Clonazapan, ADHD, and sleep...anyone?

I have not posted my 5 year old difficult child's entire history, but he's got a lot of issues with the primary dxs being Pervasive Developmental Disorder (PDD)-not otherwise specified, ADHD, sleep disorders, and asthma.

He's had 2 sleep studies. Both studies show severe sleep fragmentation. In his last study, he was asleep for 5 hours and had 94 arousals not related to specific limb movement or breathing episodes. He only had 2 cycles of REM sleep during each study, and his sleep seemed normal compared to home. He did not have enough apneas or hypopneas to warrent xPAP (any type of positive airway pressure) which was my goal (it's sort of an easy fix, and xPAP is not new to over here).

His sleep Dr said we should try clonazapam. It can have the opposite effect and reduce REM sleep, and he has none to spare. But the doctor's theory is that the medication could basically shut off his ADHD enough for restful sleep.

When I looked up the medication, my biggest concerns were that he would need blood draws to check the levels, and it did say to let your doctor know if you have asthma. I'm assuming it can cause issues in asthma, but doctor knew nothing of it.

Also, if the medication seems to help his sleep, he'll need another study while on it which he does not want. No, I don't let the 5 year old make medical decisions, but he does play a part since he has to learn some time.

If we do decide to try the medication, it's effectivness will be based on behavior. If his behavior tanks, we're going to assume he's not getting any sleep and taper off. If his behavior gets better, we'll assume it helped his sleep and repeat the study.

What do you think?
 

BusynMember

Well-Known Member
I can tell you what I know about Clonazepan. First of all, I have taken it for over twenty years because it really helps my panic attacks. I was unable to leave the house until I started taking it along with Paroxatine. Secondly, it is habit forming and if I tried to withdraw from it, after all these years, I couldn't. At my age I have no intention of trying life without benzos as it was a crummy life for me, but you should be aware that it has withdrawals. Your son is very young.

I find Clonazapen (1 mg. at night) to give me a great sleep and I wake up refreshed. I don't know what it does to my REM sleep, but I don't feel tired during the day. Still, I'd be reluctant to place a child on any benzo. This is a cousin to Valium. It is longer acting and in my opinion far more effective, but it's still a benzo.

Did your doctor explain that it will become habit forming? I take a small dose, yet I'm sure my body would have to adjust to my quitting. As far as I know, Clonzapan is not an ADHD medication. It is for many things, primarily anti-seizure and anxiety.
 

Andy

Active Member
Each person reacts differently to different medications. That the main reason it is so hard for doctors to prescribe something. They do their best with the experience they have with other patients.

Also, the effects of each medication many times changes as the child grows. What works at first may not work in a few months. What had no side effects at first may develope some later. (watch for rashes and behaviors)

That being said, our experience with Clonazapan: My difficult child had severe anxiety. To the level that everything in his life stopped, he was not able to do anything, go anywhere. He had enterred into a self harm stage (he did not want to hurt himself but his body was "telling" him to do things that would hurt him and a few could have lead to death if he followed through).

He was put on Flouxetine to get control of the anxiety and was also prescribed Clonazapan to take the edge off the anxiety. This truley worked as magic. However, as time went on, the Clonazapan was taking him into a disinhibitive state. It was relaxing him to the point that he had no fear over talking back to authority. He started disrespecting the teachers (something that he had never done).

He started the medications in October of his 5th grade. That winter, I tried taking him off of the Clonazapan but he could not face the school day and school work without out it. So, I decided to put his academics above his behavior and with the help of an awesome teacher, we got him through the school year dealing with his disrespect of teachers and fellow students.

Once school was over, we were able to ween him off this medication. By fall, he was back to his respectful self. The other students were relieved that the pre-difficult child was back. There were several that did not want to return to our small school because of his behavior. It was a stress on the entire school.

I would look at this as a short term medication. Even though we went through behavior h.e. double l, it was what my difficult child needed for his diagnosis at the time.
 

Mattsmom277

Active Member
I've had a positive experience with it my self, and I was put on it at a very very young age (anxiety and yes, it helped my sleep that was interupted from my anxiety). That being said, it works for some and not for others.

As an adult, when I'd take it during daytime, it was affecting my energy and mood over time. That sedative affect during daytime hours was difficult. However, a bedtime dosage was very effective for my sleep quality.

I think that if you realize weaning down the line is likely, dependency can be put into perspective. I take a non benzo medication for my leg spasms for MS. Even it must be weaned as it builds up in my system with daily intake. The benefit outweighed the dependency. It seems a small price under certain circumstances, to have to wean off something. It all depends on benefits, risks, etc and is so individual.

I do think it sounds a good starting place to try to help his sleep pattern. Under the doctors care, you will be able to gauge of there is a daytime lingering affect to difficult child that is impacting in a negative sense. Then it can be reevaluated. I do think it might be a more sensible approach than a typical sleeping pill type medication which can sometimes induce a longer sleep but also can reduce quality. I have always woken refreshed if I've taken clonazepam. I've been off it for a considerable time but would not hesitate to return to using it if needed.
 
Thanks for the positive experiences!

I think we'll start it this weekend (of course on the advice of the doctor, not an online forum!). I'll collect data for the next few weeks as well and see if there are any major changes.
 
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