Clonazapam

[Bigal]

My son's tics got much worse last week. They have since gotten better, although they are still worse than they had been prior to the outbreak. I asked his ped neurologist about medication. He initially suggested .5 mg guanfacine every night before bedtime. I then asked if there was anything that I could just give my son on an as needed basis. He then suggested Clonazapam. He said we'd start at 0.25 mg and give it to him in the morning.

 

I filled the prescription, but since then tics have lessened. So I have not given him any. I searched this forum to read about Clonazapam. I seems like the "taken as needed approach" is not the norm. Also, it seems that giving it to him in the morning is unusual. I asked the nurse about giving it to him in the morning. She agreed that there is the risk that he will be tired at school.

 

Has anybody tried Clonazapam on an "as needed basis"?

 

Any thoughts on this approach?

 

Thanks

Alan

[guy123]

Guanfacine (Tenex) likely has a less severe side effect profile. Clonazepam (Klonopin) is a benzo which carries with it more serious risks should "as needed" become "fairly regularly." There is also the issue of withdrawal, although this is usually after many years at a significant dosage. I don't think "occasional use" promotes enough dependency to cause withdrawals, but don't quote me on that.

 

That being said, I'm not sure how either of those medications will work with a child.

 

You can find more information about them here:

http://www.tourettestreatment.com/list-of-treatments.php

 

Clonazepam

METHOD:

- GABA receptor antagonist.

NOTES:

- It is "sometimes useful in managing tics 'since some of the premonitory sensations resemble obsessions and the tics may be viewed as "compulsive" movements, anti-OCD medications also may be helpful.'"

SIDE EFFECTS:

- Sedation, weight gain, impaired academic performance, social anxiety with school refusal in children and a worsening of attention in children with comorbid ADHD

 

Guanfacine

METHOD:

- Alpha 2-adrenergic agonist

- °62- agonist

NOTES:

- a study found a significant decrease in the severity of motor and phonic tics

- double bline study of guanfacine for tics and ADHD found a 31% decrease in tic severity compared to placebo

SIDE EFFECTS:

-Dry mouth

-Drowsiness (less than Clonidine)

 

 

But like you said, Guanfacine is kind of an every day thing, and Clonazepam can be used as needed. Clonazepam is the only benzo that is used to treat tics from what I've heard (meaning Lorazepam (Ativan), Diazepam (Valium), etc. are not used to treat tics).

 

I'm sure the users here can give you other things to try "as needed" for tic increases. Vitamin B, magnesium taurate, Epsom salt baths, etc.

 

Fortunately, it seems his tics have lessened. Is he still on the Clonazepam?

Edited February 14, 2012 by guy123

[Bigal]

Guanfacine (Tenex) likely has a less severe side effect profile. Clonazepam (Klonopin) is a benzo which carries with it more serious risks should "as needed" become "fairly regularly." There is also the issue of withdrawal, although this is usually after many years at a significant dosage. I don't think "occasional use" promotes enough dependency to cause withdrawals, but don't quote me on that.

 

That being said, I'm not sure how either of those medications will work with a child.

 

You can find more information about them here:

http://www.tourettestreatment.com/list-of-treatments.php

 

Clonazepam

METHOD:

- GABA receptor antagonist.

NOTES:

- It is "sometimes useful in managing tics 'since some of the premonitory sensations resemble obsessions and the tics may be viewed as "compulsive" movements, anti-OCD medications also may be helpful.'"

SIDE EFFECTS:

- Sedation, weight gain, impaired academic performance, social anxiety with school refusal in children and a worsening of attention in children with comorbid ADHD

 

Guanfacine

METHOD:

- Alpha 2-adrenergic agonist

- °62- agonist

NOTES:

- a study found a significant decrease in the severity of motor and phonic tics

- double bline study of guanfacine for tics and ADHD found a 31% decrease in tic severity compared to placebo

SIDE EFFECTS:

-Dry mouth

-Drowsiness (less than Clonidine)

 

 

But like you said, Guanfacine is kind of an every day thing, and Clonazepam can be used as needed. Clonazepam is the only benzo that is used to treat tics from what I've heard (meaning Lorazepam (Ativan), Diazepam (Valium), etc. are not used to treat tics).

 

I'm sure the users here can give you other things to try "as needed" for tic increases. Vitamin B, magnesium taurate, Epsom salt baths, etc.

 

Fortunately, it seems his tics have lessened. Is he still on the Clonazepam?

 

 

Thanks Guy

 

No, I actually have not put him on the Clonazepam. I have the pills though. Unfortunately, his tics remain constant and frequent. I thought they were waning and perhaps they did from a peak last week. But they're still far more than we are accustomed to. When they initially got bad, I had him take some espsom salt baths, to no apparent benefit. I'm going to have some blood work done, hopefully tomorrow. I think we'll be testing for Magnesium, Vit D, metals, lyme. After the blood test, I'll probably start him on a Mag supplement. But I want to get a reading first.

 

After that, we'll probably try a food elimination diet. I just posted some questions about that as well.

 

Thanks again

 

Alan