Clonazepam advice

[[Al...]]

Thank you @[je...] and @[Co...]

As mentioned at the start of this thread, my case is a little complicated in that I originally started taking clonazepam to treat insomnia and inner restlessness resulting from an adverse reaction to an increase in my Prozac dose. Those symptoms seemed to be largely under control at 0.5 mg, but after dropping down to 0.375 mg, I can feel them coming back and they are very unpleasant. I'm not sure what to do now and am starting to feel quite frightened.

[[je...]]

I can understand these symptoms can be scary. Instead of thinking about these symptoms as "oh no, look at what is happening to me", rather observe it and acknowledge it for what it is - your brain recovering and adjusting to the new dose. It is uncomfortable, it is unwanted, but it cannot harm you. I was sleeping 8hrs a night before touching a benzo. Then while on Clonazepam I started having sleeping problems. I suspect I was having/going into tolerance withdrawal. When I started my taper I was averaging 1-3hrs a night. This has continued for 3 years. Was is nice? Absolutely not. Did I die? No I didn't. Was I functional? Yes, I was able to work, take care of my family and kids and participate in life. Did I enjoy these activities and feel like a normal human being? No, I didn't. But you know what, it could've been so much worse - at least I was not bedridden. My children will remember I was present at all their events. I was able to look after them, drive them to play dates, and take care of them.  Now I am recovering. The past 2 months I am starting to get 3-5 hours of sleep. 

Withdrawal will be unpleasant. I felt like !@#$# all of the time.  I felt like I should be in bed because my body felt physically sick. There were lots of weekends I spent my days on the couch when we had nothing planned, because that's all I wanted to do. It is unlikely you'll be able to taper symptom-free. The goal is to keep you functional. Functional doesn't mean you are feeling great or good, but you are able to do what is expected of you on a daily basis. Benzo's do not treat the core problem, it is symptomatic relief. It is a short term answer for those symptoms. The moment you remove the benzo, those symptoms will very likely return. My pre-existing condition for which Clonazepam was prescribed, has returned. Now I have to deal with that pain, together with a myriad of other symptoms caused by the Clonazepam as well.

In monitoring your symptoms you have to assess whether or not you are functional. It will probably be good to stay on this dose for the next week or two to see how you react. And it is really important to track your symptoms on a daily basis. I understand how scary it can be when we encounter symptoms we are unfamiliar with. Unfortunately those of us who end up here at BB can't go through this process without experiencing some uncomfortable symptoms. We just have to manage the intensity of those symptoms. And I promise you, when tapering becomes part of your daily routine, it becomes easier to accept your new reality. You learn to adjust to these symptoms and you learn how to optimise and work around it so you can still participate in life. 

[[Al...]]

@[je...]

Thanks, I plan to stay on this dose a little longer to see how I react. The problem I have is that the adverse reaction to Prozac triggered very uncomfortable inner restlessness which made it so hard to continue functioning that I have had to take medical leave from work. I was then prescribed Clonazepam to deal with the restlessness. I know this was a bad idea as it only covers up the symptoms, but it's hard to know what else to do about the restlessness which can feel unbearable at times.

Edited May 26 by [Al...]

[[je...]]

If I understand correctly you have been on this increased dose of Prozac for over 3 months now and you haven't lowered the dose right? If this is the case then you might want to consider going down in Prozac again and whether it's worth it to stay at this dose if it renders you non-functional. 

It is a bit difficult to understand your symptoms when your initial description is "unpleasant". There's quite a big difference between unpleasant and unbearable. The difference being functional. You are the only person that fully knows the extent of what you are going through and the intensity of your symptoms. I am only going by what and how you describe it to me. And I'm not upset or annoyed, I'm just explaining to you what it is like on the other side, trying to give advice.  I also understand when you're going through withdrawal and when you're scared, it's not easy to always express how you are feeling. 

If you feel you need the Clonazepam to keep you functional right now and you need to increase the dose, then there's nothing wrong with that. Ultimately you are the person dealing with the symptoms. But I don't think these symptoms are necessarily caused by the Clonazepam. There is a very real chance it could be caused by the Prozac. Then you need to consider how you would like to proceed if this is indeed the case. 

[[Al...]]

@[je...]

Thank you. I really appreciate you taking the time and effort to give me advice and I'm sorry not to have made myself clearer. I increased the Prozac dose about 3 months ago to 30 mg, and have since reduced the dose to 20 mg (it has been reduced for about 2 months now). The original symptoms of restlessness and insomnia were almost definitely caused by the increase in Prozac dose, but because they were so bad I took Clonazepam to make them more bearable. In hindsight, I wish I hadn't done this because I am now dependent on the Clonazepam and feel much worse than I did at the start. I want to get off the Clonazepam, but when I tried to taper the dose, the original symptoms from the Prozac (which were eased by the Clonazepam but never truly resolved) started to feel unbearable again. To be honest, it feels like my life has been ruined by the drugs. At the end of last year I was fully functional, working full time, exercising regularly, engaged in my hobbies and family life. The only issue was that my OCD was playing up, so I tried to make a very small increase in my Prozac dose from 28 mg (20 mg capsule + 8 mg liquid) to 30 mg (20 mg + 10 mg capsule). Three weeks after that the restlessness and insomnia hit and I haven't been the same since. I wish with all my heart that I hadn't tried to raise the Prozac dose and I wish with all my heart that I hadn't resorted to Clonazepam when things went wrong. You and everyone else on the site have been so kind to me and I really appreciate that. I just feel trapped and don't know what to do. I also feel so sorry for my wife, parents and brothers who desperately want me to get better and don't understand what is going on.

[[je...]]

You have nothing to apologise for. We’re all trying our best in withdrawal. It’s really devastating what can happen to us and most of the time we have no idea what the impact of these meds could be.

 The way I see it you have two options:

1) You can attempt a faster taper off Clonazepam due to short term use and try to see if you can manage the symptoms.

2) You can focus on quality of life and accept that this is likely going to be a much longer process. 

I’m still not sure if I’m correctly interpreting the intensity of your symptoms but it sounds like you’re really struggling. It might be worthwhile to consider option 2?

[[En...]]

On 27/05/2024 at 17:45, [[A...] said:

@[je...]

Thank you. I really appreciate you taking the time and effort to give me advice and I'm sorry not to have made myself clearer. I increased the Prozac dose about 3 months ago to 30 mg, and have since reduced the dose to 20 mg (it has been reduced for about 2 months now). The original symptoms of restlessness and insomnia were almost definitely caused by the increase in Prozac dose, but because they were so bad I took Clonazepam to make them more bearable. In hindsight, I wish I hadn't done this because I am now dependent on the Clonazepam and feel much worse than I did at the start. I want to get off the Clonazepam, but when I tried to taper the dose, the original symptoms from the Prozac (which were eased by the Clonazepam but never truly resolved) started to feel unbearable again. To be honest, it feels like my life has been ruined by the drugs. At the end of last year I was fully functional, working full time, exercising regularly, engaged in my hobbies and family life. The only issue was that my OCD was playing up, so I tried to make a very small increase in my Prozac dose from 28 mg (20 mg capsule + 8 mg liquid) to 30 mg (20 mg + 10 mg capsule). Three weeks after that the restlessness and insomnia hit and I haven't been the same since. I wish with all my heart that I hadn't tried to raise the Prozac dose and I wish with all my heart that I hadn't resorted to Clonazepam when things went wrong. You and everyone else on the site have been so kind to me and I really appreciate that. I just feel trapped and don't know what to do. I also feel so sorry for my wife, parents and brothers who desperately want me to get better and don't understand what is going on.

I find Clonazepam takes much more from us than it offers. I am also struggling with Clonazepam and am also on Prozac. Luckily I took a DNA test for drug metabolism and found Prozac was a drug that I was compatible with. I tried Zoloft and side effects were horrible. I tried Imipramine and almost went insane. It wasn't until I got the gene test that I found my antidepressant that works for me. 

The clonazepam is horrible. It has taken at least a year so far of my life away. I had to go on disability from work and my personal life has suffered as well. I sometimes also think  back to if I just didnt take the lorazpam when I was in a bad place maybe this all would have been a different story. Unfortunately I cannot go back in time and can only deal with the hand I have been dealt. We learn from our mistakes. I accept where my life is at right  now and am trying to make sense of it. I spent many an hour educating myself on this drug. I have explained to my wife and kids what is going on with my brain but no one knows what you are going through but you. Acceptance and management is your ally. Dont concentrate on the mistakes of yesterday and look to today for resolution. 

[[Al...]]

On 30/05/2024 at 00:37, [[E...] said:

I find Clonazepam takes much more from us than it offers. I am also struggling with Clonazepam and am also on Prozac. Luckily I took a DNA test for drug metabolism and found Prozac was a drug that I was compatible with. I tried Zoloft and side effects were horrible. I tried Imipramine and almost went insane. It wasn't until I got the gene test that I found my antidepressant that works for me. 

The clonazepam is horrible. It has taken at least a year so far of my life away. I had to go on disability from work and my personal life has suffered as well. I sometimes also think  back to if I just didnt take the lorazpam when I was in a bad place maybe this all would have been a different story. Unfortunately I cannot go back in time and can only deal with the hand I have been dealt. We learn from our mistakes. I accept where my life is at right  now and am trying to make sense of it. I spent many an hour educating myself on this drug. I have explained to my wife and kids what is going on with my brain but no one knows what you are going through but you. Acceptance and management is your ally. Dont concentrate on the mistakes of yesterday and look to today for resolution. 

Hi @[En...]

Thank you for your kind words. If you're stable on Prozac that's great, but please be very careful if you ever need to stop taking it for any reason or make any changes to your dose. That's what first got me into trouble.

[[Al...]]

Hi @[je...]

Reading through some posts I see that some people crossover to valium from clonazepam when tapering.  Do you think that is something I should consider? I know that valium has a longer half life and is easier to taper due to the greater mg value, but are there any other pros or cons to consider?

 

[[Co...]]

2 hours ago, [[A...] said:

Hi @[je...]

Reading through some posts I see that some people crossover to valium from clonazepam when tapering.  Do you think that is something I should consider? I know that valium has a longer half life and is easier to taper due to the greater mg value, but are there any other pros or cons to consider?

Hi @[Al...]

I generally suggest that members make no unnecessary changes to their medication. If your dosing regimen is working, don't change it.* And if the medication you are taking is working, don't change that.

Every change we make carries a certain (undefinable) risk. Changing the medication includes certain risks, so if the change is not required, don't make it.

Sometimes, the benzodiazepine we use becomes unsuitable or less suitable. That's when when you might/should consider your options.

For the most part, a gradual swap to another benzodiazepine causes no great difficulties. And as you suggest, some people benefit from diazepam's longer half-life. But a small number of people do not react well to diazepam, so why take the risk unless there is an obvious benefit from the change?

* I refer to the schedule, not the precise doses. Of course, if you wish to quit benzodiazepines, you will necessary need to make changes to the dose.

[[je...]]

As Colin said, generally we don’t recommend crossovers unless there’s a really good reason such as struggling with interdose withdrawal.

[[Al...]]

Hi @[je...]

At the moment, I'm dosing 0.25 mg in the morning and 0.25 mg in the evening. If I wanted to try switching the entire dose to the evening, would I need to do that gradually? Also, all other things being equal, is it preferable to dose once a day or twice a day with Clonazepam?

[[Co...]]

On 18/06/2024 at 10:10, [[A...] said:

Hi @[je...]

At the moment, I'm dosing 0.25 mg in the morning and 0.25 mg in the evening. If I wanted to try switching the entire dose to the evening, would I need to do that gradually? Also, all other things being equal, is it preferable to dose once a day or twice a day with Clonazepam?

Hi @[Al...]

I'd say, all things being equal, do not change your dosing regimen unless you feel there is need to do so. Why are considering switching to once-a-day doing?

I will add that, generally specking, people tend to do better taking multiple doses per day. Again, this is a generalisation. For someone who suffers from insomnia, they might benefit from concentrating their dose in the evening. Or, for someone who suffers from morning anxiety, they might prefer to concentrate their dose then.

How are you dividing your pills? Depending upon your method, this might be another consideration.

[[je...]]

My question is the same. Why do you want to combine your doses?

[[Al...]]

Hi @[Co...] and @[je...]

I was considering combining the doses because I get side effects like dizziness when metabolizing the medication. I thought that might be easier to handle in the evening, but I don't know because the side effects are likely to be stronger if I take only one dose. I also take an AD in the morning, so I thought separating the AD and the benzo might be wise. If I was to experiment with a single dose in the evening, is it okay to just switch directly to single dosing?

[[je...]]

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

because I get side effects like dizziness when metabolizing the medication

I’m not sure what this means. How do you know the symptoms are related to metabolising the med and not withdrawal related?

[[Al...]]

9 minutes ago, [[j...] said:

I’m not sure what this means. How do you know the symptoms are related to metabolising the med and not withdrawal related?

Just the timing. They always seem to occur soon after taking the med and then ease off after a couple of hours.

[[je...]]

On 23/05/2024 at 11:40, [[A...] said:

I'm currently dosing three times a day

When and how did you change your dosing to twice daily? Did you feel a difference when you made that change? It will be very helpful if you can update your history.

[[Al...]]

38 minutes ago, [[j...] said:

When and how did you change your dosing to twice daily?

 

I changed about two weeks ago by cutting out the afternoon dose and increasing the morning and evening doses to compensate. 

39 minutes ago, [[j...] said:

 Did you feel a difference when you made that change?

I think the immediate side effects increased a little, which is why I'm in two minds about switching to single dosing and risking the side effects increasing again. The reason I'm still considering the change is that I think it might be easier to deal with the side effects once a day in the evening before going to bed. I also think it might be safer to separate my benzo from my AD dose (which I take in the morning).

41 minutes ago, [[j...] said:

It will be very helpful if you can update your history.

Updated!

 

[[je...]]

Your history needs to contain all the information related to your medical history, taper and changes you made. Please look at mine to get an idea of what we’re looking for. I have to continuously go back and read this thread to remember your medical history as I’m working with many members. It’s much easier if I can quickly access a detailed summary of your history. 

If you can summarise your Prozac and Clonazepam use and changes by date without using sentences just 2-3 words that would greatly help to get an overall picture of what has been happening to you. Thanks!
 

 

[[Al...]]

Hi @[je...]

I updated my history. Hopefully it is clearer now. Please let me know if I need to make any other changes.

[[je...]]

Thanks! Now getting back to your question:

23 hours ago, [[A...] said:

The reason I'm still considering the change is that I think it might be easier to deal with the side effects once a day in the evening before going to bed. I also think it might be safer to separate my benzo from my AD dose (which I take in the morning)

I wouldn't make any changes yet, because your last change was 10 days ago. I think you need to give your body some time to adjust. Making too many changes too quick is not advised.

If combining doses is something you are really keen to explore, rather than moving the entire dose, how about moving some of the dose to the evening and see how that goes? This way you can test the waters but still keep a buffer for the morning in case it doesn't work. 

[[Al...]]

Thanks @[je...]

That sounds like a good plan!

[[Al...]]

@[je...]

I haven't made any changes to my dosing schedule yet, but I have developed this very distressing symptom of chest tightness and air hunger. It feels like my body isn't getting enough oxygen even when I'm resting. What do you think this means and is there anything I can do about it? It's a really uncomfortable feeling, the worst symptom I have experienced so far.

[[je...]]

When did this symptom start? Do you feel it all day long or is it more intense at certain times?