Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

172 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What medication can helping in safely weaning off Klonopin?

Answered by
Dr.
Dr. Soujanya

Psychiatrist

Practicing since :2008

Answered : 611 Questions

default
Posted on Tue, 16 Oct 2018 in Mental Health
Question: It may have been a mistake to read too much on line about Klonopin? That said, my wife of 41 years died about 4 years ago and my anxiety driven depression hit the roof. My psychiatrist prescribed a low does of Klonopin, i.e. .5 mg. per day (along with other SSRIs). At one point he increased that to 2, .5mg per day. I'm now back down to .5mg a day and very much want to get off of Klonopin altogether. With great concern about what I've been reading regarding memory loss (is memory loss reversible ?), and one piece/study that said a person is twice as likely to acquire Alzheimer's with long term use of Klonopin. I was terrified! Some of my friends have said they notice that I'm not as sharp (they said it more nicely) as I used to be. I'm 68 and fairly healthy other than I may in fact be struggling with short term memory problems? I'm under the care of a new psychiatrist now (I just moved from So Cal to No Cal) and am working with him to titrate off the Klonopin. That said, I'm struggling to stick with the titration protocol. I cut the pill in half (1 in the morning, then one in the evening) and I'm on track for a few days, then the least little think will kick me back to taking the whole pill at once. There have been a few days (per month) that I have taken 2 pills in a day. I just e-mailed my psychiatrist and disclosed what I'm saying to you (it's a 3 day holiday and I'm anxious just thinking about this). I read that sometimes Valium or a drug called Flumazenil (if I understood correctly) might be used in helping come off Klonopin. I don't want to trade one dependency for another but I also want to figure out what might help me in this process. Have you heard of Valium, Flumazenil or any other medication helping in weaning off Klonopin?
doctor
Answered by Dr. Soujanya 1 hour later
Brief Answer:

My suggestion.

Detailed Answer:

Hello!

I have gone through your query in detail and can understand your concern towards the weaning of Klonopin and the adverse effects of it.

Yes, it is accepted according to some studies that the long term use of Klonopin may result in Alzeimer's, but the dose, duration of use matters in most of the cases.

I would like to inform you that there is very less risk of cognitive disturbance with long acting benzodiazepines like Klonopin.

So, I would advise you to not to worry much about its side effects, as those changes are reversible if you wean off from it as advised by the psychiatrist.

I hope that you are following your doctor's advise in weaning of from it, to prevent its withdrawal effects.

Usually, Flumazenil is a drug used in benzodiazepine overdose, but it is not advisable in the process of weaning off from Klonopin.

Hope this information would help you. Feel free to ask any further questions.

Regards,

Dr. Soujanya,
Psychiatrist.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
default
Follow up: Dr. Soujanya 16 hours later
Thank you Dr. XXXXXXX can you elaborate just a bit on the lower probability that long lasting benzos, like Klonopin, will interfere with cognitive functioning and memory loss? Is there an online article you can point me to? It's good to hear that any memory loss is reversible. Also, from what I've read on line, weaning off is often unsuccessful (I'm paraphrasing). Do you agree with this? Can you also elaborate a on how well established it is that long term benzo use can lead to Alzheimer's? One article I read said it could double the chances of developing Alzheimer's! Is this true?Is there an article I can read on this? Finally, you have said that "usually" flumazenil is used for overdose. Is it ever used to help in weaning off Klonopin? Are there any other medications that might help in the weaning off process? Thank you for getting back so quickly. Will you (the same psychiatrist) be responding or will I get responses from different psychiatrists each time I ask a question? I imagine every psychiatrist may have slightly different views. Yes, I am working closely with my psychiatrist but usually he only asks to see me every 6 to 8 weeks. I have Kaiser and I have used "KP.org" to emailed him pretty much what I have emailed you. It's nice to get such a quick response as well as a second opinion. Thank you very much Dr. XXXXXXX




doctor
Answered by Dr. Soujanya 8 hours later
Brief Answer:

You are most welcome.

Detailed Answer:

Hello and welcome back,

I have gone through your queries in detail and can understand that you are browsing a lot about Klonopin.

Anyway, it is good that you are gathering information, but it shouldn't aggravate your anxiety.

Risk of Alzheimer's is more in the long term usuage of benzodiazepines like diazepam, but it is around 0.1 - 1 % in case of Klonopin.

More over, it depends on duration and dosage of it along with the presence of overdose symptoms. Definitely, it is nothing to worry if you does not have any withdrawal symptoms and get weaned off as advised by psychiatrist.

Yes, it may double the chance but not in case of Klonopin. Flumazenil is never used in weaning off from Klonopin, unless and otherwise if you have any respiratory depression due to its abuse.

You can wean off by taking equivalent doses of other long acting benzodiazepines like Chlordiazepoxide.

You can get response from the same psychiatrist everytime, so nothing to worry.

You can discuss your queries with me comfortably.

It is good that you are following your psychiatrist advise by regular follow ups.

Hope I have answered your question. Let me know if I can assist you further.

Regards,

Dr. Soujanya,
Psychiatrist.
Above answer was peer-reviewed by : Dr. Kampana
doctor
default
Follow up: Dr. Soujanya 18 hours later
Thank you so much Dr. XXXXXXX I can't tell you what a relief it is and how helpful you have been to me in hearing a second opinion and getting responses so quickly. I've never done this on line before and I'm not sure about how long this service last? Regardless, can you tell me a way that I can stay in touch with you (specifically) if I want to reach out with some questions two or three months from now?

So I'm interpreting what you wrote as it can be successful in weaning under my doctors supervision. I'll keep trying but the motivation behind my searching all over the internet is that I keep trying then relapsing.

My wife of 41 years died a few years ago and I am the sole provider/caregiver for my 33 year old daughter who was born with cerebral palsy, is confined to a wheelchair and dependent on me. I share this because I don't really have the money or the time to check into a rehab center over just .5 mg of Klonopin. Also, I couldn't leave my daughter for any prolonged period of time.

I did read an article (I believe it was authored by a psychiatrist) that clearly stated that Flumazenil is the preferred approach to detox from benzos including Klonopin. I found this article at: (https://www.recovery.org/forum/discussion/237/does-benzodiazepine-detox-work) in Benzodiazepines/Benzos (https:/www.recovery.org/forums/catagories/benzodiazepins-benzos)

I don't know if you would have time, or can even find the article, with the information I gave you but, if you do have time and can find what I have read I would be interested in your opinion. If you don't have time I totally understand.

Thanks again for your support. I really appreciate it.

PS: I've been a licensed clinical psychologist here in California for 35 years. I'm pretty familiar with addictive medicine and find it ironic (yet sad and frustrating) that I have gotten caught up in it at a personal level.
doctor
Answered by Dr. Soujanya 8 hours later
Brief Answer:

I'm very much thankful for your response

Detailed Answer:

Hello,

I have gone through your query in detail and understand that you are very much familiar with addictive medicine.

I'm glad that my information regarding Alzheimer's helped you, and make you feel comfortable.

You can always keep in touch with me through XXXXXX XXXX XXXXX, by preferring direct premium questions.

It's my pleasure to follow up with you.

With the information provided by you, I have gone through the particular article and got to know about the role of Flumazenil in rapid detoxification process.

I also advise you to go through rapid detoxification process ( RBD), in which it is clearly understood that Flumazenil helps in rapid detoxification, comfortable with less withdrawal symptoms and it would be done in around 8 days.

I'm thankful to you for sharing such a good and relevant information with me.

So, l can advise you to consider this option if you want to get rid of withdrawal symptoms in a short duration.

Usually, Flumazenil has to be given by subcutaneous infusion. The only risk I can find is seizures may occur. The possibility may be around 1-3%. So, it has to be accompanied with seizure preventive therapy.

Anyway, this therapy has to be carried out in proper supervision of psychiatrist, usually in rehabilitation centres.

I can understand your financial situation, but it is definitely has to be done under supervision.

Another way I can suggest you to wean off with the present dose of Klonopin that is 0.5 mg twice a day for 1 week.

Then taper it to one forth in next week. Half of it in the following week and then completely stop in the 4th week.

The morning dose has to be tapered first when compared to the night one.

Hope this information would clears your concerns. Let me know if I can assist you further.

Regards,

Dr. Soujanya,
Psychiatrist.


Above answer was peer-reviewed by : Dr. Kampana
doctor
premium_optimized

The User accepted the expert's answer

Share on