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Doctors' Answers to "Frequently Asked Questions" - Klonopin


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 09/23/2000]
Question: Im concerned about taking klonopin for 10 years started out with .05 1x daily increase .05 x3 daily. I've tried other meds such as ssri and can not tolerate them. Should i be concerned about liver or other organs and do you have any suggestions about other meds i could try. I am under supervision of a physician.

Answer: The liver should not be a problem at this dosage, dependency will be, but that is anticipated.

[posted 07/18/2000]
Question: I have a history of anxiety, panic attacks, and PTSD.
today I was prescribed klonopin 1 mg tablets to be taken 3 times daily. This just seemed like alot to me and I was wondering if that was a high dosage for this type of medication.

Answer: Higher than average, but this depends on the severity of the anxiety and your weight. You can certainly start with .5 mg twice a day and work the dosage up every day watching for excessive sedation.

[posted 07/2/2000]
Question: I have had anxiety disorder since I was a child and panic attacks since I was 20. I have tried 5 different anti dep and tranzene, xanax, and now klonopin. Klonopin seems to help alot but I worry about addiction. My Dr. says I have had no luck with the others and he sees no problem with leaving me on 2 mg a day for the rest of my life if it works. He says that it will cause physical addiction but there are different types of addiction and with my type of personality he does not worry about me abusing the drug. He tells me if he could just get me to take the dose I am perscribed then he'd be happy. The only side effect I seem to get is the hang-over feeling, sluggishness, and loss of balance at times. Should I give in and take the drug and not worry about it? Can I be on it for the rest of my life? Dr. says it beats the alternative.

Answer: Take the drug, you can occasionally decrease the dosage by using ssri antidepressants(prozac and the like) but in marked cases, one usually needs both and sometimes only the klonopin helps.

[posted 04/25/2000]
Question: PLEASE HELP!!!!! I HAVE BEEN ON CLONAZEPAM FOR A LITTLE OVER A YEAR 2mg ONCE A DAY (MORNINGS). I WAS TRANSFERRED TO THIS DRUG FROM XANAX WHICH I HAD BEEN ON FOR 3 YEARS 2mg TWICE A DAY..I MADE THE TRANSACTION SUCCESSFULLY, BUT 2 WEEKS AGO,I TRIED TO STOP THE CLONAZEPAN COLD TURKEY I FELT THE NED TO TRY TO CLEAR OUT MT SYSTEM OF ALL THESE DRUGS (WITH NO SUCCESS) I NEED THEM. MY DR. NOW REFUSES TO WRITE ME ANOTHER PRESCRIPTION FOR CLONAZEPAM. SHE IS INSISTING I TAKE BUSPAR INSTEAD. PROBABLY SO WHEN I CHOOSE TO QUIT I CAN. I HAVE COME TO THE CONCLUSION THESE PANIC/ANXIETY ATTACKS ARE HERE TO STAY SO I AM IN NO HURRY TO QUIT. SHE HAS STOPPED THE CLONAZEPAM COLD TURKEY AND HAS ME SLOWLY UPING MY DOSAGE OF BUSPAR, AND I AM FLAT ON MY BACK, HEAD SPINNING, HEART PAINS/PRESSURE,CAN'T FUNTION, AFTER I CALLED HER WITH THE NEWS OF HOW SICK I WAS AND THE SYMPTOMS AFTER 5 DAYS OF TRYING TO SWITCH OVER SHE TOLD ME TO TAKE A WHOLE 15mg PILL (JUST AFTER 45 MIN OF TAKING HALF 15mg). I TOOK IT AND THOUGHT I WAS GOING TO DIE, MY WHOLE BODY WAS LIKE IT WAS GOING INTO ELECTRICAL SHOCK TREATMENTS, MY HEAD WAS SPINNING, I WAS HAVING ANXIETY ATTACKS BAD. SHE HAS NOT CALLED ME BACK. THAT WAS THE LAST BUSPAR I TOOK I AM BEGGING HER TO CALL ME AND SEE ME, SHE HAS NOT...HELP I AM OUT OF CLONZAPEM ( I TOOK 2mg today,MY LAST 2) TO RELEIVE SOME OF THESE WITHDRAWLS, I FEEL LIKE I WANT TO JUST CASH IN AND GIVE UP. I DON'T WANT TO TAKE BUSPAR..IS THERE A LAW THAT SAWS I HAVE TO? WHAT, IF ANY, ARE THE DANGERS OF QUITTING CLONAZEPAM COLD TURKEY FOR BUSPAR?

Answer: Clonazepam and any of that class of drugs should never be stopped abruptly. This gives a very distinct risk of seizures within the first few days of stopping. You are probably past the point of risk from this, but makes me question your mds medical judgement.

[posted 04/24/2000]
Question: I am 33 years of age and have been controlled for partial complex seizures by taking clonazepam for the last 15 years approx. Since then the neurologist tried to wean me off this medication 8 years ago without success. I suffered a major seizure as a result and immediately went back to taking the rivotril. It happened once again 2 years later when I had gone on a weekend out west without my medication. I have been concerned about having children for a long time. My neurologist told me to come back when I was pregnant! I think this is a little too late! Since then, I have moved and asked for a second opinion. I was told that I was misdiagnosed initially for petit mal instead of partial complex epilepsy, and was also told I should have been placed on 2 medications, not one. I have been happy to be seizure free, but I am wondering whether or not to take the chance of changing my medication before I become pregnant. I am currently in a relationship, and would like to know what the chances of having a healthy baby are, whilst on this medication. If I can help it, I would prefer not to change my medication. Currently I am on 1mg clonazepam daily, which is a minor dose. I am so angry with the doctor that placed me on this medication in the first place. I believe you become addicted to this drug and it is very hard to come off it. Could you please give me your advice and information on your knowledge in this area?

Answer: I'm not sure I understand your anger. It has worked and you have been seizure free, until you stopped the medication. Why do you think the 2nd opinion is accurate. Why would you need two medications if you are seizure free. Sounds like the 2nd md is the one to doubt. Clonazepam is not a usual seizure drug but does work. We avoid it due to the things you are describing. But, some patients need this medication and do not respond to another medication. There are certainly other seizure medications you can try, but they all have fetal risks-some severe. Clonazepam is probably one of the less risky. This needs to be handled by your neurologist.

[posted 04/21/2000]
Question: I'm a Women's Health Care Nurse Practitioner. I have a patient diagnosed with Bipolar Disorder who is currently breast-feeding. This patient is taking Clonazepam 0.5mg prn to control her Manic episodes. Is it safe to breast-feed while taking the medication? If not, how long after discontinuing use of the medication can she resume breast-feeding?

Answer: She will pass Clonazepam into her breast milk. The medication will be present about 30 hours after stopping the medication effectively eliminating breast feeding or the Clonazepam. You might discuss this with her psychiatrist, she may be able to take it prn. But, she is probably going to go through some withdrawal as well.

[posted 04/15/2000]
Question: I was recently at a so-called friends house where I had a couple of glasses of wine when before I know it I am out cold. I had no muscle coordination, I passed out, I don't remember a thing from the second part of the evening but remember everything from the beginning as clear as a bell. My husband thought that I just had too much to drink but I have had a heck of alot more than that in one night in my lifetime with no effect whatsoever. I did not vomit and I did not have your typical hangover the next day just an excruciating headache and very foggy feeling. I was wondering, since the person's whose house we were at is on Klonopin could have spiked my drink with it. I just heard on the news that it is now the new date rape drug. Also, the next day I went to the doctor because I knew that something was very wrong and gave a blood and urine sample and they ran all the drug tests that would be run for say a company like barbituates, sedatives, etc. and they all came back negative. If I was given Klonopin would it show up in a blood test? I would greatly appreciate expertise. Thank you.

Answer: This should be present in the urine tests taken the next day. I'd discuss this with your md and see if he/she wants further medical evaluation. I would have no suspicion of being drugged in this scenario.

[posted 03/26/2000]
Question: I have severe fibromyalgia however have been going to a great Dr. the last three years. Taking many vitamins and 0.5mg of Klonopin. I have been perfect with
with these combinations and off all other medications except Premarin 0.9mg. I wanted to come off the Klonopin myself and the Dr. said to taper off slowly. I am supplementing Valerian with Klonopin. It has now been two weeks and I feel horrible in pain all over not sleeping well. I have read alot and said Klonopin is addictive.
Can I be on this drug forever? What will the side effects be? I am 47yrs old, had brain surgery l0 yrs. ago had an aneurysm and lung surgery in 1984, and a hysterectomy in 1985. Since I have been seeing this great Dr. I have been taken off of my heart medicine one year ago by my cardiologist had attachacardia(was on Loperessor and Calan). I was doing great.I also for this first time in my life stopped my 8 allergy shots a week by the allergist and have been fine for 2 years. Everything has cleared up once this Dr. put me on this regiment of vitamins and diet.Please tell me what Klonopin does to the body like organs. Does it ruin the liver /kidneys or anything long term?
I anxiously a wait for your answer.

Answer: If it is the Klonopin you should be getting better in 2-3 weeks. However, it may be increasing pain from the fibromyalgia. This would be seen in more/more marked trigger points, discuss this with your md. I doubt the klonopin is responsible at this point. It should have no long term problems except the addiction potential.

[posted 03/24/2000]
Question: I have been on klonopin for 8years for anxiety. I want off of this drug. if I had known it was going to be so addictive I would never have started taking it. If I try taking less than 2mg a day I get withdrawel symtems I can't control. On an average week I probably throw up 3 times a week and that's just from waiting too long to take the klonopin. I take .5mg first thing in the morning,then by 11:00am my body let's me know you will take it or else suffer the effects of not. If I'm having a more stressfull day I sometimes take another .5mg in the afternoon. I always take .5mg before bed. Ihave tried several times to stop taking it but keep going back to it. What anti convulsive medication can I take to help get off. I think I can handle the anxiety now. I have noticed when I try taking less my back and neck problems get worse. I admit I'm a tense somewhat withdrawn person. I'm also in a position at work of having quite a lot of responsibility and in charge of others which I can handle but it is very stressfull

Answer: I'm confused, are you trying to stop the klonopin or are you still having symptoms of stess/anxiety. If you are still having anxiety then you will probably need the klonopin long term. You might try an antidepressant (like Prozac or that class called SRI antidepressants) to see if they will help the anxiety. I suspect til that happens you won't be able to stop. Klonopin can be difficult to stop, but impossible if you still need it.

[posted 03/20/2000]
Question: I have been on Klonopin for the last ten years for Anxiety. I have tried several antidepresents though out the years, both SSRI's and TCA's to no avail. I know that Klonopin is addictive but what other long term affects does the drug have, such as memory loss and/or is it permenate or just while on medication. Secondly, my doctor suggest I get off the Klonopin and try Serzone to better treat my Anxiety problems. I don't consider myself as depressed but highly stressed due to my job and thus I become anxious, etc. So far the Serzone seems to be working just fine other than your normal amount of drowsiness which could be contributed to taking in conjuction with Klonopin ??? . What side effects or adverse interactions does Klonopin have with Serzone, I.E. central nervous system, etc. Also, how and at what dose of Serzone do you suggest I wean off the Klonopin. I'm currently taking .5mg of Klonopin twice a day and presently on my first week of Serzone at 100mg a day which is to be increased next week to 150mg's a day then 200mg a day the following week and so forth up to 300mg a day, etc.

Thank you and would appreciate your help.

Answer: There should not be any particular interactions between the klonopin and the serzone. Nor are there any particular long term side effects to klonopin (at least to this point)which would be any different than the short term side effects. As to the weaning, discuss this with your md. They sound like they are on the correct path.

[posted 03/16/2000]
Question: I suffer from social anxiety and have heard that Klonopin can help. I have also heard that this drug can trigger hair loss (alopecia?) which I already have a problem with. Is it likely that Klonopin could aggravate my hair loss? Also, is there any evidence to suggest that Klonopin causes weight gain?

Answer: Possible, but not a usual problem with most patients-either hair loss or weight gain.

[posted 03/13/2000]
Question: I suffered a panic attack on Sept. 7, 1999. I was diagnosed with Panic Disorder which changed my life. I don't know what caused this, but I assume it was stress built up over a period of time. I am 35 years old. I have had 2 major attacks, but since Sept. I have had a contiuous sensation of nervousness, tingling in my extremities, palpations and a feelings of being in a daze. I have been able to work and carry on my daily activities however it has been very difficult. I have been on Buspar, Paxil, Xanax and now Klonopin exclusively since November. I also take 80mgs of Prilosec for ulcers found Jan, 2000. I am currently weaning off Klonopin - I am down to .25mg/day for the past 2 weeks. The most I have taken is 2mgs. This week I have felt terrible - increased sensation of nervousness and tingling in the legs. Is this because of withdrawal from the Klonopin? Are my symptoms due to side effects from Klonopin? I do feel better than when this initially began and I have not had any panic attacks in the past 5 months. I feel that alot of my symptoms are from the drugs. Am I correct to assume this?

Answer: Hard to know at this point, keep slowly decreasing the klonopin and see what happens, if it gets better over a few days, it is klonopin withdrawal, if it doesn't/worsens probably a return of your anxiety disorder.

[posted 03/13/2000]
Question: I've read the FAQs regarding withdrawing safely from Klonopin I take .5 to 1 mg. per day and have been for 2 years my attention span is shot and I'm not certain how to go off of this safely. I experience dizziness while taking the drug, which I found out is a side effect. I've begun a stringent exercise plan, as I once did before I had severe anxiety. My questions are: does increased exercise over the long-term really reduce anxiety? And you said that those who take Klonopin should reduce their intake by 20% for 4-5 days. Do I reduce 20% of the total dose I'm taking (1 mg.)?

Answer: Exercise can improve anxiety, but it depends on how severe the anxiety was. Practically, you will need to decrease the dose to .5 mg since it is hard to decrease it by 20% at the dosage you are taking. Then cut to .25 for 10 days or so, .25 every other day for 8-10 days.

[posted 03/8/2000]
Question: I am on 6 MG/day Klonopin and 60MG/day prozac. I was recently wrongfully arrested and I spent about 24 hrs without
geting any medication. I started to feel panic stricken. Under the fact that I was under such a stressful situation
and I did not get my medication, particuarlly KLonopin, what could have happened to me? Or what long term effects might
this have on me?

Answer: Sudden cessation of klonopin can cause seizures, fortunately it did not in this circumstance. Stopping the prozac for a few days is usually not a big deal since it has a long biologic half life and will have effects present for 10 days to 2 weeks. There should be no long term effects from missing your drugs.

[posted 03/8/2000]
Question: I have not had a panic attack in over a year, but I do get very anxious in certain social situations. I was prescribed .5mg clonazepam and took my first pill last night. I woke up at 4am feeling like it was hard to breath and that I started having a panic attack!?! Is this a pradoxical effect? I ended up in the emerency room and was told I was fine. But why would I feel worse on this medication?

Answer: You'll need to have sufficient dosing before you'll know the effect. This is a small dose and you will need to take it twice or three times a day to get effectiveness.

[posted 01/25/2000]
Question: I had a sleep test done and (originally for sleep apnea) but they found out I have limb movement disorder. In the sleep study (5 hrs 40 mins of which I thought was good sleep) I woke up 185 times (155 due to limb movement, 14 due to sleep apnea).

I have had headaches for years, depression, the works. Now that I am sleeping 7-8 hrs a day - I feel unbelievable better ... but I have some questions.

The doctor has me on 2 tab (he would prefer less but on 1 or 1.5 I only get about 5 hours sleep at most.

During the day I at times seem to loose balance. I don't feel dizzy but just loose balance. It usually happens when I get up too fast from sitting or laying down or walking up stairs too fast. It never happens when simply sitting (chair, car etc.). Could this be a result of the klonopin?

In your FAQ, you make it clear that klonopin is physically addicting. I can live with that as long as no other things happen as a result. It is better than being on ambien, prozac, zoloft and numerous other drugs.

But I wanted more input.

Who makes klonopin or its generic?

Thanks

Answer: Klonopin is made by Roche. Generics are made by Novopharm,Mylan, Par, and Watson. Probably the klonopin that it responsible for the balance problems. But, get your blood pressure checked to ensure it doesn't drop excessively when standing.

[posted 01/22/2000]
Question: My daughter age 18 found out she is 7 weeks pregnant. She has been taking Klonopin for anxiety. What possiblle effects could this have on a fetus, child birth, or problems of a new born.

Answer: Probably pretty minimal unless she is taking high doses or persist in taking through the pregnancy. However, this class of drugs is used commonly in pregnancy and seems to be pretty low risk. In all cases, less is better.

[posted 11/23/1999]
Question: Hi..
My doctor gave me 'Klonopin' to take. 0.5 mgs. I just want to know if this drug produces or induces delta 4 sleep..thanks Carol

Answer: I don't know specifically, I would suspect it would slightly decrease Stage IV sleep. You can check with the manufacturer Roche 800-526-6367.

[posted 11/20/1999]
Question: Could you please tell me how (2) .5mg of Klonopin could do any damage to me. I take 1 at bedtime and 1 again in the middle of the night if necessary.

Answer: Slightly more sedation, but nothing to worry about.

[posted 11/10/1999]
Question: I only drink alcohol on the weekends. I'm taking .5mg of Klonopin twice a day. If I know I'm going to have "the guys over for a Redskins game" should I discontinue the Klonopin for that day or is the drug interaction not that severe?

Answer: In small amounts, not a problem after two or three your judgement and ability to drive would be markedly impaired.

[posted 11/8/1999]
Question: I am a 26 year old male and have been taking a low dose of Klonopin every morning (1/2 of 0.5mg tablet) for panic attacks for about 1 1/2 years. I also take an additional 1/2 if I anticipate anxiety or feel anxious at some point later in the day. My doctor recommended Paxil and I tried it for several months, it worked well, but had sexual side effects. I have found that the Klonopin has fewer side effects. Is there any danger in the long term use of Klonopin in this way? If so, are there any other medications which would help, but not have sexual side effects?

Answer: Klonopin is addicting but as long as you keep on it shouldn't be a problem. Avoid alchol and any performance situation. Serzone or Celexa would be worth a try.

[posted 11/10/1999]
Question: What effects should I expect when I stop taking Klonopin? I have been taking 0.5 mg for 4 years and I am going to stop taking it soon.

Answer: This can vary quite a bit. Anxiety, tremor and occasional abdominal pain would be common. Occasional patients can have seizures if it is stopped too quickly, ensure you taper it very slowly.

[posted 08/29/1999]
Question: Does Clonazepam cause any sexual side effects, i.e. abnormal ejaculation, abnormal orgasm?

Answer: Occasionally.

[posted 08/28/1999]
Question: Have been on Klonopin 0.5 mg once daily for several years (around 6) for mild anxiety problem which I've had for 20 years. I am experiencing scalp problems - over production of oil glands and hair loss. Are these side affects from the meds?

Answer: Not usually.

[posted 08/27/1999]
Question: I take 30 mg of Paxil each day as drug therapy for anxiety/panic disorder. When I was having panic attacks, I found Klonopin to be extremely effective. Although panic attacks are now rare, I still receive comfort in carrying the Klonopin as I know I have the medicine if needed. My question is that my prescription is now nearly two years old and the bottle said to use within six months. What is the actual shelf life of Klonopin? Should I dispose of my pills and get a new prescription?

Answer: I'd get new ones, probably ok, but they're cheap.

[posted 10/29/1999]
Question: What is the period of detection for Klonopin (clnazapam) --
a benzodiazepine -- in a urine drug screen? The drug is taken
by prescription and under the direction of a physician --
not an abuse situation.

Answer: Usually up to six months depending on the sensitivity of the test, for example some could be up to a year.

[posted 10/18/1999]
Question: I am taking a very low dosage of Klonopin (0.25mg/day). I had heard that this medicine can have a bad interactio with calcium-based antacids such as Tums. As a 47 yr old woman, I also want the benefit of taking calcioum. Is this a problem? The pacaging on the antacids says that it can react badly with some Rx medicines.

Thank you.

Answer: I'm not aware of this as a problem and couldn't find any reference to this in the PDR. You can call Roche Labs scientific department 800-526-6367, they would have all the possible interactions.

[posted 10/15/1999]
Question: I read over the questions submitted about clonazepam, and while some were similar, mine is a bit different. I was diagnosed with panic disorder about 3 months ago. I tried a few drugs, including zoloft. It made me feel so sick that I got off it after only a few days. I then went several weeks without any medication. It was OK, but I still needed something. 2 weeks ago under the doctor's approval I started to take a half a .5mg tablet of clonazepam in the morning, and the other half in the evening. This seems to be doing the trick, but my questions and concerns are the following. 1. If I continue at that amount, will tapering off be a problem or long process? 2. I keep hearing about side effects like seizures and memory loss. I've never had a seizure in my life, but are either of these possible for me on the dose I have? 3. On such a low dose, is missing a dose a big problem?

Answer: Any of these drugs is addictive. The addiction is a function of the dosage and the time taking the medication. This is a small dosage, but will be addictive over time. Seizures and memory loss would not be expected to be a problem at this dosage. Stopping the drug abruptly could potentially cause seizures, although unlikely at this dosage. Missing a dosage here and there should be no problem.

[posted 08/12/1999]
Question: Recently, I have been treated by a psychiatrist for depression and generalized anxiety -- anxiety that was severely exacerbating my Crohn's disease and has put me on medical leave from work for several weeks. He has started me on Celexa and Klonopin (.5 mg in AM and .5 mg in the PM, with .25 mg during the day as needed). While the Klonopin DOES help the anxiety, I am very concerned about taking it. Five years ago, I was treated for an addiction to pain medication, and I continue to attend AA meetings. Because my Crohn's disease sometimes requires my taking pain medication, my fears surrounding becoming "re-addicted" has plagued me and I am very cautious about taking these medications. I realize that Klonopin is also an addictive drug, but this psychiatrist is trying to reassure me that it doesn't necessarily mean I will become addicted to it. His feeling was that because my anxiety and panic attacks were becoming so crippling to my daily life that the use of Klonopin is warranted. On the other hand, I am VERY concerned that I may be opening myself up to a future problem of becoming very dependent on it. In fact, I many times do not take the Klonopin during the day, although I suffer greatly, because I fear that my wanting to take it suggests that my tolerance for it is growing (I've only been on it for two we upd. I guess I am not sure what my actual question to you is, but I am wondering where you draw the line? Does my addiction to pain medications mean that I will indeed become addicted to the Klonopin? And, if so, what would be left to help me? My biggest fear is that my addiction will leave me without any help of pharmaceutical help -- that I will not be able to take anything that can help my anxiety. Would you, as a physician, treat a chemically dependent patient with Klonopin is she were suffering from severe anxiety?

Answer: Sure, knowing that there may be some work needed down the line in terms of detox. But, either you need the klonopin or you don't. If it is working, there are few alternatives, save the SRI antidepressants-which you are taking. You will probably wind up taking more klonopin and for a longer time by trying to cut corners rather than extinguish the anxiety. You know how to detox, so if in the future it is necessary so be it. There is far too much concern about the social ramifications of addiction by patients who truly need the drug.

Paradoxical effect from Klonopin [posted 1/7/99]
Question: Can Klonopin or other medications in the benzodiazepine family cause a paradoxical effect?

Answer: Yes.

Klonopin [posted 1/5/99]
Question: My doctor has prescribed Klonopin and has directed me to take one tab for Anxiety. I do not have extreme and regular bouts of anxiety so I only take it when needed. Is it safe to take it this way? I have had a three months supply that has lasted for a little over a year.

Answer: Yes, and less addicting.

Klonopin & Rivotril Questions  [posted 12/01/98]
Question: I am a patient that has a form of dystonia called spasmodic torticollis. My neurologist has me on Botox injections every 10 to 11 weeks. As well, He has prescribed Rivotril for me, I am taking the generic drug clonazepam .5mg, up to 4 per day. My question is this the same as klonopin or is there a difference. I was of the understanding that he gave it to me for spasms in my neck, yet I read that klonopin is an anticonvulsive drug. Am I correct? What is the difference between rivotril and klonopin? Any help would greatly be appreciated.

Answer: Same and the class of benzodiazepines is used for muscle relaxation as well as sedation and seizures.

Xanax and Klonopin  [posted 12/01/98]
Question: Have panic disorder. Dr. prescribed 1-1/2 .25 Xanax morning, noon, dinner, and 2 .25(.5) at night for sleeping. Take nighttime dose around 10p.m. because I feel so sedated I can't wait any longer, but wake up every morning around 4a.m. Have awake and half asleep. Get up and take morning dose around 7a.m. and then have a bad 2-3 hours. Dr. just ordered .5 Klonopin to take instead of Xanax at bedtime. Is it o.k. to mix the two? I feel if I could just get a full night's sleep, I could handle the mornings better. I might add that I'm very sensitive to all drugs, and, in my opinion, need less Xanax than I'm taking, but the doctor wants to give more and more. Please help! I also am in therapy. Thank you for any help - greatly appreciated.

Answer: Klonopin and Xanax are very similar in effect, level of sedation and dosage would be the significant variables. Usually we use one or the other not both, but it is ok to mix the two.

Could Muscle Twitching be Due to Klonopin   [posted 11/25/98]
Question: I was put on klonopin for anxiety and an eyelid twitch. The eye lid twitch is gone, however it was gone before I began the klonopin. I take a forth of a .25 dose when I need it. So basically I may take it 3 days then stop then a week later I'll take one and so on. I am now having muscle twitches all over my body ...could this be a result of sporadic taking klonopin? Also, I take such a small dose because its all I need to do the job. A 1/2 of a pill seems to give me some strange pain in my arms and really knock me out making me feel hung over the next day.

Answer: Possibly due to the Klonopin;but, would be uncommon. The hang over feeling is a common one.

Using Klonopin As a Sleep Aid  [posted 11/24/98]
Question: My doctor prescribed Klonopin about six months ago because I could not sleep well at night. I take one 2mg tablet about 20 min.before bedtime and I sleep like a rock and wake well rested and ready for another hard day at work. The problem is I worry about taking the drug for a long time. Should I be worried about long term use of this drug?

Answer: Don't do this. There are plenty of ways to address sleep without huge daily doses of klonopin. Most physicians would use 0.5 or 0.25 as a starter dose. This is a huge dose. Try Tylenol PM or melatonin or benadryl and use the klonopin as a last resort-but a smaller dose.

Klonopin: Memory & Addiction Concerns  [posted 11/18/98]
Question:  I am a 51 yr. old female. I was finally diagnosed with panic disorder about 4 years ago. At that time I was given Klonopin and Zoloft. I weaned myself off the zoloft. Since taking the klonopin, I feel my memory is gone. Is this old age or a result of this drug. I have trouble finding words and remembering names. My Psychiatrist says the drug is safe and I am fine. My internal medicine doctor says this is one of the strongest and most serious drugs out there. I want off this drug. I can feel the addiction as my body clock sounds the alarm for klonopin! How can you tell when the cluster of panic is gone? I am scared of the whole thing!

Answer: Panic disorder tends to be lifelong;although some patients have episodic problems and not continual anxiety/panic. Of the two drugs, you would be better on the zoloft since it is not addicting. However, if you need klonopin so be it. The memory loss might be the klonopin and I would try to use the klonopin only occasionally and substitute the zoloft on an every day basis. Consult your doctor for the specific steps. Do not stop the drug "cold turkey".

Klonopin & Blood Sugar  [posted 11/18/98]
Question:  My husband is concerned about Klonopin and the effects it might have on blood sugar levels. Is there any information on drugs and the possibility of them raising your blood sugar level? I would appreciate any information you could give me. Thank you.

Answer:   Little or none in clinical practice

Klonopin & Xanax [posted 11/11/98]
Question: Please advise me the strength comparison between Xanax and Klonopin. In order to transfer me from Xanax to Klonopin my Psychiatrist has recommended that I take two mg. of klonopin five times a day in addition to the Zanax and Zoloft. I am already hypersedated. He believes that Klonopin is only 1/4th as strong as Xanax and thus the reason for the heavy dose. I want to transfer to the longer acting bz. to prevent break through anxiety and to help taper the bz. to a lower dose level. I am afraid however that my doctor is not correct about the dose comparisons between these two drugs and that it would be two great an amount of benzos. to take.

Answer: They're pretty similar and his numbers are about right.

Klonopin & Pregnancy [posted 11/6/98]
Question: My daughter takes klonopin for panic attacks. She takes one half of .5 mg once a day. She has recently found out that she is pregnant and we were wondering if she should get off this drug.

Answer: optimally use as little as possible. Larger doses will potentially result in physical dependence in the fetus. However, the antidepressant drugs are less well followed during pregnancy with less predictable side effects. I would use what is necessary to keep control-but as little as possible.

Ok to Take Nytol While Tapering Off Klonopin [posted 11/5/98]
Question: I have been taking 0.5 mg klonopin for 2 years and I would like to try to get off it and get back to seeping without drugs. would it hurt to take an over the counter like nytol while tapering off klonopin?

Answer: NO. Just taper slowly. (see below)

Tapering Off Klonopin [posted 11/3/98]
Question: I have been taking 2 mg. of Klonopin for weeks now and it is time to taper off. How do you suggest that I do so without having serious problems. I have been taking it twice a day.

Answer: Cut it about 20% and keep the dose 4-5 days then cut another 20%.

Zoloft Withdrawal or Klonopin Side Effects [posted 10/29/98]
Question: Since 1987 I have suffered from panic attacks, at the time the medicine of choice was Nopromin and Klonopin, when I became pregnant in 1990, I had to come off of these drugs. I was able to make it, and 3 months after I had my child, I began to have panic attacks again. I was on a placebo program, and then received free treatment for 6 months. I was on Prozac with really bad side effects, then the doctor put me on Zoloft and Klonopin. Since 1991 I have been on Zoloft and Klonopin in a variety of doses. My new doctor reduced my Zoloft first by half, now he has taken me off it completely, because I had a side effect of the inability to achieve an orgasm. Now I'm on .05 mg. of Klonopin in the morning, .05 of Klonopin at lunch and two 1mg tablets of Klonopin before bed time. This has been almost two weeks ago. Is it a side effect of Klonopin to become nauseous throughout the day, and to have severe problems with your ears?

Answer: Not usually, but possibly a withdrawal syndrome from the SRI drugs.

Could Klonopin Be Responsible for Bladder Problems [posted 10/23/98]
Question: I have been on Klonopin for 10 years. I have frontal brain damage from my ex husband. This drug has given me back many functions I thought were from just anxiety. I am now not going through a divorce with three little children but when I have the flu or any thing that impedes the delivery of the drug into my body I and others notice my decreased abilities. Now I have had a long term bladder problem with an infection and 11 pieces removed to be checked for cancer. It is all cancer free but what is causing the bladder to become defective? Is it the klonopin? Is there another betterned g of choice to try as I have years while I have to work to support my self. Thank you for any help.

Answer: Not the klonopin, I doubt that I would change the klonopin as effective as it sounds.

Klonopin Side Effects
Question: Can you tell me the side effects .....physical withdrawal symptoms of a dosage change with the drug "Klonopin"....From 1 Mg to 0.25 Mg, overnight,and how long before the symptoms would manifest themselves?

Answer: It would depend a great deal on why she was taking the drug. That is, how much of her previous symptoms reoccur and how much is drug withdrawal. Drug withdrawal is usually manifested by agitation, anxiety and occasional GI pain.

Klonopin Side Effects
Question: I am looking for information on the drug klonopin. My 9 month old son just started taking it for seizures. What are the side effects?

Answer: Klonopin is an effective anti-seizure medication that belongs to the same general class of drugs as Valium, Librium, etc. Like these drugs, it produces sedation, decreased attention span, and long term physical dependence.

Klonopin
Question: I have been taking klonopin for panic attacks. I now want to discontinue using the drug. I am currently taking 1/2 of 0.05 mg once a day. How should I taper off of such a small dose?

Answer: About a week would be more than enough.

Long term effects
Question: For the past year and a half I’ve experienced obsessive worry and resulting insomnia. I had very bad side effects with Paxil and Prozac. Currently, I take a small dose of Klonopin. I don't like taking a tranquilizer. The klonopin is workable for now, but I'm concerned about long term effects. I'd like to get back to a drug free restful sleep.

Answer: Klonopin is very effective. I'd focus on its effectiveness. If it works and other less addictive drugs do not, then stick with it. You could try other alternatives, but don't fix it if it ain't broke.

Klonopin
Question: I have Restless Leg Syndrome. My Doctor has me take 1 mg of Klonopin at bedtime. It works well for me. Many articles on the subject warn about suddenly stopping the use of Klonopin. I would like to know what problems I might have if I miss a night once in a while. Also, can I get physically hooked on this daily dosage?

Answer: Abruptly stopping Klonopin can lead to irritability and even to seizures in some cases. Any drug of this class used on a regular basis can produce dependence. However, there are few effective treatments for Restless Leg, and if it really works, I would be reluctant to stop it. Missing one day is unlikely to produce withdrawal at these doses.

Klonopin and MVPS
Question: I have a mitral valve prolapse with all the symptoms(Panic attacks, insomnia, extreme fatigue, IBS, etc..), and I have been instructed by the Society for MVPS to ask my doctor about getting on Klonopin. Will it help all of these symptoms? What about the drug called Buspar? Which one should I take?

Answer: Klonopin is often very effective in minimizing the symptoms of MVP--especially anxiety and panic. However, it is addictive and should be avoided unless you are really incapacitated. Buspar might be useful, and it doesn't appear to be addicting. Also, betablockers often will block most of the symptoms and are not addicting. If you were to take klonopin when you had severe problems that would be OK. Taking it regularly buys you other problems. Occasionally, SRI antidepressants are helpful since many have MVP and many have panic disorders-- differentiating them is difficult. As a consequence, you might try the SRI antidepressants.

Klonopin
Question: I was wondering if you could answer a few questions on Klonopin? If I were taking 1/2 of a 0.5 mg tablet 2 times a day and a whole at night , then was suddenly taking twice that amount, then suddenly back to the original dosage, would there be any effects from it?

Answer: Only a little sedation while taking the extra Klonopin.

Klonopin
Question: My 11 month old son was prescribed Klonopin for a sleeping disorder. He takes half of a 0.5. Is this safe for a child his age? What are the risks involved with this drug and an infant? He weighs 21 lbs.

Answer: I'd need to know the nature of the sleep disorder before I could help. In general, Klonopin is a very effective sedative but is addicting over the long term. If your son needs it, so be it. There are few alternatives to this drug or similar drugs as sedatives for sleeping. You'll need to accept the potential long term addicting properties to overcome his sleep problem.

Klonopin
Question: I am a 27 year old male, currently taking Trandate and Lozol for hypertension. I had visited my doctor and told him about the frequent nightmares from which I suffer, and he had noted that they could be caused by the Trandate. He prescribed Klonopin, 1 mg nightly, as a way of dealing with the night terrors. Is this a common use for the drug, and how effective is it for others?

Answer: There are at least 8 different classes of drugs for treating hypertension. Usually, if a patient experiences symptoms with one class I switch to another class of drugs. This is particularly important with a young adult since they will be taking the medications for a long period of time. I would never prescribe a potentially addicting medication to cover side effects unless it was life or death. I would strongly recommend a different treatment course. Also, if you have not have screening done for the preventable types of hypertension this should be done. There are about 7- 8 types of hypertension that can be surgically cured. Usually, I screen young adults(below 40) for these causes since surgery can fix the problem. Also, knowing your rennin status will predict which drugs will work best on your hypertension-with your age this is vital information. If your physician does not feel competent to do this testing it can be performed by most Internists or Endocrinologist. Hypertension clinics at University teaching hospitals are also an alternative.

Klonopin Therapy
Question: After two years of being given various drugs such as prozac, lithium, serzone, wellbutrin, and effexor and undergoing 12 rounds of ect, my severe clinical depression still persists. My doctor is suggesting I wean myself off antidepressants and give Klonopin a try. While knowing that it is principally an anticonvulsant, I have also read that it is used in depression. Do you have any information or resources which can assist my understanding of this approach?

Answer: Klonopin or Clonazepam is a Benzodiazepine which has been used in seizure disorders and in anxiety states. Its use in depression has not been reported.

Klonopin For Facial Tics
Question: I was diagnosed with facial tics (I'm 33 and have had them since I was 8). Originally, I was put on Zoloft. It seemed to be working, however it seriously decreased my sexual drive. This bothered me enough that my doctor stopped the Zoloft and put me on Klonopin instead. The Klonopin is not supposed to affect sexual drive. I've just started taking the Klonopin, so I don't know how effective it will be. My questions are:
1) Is it common to prescribe Klonopin for facial tics? (I realize that Zoloft and Klonopin are very different types of drugs.)
2) I read about this drug called Serzone which is like Zoloft but does not have the side effect of decreased sexual drive. Since the Zoloft seemed to be generally effective in my case, would Serzone be effective also?

Answer: Serzone is a similar to Zoloft in how it works in the brain. Generally, it does not decrease sexual drive. I would certainly try it in preference to Klonopin. Klonopin may be effective, but is addicting when taken for more than 6 weeks or so.

Klonopin - long term effects
Question: I have been taking Klonopin for the past seven years, and am now up to nearly four, 0.5 mg doses per day by my doctor's approval. Is the effect wearing off? Am I addicted? What effects might this drug have on any major organs such as the liver, brain, heart, etc.? I have a past history of abusing Valium. I haven't taken any Valium for seven years, but realize Klonopin is in the same chemical family.

Answer: Taking this amount of Klonopin over several years will certainly produce a physical addiction. However, it doesn't seem to have other major long term effects. Do not ever stop these drugs "cold turkey" because they can result in seizures. It sounds like you are well controlled on the medication. Consequently, I would keep on it.

Klonopin
Question: Our grown son takes Klonopin for an anxiety problem. Is this drug also used for insomnia?

Answer: Yes, along with many of the other tranquilizer type agents.

Klonopin
Question: I have been on Klonopin for a few months now for treatment of anxiety and panic attacks and I want to try to stop taking it and deal with the anxiety without mediation, under my doctor’s supervision. What is the history of Klonopin, as far as someone getting off of it? my history of anxiety is one of off and on due to certain circumstances in my life. At one time I was symptom free for more than 10 years it came back. I took no medication and it went away again. It came back and I was put on zoloft and then began to have panic attacks at which point I was put on klonopin. Can I once again be drug free and symptom free? Could being on zoloft made my condition worse?

Answer: Panic attacks commonly occur in clusters. That is, several for several weeks or months followed by several months to years of freedom. These attacks tend to run in families and often are improved with SRI drugs like zoloft. This drug would not be expected to worsen the condition. Klonopin is very useful, but also potentially addicting. Unlike heroin or morphine you should not stop this drug "cold turkey" as seizures can occur. Taper this drug slowly and see the effect on the panic attacks. I wouldn't be too concerned - you'll be able to stop the drug once this cluster of panic attacks are over.

Klonopin
Question: My 86-year-old mother started on Klonopin, 1/2 of .5 tablet (orange), two nights ago. This was to help her get off Ativan. She is very drugged, unable to walk around, and unable to function normally. Will this go away? Is this how the body responds at first, and then does it normalize? Will her body adjust? Will the lethargy and sedated feeling go away, or is this an indication she cannot take it?

Answer: Klonopin(clonazepam) is of the class of drugs called benzodiazepines. These include valium, librium, etc. These drugs are used to treat anxiety and some sleep disorders. The major side effect is sedation. While this can decrease, usually the amount of sedation will persist.

Klonopin
Question: I have been on Zoloft for about 5 weeks. To deal with the side effect of anxiety, the doctor put me on klonopin. Since I’ve been on Klonopin, I’ve noticed some shortness of breath. Is this a common side effect of klonopin?

Answer: Klonopin (clonazepam) is normally used in the treatment of anxiety disorders. It is included in the class of drugs called benzodiazepines. These include drugs like valium and librium among others. The most frequent side effects are usually related to central nervous system depression. This includes drowsiness, ataxia (loss of coordination), and behavior problems. As with most drugs, there is a long list of other reported side effects. These include shortness of breath (dyspnea). However, this is not a usual or common side effect of this drug.

Klonopin for Myoclonus
Question: I've been on klonopin for 18 months for myoclonus. I dislike the lethargy this drug brings. I am not sharp as usual. And, more important, I really can't see that it holds me even for 50% of the time. What are suitable alternatives for noctural myoclonus or PLMDS? I need to get back to my professional work with confidence. Klonopin has got to go--with me anyway. Suggestions? Or, can you tell me more about the addictive nature of this drug? I have tried to slowly get off it (2 0.5 mg tabs before bed) and got down to 1/2 tab--and then the shaking began again. I need to know: was that shaking from getting off the Klonopin or because I was not covered enough by it and the original condition was twitching through?

Answer: There are several opinions for patients looking for treatment for Restless Legs Syndrome(RLS), or for Periodic Leg Movement of Sleep(PLMS). EVERY PATIENT WILL RESOPOND DIFFERENTLY BOTH IN TERMS OF BENEFIT AND SIDE EFFECTS SO "YOUR MILAGE MAY VARY". Many patients have been tried with success on dopamine like medications which are used most commonly for the treatment of Parkinson's disease. Agents such as Sinemet, Parlodel, or Permax have become very popular in recent years. For younger patients taking these agents especially only in the evening or at bedtime, major side effects are not common. GI upset, lightheadedness are some but certainly not the only ones that can be encountered. More recently the Drug Neurontin which is FDA approved only for add on therapy for seizures has also found many proponents in this country. Other less commonly used medication include some of the other anti-seizure medications like Depakote. Baclofen which is an anti-spastically agent has also been tried. Finally the narcotic class of medications have their success stories-this category of meds used to be the most popular but for obvious reasons has fallen into disrepute.

Severe Depression
Question: After 7 mos. of ultimately reaching 40mg Paxil & 40mg Buspar to no appreciable beneficial effect, I have just started 20mg of Prozac for severe clinical depression plus Klonopin for extreme panic disorder. The limited info I know about Klonopin is that it seems to have a longer life than Xanax which is more an immediate "fix" and short lived which obviously presents the risk of addiction. My quest: in addition to the Klonopin I also received a script for Xanax. The dosage for Klonopin is 0.5mg with the OK to take as many as 20 in a 24hr period if needed. How do I make the distinction as which to take/can I take both and do they interfere in any way with Prozac? I'm not a stranger to panic disorder however I guess I've felt pretty "smug" or grateful because I saw myself as one of the few success stories. This was 18 yrs ago and with 2 yrs (3x wkly) I recovered with no prolonged medication, biofeedback etc. A specific event 7 mos. ago provided the catalyst for this depression and unbearable pain. Sorry to ramble on - my main concern is how should I treat Klonopin. should I just throw away the Xanax?

Answer: I'd focus on using one of these not both. They have similar effects-although different 1/2 lives. Either one is effective don't use both.



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