Clonazepam Withdrawal Help and Medications
Clonazepam withdrawal is often treated by a process called tapering, in which you take clonazepam in gradually smaller amounts. Here's what you need to know.
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Clonazepam withdrawal treatment options
Medication for clonazepam withdrawal
Clonazepam (Klonopin) is a prescription drug that is used to treat panic disorder and control certain seizures. It belongs to a class of medications called benzodiazepines, which are central nervous system depressants. When people use these drugs for an extended period, they may develop physical dependence and, ultimately, addiction. People who try to stop using may experience symptoms that can be dangerous and even fatal.
Safe and effective clonazepam withdrawal treatment starts with medically supervised detox and may be followed by professional addiction treatment. This combination helps to ensure a successful recovery and break the cycle of addiction. Detox may include tapering down the dose or substituting another medication for clonazepam prior to the tapering schedule.
Detoxing cold turkey is not recommended and can lead to a number of issues, including seizures.
Treatment Options for Clonazepam Withdrawal
Clonazepam withdrawal treatment options may include:
- Detox center: In a medical detox program, treatment staff helps you detox using medication and support so that you can go through withdrawal safely. After you have stabilized, the staff monitor your body as it rids itself of the rest of the drug.
- Inpatient: Inpatient programs are considered one of the safest ways to detox and get addiction treatment because professionals can monitor your symptoms 24/7. Inpatient treatment programs can last from several days to weeks, depending on your needs. These facilities allow you to receive supportive care as you move through treatments ranging from individual therapy to 12-step meetings.
- Outpatient: Depending on the severity of your addiction, you may want to consider outpatient treatment. Outpatient detox allows you to live at home while you receive treatment. A physician or other healthcare provider may monitor your withdrawal and prescribe medications, as needed. You may meet with a therapist for a set number of hours per week and also participate in group therapy.
- Intensive outpatient program (IOP): This type of outpatient program involves more hours per week of treatment than standard outpatient. Some people also enter IOPs after first completing an inpatient program. Others periodically seek the services of IOP to undergo additional therapy and remain engaged in treatment as they progress in their recovery. IOP is a great way to build the skills you will need as you transition out of treatment in order to stay sober.
Partial hospitalization program (PHP): These programs are similar to inpatient programs, but instead of living at a facility you live at home or in a sober living home. PHPs are designed for people who need structure, but prefer fewer restrictions than inpatient treatment. In addition, PHPs may be helpful if you do not need medical attention, but you require a high level of care. Tapering can be done faster in a hospital or partial hospitalization setting for high-dose abusers.1
Clonazepam withdrawal is often treated by a process called tapering, in which you take clonazepam in gradually smaller amounts. Tapering helps your body stabilize as it slowly clears itself of clonazepam (see next section).
If your doctor feels that it is necessary, he or she may switch you to a clonazepam withdrawal medication, such as diazepam, to help ease your symptoms.6 Your dosing schedule will depend on whether you were taking low doses or high doses of clonazepam.
Flumazenil is a medication used to treat overdoses, but it has also been shown to help relieve some of the uncomfortable symptoms of withdrawal from benzodiazepines such as clonazepam.2
Tapering Off Clonazepam
The safest route to taper is in a clinical setting. Many detox programs will slowly taper you off clonazepam. Generally, the approach to tapering is to establish an acute dose initially and then reduce that amount over time.
The safest route to taper is in a clinical setting, where trained nursing and medical staff can monitor your condition. This is especially important if you have other factors influencing your clonazepam addiction, such as:
- Severe benzodiazepine tolerance.
- Co-occurring medical or mental health conditions.
Tapering in an outpatient setting presents some additional challenges because users are largely unsupervised while not at the clinic or checking in with the treatment team. Withdrawal complications, should they arise at home, may be more difficult to recognize and manage.
Additionally, the recovering individual takes home a small supply of the drug in a home detox protocol. At home, that person may misuse the drug intended for the taper or may abuse it by mixing clonazepam with drugs or alcohol.
Finally, clonazepam can increase the risk of suicidal thoughts or behavior, as well as worsen depression. If you have suicidal thoughts during the withdrawal process, you should talk to your doctor immediately. 4
Clonazepam Tapering Study
In a study of 73 individuals who had used clonazepam for 3 years, researchers developed a protocol for safely tapering those individuals off the drug. The dose of clonazepam was decreased by 0.5 mg every 2 weeks until the individuals reached 1 mg per day, followed by a decrease of 0.25 mg per week. After 4 months, roughly 70% of the people in the study were free of using the drug and 26% still needed the medication.3
Detoxing Cold Turkey at Home
Going “cold turkey” or just stopping, is never recommended for individuals taking clonazepam or any sedative medication. In addition, if you have a history of any of the following conditions, going cold turkey could be especially dangerous for you.5
- Multiple previous withdrawal experiences
- History of severe withdrawal
- Presence of co-occurring mental health disorders
- Medical or surgical conditions that will require medical care
- Delirium tremens
Anyone can have seizures from clonazepam withdrawal. However, if you have a previous history of seizure disorder and you go cold turkey, your risk is significantly elevated. The most severe effects of withdrawal include psychotic reactions and seizures. 8 Other symptoms of clonazepam withdrawal may include: 6,7
- Muscle tension and muscle aches.
The most severe effects of withdrawal include psychotic reactions and seizures. 8
Entering a treatment program for your detoxification can ensure your safety and reduce your impulse to relapse – or begin using clonazepam again. Many people who go cold turkey quickly relapse when the withdrawal symptoms are painful and uncomfortable. In a clonazepam withdrawal treatment program you can stay on track for your recovery goals.
. Hu, X. (2011). Benzodiazepine withdrawal seizures and management. The Journal of the Oklahoma State Medical Association, 104(2), 62-65.
. Hood, S. D., Norman, A., Hince, D. A., Melichar, J. K., & Hulse, G. K. (2014). Benzodiazepine dependence and its treatment with low dose flumazenil. British journal of clinical pharmacology, 77(2), 285-294.
. Nardi, A. E., Freire, R. C., Valença, A. M., Amrein, R., de Cerqueira, A. C. R., Lopes, F. L., de Carvalho, M. R. (2010). Tapering clonazepam in patients with panic disorder after at least 3 years of treatment. Journal of clinical psychopharmacology, 30(3), 290-293.
. Food and Drug Administration. (2013). Klonopin Tablets (clonazepam).
. Center for Substance Abuse Treatment. (2006). Physical Detoxification Services for Withdrawal From Specific Substances.
. Dolan, K. (2010). Clinical Guidelines For Withdrawal Management And Treatment Of Drug Dependence In Closed Settings. Addiction, 105(7), 1318.
. Ashton, H. (1991). Protracted withdrawal syndromes from benzodiazepines. Journal of substance abuse treatment, 8(1-2), 19-28.
. Petursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(11), 1455-1459.