Is 1mg of klonopin a low dose?

For a patient with anxiety and a history of depression, conditions that often overlap, “you may want to avoid a benzo because they can also be depressants, and buspirone can be a safer, more reasonable option,” he said.

Patients also do not have the choice of paying more to buy the brand-name version of buspirone, Buspar, because it is no longer made.

Buspirone prescriptions dispensed in the United States rose to 13.5 million in 2017 from 10.2 million in 2015, with the number estimated to reach nearly 15 million last year, according to IQVIA, a health care technology and data analytics provider. The reasons for the increase are unclear, though the opioid epidemic may have made some physicians more reluctant to prescribe highly addictive anti-anxiety medications that can be lethal when combined with opioids.

The main reason for the buspirone shortage appears to be interrupted production at a Mylan Pharmaceuticals plant in Morgantown, W.Va., which produced about a third of the country’s supply of the drug. The Food and Drug Administration had said the facility was dirty and that the company failed to follow quality control procedures.

Mylan has told the F.D.A. the date for resuming buspirone production is “T.B.D.”

“Companies don’t have to tell the F.D.A. how long the shortage is going to last or when they expect it to be back,” making planning difficult for doctors and patients to manage, said Erin Fox, senior pharmacy director at University of Utah Health and director of its Drug Information and Support Services.

Most drug manufacturing plants are already running at full capacity so “when one shuts down even for a short period of time, there is no resiliency in the supply chain for anyone else to make up the difference,” Dr. Fox said.

Rock bottom prices for some generic drugs are also contributing to the crisis. Consolidation among wholesalers has led to the creation of three buying consortium behemoths that purchase 90 percent of the generic pharmaceutical products in the United States, said Adam Fein, a consultant and chief executive of Drug Channels Institute. These “monster” buyers have squeezed manufacturers on prices, and “some of those generic manufacturers are deciding the profit is so low they can’t make money, and they’re exiting the category,” Dr. Fein said.

At least one relatively small buspirone manufacturer, Impax, has left the market.

“Drugs like buspirone are not considered critical or lifesaving drugs by the F.D.A.,” said Dr. Beth Salcedo, president of the Anxiety and Depression Association of America. “But the reality is that when you look at anxiety and depression, we lose a lot of people every year to these illnesses.”

Klonopin vs Xanax – Which of These Anxiety Medications Put You More At Risk?

Klonopin vs. Xanax as treatment for anxiety are similarly ranked. They both have their pros and cons for helping people with various types of mood disorders.

Klonopin (Clonazepam) is a fast-acting benzodiazepine. It relaxes the mind by effectively calming neurotransmitters. Klonopin prevents muscle spasms, reduces anxious feelings and causes sleepiness. Klonopin lasts longer than Xanax so it doesn’t need to be taken as often.

Xanax (Alprazolam) is also a fast-acting benzodiazepine. It affects neurotransmitters the same way Klonopin does. Xanax also reduces anxiety and causes sleepiness. Xanax will require more regular dosing. Some like this because they can better control how the side effects will affect them, and when.

Xanax for anxiety allows a person to take more doses throughout the day. It helps with symptoms of panic attacks also, alleviating them quickly.

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While Klonopin for anxiety is used specifically for panic disorders, it can also control seizures. It may be used for someone withdrawing from alcohol to prevent delirium tremens.

Both of the drugs are similar in that they can cause dependence which can lead to benzodiazepine addiction. They can both be abused and when taken in higher doses for a long time, the withdrawal can be intense.

Include Holistic Support For Klonopin and Xanax

Regardless of the anxiety symptoms that Klonopin and Xanax can relieve, neither should be used for long periods of time. This is why there should be some sort of holistic treatment to help with anxiety disorders.

Klonopin or Xanax are used to help treat anxiety. Treatment should also include holistic methods as it’s not recommended to remain on these drugs long-term. Staying on these benzodiazepines medications for too long can cause dependency. It is also believed that people with anxiety are more prone to addiction.

Klonopin vs. Xanax Uses

Klonopin and Xanax are benzodiazepines that affect gamma-aminobutyric acid (GABA), a messenger within your brain. Both Xanax and Klonopin have uses as a depressant that affects the central nervous system.

Clonazepam is the generic drug that is sold with the brand name, Klonopin. Alprazolam is the drug that is under the brand name Xanax. Both affect the central nervous system as a depressant which causes relaxation.

Any type of benzodiazepine will cause the nerve impulses that surge through the body to slow down. This physically manifests as a noticeable calming effect.

Due to this calming effect, they are often used for various types of anxiety disorders. This includes panic attacks. Clonazepam has been FDA approved for seizures in children while Xanax has not. For the elderly, both Xanax and Klonopin may have a greater effect on them.

Klonopin Uses

Klonopin is an anxiolytic prescription medication with the active ingredient clonazepam in it. Clonazepam is FDA approved as an anti-seizure medication for both children and adults. It counteracts negative imbalances in the brain that cause anxiety disorders also.

The most common reason Klonopin is prescribed is for epileptic seizures, panic disorders, and agoraphobia.

The medication works by enhancing effects of the GABA receptors which is in charge of inhibiting neurotransmitters. Klonopin blocks arousal in the brain from stimulating pathways that can lead to anxiety.

Klonopin helps anxious people relax but should only be used occasionally. It shouldn’t be used for longer than 4 weeks at a time for treatment of anxiety or seizures. This is because it’s extremely risky for causing addiction. There are instructions for any patient who gets this medication on how to taper off responsibly to avoid a Klonopin Addiction.

Clonazepam is also used to treat withdrawal of other benzodiazepines.

Xanax Uses

Alprazolam is the active ingredient in Xanax and works as an agonist on certain brain receptors that are responsible for sleep. Xanax binds to the GABA receptors so they work at inhibiting neurotransmitters that can ultimately cause stress.

Xanax helps to calm a person down so they’re able to sleep. The theory for these drugs within the medical world is patients just need a break from their anxiety. This allows them to put their life back together while they are in a calm state of mind.

If they have a few weeks to feel a sense of calm, they can begin to manage things better. Gaining control of their life will prevent overwhelming anxiety. This is the hope when taking anti-anxiety pills. Xanax can be used for a longer period of time to treat panic attacks.

Klonopin vs. Xanax Dosage Forms

Klonopin is a longer acting benzodiazepine so regardless of dosage strength, it will last longer. Here are the dosage forms that are available with Klonopin and Xanax.

Klonopin Dosage Forms

  • Klonopin is also called Teva 834. It is a 2 mg dose and is manufactured by Teva Pharmaceutical USA.
  • Clonazepam comes in a 2 mg tablet and an oral disintegrating tablet to be dissolved in the mouth. Usually, a person can take Klonopin 1-3 times daily.
  • Clonazepam oral tablet – Klonopin dosage 0.5 mg, 1 mg, 2 mg
  • Clonazepam oral disintegrating tablet – Klonopin dosages 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg

Xanax Dosage Forms

  • Xanax is available in immediate-release and extended-release oral tables. Immediate-release tablets may need to be taken many time per day.
  • Extended release – Xanax dosage 0.5, 1 mg, 2 mg, 3 mg
  • Immediate Release Oral Tablet – Xanax dosage 0.25 mg, 0.5 mg, 1 mg, 2 mg
  • Alprazolam oral solution – Xanax dosage 1 mg/ml.

Klonopin vs Xanax High

Klonopin High

Klonopin is one of the most addictive, abused sleeping aids because of the euphoric effects it offers. The Klonopin high offers the user a sense of calm. They feel drowsy but also euphoric. These feelings arise from brain receptors being depressed from the drug.

All of the drugs within the benzodiazepine group come with the risk of tolerance and addiction. What makes Klonopin even more risky is how quickly it sets in along with a lengthy half-life time. The KIonopin high passes through the brain in one hour but stays in the body for up to 72 hours.

Those effects are what will cause the body to quickly develop a tolerance to the drug. The high is enticing enough that people may become dependent on that feeling. Klonopin, along with other clonazepam products are only meant to be prescribed for up to 14 days. This is due to the high potential of abuse and addiction.

When used on the streets, a Klonopin high is intensified from being ground up and snorted. It can also be dissolved and injected intravenously. Recreational users combine Klonopin with other substances.

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Xanax High

The Xanax high has enough of a reputation that many will use it recreationally. Xanax relaxes the body and makes for a better sleep. A Xanax high offers a greater buzz than Klonopin but won’t last as long. The high with Xanax has a shelf life of 2-3 hours.

Klonopin vs. Xanax Reviews

The reviews for Klonopin and Xanax are quite close when it comes to what people liked or didn’t like about them.

Klonopin Reviews Conclude

  • 52% of Klonopin users say that the drug works well for what it’s prescribed for.
  • 14% of Klonopin users weren’t happy with the medication and stated it was a hassle.
  • 70% worth it
  • 19% not worth it
  • 12% Not sure

Xanax Reviews Conclude

  • 55% of Xanax users were happy with what the drug did for them.
  • 13% of people taking Xanax said that taking it was a hassle.
  • 74% worth it
  • 12% not worth it
  • 14% Not sure

Klonopin vs. Xanax Side Effects

With any kind of benzodiazepine, there is the potential of side effects. Klonopin and Xanax side effects are often mild. It takes a few days for the body to get used to the drugs so side effects are more intense and then taper off.

Common effects for both drugs are drowsiness and one should use caution when driving. There’s the possibility of an allergic reaction when it comes to Klonopin and Xanax. This can include side effects such as:

  • Hives.
  • Itching.
  • Development of a skin rash.
  • Trouble breathing.

Xanax side effects

Clinical trials with patients taking Xanax experienced the following side effects:

  • 41% experienced drowsiness
  • 21% Light-headedness
  • 15% Dry mouth
  • 14% Low mood disorder
  • 13% Headaches
  • 10% Confusion
  • 10% Constipation
  • 10% Nausea or Vomiting
  • 10% weight increase
  • 9% Insomnia
  • 3% irritability

Klonopin side effects

Clinical trials with patients taking Klonopin:

  • 37% experienced drowsiness
  • 8% received ear, throat, or nose infections
  • 8% Dizziness
  • 7% low mood
  • 7% fatigue
  • 6% abnormal coordination
  • 5% lack of muscles coordination

Klonopin vs. Xanax Risks

Long-term use of Klonopin or Xanax both have the potential to cause cognition problems. People who use either drugs for too long are at risk of memory loss, how quickly they think and how they process thoughts.

Klonopin Risks

Risks with Klonopin include the possibility of a Klonopin overdose. It can be recreationally abused and when mixed with other substances, Klonopin can become lethal.

Klonopin risks occur when:

  • The user takes more than the prescribed dose.
  • The user takes the drug for longer than 4 weeks. This can lead to Klonopin addiction.
  • The user has a history of drug abuse.
  • The user has an alcohol abuse problem.

The combination of Klonopin and alcohol are risky because the drug increases the alcoholic effects. The user will feel more intoxicated than they should.

Klonopin takes longer to metabolize than other benzo’s so it passes through the system more slowly. People that like the Klonopin high may increase dosages which can create drug accumulation in the body quickly. The addiction risk is extreme. There are many celebrities who have spoken out about their battle with Klonopin addiction.

Xanax Risks

Again, Xanax overdose is possible if a person takes a very high amount. Taking Xanax with other substances is where the risk comes in. Also recreationally using Xanax by snorting or injecting it has the potential to cause overdose.

Xanax risks occur when:

  • The user has a history of drug abuse.
  • When Xanax is abused with alcohol or other drugs.
  • Taking more than 4 mg. per day or for a longer period than 4 months.
  • Stopping Xanax too quickly.
  • If the user is severely depressed.

Klonopin vs. Xanax Interactions

Klonopin and Xanax have many of the same risks which include intensifying effects of other CNS depressants. This includes the following:

  • Sleeping pills
  • Tranquilizers
  • Mood stabilizers
  • Muscle relaxants
  • Seizure medications
  • Prescription pain medications
  • Alcohol
  • Marijuana
  • Antihistamines

Klonopin vs. Xanax Withdrawal

Klonopin Withdrawal

Using Klonopin for longer than 4 weeks puts a person at risk of building a tolerance which can lead to addiction. Often, a patient won’t realize how dependent they are until they stop using it.

Klonopin withdrawal can be challenging which is why it’s only recommended that it be taken for a few weeks. Tolerance builds up quickly so the person needs more of the drug to gain the same effects. Following medical professional instructions will help a patient prevent withdrawal discomfort and addiction.

Sudden Klonopin withdrawal can cause an increase in heart rate. Anxiety may also come back quickly and more intensely. If the drug is stopped quickly, it can cause sleeplessness and the mind becomes agitated.

Stopping Klonopin suddenly can cause withdrawal symptoms that can last up to 6 weeks such as:

  • Nausea
  • Anxiety
  • Agitation
  • Sweating
  • Stomach pain
  • Insomnia
  • Muscle pain

Xanax Withdrawal

Xanax withdrawal is said to be more intense than other benzo’s. The withdrawal symptoms of Xanax are actually quite dangerous. Due to the very short half-life of Xanax, it comes into the body quickly and also leaves it very quickly.

If a person is dependent on Xanax and the drug leaves their system quickly, the withdrawal can be extremely potent. Xanax withdrawal is much more intense than Klonopin and does often require some assistance.

If Xanax has been abused, it may be advised that it is tapered off medically. The Xanax withdrawal will have created a psychological dependency if taken for too long.

Stopping Xanax suddenly can cause withdrawal symptoms that can last up to 6 weeks such as:

  • Problems with sleep.
  • Irritability.
  • Anxiety.
  • Panic attacks.
  • Trembling.
  • Nausea and flu-like symptoms.
  • Heart palpitations.
  • Muscle pain.
  • Headaches.

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Klonopin and Xanax are both used for anxiety disorder. They are similar in that neither should be used for very long. They both have potential to be abused and can cause dependency.

Klonopin is a longer lasting medication than Xanax so it is taken less times per day. Xanax may be considered to be less convenient in that sense.

Xanax is also considered more addictive and is harder to withdraw from. When Xanax and Klonopin were tested beside one another, a greater amount of patients experienced more severe withdrawal effects from Xanax.

The question is, what are the less of two evils? Benzodiazepines slow down the brain significantly. This is what the medication is supposed to do in order to alleviate anxiety or seizures from a patient. The problem is that they can so easily lead to an addiction that lasts a lifetime.

Trazodone vs. Klonopin

Before comparing trazodone vs. Klonopin, it’s helpful to see what each is on its own.

Trazodone is a prescription, generic drug that’s approved by the FDA to treat depression. It’s an atypical antidepressant and a serotonin antagonist and reuptake inhibitor (SARI). It’s often used in patients who don’t respond to other antidepressants.
In addition to serving as an antidepressant, there are many extra-label uses for trazodone, one of the most common of which is as a treatment for insomnia. There are many other uses for trazodone too, such as for the treatment of chronic pain, OCD and also the symptoms of alcohol withdrawal.

Trazodone has fewer risks and side effects than many other similar drugs. For example, it’s not considered to be very habit-forming, which is why it can be useful during alcohol withdrawal or to help people with insomnia or are predisposed to substance abuse.

Trazodone’s primary side effect is drowsiness, although this can be reduced when depression and other conditions are being treated if it’s taken in divided doses with the largest dose taken before bedtime.

Trazodone acts on certain receptors in the brain to influence how much serotonin is available, which is how it increases mood and also things like appetite.

Klonopin, on the other hand, is an incredibly controversial drug, first available in the U.S. in 1960.

Klonopin is in a class of drugs called benzodiazepines which also include Valium and Xanax. Benzodiazepines are among the most prescribed drugs in the U.S., and they affect a certain neurotransmitter called GABA. This is an inhibitory neurotransmitter, so when someone takes a benzo like Klonopin, it inhibits the activity of other neurons in the brain and has a calming effect.

Klonopin is considered a controlled substance and also a psychoactive drug because it affects thinking, mood and cognitive function. In some cases, along with being used to treat anxiety, Klonopin and other benzos can be used to treat bipolar disorder and schizophrenia. Because of the calming effect, Klonopin can sometimes be used as a sleep aid, whether directly or when it’s an indirect side effect.

Klonopin is a drug that has a high potential for abuse, which is why it’s a controlled substance in the U.S., and it’s considered very addictive.

The overall effects of Klonopin, along with relaxation and a reduction of anxiety, include euphoria, slowed reflexes, and a feeling of well-being. These effects are some of the reasons it’s addictive and is often abused.

What Are Clonazepam Withdrawal Symptoms, Length, and Treatment?

Benzodiazepines are a class of drugs that act as central nervous system depressants, or sedatives and tranquilizers.

Clonazepam, with a trade name of Klonopin, is an anxiolytic drug prescribed to treat seizure disorders and also panic disorders by slowing down some of the bodily and brain functions related to anxiety and stress. Clonazepam is thought to increase the presence of gamma amino-butyric acid (GABA) in the brain, which helps to slow down heart rate and blood pressure, and calmemotional disturbances.

The U.S. Food and Drug Administration, or FDA, warns that taking Klonopin can be habit-forming and that users may become physically and psychologically dependent to the drug. Users should therefore not stop taking clonazepam suddenly without medical supervision due to the dangerous side effects, or withdrawal symptoms that may occur after the discontinuation of the drug. Side effects and withdrawal may occur in users who take the drug only as prescribed.

Klonopin and other benzodiazepines are often abused and even taken with other drugs and/or alcohol, which may increase the withdrawal side effects. The Drug Abuse Warning Network (DAWN) reported that over 61,000 people sought emergency department treatment for a negative reaction involving the recreational, or nonmedical use, of clonazepam in 2011.

Clonazepam, when taken or abused for any length of time, can produce chemical changes in the brain. Parts of the brain that are normally suppressed by the drug may become accustomed to the interaction of the drug and stop functioning normally without it. This is when a dependence on the drug has been formed. When clonazepam is removed, these functions that were being dampened are suddenly not, and a kind of rebound may occur. The symptoms that Klonopin may have been managing, such as anxiety, panic, seizures, and insomnia, may then be magnified.

Withdrawal Symptoms

The drug should not be stopped suddenly or without the direct supervision and guidance of a medical professional. Potentially fatal seizures or a coma may occur with the sudden cessation of Klonopin.

Withdrawal from clonazepam can be dangerous and even even life-threatening.

Clonazepam withdrawal symptoms can include:

  • Headaches
  • Stomach pain
  • Nausea
  • Tremors
  • Sweating
  • Hallucinations
  • Dizziness
  • Fatigue
  • Confusion
  • Anxiety
  • Depression
  • Seizures
  • Thoughts of suicide

Acute withdrawal symptoms peak two weeks after stopping use of clonazepam, but subtle signs can last anywhere from a week to a month.

Catatonia is also a rare, but documented, side effect of clonazepam withdrawal, as noted by the journal Psychosomatics. Vital signs such as blood pressure, heart rate, respiration levels, and body temperature may need to be observed during withdrawal, as they can jump to unhealthy levels rather quickly as the brain and body attempt to restore order without clonazepam. Physical symptoms of clonazepam withdrawal may include:

  • Headache
  • Stomach pain
  • Nausea and vomiting
  • Tremors
  • Short-term memory loss
  • Insomnia
  • Irregular heart rate or heart palpitations
  • Sweating
  • Increased blood pressure
  • Impaired respiration
  • Dizziness
  • Blurred vision
  • Fatigue
  • Muscle spasms and cramps
  • Impaired coordination and motor functions
  • Diarrhea
  • Feeling lightheaded
  • Seizures

Benzodiazepine withdrawal is also known for the debilitating psychological side effects that may occur after a drug such as clonazepam is stopped. Perhaps one of the most serious emotional side effects of Klonopin usage is the increased risk for suicidal thoughts and actions, as the FDA even made a point to add warning signs about the potential risks for increased suicidal ideation to Klonopin labels in 2009. Psychological symptoms of withdrawal from clonazepam may also include:

  • Hallucinations
  • Nightmares
  • Mental confusion
  • Short-term memory lapses
  • Difficulties concentrating
  • Irritability
  • Drastic mood swings
  • Trouble feeling pleasure
  • Anxiety
  • Panic
  • Depression
  • Drug cravings
  • Lack of motivation
  • Feeling “out of it” and disconnected from reality
  • Anger and hostility

The emotional benzodiazepine withdrawal symptoms will often subside with time and psychological support.

Benzo Withdrawal Phases

There are generally three main phases of benzodiazepine withdrawal: early withdrawal, acute withdrawal, and protracted, or late withdrawal. Since Klonopin is a benzo with a long half-life of 18-50 hours, as published by the journal Case Reports in Psychiatry, withdrawal will not usually start until about 1-3 days after the last dose, or when the drug stops being effective.

Early withdrawal usually lasts about 2-4 days and is likely to include “rebound” symptoms, such as anxiety and insomnia. Acute withdrawal usually peaks around two weeks after stopping clonazepam and may last anywhere from a week to a month, according to information published in the Center for Substance Abuse Treatment’s Substance Abuse Treatment Advisory. The bulk of the withdrawal side effects will likely occur during acute withdrawal. Protracted withdrawal may include a continuation of psychological symptoms and drug cravings that may appear without warning at any time for several months or even years after the cessation of Klonopin.

Not everyone will experience all three phases of withdrawal as addiction and withdrawal are unique to each individual. For instance, protracted withdrawal is considered fairly rare; however, it may be more likely to occur in someone taking clonazepam than someone taking a shorter-acting benzo such as alprazolam (Xanax). Protracted withdrawal may be able to be avoided or controlled with therapy and mental health treatment.

Things Influencing Withdrawal

Some of the factors that may influence the number of symptoms and the length of withdrawal may include:

  • Age: Older individuals may have a more intense withdrawal experience.
  • Amount taken each time: The more of the drug ingested each time, the more rapidly and heavily dependent the brain may become.
  • Length of time taking benzos: The longer an individual has taken or abused Klonopin, the more dependent the brain may be to the substance.
  • Abuse of other substances simultaneously: Polydrug abuse can make all of the side effects of each substance worse, and may complicate withdrawal.
  • Co-occurring mental health disorders: Medical and mental health issues may be amplified during withdrawal.
  • Genetics and personal physiology: Family history of addiction may increase the propensity for an individual to become addicted or dependent on drugs, and some people may be more susceptible to the effects of withdrawal than others.
  • Environmental factors: High-stress surroundings or a non-supportive environment may impede recovery during the withdrawal period.

Generally speaking, the more dependent the brain is on Klonopin, the longer and more uncomfortable withdrawal may be.

Treating Clonazepam Withdrawal Safely

As with any benzodiazepine, medical detox is necessary for those withdrawing from clonazepam.

Medical detox ensures that trained professionals are on hand to monitor progress 24 hours a day, seven days a week, and medical detox will often utilize medications to help control the more difficult withdrawal symptoms. Since it may be dangerous to stop taking clonazepam “cold turkey” due to the range of withdrawal symptoms, detox will often include a tapering schedule. This is a way to slowly lower the dosage over a safe period of time, which can minimize potential physical and emotional side effects. The Journal of Clinical Pharmacology reports that major withdrawal symptoms can be largely avoided with a gradual weaning, or tapering, of clonazepam. Medical detox will usually last about 5-7 days until the peak of withdrawal symptoms has passed, and body is 100% clear of Klonopin. There is no specific medication currently approved to treat benzodiazepine dependence directly; however, there are several medications that may be useful during medical detox. Antidepressants may be helpful to manage depression and suicidal behaviors that may occur during detox and clonazepam withdrawal, and other medications that work to influence GABA levels, such as gabapentin, are also being studied.

Klonopin (clonazepam) is a benzodiazepine drug that has a number of therapeutic uses.

It is used to assist in the control of seizure disorders, assist in the control of anxiety disorders, and may be used as a muscle relaxant or sleep aid. Klonopin’s primary action, like all benzodiazepines, facilitates the effects of the inhibitory neurotransmitter gamma aminobutyric acid (often abbreviated as GABA) in the brain and spinal cord. This action results in a decrease in the firing rates and excitation levels of all other neurons, resulting in sedation, relaxation, and a sense of overall calmness. These effects are therapeutic at lower levels of the drug. Benzodiazepines such as Klonopin also produce feelings of mild euphoria and wellbeing. They are classified as controlled substances by the United States Drug Enforcement Administration ( Schedule IV controlled substances). Klonopin and other Schedule IV substances have a potential for abuse and the development of physical dependence. They can only be legally obtained with a prescription from a physician.

Withdrawal from Klonopin

Because Klonopin is a high-potency benzodiazepine with a relatively short onset of action, it is used in the treatment of serious anxiety disorders, such as panic disorder.

However, these properties also leave open the potential for the development of a serious physical dependence on Klonopin. The syndrome of physical dependence occurs as an individual’s system adjusts to the presence of a drug in the system and in a sense learns to operate efficiently only when the drug is present in the system at certain levels. Other system functions compensate for the presence of the drug, and the release and maintenance of freestanding levels of neurotransmitters, hormones, and the functioning levels of all systems in the body are adjusted according to the presence of the drug.

When an individual stops taking the drug or reduces the dosage of the drug significantly, and these freestanding levels of the drug in the system decline, the individual’s system is thrown out of balance, resulting in a reaction that leads to the release or inhibition of neurotransmitters, hormones, etc. This situation results in the physical withdrawal symptoms that occur when one stops taking Klonopin. The physical withdrawal symptoms are accompanied by emotional and behavioral symptoms that are very uncomfortable for the person.

Several variables affect the individual presentation of withdrawal from Klonopin in individuals who abuse the drug.

It is important to note that benzodiazepines like Klonopin are more often secondary drugs of abuse that are used in conjunction with some other primary drug, such as alcohol or narcotic medications.

When there is polydrug abuse of substances that also carry a high risk for physical dependence, the withdrawal process is much more complicated.

Variance in human physiology and psychological makeup can affect the intensity and length of withdrawal symptoms. The length of time the individual abused Klonopin will influence the length and intensity of withdrawal symptoms. The frequency of use and dosage used also affect the withdrawal process.

The most often cited depiction of withdrawal from Klonopin (or any benzodiazepine) indicates that withdrawal really occurs in two major steps. Some sources will increase this to three steps or even more to account for very acute feelings of withdrawal and/or for a post-acute withdrawal syndrome. That being said, benzodiazepine withdrawal is generally considered to occur in two stages:

Acute withdrawal

This period occurs within a period of 1-4 days following last use, depending on the half-life of the benzodiazepine. Benzodiazepines with longer half-lives will result in the appearance of acute withdrawal systems later than benzodiazepines with shorter half-lives. Klonopin has a half-life elimination of 30- 40 hours, so individuals may not begin to feel serious acute withdrawal symptoms for a day or two following discontinuation.

The other variable that affects the onset of acute withdrawal from Klonopin is the frequency and dosage of use. The more often and higher the dose used, the sooner the withdrawal symptoms will appear. Because Klonopin has a high potential for physical dependence, it is quite possible that abusers of the drug were taking very high doses very frequently, and withdrawal symptoms can appear sooner in these individuals.

Acute withdrawal symptoms can be quite variable but most often will consist of some combination of:

  • Somatic symptoms (e.g., headaches, sweating, and tremors in the hands)
  • Gastrointestinal symptoms (e.g., nausea, vomiting, and abdominal cramps)
  • Cardiac symptoms that often appear as the result of an anxiety rebound syndrome (e.g., increased blood pressure and heart palpitations)
  • Cognitive symptoms and psychological symptoms (e.g., confusion, irritability, mood swings, and rebound anxiety)
  • The risk to develop seizures

A rebound effect refers to the return of symptoms that were controlled when one took a specific medication. Since benzodiazepines like Klonopin are used in the control of anxiety, rebound, anxiety is a common acute effect of stopping the drug. Some sources may recognize rebound anxiety as a first step in the withdrawal process from Klonopin as it often presents early in the acute withdrawal process.

Protracted withdrawal

This refers to the symptoms that persist after acute withdrawal ends. People who abuse Klonopin and were taking extremely high doses of the drug may experience more extended periods of withdrawal.

Individuals will experience general feelings of malaise, cravings, anxiety, depressive symptoms, and may continue to experience some somatic symptoms, such as nausea, lightheadedness, headache, mild fever or chills, and so forth. An additional period of rebound anxiety may also occur near the end of this stage.

There is a section of the literature regarding withdrawal from drugs in general, including Klonopin and other benzodiazepines, that describes a third phase of withdrawal that consists primarily of psychological symptoms, such as mood swings, periods of irritability, periods of anhedonia (difficulty experiencing pleasure), and depressive symptoms that continue to present themselves on an intermittent basis for weeks to years following discontinuation of the drug of choice. This post-acute withdrawal syndrome (PAWS) is not universally accepted as a stage of withdrawal by many researchers, nor is it formally listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders; however, the syndrome is accepted by some individuals in the field of addiction as legitimate.

It is suggested that individuals who do not have the symptoms of PAWS addressed are at a higher risk for relapse.

Medications Used to Assist with Withdrawal from Klonopin

Withdrawal from a benzodiazepine such as Klonopin can be potentially fatal due to the risk for seizures (although this risk is rare).

As a result, medical detox is always necessary for benzodiazepine withdrawal. Several medications can be used to assist in the withdrawal process, including:

  • Selective serotonin reuptake inhibitors, such as Paxil and Prozac, may be useful in addressing some of the symptoms of Klonopin withdrawal.
  • If an individual develops complications, such as seizures, physicians will use anticonvulsant medications (e.g., Tegretol or carbamazepine to control the seizures). Some of these anticonvulsants may also assist with the withdrawal process related to discontinuation of Klonopin.
  • The hormone melatonin has been useful in assisting individuals who develop insomnia during the withdrawal process. Melatonin is a hormone that induces sleep. It also may address other symptoms of Klonopin withdrawal and reverse tolerance.

Any number of medications could conceivably be used to address specific symptoms during the withdrawal process. However, research indicates that using a tapering process, where the individual in withdrawal continues to receive increasingly smaller dosages of the drug until formal discontinuation, is the most effective means to manage withdrawal from benzodiazepines such as Klonopin.

Beyond Detox

After an individual is deemed physically stable, the emotional side effects of withdrawal are considered more thoroughly. Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) are two forms of therapy that may be used during benzodiazepine addiction treatment. Individuals often attend both group and individual CBT sessions, which may also include homework and educational sessions that strive to find the cause of addiction and how to avoid future stressors and triggers in the future. MI can aid in increasing an individual’s internal motivation level by offering rewards for clean drug tests. Peer and family support groups are also useful aspects of a comprehensive substance abuse treatment program. Levels of care may change throughout withdrawal as individual needs and circumstances change as well.

Relapse is common in individuals addicted to benzodiazepines, and it is especially hazardous after detox. Someone who has been accustomed to using drugs at a certain level, but has not used them for a period of time and then returns to previous use levels, may end up suffering a fatal overdose. The National Institute on Drug Abuse (NIDA) reported that benzodiazepine overdose deaths increased fourfold from 2001-2013, to close to 7,000 fatalities in 2013.

A relapse may occur as someone strives to self-medicate what may be uncomfortable withdrawal symptoms.

Therapy and psychological support are vitally important during benzodiazepine withdrawal in order to reduce and minimize potential relapse and avoid tragic consequences.

Clonazepam withdrawal is best managed with a combination of both pharmacological and therapeutic methods starting with medical detox.

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