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Mental Health  (Expert Forum)
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Klonpin- Long Term
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
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MedHelp Member's Question

Klonpin- Long Term

by JeffG10, Nov 06, 2006 12:00AM
I have been on klonopin 1mg daily for bout 3 months, i recently tried to go off of it because stupidly i wanted to be able to drink, it was hell, my anxiety went right back to the way it was before. I said screw this and went back on, and now i feel great. I just want to know, is klonopin ok to take long term? will the calming effects go away, or will i keep having to up my dosage, i dont know if i'll need it forever, but my anxiety is very high and when i'm off of it i twitch and shake. At least for now i know i need it, and it may be forever, i just want to know is it ok to take long term for the reasons i'm taking it???
Doctor's Answer

by Roger Gould, M.D., Nov 08, 2006 12:00AM
It's a good long term drug, but you will be better off combining Klonopin with some psychotherapy, then you won't have to stay on it forever.
Member Comments (12)

by sparkeler, Nov 07, 2006 12:00AM
You are addicted physically and mentally to the kalonopin.  You can't get off of it on your own.  Are you on any anti anxiety medication that isn't controlled, such as paxil or lexapro?  Kalonopin is good for short term anxiety and should not be taken every day unless prescribed by your doctor.  For example, I'm on lexapro and am also prescribed xanax (when needed.)  I love the way xanax and kalonopin "shut" off your brain and completely ease all anxiety, but there is a risk of "mental" dependency, so I only allow myself to take it 3 times a week.  I wish it can be used for long term, (i.e. every day for the rest of my life,) but doesn't that seem to good to be true?  I think  you need to find a doctor who specializes in treating anxiety and depression.  In the mean time, don't switch your doses or stop taking the kalonopin on your own.  The side effects can be brutal.

by jonathan06, Nov 07, 2006 12:00AM
Jeff-

It sounds like you do need Klonopin and if it helps you with your symptoms without creating other problems or side-effects, then you are doing as well as you can and you should continue with your treatment and try to live as normal a life as possible.  



DO NOT SUDDENLY STOP TAKING IT.  



It is somewhat discouraging that we still live in a fairly primitive time as far as psychopharmacology is concerned; mind you we have come a long way but there is still a very long way to go.  Anxiolytics like Klonopin are useful but they affect the entire body and do not "target" the precise areas of the brain which are responsible for panic and fear and intense anxiety.  Drugs like Klonopin are extremely useful and safe for long term use if you have a anxiety disorder which has not responded to other first-line treatments (* and if you do no abuse them but take them as directed by your doctor).   Do not be discouraged by having to take a medication which serves a useful purpose.  This is the best we can do at the moment and if Klonopin enables you to live a more full and engaged life then that is a very good thing (isn't it?).



Good luck

by JeffG10, Nov 07, 2006 12:00AM
I completely agree with you John. I am in no way addicted to klonopin physically or mentally because i did withdraw from it without any problems, however, my anxiety is at such a high level along with something called depersonalization that i need to take it. I was completely off of it without any withdrawel, but my anxeity went right back to what it was before i went on it. eg- shaking/twitching/cold sweats. I have been on anti-anxiety medicines such as lexapro since 8th grade. I've been on paxil/effexor/celexa/buspar/ and now cymbalta. So i've deff tried most other options. The klonopin works and the sedative effects i hear go away after a while but the calming effect sticks around, so i have no problem taking it forever as long as it doesnt cause any problems and keeps working. My psych knows i'm on klonopin but we havn't discussed anything long-term.

by jonathan06, Nov 08, 2006 12:00AM
I think a great number of patients would like to discuss the long-term outlook of their meds, particularly those which can cause dependency.  Their is a great deal of fear in talking about these matters and some doctors are uncomfortable about it as well.  The truth is that many doctors are not comfortable prescribing these medications (Klonopin, Xanax etc...)  The discomfort comes from many sources, and even the word addiction scares doctors.  ("hey doc, you got me addicted to these pills and now I'm going to contact my lawyer..") That is not an exaggeration.  Litigation and a frightened over-cautiousness exists in the psychiatric community. On top of that, there are still many MD's who don't appreciate the full debilitating gravity of anxiety.  Sad to say, it is often third-rate condition behind depression and schizophrenia.  A great deal of literature has come forth and most doctors are becoming enlightened to the devastating effects of living with chronic anxiety disorder or panic.    My advice to anyone who is seeing a doctor for meds and treatment; don't be afraid to discuss some of the quality of life issues which are very important and are universal from person to person.    A patient who thought I might remove him from his Xanax asked me if I would be willing to see him even if he could not pay.  I asked "why would that be necessary"?  He said "if my anxiety comes back, as it always does, I will lose my job and my health care and won't have the money to pay you so I am asking if you are making a commitment to me since the choice you make could profoundly effect my life and my ability to function".



I told him I had no intention of removing him from his meds.  I thought he made an excellent point and I hope that patients will take the same tact in discussing these matters with their doctors.   You make a commitment to your doctor, to take your meds responsibly and not abuse these very powerful drugs.  The doctor must make a responsibility to ensure that your quality of life issues are addressed, and that your doctor is aware of the co-equal responsibility of doctor and patient.  Lastly, a doctor should never use a patient to prove a theory.  That is, a doctor should not take you off your meds unless the doctor can articulate clearly why it is necessary and what the next step will be in treating the underlying disorder.   I once overheard a doctor tell a patient that she would be removing her from her meds.  When the patient asked "what do I do next?", the doctor said, "we'll cross the bridge when we come to it".  



Unacceptable!  



Sometimes there are very legitimate reasons for changing doses or switching meds or even removing them completely (if they aggravate an underlying condition that poses another danger).  Beyond that, there is no "we" when it comes to taking a med away from a patient who has achieved some balance and is living a more normal life.  Patients rights exist and sometimes it is hard to be your own advocate.   Sometimes the only advocate you have is yourself.

by JeffG10, Nov 08, 2006 12:00AM
Jonathan i had a feeling you were a doctor hence the MD haha, that makes me feel much better to talk to you, have you heard of a disorder called depersonalization? I've been suffering with this since august chronically. The klonopin is the only thing keeping me functioning. I want to get off my cymbalta however and try clomapramine because i've tried pretty much every SSRI, and i hear clomapramine has showed significant changes in DP. So when i see my doctor i'm going to ask him about that. However, i've heard that cymbalta withdrawel is hell. But then again clomapramine works on the two same things that cymbalta does, what are your thoughts? I know i deff want off the cymbalta because it hasn't done anything for me. I need the klonopin and my doctor has no problem prescribing it for me. I'm gonna bring this all up when i see him on the 30th, just curious as to what your thoughts are??

by fearfactor, Nov 09, 2006 12:00AM
I was "addicted" to Xanax for almost 2 years - I had to get off when I discovered I was pregnant with my second child.  I agree with you, Jonathan - Xanax allowed me to live a more normal life.  Thankfully, the withdrawal process was not too bad (I was on 1 mg per day) and my anxiety was also better during pregnancy (I am certain there is a hormonal component to my life-long anxiety issues).  Now that I've had the baby, I'm taking Xanax as needed and am thinking of asking my doctor for Klonopin since it's more long-acting.  I don't consider myself "addicted" to my meds - they are something I NEED to get by and live a life relatively anxiety-free.  I recently went through intensive therapy for health-related anxiety and am doing much better.  Don't think that could've happened without my Xanax.

by JeffG10, Nov 09, 2006 12:00AM
yea, i don't like being told i'm addicted to something when i certainly am not. I need these drugs to live a normal life, i wish to hell i could go on living without meds, but hopefully i'll be stronger one day having gone through this.

by delores3643, Dec 03, 2006 12:00AM
I have taken Klonopin for over 13 years. I'm sure that would be considered long-term use. Of course I'm addicted and won't pretend I'm not, but it was the only drug that worked for me then and is still working for me.  When it was first prescribed for me, it was just another in a long line of "trial and error" meds.  I did not see anxiety as my problem. I had suffered with dizziness for many years, then dizziness and headaches combined for a total of 21 years, and had seen all kinds of doctors and had all kinds of tests. I know medical professionals consider dizziness quite harmless if no serious cause can be found, but there is no worse feeling in the world. I was desperate, and fortunately had a doctor at the time who was trying his best to help me. He decided to prescribe Klonopin.  Within only a few days, all my symptoms had disappeared!  I felt like a completely new person, bursting into tears with relief.  I was able to live my life normally again.  After about one year, I noticed it was not working as well as it had initially, and a few years after that I decided to try a "drug holiday".  I was miserable in every way and went back on the Klonopin as soon as it was possible.  The amount I take has remained nearly the same the entire time.  I still feel a great amount of anxiety, but that is not what I'm taking Klonopin for, and it never made me the least bit drowsy.  It relieved my OTHER physical symptoms that were ruining my life.  Anxiety was not ruining my life and still isn't--I can deal with that.  It's still a mystery why Klonopin was such a miracle for me.  I'm sure I will probably be taking it for the rest of my life.  I'm now 63 years old and don't think I've suffered any harm by taking Klonopin for such a long time--from age 49.

by bjhw, Dec 18, 2006 12:00AM
To: delores3643
I am glad to read your story delores. I suffer from general anxiety also and have tried a few ssri's. Usually they work for a couple months and then I slowly sink into a depression. They also cause me to lose my emotions. Over Thanksgiving I was suffering from severe physical symptoms of anxiety so much that I could hardly function. My doc had given me a prescription for Klonopin but I was afraid to take it before. I took it this time because I was desperate. I felt exactly how you described. I could function again, all of the physical symptoms went away. Like you said, I still had anxiety but it is not debilitating. It's actually just the kind of axiety that causes you to get things done that you need to. On the ssri's I became catatonic almost. I didn't want to do anything and nothing mattered. This medicine makes me feel normal. My only problem is that my doctor says this med is only for short term use and that the ssri's are better for long term. I obviously don't want to take this long term if I will build up a tolerance and need more and more. But if I could just take it twice a day to feel normal I don't see what the problem is. If anyone has any info or input on this I would be grateful. I am also planning on talking more to my doctor about this. Thanks

by Greif06, Jan 09, 2007 12:00AM
I have ben taking 2mg K daily for 2 years. RX .5mg 2xnight 1 .5mg twice day. After 6 months I just took them all in the evening. It was easier to track. Last month I switched to 2 mg pills from halfs. I was still using halves and had an extreme stress