My battle - please help

[[To...]]

Hello all,

Happy to have come across this forum. I feel like I have been lied to by the medical establishment about the consequences of benzos. 
 

I went through a very stressful period in my life about one year ago related to job loss and the loss of a business shortly thereafter. Over the course of the ensuing year I have been through multiple hospitalizations related severe depression, anxiety and SI and the gamut of medication has been thrown my way. The one constant has been Clonazepam. 
 

I have recently traveled abroad to obtain the help of medical help professionals in Italy but for those of you wondering there is not a huge difference in philosophy. Lots of pills being thrown around here too. 
 

To summarize, I have just started Paxil (5mg/d) to treat anxiety/depression. The prescribing psychiatrist believes that we can get a handle on the anxiety this way and then begin to taper the Clonazepam. Currently taking 0.25mg, 4 times per day. 
 

I am quite desperate at this point as I have turned from a thriving individual, very active and living a balanced lifestyle to someone who dedicates most of his energy managing anxiety. One of the most troubling symptoms for me is the constant drowsiness and fatigue which I am sure is related to the Clonazepam. 
 

Looking for any advice on moving off of the Clonazepam to try and get my life back in order as I fear that I won’t be able to continue to work in my profession should I continue experiencing my current symptoms. 
 

Thank you, Tony 

[[Pa...]]

Hello @[To...], welcome to BenzoBuddies,

When you say the “one constant has been Clonazepam”, do you mean you’ve taken this medication for awhile?  I’m just trying to determine if the Clonazepam was added during your hospitalizations.  And because your length of use could determine the advice you receive here.

I hope the addition of the Paxil helps you, when is your doctor suggesting tapering the Clonazepam, I hope not before you reach some stability with the new medication.  We typically suggest reducing your dose by about 5-10% every couple of weeks but using your symptoms to guide your taper is important. 

We’re glad you found us and hope we can help you, you’ve suffered some significant losses in your life recently so facing this makes it all that much worse. 

Pamster

[[To...]]

Thanks @[Pa...] 
I have tried several SSRI among which ecitalopram, mirtazapine, sertraline, fluvoxamine to little avail. 
 

Yes the Clonazepam was added during an early hospitalization in October of last year (2022). There was a period last autumn when I was taking perhaps 3-4 mg/d Clonazepam together with 1-2mg Ativan in addition to one of the SSRI mentioned above. I honestly feel like a bit of a soup has been made out of my brain. 
 

The Dr. did mention to hang tight on the Paxil before attempting to reduce the Clonazepam. 

[[Th...]]

Unfortunately doctors over prescribe Benzos.  They are designed for 2-4 weeks maximum use and are short-term 
"band aids" that do not cure any underlying condition.  They simply mask symptoms.  As you already alluded to, I would try to taper off.  Ashton recommends no more than a 10% cut every two weeks or so.  ADs can have their own WD as well?  You do what is best for you, but IMO, taking drugs that alter brain chemistry is a huge risk.  Good luck.

[[Pa...]]

31 minutes ago, [[T...] said:

Yes the Clonazepam was added during an early hospitalization in October of last year (2022)

You’ve been on the medication long enough for your body to become dependent, a slow taper once stabilized on the Paxil would be wise. 

You mention drowsiness and fatigue, fatigue is a common symptom, I never experienced it, I was too amped up.  I don’t usually see drowsiness unless a person is overmedicated, this sometimes happens when members cross over to Valium in order to taper of their short acting medication.  I wonder if its being caused by one of the other medications because I doubt you’re overmedicated after reducing your dose by so much. 

[[To...]]

It’s possible that the Paxil is creating this effect too. 

Do you think it’s a reasonable strategy to try with the Paxil to reign in anxiety to then start the taper? 
 

If I’m over medicated does it make sense to take out 0.25mg Clonazepam right away? 

[[Pa...]]

22 minutes ago, [[T...] said:

It’s possible that the Paxil is creating this effect too. 

Do you think it’s a reasonable strategy to try with the Paxil to reign in anxiety to then start the taper? 
 

If I’m over medicated does it make sense to take out 0.25mg Clonazepam right away? 

I don’t believe the Clonazepam is the cause of your drowsiness because you’ve already reduced it by so much, lets try to figure this out before discussing reducing it.

As for the Paxil, you say you haven’t had much luck with other medications so I don’t know how/if it will work for you.  I do know that many members have a difficult time with other medications, supplements and even food when dependent, tapering or recovering from benzodiazepines, our central nervous system is highly sensitized. 

I do feel that with so many medication changes recently, it would be a good idea to hold whatever you’re currently taking and hope you can become a bit more stable. These medications are a big deal, they change how our brain functions.

[[To...]]

Thanks for continuing the conversation 

I was already drowsy in the same fashion before starting the Paxil 6 days ago. 
 

I agree that my CNS is highly sensitized. My agitation level is constantly high between doses of Clonazepam. Also irritable and very low tolerance for stress of any kind. Low concentration, low mood. 
 

So fair to say that the clonazepam could be the issue here?

[[Pa...]]

Everything else sounds like the clonazepam, so it will be interesting to know if the drowsiness dissipates when you begin to reduce.  Are you going to continue the Paxil?

[[To...]]

I have no idea whether it is a good idea to continue with the Paxil. As you mentioned it seems that SSRI have not really been the ticket for me. 
 

The anxiety is really unbearable and I don’t know where to attribute the symptoms. 

[[Pa...]]

@[To...], I typically blame the benzo’s but I don’t know what the side effects of Paxil are, you might want to do a search of the platform to see what others have had to say.

How many times a day are you dosing, are you feeling symptoms before your next dose?  

Most members develop tools they use for symptoms, I found distraction helpful.  Of course, nothing can totally distract us from our symptoms but it can help give us some moments of relief. 

[[Hi...]]

@[To...]

Most of the "old" SSRIs you tried also have anxiety-reducing properties. What if you asked your doctor about an SNRI? They are a bit more activating. 

Paxil can cause drowsiness, brain fog and fatigue. It has strong antihistamine properties.

Maybe some of the earlier meds would be better in a low dose? ADs you know already? Talk to your doctor. It takes up to one month for an AD to take effect and some people do well on minimum doses. 

Your pdoc is absolutely right. Don't quit the AD before the benzo. These side effects you experience are from both paroxetine (Paxil) and clonazepam combined. You may ask your pdoc to switch you to a less sedating AD.

But clonazepam alone won't cure your anxiety. Especially in the absence of an AD. It will exacerbate it in the most cruel way. And it will deepen your depression.

There are also mood stabilizers, tricyclic ADs and some less addictive anti-anxiety meds as add-ons. But you say you suffer from depression, along with anxiety. Yes, life circumstances most often make us dependent on meds.

The classic case are US Vietnam War veterans, who just quit heroin upon returning home. Cause their circumstances changed for the better, and there was no pain to numb anymore. They returned to their families and normal lives. The heroin stayed in Vietnam, the land of terror. This was the case for a majority of them. 

Edited September 19, 2023 by [Hi...]

[[Hu...]]

I do agree with your Dr that you should stabilise on your medication before you reduce your clonazepam. You don't want to be dealing with multiple things going on at once, not knowing what is what, what is causing what. Stabilise, then reassess would be my advice for what its worth.

I'm sorry for your pain mate. I understand you, I promise.

[[An...]]

On 13/09/2023 at 08:19, [[T...] said:

Thanks @[Pa...] 
I have tried several SSRI among which ecitalopram, mirtazapine, sertraline, fluvoxamine to little avail. 
 

Yes the Clonazepam was added during an early hospitalization in October of last year (2022). There was a period last autumn when I was taking perhaps 3-4 mg/d Clonazepam together with 1-2mg Ativan in addition to one of the SSRI mentioned above. I honestly feel like a bit of a soup has been made out of my brain. 
 

The Dr. did mention to hang tight on the Paxil before attempting to reduce the Clonazepam. 

@[To...] Welcome to BB friend. When you started the Clonazepam, how much did they start you on? I only took .5 mgs of K for almost 11 years when I was on it before I became completely tolerant. In hindsight, I think work stress was the primary catalyst that caused the drug to stop working. I never slowly became tolerant and I had to gradually increase the dose over time. One day, the drug simply decided it did not want to work anymore in my brain no matter what the dose was.

 

Now, I am trying to eliminate as much stress in my life as possible.

[[Bl...]]

On 13/09/2023 at 09:25, [[T...] said:

Thanks for continuing the conversation 

I was already drowsy in the same fashion before starting the Paxil 6 days ago. 
 

I agree that my CNS is highly sensitized. My agitation level is constantly high between doses of Clonazepam. Also irritable and very low tolerance for stress of any kind. Low concentration, low mood. 
 

So fair to say that the clonazepam could be the issue here?

@[To...] I have felt fatigued/drowsy off and on during this recovery process. Early in my recovery period I would even fall asleep sitting up. It was like having narcolepsy. There was no controlling it. I unhesitatingly attribute this issue/smptom to what benzos did to my brain. 

It sounds like you may have tapered clonazepam/ativan too fast and, as a consequence are dealing with more intense inter-dose w/d than had it been a slower taper.

Even so, you still may be able to begin tapering again/now, but at a snails pace. In my case, I gradually shaved off a minute amount from the pills and would then hold for a significant amount of time before shaving off that same amount for the next decrease.

These are just suggestions, since only you can be the one to decide how you will proceed. It's not a fun process...but definitely a rewarding one. I hope for the best with whatever you decide on.

[[An...]]

I have been sick since cold Turkey April 2023 I have nausea headaches vision very bad and now gastroparesis and esophageal swallowing issues all thanks to benzos - I’m damaged it’s been 7 months and never had a good day anyone else have this

im fighting to survive I’m so sad 

need comfort stories please 

[[Th...]]

Please take the time to read the Success Stories.  Find a favorite or two and keep reading them whenever you feel hopeless.

[[To...]]

Hi all,

wanted to check in with an update. I have continued taking the Paxil (up to 10mg/d now though) 

After suffering extreme withdrawal symptoms such as uncontrollable restlessness and intense intrusive thoughts and memories there was a morning where I simply took 2,5mg of Clonazepam to get through the day (previously taking 0,25mg 4x per day). I ended up seeing a psychiatrist in the emergency room that day and he has told me to maintain the 2,5mg if that “limits my suffering”. He also added lyrica (pregabalin) 25mg 3x per day. 
 

Flash forward a few days where I had to take a long overseas flight - I was a mess. I ended up taking 5mg on the plane to manage symptoms and not disrupt the whole flight. Truthfully, I felt as though it did not give me much benefit - suspecting my tolerance is quite high now. Upon arriving home my symptoms continued to escalate.  
 

When I could not bear the intense psychological pain and restlessness further I took 10mg of Ativan and was able to sleep for about 7 hours. After having taken that “large” dose, I feel much “better” and under control today. Does not all this point to severe withdrawal? 
 

Finally, I was in my psychiatrists office today and upon hearing of the above he decided to get me on a taper. His strategy does not match the Ashton manual strictly but rather he has proposed we switch to a single dose (30mg) of diazepam at night (rough equivalent to 10mg lorazepam) and then begin to taper from there. 
 

Does this seem like a reasonable approach? Appreciate all feedback as daily functioning with the symptoms described is next to impossible. Thanks.

 

[Guest [...]]

7 hours ago, [[T...] said:

When I could not bear the intense psychological pain and restlessness further I took 10mg of Ativan and was able to sleep for about 7 hours. After having taken that “large” dose, I feel much “better” and under control today. Does not all this point to severe withdrawal? 
 

Finally, I was in my psychiatrists office today and upon hearing of the above he decided to get me on a taper. His strategy does not match the Ashton manual strictly but rather he has proposed we switch to a single dose (30mg) of diazepam at night (rough equivalent to 10mg lorazepam) and then begin to taper from there. 
 

Hi @[To...]

I’m very sorry to hear you have found yourself in this situation. 

Personally, I believe it’s clearly benzodiazepines/tolerance causing your symptoms. 

It seems the clonazepam is having little to no affect on your symptoms, so, possibly your doctors proposal to cross to diazepam, stabilise, then taper, is quite a valid option, although, a slow crossover is always advised, rather than a direct switch. It’s often not as easy as just swapping from one benzodiazepine to another simply because they are both benzodiazepines. They are still different medications with different actions. The slow crossover is to avoid (as much as possible) the underlying withdrawal from the medication you are crossing from. Diazepam also has a very long half life and takes considerably longer to build up/increase your blood serum levels. While Clonazepam has a reasonably long half life (not as long as diazepam), Lorazepam is a very short half life benzodiazepine, meaning it leaves your system very quickly. If you switch from a short half life benzo, to a long half life benzo, the long half life benzo cannot provide relief from the the quick onset of withdrawal from the short half life benzo leaving your body, because blood serum levels take so long to build up with the long half life benzo. There’s a very legitimate reason for the slow crossover. 

1mg Lorazepam is the equivalent of 8mg diazepam, and 10mg Lorazepam is the equivalent of 75mg diazepam. You can calculate this yourself at the below link. 

https://clincalc.com/Benzodiazepine/
 

You have quite an inconsistent dosing schedule, so I think you really need to figure out what a therapeutic daily dose of your current medication would be for you, based on the past couple of months. 

Although the above equivalencies are considerably higher than you doctor has informed you, I would definitely be hesitant crossing to such a high dose (75mg), but you do want to make sure when crossing over that you are somewhere in the ball park of your right dose. 

 

[[To...]]

Still on 30mg and the constant / restlessness persists. 
Perhaps worse are the psychological effects. Mind racing constantly, guilt, shame, depression - don’t know what to call it anymore. 
2 questions: 
Has anyone heard of depression being induced by benzos or worsening it?

Has anyone experimented with GABA as a supplement? 

[[Pa...]]

7 hours ago, [[T...] said:

Has anyone experimented with GABA as a supplement? 

A good place to discuss supplements is the Alternative Treatments Group, just click on Join and ask your questions. https://benzobuddies.org/forum/138-topics/

One of the most common symptoms we experience is depression caused by benzodiazepines or depression made worse.  Valium more than some of the other benzodiazepines has been known to cause depression. 

It sounds like you’re also dealing with intrusive thoughts, they’re also common and very destructive. 

Is there a reason you haven’t begun your taper yet?

[[To...]]

@[Pa...]Having intense anxiety all day long. Anytime trying to taper. Anxiety persists even when holding the current dose. 

Has anyone ever heard of the Verona detox method using flumazenil? Thanks. 

[[Pa...]]

@[To...], you can use the search function to find many threads about flumazenil, I don’t have experience so can’t comment.

It’s clear the medication is hurting you, the anxiety it causes is so much worse than normal anxiety.  I hope you can find a way off of it so you will feel better. 

[[Th...]]

I did the Flumazenil treatment at the Coleman Institute in Richmond, VA many years ago.  Dr. Coleman has since retired.  It did not work immediately, but it may have reduced the length of my withdrawal along with my symptom intensity, but I have no way of knowing that for sure.  Good luck.

[[To...]]

Hi @[Pa...] @[Th...]

Have been seeing an addictions specialist for several weeks now and he is proposing the idea of taking pregabalin potentially up to 150mg TID to aid in benzo withdrawal. Haven’t started yet. The concept is I should start sleeping better, feel less anxiety thus making the taper more tolerable. The Valium taper (at 40mg now) would proceed more or less according to Ashton (as proposed by me) but the pregab should help put the brakes on the debilitating anxiety. He put the odds at 50 or 60 % chance of getting off the benzo this versus only 10% trying a straight taper. I am not functioning well at all mentally and need input/help from whom ever is willing to give. Health deteriorating fast, career and house on the line. Has anyone had success with this approach. Please help.