Health Q&A: coming off clonazepam and leaking heart valves

Dr David Roche / 14 January 2014

Saga Magazine's Dr David Roche offers a reader guidance on coming off addictive medication, and answers a question on what a leaky heart valve diagnosis means.

Coming off clonazepam

Question: I’ve taken clonazepam for severe anxiety for about six years, but would now like to come off it. I take 500 micrograms twice a day. Will I have to cut up tablets to decrease the dose? And is there an ideal rate at which to reduce the dose?

Answer: Clonazepam is one of a group of drugs that are very addictive so you will have to reduce the dose very gradually. The speed at which you reduce is individual: some patients can reduce quite quickly over three months, others may need to reduce very slowly over some years. How you react to the initial reduction will help to determine the speed at which you will be comfortable. Your GP will be able to help with the dose reduction regime. If it proves difficult to divide the tablets, ask for a liquid form of the drug. You’ll need a high level of commitment and self discipline too.

Leaking heart valves

Question: A heart scan revealed I have two slightly leaking valves. Could they deteriorate suddenly? What happens if they do?

Answer: Leaky heart valves usually deteriorate very slowly over time, before reaching a critical point where they suddenly deteriorate and signs of heart failure occur. Fortunately your leaky valves have already been detected and regular echocardiograms (ultrasound scans of the heart) will monitor them over time. Some valves never deteriorate in the life of the patient but others gradually do. This can be detected well in advance and plans made to have the valve replaced.

The surgery is serious but has become gradually safer and more successful over the years. The risk of a serious complication during or after surgery is about 1 in 50, but remember that there will also be serious complications if the surgery is not performed. Open-heart surgery replaces the valve either with one made from animal products or an entirely artificial one. The surgery is much safer and more successful if it can be done before the old valve reaches a critical point. If a patient is not fit enough for open-heart surgery, some valves can be replaced with a device put in place via an artery in the groin.

The opinions expressed are those of the author and are not held by Saga unless specifically stated.

The material is for general information only and does not constitute investment, tax, legal, medical or other form of advice. You should not rely on this information to make (or refrain from making) any decisions. Always obtain independent, professional advice for your own particular situation.