This is a pretty unorthodox course of action man. Where should we start. Clonazepam (Klonopin) is a Benzodiazepine, as you know. Pregabalin (Lyrica) is classified as a Gabapentinoids, that is, a drug that acts upon similar receptors and in similar ways to, Gabapentin (Neurontin). First, these drugs are very often put into comparison as we are doing now. The best way I can describe their similarities is to a Ven Diagram, those to circles that intersect, implying they share some stuff but in other ways are completely different.
They are both drugs that are typically described as "sedating". If anything, this would probably be the #1 reported effect of both of these drugs. Benzodiazepines are far more predictable in action (in a specific person who has used them before), while Gabapentinoids are a little bit more elusive. Sometimes they sedate, sometimes people report consistent energy from them (myself included), they can cause myoclonic seizures. Lots of different stuff.
The thing is, a drug's subjective effect does not imply that the cause of that symptom is the same. We have many substances, herbs, drugs and in between that would be called "sedating". Ashwaghanda, Antihistamines, Benzodiazepines, Barbiturates, Bromides, hell, most people who take Melatonin would probably call it a "sedative".
The main issue here is that the mechanism of action is different between these drugs. Your body is highly unlikely to just accept the absence of Clonazepam without any kind of distress. I'm sorry to say that 2-3mg of Clonazepam is not insignificant. It's a dosage that can and does cause severe withdrawal. The fact that you've been on them for an entire decade is only going to exaxerbate that issues.
You absolutely should be tapering slowly and introducing the new drugs only when all parties are certain that you are okay with the switch. Withdrawal from sedative-hypnotics including Alcohol, Benzodiazepines and Barbiturates is an issue not just of discomfort but of safety. I'm not saying it's likely to kil you, but that doesn't mean it couldnt.
Just be careful and I would at least bring this stuff up with your doctor in a non-threatening way. Perhaps try to nudge the conversation in a direction that allows the prescriber to come to the idea himself, as that often leads to better outcomes with these types.
Well aware but I'll give you some backround.
When I was 32 my wife was gone on a worktrip, I was home with the kids. I had crazy panic attack for the first time since I was 17, but I couldn't shake it. Usually it wouldn't last long, this wouldn't go away.
I was so shook I called my friend who is an emt, after an hour or two of trying to talk me down he took me to the ER. They gave me a clonazepam and with 30 minutes it was like nothing even happened.
The next day I seen my GP and he said it sounded like generalized anxiety disorder and he prescribed clonazepam and paroxetine. Well on the day, they had a psychiatrist there as well and I spent 2 hours with her. After telling her my day to day, she said it appeared I had some sort of "break". I was working way too much, taking care of the kids, constantly busy with them, cleaning, cooking, kids sports, fishing, camping etc. I was constantly busy. Any free time I had I was busy with my wife.
Anyhow, I had to stop the paroxetine because it always felt like I was being struck by lightning (this ended up with me trying every ssri snri all with the same results) one thing worked, clonazepam. No sedation for me at all, just axiomatic.
I never abused it and almost daily used less than prescribed.
One day I filled my prescription and went golfing with my kids. This is where I knew I had a problem. They had fell out of my bag and I lost them.
Thats all it took. I called my Dr. Told him what happened, and I told him we have to taper off, I was super scared and it was like I lost a hold or something. So I went through all my old RNCP notes and found a method to taper off. It took a year but I did get down to .5-1mg per day.
My GP was great, but he retired. Now I'm working with a GP I've never met because of covid, and she's all over the place. She says wild shit at times and I have to remind her I also practiced so she can't just lie to me because I will ask her to prove via studies to back what she is saying.
So this switch in her idea and I don't necessarily agree with it, but im also not necessarily apposed to it.
As long as it helps my anxiety I'll be ok with it.
Therapy helps to as well as CBT.
CBD, b complex, magnesium bisgycinate all assist too
.
Occasionally I'll find relief through cannabis or small doses of kratom
Just some back story
Endo
never had truly lowered inhibitions on it, that just happened with acute high dosages before I developed complete tolerance to this chem. With dissociatives though I experienced what you describe ...
