usually unable to move or speak when this happens) and couldn't take anti-depressants or anti-psychotics because of my epilepsy. I have been taking Clonazepam since 2016.

I put in a complaint about the substitute doctor's behaviour recently (since it has given me nightmares and made me feel VERY UNCOMFORTABLE with seeing any doctor that's not my own. I'm afraid they're going to treat me like the substitute doctor did - the doctor also said a lot of nasty things to me the second time he saw me, which includes that the only reason he helped me the first time he saw me was because he pitied me). When I put in the complaint, the owner, who is a woman, told me that the doctor would never say anything like that (I told the owner all of the things that were said to me). I pointed out that I wouldn't say these things if they didn't happen and what would I gain by making up lies about a doctor? I wasn't rude to the owner but she told me I was no longer allowed in the clinic if I felt that way about the substitute doctor (I didn't even tell her that I thought the doctor was an asshole or a jerk nor did I say this to anyone in the clinic either).

Anyway, I have a new family doctor who doesn't prescribe benzodiazepines (AND IS THE ONLY DOCTOR TAKING NEW PATIENTS) so I'm now going cold turkey (I have been cold turkey since September 2, 2019). I'm on anti-seizure medication so there's no risk of having a Grand-Mal Seizure due to the withdrawal but other shitty withdrawal effects, like increased anxiety and feeling extremely pissed off (with issues that happened recently and in the past) are happening.

The fact that Clonazepam made you gain weight confirms what I believe to have caused me to gain weight - I hadn't changed my eating habits or exercise routine but, over the last few years, noticed that I was gaining weight. (People were commenting on that - I'm normally 135 lbs. - I tried a couple of scales a few times, on the same day, and each would say 138 lbs. - 142 lbs.!!!) My acne had also worsened even though I am taking care of my face - I read online, in one review on a website, that this happened to someone else too (the weight gain and acne worsening).

The only advice I can give you is to see if your doctor will put you on an anti-seizure drug, like Lamotrigine (I take that and it helps - it's not a benzodiazepine nor does it work at all for anxiety).

I hope your withdrawal is successful; doctors are definitely useless where I am (I won't even bother with the hospitals since they just want your provincial medical card number so they can bill the government yet not do anything for you - and I'm not just talking about drugs either).

 

[Lorne???]

^ you can still have Benzodiazepine wd- seizures, even on anti-epileptics.

That is plain malpractice

 

[Clear_Rivers]

I have had Simple-Partial Seizures when I withdrew once before (I had a lazy pharmacist that decided to use the excuse that I filled my Lamotrigine so I didn't need to fill the Clonazepam - and this was the day I called the Clonazepam in; I didn't call any earlier). The only seizures the doctors here are concerned about are Grand-Mal Seizures. I think being on an anti-seizure medication already is what is preventing me from having Grand-Mal Seizures.

By the way: The lazy pharmacist is no longer working at the pharmacy I use; he is now working at a pharmacy in Walmart (I heard he was fired from the pharmacy I normally use).

 

[Masa]

If you’ve been on clono for years I doubt highly it’s the source of your problems. AD’s are horrible, personally, but, it’s your life

If you want I could draw you up a safe and effective taper plan, I am the resident benzo expert.

And clonazepam has too low of a solubility to build up in fatty cells, although it does have a t1/2 of 12-60 hours or so

PM or post back if you want taper help

ADs are indeed horrible...

If you could draw up a safe and effective plan, that would be wonderful.

Thank you so much!

 

[Wilson Wilson]

2mg clonazepam = 2mg alprazolam, not 4mg. Although in reality I'd say it's a "lighter" benzo for subjective effects because alprazolam "hits harder" and wears off quickly while clonazepam is always more "in the background" and has a longer half-life.

Clonazepam is generally one of the less intoxicating benzos for this reason, especially once you have a tolerance (which, with the length of your script, you do). I doubt it's making you "stoned all this time without realising it" as you state you are sticking to your script not abusing your meds, in that case aside from a bit of memory loss, if no one around you has mentioned weird behaviour I wouldn't worry about it. Although I am surprised they put you on 2mg alprazolam per day straight off, usually they would start with a lower dose, but that's not really important now.

I am not sure if the symptoms of feeling sad and without energy you are getting now are from the SSRIs, the benzos, situational from unemployment, or symptoms of the depression you were diagnosed with before. It could be either one or a mixture. It really is hard to say. Even psychiatrists just make a guess. I've been diagnosed with something new and given different meds each time I saw a different doctor.

If you want to try coming off any of the meds definitely taper and I include SSRIs in that as well. As far as clonazepam goes, it's a long half-life benzo so it can be used for tapering, and small reductions should be relatively painless with the final jump off being the worst part. You could start off taking half (so 1mg) in the morning and 1mg before bed and see how you feel during the day, then from there wean down like 1mg in the morning and 0.5mg in the evening and so on.

If you are able to get diazepam however that is much better for tapering down from benzos if you are sure you want off them for good rather than just lowering your dose or having a break. If you really want to stay off clonazepam you want a diazepam taper, this is standard medical practice to get someone off benzos throughout the world. 20-40mg diazepam is roughly equivalent to 2mg clonazepam depending on what chart you use but I'd stick with the higher dose to be on the safe side as diazepam lacks potency compared to clonazepam.

You are also quite lucky to have been moved from alprazolam to clonazepam as the clonazepam is much easier to withdraw from due to the long half-life. Alprazolam with its short half-life is much rougher to come off.

Personally I also have a script for 2-4mg clonazepam but I only really use 1mg most days. I have had times where I wanted to come off it for whatever reason and found it pretty easy compared to most other potent benzos like alprazolam.

 

[Lorne???]

Tell me, do you want to taper off completely or just go down to 0.5mg? Because .5mg would be a lot easier

 

[Zonxx]

your taper seems sound, but id say you can cut to 1mg, then to 0.5 and go for a week at a time before decreasing and see how you feel at 0.5, 0.5 is a lower dose but i firmly think your dose should be a one/day dose with its long half life when its absolutely needed be it at night for sleep, day anxiety and so forth, but i somewhat don't like the 0.5 x3/day routine it genuinely doesn't sit with me very well, just because youd constantly be under its effects making it more difficult.

 

[Lorne???]

He should drop a .2(mg at a time. All the way down to an 1/8th of a mg. Goslow and low

 

[Masa]

Tell me, do you want to taper off completely or just go down to 0.5mg? Because .5mg would be a lot easier

When I first posted here, I wanted to be free from all meds, but after reading some absolute horror stories about protracted withdrawal syndrome yesterday and today, I am not sure if that is even a good idea...0.5mg would probably be more practical. If I quit and am even worse than now, I don't see the point.

 

[Masa]

2mg clonazepam = 2mg alprazolam, not 4mg. Although in reality I'd say it's a "lighter" benzo for subjective effects because alprazolam "hits harder" and wears off quickly while clonazepam is always more "in the background" and has a longer half-life.

Clonazepam is generally one of the less intoxicating benzos for this reason, especially once you have a tolerance (which, with the length of your script, you do). I doubt it's making you "stoned all this time without realising it" as you state you are sticking to your script not abusing your meds, in that case aside from a bit of memory loss, if no one around you has mentioned weird behaviour I wouldn't worry about it. Although I am surprised they put you on 2mg alprazolam per day straight off, usually they would start with a lower dose, but that's not really important now.

I am not sure if the symptoms of feeling sad and without energy you are getting now are from the SSRIs, the benzos, situational from unemployment, or symptoms of the depression you were diagnosed with before. It could be either one or a mixture. It really is hard to say. Even psychiatrists just make a guess. I've been diagnosed with something new and given different meds each time I saw a different doctor.

If you want to try coming off any of the meds definitely taper and I include SSRIs in that as well. As far as clonazepam goes, it's a long half-life benzo so it can be used for tapering, and small reductions should be relatively painless with the final jump off being the worst part. You could start off taking half (so 1mg) in the morning and 1mg before bed and see how you feel during the day, then from there wean down like 1mg in the morning and 0.5mg in the evening and so on.

If you are able to get diazepam however that is much better for tapering down from benzos if you are sure you want off them for good rather than just lowering your dose or having a break. If you really want to stay off clonazepam you want a diazepam taper, this is standard medical practice to get someone off benzos throughout the world. 20-40mg diazepam is roughly equivalent to 2mg clonazepam depending on what chart you use but I'd stick with the higher dose to be on the safe side as diazepam lacks potency compared to clonazepam.

You are also quite lucky to have been moved from alprazolam to clonazepam as the clonazepam is much easier to withdraw from due to the long half-life. Alprazolam with its short half-life is much rougher to come off.

Personally I also have a script for 2-4mg clonazepam but I only really use 1mg most days. I have had times where I wanted to come off it for whatever reason and found it pretty easy compared to most other potent benzos like alprazolam.

Thank you very much for your detailed response.

I know I was very lucky to have been put on Clonazepam from Alprazolam. I am also starting to think my symptoms are probably a mixture of a bunch of things and not just one thing (clonazepam.)

Today is the 5th day of my taper, in which I have kept to 0.5mg, 3 times a day. I have noticed a slight difference in the daytime (muscle cramps, blurred vision and a nervous energy like I have missed a dose or something, ESPECIALLY the last two days), but the last two nights were bad and really bad: half-awake/half-asleep state all night and last night crazy vivid nightmares. I can handle this though as long as I don't stroke out or have a seizure.

At the moment, I feel like if I can get the dose down lower, no matter how long it takes, I will be happier with myself. After reading some stories the last two days, I am starting to doubt that I can and should totally quit these things; I was put on them in the first place because I was going through a very tough time and my nervous system was a wreck. I don't want to go through that and maybe worse pain again and possibly for years at a time, just because I am trying to quit. It just doesn't seem worth it.

 

[Masa]

your taper seems sound, but id say you can cut to 1mg, then to 0.5 and go for a week at a time before decreasing and see how you feel at 0.5, 0.5 is a lower dose but i firmly think your dose should be a one/day dose with its long half life when its absolutely needed be it at night for sleep, day anxiety and so forth, but i somewhat don't like the 0.5 x3/day routine it genuinely doesn't sit with me very well, just because youd constantly be under its effects making it more difficult.

Haha!!! On my fifth day now and I can genuinely say my 0.5mg x3/day routine isn't sitting so well with me either...I used to take 2mg in the mornings and forget about it. I feel the change to 3 times a day from once a day has made a big difference with very slight mini withdrawal symtoms between each dose, but my brain seems clearer and I am definitely not as depressed...although it is still early days...

 

[Wilson Wilson]

Thank you very much for your detailed response.

I know I was very lucky to have been put on Clonazepam from Alprazolam. I am also starting to think my symptoms are probably a mixture of a bunch of things and not just one thing (clonazepam.)

Today is the 5th day of my taper, in which I have kept to 0.5mg, 3 times a day. I have noticed a slight difference in the daytime (muscle cramps, blurred vision and a nervous energy like I have missed a dose or something, ESPECIALLY the last two days), but the last two nights were bad and really bad: half-awake/half-asleep state all night and last night crazy vivid nightmares. I can handle this though as long as I don't stroke out or have a seizure.

At the moment, I feel like if I can get the dose down lower, no matter how long it takes, I will be happier with myself. After reading some stories the last two days, I am starting to doubt that I can and should totally quit these things; I was put on them in the first place because I was going through a very tough time and my nervous system was a wreck. I don't want to go through that and maybe worse pain again and possibly for years at a time, just because I am trying to quit. It just doesn't seem worth it.

You're absolutely correct that it's gonna be multiple factors at play. Unemployment alone will cause situational depression even in a previously mentally healthy person. Someone with previous issues will of course suffer from it.

Regarding your symptoms I am curious have you also started tapering your SSRI at the same time? Because you can get those exact same symptoms from SSRI withdrawal and they seem pretty strong for a reduction of only 0.5mg clonazepam.

Consider that clonazepam's half-life is so long that I've skipped a dose for a day or two before and the serious withdrawals didn't even set in until the third day.

I think most of your symptoms are psychosomatic because you're making the mistake of reading benzo withdrawal horror stories. And you're already an anxious person in a bad place so it feeds into everything else. To put the horror stories you read into context, most of them come from people abusing their meds and taking way more than the therapeutic dose. Not from people taking one 2mg tablet per day as prescribed.

Finally, if you are able to get weed easily in your country, it would help benzo withdrawals and also your anxiety a lot if you can get a nice relaxing strain. At least that has been my experience. The right strain of weed is great for anxiety.

 

[Masa]

I have cut the SSRI from 20mg to 15mg per day and will gradually go lower as I cut the benzos.

I really do think I made a bad mistake reading those horror stories, so I stopped reading them. I am an anxious person. I really wish there was like one pill that could change that forever...I am thinking of exercise and diet now.

Can't get no weed here...