Long-term use of Rivotril (clonazepam) anyone?

[Guzzy]

I realise I am going to be on this Rivotril long-term and I'm wondering what I should look out for as a problem, or what to keep an eye on blood-test wise, etc?

I had posted on here a few weeks ago about getting a medication for my rib-spasticity. I am on Cymbalta too for nerve pain. After a year of looking for help the neuro reluctantly wrote me a 3 month script for .5mg Rivotril. My sleep has been transformed. I have experienced less fatigue taking this med! - I know another member on here said the same. I think for years before I have just not been reaching deep enough sleep.

Twice recently I did not take the Rivotril just to see what would happen - within 10 hours of the missed dose I was shaking, edgy, nervous, sweating, and in pain. The rib-pain was seriously returning my 16 hours later but it is less than when my last relapse hit. Withdrawal from this would be really tough.

I have discovered from these 'missed dose' days what it is that was disturbing my sleep - my right side is twitching slightly every few minutes and it wakes me up. On Rivotril, this does not happen and I sleep.

But being a worrier, I worry about the long term use of Rivotril. What can this kind of dose do to me long-term?

I also worry every time I've my 2 glasses of wine - my only vice really and I so enjoy those evening with my husband as we discuss the type and flavours - so about 4-6 small glasses of wine a week. I'm worried I might be damaging my liver with Cymbalta plus Rivotril.
Anyone?

[SNOOPY]

Hi Guzzy,

Clonazepam (Klonopin) can be addictive and withdrawl symptoms can be brutal. Not everyone will become addicted or have withdrawl problems.

However, your comment:

within 10 hours of the missed dose I was shaking, edgy, nervous, sweating, and in pain

. could indicate you might already have a withdrawl problem

You are currently on a very low dose. Long term it is possible that dose will not be enough and you will need to increase, you can build up a tolerance for Clonazepam --- your Doctor may not be willing to increase long term, but that is between you and him.

There are not any blood test required for Clonazepam. Drinking alcohol is not recommended when using Clonazepam as it can intensify the side affects of the medication.

I have use Clonazepam for 9 years. I have taken it for long periods of time and on an as needed basis, I prefer as needed and my Doctor is fine with that. My dosage is adjusted as needed. Currently my prescription is 1mg 2x a day, but it will probably be increase when I see my doctor again. I have taken as much as 7 or 8 mg but that is not common nor do I like to stay at that high of a dose.

This is a medication which has given me absolutely no problems. I am able to be on it for months at a time, even at high doses and then go cold turkey with no withdrawl problems. My understanding is this is unusual.

I have two different experiences with Clonazepam: It can either make me very tired or I will have more energy. I never know, when I take it, which result I will get. My Doctor has told me both experiences are normal.

[Faey]

I have been on 0.5 mg of clonazepam for 11 years now. I worry about the long term effects from time to time and have read quite a bit about it.

Just my own personal experience, through research I've come to understand that this medication has a high probability of abuse. People will enjoy the "high" from the medicine and when their body adjusts to the dose they will increase the dose. Personally, I've never had to increase my dose. It's true that I don't have the same "high" feeling as when I started so long ago but the medicinal effects are still working so there's no need for me to increase.

From reading information available on the internet I've come to understand that benzodiazepines (the class of medication that klonopin/clonazepan is) can effect cognitive functioning. take a look at this link, where you'll find a ton of various abstracts all dealing with benzodiazepines

http://www.ncbi.nlm.nih.gov/pubmed/15762814

ultimately, you'll need to decide if any cognitive issues you develop are worth the benefit. For me, I had been on clonazepan for 7 years before my MS diagnosis and was a full time computer science student while working full time as a quality engineer in a manufacturing facility. Any cognitive issues I was experiencing were not keeping me from functioning and the benefit was exceptional. Now with MS I have terrible cognitive issues so I think from time to time that I need to quit the clonazepam to see if my issues will improve but if my past is any indicator, it's probably a minimal factor. BUT EVERYONE IS DIFFERENT!!!!

I plan on discussing weaning off of of clonazepam with my dr again once my MS is under control. In the past when we've discussed me quitting we always come back to the fact that I have issues that require treatment and if I stop the clonazepam i'll have to take SOMETHING and everything will have long term effects...

Keep in mind that if you are on clonazepam (or any benzodiazepine) you should absolutely never NOT EVER just stop taking the medication. Snoopy is an anomaly and you definitely want to talk to your dr before stopping this medication. You can literally die from withdrawals once your body has become dependent, and your body will become dependent. The normal half life of clonazepan is something like 10-18 hours so if you are having withdrawl symptoms so strongly after just a few hours of skipping your dose you really need to talk to your dr.

Again, you really want to not skip your dose of this medicine as you can really hurt yourself. even if your mind doesn't think that you need the medication, once your body becomes dependent your body needs it and your body will rebel. After long term use like mine, my dr has advised me that it could take up to a year of slowly decreasing my dose to safely ween from this medication, and that's with a small 0.5 dose.

I hope that helps. Honestly, I love what the clonazepam has done for me. I had terrible sleep paralysis since the age of 9 and by the time i found clonazepam i had spent years and years of not sleeping and nothing seemed to work. now it has the added benefit of keeping my legs still at night so i can sleep. I still think about quitting just because I hate medications in general but I can say honestly that it's served me well for years.

[SNOOPY]

Keep in mind that if you are on clonazepam (or any benzodiazepine) you should absolutely never NOT EVER just stop taking the medication. Snoopy is an anomaly and you definitely want to talk to your dr before stopping this medication.

Faey is correct.

Even though I am able to go off of Clonazepam cold turkey with absoultely no problems it is not advisable to so. Due to withdrawls is is imperative that anyone using a Benzo consult with their Doctor in the proper way to reduce and/or stop a Benzo.

I don't like using Clonazepam and the reason I prefer to use it on an as needed basis...when I can. I take Clonazepam for reasons different than you or Faey and for that reason my dosage is adjusted as needed. If I do not need to take a higher dose I don't but sometimes it is necessary. My dosage is not based on the 'high,' intolerance or not getting the same affect.

An interesting fact about Clonazepam: Many, many years ago it was used as an anti-depressant.

[Faey]

I didn't mean to imply that was the reason for your increases, Snoopy! Just that it is one common reason for why long term steady users will increase. There are plenty of legitimate reasons for increasing your dose!

I took clonazepam off and on for a few years before I started using it daily and I was much like you, Snoopy. If I was only using it for a few months at a time I had no issues starting and stopping or taking as needed. It wasn't until I had been about two years in of solid daily use that I realized that I had crossed the line into physical dependency. Emotionally I don't feel an addictive need to take the medication but my body is definitely dependent.

I was also told, like you, that it is considered a last resort antidepressant and as a person who doesn't tolerate antidepressants, it does a pretty good job of soothing depression if nothing else works for you.

[SNOOPY]

Hi Faey,

I didn't mean to imply that was the reason for your increases, Snoopy!

I know, don't worry about it

It may seem strange but I do not have a problem with dependency or addiction, even after nine years, and the reason my Doctor will adjust my dosage as needed.

I do not use Clonazepam for depression, I don't deal with depression Clonazepam is prescribed for anxiety/panic attacks which are a result of Post-Traumatic Stress disorder (PTSD). I have an exaggerated flight or fight response and if triggered can be quite extreme. Clonazepam allows me to have more control over my responses.

Through the years I have tried to work through different triggers and my responses. I prefer to try different things to control both my physical and emotional responses. If nothing is helping the I use Clonazepam.

Off an on through the years I have gone months to years taking Clonazepam on a daily basis (3 to 4 mg a day) and when I decide it is no longer necessary I simply stop taking it.

[MrsChip]

Hiya,

I'm on Cymbalta too - for the last 3 years and have been on 0.5 mg of Clonazepam for Leg Spasm for the last 2 years on and off. It has also transformed my own life and sleep but it is a long-term commitment as you cannot just stop taking it cold turkey.

BUT here's the good bit, my leg symptoms started to get better so my GP put me on a program of weaning me off the Clonazepam. You cannot reduce this type of drug by more than 10% per week.

The easiest way off it is using Diazepam to reduce dosage at a safe rate. 0.5 mg of Clonazepam = 10 mg of Diazepam. As Diazepam is available in 10, 5 and 2mg tablet which are easily split, it took 10 weeks for me to come off Clonazepam in this way. 10mg D first week, then 9 and so on. I had virtually no withdrawal symptoms, and stopped the diazepam easily in the 10th week.
If Clonazepam is helping, don't be afraid to continue taking it. If and when you want to come off it, the path I described is very easy to do with your doctors support and supervision.
When you have MS, virtually EVERY drug cannot just be stopped and you have to follow a supervised strict reduction strategy if you decide to discontinue.
Keep taking what helps and NEVER miss a dose unless its part of a structured reduction plan with your GP. And NEVER stop taking a helpful drug just because you can't stop it in one day - I tried that with Effexor and I was completely locked for weeks - that was a blast! :-(

After a nasty relapse early 2012, I went back onto it and it really helps me. Wit my previous experince I am 100% confident that should I no longer need it, I'm only 10 easy weeks away from being off it.

Hope this helps! My maiden name was Kinsella (from Killiney) so always extra glad to help a fellow Tayto :-)

[Guzzy]

Thank you to all who replied.

I am amazed you can take it and then stop like that Snoopy! - I realised that I am most likely addicted after just a few months. That said, I don't really care, because I really need it, but I hope I don't have to up it like you describe.

Faey - gosh I knew I probably shouldn't miss a dose too often but nobody explained how serious it was, or the potential problems. Thanks for that. Appreciate the link, I will read it. More cognitive problems I could do without but really it is no Rivotril = no sleep.

Hiya Mrs Chip nee Kinsella from Killiney! I'm near Lucan. Funnily enough, I see you are now in Cheshire from your profile info - my great-grandfather came from Cheshire, but the rest of my g.grandparents are Irish. That withdrawal information is really, really invaluable. I will bookmark this page for the future - like you I started taking it after the relapse in August but it's difficult to know will the rib spasms stay as severe over time, or will they lessen a bit. I'll talk to my doctor about your method of withdrawal from Rivotril in a few months to see if they are still as severe. Thanks for the reply.