Klonopin, or clonazepam, is a medication commonly prescribed for anxiety, panic disorders, and seizures. In the benzo community, is considered “the granddaddy” of all benzodiazepines. It is twenty times more potent than Valium, and it binds more tightly to GABA receptors and works on sub-receptors. This blog post will discuss Klonopin withdrawal, its potential difficulties, and suggestions for coping with withdrawal/BIND (benzodiazepine-induced neurological dysfunction) symptoms. I was on clonazepam for 18 years. I know a thing or two about withdrawing and healing from the BIND symptoms it can cause.
The Strength of Klonopin
As noted, Klonopin is twenty times stronger than Valium, making it a potent medication with a high potential for withdrawal/BIND symptoms. This difference in strength can create challenges when tapering off the medication, as even a tiny crumb of the pill packs a wallop. It’s hard to taper in small amounts with such a high-potency pill.
The late Dr. Healther Ashton ran a benzodiazepine withdrawal clinic in the 1980s. She discovered that tapering slowly, no more than 10% every two to four weeks was the best practice for coming off a benzo. Unfortunately, many doctors are unfamiliar with her work and recommend a taper designed for opioids, which is too fast. Using Dr. Ashton’s manual as a guideline is more appropriate. Slow and steady wins the race. For example, those on 1 mg of Klonopin would take about 10 to 12 months to complete. It is not advisable to stop the medication abruptly as it can cause life-threatening symptoms such as seizures.
There are a few ways one can slowly reduce their dose. The three main methods are:
- Water: Dissolve the tablet in a measured amount of water (some use milk) and gradually reduce the amount consumed over time.
- Scale: Using a precise digital scale to weigh out the appropriate dosage for each taper.
- Compounding: Having a compounding pharmacy create custom-dosed capsules to help ensure accurate and consistent dosing during the tapering process.
These methods are shown on YoutTube and are easy to follow if you need instructions. It is not recommended to “eyeball” the pill and cut it with a knife or pill cutter.
Micro Tapering Versus Cut And Hold
One can choose to do a micro taper or cut and hold to taper. A micro taper can be done with both water and a scale. You reduce the amount by a small fraction every day or every other day so that in two to four weeks, you’ve reduced ten percent. This method requires good math skills if you are using a scale. Doing a micro taper with water is very easy; you simply removed a little bit more water every day and discard it. A cut-and-hold taper is one where you cut and hold that dose for two to four weeks. A micro taper (also called a Daily Micro Taper, or DMT) has the advantage that it does away with anticipatory anxiety over the next cut as one is reducing tiny amounts daily. A micro taper may be easier on the brain/nervous system as it doesn’t “shock” with a larger reduction one has to stabilize from. Both methods are effective, and the one that is best for you is the one you are most comfortable using.
Crossing Over to Valium
Dr. Ashton moved her patients over to Valium as it comes in small doses and is long-acting. Her manual recommends this. However, we now know that not everyone can make a successful crossover to Valium and that it comes with some risks. Valium is quite sedating as it breaks down into three metabolites that are benzodiazepines (nordiazepam, temazepam, and oxazepam), and can cause severe depression. Valium also blocks the body’s ability to create DAO, which is needed to break down histamine. While some individuals may find it easier to taper from Valium vs. Klonopin, many find the crossover or the depression and histamine issues aren’t worth it. Klonopin binds more tightly to the GABA receptor and works on sub-receptors, making the transition to Valium difficult for some. (I tried crossing over in hopes it would help my severe withdrawal symptoms. It made my symptoms worse, and so I remained on clonazepam.)
Kindling is a phenomenon that occurs with ethanol, barbituates, and benzodiazepines. It occurs when one has stopped and resumed the substance or raised then lowered the amount, which causes an increase in symptoms. Being kindled does not automatically mean that one will have a protracted withdrawal (more than eighteen months of recovery) or be precluded from healing. However, it is advisable to taper slowly so that your symptoms are more manageable, avoiding the urge to up the dose and risk being kindled. If you need to hold your dose for a few days or weeks to see if your symptoms will stabilize, that is a better choice than up-dosing. Once off the medication, it is best to stay off unless your symptoms are truly unbearable. If you must reinstate, do so within thirty days of cessation.
Unique Metabolic Pathway
Klonopin is the only benzodiazepine that is metabolized through the NAT2 pathway and acetylation. This unique metabolic pathway means that individuals with certain genetic variations may experience a more intense withdrawal process due to their body’s inability to break down and eliminate the drug effectively.
Cornering the Market
Every benzo can cause all of the known withdrawal/BIND symptoms (over 300 have been listed in the benzo community.) However, some of the benzos “corner the market” on certain symptoms. Valium is known for depression, and Ativan is known for insomnia. Xanax is known for pain, and Klonopin is known for intense mental symptoms. This doesn’t mean that you will have intense mental symptoms; however, it is best to educate yourself so you know how to best navigate your recovery
Symptoms of Withdrawal/BIND
Withdrawal from Klonopin, or benzodiazepine-induced neurological dysfunction (BIND), can lead to a range of symptoms, including intense mental anguish. Common symptoms of withdrawal may include:
- Panic attacks
- Memory problems
- Muscle pain and stiffness
- Intrusive thoughts/memories
- Burning skin
For a list of reported benzodiazepine withdrawal/BIND symptoms, go here.
Coping with Klonopin Withdrawal Symptoms
There are no medications or treatments that cure Klonopin withdrawal. Many medications offered to people with Klonopin withdrawal symptoms can slow down the recovery or present with their own withdrawal syndrome down the road. While Klonopin withdrawal can be challenging, there are several strategies to help cope with symptoms.
- Establish a support network: Reach out to friends, family members, or support groups to discuss your experiences and seek encouragement during the withdrawal process.
- Maintain a healthy lifestyle: Eat right (WFPB), move enough, stress less, and love well.
- Practice relaxation techniques: Deep breathing, meditation, and progressive muscle relaxation can help manage anxiety and stress during withdrawal.
- Stay engaged in activities: If you are able, participate in hobbies, social events, and other activities that help you to distract.
- Be patient: Klonopin withdrawal can be a lengthy process, and it is essential to remember that healing takes time. Be patient with yourself and focus on small, achievable goals to maintain motivation and a sense of progress.
- Distract when possible: Distraction takes our focus off our symptoms and helps the nervous system settle down.
- Learn something new.”The process of learning grows new neuronal connections and gives us a feel-good dose of dopamine.
- Garden: Tending to a flower or veggie garden is good for the nervous system and has proven benefits for relieving depression.
- Get professional help: Work with a benzo-wise coach or healthcare professional to learn how to cope with symptoms.
- Join a support group: Become a member of a positive, solution-focused benzo withdrawal support group.
- Practice acceptance: Acceptance rewires the brain and nervous system for the better.
Klonopin withdrawal can be a challenging and sometimes overwhelming process, but it is essential to remember that you are not alone. With the right support and coping strategies, you can successfully navigate the withdrawal/BIND process and be healthy and happy. Acceptance, patience, and perseverance are powerful tools.
Add Your Voice
What has your experience with Klonopin been like? What had helped you navigate recovery? We appreciate your comment.