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Dr. Paul Cheney Discusses the Benefits of Klonopin

  [ 965 votes ]   [ 8 Comments ]
By Carol Sieverling • www.ProHealth.com • October 12, 2001




Editor’s Note: The following is based on a recent interview conducted by Carol Sieverling with Dr. Paul R. Cheney, M.D., Ph.D., and the article "CFIDS Treatment: The Cheney Clinic’s Strategic Approach" (CFIDS Chronicle, Spring 1995). Dr. Cheney gave permission to share this information, but has not reviewed or edited it.

Many CFIDS specialists prescribe the drug Klonopin. In the October 1999 issue of The Fibromyalgia Network, nine CFS/FM specialists summarized their most effective treatments, and six included Klonopin. Interestingly, the three who did not are primarily FM specialists.

Dr. Cheney prescribes Klonopin to address a condition associated with CFIDS called "excitatory neurotoxicity." To explain this condition to patients, he draws a line with "seizure" on the far left and "coma" on the far right. A big dot in the middle represents where healthy people are when awake. A dot somewhat to the right of the middle indicates where healthy people are when asleep – slightly shifted toward coma. He highlights in red the left portion of the line, from seizure to the middle, and labels it "Neurotoxic State" (damaging to the brain). He highlights in blue the right portion of the line, from coma to the middle, and labels it "Healing State."

In CFIDS, an ongoing injury to the brain shifts patients toward seizure. A dot to the left of the middle, marked "injury," represents the position of CFIDS patients. This puts us in the red "Neurotoxic" zone. When we shift toward seizure, we often experience "sensory overload." It’s as if our brain’s "radar" is too sensitive. Our neurons (nerve cells) are sensing stimuli and firing when they should not. This causes amplification of sensory input. Light, noise, motion and pain are all magnified. At the beginning of their illness, many patients report feeling exhausted, yet also strangely "wired." The "wired" feeling is the slight shift towards seizure that occurs as a result of the excitatory neurotoxicity.

Cheney frequently uses the term "threshold potential" when discussing excitatory neurotoxicity. (Think of the threshold - bottom - of a doorway. The lower it is, the more accessible it is. When it is at floor level, everything can enter. When it is raised, access is restricted to taller people. If it is too high, no one can enter.) Threshold potential refers to how much stimulus it takes to make neurons fire. If the threshold potential is too low, even slight stimulation is "allowed to enter" and is detected by the neurons. This causes the neurons to fire, resulting in sensory overload. If the threshold is dropped to nothing, all stimuli get through and the neurons fire continuously, resulting in a seizure. If the threshold is raised, only stronger stimuli can make neurons fire. A healthy person’s threshold potential naturally rises at bedtime, promoting sleep. If the threshold potential is too high, you feel drugged or drowsy. If the threshold potential is raised extremely high, coma results.

Two receptors in the brain, NMDA and GABA, determine the threshold potential. During the waking hours of a healthy person, NMDA and GABA should be equally active. This balances the person in the middle of the seizure/coma continuum. NMDA stimulates, and GABA inhibits. If NMDA increases, one moves toward seizure. If GABA increases, one moves toward coma.

In CFIDS, NMDA is more activated than GABA, lowering the threshold potential. This causes neurons to fire with very little stimulation, resulting in sensory overload. This condition of excitatory neurotoxicity is dangerous. Dr. Cheney emphasizes that in an attempt to protect itself, the body will eventually kill neurons that fire excessively. He states that brain cell loss can result if this condition isn’t addressed.

How can the brain be protected against excitatory neurotoxicity? Klonopin. This long acting benzodiazepine has been Dr. Cheney’s most effective drug for CFIDS over the years. He believes that Klonopin and the supplement magnesium may be two of the most important treatments for CFIDS patients because of their neuroprotective qualities. He recommends two or more 0.5 mg tablets of Klonopin at night. Paradoxically, very small doses (usually a quarter to a half a tablet) in the morning and mid-afternoon improve cognitive function and energy. If the daytime dose is low enough, you’ll experience greater clarity and think better. If the daytime dose is too high, you’ll become drowsy. Adjust your dose for maximum benefit, taking as much as possible without drowsiness. Adjust the morning dose first, then take the same amount mid-afternoon if needed, then take three to four times the morning dose at bedtime. Dr. Cheney recommends doubling the dose during severe relapses.

Dr. Cheney most frequently prescribes the combination of Klonopin and Doxepin, along with the supplement "Magnesium Glycinate Forte." Magnesium Glycinate alone is a good choice for the more budget minded(www.ImmuneSupport.com sells it as "Magnesium Plus".) A common dosage of magnesium is 200 mgs at bedtime. Too much magnesium can cause diarrhea, though glycinate is usually the best tolerated form.

Cheney prescribes Doxepin in the form of a commercial elixir (10mg/ml). At low doses, this tricyclic antidepressant acts as a very potent antihistamine and immune modulator. Doxepin acts synergistically with Klonopin to assist sleep, and may improve pain. Patients tend to be very sensitive to Doxepin, which can cause morning fog and fatigue if the dose is too high (5 to 10 mg or higher). He recommends starting at two drops a night and gradually increasing the dose until "morning fog" becomes a problem. Most patients can’t tolerate more than half a cc.

On a handout entitled "Neuroprotection via Threshold Potentials," Cheney lists six substances that can protect the brain. Under the category "NMDA Blockers" Cheney lists:

1. Parenteral magnesium and taurine (intramuscular injections of magnesium and taurine, usually given with procaine)
2. Histamine blockers (Doxepin Elixir)
Under the category "GABA Agonists" (increases GABA) Cheney lists:
3. Klonopin
4. Neurontin
5. Kava Kava
6. Valerian Root

Klonopin is taken "day and night"; Neurontin "night, or day and night"; kava kava “daytime only”; and valerian “nighttime only.” The first four are by prescription, the last two are herbs. In my limited experience, only certain patients are put on magnesium/taurine injections, and then only for a limited period before switching to oral supplements.

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 aren’t exactly identical to the original products, and with most drugs the slight variations don’t 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. It’s true that it can’t 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 – excitatory neurotoxicity. It’s 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. It’s like a thyroid patient stopping their thyroid medication. Dr. Cheney warned, "All hell breaks loose". However, it’s not because the drug is addicting, and it’s 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. That’s the havoc we hear about that is mistakenly called withdrawal."

MYTH NUMBER THREE: KLONOPIN DISRUPTS STAGE 4 SLEEP.

Dr. Cheney said that he honestly doesn’t 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. It’s 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 I’m wrong about the brain injury and the threshold potential aberration and the shift toward seizure? What if I’m wrong about your need for Klonopin? I’m absolutely sure I’m right, but what’s the worst case scenario? Do you know what long-term studies on Klonopin have shown? Reduced incidence of Alzheimer’s Disease. Alzheimer’s Disease is a complicated and convoluted way of knocking out your neurons, and Klonopin protects your neurons. Now it’s believed that Klonopin didn’t actually stop Alzheimer’s. It just delayed its onset so long that everyone died of something else before they ever got it - which is to say you won’t get Alzheimer’s. You’ll 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 it’s 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 isn’t an option for most of us, so we need to find the maximum dose that doesn’t 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 can’t stop the underlying mechanisms of CFIDS that are injuring the brain in the first place.

Though it can’t 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, you’ll have more of your brain left."













Please Discuss This Article:   Post a Comment 

Konopine/Ativan
Posted by: cassandra539
Jul 28, 2008
Re: Dr.Cheney on the benefits of Klonopin, would the same assumption be for the other diazopines, esp Ativan?
Reply Reply

Klonipan and Xyrem
Posted by: tmanning
May 3, 2010
@ Dr. Cheney: Have you done any research on the use of Klonipan with Xyrem? If not, do you have an opinion on how well they may work together? It's seems that if I could reach stage 3 & 4 sleep while reducing hyper sensitivity in the day it would greatly improve my EDS symptoms. Right now my neurologist is very anti-benzo. What do you think?
Reply Reply

Benzodiazepines
Posted by: welly
Apr 12, 2014
Saying that clonazepam is not addictive is dangerous and irresponsible. Adaptation to the drug begins 48 hours after the first dose in rats, and humans build tolerance and dependence in as little as two weeks. Most countries suggest not prescribing for more than two weeks.

The withdrawal syndrome from benzodiazepines typically lasts from 6 to 18 months and is very painful and debilitating, cold turkey can result in seizures and death. There are over one hundred severe withdrawal symptoms spanning the entire nervous system.

The leading expert in benzodiazepine withdrawal, Dr. Heather Ashton (professor emeritus http://www.benzo.org.uk/manual/) dedicated a large part of her life in educating of the dangers of these drugs.

Membership in withdrawal support groups number in the thousands.

This article reads like an infomercial for big pharma.
Reply Reply

misleading info
Posted by: thornwood
Apr 12, 2014
I had to take a moment to calm down after I read this article. So full of lies and misinformation. Klonopin and benozodiazapines arent addictive and dont cause brain damage? Seriously? All you have to do is google "benzos withdrawal" or even "benzos protracted wd" and you can spend hours and days reading up on how destructive and dangerous these drugs are. How do I know? My life has been destroyed over the last 6 years due to hitting tolerance wd then being ripped off cold turkey by my ignorant doctor. I was a healthy vibrant man before this drug went into my body. Ive had over 50+ wd symptoms that I have never had in my life till taking this poison. There are around 10 facebook support groups helping people come off this drug and giving them needed support through the torture of wd. Ive met literally thousands through the world who have experienced the same thing. Please educate yourself instead of promoting this garbage to avoid destroying other people' lives.
Reply Reply

Klonipin kills
Posted by: Booksrgood
Apr 12, 2014
This drug is addictive, and has terrible other effects. Why use it all might be a good place to start.
Reply Reply

The Benefits of Klonopin
Posted by: ASmithfield
Apr 12, 2014
Dr. Cheney, I am looking for newer information regarding your stance on Benzodiazepines. I sincerely hope it exists since there has been much more research since this paper was written. In fact, it has been known with certainty since the 1980's that any Benzodiazepine should not be given for any period longer than a few weeks. It has also been shown that real damage is done by these drugs and the withdrawal is brutal at best: whether or not the "underlying condition" has been mitigated.
It has also been known that CFS is most likely not caused by a lack of Klonopin in one's diet.
My sincere hope is that the scientific community completes its research and discovers the true cause of CFS and proves that drugs do nothing to heal a body seeking homeostasis.
Thank you for your time and attention.
Reply Reply

Saying yes to Klonopin was the single worst treatment decision I ever made
Posted by: lifelieswaiting
Jun 22, 2014
At first it worked great. After two years I became tolerant to it and started having withdrawal symptoms despite continuing to take the drug. This wasn't recognized. I was told instead that my condition had gotten worse. My dose was doubled and then tripled. This worked for some number of years until tolerance happened again. This time other drugs were added to the mix. We moved to another city, so I had a new doctor. He didn't want me on Klonopin, so took me off very quickly. I seized and was reinstated in the ER. I tried to taper off the drug, but that was nightmarish as well. So I came off in a detox facility. Sixteen months post-detox, I was still suffering the full fury of the benzodiazepine withdrawal syndrome (Google it), so in desperation, I reinstated the drug. This worked, but about two years later, I went into tolerance again. I realized I would spend the rest of my life on this roller coaster unless I came off the Klonopin for good. So I tapered off very slowly. I'm almost four years benzo-free now, but protracted benzodiazepine withdrawal won't loosen its grip on me. Keep in mind, this was taking the drug as prescribed to me by my doctor. There was no abuse. To the best of my knowledge, there is no drug withdrawal worse than benzo withdrawal. Heroin withdrawal is usually over with in 5-7 days. Protracted heroin withdrawal might take weeks or even months. Protracted benzo withdrawal can take months, years or even decades. Some of the damage might even be permanent. Learn from my mistake. Say no to Klonopin and other benzodiazepines (Xanax, Ativan, Valium, etc.) Also say no to the chemically distinct, but similar acting Z-drugs (Ambien, Lunesta, Sonata, etc.) It's bad enough having CFS/ME. You don't need an even worse problem.
Reply Reply

The Virus that Never Was/ Dr. Paul Cheney Discusses The Benefits of Klonopin...
Posted by: Stultz
Jul 25, 2014

Not even Hilary Johnson in "Oslers Web" asked the Imperical question, as an Investigative Journalist..even Dr. Hunter S. Thompson would have known to ask.

When patients in an upscale skiing resort town in incline Village, Nevada suddenly came down what appeared like a Flu like Virus that lingered, what antibiotic did you give your patient Doctor?

Clue: Flavor of the Decade in the Pharmaceutical world was Fluoroquinolones...and Keflex, Bactrim,Cipro, Levaquin, Avelox et al: The Big GUNS...see delayed adverse long term effects.

It was in the food supply as well. http://www.iatp.org/files/64_2_37219.pdf

Give it time, things happen...Researchers warned us all...

Rather questioning the "Official Story" greedy people banked on this...Support Groups, CFIDS Doctors profited off the ill. Stock options ...big bucks $$$$$$$$$$

Incredible that the Justice Department never investigated this scam. With TORT reform how could they?

http://www.amazon.com/Torts-Personal-Injury-Cathy-Okrent/dp/1133691854/ref=sr_1_2?s=books&ie=UTF8&qid=1406308424&sr=1-2&keywords=Tort+Reform

http://www.amazon.com/Judge-Jury-American-Tort-Trial/dp/0945999992/ref=sr_1_1?s=books&ie=UTF8&qid=1406308476&sr=1-1&
.

Dr. Peter Breggin testified before Congress. http://www.youtube.com/watch?v=YPx95sk7k1U.

Many people were unaware of Delayed Long Term Effects of Antibiotics..given new ICD codes for the DSM. To say that Klonopin protects the brain is simply ignorant by people we trust as our Doctors. It destroys peoples lives.

http://breggin.com/spellbinding_psychiatric_drugs.pdf

Buy a used copy of:

http://www.amazon.com/Psychiatric-Drug-Withdrawal-Prescribers-Therapists/dp/0826108431/ref=sr_1_2?s=books&ie=UTF8&qid=1406308313&sr=1-2&keywords=dr.+peter+breggin

As long as they can legally milk the Medical System, cost for Healthcare will continually soar.

Finally after three decades we can at last put this Myth to bed. Few will realize what or read the truth, many have already died. These innocent human beings now are all on Memorial Boards disguised as Support Groups.... give, donate, and bend over.

The bottom line, Klonopin does not help the brain, it destroys all human functioning. With this so called Protocol or info-mercial, this drug destroys and is misleading of the facts of what it does to a human being.

Yet Support Groups continue to grow on the world wIde.. Internet, give, donate, bend over. The Patient is deceived and given incorrect medical advise by people who know little of the destruction of Benzos to the brain. This is the Fox guarding the Henhouse.

Many people, thirty years later have learned the cold hard truth. No one was looking out for the patients, young children, adults that got ill from a virus, URI, or UTI. Instead they invested, profited and promoted. Keep the lie going long enough, repetitive, people will take it as the truth. Propaganda, PR, and Spin

No Oversight, nor Malfeasance, nor Justice from those lives destroyed.

Many Motherless and Fatherless children roaming our PLANET we call Earth because of a "Bitter Pill" by Stephen Fried.

http://www.amazon.com/Bitter-Pills-Inside-Hazardous-World/dp/0553103830/ref=tmm_hrd_title_0?ie=UTF8&qid=1406318476&sr=1-1-fkmr1


Finally this CFIDS/CFS/ME/MS/GWS/MCS or Delayed Long Term Adverse Effects was made into a movie, directed by Ridley Scott in 2013.., "The East".

As social networks have been discussing "Delayed Adverse Long Term Affects" and the informed patient community connected the dots, more of the patient community are advocating.
see: saferpills.org

The others groups claiming to be CFIDS/FMS/ME Support Groups, they HAVE deliberately misled and Gaslighted the patient community.

Many patients have so much dedication and already develop Stockolm Syndrome. They were simply deceived, and misled. Not knowing any better because their minds are mis-firing in Brain Synapse from the horrific brain damaging drugs prescribed.

THE EAST
http://www.amazon.com/East-Marling/dp/B00DVD5STQ/ref=sr_1_2?s=movies-tv&ie=UTF8&qid=1406315607&sr=1-2&keywords=the+east


- - - -- - - -- - - - -- - - - -- - - - - -- - - - -- - - - -- - - - - -- - -- - - -- - - - -

More delayed adverse events

http://www.amazon.com/Certain-Adverse-Events-Nancy-Edwards/dp/B0076D0B2G
.
http://www.webmd.com/brain/news/20130826/fda-strengthens-fluoroquinolone-warning

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875918/

Justice is Not Blind
Reply Reply


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