Weaning Clonazepam

[Guest guest]

We are taking my son Caden off of Clonazepam, the doctor thinks this

might be causing his aggresive behavior, since the diet has started,

Caden has been biting at school and his behavior is completley

different. He has been on this drug for along time around 1 1/2, the

doctor said he could go through withdrawls, has anybody been

through this with this drug before , have you seen the seizures get

worse, or was the behavior worse, just wondering. Any info

appreciated. Thanks Caden,s mom Viola

[Guest guest]

Weaning after a long period on any of the benzodiazepines (incl clonaz) will

usually lead to withdrawals, which in our kiddies often brings with it (usually

temporary) increased seizures.

had a 3 1/2 yr addiction to this class of meds, starting with clonaz,

then clobazam, then oral diazepam, then nitrazepam, then back to oral diaz

before they were removed in an emergency setting late last yr.

The state of ketosis in 's case heightened all his medication side

effects (the binding protein mechanism of many drugs is affected by the

increased acidity that produces ketones causes) and also caused various nasty

toxicity issues, so with behaviour difficulties being a common clonaz side

effect, this is poss why Caden's behaviour may have worsened since starting the

diet.

The reason why the addiction/withdrawal aspect makes these meds such hard work

to wean, is very logical once you realise the role this class of meds plays in

the brain, and knowing why the withdrawal symptoms occurred helped me with my

resolve to get off them, and survive the (often v rocky) withdrawal

phases.

For a more technical/detailed explanation you can search at benzo.org.uk, but

the basics behind it from what I have learnt over the yrs are...

- The role benzo meds play in the brain is to enhance GABA, which is the

brain's natural neuro-inhibitory chemical. By increasing GABA, the CNS is

depressed, meaning often a reduction or cessation in seizure activity, hence the

reason drugs like diastat and ativan are used for emergency situations when

seizures get out of control or the kiddie is in status.

Unfortunately though, due to a compensatory process that occurs, the more 'top

up' the brain receives over time through drugs like benzos if used as regular

AEDs, the less natural GABA the brain will produce, leading to a need for more

and more of the med being required to achieve the same 'calming' effect'. This

is where the tolerance aspect comes in, and it is very rare for a drug in the

benzo class of meds to not need increasing peridodically to keep ahead of this

compensatory process. This then begins the vicious cycle that many addicts

(including a lot of our kiddies) get caught up in.

When weaning, the artifical top up is reduced through less oral medication

being given, and for a period (the withdrawal period after each reduction) the

GABA is therefore left at a lower than usual level. During the withdrawal phase,

the brain gradually starts to produce more of it's own natural GABA to balance

things out again, but in the period in between, the brain is actually left in a

state of neuronal hyper-excitability, which obviously for an epileptic, is not a

good place to be in....

This is why many people experience a worsening of the effects they were

originally prescribed the med for during reductions, be it in seizures if it was

prescribed as an AED, behaviour if prescribed for that side of things, insomnia

if it was prescribed as sleeping aid, in anxiety if it was prescribed as a

relaxant, and so on.

Once the brain's own production has 'caught up' after recognising that same

level of artifical top-up isn't there any longer (usually when the blood levels

stabilise) the withdrawal symptoms ease off, and status quo is resumed, until

the next reduction...and on it goes until it is all weaned.

The problem seizure wise with withdrawing though, is that if an epileptic's

brain gets too 'over-excited', you can get the seizures begetting more seizures

scenario, and sometimes an intervention is needed to stop that seizure

withdrawal cycle. Like even though the GABA levels may have stabilised again

(the time for this to occur varies depending on the individual benzo's half

life), the brain is caught up in seizure mode, and this is often where many

prescribing mistakes are made, like the assumption by many Drs is that this is a

sign the person 'needs' this med put back up again - which is where we ran into

trouble with .

Not everyone will have this happen, some can keep on withdrawing the meds

after each stabilisng period till it has all gone, but in our case we had to

intervene more often than not, usually with a benzo 'cousin' (like when he was

on nitrazepam, we used diaz) for long enough to allow the seizure excitability

cycle to come to an end, (24-48 hrs in his case) but not for long enough to

allow an addiction to the intervening med to then form.

You may find that Caden has none of the withdrawal problems that we

experienced with , his turned into a fairly extreme case, where he went

past the stage of tolerance of the benzo meds to 'in'tolerance' that eventually

ended in an emergency cold turkey withdrawal in PICU. Which was v dangerous, but

we were left with no real choice. Had we been able to, we would have continued

with 10% decremental reductions (as recommended by Prof Ashton at that benzo uk

site) till it had all gone.

Short answer yes, we did see seizures and behaviour worsen during each

reduction,

----- Original Message -----

From: vihairaffair2000

We are taking my son Caden off of Clonazepam, the doctor thinks this

might be causing his aggresive behavior, since the diet has started,

Caden has been biting at school and his behavior is completley

different. He has been on this drug for along time around 1 1/2, the

doctor said he could go through withdrawls, has anybody been

through this with this drug before , have you seen the seizures get

worse, or was the behavior worse, just wondering. Any info

appreciated. Thanks Caden,s mom Viola