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Spasms, Clonazepam and tolerance

Hi all

Has anyone got experience of taking Clonazepam for spasms?

I’ve had trouble with spasms in my legs particularly for years. I already take baclofen for stiffness and have tried magnesium (which I still take even though it doesn’t seem to help much). In April it was suggested that I try Clonazepam @ initially 500mcg but with the Drs OK to increase as needed. In the early days I thought it was a miracle drug, not only did it stop the leg spasms that had been plaguing me, waking me up through the night etc, but also helped out with the internal spasms that felt like my heart was racing incredibly fast. It seemed to even have an effect on the daytime spasms, and I found I could take half a pill mid afternoon which helped.

I’ve gradually had to increase the dosage so now I’m on about 2.5 mg per day. But over the last few weeks I’ve felt like its losing effectiveness. For the last couple of days the Clonazepam hasn’t seemed to work at all. Last night I went to bed and felt all my insides sort of shaking, I got up, took a Zopiclone to help me sleep and an extra half of Clonazepam. Eventually went back to bed and slept. Only to wake at 5.30am with terrible leg spasms that kept me awake for over an hour. Then today I’ve had spasms in my legs most of the day, I think my bladder is also in spasm because I just want to wee all the time (have checked for UTI).

So, have I developed a tolerance to Clonazepam? Is it just not going to work any more? Should I take more than 2.5mg? If I take it earlier in the day it’ll impact of fatigue. Any help, advice or experience gratefully received.

Sue

Hello Sue,

I take 3mg of Clonazepam at night and find it works a treat, although during the day I do get the odd spasm but nothing like I used to experience. I would not stop at night, every time I would start to drop off the spasms would come fast and furious and I would be sitting downstairs trying not to disturb my hubby shaking like mad. I started on 500mcg then onto 1gr and slowly worked up to 3gm and I manage on that and get a nights sleep. I suggest you have a word with your GP maybe you need to increase your dosage. Do let me know how you get on.

Janet

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Clonazepam is a benzodiazepine. You might want to look up what implications this has. What I understand is that benzodiazepines are very addictive and also become less effective over time - your body gets used to what they do and you need a higher dose to achieve the same effect. I think I have read (on here) about someone was advised by her doctor to gradually reduce and then increase the dose, then reduce it and increase it again, to avoid becoming dependent on an ever increasing dose. I think this is called ‘cycling’ and you might ask your doctor about it.

I am on clonazepam and I find it helps with my spasms. I generally sleep well on it (it is also used as a sleeping pill in other countries). I do try to reduce my dose periodically and I worry a bit about the effects of taking it long term. I’ve been on it for four years and I know that benzodiazepines increase your risk of getting dementia, if you take them for more than a few days. But having sleep disturbance (from leg spasms or anything else) increases your risk of getting dementia, so I’ve sort of come to terms with that.

It is not proved that there is a causal link with dementia. It may be that people with early (i.e. undiagnosed) dementia are simply more likely to be on benzodiazepines, because they are commonly prescribed for problems such as sleeplessness and anxiety - which, guess what, are associated with dementia.

All it may turn out to mean is that people with dementia begin to exhibit symptoms - for which they are prescribed common medication - many years prior to diagnosis.

I am not going to worry about it at all. I’ve been on (low dose) diazepam for many years, and my doctor told me there is no evidence it would do much harm if I was on it for life (which I almost certainly will be, as MS is unlikely to be cured in my lifetime).

The mechanism of action is comparable to that of alcohol, so just like alcohol, some people develop problems with dependancy, others don’t. Susceptibility is believed to be at least partly genetic, so people who have ever felt a tendency towards alcohol or other substance abuse, or have a close blood relative who developed a problem, may be best advised to keep away from benzos. Unfortunately, there is so far no genetic test to determine who is most at risk of addiction. I believe in future, with more personalised medicine, this will become possible, so people will be able to take them knowing they’re at low risk.

I think they’re the best stuff ever. For me they beat ADs hands down for anxiety, with the additional advantage of no side-effects and that I only had to take them as needed (i.e. when excessively anxious), and not every day, as per ADs.

Ironically I’ve now ended up on them nightly anyway for cramp/spasticity. It never occurred to me I would first take them for one reason, but end up needing them for something completely different! However, the anti-anxiety effects in addition to the muscle-relaxant properties are still a plus.

I just can’t afford to worry about all this. Like you, I’m sure years of untreated or inadequately treated pain aren’t good for you either. Being precious about the risk of meds was fine until I got a lifelong, serious illness, which meant popping pills was no longer optional, unless I wanted to be permanently stuck at home, crying and incapacitated. :frowning:

Tina

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Thanks to you all, you’ve put my mind at rest. I can’t really worry about potential Alzheimer’s/dementia to the extent that I’m prepared to live a life of spasms and pain. I might decide not to take a benzo and get dementia anyway (lovely thought eh?)

Today I’ve woken up with my legs feeling absolutely useless after another night of spasms. But I’ve just realised I’ve not been taking 2.5mg, but only about 2.5 tablets of 500mcg each. Doh. So I reckon I can increase to 2mg quite easily and maybe that’ll help. If I can get to a point where the spasms will stop for the whole of the night I’ll be happy (ish). And I’ll see my GP in a couple of weeks when I can talk about it to her.

Sue

Oh, no wonder they haven’t been working! I now take 5mg a night (up from 2.5 originally), but I genuinely think this is because they are having more to fight, rather than because I’ve developed massive tolerance. I’m on diazepam, which I believe is not as strong as clonazepam, but all the same family.

I was rather naughty and raised the dose myself, after 2.5 was no longer working, but I did tell GP and neuro, of course - neither of whom were worried about anything other than: “And did it help?”

When I said yes, they were perfectly happy with my course of action, and my prescription now just says “one as needed”, so I’m not even confined to taking one at night, if I’m having a particularly crampy (or angsty) time. It’s great to be trusted enough to do what needs to be done, instead of wondering: “Oh dear, dare I take an extra half - what would my doctor say?” when I’m in a real state! It saves them time as well, because they don’t have me ringing up all the time, asking whether it’s OK to do whatever. There are certain of my drugs (quinine, baclofen) I won’t fiddle about with without asking, but the painkillers and diazepam basically all now say: “take as necessary”, or: “take up to”, which gives me wide personal discretion over what to do, and allows for the daily variability of symptoms.

Tina

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