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Jimmyboy Which is better? Tapering off Ambien or tapering off Clonazepam?


Jimmyboy

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Hi All,

I've been on Ambien CR for nearly 10 years. Began to develop tolerance 5 years ago, So Psych Doc added 10mg of regular ambien (initially it was 5mg for breakthrough and later on it became 10 mg after couple of years.

Also have Chronic anxiety. Was on lexapro for 8 years. anxiety improved after being diagnosed with moderate Obstructive Sleep Apnea and started on CPAP. Sleep doctor told me my anxiety would go off with the CPAP. Didn't belive her, but nearly 4 months into CPAP 75-80% of anxiety was down. Therefore with permission of PD tapered off lexaapro over 3 months. No problems.

Year later, Father passed away - Guess, the subsequent grief and stress reactivated my anxiety and maybe depression accompanied it. New Psych Doc restarted back on lexapro 20. Also put me on Clonazepam 4 mg with advise to go up as needed to sleep to 8mg. started working around 6 mg. so stopped at that dose. Clonazepam has a tendency for me to stop working after 3-4 weeks. I guess my body wants more. So, instead of going up on Clonazepam, went back to the Ambien CR12.5 + regular ambien 10mg. He also started me on Nuvigil explaing that if I was up and perky all day long, I would sleep at night. Good theory. The Nuvigil did perk me up, but it also perked my anxiety. 6 months later tpered off the Nuvigil without problems. Then over 3 months tapered off the Lexapro - no problems. Trying to taper off the Ambien over 3 months - manged to come off it for 2 weeks ( 1st week - doc covered me with low dose phenobarbitol to prevent seizures. next week completely off all meds). Then some minor stressful event triggered off the insomnia again - so went back to the Ambien CR/Ambien combo. it helps me sleep, but by the end of the day I'm still jittery. tried Clonazepam at 6mg. works better - no jitteriness/anxiety on it, but know that it will sturate in 3 - 4 weeks. So, doing the Ambien CR/Ambien combo now.

Doc advises me to do a Clonazepam taper - he recommend coming off 2% every week. Can't find a way to break my pills to make that 2% reduction. will need a compounding pharmacy to accomplish that. But worried that the Clonazepam might stop working (as it usually does) in 3-4 weeks. So, not sure if the tapering will work out.

 

Question - should I do a Ambien taper or a clonazepam taper (at 2% per week). Where can I get a compounding pharmacy for liquid Ambien or liquid Clonazepam to accomplish the 2% taper?

 

50 yr old with Chronic Insomnia

Halcion 0.25 mg on and off 20 yrs - 10 yrs ago

Diagnosed GAD 10 yrs ago - Remeron 6 weeks (didn't work) Doxipem - 6 weeks (DW). Ambien CR 12.5mg started nearly 10 years ago.

Year later - sleep study - nothing conclusive (per report) started on Xyrem 4.5 gms (9cc) - new wonder drug, for insomnia, in town. 3 months later, couldn't sleep on the Xyrem, agitated, super anxious. Psych Doc (not the one who prescribed Xyrem) put me on Klonopin till symptoms under control. was taking 0.5 mg 3 times a day. (no Ambien while on Xyrem). Klonopin stopped working 3 weeks into therapy. Sleep doc/neurologist --> Continue back on Xyrem. Worked for 3 months - again saturated, WD symptoms relieved by Klonopin. Same cycle after 3 weeks. 3rd time, PD stopped Xyrem, started back on Ambien CR 12.5mg with lexapro built up to 20mg/day.

nearly 5 years later Ambien CR working for only about 4-5 hours, so PD presribed 10mg regular ambien for breakthrough.

2 years ago repeat sleep study - moderate OSA (weigh 185 lbs, height 5'11") CPAP controlled 75% anxiety in 4 months. Began lexapro taper 3 months later to off in 3 months

Last year father passed away - bad anxiety /depression. New PD started back on lexapro 20, Clonazepam 4-8mg (worked at 6mg - so stopped at that dose) and started Nuvigil (theory - awake during the day - will sleep at night). Clonazepam saturated in 4 weeks. Went back to Ambien CR 12.5 +regular ambien 10mg.

Tapered off Nuvigil end of Novemmber (theory didn't work out). Tapered off Lexapro end of February. Tried tapering off Ambien - was off for nearly 2 weeks in early May. But a stressful event - led me back to Insomnia --> Ambien CR+regular ambien.

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  • Administrator

Welcome, Jimmyboy.
 
Your doctor has been remiss keeping you on Ambien so long. The sleep drugs are supposed to be used for only a couple of weeks.
 
You are physiologically dependent on both Ambien and clonazepam. Both need to be tapered. Generally, we address the benzo last.
 
With your long history of going on and off drugs, you should be prepared for a long, careful taper.
 
Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.
 
Read these to discuss further:
 
What is withdrawal syndrome?

Important topics about symptoms, including sleep problems
 
Tips for tapering off Z drugs for sleep (Ambien, Imovane, Sonata, Lunesta, Intermezzo, etc.)

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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