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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Decreasing Dosage Of Klonopin For Anoxic Brain Injury. Feeling Cold, Foot Pain, Short Term Memory Loss. Normal?

I was okayed to begin decreasing my husband s Klonopin from 1.0 mg to .5 mg. He takes this 2xs a day and has been on it for about 3 mos. He has an anoxic brain injury and was feeling very anxious while in rehab. This medicine was also given to settle myoclonic jerks and has seemed to help with that. However, now that he is home, I became concerned with all the side effects I have read. I awake to him shaking each morning and saying he is freezing when his body is warm to the touch. He also suffers from a great deal of foot/toe pain. His short term memory is already affected from the anoxic brain injury and he is confused during the day. I really want to be able to determine how much of this is truly due to his brain injury and how much is medicine related. He also takes 1500 mg of Keppra each day. Only day one but he was agitated this morning. Wanted your thoughts on what is normal to expect when weaning him down here.
Mon, 18 Nov 2013
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Internal Medicine Specialist 's  Response
Hi there,

Thanks for your query.

Firstly, the effects of anoxic brain injury depend primarily on the brain sites and whether left or right brain, involved. But, in general, confusion, loss of short-term/old memories, jerks, weakness of limbs, possible bladder and bowel problems are some of the features.

Since, both : Klonopin and Keppra produce (and, also POTENTIATE each other's action) increased sleepiness, memory impairment, cognitive functions, rational thought process, confusion etc... , it is very difficult to determine whether his problems are due to brain injury or drugs; or BOTH.

Klonopin was given to reduce/curb anxiety, as well as, myoclonic jerks; while Keppra too prevent seizures (common in brain injury due to any cause) and myoclonic jerks.

It is therefore recommended that doses of both : Klonopin and Keppra may be reduced AND titrated to the basic minimum dose, required to keep anxiety, myoclonic jerks and potential seizures under control. This way, the aim of reducing side effects to minimum, while at the same time, keep the brain injury symptoms under control- will be achieved AND DESIRABLE.

Consult your Neurologist and discuss my views, opinion and recommendations with him. I am sure that he will agree with me and do the needful.

If you find my response helpful and informative, do not forget an “excellent” rating to my answer, to encourage all doctors- engaged in social service- to render sound advice to the FREE queries.

Fond regards and have a nice day

Dr. Rakesh Karanwal
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Decreasing Dosage Of Klonopin For Anoxic Brain Injury. Feeling Cold, Foot Pain, Short Term Memory Loss. Normal?

Hi there, Thanks for your query. Firstly, the effects of anoxic brain injury depend primarily on the brain sites and whether left or right brain, involved. But, in general, confusion, loss of short-term/old memories, jerks, weakness of limbs, possible bladder and bowel problems are some of the features. Since, both : Klonopin and Keppra produce (and, also POTENTIATE each other s action) increased sleepiness, memory impairment, cognitive functions, rational thought process, confusion etc... , it is very difficult to determine whether his problems are due to brain injury or drugs; or BOTH. Klonopin was given to reduce/curb anxiety, as well as, myoclonic jerks; while Keppra too prevent seizures (common in brain injury due to any cause) and myoclonic jerks. It is therefore recommended that doses of both : Klonopin and Keppra may be reduced AND titrated to the basic minimum dose, required to keep anxiety, myoclonic jerks and potential seizures under control. This way, the aim of reducing side effects to minimum, while at the same time, keep the brain injury symptoms under control- will be achieved AND DESIRABLE. Consult your Neurologist and discuss my views, opinion and recommendations with him. I am sure that he will agree with me and do the needful. If you find my response helpful and informative, do not forget an “excellent” rating to my answer, to encourage all doctors- engaged in social service- to render sound advice to the FREE queries. Fond regards and have a nice day Dr. Rakesh Karanwal