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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by fires on July 7, 2005, at 0:02:24
I've been on 2 to 3 mg of Klonopin for many years.
I've been told that I need to stop taking it 48 hrs. prior to having a med. test(esophageal manometry).
Can I last 48 hrs.? or will discontinuation start?
I'm asking here before I see my pdoc next week.
Posted by ixus on July 7, 2005, at 2:08:07
In reply to Klonopin discontinuation?, posted by fires on July 7, 2005, at 0:02:24
> I've been on 2 to 3 mg of Klonopin for many years.
>
> I've been told that I need to stop taking it 48 hrs. prior to having a med. test(esophageal manometry).
>
> Can I last 48 hrs.? or will discontinuation start?
>
> I'm asking here before I see my pdoc next week.Hi,
I doubt. Withdrawal symptoms may be a problem. Especially seizure.
/ixus
Posted by fires on July 7, 2005, at 12:31:44
In reply to Re: Klonopin discontinuation? » fires, posted by ixus on July 7, 2005, at 2:08:07
Do you know how fast one can taper off Klonopin?
For example: drop 0.5 mg every 3 to 4 days? Would be a total of 18 - 24 days for 3mg.
I'll try searching for answer, too.
Thanks
Posted by 4WD on July 7, 2005, at 21:33:04
In reply to Klonopin discontinuation?, posted by fires on July 7, 2005, at 0:02:24
> I've been on 2 to 3 mg of Klonopin for many years.
>
> I've been told that I need to stop taking it 48 hrs. prior to having a med. test(esophageal manometry).
>
> Can I last 48 hrs.? or will discontinuation start?
>It seems to me the people who are doing the test ought to know you can't just stop 3-4 mg of Klonopin like that. Did you tell them your dosage and how long you've been taking it? Maybe they will let you just reduce the dosage?
Marsha
> I'm asking here before I see my pdoc next week.
Posted by fires on July 8, 2005, at 13:01:24
In reply to Re: Klonopin discontinuation? » fires, posted by 4WD on July 7, 2005, at 21:33:04
> > I've been on 2 to 3 mg of Klonopin for many years.
> >
> > I've been told that I need to stop taking it 48 hrs. prior to having a med. test(esophageal manometry).
> >
> > Can I last 48 hrs.? or will discontinuation start?> It seems to me the people who are doing the test ought to know you can't just stop 3-4 mg of Klonopin like that. Did you tell them your dosage and how long you've been taking it? Maybe they will let you just reduce the dosage?
>
> MarshaYeah. The instructions for the test state, in part:
48 hrs prior to your scheduled appointment please discontinue use of all medications of the following type:
Sedatives and hypnotics: Halcion, Xanax, Valium, Nembutal, Reglan
I got a nurse on the phone who understood my predicament and will call me back on Tues. to report what the Dr. doing the test says.
In the mean time I've started reducing my dose -- maybe too fast. I went from 3 mg per day down to 2.5 mg. On Monday I plan to drop to 2 mg if things are going OK.
Thanks
Posted by SLS on July 8, 2005, at 20:03:05
In reply to Re: Klonopin discontinuation? » 4WD, posted by fires on July 8, 2005, at 13:01:24
Hi.
> In the mean time I've started reducing my dose -- maybe too fast. I went from 3 mg per day down to 2.5 mg. On Monday I plan to drop to 2 mg if things are going OK.
You might want to check out the Withdrawal board for some ideas as to how to go about discontinuing Klonopin. I would consider using a flexible-dosing strategy in which one takes very small doses of drug whenever withdrawal symptoms appear - but not sooner. It's like taking aspirin for a headache only when the headache reappears. You might end up dosing several times a day. I believe this method helps "nudge" the system into re-regulating itself.
- Scott
Posted by fires on July 8, 2005, at 20:25:12
In reply to Re: Klonopin discontinuation?, posted by SLS on July 8, 2005, at 20:03:05
> Hi.
>
> > In the mean time I've started reducing my dose -- maybe too fast. I went from 3 mg per day down to 2.5 mg. On Monday I plan to drop to 2 mg if things are going OK.
>
> You might want to check out the Withdrawal board for some ideas as to how to go about discontinuing Klonopin. I would consider using a flexible-dosing strategy in which one takes very small doses of drug whenever withdrawal symptoms appear - but not sooner. It's like taking aspirin for a headache only when the headache reappears. You might end up dosing several times a day. I believe this method helps "nudge" the system into re-regulating itself.
>
>
> - ScottDo you mean that very small doses can alleviate the symptoms from a much larger dose reduction? Seems counterintuitive to me, but I may try it if needed.
Posted by SLS on July 8, 2005, at 20:48:12
In reply to Re: Klonopin discontinuation? » SLS, posted by fires on July 8, 2005, at 20:25:12
> > Hi.
> >
> > > In the mean time I've started reducing my dose -- maybe too fast. I went from 3 mg per day down to 2.5 mg. On Monday I plan to drop to 2 mg if things are going OK.
> >
> > You might want to check out the Withdrawal board for some ideas as to how to go about discontinuing Klonopin. I would consider using a flexible-dosing strategy in which one takes very small doses of drug whenever withdrawal symptoms appear - but not sooner. It's like taking aspirin for a headache only when the headache reappears. You might end up dosing several times a day. I believe this method helps "nudge" the system into re-regulating itself.
> >
> >
> > - Scott
>
> Do you mean that very small doses can alleviate the symptoms from a much larger dose reduction? Seems counterintuitive to me, but I may try it if needed.
I am not explaining myself very well - sorry.Perhaps you can start by limiting your doses to 0.5mg, and take them only when you feel the withdrawal symptoms appear. You might be dosing 3-5 times a day to begin with. You can experiment with dosages (splitting pills if necessary) and find that amount that will allow you to go 6-8 hours without symptoms. You should find that this dosage amount can be reduced over time. Alternatively, you will find that the same dose will allow you to go beyond 8 hours without symptoms. However, to optimize the taper to discontinue the drug as soon as possible, you are better off reducing the dosage and maintaining the 6-8 hour period.
This flexible-dosing method has worked for quite a few people, including me, but there are no guarantees. This method also reduces suffering. It is important not to allow the withdrawal symptoms persist once they reappear. Take your next dose once you recognize the symptoms. Try not to wait beyond an hour before dosing again.
I have used this method to discontinue SSRIs, Effexor, Cymbalta, Klonopin, and Ativan. With it, I can discontinue 300mg of Effexor within two weeks.
- Scott
Posted by fires on July 8, 2005, at 21:04:07
In reply to Re: Klonopin discontinuation?, posted by SLS on July 8, 2005, at 20:48:12
> > Do you mean that very small doses can alleviate the symptoms from a much larger dose reduction? Seems counterintuitive to me, but I may try it if needed.
>
>
> I am not explaining myself very well - sorry.
>
> Perhaps you can start by limiting your doses to 0.5mg, and take them only when you feel the withdrawal symptoms appear. You might be dosing 3-5 times a day to begin with. You can experiment with dosages (splitting pills if necessary) and find that amount that will allow you to go 6-8 hours without symptoms. You should find that this dosage amount can be reduced over time. Alternatively, you will find that the same dose will allow you to go beyond 8 hours without symptoms. However, to optimize the taper to discontinue the drug as soon as possible, you are better off reducing the dosage and maintaining the 6-8 hour period.
>
> This flexible-dosing method has worked for quite a few people, including me, but there are no guarantees. This method also reduces suffering. It is important not to allow the withdrawal symptoms persist once they reappear. Take your next dose once you recognize the symptoms. Try not to wait beyond an hour before dosing again.
>
> I have used this method to discontinue SSRIs, Effexor, Cymbalta, Klonopin, and Ativan. With it, I can discontinue 300mg of Effexor within two weeks.
>
>
> - ScottI forgot to mention that I take 1mg of Klonopin 3 times a day. Therefore I'm already going to have an easier time discontinuing it -- right? (Compared to someone taking 3 mg all at one time each day) I reduced my AM dose to 0.5 mg. Then, from what I think I understand about your technique, my next .5 mg reduction should come out of my noon dose -- then the next reduction out of my bedtime dose. Then repeat the above? Maybe reducing by only .25 mg each dose, but reducing the dose sooner (every 3 days vs. 4 days)?
Or, am I still not grasping your concept?
Posted by Declan on July 8, 2005, at 23:05:08
In reply to Re: Klonopin discontinuation? » SLS, posted by fires on July 8, 2005, at 21:04:07
I don't think you can stop using benzos so precipitately, you just won't be able to do it, or you will be a wreck, IMO. Maybe they mean you should not be under *the influence* of Klonopin.
Declan
Posted by SLS on July 8, 2005, at 23:25:01
In reply to Re: Klonopin discontinuation? » SLS, posted by fires on July 8, 2005, at 21:04:07
> > > Do you mean that very small doses can alleviate the symptoms from a much larger dose reduction? Seems counterintuitive to me, but I may try it if needed.
> >
> >
> > I am not explaining myself very well - sorry.
> >
> > Perhaps you can start by limiting your doses to 0.5mg, and take them only when you feel the withdrawal symptoms appear. You might be dosing 3-5 times a day to begin with. You can experiment with dosages (splitting pills if necessary) and find that amount that will allow you to go 6-8 hours without symptoms. You should find that this dosage amount can be reduced over time. Alternatively, you will find that the same dose will allow you to go beyond 8 hours without symptoms. However, to optimize the taper to discontinue the drug as soon as possible, you are better off reducing the dosage and maintaining the 6-8 hour period.
> >
> > This flexible-dosing method has worked for quite a few people, including me, but there are no guarantees. This method also reduces suffering. It is important not to allow the withdrawal symptoms persist once they reappear. Take your next dose once you recognize the symptoms. Try not to wait beyond an hour before dosing again.
> >
> > I have used this method to discontinue SSRIs, Effexor, Cymbalta, Klonopin, and Ativan. With it, I can discontinue 300mg of Effexor within two weeks.
> >
> >
> > - Scott
>
> I forgot to mention that I take 1mg of Klonopin 3 times a day. Therefore I'm already going to have an easier time discontinuing it -- right? (Compared to someone taking 3 mg all at one time each day) I reduced my AM dose to 0.5 mg. Then, from what I think I understand about your technique, my next .5 mg reduction should come out of my noon dose -- then the next reduction out of my bedtime dose. Then repeat the above? Maybe reducing by only .25 mg each dose, but reducing the dose sooner (every 3 days vs. 4 days)?
>
> Or, am I still not grasping your concept?:-)
You will actually take 0.5mg ONLY when you feel the withdrawal symptoms appear. That might be a good place to start. Don't worry about reducing the dosage for now. Just count how many times you need to dose yourself per day. Hopefully, it will be 5 or less. However, it is important to wait until the withdrawal symptoms begin to reappear before taking each dose. These might include dizziness, anxiety or nervousness, tremulousness, teeth-clenching, heart palpitations, sweating, and dry mouth.
The next step might be to use 0.25mg doses or something in between 0.5 and 0.25. You will initially need to take it more often, but you should find that the periods between dosing grows longer and longer until you are back to dosing 3-4 times a day. Try to avoid allowing the withdrawal symptoms from persisting for more than an hour before taking your next dose. This might be important in minimizing the withdrawal syndrome once you discontinue the drug entirely.
- Scott
Posted by fires on July 8, 2005, at 23:47:42
In reply to Re: Klonopin discontinuation?, posted by Declan on July 8, 2005, at 23:05:08
> I don't think you can stop using benzos so precipitately, you just won't be able to do it, or you will be a wreck, IMO. Maybe they mean you should not be under *the influence* of Klonopin.
> DeclanI just read on the Cleveland Clinic site that sedatives need to be stopped only 12 hrs before the test. Not 48 hrs like my University Med Center says. That seems like it would be possible. I go 8 to 10 hours sometimes between my nightime dose and morning dose.
Thanks
Posted by fires on July 9, 2005, at 8:35:53
In reply to Re: Klonopin discontinuation?, posted by SLS on July 8, 2005, at 23:25:01
>
> You will actually take 0.5mg ONLY when you feel the withdrawal symptoms appear. That might be a good place to start. Don't worry about reducing the dosage for now. Just count how many times you need to dose yourself per day. Hopefully, it will be 5 or less. However, it is important to wait until the withdrawal symptoms begin to reappear before taking each dose. These might include dizziness, anxiety or nervousness, tremulousness, teeth-clenching, heart palpitations, sweating, and dry mouth.
>
> The next step might be to use 0.25mg doses or something in between 0.5 and 0.25. You will initially need to take it more often, but you should find that the periods between dosing grows longer and longer until you are back to dosing 3-4 times a day. Try to avoid allowing the withdrawal symptoms from persisting for more than an hour before taking your next dose. This might be important in minimizing the withdrawal syndrome once you discontinue the drug entirely.
>
>
> - ScottI have other med. conditions that would make the above method impossible. I wouldn't be able to tell a withdrawal symptom from another "regular" symptom. Also, I take a total of around 10 meds.
Also, my pdoc would never approve of it. I know her to well. "Low and slow" is her motto. I just want to go a little faster than what I think her "slow" is.
Thanks
Posted by SLS on July 9, 2005, at 9:05:07
In reply to Re: Klonopin discontinuation?, posted by fires on July 9, 2005, at 8:35:53
I guess it goes without saying that you should perhaps let your body's reaction to decreasing dosages help to determine your rate of taper and discontinuation. It is no fun to remain in a constant state of withdrawal over the course of weeks. I once did that with Klonopin. Others have pointed out that it is important to reduce stress during the withdrawal period, get rest, and exercise. Some use vitamins and certain supplements to help them along. You can find some of these ideas posted by people on the Withdrawal board.
Are any of the other medications you are taking an anticonvulsant? I am curious to know how anticonvulsants might modify the withdrawal process.
- Scott
Posted by fires on July 9, 2005, at 11:06:24
In reply to Re: Klonopin discontinuation? » fires, posted by SLS on July 9, 2005, at 9:05:07
> I guess it goes without saying that you should perhaps let your body's reaction to decreasing dosages help to determine your rate of taper and discontinuation. It is no fun to remain in a constant state of withdrawal over the course of weeks. I once did that with Klonopin. Others have pointed out that it is important to reduce stress during the withdrawal period, get rest, and exercise. Some use vitamins and certain supplements to help them along. You can find some of these ideas posted by people on the Withdrawal board.
>
> Are any of the other medications you are taking an anticonvulsant? I am curious to know how anticonvulsants might modify the withdrawal process.
>
>
> - Scott
I'm not currently taking any other anticonvulsant, but will probably try Lamictal again after stopping Klonopin. I'm going to browse around the withdrawl board.Thanks
Posted by ixus on July 9, 2005, at 15:30:03
In reply to Re: Klonopin discontinuation? » ixus, posted by fires on July 7, 2005, at 12:31:44
> Do you know how fast one can taper off Klonopin?
>
> For example: drop 0.5 mg every 3 to 4 days? Would be a total of 18 - 24 days for 3mg.
>
> I'll try searching for answer, too.
>
> ThanksMaybe too quick, but considering half life of clonazepam it is certainly enough to observe the side effects.
/ixus
This is the end of the thread.
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