Why Don't Doctors Want To Prescibe More Clonazapam?

[bigtrouble]

I was prescribed clonazepam 0.5 mg, 30 pills. These pills worked great to get rid of the chest pain I was having (left lower chest, below bone and sometimes it rises all the way to underarm). I wasn't even taking them everyday just to save up.
I went back but the doctor did not want to prescribe more. She said it is like a patch and I can't be on it continuously. She prescribed Effexor (Venlafaxine) 37.5 mg.
This is manking me very nauseated and I feel very lightheaded for 2-3 hours at work. I have to take at 8 AM. If I take it at night, once I wake up, I can't go back to sleep.
Plus on top of that, she says it is going to take 1 month for it to start having an effect.

[Becia]

Effexor was a bad drug for me. I was on it for 2-1/2 weeks, and it set me into a pots crisis that a hospital stay and then a nursing home stay for a couple months to get my energy back, was needed. I was nauseated, throwing up, having horrible thoughts, lightheaded, dizzy even worse than normal, and I couldn't function.

I've never been prescribed clonazapam, but I have heard from others sometimes doctors don't like prescribing it. I do hope you find something that works.

[bigtrouble]

Wow, that is pretty bad. I was also getting this weird feeling in my head, like electricity. I stopped taking it for a few days. I started to take it again. I take it at 3 PM now, when it is close to time to go home. It's is easier to tolerate. This stuff is for anxiety but I don't feel anxious, I just have anxiety like symptoms. The worst is the chest pain, left side, below the bone, near intestine. It starts to feel like a pressure, then inflammation, then slight pain. The pain extends to upper chest sometimes all the way to the underarm. The pain is sometimes intense.

I had a hospital stay recently because of nasty symptoms. They could not find anything wrong except for a lot of PVCs.

The clonazepam is an amazing drug. It works fast but its life is short. In 5 hours, the effect is gone. It was getting rid of the chest pain and I was feeling more functional in my daily life. Who can function with chest pain all day long?

[Sylvie33]

I suggest you spend some time researching these medications. Wikipedia is an excellent starting point. As noted, Effexor is primarily an antidepressant -- I have taken it for depression and found it was extremely rife with side effects; it is also extremely difficult to discontinue. (As noted above.) I'm not sure why it was prescribed as a first-line treatment for your anxiety.

I find clonazapam (Klonopin) to be very effective for anxiety, however it is also highly addictive and also can create terrible withdrawal symptoms when stopped -- these can range from anxiety rebound to seizures. Your doctor is wise to hesitate. I am taking it now, and luckily, I respond to tiny doses (no more than .75 mg total). I split my pills and only use it for insomnia. I don't like taking it, and I am sure it is contributing to my cognitive "fogginess."

There are other medications to try for anxiety that may be more appropriate for those who suffer from dysautonomia. Lots written on this site about Neurontin and alpha/beta blockers.

Unfortunately, I am also quite depressed now and am searching for an antidepressant with the least likelihood of causing neurological symptoms. I am not having much luck!

--Sylvie

[Sylvie33]

Oh, I just noted you don't even have anxiety! There are antidepressants that are prescribed for pain -- Lyrica, Cymbalta, etc. However, if you are like me, these also may cause more trouble than they are worth.

You may wish to search this site for pain medications that work well for people with POTS.

--S

[statesof]

They probably don't want to continually prescribe clonazepam because it is a benzodiazepine; their pretty much just prescribe for short term or every now and then type situations. Each doctor has their own views on prescribing these meds. Like other people said they're considered easily addictive and tolerance developes quickly. If chest pain/ pressure is the symptom your trying to control have you asked your cardiologists about meds you could try? For my own chest pressure, I found other meds that work better than benzos, but their also not antidepressants so I didn't have to worry about too many side effects.

[ks42]

It's tough. Klonopin was actually originally developed as an anti-seizure medication and was designed for long term use. Now, it's used more for anxiety, and because of the stigma surrounding benzodiazepines, it's been designated more for short term use. Benzodiazepines are narcotics, which are very often abused recreationally (like opiates), and doctors are taught to avoid prescribing them, especially long term. Because one of their primary uses is anxiety, doctors are also generally taught that antidepressants are good equivalent alternatives (which they would be, if all you were dealing with was anxiety).

I've been on Klonopin for 1.5 years, taken every day. I've tried 15 other medications for chest pain, pressure, and the elevated catecholamines that come along with HyperPOTS, and Klonopin hands down is the one that works the best. You name it, I've tried it - calcium channel blockers, beta blockers, antidepressants, gabapentin, lyrica, and so on. The gabapentin class worked in conjunction with Klonopin, but not alone. Without the Klonopin, I'd be bed-bound, and would probably be in the hospital every other day. So it's made a HUGE difference in my quality of life. Yes, it causes dependency, so it is DEFINITELY not right for everyone!! Stopping immediately can cause serious side effects such as seizures. But there are taper schedules that can be used to reduce dosages (10% a week or every two weeks) and I've successfully gone on and off benzos using this schedule with absolutely no withdrawal issues whatsoever (although not everyone has that experience). And to be honest, antidepressants cause dependency as well, and can't be stopped suddenly without serious side effects either (they just aren't abused recreationally, so are deemed safer).

Unfortunately, many doctors aren't educated on the benefits of long term use or how to safely withdraw patients from these drugs anymore, because of the risk of recreational abuse and addiction. What I had to do was start seeing a psychiatrist regularly, who advocated for my Klonopin use, because they are typically more familiar with (and more willing to prescribe) drugs from this class long term for various medical issues. They're also more familiar with safe tapering & withdrawal.

[bigtrouble]

I read about these drugs + more. The chemistry part is interesting and so are the details. Unfortunately, they don't explain what addiction means. Am I going to feel bad when I stop? It looks like a lot of these pain killers are marked as addictive and the effectiveness goes down over time.
When I first took clonazepam (klonopin), I felt extremely dizzy for 15 min. That's the way it was the first 3 days but I guess my body adjusted to it.
I'm not sure what kind of "high" you can get from clonazepam. Perhaps you have to take a high dose.

Since it is written clonazepam enhances the effect of GABA by binding to GABA1 receptors, I'm wondering if taking GABA pills would have a similar effect. From the looks of it it won't work since it doesn't cross the blood brain barrier.

ks42:
"Without the Klonopin, I'd be bed-bound, and would probably be in the hospital every other day. So it's made a HUGE difference "

==Glad you have something that works.

[ks42]

So to explain about addiction / dependence... Klonopin is a narcotic sedative with anti-seizure and muscle relaxant properties. When you take it for long periods (say, daily for a couple of months) your body becomes dependent on the chemicals it's causing your brain to produce. It causes your brain to "forget" how to produce those chemicals on its own. So if you stop suddenly, you will not only feel awful, but will create a potentially dangerous situation where your brain isn't producing some of the necessary chemicals it needs to regulate certain things. Seizures are common in people who stop Klonopin suddenly after taking it long term, and sometimes some of the sudden withdrawal effects can be life threatening. Tapering off slowly re-trains your brain to produce these chemicals again, which is much safer.

Addiction is actually different than dependence. Klonopin causes dependence in 100% of cases when taken long term; however, when you're dependent on it, your body needs it to function, but you don't crave it or feel you need to take it to produce a high. Addiction typically results from recreational use, and comes along with cravings for higher and higher doses to continue to feel "high". People who take Klonopin for medical reasons won't always get addicted, especially if they don't feel high while on it, and don't use it recreationally.

Yeah, I've been told by a couple of naturopaths and psychiatrists that GABA pills don't work as they do need to cross the blood brain barrier to have any effect, and they never worked for me personally.