scoot asked
I've been on 1.5 mg of Klonopin for 21 years now, for insomnia. I increased it once by .5 mg 10 years ago-with dr. permission, of course. I was told I would be on it forever, told it was addictive and told to never miss a dose as I could have a seizure. I only take it at bedtime. Was diagnosed with chronic insomnia. My question is: if I were to ever need to come off of it, what is the best way, in your opinion, to do such a thing?
Answer
Klonopin (clonazepam) is a benzodiazepine medication used for a variety of indications including anxiety disorders and insomnia. While effective, benzodiazepines are notorious for causing problems with dependency, making them difficult to discontinue.
While there is no single way that is recommended over another when it comes to how to safely taper Klonopin, there are various recommendations (based on medical guidelines and studies) on how to go about doing it.
How To Taper Klonopin
There are many factors to consider when determining an appropriate discontinuation strategy for Klonopin, including:
- Length of time you have been taking the medication.
- The dose you are taking.
- How often you take the medication.
- Prior experience with withdrawal or side effects.
Everyone who takes a benzodiazepine like Klonopin is at risk for developing withdrawal symptoms, which include:
- Sweating
- Nervousness
- Fast heart rate
- Trouble sleeping
- Agitation
- Muscle cramps
- Nausea/vomiting
- Hallucinations (rare)
- Seizures (rare)
Individuals who are at the greatest risk of withdrawal side effects to Klonopin include people who:
- Have taken Klonopin for more than 12 months.
- Have taken high doses of Klonopin consistently.
In terms of an actual taper, one source recommends to consider reducing the dose rather than extending the dosing interval. In other words, slowly reduce the amount of Klonopin you take per dose as opposed to taking it less often. This is done to avoid withdrawal in between doses.
When it comes to deciding how much to lower each dose by, recommendations vary. One study recommends to decrease your dose by 10-25% every week or two and adjust based on tolerability.
For those treating panic disorders, a more prudent approach is often recommended. The Practice Guidelines For The Treatment of Patients With Panic Disorder recommends to discontinue over 8 to 28 weeks, and not to decrease your dose by more than 10% per week. This slow approach is done to avoid relapse or "rebound" of panic/anxiety symptoms.
It is a common need for individuals to discontinue their benzodiazepine, like Klonopin, for whatever reason. When it needs to be done, slowly tapering your dose, as opposed to stopping cold turkey, is highly recommended to prevent withdrawal symptoms. Be sure to speak with your doctor regarding a tapering regimen that works for your specific medical situation. It is important to be aware of the potential withdrawal reactions and perhaps taper more slowly if they are particularly difficult.
