Guest guest Posted November 22, 2004 Report Share Posted November 22, 2004 Thanks MMC. I guess if there was anyone it worked for they wouldn't be on here! LOL/Sigh. How is Jess? Is November a " month? " Seem to recall it is. If so, holding my breath for you. Re: Weaning Clonazepam > > > > > > > > > > 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, > > > > > > > > > > > > > > " The Ketogenic Diet....a realistic treatment option, NOT just a last > > resort! " > > > > List is for parent to parent support only. > > It is important to get medical advice from a > > professional keto team! > > Subscribe: ketogenic-subscribe > > Unsubscribe: ketogenic-unsubscribe > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 22, 2004 Report Share Posted November 22, 2004 Shhhh.......so far, so good Actually we have had a few strange incidents where we show all he** was going to break loose but........perhaps that was all we will get. Yup, hope does spring eternal LOL Barbara Swoyer wrote: > Thanks MMC. I guess if there was anyone it worked for they wouldn't > be on > here! LOL/Sigh. > How is Jess? Is November a " month? " Seem to recall it is. If so, > holding > my breath for you. > Re: Weaning Clonazepam > > > > > > > > > > > > > > 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, > > > > > > > > > > > > > > > > > > > > " The Ketogenic Diet....a realistic treatment option, NOT just a > last > > > resort! " > > > > > > List is for parent to parent support only. > > > It is important to get medical advice from a > > > professional keto team! > > > Subscribe: ketogenic-subscribe > > > Unsubscribe: > ketogenic-unsubscribe > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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