Introduction and Question about Klonopin (Clonazepam)

I am a 60-year old male with some pain issues which affect sleep. Recently, I was prescribed 0.25 mg (split tablet) clonazepam daily. I usually go to bed around 11:00 p.m. I will awaken around 3:00 p.m. with pain and unable to go back to sleep. So now, I am taking 0.25 mg clonazepam when I awaken. After about 45 minutes, I am able to fall back to sleep and get 3 to 3.5 hours of wonderful sleep. I am sleeping and feeling better than in years!!

I have been working with my medical team to address the pain issue, but in the meantime, clonazepam is working like a miracle for me. I have one question for the forum. If I take 0.25 mg clonazepam for a long time, will I have withdrawal problems if I ever discontinue it?

Thank you for reading my post.

Withdrawal symptoms probably not. Dependence yes.

Hello Pinnacle: I'm sorry I can't comment with regard to your question. I took Klonopin for a short period of time. But not long enough to develop any kind of dependence. And I did not experience any withdrawal symptoms when I went off of it. However I noticed this is your first post here on PC. So... welcome to PsychCentral!

I don't know, of course, if you're here simply seeking an answer to this particular question, or if you plan to hang in here with us. However, should you be planning to continue on, (we hope you do) may I suggest you introduce yourself over on our New Members Introductions forum? Here's a link:

https://forums.psychcentral.com/new-...introductions/

One additional forum that may be of interest to you would be the chronic pain forum. Here's a link to that forum:

https://forums.psychcentral.com/chronic-pain-support/

I hope you find whatever amount of time you spend here on PC to be of benefit.

That's an interesting comment. What are you using as the definition of "dependence"? The drug resources I checked include withdrawal symptoms as one of the criteria for a diagnosis of dependence. If there are no withdrawal symptoms, they would not consider a person to be dependent on a drug.

There is psychological dependence as well. Eventually if you stay on this you may likely need an increased dose to do the same thing. It's not an addiction thing as much as it is habituating.

Exactly this.

hi. to put this into perspective...Klonopin, used for social anxiety disorder, is often dosed at around 2mgs/day. To put this into context, one can find the diazepam equivalent of a Klonopin dose by x 20. So, 2mgsx20=40mgs/Valium, which, btw, is on the upper end of standard dosing back when Valium was the "It" benzodiazepine.

.25mgs/Klonopin x 20= 5mgs/Valium. Not much, not really. You might want to ask about Valium or even Librium. Both require higher doses than Klonopin to exert an effect, -but- they're also more sedating (at equivalent doses) and they have more pronounced muscle relaxant properties, especially Librium. They also act rapidly, last a long time, and are usually easier to taper than Klonopin.

hope this helps.

Hi, Welcome to PC

I've been on Klonopin for over 20 years, so...yeah, I know a lot about the med - at least, I know how it works for me and in general.

.25 mgs is a tiny, tiny dose. Great that it's helping your sleep! Sleep, as you know, is so very important for physical and mental wellness.

You can most likely remain on .25 for at least 6 months before you will find that.....You need a higher dose to achieve the same results you were getting at .25. In other words, your body has built up a tolerance to the Klonopin.

Hopefully at that point, your pdoc will be amenable to prescribing a slighter higher dose. At a slightly higher dose you'll still be taking a very, very small amount of K-pin.

Your other option (and, in the long run, probably a wiser option), at the time you find you have developed a tolerance to the .25, is to cut the .25 down, bit by bit, over a period of about 2 to 3 weeks. You have to be patient and titrate down slowly. If you titrate down slowly over a few weeks from such a small dose, you will not likely have withdrawal symptoms. (Don't believe your pdoc if s/he tells you to just stop taking the K-pin. Even at .25 you can experience withdrawal that can be extremely difficult, painful, etc. Some of the worst aspects of K-pin withdrawal is a horrible sensation of the awareness that you are sleeping while you are sort-of asleep. In other words, you are not getting a restful sleep. The sensation is, frankly, absolutely horrible...heroin withdrawal is extremely similar).

So. At that point, after you have come off the .25 you'll want to find out how your sleep is. If you're sleeping well, terrific. If not, try taking some other kind of sleep aid - otc ZZZQuil or whatever - for at least 10 days. Then go back on the K-pin. Either the .25 will work again, just as it did before, or you will need a slightly higher dose.

But here's the thing. .25 is so tiny that even if you eventually wind up at 1 mg. every night you'll still be at a very low dose that you can maintain for a year or more...for some people, even 2 or more years.

The major problem with Klonopin happens when you've been on at least 2 mg./day (as I have been for over 2 decades), then you try to come off. Even titrating down very, very slowly (I'm talking months to a year), most people who have been on 2 mg. or more for more than a year will experience extreme withdrawal. Usually the withdrawal is so severe (anxiety, body pain/aching all over, feeling stressed out, feeling crazy, feeling sick, difficulty walking very much because of weakness and pain, inability to sleep, and so on) that...we end up right back on the Klonopin.

But, like I said, at .25 mg (and it's working for you)...get some good sleep and when the time comes, if it does, when you're no longer sleeping well...cross that bridge then.

I wish you the very best and continued rest.
(Hey, that rhymes. )

You are on a very small dose and if you eventually increase to 1 mg at night, you are still on a small dose.

I feel the withdrawal experience is very individualized.

I had taken 0.5mg to 1.0 mg nightly for over 20 years, I had gotten off of it by decreasing to 0.5mg for 2 weeks and then to zero with no major issues at all.

Laurie describes a nice slow titration for anyone experiencing symptoms while titrating off of the med.

Personally, I have found temazepam to give deeper sleep.

I strongly prefer these benzo meds to pdocs using antpsychotic meds for sleep.


WC

I could not agree more. Isn't it wrong to prescribe such powerful medication for sleep problems, when there are less potent options? My pdoc has prescribed 50 mg. Seroquel at bedtime to help me sleep. She hasn't tampered with my Klonopin yet, but has mentioned wanting me to come off of it in the future because it "might cause dementia symptoms". Pffft. As if AP's don't!

The Seroquel not only is only so-so for sleep, it definitely has caused me to gain weight, I built up a tolerance to it quickly, and it has the potentially very dangerous side effects that come with an AP.

I think the current attitude toward benzos is ridiculous. They don't cause weight gain and the dangers (diabetes, for example) that accompany weight gain. Benzos don't cause such things as tremors or TD.

I believe that benzos will inevitably come back "in style" and I look forward to when they do.

I took it twice. Both times I only took it for about a week.

I don’t remember exact details, but I was having a reaction to it both times.

I forget what exactly. I just remember feeling really sick on it.

Welcome to Psych Central! As everyone has said, that's a small dose. If you ever stop taking it, you might have some small withdrawal, but I doubt it would be very much. I wouldn't worry about it.

I took Klonopin for years--300 mg a day and I had a long withdrawal. Just keep things in perspective.

If it ain't broke, then don't worry about fixing it. I'm glad to hear it's helping you to sleep! Again, welcome!

Hi TL, Did you mean to type 300 mg? No, you couldn't have meant that...isn't that highest dose of Klonopin, when used for seizures, 20 mg.?

Thanks for all the replies. Here are a couple of additional points about me.

1. In addition to RLS and a touch of PLMD, I have severe obstructive sleep apnea (OSA). My OSA is very well controlled by CPAP. As a general rule, sleep docs don't like to prescribe medications that have muscle relaxant properties to OSA patients. This is because of the effect on the airway muscles which could make OSA more severe. In my case, it might cause an increased CPAP pressure requirement. Generally, a high pressure is more uncomfortable than a lower pressure and may cause unwanted side effects.

2. I have a followup appointment with my doc in June. My prescription is for 1.0 mg per day. I quickly cut it back to 0.25 mg per day because it works so well. I have a concern that the doc may not want to prescribe 0.25 mg for long-term use. If he doesn't, he needs to prescribe something and not leave me hanging out with limited sleep.

Pinnacle, I suggest that you tell your doc you're sleeping well on the .25 and that that is the dose you'd like to remain at, at least for some months. My husband was having panic attacks that led to very non-restful sleep, his pdoc prescribed .25 K-pin and it helped my husband's sleep nicely. After about 6 months he was able to taper down and stop the K-pin. That was almost a year ago and his sleep has been okay, most nights. Of course, one can always take Klonopin prn, too.

Wow, I started this thread almost exactly two years ago and just now had a need to come back to it. I've got a little something going on now, but seem to be working through it. The old comments here have been helpful.

Just two points of clarification.

1. I am taking clonazepam for painful RLS (not everyone has pain with RLS). My family doctor says clonazepam is widely prescribed for RLS.

2. My family doctor also says a buildup of tolerance, while a problem with some conditions, is not a problem with RLS.

Thanks to everyone who replied. I see Laurie is not around any longer. I hope she and everyone else are doing well.

(I'll keep this thread bookmarked in case things change for me.)