Join Date: Sep 2006
Benefits of Klonopin for CFS
Here is an article by a dr who treats patients with CFS. The article at the link starts off with a discussion of "excitatory neurotoxicity" and the brain. Then Cheney discusses the myths of Klonopin.
I'm guessing that most of what he says also applies to people with bipolar who take Klonopin.
Dr. Paul Cheney Discusses the Benefits of Klonopin
by Carol Sieverling
......Many myths abound concerning Klonopin. When asked about these myths, Dr. Cheney shared the following information.
MYTH NUMBER ONE: THE GENERIC IS JUST AS GOOD.
When the generic Clonazepam came on the market, many patients switched to it because it was less expensive than Klonopin. Cheney then began hearing that most patients had to take more Clonazepam to get the same effect. Generics arenít exactly identical to the original products, and with most drugs the slight variations donít matter. However, most CFIDS patients can tell the difference between Klonopin and its generic form, Clonazepam. Most find Klonopin to be more effective.
MYTH NUMBER TWO: KLONOPIN IS ADDICTIVE.
Dr. Cheney was adamant that Klonopin is not addictive. In treating thousands of patients, he has never seen a patient become addicted to Klonopin. He reviewed the definition of addiction, stating that it involves: (1) psychosocial disruption, (2) accelerated use, (3) inappropriate use, and (4) drug seeking behavior.
Dr. Cheney said a case might be made that Klonopin is habituating. Itís true that it canít be stopped suddenly. You must taper off of it gradually. However, he was cautious about even calling it habituating. The process of tapering off a drug is not the same thing as withdrawal, a term that implies addiction.
Dr. Cheney said to keep in mind that Klonopin is given for a physiological problem Ė excitatory neurotoxicity. Itís prescribed to adjust the threshold potential: to keep neurons from firing inappropriately and being destroyed. He stressed that Klonopin should never be given unless you intend to raise the threshold potential. He stated, "Problems arise when you begin to use benzodiazapines for reasons other than threshold manipulation." However, CFIDS patients have a "threshold potential aberration" and need Klonopin (or something similar) to avoid brain injury.
Dr. Cheney has never seen a recovered patient have difficulty coming off Klonopin. He stated, "When you no longer need the drug, coming off it is very easy."
On the other hand, trouble arises when someone who still has an injured brain tries to come off Klonopin. Itís like a thyroid patient stopping their thyroid medication. Dr. Cheney warned, "All hell breaks loose". However, itís not because the drug is addicting, and itís not withdrawal. The condition still exists, and the body lets you know it has a legitimate physical need for the drug. Cheney stated, "When a CFIDS patient who is still experiencing the underlying mechanisms of brain injury goes off Klonopin, there is a burst of excess neural firing and cell death. Thatís the havoc we hear about that is mistakenly called withdrawal."
MYTH NUMBER THREE: KLONOPIN DISRUPTS STAGE 4 SLEEP.
Dr. Cheney said that he honestly doesnít understand this concern. He believes Klonopin might disrupt the sleep of people who take it for conditions other than the threshold potential aberration found in CFIDS. He also acknowledged that if you are looking just for drugs to facilitate sleep, Klonopin is certainly not the first one to come to mind, nor should it be used to induce sleep in "ordinary" patients. Itís not a sleep drug per se.
However, a large part of the sleep disorder of CFIDS is excitatory neurotoxicity and the resulting shift toward seizure. If you treat this condition with Klonopin, then you have treated a large part of the sleep disorder in CFIDS. Most importantly, he said he simply does not see stage 4 sleep disruption in his patients on Klonopin.
Towards the end of this discussion on Klonopin, Cheney smiled, and remarked, "But suppose Iím wrong about the brain injury and the threshold potential aberration and the shift toward seizure? What if Iím wrong about your need for Klonopin? Iím absolutely sure Iím right, but whatís the worst case scenario?
Do you know what long-term studies on Klonopin have shown? Reduced incidence of Alzheimerís Disease. Alzheimerís Disease is a complicated and convoluted way of knocking out your neurons, and Klonopin protects your neurons.
Now itís believed that Klonopin didnít actually stop Alzheimerís. It just delayed its onset so long that everyone died of something else before they ever got it - which is to say you wonít get Alzheimerís. Youíll die of something else first."
The last question Cheney addressed concerned the dose: what happens if the dose is too high? He said the only down side was that if you took a little too much (we are not talking overdose here) it would shift you toward coma on the continuum. It would shut your brain down to some degree, and thus impact your ability to function. This is inconvenient, but itís not harmful.
In fact, it shifts you into the "healing state" on the continuum. You may feel like a zombie, but your brain is protected and your neurons are not getting fried. However, not being able to function isnít an option for most of us, so we need to find the maximum dose that doesnít make us drowsy.
Dr. Cheney emphasized that Klonopin, Doxepin, and magnesium are very, very good at protecting the brain from cell death due to excess firing. However, they canít stop the underlying mechanisms of CFIDS that are injuring the brain in the first place.
Though it canít stop the underlying mechanisms causing the injury, Klonopin can protect your brain and keep your neurons from being destroyed. Then, as Cheney put it, "When you come out on the other side of this, youíll have more of your brain left."