Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Social Anxiety
Question: I have been taking 1/2 of 0.5mg of clonazepam 3 times a day. I started taking about 1/2 of 0.5mg once a day 2 years ago when my dad had alzheimers and then died of a heart attack. Last July I moved to North XXXXXXX from New York and my only child stayed in New York. When I first moved it was the summer and I went to the pool every day and was very happy then in October I started really missing my family and started taking Remeron antidepressent and started taking clonazepam 1/2 pill of 0.5 mg once a day. Since then I raised it to 1/2 a pill twice a day and for the past 6 months or so I now take 1/2 of 0.5 mg 3 times a day morning, noon and night. I notice that the clonazepam doesn't seem to have the same effect on me any more. I feel a nervous now a few hours after taking the dose. I read that if you are on it for a while you have to increase the dose to get the same affect that you got when you took it for a short time. I also lost about 12 pounds since I started taking the medicine two years ago. I went from about 126 pounds to 115 pounds in the past year from the anxiety. I have read that anti-anxiety drugs should be taken as needed but I was prescribed to take 2 0.5 mg a day but I never took that much just what I told you 3 1/2pills of 0.5 mg not 2 whole pills. I am starting to wean myself off by cutting a small piece off of my 1/2 a pill that I take at night. I read that you have to wean off slowly so you won't get withdrawal symptoms. I was able to wean myself off the Remeron 15mg doing a small piece for two weeks and then cutting a bigger piece off for another two weeks and so on. I would appreciate your advice on what to do about my situation. I also have social anxiety issues and get nervous now and then when I go into restaurants but I take a small piece of my mothers little helper and it helps. I don't get any panic attacks just feel nervous. Please Advise. Just my second husband and I live down here in North XXXXXXX and he works a lot of hours and I can't seem to be able to get a job except I volunteer at 2 local schools 4 times a week for about 3 hours a day. Everytime I want to go somewhere by myself I am always very nervous but I don't like being like this. I go to a cognitive behavior therapist who is helping me to face my fears and just do things and don't worry about it. The clonazepam makes me feel spacey and that is why I feel that way about going places. Being I lost the weight and am taking the same amount of dose as 2 years ago should I not be taking as much of the drug because of the weight loss?
Brief Answer:
Anti-anxiety medicines are needed for treatment
Detailed Answer:
Hello thanks for asking from HCM
I have read your query and I can understand your problem. After the death of your father you started to take Clonazepam 0.25 mg a day and which was later increased to 3 times a day when you shifted away from your family. You also started Rameron (Mirtazepine) and the drug also resulted in improvement. Then you failed to get effects of clonazepam and it was not able to produce same effects. You are trying to wean off clonazepam and you have successfully stopped to take Rameron.
Clonazepam is a benzodiazepine drug and yes it is known to produce tolerance and with time progressively increase in dose is needed to get same effect. The drug is known to produce dependence. So its better idea that you have started to wean off the drug doses gradually.
As per my opinion Clonazepam is not implicated for weight loss. The drug is not known to produce significant weight loss as side effect. You should not take the drug because of its abuse potential, the drug is not associated with significant weight loss.
Now coming to your anxiety. You are attending cognitive therapy sessions for fear. As you have weaned off Rameron so you are not on any antidepressant or anti anxiety drug. As per my opinion there is need to add some anti anxiety drug like SSRIs as Sertraline, Paroxetine to your prescription. These drugs will help in reducing the anxiety and fear you are having in social situations. These drugs will also help in good sleep. You need to take the drugs regularly to see full effect. These drugs are not associated with abuse potential so no need to worry. Apart from that if you don't want to take the drugs on regular basis other drugs like Propranolol can help you. The drug reduces anxiety of social situations and increases confidence to perform in social situations. The drug can be used on SOS basis and will help to reduce the symptoms without causing risk of dependence. Consult a psychiatrist for prescription of these drugs.
As you are on 0.25 mg doses of clonazepam so it will be easier to you to wean off from that dose. Mild doses of other anti anxiety drug like Propranolol will help to wean off the drug completely. You may suffer a little insomnia for some period but that will go in some days. You should also avoid taking the drug because it may increase the risk of cognitive impairment and you have family history of Alzheimers disease in your father.
I would also advise you to ask your therapist for Behaviour therapy methods like Progressive Muscle Relaxation exercises and Breathing Exercises. This will help to reduce your anxiety and will increased your confidence.
Thanks, hope this helps you. Please ask again for more doubts in follow up questions.
Anti-anxiety medicines are needed for treatment
Detailed Answer:
Hello thanks for asking from HCM
I have read your query and I can understand your problem. After the death of your father you started to take Clonazepam 0.25 mg a day and which was later increased to 3 times a day when you shifted away from your family. You also started Rameron (Mirtazepine) and the drug also resulted in improvement. Then you failed to get effects of clonazepam and it was not able to produce same effects. You are trying to wean off clonazepam and you have successfully stopped to take Rameron.
Clonazepam is a benzodiazepine drug and yes it is known to produce tolerance and with time progressively increase in dose is needed to get same effect. The drug is known to produce dependence. So its better idea that you have started to wean off the drug doses gradually.
As per my opinion Clonazepam is not implicated for weight loss. The drug is not known to produce significant weight loss as side effect. You should not take the drug because of its abuse potential, the drug is not associated with significant weight loss.
Now coming to your anxiety. You are attending cognitive therapy sessions for fear. As you have weaned off Rameron so you are not on any antidepressant or anti anxiety drug. As per my opinion there is need to add some anti anxiety drug like SSRIs as Sertraline, Paroxetine to your prescription. These drugs will help in reducing the anxiety and fear you are having in social situations. These drugs will also help in good sleep. You need to take the drugs regularly to see full effect. These drugs are not associated with abuse potential so no need to worry. Apart from that if you don't want to take the drugs on regular basis other drugs like Propranolol can help you. The drug reduces anxiety of social situations and increases confidence to perform in social situations. The drug can be used on SOS basis and will help to reduce the symptoms without causing risk of dependence. Consult a psychiatrist for prescription of these drugs.
As you are on 0.25 mg doses of clonazepam so it will be easier to you to wean off from that dose. Mild doses of other anti anxiety drug like Propranolol will help to wean off the drug completely. You may suffer a little insomnia for some period but that will go in some days. You should also avoid taking the drug because it may increase the risk of cognitive impairment and you have family history of Alzheimers disease in your father.
I would also advise you to ask your therapist for Behaviour therapy methods like Progressive Muscle Relaxation exercises and Breathing Exercises. This will help to reduce your anxiety and will increased your confidence.
Thanks, hope this helps you. Please ask again for more doubts in follow up questions.
Above answer was peer-reviewed by :
Dr. Yogesh D
Doctor, How can I wean off of Clonazepam without side effects. Right now I only take a small piece off my evening dose and take the whole .25mg in morning and afternoon. I can't stand the way I feel after taking the dose like the spaciness and feeling a little dizzy which makes me feel nervous but I know that you have to gradually taper down. Is that the best way to do it by starting with tapering one dose and then gradually stop taking that dose and then taper off say the afternoon dose next? My doctor prescribed Busparin a few months ago for me but I never took it. Can you take both Buspirone 7.5mg. and Clonazepam together without any problems and do you think I should take the Buspirone and will it make me feel more spacey feeling? Now I just found out today that my daughter's father has Stage 4 pancreatic cancer so I am now upset about that and may need the anxiety pills. My daughter and I are going down to Florida to help him because he is all alone and needs us. She can't handle it by herself so now I have another upsetting thing going on in my life. Please advise me I need advice.
Brief Answer:
Gradual tapering of doses by 20-25% every two weeks will be sufficient
Detailed Answer:
Hello again
There are two common ways by which you can wean off clonazepam. One is reduction of doses by 20-25% every two weeks and then stopping the drug completely at about 6-8 weeks. In this way you will not suffer significant symptoms. I will also advise you to first reduce the day time doses and then progress to reduction of night time dose. As 0.25 mg dose is very less, so you can skip afternoon dose and continue to take morning and night dose. After two week half dose in morning and full in night, then in next 4 weeks reduce the night dose to half followed by stopping the morning dose in further two weeks and then in next two weeks stopping the night dose completely. As per my opinion this method will not result in significant withdrawal.
Other method is to substitute the clonazepam with Diazepam. Equivalent doses of Diazepam is 5 mg to 0.25 mg of Clonazepam. Diazepam is longer acting and it is relatively easy to wean off from that drug. You can start taking Diazepam 5 mg (instead 0.25 clonazepam) for about next two weeks and then reduce the doses of about 25% every two weeks. This will prevent any withdrawal symptoms. This is what I advise to my patients of benzodiazepine dependence. I would advise you to visit your psychiatrist for proper prescription of drugs.
Yes you can take Buspirone with Clonazepam. Both drugs have different actions and no significant interactions. But I am afraid Buspirone will not result much benefit in Benzodiazepine withdrawal. Buspirone will not make you feel spacey feeling.
I am sorry about diagnosis of Pancreatic Cancer in your daughter's father. Try to remain calm in this difficult situation.
Please remember that these are prescription medications, you need to take them under suprvision of your primary care giver. Any change in dosage has to be discussed with them.
Thanks, if you have more doubts or any uncleared things of my answer please don't hesitate to ask again.
Thanks
Gradual tapering of doses by 20-25% every two weeks will be sufficient
Detailed Answer:
Hello again
There are two common ways by which you can wean off clonazepam. One is reduction of doses by 20-25% every two weeks and then stopping the drug completely at about 6-8 weeks. In this way you will not suffer significant symptoms. I will also advise you to first reduce the day time doses and then progress to reduction of night time dose. As 0.25 mg dose is very less, so you can skip afternoon dose and continue to take morning and night dose. After two week half dose in morning and full in night, then in next 4 weeks reduce the night dose to half followed by stopping the morning dose in further two weeks and then in next two weeks stopping the night dose completely. As per my opinion this method will not result in significant withdrawal.
Other method is to substitute the clonazepam with Diazepam. Equivalent doses of Diazepam is 5 mg to 0.25 mg of Clonazepam. Diazepam is longer acting and it is relatively easy to wean off from that drug. You can start taking Diazepam 5 mg (instead 0.25 clonazepam) for about next two weeks and then reduce the doses of about 25% every two weeks. This will prevent any withdrawal symptoms. This is what I advise to my patients of benzodiazepine dependence. I would advise you to visit your psychiatrist for proper prescription of drugs.
Yes you can take Buspirone with Clonazepam. Both drugs have different actions and no significant interactions. But I am afraid Buspirone will not result much benefit in Benzodiazepine withdrawal. Buspirone will not make you feel spacey feeling.
I am sorry about diagnosis of Pancreatic Cancer in your daughter's father. Try to remain calm in this difficult situation.
Please remember that these are prescription medications, you need to take them under suprvision of your primary care giver. Any change in dosage has to be discussed with them.
Thanks, if you have more doubts or any uncleared things of my answer please don't hesitate to ask again.
Thanks
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
