Anxyoltic effects on analgesics

[ted_marx]

Hello, work in pharma and know enough about this stuff to be dangerous, but you can still help!!

 

I've been taking Klonopin for 13 years for anxiety at a low dose and now, pain medication at usual doses doesn't work for me at all. Plus, recently I dislocated my shoulder and the ER doc couldn't believe how much sedative I needed before I was "semi out" enough to have the arm relocated. Finally, during knee surgery, the docs said I needed an incredible amount of anesthesia before I was totally out.

 

Is there a receptor effect or something of that sort from Klonopin and similar med usage that negates the effects of pain meds and anesthetics? If so, is it a permament dynamic or will it go away with stopping Klonopin, and if so, how long will this reversal take to occur.

 

Thanks!

[badchad]

Why are you taking klonopin for anxiety? It is usually prescribed for seizures. If you have problems with anxiety an anti-anxiolytic makes more sense.

 

Klonopin is a benzodiazepene and a general CNS depressant. While I have only briefly looked at some side effects and such, I haven't seen anything directly related to analgesics. This drug is habit forming and I would assume tolerance would develop.

 

This is a wild guess, but for setting a shoulder the Dr. may have given you another type of CNS depressant to calm you down while you had your shoulder "set". Thus, if you've been on klonopin that long you probably developed some cross-tolerance to whatever drug the Dr. used.

[muad'dib]

It may not be the klonopin; when I go to the dentist I have to have four or five shots of novacaine before they can fill a cavity becuase it doesn't work very well for me; when I had my wisdom teeth out the pain meds they gave me didn't work either.

 

I have heard of doctors prescribing anit-seizure medications for anxiety though. Probably because a real anxiety attack can be almost seizure-like so that's not uncommon as badchad's post insinuates.

[Bald Wonder]

Is there a receptor effect or something of that sort from Klonopin and similar med usage that negates the effects of pain meds and anesthetics? If so' date=' is it a permament dynamic or will it go away with stopping Klonopin, and if so, how long will this reversal take to occur.

 

Thanks![/quote']

 

Absolutely! Long-term administration of benzodiazepines produces tolerance. Benzos (i.e. Klonopin) bind to benzo-GABA receptors in the brain. GABA is the major inhibitory neurotransmitter in the brain, and increased GABA results in sedation, anxiolysis, hypnosis, and anticonvulsant action. Incidentally, most opiates and anesthetics also exert their effects by some type of involvement with the GABA receptor. Long-term exposure to benzos causes downregulation of the benzodiazepine-GABA receptor complex (less receptors are available), hence an increased dose of anesthesia is required in patients who take benzos on a long-term basis. This has been well-documented in the medical literature.

 

After the cessation of long-term use of benzodiazepines, the receptor is upregulated. I'm not sure how long the process would take to normalize, but I know that patients do have an increased susceptibility to benzodiazepines and other sedative drugs almost immediately after benzos are discontinued.

 

Klonopin should be a "last resort" choice as an anxiolytic because it is highly addictive and results in dependence. It is only supposed to be used as a short-term treatment (4-6 weeks) for anxiety.

 

On a personal note, I was prescribed Klonopin for a little over a year for anxiety and became extremely dependent on this drug. When they tried to taper me off, they did so too quickly, which resulted in profound rebound anxiety. I had frequent panic attacks, tremendous anxiety, and even became suicidal. It was a miracle that I didn't have a seizure. My physician placed me on a much slower taper (6 months) and, although it was still unpleasant, my symptoms eventually dissipated. (it took over a year!)

 

Benzos are nasty, nasty drugs! Klonopin is the WORST because it has such a long half-life.

 

What dose are you taking, 0.5 mg/day?

[YT2095]

Wow, some good answers!

 

I don`t supose anyone knows if Tramadol (Zydol) 50mg x 2 has any effect on anaesthetics at all?

I take it for my Arthritis occasionaly (only when it`s really playing up).

 

Cheerz

[ted_marx]

Thanks all, VERY helpful stuff. Yeah, .5 but only PRN. Think I'll throw it in the trash after a little tapering.

[YT2095]

personaly, I`de taper off under medical supervision, don`t attempt this on your own after 13 years!

 

get professional advice 1`st! you could end up making matters worse than the original problem if you don`t

[Bald Wonder]

I don`t supose anyone knows if Tramadol (Zydol) 50mg x 2 has any effect on anaesthetics at all?

 

I wouldn't think you would get the same effect with Tramadol since it acts on opioid receptors. You might develop decreased sensitivity to other opiates if you take it chronically, but since you only use it infrequently PRN I wouldn't suspect any problems.

 

Thanks all, VERY helpful stuff. Yeah, .5 but only PRN. Think I'll throw it in the trash after a little tapering.

 

True, 0.5mg PRN is an extremely low dose...unless your PRN is every 15 minutes! I would definitely agree with YT in having your taper medically supervised since you have been using it for so long. You don't want to play around with status epilepticus. From what I've seen it's not too pleasant!!