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What Causes Anxiety, Panic Attacks And Depression After Discontinuation Of Klonopin?

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Posted on Mon, 20 Jul 2015
Question: I have anxiety and panic attacks and depression. I did a acute withdrawal from klonoplin (not recommended) at a hospital for10 days. I was taking as precribed for years. 3mg three times a day. The docs at hospital switched me to effexsor. 150 mg, I had protracted withdrawal from Klonopin, panic attacks, confusion, unusual skin sensations. Horrible. It has been two months now. I went to pych doc who said effexsor can cause exitabiity. he put me back on klonopin .5 mg 3 times a day and cut effesor in half and added paxil, which I took for years. I'm very concerned about the reapid detox of klonopin, musctle jerks etc, The .5 mg of K doesnt help panic. The doc questioned why the hospital (inpatient) put me on effexsor. I scared that i have protacted withdrawal syndrome and will have it for life. I never had panic. before
I was army pilot with PTSD the reason my former doc put me on Klonopin. My last dosage was 1mg 3 tx day, I read extensivly on protracted withrawal syndrome, Can last monts/years/ or forever. one remendy is go back on Klonopin and taper very slowly. I thought it would be wise to go back to last dosage (2 months ago) to establish baseline with the paxil and work from threre for extended taper,
Dear Doctor, I read a study fro UK regarding Protracted Withdrawal syndrome from bensodiazapie. Search UK study on Protracted Withdrawal Syndrome (benzo) . Most docs are not familiar. My knew pych doc said "he heard of it" I need an expert on the matter. Just using the scientific proccess,it makes since to start over at the last base line: 1 mg klonopin 3 tx day and back to paxil. I am going to Rutgers for voc reab from Army and received a 3.7 cum and was doing well prior to the10acute withdrawal from knlonopin. Klonopin has a long hals life vs xanx, The hospital i went to never inquired what I was taking, ie klonopin nor for long. !0 months is what i read for appropriate taper from klonopin, not 10days. I read report from Dr XXXXXXX Statyner from Mount Sinai School of Medicine in NY. He seems to be the SME in this field. Can you consult with him. I'm terrified that I'm not getting the right help. Please help My current new doctor id Dr Heller in Colts neck NJ 732-915-8905 He seems good. And compassioate, ut this syndrome is rare. By the way , I never abused my prescription
doctor
Answered by Dr. Shubham Mehta (1 hour later)
Brief Answer:
restart klonopin with initial dose and withdraw slowly.

Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.

Benzos can cause protracted withdrawal syndrome.

Your Klonopin was stopped abruptly and effexor 150mg was started.
You suffered panic attacks,confusion and unusual skin sensations.
In my opinion, these symptoms were most probably the withdrawal effects of klonopin. Also, starting effexor 150mg straightaway would have added to the confusion and panic. Effexor is never to started at a go at this high dose.

I also feel that effexor was a wrong choice for you as this drug can itself cause withdrawal symptoms when discontinued.

Yes this protracted withdrawal syndrome is rare and the symptoms can persist from months to years.

I would also opine that you must start with your initial dose of klnonopin (that is 1 mg three times a day).
The drug can be gradually tapered from there depending on how you tolerate the tapering.

Other way is to start with a long acting benzo (like diazepam or chlordiazepoxide) in the equivalent doses to klonopin and then gradually withdraw from this drug. These long acting benzos are relatively easy to stop.
(klonopin 0.5mg=25mg chlordiazepoxide=5mg diazepam).

Secondly, there is no reason to use effexor. There is no rationale in using two antidepressants, effexor and paxil. Only paxil would be sufficient.

Kindly discuss these issues with your doctor and you can plan further management accordingly.

Do not worry. You will be fine once you restart with the initial doses of klonopin.

Hope this helps.
Feel free to ask further.
Thanks.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shubham Mehta

Psychiatrist

Practicing since :2008

Answered : 2145 Questions

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What Causes Anxiety, Panic Attacks And Depression After Discontinuation Of Klonopin?

Brief Answer: restart klonopin with initial dose and withdraw slowly. Detailed Answer: Hello Welcome to HCM. I can understand your concerns. Benzos can cause protracted withdrawal syndrome. Your Klonopin was stopped abruptly and effexor 150mg was started. You suffered panic attacks,confusion and unusual skin sensations. In my opinion, these symptoms were most probably the withdrawal effects of klonopin. Also, starting effexor 150mg straightaway would have added to the confusion and panic. Effexor is never to started at a go at this high dose. I also feel that effexor was a wrong choice for you as this drug can itself cause withdrawal symptoms when discontinued. Yes this protracted withdrawal syndrome is rare and the symptoms can persist from months to years. I would also opine that you must start with your initial dose of klnonopin (that is 1 mg three times a day). The drug can be gradually tapered from there depending on how you tolerate the tapering. Other way is to start with a long acting benzo (like diazepam or chlordiazepoxide) in the equivalent doses to klonopin and then gradually withdraw from this drug. These long acting benzos are relatively easy to stop. (klonopin 0.5mg=25mg chlordiazepoxide=5mg diazepam). Secondly, there is no reason to use effexor. There is no rationale in using two antidepressants, effexor and paxil. Only paxil would be sufficient. Kindly discuss these issues with your doctor and you can plan further management accordingly. Do not worry. You will be fine once you restart with the initial doses of klonopin. Hope this helps. Feel free to ask further. Thanks.