How this thing came on
 

I was going along reducing my gabapentin when suddenly I wasn't sleeping for 5 days. Then the most debilitating panic began until I had to call an ambulance and they said I was having some kind of seizure. When they got me to the hospital I became dissociated and so they gave me Ativan. But no matter how much they gave me while they held me there I continued to shake and remained sleepless. They tried everything including Thorazine and I did not sleep. This went on for another 2 days and then I was in and out for 4-5 days. Then I was apparently sobbing and moaning for no reason. They gave me a series of anti-psychotics which gave me akathisia. I am on the Klonopin now at 1.5mg and they have given 100mg Elavil. Now at home I still don't sleep really and cannot get up to do anything. Their only explanation is that my brain chemistry had somehow changed after a few months ago when I sick with what for weeks they were certain was lung cancer but turned out to be only Valley Fever. Needless to say, I am shocked because I have never had any such severe mental disturbance and there is no history of it in my family.

To Waves and Dr. Smith: I just wanted to say you guys were kind to have taken an interest in me. If you know how I might get off the Klonopin I'd appreciate it. If this whole thing just freaks you out and you are uninterested I fully understand.

Hi Adamo
 

Don't worry about what you say here. We are all in your corner and do care. Thats why this site was created no doubt. You have been on a hard path.
Do you think the Klonopin is doing you harm? As far as weaning off a medication, I do have experience with that. Do it with your doctors input. Sometimes as you already found out, withdraw from meds. can produce its own set of issues. Go down little by little.
I did this too, and use an over the counter sleep med, just to help me at night.
Wean off slowly and you should be OK. Keep us posted. I do talk to DocSmith and waves. They both have good knowledge about weaning off medications. Hang in there. You are not alone when you are posting us. I will keep you in my thoughts and prayers. ginnie:grouphug:

I do not know what harm it is doing but....
 

At night it does help sleep somewhat but when I am awake it makes me more agitated. Sleeping or waking I am constantly shaking and in discomfort!
I wish all I had to do was continue with a gaba withdrawal but that's a distant dream. My psyches say it is now all up to me to get it together — there's nothing they think they can do short of ECT which I don't want! Truly disheartened and hopeless!

Hello there, Adamo
 

Dear Adamo,

I am sorry to hear of this terrible experience you've just been through, and the current situation of chronic discomfort.

First let me say it does not freak me out and and "uninterested" does not apply either. On the contrary, I am quite worried about you. I might not be able to visit NT daily as I have some things going on myself, but I will flit and out every few days to check on you, ok?

Now, on to business. I am afraid -- don't hate me -- that your present situation is far too complex for me to toss numbers out. With rare exception, a benzodiazepine taper is inadvisable in the presence of the symptoms you describe. :o The big picture needs to be looked at first, and an expert (in psychopharmacology, i.e. a psychiatrist) needs to look at it and make the calls.

I wish I could be of more help but, other than being here, I'm afraid my best advice is to enlist the help of a psychiatrist on this. I realize it must be very scary, but please don't worry about having some mental illness right now. These problems may possibly have manifested because of an inherent illness, or they could have been precipitated by your phsyical illness, the situation, or a medication. It doesn't matter though - what does matter is for you to get better, and I really believe that expert help is required here.

If you have a psychiatrist, put in a call and say you are not sleeping. That usually sets alarm bells off for them. Same if you have to make an appointment with a new one -- it should get you in quicker. Bring in the records from the hospital stay. It will help the doctor to see the precise medications given and to see their documentation on observed symptoms.

Keep us posted and I really hope you feel better soon.

waves

p.s. Are you off the gabapentin now? If not, how much are you taking? I am confused because you didn't mention it.

If you only take it in the evening, the effect might have worn off enough during the day so as not to help you. There are rare cases of paradoxical agitation from benzodiazepines, but in that case, it should not help you sleep. Of course... it could be that the Elavil alone is what is helping you to sleep.

I don't know who "they" are who say they cannot do anything else, but I would talk to someone other than "them" ... a different psychiatrist. This all sounds positively horrid. I am so sorry! :hug:

waves

Thanks for the encouragement
 

I am no longer on gaba. I was instructed to take 1.5 klon at night and .5 in the am. When I said "they" I referred to a psyche who conferred with a hospital doctor at the time recommending ECT. Their last claim is that once the elavil starts working on the depression they intend then to take me off the klon: .5 mg a time every 5 days. Isn't that too fast? I have a sneaking suspicion that klon withdrawal will guarantee that I will not sleep — but that would be withdrawal sxs. Is five to seven weeks at 2mg klon/day something difficult to withdraw from? I feel like I was better off simply withdrawing from gaba. I have heard that withdrawal from Klonopin is far more difficult than gaba. Is this true? At least I could exercise vigorously while on gaba. I wonder if it dangerous to exercise that way on klonopin or elavil because I am otherwise healthy. This may all sound preposterous but I still foolishly aspire to get myself together if at all possible by December. I mean my wish is to be merely on elavil if possible. I don't expect you to advise me in any direct manner about this, I simply appreciate your impressions of this screwed-up situation. Thanks again.

Hi Adamo
 

Neither drug is fun to wean off. Both present issues, which a lot of people do feel. I want you to know however there is an END to the withdraw effects. Eventually you even out, and feel better. It does take some doing, but in the end you may be better off. 2 mg. is quite a bit of klonopin. Ginnie:grouphug:

You are very kind
 

Thanks for the encouragement. I feel stupid to have gotten into this mess in the first place! I have now reduced it to 1.5 mg (1 at night, .5 in the day) with some discomfort. At this point I am just frustrated to be so indigent. I wonder if I could stop at all. Again, thanks for the pep-talk

Answers as best I can, and thoughts...
 

Well, this is progress! The big nasy beastie is out of the picture! :)

To summarize, it does seem fast to me, but you haven't taken Klonopin very long so it might be just fine.

Tidbits from my personal experience and some general information:

When I taper, I roughly observe Ashton's protocol, but then this is designed for those who've been in long-term treatment which is my case (6 years of use the first time, 2 years the second time and I'm still working on that taper ;)).

For your reference, Ashton's guidelines are described here:

The Ashton Manual

Bear in mind that, except for the Valium & Librium ones, all the different schedules are for substitution with Valium. I use the Valium schedule as a basis for my own tapers. It calls for a 5-10% reduction every 1-2 weeks.

0.5mg is 25% of your starting dose (2 mg) every 5 days. That may be ok given you've only taken Klonopin for 7 weeks so far. You could simply try it and see what happens after one reduction. If there is discomfort, you should report it and ask to taper more slowly (you could suggest 10 days between decrements). The point of a rapid reduction might be to keep the total treatment time down, to reduce the chance of stronger dependence. These are all things to discuss with a doctor.

Do you have a psychiatrist you can see, without going to the ER?

I don't think a comparison is useful. Your experience with the gabapentin does not predict how you will react to removing the Klonopin because they act on the brain via different mechanisms.

Also you were on a very high dose of gabapentin, but 2 mg of Klonopin is still moderate.

There isn't any contraindication to exercise per se. If you use machinery or weights that could pose a danger to you, then you'd have to evaluate how the meds affect you and whether you are "safe" using the equiment.

It is good to keep thinking positively. Whatever happens though, try not to get down on yourself, ok? This wasn't your fault. Just do the best you can. It will work out.

waves

I appreciate your kind advice
 

Excluding the 7 days when they made me cold turkey after 26 days of use, I count a total of 37 days of use (with some ambien mixed in for some reason for sleep). Yes I have a psychiatrist I can see who is an addiction specialist — if indeed I am dealing with addiction which it kind of feels like already. I am now already at 1.5 mg/day, .5 in day and 1 at night (for 3 days). So conceivably I could reduce .5 every 5 days and be off in 15 days (or conservatively in 30 + days)? Or should I be reducing more like .15-.25 next reduction and so on so that it would be more like 45+ days? How long can one go without sleep during such a withdrawal — or does that matter? Also, in your experience how long (weeks or months?) after complete cessation might withdrawal continue — or does this just depend on each person?

When I meant exercise, I was referring to aerobic exercise where one sweats a lot and one's heart rate/pulse is up. I was told that this will cause panic attacks because of cortisol levels or something? I have read that this is not a good idea during withdrawal.

I hope I don't sound like a naive and am not blowing my situation way out of proportion — I have just read so many horror stories about Klonopin withdrawal on the web that I am just worked up into believing the worst!

With all good wishes, Adamo