Here is a graphic showing equivalence of various alcoholic drinks:

http://rethinkingdrinking.niaaa.nih....ndarddrink.asp

Hence 4 whiskeys (6oz) = 4 -- twelve oz beers.

The body does not separate out what form the alcohol is in.
A breath test by a police officer will register intake independently from the type of alcohol consumed.

Remember CONGENERS in various drinks may affect nerves, as well as gluten (beers) and yeasts.(in wines and beers).
This is what a congener is:
http://en.wikipedia.org/wiki/Congener
Congeners are thought to create hangovers. Hence the quality charcoal filtered vodkas, which have them removed.

People with gluten intolerance will have significant reactions to beers independently from the alcohol content. There are gluten free beers with alcohol in them.

It is highly idiosyncratic how people with PN will respond to various alcoholic beverages, therefore.

% alcohol content of beers:
http://www.alcoholcontents.com/beer/

If you are still taking that clonazepam, you should avoid alcohol consumption, but you probably know that already.

--Thank you, mrsD: this is very helpful. I'm actually surprised at how many people ask me about drinking beer and nonalcoholic neuropathy. ...Especially at this time of the year.

For me, I don't feel any flare-up from drinking a few beers on the weekend, but then again, I'm very cautious about it and limit my drinking to low alcoholic beer and just a few over a few hours. Now that I think of it -about 4 beers in 4 hours. I "Buzz" quickly so I never drink more than a 6-pack on a drinking day.

I skip a week a lot, too, sometimes not drinking a beer for over 2 weeks or so. But honestly with the holiday parties coming up, it seems harder to dodge the urge to sip a few.

I do not mix Clonazepam with alcohol or - leastwise I don't think I do. There's at least 8 hours to a full day between me drinking a few beers and taking a clonazepam.

But this was not always the case - months ago, I would take the 0.5 pill about 3 hours or so after a few beers. The only thing I noticed then was an increased drowsiness. Still, I do my best to avoid it and certainly never mix them outright.

---To mrsD: I tried to get off of clonazepam cold-turkey with bad results - meaning that my PN flare-ups got worse just 3 days after ditching my usual twice-a-day 0.5 pills. Then I tried to do so using low dose Melatonin 1 as a substitute, but that didn't work out too well. (I was afraid of the possible side effects of melatonin so I gave up that attempt very quickly).

I was once on 2mg of Clonazepam per day for about 2 years in the past (before that just 1mg) and now, 0.5 - so far the dose reduction has gone well over the last 5 months. But there will be a time soon enough where I will try to get off of it again.

My goal is to give up ALL medication and just rely on vitamins for my health conditions. I hope that sounds realistic and not silly. As it is, clonazepam is the only drug I take other than my staple of vitamins.

My problem is actually my PN - my doctor wants the severity of my PN to go down before attempting to wean me off of the pills. Indeed, for long periods at a time, my PN does seem to fade away quite a bit - but I'm afraid that attempting to wean off of it at those times would cause me to relapse.

...also about the previous issue of alcohol, how long am I supposed to be off of Clonazepam before I have a drink? --Is my current 8-hours difference alright?

I hadn't noticed a thing concerning this other than being tired more. I hope it doesn't instigate PN flare-ups...though that never happened to me.

Truthfully, I was absolutely furious with my doctor when he told me a full year after taking clonazepam, that I might be addicted to it. He told me that small dosages don't addict patients -and I fell for it.

So, the guy actually got me addicted to a drug without letting me know it was highly addictive! ...oooooh, that freakin' quack!

Anyway, I don't want to be addicted to any drug ever -and to be honest, I don't even know if I AM addicted to it -I just assumed I was because I've been using it for so long. (5 years now -but no more than 2 mg per day in the past) Don't know if that makes a difference.

Yes, it is difficult to totally wean off clonazepam. I mentioned that to you before.

Of all the benzos it binds very tightly to receptors. Some people take 6months or more to get off it completely. The serum half life for clonazepam is 18 to 50 HOURS. That means only 1/2 of the drug is gone within that time frame. So waiting 8hrs to drink is not wise, as you are getting a synergistic effect. This is why getting off this drug is very problematic. Also your age factors into this. Older people, have slower renal clearance of benzos, and for this reason the 1/2 life would be much longer. So the drug can build up in the body in elderly patients.

You need a careful SLOW taper. Klonopin makes wafers you can split to get to lower doses more easily.
http://www.drugs.com/imprints/1-8-1521.html
This photo is of the .125mg wafer.

I believe the clonazepam is masking your PN, and once off of it you will have much more pain for a while. Over time tolerance to this drug leads to higher doses to get relief...and becomes a vicious cycle.

There are websites devoted to benzodiazepine withdrawal, and all of them suggest very slow tapers (most doctors go too fast).

Melatonin is not going to work as it does not sit on GABA receptors.
Melatonin is only for sleep. It is not a tranquilizer. The inhibitory receptors benzos sit on, prevent excess firing and are rather unique.
You may find some suggestions for this on the benzo withdrawal sites.

.................................................. ............................................

Thanks -I did not know about the waffers so that's something to look forward to when the time comes.

As for beer and clonozapam, I'm sure you're right. My doctor says separate them for at least 8 hours, but he probably means more. Still, he says that the only synergistic effect that 0.5 would have at that time is an increase in drowsiness - a hazard when driving, no doubt. Truthfully though, I haven't noticed a thing. Maybe because I'm a big guy (6 feet tall, 240 pounds) body size might be a factor as well.

I'm a bit confused about one of the statements you made...You said: "I believe the clonazepam is masking your PN, and once off of it you will have much more pain for a while."

This isn't a very good incentive to get off of the Clonazepam.

Do you mean that my PN pain is actually much worse than I feel it is -and that if I get off of Clonazepam, I will return to stronger pains? --If that were the case, it would be better for me to stay on the clonazepam, as PN is the worst antagonist here. Perhaps this is why my doctor doesn't want me to wean off of it yet???

Or do you mean that I would get stronger pains for awhile (due to Clonazepam withdrawal) then return to my usual PN cycle, which is not much pain, leastwise not much pain between flare-ups?

Another thing that's puzzling for me concerning Clonazepam - Since I dropped in dosage, I still feel it's effecting me the same -I don't feel like I need to up the dosage or take more than what's given to me. In fact, I've been steadily dropping to lower dosages over the last year.

The only time I take an extra pill is when I'm under harsh stress or when a mega-flare-up occurs, which doesn't happen often, thank God.

In fact, there are days, I forget to take my nighty pill and feel fine. Many times I feel fine even from just one 0.5 instead of the 2 per day mandated for me. Luckily that seems to go against the tolerance-issues I've heard of.

Do you think that taking the vitamins I do has something to do with that?

Also about melatonin -my doctor told me that retirement homes often use melatonin to get elderly patients off of Clonazepam. I've read some short articles about it, but they seem vague and probably way out of date, too. I don't even know if they still do that. Do you know anything about that?

The reason you don't notice a day or two missed dose is because Clonazepam has such a LONG half-life in the body. It is still there during the skipped periods.

Wait a week or more and you will notice something. It appears that your anxiety disorder may be due to a defect in the GABA
system, and you have a threshold minimum you need to provide with the drug. And there is a big difference in the actions of
habituation vs addiction. They are not the same. In habituation the body NEEDS a drug to function and withdrawing it causes regression and increased symptoms. Addiction is a craving and desire for the drug for euphoric/enjoyment purposes. The body rewards the use of the drug with a dopamine hit, and thus the dopamine release is the trigger for the craving. Doctors often do not understand this difference, and misuse the terms often.
So do lay people.

The benzodiazepines have anti-convulsant properties. I have an explanation of this in the Subforum:
I strongly suggest you learn how neurons work:
http://neurotalk.psychcentral.com/post828704-7.html
and
http://neurotalk.psychcentral.com/post829772-9.html

Anti-convulsants are commonly used in the treatment of nerve pain. They dampen signals. When suddenly removed, they will cause a rebound of pain.

And yes, it is not an easy path...to discontinue this drug. Everyone who has to do this for some reason, suffers in many ways.

It will be your choice as to whether you want to continue in the tapering to zero of this drug.

There are supplements that help with anxiety, and hence PN as well, by affecting GABA receptors in a more natural way.

1) Theanine which is in green tea. Joano brought to this forum information from Dr. Blaylock's newsletter about this in fact.
This is the thread:
http://neurotalk.psychcentral.com/sh...light=theanine
Since then I've been using Doctor's Best Theanine at bedtime with good results. My effective dose is 300mg. Amazon has this at affordable prices.

2) Another useful supplement is PharmGABA. Normally GABA is not absorbed orally, but there is a new form, from Japan that has some oral activity. I tried this last spring when our kitten went missing...it was a very upsetting, stressful time. And this product worked well for me. I've had anxiety at times during my adulthood, and I think this comes from my unpleasant childhood.
This is not expensive if you get it at Amazon. I took one capsule twice a day. It is not addicting and has no sedative effects on me. Doesn't affect driving or create sleepiness.

Either or both of these can help with anxiety, and I do think the Theanine at least, helps with sensory pain issues as well.
I never needed the higher doses that Dr. Blaylock recommended.

As far as the elderly go.... Doctors don't understand drugs at all. Many elderly develop sleep problems, and are given this drug or another benzo (this practice is less common today however). But we now know benzos are BAD for the elderly because they cannot clear the drug as well as a younger person. So because melatonin is used to fix sleep cycles it is tried. But the CAUSE of the sleep disturbance in the elderly may be low B12 levels. Methylcobalamin is the cofactor in synthesizing melatonin in the body. People over 50 or those taking acid blocking drugs start to lose B12 because of poor absorption due to lack of intrinsic factor in the stomach. Intrinsic factor is the carrier of B12 from food into the bloodstream. Low B12 then leads to poor sleep because melatonin cannot be made properly. So melatonin WOULD help these people. But it does not work like benzos do biologically. So you cannot compare them. It is like apples vs oranges.
Both drugs promote sleep...but by different mechanisms.

So the bottom line is you or your doctor don't know what will happen if you get off the clonazepam completely. The initial rebound can be worse than your typical baseline pain. That would be temporary hopefully, and you would return to your baseline with time. Drugs that affect receptors in the body can CHANGE the number of receptors present. We know that opiates do this. If the benzos do this, and I suspect they do, considering how hard it is to get off them completely, it is possible you have changed your system in a more or less permanent way.

You will have to decide what to do. If you are thinking of a "cure"... that is not likely for you with Cipro as a trigger. Basically PN is for life. We all understand that here. Once nerves are damaged they often do not return 100%. Where severed nerves grow back, they will often misfire and send odd signals as a result. So accepting that you will always have some form of PN discomfort is important. You will need to learn to deal with some level of chronic pain. Many of us do that daily.
You can control anxiety to some extent with breathing exercises, and mindful meditation.
This is a link to a very good exercise that was posted on RSD forum recently. It is a guided example of diverting your mental attention away from pain or noxious stimuli.
http://www.openfocustraining.co.uk/exercise.html

I've used similar relaxation (auto hypnosis) techniques for over 30 yrs. They can be very effective.

I agree with you on almost everything you've said here -and I wasn't aware there was natural alternatives to handle the anxiety issue either. That was very helpful.

The only thing I disagree with is your statement that PN is for life. When PN first hits some people, a lot are suicidal - so, not a good thing to say...especially if it's not entirely true.

Are you saying that you never known even one case of PN that has healed?

It's also important to understand that having hope of healing isn't denial either.

Because PN comes from very different causes, it's impossible to tell how it will affect any one individual.

A permanent case may be true for some people, but certainly not all. According to Dr. Roos, the lead neurologist for the University of Chicago's neurology department; - a man with over 30 years experience in the field - more than half of the people that get PN DO heal from it, though it does take time and the right treatment, which is different for each person.

More so, I've met people who have healed from PN -2 actually -one a diabetic and another man who was floxed from the drug Flagly.

I think the question here is how PN devolves. Clearly, some severe cases may be permanent, but others may not. ...And even if it is permanent, big healing strides do take place.

As for me, I don't expect a cure. I'll be happy if I can get the pain down to a level that I can deal with. Already, it went from unbearable to liveable -and between flare-ups, sometimes nearly non-existent and this has been only in the time span of less than 5 months. Not bad since even Dr Roos, says it takes about 7 months for drug-induced neuropathies to really start healing, although like my case, nearly all of the severe stabbing pains and such fades within weeks.

This might have to do more with peoples' own ability to heal as well as what is actually causing the PN to begin with.

My case with Cipro is not so dooming. Don't get me wrong, I will be disabled all my life from this one mistake from an incompetent doctor. I won't be able to exercise or lift weights as much as I used to. And I will probably have some degree of light pains and many mental emotional issues for the rest of my life. Still, there are and will be many people who haven't had a case as severe as mine that will heal - completely.

Many people take the full 2 months of Cipro 500mg with no neuropathy at all. ( I warn AGAINST this) -some do get it, I know one man that has the exact same Cipro problems I do - but he took it for 6 weeks while I took if for under 3. Both of us were prescribed it for a prostate infection...unfortunately an all too often prescribed drug for it.

Obviously, not everyone that gets PN from Cipro (or anything else) is doomed to have PN permanently -leastwise not painful PN. This is not to say that over the months or years some flare-ups will return -I'm sure of that, but basically over time, it will heal. At least to a degree where you can get your life back.

So here is where I DO agree with you: that PN might be for life, but you will get better, eventually to a time where you can enjoy life again.

...PS - I hope you found your kitten - I love cats. I also wish you Happy Holidays, you've helped so many people here.

No the kitten is gone, perhaps forever. But I still look outside for her. I hope someone nice took her in and she did not suffer some
painful situation or death. Long story, which came back in Oct, when neighbors thought they saw her and contacted me, and it all began AGAIN. Still nothing after many long hours staking out the area with bait/food. I gave up finally. sigh.

Some drugs, like Macrodantin, cause neuropathies, but how it does is not permanent. It is always possible that a toxic one will reverse. I think the most likely reversal comes with nutritional types with deficiencies. If caught early on, supplying the nutrient, which is most commonly B12 may lead to some repair. But if the cells die, that are damaged, that is it. Chemo PNs don't resolve as a rule. Cipro damages DNA functions, (as do Chemo drugs), and that is why its PN is more serious than perhaps other types.
from http://en.wikipedia.org/wiki/Ciprofloxacin

Doctors may say things to keep you positive, just in case some aspect of your pain, is being generated by stress. But we don't see total resolutions on this forum. We see posters returning with no further progression and some improvement (like me), but no cures. Heavy metal damage also is more or less permanent. And Thallium which is a heavy metal in ant poisons, is lethal. No antidote for that exists as yet.

And there are people damaged by one dose of fluoroquinolones.
The author of Bitter Pills, Stephen Fried's wife has a permanent seizure disorder brought about by Floxin oral tablets. Hence he wrote the book. You might find it interesting. I read it many years ago (bought the book). You are correct about not everyone is damaged by these drugs. That remains a mystery until someone uncovers the reason(s). That will most likely be a genetic answer.
http://www.amazon.com/Bitter-Pills-I...s=Bitter+pills

I'm sorry about your kitten - the most likely scenario is someone saw it and took it home. That's what happens in my neighborhood. I'm sure it has a nice home, and I'm not just saying that, I believe that's what happened most logically. -kittens are cute - people like them: result - adopted kitten.

I genuinely hope you feel better for the holidays, too. God Bless.

Thank you Jesse. She was an 8 month old kitten, and almost full grown but very very handsome and nice temperament.

I had exposed her to a little outside like I do all our cats, and she was very good at coming home, coming when called, and using the cat doors(for almost 4 wks). She just vanished on Sunday around 6pm.
She had a microchip and was spayed.

BTW I just added a bit to the post above, you may have been posting and not seen that yet. Info on Cipro.

Here is her photo: She grew up in an outdoor only farm area place, and we kept her inside until early May or so. I was hoping those feral beginnings would have dwindled...but I guess not.

We have a new black kitten named Maya, that we adopted upNorth in the UP. She is quite the character and has a very colorful personality, and having her helps (but not all the time).