Erin writes in with a very common question:
I am coming off Klonopin. I am currently at .25mg. and have been for three nights. Does the withdrawal symptoms have a peak and then they get better? I really want to stick it out but I am feeling pretty crappy.
There are a number of factors that go into the answer for this question. First (and sometimes easiest) issue is this–do the current symptoms that you have feel like the anxiety that you used to have before the Klonopin (or other anxiety medicine) was started? Klonopin, like other benzodiazepines, is no cure. It helps to alleviate symptoms while it is present, but, once removed, previously experienced symptoms may return. If what you feel is that old demon anxiety . . . it has little to do with ‘withdrawal’ from Klonopin. It just isn’t there to work anymore. The solution may be to restart the Klonopin at the last effective dose, and/or try an antidepressant that has antianxiety efficacy, and/or do some hard work with a cognitive behavioral therapist. It is certainly possible that what you are experiencing is true withdrawal symptoms from the absence of the Klonopin. That would depend on several factors including: (1)how high a dose you were on (if you were on really high doses you might have more difficulty getting off), (2) how fast you are getting off (more likely to have anxiety and withdrawal with a quick taper) and (3) your own biological sensitivity (cannot measure that but you know yourself better than anyone else).
Regardless of the reason for the difficulty, what I typically do if someone is having a difficult time coming off the medicine is to go back to the last dose that was effective and then slow down the taper schedule. Unless you are in a particular hurry (eg, getting pregnant soon), it may be better to make the taper schedule very long and slow. The duration of withdrawal symptoms can be anywhere from a few days to a few weeks. Typically, 7-14 days is sufficient to wait out withdrawal symptoms . . . but who says you are typical! But seriously, if you did the standard taper of 0.5 mg Klonopin for a few weeks and then go down to 0.25 mg for a few weeks you are unlikely to be experiencing “withdrawal” unless you have a particular biological sensitivity. Again, that would be addressed by a more gentle taper. Talk to your psychiatrist about going down by 1/4 tablets rather than 1/2 tablets every few weeks or so.
The following url will get you to the website for the American Academy of Family Physicians. Once there, type in Klonopin withdrawal and you will get a good overview of benzodiazepine withdrawal symptoms and the management of it.
Hope you feel better soon.
–Dan Hartman, MD
With all due respect to the Doctor… to suggest that 7-14 days is sufficient to “wait out” Klonopin withdrawal is simply not the case for the majority of those who have become dependent. I’ve been prescribed Klonopin, and before that Ativan, for over a decade and have recently decided to come off of it. I researched benzo withdrawal very carefully and have found numerous resources both online, in bookstores, and from speaking to others who have gone through this process. The recommended taper schedule for me, starting from my prescribed dose of .5mg tid, was almost 10 months! I didn’t believe that, so tried to taper myself over a period of 3 months. At the three week point I started getting leg cramps. By eight weeks my withdrawal symptoms were so severe I had to up my dosage again. These were classic withdrawal symptoms, and had nothing to do with ‘re-emerging panic or anxiety.’ Leg and stomach cramps are withdrawal symptoms. They were not caused by anxiety.
My GP was under the impression that I should be able to wean off Klonopin in 30 days. She also suggested when I ran into difficulty that I was simply experiencing my underlying anxiety disorder. There seems to be a common belief that withdrawal from alcohol or drugs of any sort takes the standard ’30 days’ which is the typical stay in a rehab center. Unfortunately many MDs simply do not seem to be aware of the need for a slow and steady taper for benzos. (Reducing by 1/2 a dose is NOT recommended! Any doctor who suggests such a large reduction needs to take a hard look at this issue.)
I’ve now found a new psychiatrist who understands the need for a lengthy taper. Some taper methods include the introduction and slow substitution of Valium over a period of weeks or months. Valium is also a benzodiazepine, but with less severe withdrawal effects. The taper is then completed until the Valium is completely withdrawn.
Typically doses are reduced by 1/8 every 2-4 weeks. Even at low doses Klonopin withdrawal can be difficult. Klonopin is available in wafers of .25mg and .125mg which makes tapering at lower doses possible.
While I’ve found several good websites and online resources, I’m not going to advocate any particular sites here. Simply do a Google search and you’ll find quite a bit of very good information… including direct contact with benzo users world-wide who are in the slow process of weaning off these drugs. And you’ll find many who’ve already quit.
Good luck. And be careful! Do not rush this.
Mark
Mark, you are so right. I have been on klonopin 3yrs. up to 2mg per day. Went off cold turked 12 days ago and have all the symptons and started having them long berfore I went off.But was too foggy too realize I was such a mess from this drug. Went to my docs on day 6. Gave me LIBRIUM. Cried becausse the withdrawal is so hard. Took the prescribed dosage and went to emergency the next day. All because I finally looked on the internet and found out what I had been prescribed, that was on day 5 of my withdrawal. Doc said it was psychological and if I didn’t want to not to take anything else because I’m out of the woods as far as siezure goes and, fine. RIGHT. THIS IS CALLED BENZODIAZEPINE WITHDRAWAL. Maybe the docs are doing this in good faith but they need to educate the GP fully about side affects withdrawal before writing this out to patients. I found a site called the Road Back explaining the truths about benzos and regardless of my intelligence, had no idea what a benzo meant until I researched it after quiting myself. It’s a rough road, anybody out there. RESEARCH THIS DRUG. YOU MAY NOT WANT TO GET ON IT. God Bless, Teresa
But, Theresa, where did you get the idea that it was OK to go cold turkey off your Klonopin. Is that what the doctor recommended? Did you do this on your own? Benzo withdrawal can be VERY uncomfortable and VERY dangerous. That does not make Benzos evil. It makes them an intervention that must be managed carefully . . . like most of the interventions that are prescribed by western medicine.
–DH MD
Mark– Many excellent points in the above (all due respect received!). While most people do not have protracted withdrawal symptoms, some do. The most important thing is to have a psychiatrist who is listening to you and not dismissing you. Once you have that, you can manage your way through the difficulties of discontinuing the benzo. I agree with the go slow approach–especially if you have been on the meds for a long time. Valium can be helpful because it’s half-life is even longer than Klonopin so that you detox easier.
Getting off benzos is complicated by the fact that the underlying symptoms can come back and, for some, appear very “withdrawal” like. Going slow is important. For some, life is better ON the benzo. I just don’t want people feeling like they have to get off the medicine because they are a bad person for being on the medicine. Nobody ever thinks that about other medical states (hypertension, diabetes, etc). Why should it be true of medicines that manage psychiatric issues?
–DH MD
HI I WAS ON KLONOPIN FOR ABOUT 15 YEARS NOW AND I AM TRYIGN TO WEAN MYSELF OFF. I AM NOTICING I HAVE THE SHAKES, I CANNOT THINK STRAIGHT AT ALL, I CANNOT RETAIN MUCH OF ANYTHING, MY FACE GETS ALL TINGLY AND IT GOES NUMB.ALSO, MY MIND SEEMS OT FOCUS MUCH MORE ON OBSESSIVE THOUGHTS. SOMETIMES I EVEN FEEL LIEK IM GONNA LOSE MY MIND.I DONT FEEL LIKE MYSELF AT ALL AND I CAN DEFINATELY TEL LTHE DIFFERENCE BETWEEN A PANIC ATTACK, WHICH I GET EVEN ON THIS KLONOPIN, AND THESE OTHER ODD SIDE EFECTS. SEE, I AM DOIGN THIS MYSELF. I WAS ON 3 MILS A DAY AND NOW I WENT DOWN TO 1 MIL A DAY AND ITS BEEN ABOUT 3 WEEKS. I AM FREAKIGN OUT. BUT I DINT THINK IT WOUDL BE THIS BAD. MY DOCTOR HAD SAID GO DOWN FROM 3 TO 2. MAYBE I SHOULDA DONE THAT? I DUNNO.I JUST FEEL COMPLETELY NUTTY. I WISH IT WOULD GO AWAY :0(
This will be short due to lack of time. PLEASE take this withdrawal thing VERY seriously. I am not being dramatic, I am speaking for the most horrible experience of my life.
I started Klonopin 8 years ago for “Nocturnal Myoclonus”. I had heard they were difficult to get off but not to the extent I foun d.
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.
I had been taking .5mg of Klonopin twice per day or 1mg/day total for about 1 1/2 years to treat panic attacks after having a DVT/PE about two years ago.
I attempted getting off of the medication after about 1 year and then at the same time my brother passed away from a major heart attack. At that time I started having chest pains myself — perhaps transferred thoughts of some sort? Nevertheless, the cardiologist I went to found nothing wrong. I was still having the chest pains so a general practice physician recommended getting back on the Klonopin … I did and the chest pains went away.
So, long story short about a year passed and this past October I decided it was time to stop taking the Klonopin. I tapered relatively quickly from what I am hearing or reading about on various Internet sites. I could definitely tell during and now about 1 month after tapering and being off of the Klonopin there were and have been some side effects. The most concerning to date is the possibility of some hypertension … is this possible?
I have always enjoyed normal blood pressure readings of right around the perfect number of 120/80 or a little lower or higher +/- a point or two. And those readings continued while on the Klonopin. One day at a grocery store – they had their little BP machine and the reading was around 135/95. It has been around that range the last several times I have checked. However, I typically have tried taking my BP at least three times and invariably the reading will drop each time I measure it. So, I don’t know if the machine is not reading correctly … perhaps there is anxiety before taking a BP reading and therefore it goes up … or if the Klonopin actually upon withdrawal causes some hypertension? A little worried but at the same time I have read in several different articles that withdrawal can cause slight hypertension. If this is true can I expect it to eventually go back down or not — if so, how long does that generally take? Please advise – thanks!
Khail–
Those machines are notoriously inaccurate . . . but raise a good point. Blood pressure can go up with a taper of Klonopin, both because of the physical withdrawal of the medicine, and because of the increase in stress/anxiety that is no longer being managed. I would urge you to get to the family doc you use and get it measured regularly for a while (you can often just go in and have the nurse take it without a charge just to keep it monitored). If your pressure is up consistently, I would urge you to do those things that help decrease BP–exercise and meditation. If you continue to have difficulty, you must consider your options . . . benzo or BP meds.
–DH MD
I know this is an old article, but maybe this will help someone else surfing by.
A few years ago I was ordering klonopin (and other things) online from a pharmacy in India. I was just doing it to get high. Pure abuse. I got to the point, quickly, where I was taking 5 or 6 2mg tabs a day, with a xanax or two thrown in. I was the calmest man on earth. Completely incapable of being angered or upset. I was more or less a professional drug abuser at the time, heavily into coke and off and on with opiates, so benzos seemed like a soft drug to me.
Boy was I wrong.
When I ran out of the 300 I had ordered I went from that 5 to 6 a day to zero within 2 days with only a few xanax and a valium or two as a buffer. What followed was three days of literally laying on my bedroom floor and crying. It was like the worst breakup I have ever been through, and even though I knew it was just the withdrawls, I couldn’t help feeling emotionally crushed. Whenever my room mate was home it took all the willpower I had to just not cry loudly while he made his way to his room. That’s it. Completely incapable of doing anything else, like eating, going to work, or classes, or showering. Just laid there and cried for 3 days.
After that it was another week or so of wack emotions, but that 3 days is easily the worst 3 days of my life. I found out later you can die withdrawling that fast from that much, so, yeah. Be careful.
My mom has been on Klonopin for almost a year and is now getting off of it. She is having trouble because she is having mood swings. At first she was dizzy all the time, all day long and wasn’t able to function. The problem we are having is that she just went on Medicare so she has a new set of doctors. The therapist she was seeing is not on her plan and the Primary care physician has been trying to change her dosage. From what I’ve been reading this may not be the best thing. Should she go back to a licensed therapist? The PCP cut her dosage drastically and she’s actually doing better with less than more but apparently she may have a rough road ahead. Any suggestions on weather a PCP is the best person to help her though this?
My SO is on Klonopin (2mgx1) and Zoloft (100mgx1) and has no desire for sex. It’s really negatively effecting our relationship. He’s tried to get off the Klonopin before, but I think that the combination of the two is causing anorgasmia and decreased sex drive. I’ve been as compassionate and understanding as possible, but I really want him to get off both medications if at all possible. He’s agreed to talk to his doctor about it but in the meantime, I’m frustrated and looking for answers.
PL and SO–
This one is easy . . . it’s the Zoloft.
DH MD
That’s reassuring. I asked him when he started the Zoloft, and it coincides with the time this problem began 3 years ago. He’s going to talk to his psychiatrist about weening off the Zoloft. Originally, another doctor put him on the Zoloft to ween him off the Klonopin but that never happened. I’m sure there must be other anti-depressant alternatives that don’t have these effects. Thank you very much for your reply. You affirmed my suspicion.
My sister’s doctor recently dropped her. She is experiencing major withdrawals from being forced to go cold turkey from the numerous medicines including klonipin. She is disabled, and without insurance…trying to find a new doctor. Any suggestions appreciated.
Cindy–Usually the family docs have some idea who is good and who is not, so that is a good place to get names. The biggest problem without insurance is paying for care. Private docs rarely offer much of a sliding scale. Clinics and some larger group practices can offer pricing that is discounted or sliding. I don’t know where folks live so I can’t be too specific. This is a big problem in all areas of the country, however. And STILL our representatives in Washington argue about the need for health care reform!!! I would like to see how they would respond if some of their family had to struggle to get by without adequate health care coverage.
–DH MD