Aa
Leg parethesia and Klonopin withdrawal?
I'm trying to stop taking my klonopin. I'v been taking almost daily for 4 months (.25mg-.5). I can go a week without then I feel I need to take it to stop my panic.I went a another week before the goose/bump feathery sensations started (parethesia). I started taking it again and they diminished somewhat. Does anyone get feathery/goose bump like sensations on their calves when coming off of it? I've been told it could be my nerves in my lower back. My hamstring/calf muscles have been tight for months now and I've been stretching them out. Now my low back hurts somtimes. I've haven't had a x-ray yet. Chiro said he's heard it described like water pouring down one's leg. I'm kind of scared of this sensation. It happens a off and on through out the day (not everyday though). Any advice please.
Thank you for your advice. I stopped taking it after taking .125 for a few days. So far so go. It's impossible to attribute any of my current symptoms to the klonopin withdrawal. My headache, scratchy throat and facial pressure is probably from a mild sinus infection that I'm battling. I also decided to wean myself off of my Remeron (keeping the 20mg of Celexa though). I had a low WBC count (and small white painless mouth sores)while on it and now with the sinus infx not clearing up with anitbiotics, I believe it might be better if I stopped the Remeron. I will see my Psych. on tues and see what he says (even though I have already started to wean last night-22.5mg down to 11.25mg).
The main issue here is in the way the Klonopin is currently dosed (once daily). While Klonopin does have a long elimination half-life, you will not achieve any meaningful accumulation if it is dosed only once daily.
Klonopin works on the principal of accumulation. When dosed at a minimum of twice daily, it will accumulate to a steady-state plasma level over a span of two weeks. Following an additional two weeks, it will accumulate to 1.5 times that of the steady-state plasma level. The advantage of this accumulation during discontinuation is important, as it can be utilized to your advantage. The steadier the blood plasma level is, the more slowly the drug level declines following a dosage reduction.
While you could theoretically take 0.125 mg twice daily, you would likely find that this dosage level is ineffective and intolerable to taper from. 0.25 mg twice daily is felt to represent the minimum therapeutic dosage. You would likely find it easier to taper off of an effective dosage, rather than an ineffective one.
Since you've only been taking an average of 0.25 mg daily, it is important to begin the taper immediately following a dosage increase to 0.25 mg, twice daily after a span of two weeks. This would help to prevent any additional dependency on the drug.
Alternatively, you could also cut your daily 0.25 mg dose in half every four weeks. The dosage is low enough that few problems should arise. If they do, I would use the twice daily dosing strategy, which would provide for a smoother decline of the drug.
Klonopin works on the principal of accumulation. When dosed at a minimum of twice daily, it will accumulate to a steady-state plasma level over a span of two weeks. Following an additional two weeks, it will accumulate to 1.5 times that of the steady-state plasma level. The advantage of this accumulation during discontinuation is important, as it can be utilized to your advantage. The steadier the blood plasma level is, the more slowly the drug level declines following a dosage reduction.
While you could theoretically take 0.125 mg twice daily, you would likely find that this dosage level is ineffective and intolerable to taper from. 0.25 mg twice daily is felt to represent the minimum therapeutic dosage. You would likely find it easier to taper off of an effective dosage, rather than an ineffective one.
Since you've only been taking an average of 0.25 mg daily, it is important to begin the taper immediately following a dosage increase to 0.25 mg, twice daily after a span of two weeks. This would help to prevent any additional dependency on the drug.
Alternatively, you could also cut your daily 0.25 mg dose in half every four weeks. The dosage is low enough that few problems should arise. If they do, I would use the twice daily dosing strategy, which would provide for a smoother decline of the drug.
Thanks Carmen. I only take .25 mg a day (sometimes another .25mg at the end of the day). So would I have to taper down still from there? I keep thinking that my chemistry is really messed and that's why I take well to the slightest anti-anxiety dose. Too bad there wasen't something I can take for the rest of my life.
The half-life of Klonopin is 34 hours. In 5 half-lives, the drug is eliminated, after which point withdrawal symptoms (if they occur), will peak. 34(5) = 170/24 = 7 days. This correlates precisely with the time frame that you've specified, and thus your symptoms may be the result of a withdrawal syndrome. This is easily managed.
If you wish to discontinue the drug, begin taking 0.25 mg twice daily. Take this dosage for two weeks. Thereafter, use the schedule below to taper off...
Days 1-7: Morning (Klonopin 0.125 mg), Night (Klonopin 0.25 mg)
Days 7-14: Morning (Klonopin 0.125 mg), Night (Klonopin 0.125 mg)
Days 14-21: 0.125 mg of Klonopin every other morning. 0.125 mg of Klonopin nightly.
Days 21-28: 0.125 mg of Klonopin every other night, then stop.
There will be no withdrawal. Using this process, you are taking advantage of Klonopin's long half-life and accumulation properties. These allow you to gradually taper off of the drug with a smooth and steady decay in the plasma level. Taken only once daily, this would not be possible.
Carmen
If you wish to discontinue the drug, begin taking 0.25 mg twice daily. Take this dosage for two weeks. Thereafter, use the schedule below to taper off...
Days 1-7: Morning (Klonopin 0.125 mg), Night (Klonopin 0.25 mg)
Days 7-14: Morning (Klonopin 0.125 mg), Night (Klonopin 0.125 mg)
Days 14-21: 0.125 mg of Klonopin every other morning. 0.125 mg of Klonopin nightly.
Days 21-28: 0.125 mg of Klonopin every other night, then stop.
There will be no withdrawal. Using this process, you are taking advantage of Klonopin's long half-life and accumulation properties. These allow you to gradually taper off of the drug with a smooth and steady decay in the plasma level. Taken only once daily, this would not be possible.
Carmen
You must join this user group in order to participate in this discussion.
You are reading content posted in the Psychopharmacology Group
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
