Advice regarding Klonopin/Paxil

[[Fe...]]

Hello friends,

I am new to this forum and would like some advice about medications.  This is a bit complex.  I retired from my job as a physician 1 1/4 years ago as I had a lot of stress in the setting of chronic anxiety and was having some difficulty functioning related to both job stress and anxiety.   At the same time, I had severe hamstring pain which was attributed to a  running injury which did not improve with PT and discontinuation of running.   Before being diagnosed with a spinal tumor which caused some of the pain (I had not slept well in a year related to the pain, and at the end, not at all), I went to the ER with panic attacks, severe hypertension and terrific pain.  Three months after retirement, I found out that it was due to a benign spinal nerve tumor which was removed. I was begun on Ativan which abolished the pain, but the panic and insomnia persisted. Panic attacks became almost constant along with lots of memory problems and language difficulties. I then had the benign spinal tumor removed.   I had not planned my retirement very well and have had little to do since then, along with isolation which increased my anxiety. Ativan  was changed to Klonopin (0.5 mg twice daily), which continues to help with sleep.  With a very slow taper over several months, (0.5 mg twice daily down to 0.5 mg before sleep) I continued to have constant anxiety and panic attacks. With excess exercise, the hamstring spasm comes back, although it is greatly helped by Klonopin. Other medications tried and failed include Robaxin, Trazodone, hydroxyzine, Lexapro, high dose Prozac, Cymbalta.  Finally out of desperation, I requested Paxil from my psychiatrist because a friend had done well on it and thought it might help (yeah, I know, dumb idea but having near constant panic attacks was no fun). He recommended 40 mg but I only wanted 20 mg as high dose SSRI caused blurred vision, anxiety and headache. It actually worked but blurred my vision. I had to stop driving and cannot read well or participate in many activities (failed doing fine work and pickle ball) due to visual problems (high myopia, retinal problems, cataract) which were worsened by Paxil. Paxil did abolish the panic attacks and helped irritable bowel syndrome with some incontinence..  My cognition deteriorated to the point where both short and long term memory, speech and clumsiness worsened. I lost fluency in English and lost my ability to speak in my second language which I could speak 1 year ago and cannot comprehend or remember much of what I read and cannot follow the plot of a movie or TV program, make calculations or handle my finances.  So I have derived some benefit from the Klonopin in terms of pain relief and insomnia and Paxil in terms of irritable bowel with incontinence and panic attacks, although at a terrific cost.  I am exercisng, tried meditation and psychotherapy, none of which help in terms of my anxiety and depression.  So i do not know how much of much cognition problems are due to meds and how much from constant severe depression and anxiety which have prevented me from enjoying almost anything I enjoyed in the past.   I am uncertain how much of my stress and anxiety to attribute to life events (loss of job, self esteem, visual loss, unable to learn new things due to anxiety, isolation) and whether they would respond to medications. Currently, I am on Paxil 20 mg daily and Klonopin 0.5 mg daily.  I am worried about balancing my loss of memory with the improvement Paxil gives me with panic attacks although I am not the point where I can function well with anxiety.  Any suggestions about whether to taper medications and if so how to handle the insomnia, panic attacks, and bowel symptoms that will result if I stop them. 

[[Ho...]]

Hi,

I'll try to share what I've learned. My experience, like yours, had several confounding factors that made it difficult for me to see the forest for the trees. I won't pretend to know what has caused so much debilitation in your life, but for what it's worth, here's my story.

I was taken off Mirapex which had addressed my longstanding RLS. Sleeplessness ensued and the doctor threw a cocktail of different meds in my direction. Lyrica, Gabapentin, Horizant, Tramadol, Tylenol #3, Clonazepam, Ambien were some. I slowly because a bit depressed because my sleep was severely broken. I could not sit through movies, theater, dinners with friends etc. Then, retirement and Covid happened at the same time, and a grandchild, who we'd help to raise, left us for good. Sad for us, but this is a part of life.

I finally went to the Mayo Clinic. They recommended low dose opiates to address my RLS. I frankly didn't want to. In the end, I did, and went off clonazepam. I'd only been on .75 mg a day for six months or so.

I lost 40 lbs, developed an inner tremor that made me feel inexplicably weak and ill. Ringing in my ears. Constant jitteriness. Could not think; could not carry on a conversation. I'd walk into a room and wonder why. I could hardly stand to watch TV or listen to music. Even my eyesight suffered. My thoughts were so black and sad; I felt envious of people and desperate and despairing. All I could think about was how to end things without hurting anyone. Everything seemed pointless and hurtful. My small business hit the skids. The doctors thought I was depressed from not sleeping, or maybe it was Covid, they speculated. I saw three neurologists, an ophthalmologist, my regular GP, a pain specialist, a psychiatrist and a sleep therapist. 

I was put on 15 mg. Mirtazepine and then a host of other AD's that made me feel worse and were discontinued pretty quickly. 

My daughter has a severely disabled child with migrating malignant siezures. Her other child is three and still does not speak. My mother in law has dementia. There were and are other stressors in my life. I too didn't exactly plan retirement well because we've always just taken care of others. Now, I could no longer take care of a soul, although I did make it my mission to do something for others every day, however small.

For me, the culprit was Clonazepam. As soon as I went off of it (and remember, I'd only been on it for about 6 months) all of the above symptoms came piling in. It took me months to realize this, because I thought it was depression over life circumstances, perhaps depression over Covid and the loss of a social life, or empty nest stuff, or anxiety over my two special needs grandsons. 

Nope. It was the Clonazepam. Even my brilliant psychiatrist didn't get it, although a few months ago during a med check she finally told me she had an attorney who'd been taking clonazepam for years. She helped him off; it took a year. But it took three years for him to feel like himself again. 

I've been off for almost a year. I'm definitely not myself yet, but I hope to be in God's good time.

There is something called tolerance that many here have had. It's something like withdrawal between doses, but if you do a little investigating into other people's stories here, you'll probably find similarities that will help you deepen your understanding of what is happening to you. I suspect that's why you're here!

I play pickleball now. Not well, but I play! Things are slowly, ever so slowly getting better. I haven't hit enjoyment yet, but I've begun to have a few moments here and there. 

There is a growing body of information on Clonazepam and poor cognition outcomes. 

I hope something in all this helps you!!

 

 

 

 

 

 

[[Gl...]]

4 hours ago, [[F...] said:

Any suggestions about whether to taper medications and if so how to handle the insomnia, panic attacks, and bowel symptoms that will result if I stop them. 

I'm sincerely sorry for all you are going through.  There are so many of us here who can relate to all that you've mentioned, so you're in the right place.  I would absolutely taper your meds, especially Klonopin.  I would get as far away from that as possible (slowly).  As far as panic attacks, I've only had a few, and they were terrifying.  Someone here must have a suggestion for them.   I pray a lot.  That's what helps me through everything. I hope you will find the answers you're looking for.  I wish you all the very best.  We're here for you.  Stick around!

[[Li...]]

Hello @[Fe...].  Welcome to BenzoBuddies.  We’re glad you’ve joined our community.

After reading your post, I am struck by the number of changes that have been made in your psychiatric medications.  Dr. Josef Witt-Doerring (a psychiatrist who specializes in the treatment and management of adverse drug reactions as well as “judicious medication management for individuals seeking to improve their quality of life”) recently interviewed Chris Paige (a licensed clinical social worker who supports people who are using or discontinuing psychiatric medications).  I found Chris’s comments about the impact multiple medication changes (e.g. increases/decreases in dose, changes in medications) may have on the nervous system interesting; perhaps you will as well:

https://youtu.be/XYs7T3UilpA