Another Klonopin Horror Story . . . why do I prescribe this stuff anyway???

I have had such an overwhelming number of negative comments about Klonopin lately, I thought I would feature it in another blarticle again.  I thought I would use the following comment sent in not long ago . . .

I started Klonopin 8 years ago for “Nocturnal Myoclonus”. I had heard they were difficult to get off but not to the extent I found.

Here goes:

Changing my life. Getting healthy. Lost a LOT of weight. Now time to get rid of the chemicals poisoning my body. Started on a Monday Cold Turkey. I know, STUPID. Hit some rough patches of trembing, anxiety and did research to take Benadryl, Clonodine (which I had for my BP), drank a lot of water. Long story short….went into a full blown “PSYCHOSIS”. It was early in the morning about the 8th day. My husband got up for work. I had a bad cold and felt awful. I have heard by some the “cold symptoms” could be part of W/D. After my husband left, I felt nervous and peeked out our blinds. To my horror, there was 4 people laughing and talking by my garage. I gasped and went to another room and looked on thefront porch only to find some ghastly looking people looking at me. I called my husband screaming and crying like a 2 y/o. He tried to talk me down to no avail. He stayed on the phone telling me he was on his way back and I just kept looking…NOT Believing my eyes!!! Everywhere were people.Not like monsters but some laughing and talking. Finally my husband got back home and I was telling him “watch out, they are waiting for you to kill you”. He opening the door and grabbed me, hugging me so tight and said I was trembing in horror. NO ONE IS THERE he promised. He gently took me outside as the sun was coming up….there was no one there. The type of hallucinations you get I found out later are “Light” based. Under sources of light images form in your brain and appear distorted. They came back the next night. Inside the house. I felt a horror, and a fear like none other I have known. I was actually relieved to research by googling “Hallucinations Klonopin”. The British study is excellent.

Needless to say. I am back on my medicine and will taper very slowly over months. I was also fearful of having a seizure (that is mentioned in the literature). I had huge twitches circling from my ankles, calves, thighs, and all the way back around. Please get back on them and see someone ASAP. I also developed severe tinnitus. Everything in my house seemed to make a buzzing or horn like sound. This is supposed to be caused by the hyper sensitive hearing while in W/D. And, from what I am learning , Most people never get rid of it. i sit here now hearing a slight sound of a car horn in my ears. I will pray for you. I see it has been a while and I hope you are ok.

Yikes!!!  This story is about as bad as it gets.  It reminds me of a book that came out in the 60’s or 70’s about a poor woman who came off Xanax cold turkey and went just bonkers (10 points to whoever can tell me the name of the book . . . I’m drawing a blank).  As if the issues of addiction, sedation, impaired memory, etc are not bad enough, coming off this stuff can be a nightmare.  

So why do I prescribe it???

Because it works.  

But lets be reasonable about this.  Like all medicine, it is not for everyone.  While most tolerate the medicine with minimal side effects, some have great difficulty even with the lower doses.  As with all benzodiazepines, there is a percentage that will develop tachyphylaxis (tolerance to the medicine).  These people require higher and higher doses of the medicine to maintain there level of benefit.  I have learned over time to abandon this tactic early rather than later when the dose of the medicine concerningly high.  When folks come in who looking for their 2nd or 3rd increase in the dose of Klonopin in as many visits, I start thinking about taking them off it completely (the patient is usually quite unhappy with me!!!).  It is way better to start the weaning process early, however, rather than to wait till the patient is on high doses for a long period of time.

But, as mentioned in many of the letters sent in, it is getting off the stuff that is the greatest difficulty.  This is especially true if you have been on higher doses for longer periods of time, but it can be difficult even if you have only been on the medicine for months (as opposed to years).  The biggest error in getting off is going too fast.  We live in an impatient world and people want change NOW.  Our biological system does not work that way.  Slow changes are accommodated much easier and the psychological burden of a slow change is much less.  As mentioned many times before, there is a difference between withdrawal effects and return of anxiety . . . and that difference can be difficult to tell in some people.  But always, always, always, the risk of difficulty is minimized when doses are changed in very small increments with lots of time in between the change.  Don’t get impatient.  Keep your eye on the goal of getting med free.  Make sure you are doing all the other things that are good for you (good food, exercise, therapy, etc).  When done right, the chances of getting off the medicine can be much higher and still leave you feeling good in the process.

–Dan Hartman, MD

8 comments to Another Klonopin Horror Story . . . why do I prescribe this stuff anyway???

  • Ron

    Quote:
    So why do I prescribe it???
    Because it works.
    ——————

    That’s right. I’ve been taking .5 to 1 mg. Clonazepam as needed for about 3 years because of essential tremor and it has made a tremendous difference in my life. Before starting the medication, the tremors prevented me from writing or typing. I get very tired of reading that “this is a terrible drug” and “it should be banned!!”. Also some doctors are very reluctant to prescribe this medication. After moving to a different state, a new doctor emphatically told me that “this medication should not be taken for more than a few weeks!”. I do understand a patients desire to stop taking a medication. I also wish I didn’t have to depend on this medication. But, there’s not much choice.

    I wish your patient well.

    By the way, was “I’m dancing as fast as I can” by Barbara Gordon the book you’re referring to? Do I get 10 points?

  • Ron–

    Excellent reply. I’m glad to pass along a positive story about Klonopin. I agree with all my patients that don’t want to be on medicine. In fact, I think that some (especially adolescents) are taken aback when I tell them that I don’t want them to want to see me or to take the medicine. “Wanting to” is optional. It is about deciding what is best for you so that you can lead a full and happy life. Klonopin is a great medicine when used with the proper precaution and discretion.

    And, yes, i do believe you are correct . . . and you get the 10 points!

    –DH MD

  • Hugh

    Have been taking Kloopin for several years 1 mg to 1.5 daily for Tinnitus and anxiety. Before that I was on Xanax for the same thing. Switched to Klonopn to get off all benzo but I am having a difficul time tapering off. I am currently taking 0.75 mg. I recenly read that switching over the Valium would be a better drug to taper off of do to the longer 1/2 life. What are your thoughts on this?

    Thanks,

    Hugh

  • Hugh–

    As my mother used to say . . . six of one . . . half dozen of the other . . . for most people a benzo is a benzo is a benzo. Sure, there can be individual differences on which one works best. Mostly, however, the choice boils down to convenience. For a chronic problem like severe anxiety and tinnitus (I’ve never heard of using benzos for tinnitus, but it is not my area of expertise), a long acting agent is better. That said, the switch to Klonopin from Xanax was probably a good move. Now, why switch from Klonopin to Valium? If the difficult time is the re-emergence of tinnitus . . . you just might need to stay on something (benzo or other) for it. If by “trouble” you mean withdrawal symptoms, you have two choices. Go down really really slowly. Like 0.25 mg every couple months slowly, or, you could try switching to Valium. Like Klonopin, it has a very long half life. But, ultimately, you are still talking about hitting the benzo receptor less as you go down and you might have withdrawal. The only way around that is to be very patient and taper the medicine very slowly.

    –DH MD

  • Luis

    Hi.

    I hope I can still comment on this blog entry from 2008.
    I also find that Clonazepam works pretty good. I was originally give 3 x 0.5mg a day for general anxiety which worked pretty good and then slowly reduced it to 2 x 0.25mg a day. I’ve been taking this low dose for most of the time which is about 4 out of 5 years. I never felt the need to increase the dose but I’m generally not an addictive person.
    Anyway, I just started a cognitive behavioral therapy and was thinking of getting off of the meds some time in the future(although I never experienced any bad side effects). The problem is that the Internet is full of millions of horror stories about how hard it is getting off Clonazepam that I’m not sure I want to go through this. I thought if I tapered down really slow over a period of several months that the withdrawal symptoms would be mild and bearable but the more I read on the Internet the scarier it sounds. Is it even possible to still get severe withdrawal symptoms even after you taper down to a super small amount? How much withdrawal is still to be expected?

  • Luis–

    At this point, I think you are in the clear. The likelihood of getting significant difficulties when you get down that low in the dose is very small. If you were my patient I would tell you to decrease to 0.25 daily for a month or so and then stop. Check with your doc.

    –DH MD

  • Billy

    If you’re going to come off Klonopin because of tolerance, which will happen or having interdose withdrawal… switch to Valium, 1,g of Klonopin=20mg of Valium, and also the name of the movie is called “Dancing as fast as I can” it’s about a woman who cold turkeied Valium, but she healed up and leads a normal life, Benzos are ok for anxiety, just not long term.

  • savannalady

    Hello- was researching interdose wd and found this. How are YOU doing now? I see this is old.
    Im yet another victim. Prescribed Klonapin plus Ambien for 12 years. My psychiatrist closed his practice this summer and I was left without a refill….cold turkey. Have lived in utter hell since. Most days I live in terror that I crossed some lione into true insanity…theres a part of my mind that clings to what Ive read, that its all part of withdrawal syndrome. There is ZERO local support here. My only support has been BenzoBuddies. They have been a lifesaver, yet I continue to search for other support…without success yet.
    Its been hell. When I meet someone now who takes a benzo, I want to grab them and shake them silly. When will this stop? Why is the USA so blind and dumb to this?? Im an RN and never once, even when I worked in a DETOX program, heard mention of protracted withdrawal!