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Author Topic: Medication and sleep - zoloft and clonazepam  (Read 908 times)

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Offline reznor

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Medication and sleep - zoloft and clonazepam
« on: August 20, 2013, 01:39:30 PM »
Hey everyone,

So i take Zoloft (currently 50 mg, still working up to 100mg) daily in the mornings. I recently changed from 25mg-50mg and actually to my delight feel like i was getting a pretty good response (still have anxiety and anxious thoughts, but the triggering of the total fear is less).

I also have a prescription for Clonazepam (.5mg). These are PRN. Typically i was finding myself taking it once every 2-3 days.

I find that when i take Clonazepam before bed (after i get home from the gym/work/etc - 7pm..) it really relaxes me and I kind of unwind for a few hours and go to sleep around 11pm.

On nights when i do take the Clonazepam I typically sleep MUCH better. Not purely for a narcotic like high (zonked out on NyQuil sleep) but rather that it deals with one of my few real difficult symptoms (sleep anxiety - anxious dreaming, anxious wakeup).

So i guess my real question is: Does anyone take a bezno daily before sleep? If so, for how long (months, years)? Do you find it helps you? Have you had issues with dependence/addicition/need for increased dosage etc?
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Offline hikingchik63

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Re: Medication and sleep - zoloft and clonazepam
« Reply #1 on: August 20, 2013, 02:59:09 PM »
Hello, Ive taken .5mg klonopin for 5 years before bed every night. I havent had to increase it, and I was able to taper off zoloft and remeron that I had been taking for 2 1/2 yrs. I needed to lose weight, and I found the klonopin works for all my issues(gad, panic, depression), and Ive lost the weight and then some. Good luck to you!
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"Frame your mind to mirth and merriment which bars a thousand harms and lengthens life."--Shakespeare

Offline kate39

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Re: Medication and sleep - zoloft and clonazepam
« Reply #2 on: August 20, 2013, 04:43:55 PM »
I was prescribed klonopin .5mg to help with sleep as well.  I have taken it daily for over 3 months now.  Recently, I decided to wean off as I am on a few meds and think that this makes me foggy and forgetful.  Anyway, I have found weaning to be extremely difficult.  I cut the pill in half initially, then in 1/4s and now only take 1/2.  During the transition period, I have been experiencing insomnia and rebound anxiety during the day....

I guess it just depends how you feel about becoming a long term user...It's tough to get off of this stuff.  Although, you are using it PRN which may be entirely different then every night for withdrawing.

My Dr. suggested today that I take Ativan to help with the weaning process. Aren't I just going to get addicted to that?

Thanks and good luck!
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Offline hikingchik63

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Re: Medication and sleep - zoloft and clonazepam
« Reply #3 on: August 20, 2013, 05:23:16 PM »
I agree with you Kate. Its tough to taper klonopin. I do worry about it, as Ive tried to get down to .25mg and have not been successful. I actually think the ativan could be a good idea to use to help get off of the klonopin. I guess because its shorter acting and could help ease the transition, and you use tiny pieces of it just to get thru, u could probably disolve a tiny morsel under ur tongue to help u get thru the worst. I just havent been 100 percent ready to taper klonopin. I do want to be med free at some point, and when I decide it's time, I know it will be tough. But there are people that find the taper easy. Judging from the times Ive tried to go down in my dosage, I dont think it will be for me. So there is definitely dependence going on, even though I would never consider increasing it.
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"Frame your mind to mirth and merriment which bars a thousand harms and lengthens life."--Shakespeare

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Re: Medication and sleep - zoloft and clonazepam
« Reply #4 on: August 20, 2013, 10:25:05 PM »
So i guess my real question is: Does anyone take a bezno daily before sleep? If so, for how long (months, years)? Do you find it helps you? Have you had issues with dependence/addicition/need for increased dosage etc?

Benzodiazepines are not good sleeping pill as tolerance to the sedation builds with a couple of weeks, but the main benefit you seem to be getting is an easing of anxiety. Tolerance to this probably will never develop.

The main danger is that your doctor may at some point refuse to continue prescribing benzodiazepines, more and more are unfortunately. Some then demand their patients wean of them within a few weeks which can cause much suffering.

If you need something for insomnia then small doses of the sedating antidepressants trazodone (Desyrl) would be a better option. As for the anxiety, Zoloft should deliver the calmness you're seeking once you've been on an adequate dose for 3-12 weeks.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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Re: Medication and sleep - zoloft and clonazepam
« Reply #5 on: August 20, 2013, 10:43:28 PM »
My Dr. suggested today that I take Ativan to help with the weaning process. Aren't I just going to get addicted to that?

Yes, plus it would be even harder to wean off Ativan (lorazepam) than from clonazepam because of the short half-life of lorazepam.

Your best option would be to switch to the very long acting BZD diazepam (Valium). Not only would its longer half-life, up to 200 hours compared to up to 50 for clonazepam and about 12 for lorazepam, smooth the peaks and troughs, but the greater relative dose to smallest dose tablet ratio makes it easier to taper off in small increments.

Is your current clonazepam dose half of a 0.5mg tablet?

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline kate39

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Re: Medication and sleep - zoloft and clonazepam
« Reply #6 on: August 21, 2013, 08:48:07 AM »
Thanks Insights!

Yes, I was originally prescribed .5 to take at night.  I have used it for the last 3 months and tried to wean back to .25.  For the last 8 days I have taken .25 at night.  The first week was rough...waking up sweating, shaking, increased pulse and increased anxiety during the day.  Finally yesterday I seemed a little more like myself and slept better last night with Tylenol PM.

Dr. prescribed Ativan because he thought I should have "something" to get me through the transition.  I discussed the valium with him from the Ashton manual and his response was that it would be harder to get off the valium because it is stronger....  Now I hear what you are saying about it staying in my system and making the transition a bit more tolerable.  Do I replace the klonopin .5 with the valium or do I taper the klonopin back while starting the valium?  and yes, I realize you are not my dr.  Just trying to get some advice....

Thanks for listening and helping...
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Re: Medication and sleep - zoloft and clonazepam
« Reply #7 on: August 21, 2013, 05:31:11 PM »
his response was that it would be harder to get off the valium because it is stronger....

He is wrong. Clonazepam was specifically developed as a high potency alternative to diazepam (Valium) because some epileptics were needing to take huge doses to adequately control their seizures. This is why the equivalent clonazepam doses are 1/20th that of diazepam. 

Quote
Do I replace the klonopin .5 with the valium or do I taper the klonopin back while starting the valium?

You replace the 0.25mg with 5mg diazepam, stabilize for a week or two and then you can begin cutting back. Try reducing the dose by half a 2mg tablet every 3-4 weeks. If this proves too difficult then taper by a quarter of a tablet, but you probably won't need to until you get down to the last 1 or 2 milligrams.

Also don't be tempted to go any faster as it takes about 3 weeks for blood plasma levels of diazepam to stabilize after each dose reduction (I'm aware that this is much slower than the Ashton manual recommends, but I'm not a fan and disagree with just about everything Heather Ashton says about benzodiazepines (and antidepressants) apart from the use of diazepam to taper off them). Take an extra week to regain some confidence if you need to. Nobody is handing out gold stars to those quitting in record time.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline kate39

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Re: Medication and sleep - zoloft and clonazepam
« Reply #8 on: August 22, 2013, 08:42:08 AM »
I take the .25 klonopin before bed.  My anxiety is the worst in the morning.  When I wake up I try all kind of breathing and relaxation techniques to calm myself.  I'm wondering if I should be taking it in the morning instead?

I never had anxiety like this until this past year.  I started having medical issues, underwent scary testing and eventually had major back surgery.  I'm 3 months post surgery and want to get off some of the meds that they put me on.  The anxiety makes my pain worse so it's hard to think of weaning off the rest of this klonopin.  Mentally, I don't feel like I have to be so worried anymore...so I cant figure out why I am having so much anxiety while going off of this.  Is that a normal withdrawal response...to have increased anxiety as you wean off the med?

Thanks for the support....
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Re: Medication and sleep - zoloft and clonazepam
« Reply #9 on: August 22, 2013, 09:04:21 AM »
I take the .25 klonopin before bed.  My anxiety is the worst in the morning.  When I wake up I try all kind of breathing and relaxation techniques to calm myself.  I'm wondering if I should be taking it in the morning instead?

Yes. Even though clonazepam is long acting, the biggest response comes when blood plasma levels peak which is 1-4 hours after its taken.

Quote
The anxiety makes my pain worse so it's hard to think of weaning off the rest of this klonopin.  Mentally, I don't feel like I have to be so worried anymore...so I cant figure out why I am having so much anxiety while going off of this.  Is that a normal withdrawal response...to have increased anxiety as you wean off the med?

I think the reason you are experiencing heightened anxiety can be found in the first sentence of the above.

Is there a pain clinic in your area? If so, I think you should seek their opinion on where you should go from here. They may suggest alternative meds for the pain, antidepressant maybe, but will probably recommend a non drug approach.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Gandalf the grey

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Re: Medication and sleep - zoloft and clonazepam
« Reply #10 on: January 13, 2014, 11:03:46 AM »
I've noticed the clonazepam has been only moderately successful for the reason my doctor prescribed-.25mg at night before sleeping. It has, however, been very good for the physical symptoms of my anxiety, even at such a low dose. I'm now wondering if i should ask my doctor for Remeron (his other option for sleep, although he preferred clonazepam) and request to take the klonopin in the morning rather than at night
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Offline hikingchik63

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Re: Medication and sleep - zoloft and clonazepam
« Reply #11 on: January 13, 2014, 02:50:41 PM »
sev times a month i add a crumb of a 15 mg remeron pill to my daily,nightly klonopin dose. per my pdoc. works very well, but careful....too much and u awake with a hangover.
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Re: Medication and sleep - zoloft and clonazepam
« Reply #12 on: January 13, 2014, 06:48:16 PM »
I'm now wondering if i should ask my doctor for Remeron (his other option for sleep, although he preferred clonazepam) although he preferred clonazepam) and request to take the klonopin in the morning rather than at night

If it is only for sleep then trazodone (Desyrel) would be a better option, IMHO. It has a shorter half-life than Remeron so there's less risk of a sedation 'hangover' the next day, it is far less likely to poop-out, no antidepressant side-effects and at the doses prescribed for insomnia it won't interfere with most other meds except antihistamines which you shouldn't need to take anyway because trazodone itself is a powerful antihistamine at low doses.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline dh1972

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Re: Medication and sleep - zoloft and clonazepam
« Reply #13 on: January 13, 2014, 10:46:42 PM »
For the last couple of months or so I have been using Xanax about twice per week (occasionally three times per week) at about .5 mg just before bed and it really does help me sleep well.  I just feel so relaxed this way before bed (especially if I do a 20 minute guided meditation before bed, as well).  I realize this is not optimal and plan on finding another solution particularly since I am seeing a Psych Dr. for the first time on Wed.

Trazodone does work generally well for sleep, as well, based on my experience but I seem to get heightened anxiety on it.
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Offline Gandalf the grey

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Re: Medication and sleep - zoloft and clonazepam
« Reply #14 on: January 14, 2014, 04:57:08 PM »
I'm now wondering if i should ask my doctor for Remeron (his other option for sleep, although he preferred clonazepam) although he preferred clonazepam) and request to take the klonopin in the morning rather than at night

If it is only for sleep then trazodone (Desyrel) would be a better option, IMHO. It has a shorter half-life than Remeron so there's less risk of a sedation 'hangover' the next day, it is far less likely to poop-out, no antidepressant side-effects and at the doses prescribed for insomnia it won't interfere with most other meds except antihistamines which you shouldn't need to take anyway because trazodone itself is a powerful antihistamine at low doses.

Ian

It was my Psychiatrist who preferred Remeron over Trazodone, due to a bad reaction a few years ago when i was dealing with sleep issues (long before i realized my anxiety was abnormal).
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