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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by lois on September 2, 2015, at 7:53:41
I tapered off clonazepam slowly over the last few months. I have been completely off for about 3 weeks. I understood I would have some insomnia while tapering, which I did. But I continue to have it severely. Is it possible for the insomnia to last several months or more after being off?
Thanks.
Posted by Hugh on September 2, 2015, at 9:20:18
In reply to insomnia after Klonipin (clonazepam) taper off, posted by lois on September 2, 2015, at 7:53:41
I took Ativan for insomnia for three years, and did a four-month taper to get off of it. I did a crossover to Valium halfway through my taper. My insomnia was worse during my taper, and for several months after I was benzo free, than it had been before I took Ativan.
Posted by lois on September 2, 2015, at 10:21:43
In reply to Re: insomnia after Klonipin (clonazepam) taper off, posted by Hugh on September 2, 2015, at 9:20:18
My insomnia was worse during my taper, and for several months after I was benzo free, than it had been before I took Ativan.
>Sounds like we have a similar experience with insomnia, except my med was clonazepam. So I have several months to deal with this.Did you ever get better without meds or did you have to take something else? I got tolerant to Ativan and Ambien. I want/have to try without meds for now.
Thanks for posting.
Lois
Posted by Hugh on September 2, 2015, at 12:21:23
In reply to Re: insomnia after Klonipin (clonazepam) taper off » Hugh, posted by lois on September 2, 2015, at 10:21:43
> I want/have to try without meds for now.
> Thanks for posting.
> LoisYou're welcome. This has been working for me for a year and a half:
http://www.dr-bob.org/babble/alter/20131226/msgs/1065521.html
I've read good things about this treatment for insomnia:
Posted by jpa on September 2, 2015, at 17:48:27
In reply to insomnia after Klonipin (clonazepam) taper off, posted by lois on September 2, 2015, at 7:53:41
Just is the process of tapering off valium. Ouch. I was taking it regularly at a low dose since January to help after discontinuing antidepressants.
I've been tapering for over a month. Currently I'm taking some once or twice a week. I have to bite the bullet and get off it entirely, but the insomnia is so bad, it is proving very difficult. I will go entire nights without sleeping and have to go to work the next day. I don't know how much is rebound or chronic insomnia. I will see a sleep CBT expert next week to help deal with the insomnia.
Medication is ineffective for me now. I've tried more than most. So I want to see if I can manage without medication...what a struggle.
Posted by lois on September 3, 2015, at 8:15:39
In reply to Re: insomnia after Klonipin (clonazepam) taper off, posted by jpa on September 2, 2015, at 17:48:27
I sleep only about every 3rd might. Maybe 1 hour on the other nights. Waking up interspersed with partial sleep. On the 3rd night, maybe 4 hours. Have a lot of nervousness during the day also, but exercise is helping. I am also coming off Latuda. I have only 2 drugs lelft that I will be on: Cymbalta and Lamictal. I don't know if these are all he'll keep me on, or if I can get a dopamine type of drug that had worked for me before. I am retired, but through the years I have had to work while going on and off meds. So I know how that is. Hope we both find relief soon. Thx.
Lois
Posted by phidippus on September 5, 2015, at 15:39:23
In reply to Re: insomnia after Klonipin (clonazepam) taper off » jpa, posted by lois on September 3, 2015, at 8:15:39
Is your lack of sleep characterized by an inability to sleep or lack of need to sleep? If you're feeling like you don't need to sleep then you're probably experiencing an elevated mood.
If this is the case or not, I'd recommend you try Seroquel, an AP that can help you sleep much better than the clonazepam. Seroquel can help with motivation and help you sort your thoughts better, too.
Eric
Posted by lois on September 6, 2015, at 6:35:55
In reply to Re: insomnia after Klonipin (clonazepam) taper off » lois, posted by phidippus on September 5, 2015, at 15:39:23
Eric,
I have an inability to sleep. However, when I took respiridone I slept less but didn't mind it since my mood was better.
Lois
Posted by phidippus on September 6, 2015, at 18:06:13
In reply to Re: insomnia after Klonipin (clonazepam) taper off » phidippus, posted by lois on September 6, 2015, at 6:35:55
Have you seen a sleep specialist who practices in CBT-I? They may be able to help.
Otherwise, Gabitril or Belsomra may help.
As for a replacement for Risperdone, I think Invega is going to be your best bet.
Eric
Posted by lois on September 7, 2015, at 7:16:12
In reply to Re: insomnia after Klonipin (clonazepam) taper off » lois, posted by phidippus on September 6, 2015, at 18:06:13
I have had Cognitive Behavioral Therapy in general. I know about conscious relaxation and things like exercise, etc. Is that what you mean? How does Invega differ from respiridone?
Lois
Posted by lois on September 7, 2015, at 7:26:49
In reply to Re: insomnia after Klonipin (clonazepam) taper off » lois, posted by phidippus on September 6, 2015, at 18:06:13
I wonder about Belsomra and Restoril being given with an SSRI and Lamictal. I see there is possibility for daytime sedation which has been my problem when I 'can' sleep. I stopped my clonazepam and it is better but I can't sleep and wake up with anxiety and a sense of foreboding. I see the Dr. Wednesday and want to have a list of possible things that might work. Of course, he will have ideas too, but it's scary to start something new 'again'. I am either nervous and depressed 'or' sedated and foggy. In between a rock and a hard place................
Lois
Posted by phidippus on September 7, 2015, at 13:44:51
In reply to Re: insomnia after Klonipin (clonazepam) taper off » phidippus, posted by lois on September 7, 2015, at 7:16:12
here's a good overview of CBT-I: https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy_for_insomnia
Well, Invega is the active metabolite of Risperidone, which means it gets processed by the liver differently. It has a similar effect as risperidone and most people taking it don't report much of a difference between it and risperidone.
I've taken it and really liked its effects-it is very calming and really helps clear your thinking.
Eric
Posted by phidippus on September 7, 2015, at 13:55:17
In reply to Re: insomnia after Klonipin (clonazepam) taper off » phidippus, posted by lois on September 7, 2015, at 7:26:49
Restoril is a benzodiazapine like clonazepam - it will have similar effects to clonazepam. It isn't contraindicated with Cymbalta and Lamictal.
Belsomra is an orexin antagonist and works very differently than restoril or clonazepam. It doesn't have a lot of side effects and will work perfectly fine with your current meds-Cymbalta and Lamictal.
If your nervous and depressed a lot of the time, I'd suggest another antidepressant. Have you ever been on Mirtazapine? That can help with sleep, anxiety and depression.
Eric
Posted by lois on September 7, 2015, at 17:21:52
In reply to Re: insomnia after Klonipin (clonazepam) taper off » lois, posted by phidippus on September 7, 2015, at 13:44:51
Eric,
Is Invega more or less likely to damage the liver?Why did they make it if it's so similar to resperidone? Because the patent ran out on resperidone? Are there less side effects?
I don't know whether to retry resperidone or try Invega. Does it help insomnia
'and' depression/nerves? Is it more expensive than resperidone?Lois
Posted by lois on September 7, 2015, at 17:27:19
In reply to Re: insomnia after Klonipin (clonazepam) taper off » lois, posted by phidippus on September 7, 2015, at 13:55:17
Eric
I really like the pain control that Cymbalta offers. My skin is really sensitive without it.
Well now I have more hope with controlling my insomnia. I didn't know there were any meds left that I hadn't tried.
I loved mertazapine (Remeron), but gained soooooooo much weight. I will never forget the wonderful sleep though and with no somnolence during the day.Thanks.
Lois
Posted by phidippus on September 8, 2015, at 9:52:05
In reply to Re: insomnia after Klonipin (clonazepam) taper off » phidippus, posted by lois on September 7, 2015, at 17:21:52
I think Invega is going to be processed by the liver differently than Risperidone, which may make it easier to metabolize.
Invega was made because the active metabolite of a drug usually has less side effects-for instance, Invega doesn't have the same prolactin issues Risperidone has.
The patent for Risperidone has probably not ran out.
Yes, there are fewer side effects.
Invega may help insomnia by calming things down-it helped me sleep.
It may help with depression, as it is a 5ht7 antagonist.
I don't know if its more expensive than Risperidone.
Eric
Posted by lois on September 8, 2015, at 10:10:08
In reply to Re: insomnia after Klonipin (clonazepam) taper off » lois, posted by phidippus on September 8, 2015, at 9:52:05
I'll see tomorrow if my Dr. will let me try Invega. He is new to me so I don't know how open he is to patients' suggestions. I can get the generic resperidone for less, I'm pretty sure, but if Invega works it'll be worth the cost.
Lois
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