Are Clonazepam and Zopiclone similar in terms of causing withdrawal?
April 12, 2014 7:30 AM   Subscribe

I take clonazepam for anxiety. I take 1.5 mg around 6 - 7 times a week which avoids me withdrawal. Lately I have been taking zopiclone for sleep. I take 7.5 mg about twice a week. I know these two drugs are similar. Does taking these drugs like this increase my chance of going through withdrawal since they both act upon the same area of the brain? I know they are both addictive and have a similar structure, but do they create the same kind of withdrawal? I took 1.5 mg of clonazepam yesterday and 7.5 mg of zopiclone to sleep. When can I expect withdrawal to start if it does and when do I know I am in the clear?
posted by Jack V to Health & Fitness (9 answers total) 1 user marked this as a favorite
 
This is a question for your prescribing doctor or a pharmacist. Drug interactions are tricky enough that medical advice you can get from the internet should not be your first port of call.
posted by lydhre at 7:34 AM on April 12, 2014 [2 favorites]


Yes, you need to talk to your doctor about this. And given your question history, I think you need to address whether your current habits with your clonazepam are healthy, because you've asked questions on a number of occasions that indicate that you have, well, some anxiety about the thought of withdrawal symptoms from your benzo. I really think you need to be wary about whether you are overdoing the sedatives trying to avoid some imagined horror of withdrawal, because that's going to increase your risk of suffering worse in the long run. You really need to be in ongoing contact with your doctor and with a therapist to help manage this properly. I only feel the need to say this because evidently you have more than tripled your consumption of them since November, and added a sleep aid, and that's generally a sign that something in this plan for coping with your anxiety is not working well.
posted by Sequence at 8:27 AM on April 12, 2014 [1 favorite]


Response by poster: Sorry I meant to say 6 - 7 times a month for my clonazepam usage. Sorry!
posted by Jack V at 8:35 AM on April 12, 2014


Whew! That sounds a lot more reasonable and I'm very glad to hear it. In which case, I still think you should talk to a therapist because I think you're fine, but it's clear that you're really worried about this withdrawal thing and something CBTish would probably help come up with ways to divert your brain while still being attentive to your usage. Definitely check with your doctor and make sure they know you're taking both, but I think the problem here is more your worries than your medications.
posted by Sequence at 9:49 AM on April 12, 2014 [1 favorite]


Response by poster: I do have a fear of withdrawal. Maybe it can be a good thing in a way because it keeps me from overuse, but sometimes the fear can be overwhelming. I am going to talk to my doctor next week.

I wanted to wait a week and hope not withdrawal symptoms develop.
posted by Jack V at 10:13 AM on April 12, 2014


Not a doc, not your doc. But both of those meds have such a short half life that a couple of times a week in such a small dose for either/both isn't going to build up in your system in such a way as to cause withdrawl. They use different pathways, so not reinforcing one another either.

I've taken both of those drugs (well, the US version of zopiclone, Lunesta), and neither one is known for being hard to come off of from daily use. Some docs give you clonazepam to help wean off of Xanax. It would only be a problem if you took clonazepam every day for a long time and suddenly stopped without tapering.

Please don't worry about this. You're ok.
posted by monopas at 11:25 AM on April 12, 2014 [2 favorites]


Your withdrawal symptom will probably be rebound insomnia/rebound anxiety. When I was tapering down clonazepam it took about a week each step down for the insomnia to clear. Once I was sleeping normally on the new dose I would step down again. 1.5 mg clonazepam is high enough to taper, if you have 0.5 mg tablets you can easily taper down 0.25 mg at a time, one step a week assuming symptoms stabilize on new dose.

You will have to figure out some way to manage the sleep/rebound aspects during the step down process. A strong exercise program and some mindfulness/CBT training would be useful here.
posted by crazycanuck at 9:01 PM on April 12, 2014


IANYD. Talk to your doctor or pharmacist for more details.

You should not experience withdrawal from drugs that you take only occasionally. In order to be physically dependent on a chemical, it has to be consistently present in your system.

For example, check out these case reports of physical dependence on zopiclone. Zopiclone is generally considered to be very safe in terms of not causing physical dependence or withdrawal, so these are rare occurrences. In all the case reports, people were taking zopiclone inappropriately, using extra-high doses or taking it multiple times a day. If you take it as prescribed, the risk of having withdrawal from zopiclone is low, and you are not even taking it every night.

Clonazepam is quite different as it is well known to cause physical dependence and withdrawal, but again, you have to be taking it frequently, not occasionally. The half life of the drug is about 30-50 hours. After a few days, you have no physiologically relevant amount of the drug in your system, and if you were used to always having the drug in your system, that's when you'd notice withdrawal side effects. But you already know that because you got many detailed answers to that effect when you last asked the question about clonazapam withdrawal.

It might help to discuss with your therapist or psychiatrist what your specific fears are about withdrawal and whether there are other medication options for you aside from benzos. It sounds like this could be a manifestation of your anxiety worsening/not adequately treated. For any patient with anxiety (but especially for anyone who is concerned about withdrawal and physical dependence/tolerance) it is a good idea to talk to your prescribing physician about the other options for medications that treat anxiety that have lower potential for these effects (i.e. SSRIs, SNRIs, TCAs, and so forth).

Consider what you might do if you started experiencing symptoms of withdrawal - I think this is highly unlikely given how infrequently you use these medications, but let's talk worst case scenario and say that you do get withdrawal symptoms. You realize you could just take a dose of your medication and those symptoms would go away, right? It would be a problem with an easy fix. The reason I see people in the emergency department for benzo withdrawal is because they lost their meds, or took too many of them and ran out early. The ones who have meds just use them and solve their own issue. I realize that if this is your anxiety talking, reasoning through the possible scenarios might not be helpful to you, but just thought I'd point this out anyway.
posted by treehorn+bunny at 9:36 PM on April 12, 2014 [1 favorite]


IANYD.

I take .5 Klonopin (1 tab) and 1 tab of Ambien (5mg) nightly. I suffer from anxiety and insomnia and the two have drastically helped me. I only started taking them becuase I really feel like I exhausted all other avenues.

Although I was concerned about withdrawal, honestly, I am now of the mentality that if they are helping me with my symptoms, then I'm just going to go with it. Getting enough sleep does incredible things for mood, stamina, outlook, work function, weight management, all of it, so I feel like the benefit far outweighs the risk. You may believe differently, however, and that's ok. It's a good thing that you are thinking about this stuff though and taking it seriously!

I DO still try to not take these though if I am able.

On nights where I generally feel TIRED, I will not take anything. I WILL resort to other tactics however, like a long hot shower, chamomile tea, no food 2 hours before bed and no ipad 2 hours before bed. Reading (a real book or magazine) quietly in bed for around 15-20 minutes with the lights purposely on DIM really helps get me to sleep, paired with a white noise machine since I'm a light sleeper. Nice lavendar-scented hand lotion helps too.
posted by floweredfish at 7:17 AM on April 15, 2014


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