Weaning off of Klonopin

[PillBoxHeart]

Hello, new to the community here...I've been dealing with anxiety since I was 22 (am now 34). Been in therapy almost the entire time and on meds as well. Took Paxil and Klonopin until a few months ago. My therapist and ob/gyn switched me to Zoloft because my husband and I want to start a family. I LOVE the Zoloft, feel much better than I did when taking Paxil. Clearer, more energy, just more awake to the world in general. So...my problem is the Klonopin. I started the year taking 3 mg after weaning myself off completely in November of 2012. I came back from the holidays and felt extreme anxiety...decided it was best to go back on. I'm now down to 1 mg, although two nights ago I decreased down to .75mg and now am feeling anxious - headache, waking up two hours earlier than normal and I'm not able to go back to sleep because my mind is racing, heart pounding. I also have chills all over my body, almost as if I'm electrified. I'm terrified that I'll never be able to get off of the Klonopin and of course have (self-destructively) read a lot of horror stories about Benzo addiction.

We are trying to get pregnant and so I know once I do I HAVE to get off of the klonopin. Another HUGE fear of mine: what if I can't handle being off and pregnant? My ob/gyn is fine with Zoloft for the pregnancy but I know the Klonopin is out.

I know there is no "quick fix" so I'm trying to be patient. I do meditation, yoga and as much exercise as I can.

Just looking for some advice or just kind words as I continue on the path.

Thanks!

[Paxiled]

I also want to add that all the above discussion is about birth defects caused by drugs.  While that's a big concern, that's not the only reason medications are contraindicated while pregnant.  Antidepressants and benzos affect the brain of healthy adults in a way that alters the normal way the brain operates.  When pregnant, all drugs taken pass to the fetus, and that means the fetus will be taking a drug that alters normal adult brain function and fetuses and infants don't even have a developed brain yet, so imagine the possibilities of emotional harm that can result to be born taking one of these drugs.  And it might not turn up for years.  Why take this risk?  Again, all the talk about birth defects is important, but it is not the only reason none of these medications is recommended for pregnant women or even women trying to get pregnant.

[nursegirl6572]

Hello!

Could you please post a link to the studies that indicate that Zoloft is the "safest" AD to be taken during pregnancy?  

ALL SSRI antidepressants are classed as a "C" level risk, with the exception of Paxil (which is classed as a "D" risk).  Actually, different antidepressants carry different risks for different reasons.  One AD may increase the risk of low birth weight, while another may believed to increase the miscarriage rate.  Most doctors have a very different perception of what THEY think is the "safer" med out of the bunch.  As of now, though, I'm not aware of any studies that make that declaration.

Benzos, like Ativan are absolutely strongly contraindicated and given a risk category "D" rating for pregnancy.  VERY rarely would it be recommended to take a benzodiazepine during pregnancy.

I just want to make sure we put the most accurate info out there, for the benefit of the readers.

Thanks!

[newmamma424]

Ok, some people on here have no idea what they are talking about in regards to what in safer in pregnancy. I have myself just gone through a pregnancy that was totally awful and I had to be medicated around my 23rd week. Studies show that Zoloft is the safest AD to be on during pregnancy. The risks are more in the first trimester as it can sometimes cause malformations in the heart; however, this is very rare. Most moms on Zoloft give birth to healthy children. Zoloft is a category C and Paxil is a category D. I myself was on 40mgs of Celexa and 2-4 mgs of ativan my entire 3rd trimester and gave birth to a healthy boy who is developmentally normal. I know your post is fairly old but my advice would be to wait until you feel stable just on the Zoloft before tyring to concieve. Best of luck to you.

[nursegirl6572]

Hello and welcome!!

It sounds like you've got a very good grasp on this, and this statement of yours pretty much sums it up:

"I know there is no "quick fix" so I'm trying to be patient. I do meditation, yoga and as much exercise as I can. "

That's absolutely true.  Other than weaning slowly off of these kinds of meds with a doctor's supervision, the only other aspect is just giving yourself time to readjust, and it seems like you're doing what you can to help that process along.

As for the medication during pregnancy, you're correct that there are a lot of varying opinions as to the "safety" of taking an antidepressant during pregnancy.  You are also correct that there are some ADs that are considered "safer" than others.  While of course there is no guarantee with ANY med during pregnancy, a lot of women have taken ADs throughout their pregnancy with no ill effects to the baby.  I'm one of them.  I was switched from Lexapro to Prozac during my pregnancy and had no problems.

Really, it's a personal decision that each woman must make for herself, after closely weighing the risks and benefits with their doctors.  Each situation is different and unique.  For ME, I felt my mental health would drastically suffer if I came off the meds completely, and recognized that good mental/emotional health was just as vital to a healthy pregnancy as physical health was.  I commend you for addressing all of this BEFORE getting pregnant.  It's very unfortunate when women get pregnant while still taking meds that really ARE contraindicated during pregnancy (ie benzos), and then they find themselves in a rough situation, where they are trying to come off safely, but obviously faster than they would if they weren't pregnant.  That can be a nightmare.

Keep doing everything you're doing.  I think it's just going to take time for you to adjust, and I DO agree with Paxiled's therory that probably a lot of your symptoms are more attributed to the Paxil w/d versus the Klonopin.  The Zoloft cannot replace the Paxil med for med, as they differ a lot.  Your body WILL adjust, and it sounds like, despite some of the unpleasant symptoms, you're feeling okay emotionally.  That's good.

Definitely keep up with the therapy.  If you're struggling a lot, ask to INCREASE the frequency of therapy.  Try to incorporate some exercise into your routine (or increase the intensity/frequency of an already established exercise plan...with your doc's okay)...keep yourself well hydrated, and look into making any lifestyle changes that would improve the overall quality of your health (diet, cutting out stimulants, etc).  When you do that, you will notice accross the board changes in how you're feeling.

Best of luck to you, keep us updated, and certainly post anytime for support!  We're here for you!

[PillBoxHeart]

Hi everyone,
I should have been clearer...I've been in weekly therapy for the past 6 years. I'm doing ALL of this under Dr. supervision, not a general practitioner but a Psychiatrist who has extensive knowledge of these medications. I think most people vary wildy on which anti-antidepressants are ok for pregnancy, but my OB/GYN and my psychiatrist are very comfortable with me taking Zoloft. I also have three friends who have had successful pregnancies and births (and now perfectly healthy children) after taking Zoloft. The only other one I have heard is safe to take is Prozac, because it is older and they have more research on its effects. However I have another friend on Wellbutrin, so again, I think medical opinion on this varies.

I do agree that I tapered too quickly off of Klonopin...but no I did not go from 3 mg to nothing. I tapered off of that during the span of three months from 3 mg to 1 mg.

The Paxil was definitely controlling my anxiety, I was on it for over 10 years. However, this is not a drug that can be taken during pregnancy. I think the Zoloft is helping me and I think the Paxil did have a sedating effect that now that I'm off of it I realize made me extremely tired and lethargic.

I think the lesson from your posts are that experiences with these medications are unique to each individual. I appreciate your feedback.

[Paxiled]

You're not clear on the timetable here, at least to my humble brain.  Some of your symptoms are a bit odd -- did you say you went completely off klonopin and didn't suffer any withdrawal after taking a high dose for so long (3mg)?  Here's my confusion:  Paxil is known to pack a wallop of a withdrawal, and many of your reported symptoms sound more like Paxil withdrawal than klonopin withdrawal.  Klonopin withdrawal packs quite a wallop as well, and is usually gone off of the same way as other addictive drugs -- slowly and carefully, as abrupt quitting can also lead to seizures as this is also an anti-seizure medication.  Taking Zoloft won't end Paxil withdrawal, but as Paxil is generally stronger in action, your problems could be due to the klonopin and could also be that Zoloft isn't actually working for your anxiety as it's a weaker med than Paxil -- and you probably can't go back on Paxil now as it often just doesn't work again once you've quit.  So you could be suffering klonopin withdrawal, or the lack of klonopin, but more likely in my personal experience, the Paxil was probably controlling your anxiety on a regular basis better than klonopin was.  For all any of us know, your brain is still trying to acclimate to the lack of Paxil as much as the lack of klonopin, and quitting both at the same time is a slow, difficult process that should be given respect and time for your brain to adjust.  Now, I have no idea what's happening, but some of the side effects of Paxil you're missing may mean it was metabolized better by you than the Zoloft and so the Zoloft feels better, your mind is clearer, etc., but it's possibly just not as effective, at least not yet.  Again, once we've been on Paxil, it's hard to find another med that works as well because for whatever reason Paxil is just stronger -- probably too strong for many of us.  And as the above states, as far as I'm aware, Zoloft is just as contraindicated for pregnancy as Paxil is.  So again, there's a lot here that needs thinking and discussion and sorting out, but the one thing we can all tell you is, take your time with this.  Getting this right is more important right now than getting pregnant, which can wait.  Have you seen a psychiatrist who specializes in these meds?  It might be worth a chat if you can find a good one who isn't wed to often incorrect or misleading mainstream thinking.  Whatever you do, I'm sure in the end it will all work out fine once you sort out what's what.

[BluCrystal]

Please see my post in anxiety forum called 'my psych ward story'.  It's a long one and will take several min to read, but it might help you in some ways.  Post me back with your thoughts on it, maybe we can share other ideas. - Blu

[remar]

I'm kind of surprised your Dr is letting you stay on Zoloft if you're trying to get pregnant. It's best not to be on anything while pregnant but some of the antidepressants should not be taken while pregnant. There are some that are safer to take. From what I've heard and read Zoloft is not one of them.
Are you working with your Dr on a tapering plan to get off of Klonopin? You really should'nt try to do this on your own because of the symptoms you're having right now. It may take awhile but you really should have that tapering schedule. Can you get in to see your Dr soon? It sounds like you may be cutting back to fast.