Benzodiazepines such as Klonopin are usually very effective in easing anxiety. Their perceived downside is that patients will become dependent on them when they are taken long-term. However, antidepressants aren't necessarily any better in that regard.
"Even after short-term use of clonazepam, there is evidence of physiological dependence and consequent adverse withdrawal symptoms. Abrupt discontinuation of benzodiazepine therapy has been reported to cause withdrawal symptoms including irritability, nervousness, and insomnia. Benzodiazepine withdrawal is more likely to occur following abrupt cessation of excessive or prolonged doses, but it can occur following the discontinuance of therapeutic doses that have been administered for as few as 1?2 weeks. Abdominal cramps, confusion, depression, perceptual disturbances, sweating, nausea/vomiting, paresthesias, photophobia, hyperacusis, tachycardia, and trembling also occur during benzodiazepine withdrawal, but these reactions are less frequent. Convulsions, hallucinations, delirium, and paranoia also can occur. Benzodiazepines should be withdrawn cautiously and gradually, using a very gradual dosage-tapering schedule."
CBT is a multifaceted therapy that teaches you how to handle anxious thoughts. This site has a good explanation:
It is true that you may become physiological dependent on benzodiazepines (and antidepressants). The body adapts to the presence of the drug and it takes time for it to readjust if the drug is withdrawn. There are many medications that cause such dependence to varying degrees, including antibiotics, some blood pressure medications, even vitamin C may trigger rebound scurvy if stopped abruptly after long-term use at high doses. On the other hand, aspirin can be highly addictive in the true medical sense of the term.
However, I believe that many of the problems blamed on benzodiazepine withdrawal have more to do with a return of the anxiety. It is an interesting fact that withdrawal is almost a non issue in the other main patient group treated with benzodiazepines, epileptics. They often are prescribed huge doses compared to those typically prescribed for anxiety - 10mg/day Klonopin is about average, but 20mg isn't rare.
I have had a rough couple of days on klonopin....sleepy in the daytime and restless at night....I am going to ask my dr for a taper off schedule....I have only been on it 3 weeks so it shouldn't be too hard...I hope....
Given the long half-life of Klonopin, you may be able to get by taking it just once per day. Taking it in the evening may ease the sedation issue, which tends to be short lived anyway. However, do not change the dosing regime without discussing it with the prescribing physician first.
I suspect that the nausea is being driven by anxiety instead of this benzodiazepine.
If you wish to discontinue Klonopin then it should be relatively easy given the short time you've been taking it. If possible try not to dwell on the possibility of withdrawal. Doing so can often trigger such symptoms. Indeed, there have been a number of studies showing that simply telling patients that their benzodiazepine dose is being reduced will bring on withdrawal symptoms even though there was no change in the dose.
I may have gone for a 50% cut for a week and then down to a quarter for another 4-5 days, mostly for your peace of mind. But your doctor know much more of your history and is best placed to make the call.
Given the low dose and short period you've been taking Klonopin (clonazepam), I doubt you will have significant problems. To put this into perspective, Klonopin was initially developed to prevent epileptic seizures. The typical dose for this is 10mg/day, and 20mg isn't rare.
However, you may experience an increase in anxiety. You already may be if you are having 'withdrawal' symptoms so soon. The half-life of Klonopin is 30-60 hours, so any 'withdrawal' effects you're experiencing after 24 hours or less are unlikely to result directly from tapering off the drug, especially when you are still taking it, abet at a reduce dosage.
The problem with staying asleep should pass in a few days.
The ruminating is of greater concern. As a preexisting symptom it probably won't resolve by itself and is likely to get worse over time. It needs to be treated. What anxiety treatment has your doctor proposed now that the benzodiazepine is being discontinued and when will it start?
Okay, I didn't know that. Have you only started taking this recently? Which antidepressant is it?
Why do you say the staying asleep will resolve in a few days? Are you saying the Klonopin is causing me to not sleep all night?
Klonopin, like most benzodiazepines is usually sedating and is sometimes prescribed to assist sleep. I thought that your awakening during the night was a recent development which began after you dropped the Klonopin dose. This may cause disturbed sleep for a few days.
I'm just someone who developed panic disorder 22 years ago, and, fortunately, had through my then job psychiatrists and psychologists on tap whose brains I could pick. I've been writing for anxiety self-help groups, and websites for more years than I care to think about.
Ian, I seem to be having trouble cutting back on the klonopin. I have now gone 2 nights without taking any, but have taken the full .5mg during the day. Can you suggest what I might do to cut down further?
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