Small dose of Clonazepam for life?

[[Mi...]]

I was prescribed 0.125 clonazepam eleven years ago for insomnia.  I have tried to quit four times and I realize I was tapering too fast.  I take cymbalta and I’ve tried other antidepressants.  This one seems to work best.  My main complaint on the medication is that ever since I’ve taken it, I’ve needed a mid day nap.  My psychiatrist (not happy about this) agreed 2 years ago to switch me to Xanax and a small dose of trazadone.  In the hopes that the short half life of Xanax would cure my daytime fatigue and the trazadone would provide me with a better quality sleep.  I now realize this was a huge mistake.  After months of seeing doctors - I realized I had inter dose withdrawal.  At the end I could barely eat or sleep.  So I switched back to a higher dose of clonazepam and trazadone than I’ve ever taken. This was DEVASTATING to me.  I am now on 0.75 clonazepam, 50mg Trazadone and 60 cymbalta.  Believe me - I am all for being medication free.  But I have two kids to continue raising (4 and 11); and it seems to me that some people still struggle mentally years after completing a taper. I’ve read two books where the author decided to cut and hold on a very small dose.  I’m wondering if this is best for me? My plan is to get trazadone down to 25 or 12.5 (whichever dose still helps with sleep); and then do the slowest taper ever heard of for the 0.75 clonazepam.  I’m talking .01 every two weeks.  It is impossible for me to experience withdrawals and keep up with my busy family.  Also I’ve tried this four times now and I can’t put my family through more instability.  Maybe in the end I can be on 60 cymbalta, 25 trazadone and .06 clonazepam? I also know so many people just think you should get off all meds - I’ve dealt with depression and anxiety my whole life - I’ve seen it ruin lives in my family for those that chose not to be medicated - so I feel staying on an antidepressant is the best choice for me.  May I ask a favor? Would you please be very kind in your comments? It has taken me years to work up the courage to post something here.  I haven’t read much on the site because the horror stories are so upsetting to me.  On the flip side - I WISH I would have read more on this site - because I would have known what a stupid mistake it was to switch to Xanax.  TIA for any help you can offer.  

[[Bu...]]

Hello @[Mi...],

Welcome to Benzobuddies.  We are not anti-medication, anti-doctor or anti-psychiatry here.  We also understand that everyone has a unique situation that needs to be taken into account when deciding the best course of action.  

If I read correctly, you are considering tapering both the trazadone and the Clonazepam.  We recommend only doing one at a time, so that it is less confusing as to what to do if/when withdrawal symptoms arise.  You can absolutely do a slow, symptom-lead, microtaper to reach your goals.

Do you have an idea of which one you would like to taper first?  And is your doctor aware of your goals yet?

We are so glad you're here and we will do our best to support you.

[[Re...]]

1 hour ago, [[M...] said:

I was prescribed 0.125 clonazepam eleven years ago for insomnia.  I have tried to quit four times and I realize I was tapering too fast.  I take cymbalta and I’ve tried other antidepressants.  This one seems to work best.  My main complaint on the medication is that ever since I’ve taken it, I’ve needed a mid day nap.  My psychiatrist (not happy about this) agreed 2 years ago to switch me to Xanax and a small dose of trazadone.  In the hopes that the short half life of Xanax would cure my daytime fatigue and the trazadone would provide me with a better quality sleep.  I now realize this was a huge mistake.  After months of seeing doctors - I realized I had inter dose withdrawal.  At the end I could barely eat or sleep.  So I switched back to a higher dose of clonazepam and trazadone than I’ve ever taken. This was DEVASTATING to me.  I am now on 0.75 clonazepam, 50mg Trazadone and 60 cymbalta.  Believe me - I am all for being medication free.  But I have two kids to continue raising (4 and 11); and it seems to me that some people still struggle mentally years after completing a taper. I’ve read two books where the author decided to cut and hold on a very small dose.  I’m wondering if this is best for me? My plan is to get trazadone down to 25 or 12.5 (whichever dose still helps with sleep); and then do the slowest taper ever heard of for the 0.75 clonazepam.  I’m talking .01 every two weeks.  It is impossible for me to experience withdrawals and keep up with my busy family.  Also I’ve tried this four times now and I can’t put my family through more instability.  Maybe in the end I can be on 60 cymbalta, 25 trazadone and .06 clonazepam? I also know so many people just think you should get off all meds - I’ve dealt with depression and anxiety my whole life - I’ve seen it ruin lives in my family for those that chose not to be medicated - so I feel staying on an antidepressant is the best choice for me.  May I ask a favor? Would you please be very kind in your comments? It has taken me years to work up the courage to post something here.  I haven’t read much on the site because the horror stories are so upsetting to me.  On the flip side - I WISH I would have read more on this site - because I would have known what a stupid mistake it was to switch to Xanax.  TIA for any help you can offer.  

Welcome to BB. If you are interested in how to safely discontinue psychiatric drugs, you may find Dr. Mark Horowitz's book, 'Maudsley Deprescribing Guidelines' helpful. Dr. Horowitz is a renowned deprescribing expert based in the UK. The book was published this year and is available on Amazon.

[[Mi...]]

9 hours ago, [[B...] said:

Hello @[Mi...],

Welcome to Benzobuddies.  We are not anti-medication, anti-doctor or anti-psychiatry here.  We also understand that everyone has a unique situation that needs to be taken into account when deciding the best course of action.  

If I read correctly, you are considering tapering both the trazadone and the Clonazepam.  We recommend only doing one at a time, so that it is less confusing as to what to do if/when withdrawal symptoms arise.  You can absolutely do a slow, symptom-lead, microtaper to reach your goals.

Do you have an idea of which one you would like to taper first?  And is your doctor aware of your goals yet?

We are so glad you're here and we will do our best to support you.

Thanks so much for your kind response and support.  Yes - I would plan to taper down the trazadone first.  The cymbalta interferes with my sleep yet after 11 years of trying different antidepressants - it seems to be the best one for me.  However - I am sensitive to medication - so I thought perhaps 25mg or 12.5 mg of trazadone might work for me for sleep.  Then I would tackle the 0.75 mg of clonazepam.  I am suspicious all these years - the benzo “for sleep” as it was initially prescribed - probably stopped working at some point, and contributed to my daytime fatigue.  So that’s why I’m thinking I need to stay on a small dose of trazadone.  Then my plan is to do basically a micro taper cut and hold - like .01 mg every two weeks - because I need to experience as few withdrawals as possible to function with my small kids :-) thank you again. 

[[Mi...]]

8 hours ago, [[R...] said:

Welcome to BB. If you are interested in how to safely discontinue psychiatric drugs, you may find Dr. Mark Horowitz's book, 'Maudsley Deprescribing Guidelines' helpful. Dr. Horowitz is a renowned deprescribing expert based in the UK. The book was published this year and is available on Amazon.

Thank you Rebecca29 - yes - I have the book.  I’m still scared to completely get off clonazepam after the scary stories I have heard.  I also have a close relative (who I’m sure I take after) that gets paralyzing, debilitating anxiety that has affected him his whole life.  He will go on medication - everything will clear up - then he will get off - and then it happens all of over again a year or two later.  I’m scared I genetically take after this person and I’m wondering if staying on a super low dose for life would be like an insurance policy for me.  On the other side I would love to have my old energy back and be able to get through a day without needing a nap. 

[[Bu...]]

@[Mi...],

It sounds like you've got a good plan in place.  Keep in mind that you can hold your doses as long as needed to feel stable.  I'm sure you know this, but I figured it was worth mentioning.  

I would like to offer a bit of perspective regarding clonazepam, as I took it for 20 years total.  I was on it for 7 years ,then about 9 months off, and then on again for 13 years.  I never upped my dose nor took more than prescribed (.25 mg twice a day).  It did quit working for me and then ended up causing some health issues.  (I have been off for 7ish months and those issues are slowly fading.)  As you may know, these are some of the potential problems with benzos.  They can negatively impact our health in the long term and they may quit working all together.  That said, this doesn't happen to everyone, but I wanted you to have the information. 

I also understand the worry about what we may be genetically predisposed to and who we may take after.  My parents and my siblings all struggle with anxiety disorders and my father has severe depression.  I am the only one, however, who has been through talk therapy and CBT, and it has made a world of difference.  I just thought I'd throw that out there as an option.  Ultimately, whatever meds you choose to stay on , it could help tremendously.

I hope I haven't overwhelmed you or upset you.  These are just some things that I wish someone had told me 13 years ago, so that I could have made a more informed decision. 

[[Re...]]

5 hours ago, [[M...] said:

Thank you Rebecca29 - yes - I have the book.  I’m still scared to completely get off clonazepam after the scary stories I have heard.  I also have a close relative (who I’m sure I take after) that gets paralyzing, debilitating anxiety that has affected him his whole life.  He will go on medication - everything will clear up - then he will get off - and then it happens all of over again a year or two later.  I’m scared I genetically take after this person and I’m wondering if staying on a super low dose for life would be like an insurance policy for me.  On the other side I would love to have my old energy back and be able to get through a day without needing a nap. 

@[Mi...] My two cents on this: I don't believe that comparing genetics with another relative with no hard data is a beneficial approach. Making decisions based on fear can lead to fear-based outcomes in life. Instead, you could come from an empowered perspective and give yourself the informed consent that we all should have been provided with by our doctors.

You can conduct a cost/benefit analysis of staying on a drug like this and decide if you are willing to take the risks for the potential benefits. Also, consider the likelihood of developing tolerance and needing increased doses over time, as this is a known factor in long-term use. You can thoroughly read the FDA black box warnings and speak with leading drug harm experts to consider the many symptoms these drugs can cause over time, and decide if it is worth dealing with to address anxiety. You need to know all the facts to make an informed decision, even if they scare you. Your health is the most precious gift in your life.

I found that anxiety was easy compared to what I experienced becoming tolerant to Ativan. I then suffered an adverse reaction to an antipsychotic that I was given due to the Ativan symptoms. I wish I had learned to tolerate what felt intolerable when I took the Ativan to begin with because compared to what I have been through, it was NOTHING and I would have never taken these drugs. I told my doctor I did not want to and he assured me they were perfectly safe which is not true. Nothing is risk-free when it comes to psych drugs.

Fortunately, there are many effective non-drug ways to cope with anxiety these days. A study concluded that mindfulness is equally as effective as an antidepressant. You can try dietary changes as they are foundational for health issues across the board. Etc., etc., etc. The list goes on.

 

 

 

[[Mi...]]

Thanks so much everyone - basically what I was thinking was holding indefinitely at a very small dose of clonazepam - perhaps 0.06 mg - not to get much benefit at all from it - but so that I don’t get “dopesick”.  If I do an extremely slow taper and handle that ok - and I’m on cymbalta 60mg for depression and anxiety and 25mg trazadone for sleep - my thinking is basically the .06mg clonazepam could just keep me stable.  Hate to say it but sort of like how opioid users use methadone.  Considering my kids are young - I just don’t want to risk “jumping off” as I think I’ve been scared too much by everyone’s stories. Not to mention what I have experienced the four times I have tried to quit.  Each time I only lasted a few days.  It was not compatible with being a mom of young kids.  I also hear stories about prominent benzo advocates that end up “losing their battle” - even after successful slow tapers - and this also makes me question if “indefinite holds” might be an ok choice.  My psychiatrist thinks this will work - but ha ha - naturally I don’t trust her at all anymore (sorry just have to laugh about how crazy all this is).  Anyway - I appreciate the kind and supportive comments so much - If you have anything to add I am all ears.  :-) 

[[Bu...]]

@[Mi...],

I hear you.  Sometimes we have to make the best decision that we can for the situations we are currently in.  There's nothing wrong with that.  And since you are wanting to taper the trazadone first, the rest can wait a bit anyway.

Has your physiatrist suggested medications other than a benzo to treat your anxiety?  My doctor had suggested other options to me if I felt that I needed something.

Keep in mind that nothing is written in stone.  One of the things I've learned from this journey is the value of reevaluating my situation and my resources fairly often.