Concerned316 asked
Husband was prescribed. 50mg Klonopin on 3/12/18 since he has taken 3.5 tablets since 3/12/18 will he have withdrawals if he doesn't take anymore. Here is what and when he took it. 3/12. And 3/14 took .25mg at night he also took .25mg am and pm Sat 3/17 and Sun 3/18 then not sure if last .25mg was taken Friday 3/16pm please advise thank you
Answer
Klonopin (clonazepam) is classified as a benzodiazepine medication and is used for the treatment of a variety of conditions including:
- Anxiety
- Panic attacks
- Insomnia
Benzodiazepines, while effective, carry certain risks such dependence, and withdrawal reactions if taken for long periods of time.
It can be difficult to determine who exactly is at risk for withdrawal reactions when it comes to benzodiazepines. Studies have determined all of the following as "risk factors" for withdrawal symptoms:
- Continuous use over one year
- Use of high doses
- Benzodiazepines that have a short half-life (e.g. Xanax, Halcion)
If withdrawal reactions occur, they can manifest as the following symptoms:
- Sweating
- Fast heart rate
- Muscle cramps
- Tremor
- Insomnia
- Anxiety
- Agitation
- Nausea
- Hallucinations
Risk Of Withdrawal Symptoms With Klonopin (Clonazepam)
The half-life of a drug is defined as the time it takes for the body to metabolize 50% of the drug and is an indication of how long a drug lasts in the body. Benzodiazepines with a long half life are considered to have less of a risk of withdrawal reactions as the drug is slowly eliminated from the body, giving it time to adjust.
Klonopin (clonazepam) has a long half life when compared to other benzodiazepines. According to the prescribing information, it is reported to be between 20 and 50 hours, depending on the individual. Due to this long half-life, Klonopin is considered to have less of a risk of withdrawal reactions when compared to other benzodiazepines that have a shorter half life, such as Xanax.
Klonopin has a large dosage range, with effective doses from 0.25 mg all the way to 20 mg per day. While there is no defined level for "low does vs. high dose", doses up to 6 mg per day of Klonopin are the most common.
In the situation described in the question, the risk of severe withdrawal reactions would be considered low when taking into account risk factors for withdrawal symptoms as described above (i.e. length of therapy, high doses, half-life of the drug).
However, as everyone is different, it is difficult to definitively tell whether or not someone will experience withdrawal symptoms, regardless of what the risk factors are. Determining if a taper is an appropriate choice to discontinue Klonopin should be based on a conversation with the doctor.
If a taper is recommended, there is not one univserally agreed on “best” method. All tapers are individualized based on response. One source recommends, if you wish to be cautious, to taper Klonopin over at least 1 week if you have been taking the drug for one month.
Summary
- All benzodiazepines, such as Klonopin (clonazepam), carry the risk of withdrawal reactions.
- Risk factors for withdrawal reactions include: Length of therapy, dose used, medication used (with drugs with a short half-life carrying higher risk).
- Klonopin has a long half-life and is considered to carry less of a risk of withdrawal reactions when compared to other benzodiazepines if used for short periods of time.
