Treating Chronic Fatigue Syndrome (ME/CFS) Klonopin (Clonzepam)

"For years I have said that Clonazepam is perhaps the most useful medication in chronic fatigue syndrome "

Dr. David Bell, August 2007

"Klonopin has been Dr. Cheney’s most effective drug for CFIDS over the years"

Carol Sieverling

Klonopin (Clonzepam) is  a benzodiazepine that calms down the brain by reducing the ‘set point’ at which it’s neurons are activated by increasing the production of GABA, a chemical that reduces neuronal activity. Klonopin has primarily been used to treat panic and seizure disorders.

Klonopin May Work in ME/CFS Because overactive neurons in chronic fatigue syndrome (ME/CFS) patients brains may lead to ‘information overload’, oversensitivity to stimuli and exhaustion.

Imagine being surrounded by a bank of TV sets and trying to concentrate on all of them – that’s what may be happening in CFS. Dr. Cheney believes this constant flood of information may cause the state of ‘sensory overload’ that requires patients to seek a place of quiet to rejuvenate themselves. Dr. Baraniuk believes the 'gates' that filter information into the brain are damaged. Several studies suggest, in fact, that the brains of ME/CFS patients have difficulty turning their attention off from innocuous stimuli such as background noise.

By reducing the ‘set point’ at which the brain becomes active Klonopin and other drugs and therapies that reduce central nervous system 'arousal' may give the brain the chance to rest and rejuvenate itself. Dr. Bell states Klonopin is most effective in those patients who feel ‘wired but tired’.

Drugs For Sleep in ME/CFS

Sleep and CFS
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Healing A Damaged Brain? Dr. Cheney puts Klonopin in the ‘neuroprotector’ category. In 2000 he stated that since overactive neurons eventually burn themselves out and die that ME/CFS patients will suffer neuron loss unless this problem is brought under control. Since he made this predication several studies have shown some brain volume (grey matter) loss does occur in both ME/CFS and fibromyalgia.

Dose - Klonopin’s effectiveness in ME/CFS is intriguing given that one of its side effects is fatigue. Too much Klonopin can, in fact, cause fatigue in ME/CFS but just the right amount will increase energy levels and calmness. Physicians seek to find the ‘sweet spot’ between over and over activation of the brain by varying the dose.

Dr. Cheney most frequently prescribes a combination of Klonopin, Doxepin elixir and a magnesium supplement (Magnesium Glycinate Forte/with taurine or a magnesium (glycinate) complex.

  • Klonopin – two or more 0.5 mg. tablets at night for sleep. One quarter to half a tablet in the morning and mid afternoon to improve energy and cognition. Increase the dose until you become drowsy and then cut back. Double the dose during severe relapses.
  • Doxepin elixir (10 mg/ml.). Acts synergistically with Klonpin to assist sleep. Start with two drops at night and gradually increasing until you experience grogginess (‘morning fog’) in the morning.
  • Magnesium glycinate (200 mgs.) at bedtime.

Side Effects

Addiction: Because Klonopin is a benzodiazepine it has the potential to be addictive. Dr. Cheney reports, however, that he has never seen a case of addiction in the many patients he’s treated.

Withdrawl: Klonopin must be withdrawn slowly. Interestingly Dr. Cheney reports that patients who are recovered suffer no withdrawl symptoms – only the still ill patients who must withdraw from the drug gradually.

Klonopin vs. Clonzepam

Clonzepam is the generic form of Klonopin. In Dr. Cheney’s experience Clonzepam is not quite as effective as Klonopin. Dr. Bell, however, reports good success with Clonzepam.

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The Phoenix Rising website is compiled by a layman. It is not a substitute for a physician and is for informational uses only. It does not present complete information on this drug. Please discuss any treatments in these pages with your physician.

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Bell Lyndonville News, Volume 4, Number 3: August 2007

Carol Sieverling. 2000. Paul Cheney, M.D on Klonopin – Protecting Your Brain. by Carol Sieverling from the CFIDS and FMS Support Group of Dallas Fort Worth.