Benzo detox experiences ?

[Breen]

Taking 2 mg clonazepam a day, single dose. 

 

The suggestion of an addiction doc (not my doc!) to try oxazepam didn't work out.

Peak levels for 3 hours, followed by a very mild effect that lasted 3-4 hours. Too many ups and downs during the day, and sleeping was just difficult. 

 

Diazepam is used quite often but since it would be difficult for me to tolerate the drug it's not much of an option. Variations on diazepam are Tranxene and prazepam, which accumulate in fatty tissues and may have their own issues. 

 

There is a difference between 'duration of action' and 'half life'. This crucial difference is often ignored.

I am interested in other benzodiazepines that have a long/intermediate duration of action. Basically, the longer the better. Preferably, benzodiazepines that do not accumulate in fatty tissues.

 

I have seen many charts, but as a rule the duration of action is referred to as 'short', 'intermediate', 'long'. In words, not in hours. I really would like some numbers.

Alternatives to oxazepam could be lorazepam, alrazolam, clobazam or some other drug.

What's their 'duration of action' like ? And how smooth is the 'curve' of the duration of action ? For example, does it have have a peak effect of a couple of hours followed by a steep decline ?

Obviously, maintaining a somewhat stable effect is preferable.

 

The idea is to just switch to a different drug. I know that even under the best circumstances it will be harsh.

Edited December 27, 2014 by Breen

[Phoenix_Rising]

Hello Breen,

 

Go up to the top of the Benzo Forum and there are a couple of links on speed of onset and half life for all the benzos.  Its my understanding that clonazepam is one of the longest acting.  Hope this helps.

[Breen]

I appreciate that, but I am particulary interested in the 'duration of action'. How long the drug works. Half life simply refers to the time it takes the body to reduce blood levels by 50 %. It does something during the half life, past the 'duration of action', but that effect is usually subtle.

 

Those links I have seen use words like intermediate, short, long etc. That's a bit vague.

 

Hours ? Charts, experiences ?

 

I do know clonazepam is one of the longest acting. But it appears that is impossible to taper for me, partially because of some complicated health issues ('not a disease', but something is physically wrong, lousy national healthcare system).

Bottom line: I am looking for something else. It's anything but neutral. 

To go from clonazepam to a very short acting benzo like oxazepam with short peaks and valleys would be a problem !

What about the other benzos ?

[Obsessively curious]

Not sure if you want to taper or change meds. I have been taking Tranxene 3.75 mg 2 x a day for about a year but trying to quit. 4 days off so far CT. IMO and experience fast onset of action and long duration but anxiety is also situational.

Prescribed 0.5 mg Clonazepam for panic attacks but it is much stronger and lasts a long time and makes me sleepy. Tranxene worked fine for me and I am not anti-med but the fewer the better and I like as needed. Trying behavior changes, breathing exercises etc....

So your doses and strengths are much higher so any equivalency would be skewed higher. As always ymmv and keep working with doc to get meds and anxiety matched up. Good luck!

[crtclms]

Lorezapam is not a good option, I would think. It is a very fast acting benzo, used for panic attacks and seizures (and anxiety on top of anxiety). My husband has epilepsy, and he would receive a shot of 2mg in the ambulance, sometimes after he had tried to avert it by taking a 2mg pill. So even thought he would have 2-4 mg of Ativan (brand name), he would be awake when I got to the ER, usually 45 minutes later.

 

Now my husband is kind of an ox when it comes to meds, and not everyone could shrug off 4mg of Ativan that quickly. But it is very short acting. He uses klonopin for sleep and seizure control, and it lasts much longer.

 

I use xanax (alprazolam) for GAD because I had a paradoxical reaction to klonopin. Xanax is supposed to last longer than Ativan, but it is still considered short-acting. I want to say its half life is 6-8 hours, but I am pulling that out of my 2006 ass, as in, it has been a long time since I've discussed it; you notice I am too lazy to go to the link. But I have been taking 1mg BID, with 1mg PRN, for almost 9 years, and with the half life, I have a pretty consistent blood level at this point.

 

And most of us here do understand half-lives, it isn't an uncommon topic.

 

It's too bad you can't take diazepam. Is one of the generics you mentioned Librium? I don't think so, but I can never remember the generic name, since it doesn't end in "am."

 

I just tried to look up a new benzo I know exists because I heard about it at an Epilepsy Foundation meeting. It begins with a C but I can't find it. It has been on the market maybe 2 years.

 

Does the chart in this Wikipedia entry help?

 

http://en.wikipedia.org/wiki/List_of_benzodiazepines

[jt07]

Prazepam helped me like no other benzo did. It's no longer available in the US but maybe it is where you live. I never used it for tapering though.

[Breen]

Tranxene and prazepam both produce desmethyldiazepam, and I guess it's worth considering.

I just wonder if it's not too diazepam-like, since it's pretty much diazepam (which also converts to desmethyldiazepam) without the diazepam !

 

Librium ? I wonder if it's any better than tranxene or prazepam. My GP seems to have something against Librium, claiming it's relatively short acting- of course without the metabolite of desmethyldiazepam.

And I just wonder if it's not too weak.

After trying oxazepam I have my doubts about Librium. According to the GP Librium is even more short acting than oxazepam, which lasted about 7 hours.

 

I'm used to Klonopin/clonazepam, which I take once a day and in a way it seems it lasts 24 hours.

[Breen]

Lorezapam is not a good option, I would think. It is a very fast acting benzo, used for panic attacks and seizures (and anxiety on top of anxiety). My husband has epilepsy, and he would receive a shot of 2mg in the ambulance, sometimes after he had tried to avert it by taking a 2mg pill. So even thought he would have 2-4 mg of Ativan (brand name), he would be awake when I got to the ER, usually 45 minutes later.

 

Now my husband is kind of an ox when it comes to meds, and not everyone could shrug off 4mg of Ativan that quickly. But it is very short acting. He uses klonopin for sleep and seizure control, and it lasts much longer.

 

I use xanax (alprazolam) for GAD because I had a paradoxical reaction to klonopin. Xanax is supposed to last longer than Ativan, but it is still considered short-acting. I want to say its half life is 6-8 hours, but I am pulling that out of my 2006 ass, as in, it has been a long time since I've discussed it; you notice I am too lazy to go to the link. But I have been taking 1mg BID, with 1mg PRN, for almost 9 years, and with the half life, I have a pretty consistent blood level at this point.

 

And most of us here do understand half-lives, it isn't an uncommon topic.

 

It's too bad you can't take diazepam. Is one of the generics you mentioned Librium? I don't think so, but I can never remember the generic name, since it doesn't end in "am."

 

I just tried to look up a new benzo I know exists because I heard about it at an Epilepsy Foundation meeting. It begins with a C but I can't find it. It has been on the market maybe 2 years.

 

Does the chart in this Wikipedia entry help?

 

http://en.wikipedia.org/wiki/List_of_benzodiazepines

 

Lorazepam short acting ? I've seen a number of charts, and lorazepam is usually described as intermediate acting. According to one chart, more than 10 hours.

One source claims it lasts 8-12 hours.

In a way it would be better than oxazepam: when oxazepam has stopped working, I have to wait 1.5 to two hours till the new dose starts working !

 

Perhaps lorazepam IV works differently ?

 

And a number of people have stated that lorazepam acts longer than alprazolam !

 

This 'new' benzo for epilepsy - would that be clobazam ?

[crtclms]

Yes, it was clobazam.

 

Well, I was told ativan was short acting by my pdoc, as was my husband by his neurosurgeon. That has certainly been my experience with it.

I only know about clobazam because drug company reps came to an Epilepsy Foundation meeting to talk about it.

[Breen]

The info about clobazam talks about omega receptors. That's outdated theory about the 'benzodiazepine receptors'.

 

Any idea how to translate this to binding to receptors and subunits in contemporary standards ?

[crtclms]

Nope. I really don't know that much about it, just that it was fairly new 2 years ago (or in 2012, since we have moved into 2015). Plus they were only interested in the anti-seizure effects.

 

I also don't know which receptors things affect in general, although there are people here who do. But I operate based on the experience that the brain is a little more complicated than our current understanding of neuro-transmitters. Otherwise we could just match up meds with neurotransmitters, and that hasn't really worked for most of our members.

[Breenn]

Lorezapam is not a good option, I would think. It is a very fast acting benzo, used for panic attacks and seizures (and anxiety on top of anxiety). My husband has epilepsy, and he would receive a shot of 2mg in the ambulance, sometimes after he had tried to avert it by taking a 2mg pill. So even thought he would have 2-4 mg of Ativan (brand name), he would be awake when I got to the ER, usually 45 minutes later.

 

Now my husband is kind of an ox when it comes to meds, and not everyone could shrug off 4mg of Ativan that quickly. But it is very short acting. He uses klonopin for sleep and seizure control, and it lasts much longer.

 

I use xanax (alprazolam) for GAD because I had a paradoxical reaction to klonopin. Xanax is supposed to last longer than Ativan, but it is still considered short-acting. I want to say its half life is 6-8 hours, but I am pulling that out of my 2006 ass, as in, it has been a long time since I've discussed it; you notice I am too lazy to go to the link. But I have been taking 1mg BID, with 1mg PRN, for almost 9 years, and with the half life, I have a pretty consistent blood level at this point.

 

And most of us here do understand half-lives, it isn't an uncommon topic.

 

It's too bad you can't take diazepam. Is one of the generics you mentioned Librium? I don't think so, but I can never remember the generic name, since it doesn't end in "am."

 

I just tried to look up a new benzo I know exists because I heard about it at an Epilepsy Foundation meeting. It begins with a C but I can't find it. It has been on the market maybe 2 years.

 

Does the chart in this Wikipedia entry help?

 

http://en.wikipedia.org/wiki/List_of_benzodiazepines

 

Quick reply: lorazepam IV lasts a lot shorter than the oral forumulation.

[Breenn]

Well, that was fun !

 

The GP chose lorazepam over clobazam.

 

I did stay on the lorazepam too long, and I failed. The lorazepam is no longer sedating, it feels like it is fairly short acting, agressive, and it is just acting  weird. Sleeping on this drug is very harsh. Great intestinal distress.

 

Back to clonazepam ?

 

Any other options ? As I understand, the clobazam has very little affinity for the alpha 1 subunit, which should mean that it is less sedating than lorazepam or clobazam. I'm not sure if it could have worked.

 

I wish I had done some sort of detox years ago. But here, they insist on tapering !

Edited April 1, 2015 by Breenn

[Breenn]

In a nutshell, I tried to taper clonazepam with lorazepam. Long story. Clonazepam was hard to taper and tolerate.

 

Ever since the hypnotic and sedative properties of lorazepam went away I had a hard time tapering the drug or sleeping on it. Clonazepam a hypnotic ? Semantics aside, it never felt like one but I had no trouble sleeping on it, for the most part.

 

I wish I had stuck to the clobazam suggestion but the GP decided otherwise.

 

I think I´m trapped. After all these years I am in bad shape, and I´m not up to hard core benzo withdrawal although maybe I will not have a choice.

 

Let´s keep in mind the difference between lorazepam oral and IV.

 

Lorazepam is more sedating than diazepam, isn´t it ?

 

In addition to all other issues, it seems I´m also in tolerance withdrawal from a hypnotic !

 

Lorazepam feels short acting and ´agressive´ ever since I developed tolerance, especially tolerance to the sedating effects. Sleeping two hours a night at lower doses is not good !

 

Any suggestions about how to get rid of this horrible, short acting drug that just makes me sick ?

 

I´m not good with the anxiolytics, like oxazepam.

 

If I decide to taper the lorazepam, is there anything that can cause a ´hypnotic´ effect ? I wouldn´t count on antipsychotics or antidepressants. Sedating antihistamines are not much good either, and anticholinergic effects are asking for trouble !

 

Perhaps I have to go through full blown benzo withdrawal, but I´m not up to it !

Edited April 28, 2015 by Breenn

[dianthus]

Usually you taper a short acting drug with a long-acting drug.  You did the opposite. 

 

If you're used to Clonazepam, lorazepam is going to feel very different because its half life is so much shorter than clonazepam. 

 

If this were me, I'd want to do a long, slow taper with clonazepam and totally ditch trying to taper with lorazepam.  It just doesn't sound like it's working.

[melissaw72]

I agree.  It is worth a slow, long taper to avoid the side effects from going off the klonopin too fast.

[Breenn]

Unfortunately, tapering the clonazepam would be a very physical process. That's my experience.

I'm not in good health, I'd have to stay active all day, and suffering from a medical issue that I don't like to discuss here but that will just get worse if I try to do that, it just doesn't seem doable. Perhaps it had some paradoxical properties from the start.

 

Lorazepam doesn't seem that sensible indeed. 

Is diazepam really the only alternative ? Aside from Librium, which is mostly a weaker version of diazepam.

 

The benzodiazepine withdrawal syndrome is serious business ...

 

In this country almost no doc knows anything about clonazepam.

[dianthus]

I'm not really understanding why you'd have to stay active all day and what you mean by it being "a very physical process."  Can you explain what you mean?

 

When I say a long, slow taper I mean doing it over 6 months to a year depending on your current dosage.

 

Diazepam is an option.  You're not going to be able to avoid some withdrawal symptoms and a return of the symptoms the clonazepam was treating.  That's the case for almost every psych drug.

 

I don't really know what you're asking for except that it sounds like it's pretty impossible.

Edited April 29, 2015 by dianthus

[Breenn]

´a very physical process´

 

Lots of physical symptoms. As in gastrointestinal symptoms, neurological (once I had some aphasia).

Rapid muscle loss.

 

Having to stay active ? Like wanting to be active, having to stay active to stave off withdrawal symptoms, to limit muscle loss.

 

Anyway, would you happen to know something about the pharmacokinetics of this drug ? I have heard contradicting things, does it have a high or low lipid solubility ? Some effects are acute, some long lasting.

[dianthus]

What I've seen as being the most successful way to taper benzos is to do it VERY SLOWLY.  As in, take 6 months to a year to avoid withdrawal and also have meds and/or therapy in place to deal with rebound anxiety.

 

You could try tapering with diazepam if your doctor approved of it, but I'm not 100% sure what that would get you, really, seeing that clonazepam is a somewhat different drug and they both have long half lives.  I have never been able to successfully replace one benzo with another, though some people can.

 

Have you considered doing a very slow taper of the clonazepam so that you could handle the withdrawal?

 

I don't know why lipid solubility is an issue, and honestly it's as close a Google search away for me as it is for you. 

 

I've never, ever heard of any benzo withdrawal causing loss of muscle mass.  Do you have a source for that?  That's interesting and not something I've ever run into.

[melissaw72]

 

What I've seen as being the most successful way to taper benzos is to do it VERY SLOWLY.

 

^^THIS ... definitely ... for me, especially weaning down on klonopin.  I'm not completely off of it, but have weaned down ... it took a very long time because I didn't want the withdrawal side effects of being antsy, irritable, headache ... it just really really sucked.

 

I haven;t heard of the loss of muscle mass from a benzo withdrawal either.

[Breenn]

I'm a more serious case, and already in 'tolerance withdrawal'.

 

Anyway, thanks.

Edited May 9, 2015 by Breenn

[Breenn]

Since clonazepam is so incredibly hard to taper I'll just have to consider other options.

 

Diazepam is commonly used. Tranxene is used less frequently.

 

Let's keep in mind the difference between 'half life' and 'duration of action'.

Clonazepam has a long duration of action, officially it's 12 hours. I used to get by on 2 mg for 24 hours.

Diazepam has a very short duration of action.

 

If my sources are correct, Tranxene would have a longer duration of action. 12 hours, is that right ?

 

Any thoughts/experiences about tapering with Tranxene vs. diazepam ? Any issues ?

[Breenn]

Tolerance withdrawal= suffering withdrawal symptoms before having reduced the dose. See the work of Heather Ashton.

An alternative term I've seen is 'relative withdrawal'.

 

I haven't been able to get a doc who has been even remotely competent regarding dealing with benzos. Pdoc "no disease", back to the GP. Pharmacist appears to have no knowlegde of physical dependence. Concept of "no addictive personality" and thinking that this is such a mild drug, which can be tapered in two weeks.

 

My former GP just told me to stop taking the stuff !

 

The only 'help' they give is some empty talking therapy, while they don't have a clue about what's going on. This drug is rarely prescribed in this country, so docs are not familiar with the issues and withdrawal symptoms.

 

Shortage of doctors, waiting lists, required referrals, near complete incompetence.

 

This country really is that horrible.

 

And this drug has some nasty side effects (paradoxical?), some of which I've had from the beginning  but milder. I was able to tolerate them at the time.

 

If you get some other health issues (minor at the time) you're just told to stop taking the drug. I was refused a mild drug that would have treated a major issue at the time because the doc insisted it was 'psychological'.

 

I could say more, but this is bad enough.

Edited May 9, 2015 by Breenn

[jt07]

I don't understand why you are complicating this. People all over the world, even in your country, go on this med and come off it without too much of a problem. Yes, some people do have problems but they get through it. I think that the thought of withdrawal has you so scared that you think it is the med but it is really your fear causing you to feel this way.

[Breenn]

Years ago I could do that. Till I got some physical health issues and dependence set in.

 

I don't know how to explain it. This anti-epilepsy drug shouldn't be prescribed so carelessly.

There has been some polypharmacy as well, which has greatly complicated the matter. I think I should leave it at that.

[Wooster]

It's not only used for epilepsy. Anxiety is a VERY valid use for lorazepam. It's also used for nausea.

 

What kind of help are you seeking from this peer support site?

 

It seems that suggestions you have been offered haven't been what you're looking for.

[Revan]

I have tried these benzos ... klonopin, xanax, ativan, restoril, valium and now tranxene

For me the tranxene makes most of them look like a joke. I would have to say a bit superior to diazepam ... Stronger and more pronounced anxiety relief with no fatigue feeling like klonopin and valium did. I highly recommend giving it a try. My pdoc says it works best for if you HAVE to be on a benzo but every other benzo failed.

 

I was up to klonopin 2mg three times a day, with tranxene I can just take it twice a day and forget it. I think this because of the longer half life and quicker onset than clonazepam.

Edited May 14, 2015 by Revan

[Breenn]

Any other differences compared to Valium ? I´ve heard reports of Valium being ´stronger´.

 

I don´t have anxiety issues, I was put on the drug as a muscle relaxant. But sleep matters a lot.

 

Does it allow you to sleep sufficiently ´long´ ?

Is daytime sedation less than on diazepam ?

[Revan]

The tranxene feels "stronger" by far for anxieties  ... diazepam/Valium had more of a muscle relaxant effect than an anti anxiety/panic effect. With both valium and klonopin I had to use pretty much the maximum recommended dose.

 

Yes ... the tranxene stayes in my system long enough to last until the next morning unlike clonazepam (not sure about the valium, if it lasted longer or not). I'm not your Dr. but perhaps try valium first? If I remember correctly tranxene and valium are nearly identical for the half life.

 

"Daytime sedation" with valium........ much less than klonopin , but more than the tranxene. 

Edited May 14, 2015 by Revan

[Breenn]

Well, I know that diazepam has a half life of 1-2 days, and subsequently is converted into desmethyldiazepam and a few minor and mostly irrelevant metabolites. 

There would be more accumulation with diazepam than with Tranxene.

 

Revan, 

Did the Tranxene or the diazepam seem to 'last longer' ?

[Revan]

Well, I know that diazepam has a half life of 1-2 days, and subsequently is converted into desmethyldiazepam and a few minor and mostly irrelevant metabolites. 

There would be more accumulation with diazepam than with Tranxene.

 

Revan, 

Did the Tranxene or the diazepam seem to 'last longer' ?

 

 

I would have to say tranxene lasts longer. Not by much though. I needed 3x a day with valium but only 2x a day with tranxene to keep the anxieties away.

Edited May 22, 2015 by Revan

[Breenn]

For a short time I have been on diazepam in an attempt to taper clonazepam, but I'm concerned about getting dependent on yet another problem drug.

 

I've never been 'abusing' the drug.

 

But about a year ago, I had been offered an inpatient/detox offer.

 

What sort of drugs besides the obvious (Librium, Diazepam (local thing!), beta blockers) do they give out ?

[jt07]

But about a year ago, I had been offered an inpatient/detox offer.

 

What sort of drugs besides the obvious (Librium, Diazepam (local thing!), beta blockers) do they give out ?

 

You mean, give out in detox?

[Breenn]

Right, in detox Inpatient, in the clinic, whatever you want to call that.

[Breenn]

I've been on 2 mg clonazepam a day for years. Any detox experiences ? What drugs do they hand out, typically or not so typically ? Antidepressants, antipsychotics, anticonvulsants, something else ? I never abused this drug, but tapering is such a problem. A diazepam taper would be hard at best. Anyone ? I know a slow taper is usually preferred.

Apologies for the crazy format, but for some reason everything is compressed into one block of text. Edited June 12, 2015 by Breenn

[IcePrincess88]

I been on Xanax 1mg 3 times a day for almost 10 years now. But when I went IP at 19, they took me off Xanax, and did a diazepam taper, like your talking about. In my experience, it was horrible. The diazepam didn't helped me at all. I was sick for 3 days from Xanax withdrawal. I was vomiting, had migraines, and just laid in bed all day. I don't want to scare you, but getting off benzo's for 9 days was extremely hard for me. As soon as I got out and went back to my regular pdoc, I got put right back on Xanax and have been on it ever since. I have not been off it again since. My new pdoc wanted to switch me over to Klonopin a couple months ago, because she "really doesn't like Xanax". I held strong about the issue and she stopped bringing it up. When you've been on benzo's for as long as I have, it's almost impossible to come off it. Your experience may be totally different, I'm just telling you how it was for me. The "Valium taper" is the only thing I have experienced and it was not good for me. But I am on a higher and stronger dose of benzo's, so it may very well work for you. I wish you the best.

[Wonderful.Cheese]

I have taken clonazepam for nearly a decade. While IP I was taken off of it cold turkey. No tapering or diazepam taper. I do not think that was a safe choice at all. But no one listens to me, they just listen to the anti-benzo dr. 

It did a number on me. I was extremely anxious and crying and felt like my heart was going to beat out of my chest. It was pounding so fast. It was scary. 

Finally I just got so anxious that I asked to leave the hospital. Luckily he let me go. 

I don't know why the IP pdoc thought that this was a good idea to cold turkey stop a med like clonazepam. I'm just glad I didn't have a seizure. My blood pressure and heart rate were high too. Not a good feeling at all. 

And I don't know what you mean by what drugs are "handed out." I wouldn't say that if I were you. Sounds like drug seeking. Not saying you are doing that but yeah. Be careful. 

Somettimes AD's are used as anti-anxiety meds. They tend to make me manic so I can't take them but a lot of people find them very helpful. Also gabapentin is used for anxiety as well. 

[lysergia]

i was given clonidine (a blood pressure med) to help come off clonazepam before ECT.  it worked well enough that we decided i'd stay on it, and can now take less clonazepam as a result.

if there isn't a reason why you need to do it quickly, time has been the best method i've experienced when coming off benzos.  reduce as slowly as you need to, even just by .25mg every week.  it takes forever but feels better than trying to get it over with quickly (which i am prone to wanting to do, i have no patience).

is there a reason you need to stop?  i've taken clonazepam for so many years i can't remember how many.  the dose varies as i need it, and no one has ever treated me like i'm "addicted" (i'm lucky enough to have a pdoc who lets me decide how much i want to take at any given time).  sometimes i skip days and don't realize it.  i figure i'll probably use clonazepam for the rest of my life, and i'm okay with that.

 

[WinterRosie]

Hi.

I merged your topics together as they were really of a similar nature. 

[Breenn]

IcePrincess88,

 

Thanks for reporting you experiences. Our doses are really not that different.

 

Cheese, that's a bit extreme. No benzo, no phenobarbital ?

Concerning 'handed out': I was simply referring to any drugs people were put on to ease the withdrawal.

ADs, beta blockers, anything.

It seems you were fortunate to escape.

 

Lysergia,

I have great difficulty tolerating the drug. Part of that is what the drug does, partly it's a matter of health.

In the past it had some mixed properties, sedating and energizing.

It's a long story. I've had some health issues that were not properly dealt with (if at all!), and now it's getting more difficult to just tolerate the drug. I get sicker and the drug gets more difficult to tolerate.

I get weird reactions if I try to taper the drug directly.

 

Edited June 13, 2015 by Breenn

[crtclms]

So. Here you are all those months later. What is your plan? Why are you so special that there is no viable solution?

 

[Velvet Elvis]

I've been on 2mgs a day for about ten years.  At least once a year I lose my bottle and have to go without for sometimes up to a month.  It's no fun but I can manage to function.  I've had worse discontinuation effect off other meds, they just seem to last longer with benzos.  

Really, it's not much worse than quitting smoking.  It just takes longer.

 

[Breenn]

So. Here you are all those months later. What is your plan? Why are you so special that there is no viable solution?

 

​There is no plan.

 

Currently I am considering forcing myself on diazepam, crossing over slowly, some detox thing or something else ?

That switch to lorazepam was a disaster. I wouldn't even have considered that a year ago.

This country has a lousy healthcare system, referrals by the GP are mandatory. I got referred back and forth and that took a lot of time and got me nowehere. And I have a GP who truly cannot handle problems with meds. lorazepam was his idea. Even for this country, what happened to me is extremely unusual.

How do you taper a drug that makes you sick, and wen you taper 'all hell breaks loose' ?

The dependency on the drug isn't the only problem.

 

In the latest thread I started (and that has been merged with other threads) I was asking about detox experience, what drugs were used.

 

Edited June 14, 2015 by Breenn

[Breenn]

I've been on 2mgs a day for about ten years.  At least once a year I lose my bottle and have to go without for sometimes up to a month.  It's no fun but I can manage to function.  I've had worse discontinuation effect off other meds, they just seem to last longer with benzos.  

Really, it's not much worse than quitting smoking.  It just takes longer.

 

​It's great that it works for you. I was fine a few years ago.

Some people can have a hell of a time when trying to stop this drug. I had never expected to become one of them.

[Sloane]

I was 'one of those people' who developed chemical dependency on Clonazepam after 7 years (I took 2MG 3x a day plus .5MG PRN). I would have major withdrawal symptoms just after missing a single dose - especially a night dose; so I had to get off it.

The trick is that you have to taper the dose slowly. In example: I was on 2MG 3x a day and .5 PRN, and my first taper was 1.75MG 3x a day and .25MG PRN, and the next taper I did was 1.5MG 3x a day and .25MG PRN, and my third was 1.25MG 3x a day .25 PRN (Clonazepam pills come in .5MG pills, and can be cut - so you can taper as slowly as you need to). The slower the taper with chemical dependency the 'smoother' the ride (although it still sucks balls). It took me a year to get off Clonazepam, and in the end I had to add Congentin to combat the akathasia. It also took another year to get over the brain fog, and other cognitive symptoms due to the 'protracted withdrawal syndrome' - but I did, and so can you. But you have to actually start.

It may suck, and it may take a long time, but it's not the end of the world. And to this day in all honesty, I tell people how Clonazepam "saved my life from my Selective Mutism" (and how "I didn't talk until I was 18").

Edited June 15, 2015 by Sloane
added more information

[Breenn]

Can we, for the sake of brevity, assume that I just cannot taper clonazepam directly ?

I don't know why, maybe it's hormones or what. It's not 'neutral'. It used to have both stimulating and sedating properties.

If I go below a certain dose I cannot exercise anymore, which changes the effect of the clonazepam. Just an example.

[Sloane]

Note to all users and readers: the message below is for Breen and deals with Clonazepam dependency, and is not in context to regular benzodiazepine use. 

Can we, for the sake of brevity, assume that I just cannot taper clonazepam directly ?

I don't know why, maybe it's hormones or what. It's not 'neutral'. It used to have both stimulating and sedating properties.

If I go below a certain dose I cannot exercise anymore, which changes the effect of the clonazepam. Just an example.

​No.

I say that because, and I know from very personal experiences, that that's not true. And I mean that in the most respective and positive way - as in, you are not alone, you are not the only one who experienced physical and cognitive and neurological effects from Clonazepam dependency...and there is no reason you can not taper from Clonazepam.

Clonazepam is hell to taper from. You will not be able to physically sit still, but you will feel weak and it will be hard to move. You will get brain zaps, and dissociation, and you may even have seizures if you are susceptible to them (I had seizures, but I have Epilepsy). You will not be able to read a book because the pages will blur and you won't be able to understand the sentences. You will not be depressed buy you will not be anywhere close to living a life. Colors will be dull, faces will be harder to recognize. And all this will occur because you just subtracted .25MG from your usual Clonazepam dosage. And when you subtract .5, those symptoms get worse. Welcome to a normal taper of Clonazepam dependency.

But you can get through it. And if you have any kind of 'protracted withdrawal syndrome' - the cognitive effects AFTER the taper (which some people do, and some people don't) you can get through that too.

You have to STICK to a doctor however, and tell him or her that you are DEPENDENT on a benzo, and that you "want their help to taper off". They will assist you if you are straightforward with them, and use those words, and will be able to supply you with whatever medication needed to handle symptoms to make the taper easier (like the Cogentin I was on). It's not easy, and it's not quick (it took me a year to taper - and another year plus to shake the protracted withdrawal) but it needs to be done.

[Breenn]

Sloane,

Thanks for responding.

I recognize some of the things you mentioned.

 

The doc knows I am dependent. 'They will assist you if you are straightforward with them, and use those words, and will be able to supply you with whatever medication needed to handle symptoms to make the taper easier (like the Cogentin I was on)'

 

I didn't get any assistance at all (except for 'talking'). For example, once I had been put on an anticholinergic for 'nocturia' (solifenacin, in my case technically off label, long and complicated story). Because of 'side effects' I discontinued the drug after two days of use.

Several weeks later I attempted to taper, with the following result: I still woke up because of nighttime bathroom issues (leading to insomnia and subsequent daytime issues), which were even worse when trying to taper. I got some extreme reactions. A 'black out' (?) during part of the third night. Extreme tinnitus. I was barely 'present'. Something like being on autopilot. Because I didn't really know what I was doing, it seemed wise to just stop that.

Did the doc offer any solutions ? No, he just told me to stop and try later.

The 'national protocol' actually calls for the use of no other drugs when discontinuing benzodiazepines by GPs. Clonazepam, they know nothing about that, it is rarely prescribed, especially at doses of 2 mg.

Generally, discontinuing 'benzos' is done by GPs. It is considered a minor issue. You may start to sweat, have a little insomnia, have some mild flue like symptoms.

I tried to taper with the GP, but things went wrong again and again. Now, the GP was expecting help from the psychiatrist I was being referred to. The psychiatrist referred me back to the GP, and considered this a case of 'quitting benzos'. The GP subsequently decided to treat this as such.

At one point I managed to get desmopressin for the nocturia, but this was not for the taper but only for the insomnia and to even get that it took a lot.

He doesn't have a clue, since it was (mostly) his idea to taper the clonazepam by switching to lorazepam, which turned out to be a disaster. I'm still dealing with the 'withdrawal' from lorazepam.

It is now clear to me that he considers this 'mental', mostly having the same attitude as my former GP.

Actually, there is a local addiction service. I talked to a very experienced addiction specialist, who had zero (!) experience with clonazepam. 'a benzo is a benzo'. He offered tapering the clonazepam with oxazepam in 4 weeks inpatient  !I I actually tried that at home and it turned out that oxazepam was very short acting.

I can't get any help from the GP beyond that what is 'common'. No referrals. Actually, he was willing to refer me to a local mental health facility, but not for tapering purposes. I think he's fed up with me, and I'm fed up with him.There is a local unwritten rule that you can switch GPs only once as long as you live in the same city. Presumably, a new GP would continue where the other one left off.

I actually told the former and my current GP that this required specialist help, with zero luck.

(referrals are mandatory)

At this point I feel mentally and physically broken. Physically I'm in really bad shape. I could try diazepam again. Any particular reason why you think I shouldn't ?

I could tell you the name of the country I live in, but what would be the point ?

Once, while I was very sick I considered the concept of 'tapering while lying in bed'. Too bad I didn't.

The situation has escalated far enough to become 'intolerant' to symptomatic treatment of some issues. Medically-technically there are things that can be done, but because it is considered 'mental' I can't get treatment that is a bit out of the box.

Not sure what else I could add.

This drug and subsequent mostly untreated health issues have made me very sick. Does it really make sense to taper like that ? Let's not forget the lorazepam withdrawal ...

As far as asking for help is concerned, the doc thinks it's 'mental' so aside from some very minor symptomatic treatment with drugs he is familiar with I can forget about that.

I guess your neurologist helped you taper ? Anyway, my GP can write presciptions based on indication, but he doesn't have a clue as to how drugs work. A third world country indeed.

Edited June 16, 2015 by Breenn

[Wooster]

It's totally a bummer that you aren't able to access the support you need via your GP.

Unfortunately, you've kind of hit the limit of what a peer support site has to offer about this topic.

It sounds like you have some very particular, uncommon reasons that you cannot do a straightforward SLOOOOOOOOOOOOOOOOOW taper.

Nobody else here has a magic bullet answer.

Unfortunately shaking the magic 8 ball here or with your GP seems to keep giving you the same answer. And I know it's an answer you feel is not tolerable.

[Sloane]

I didn't get any assistance at all (except for 'talking'). For example, once I had been put on an anticholinergic for 'nocturia' (solifenacin, in my case technically off label, long and complicated story). Because of 'side effects' I discontinued the drug after two days of use.

Several weeks later I attempted to taper, with the following result: I still woke up because of nighttime bathroom issues (leading to insomnia and subsequent daytime issues), which were even worse when trying to taper. I got some extreme reactions. A 'black out' (?) during part of the third night. Extreme tinnitus. I was barely 'present'. Something like being on autopilot. Because I didn't really know what I was doing, it seemed wise to just stop that.

 

I did not suffer from the side-affect of 'nocturia', but I did some research and saw that you definitely aren't alone in having it. It seems like not-common, but non-rare side-affect from Clonazepam. But I definitely understand what you mean by your statement of the side-affects of a medicine being worse than what it's being used for. The medication I spoke of however, Cogentin, is used to treat something called 'Akathasia'. Which is a disorder specifically caused by medications. I don't know anything about 'nocturia', or the treatments available.

At one point I managed to get desmopressin for the nocturia, but this was not for the taper but only for the insomnia and to even get that it took a lot.

Are you still on the Desmospressin? And does it work for the 'nocturia'? I hope you are and I hope it does, and that you find some relief.

Did the doc offer any solutions ? No, he just told me to stop and try later.

The 'national protocol' actually calls for the use of no other drugs when discontinuing benzodiazepines by GPs. Clonazepam, they know nothing about that, it is rarely prescribed, especially at doses of 2 mg.

Generally, discontinuing 'benzos' is done by GPs. It is considered a minor issue. You may start to sweat, have a little insomnia, have some mild flue like symptoms.

I tried to taper with the GP, but things went wrong again and again. Now, the GP was expecting help from the psychiatrist I was being referred to. The psychiatrist referred me back to the GP, and considered this a case of 'quitting benzos'. The GP subsequently decided to treat this as such.

There was many points in my Clonazepam dependency where I had to stop the taper because of health reasons/risks, and try pick back up the taper again. I have repeatedly (annoyingly) that it took me a year plus to get off Clonazepam - and one of those reasons it took me so long is because I was on 1MG and ONLY 1MG (a night) for 6 months straight. By that point, it was doing nothing for me symptomatically (as in, for my anxiety). However if I didn't take that 1MG before bed, I would have insomnia, night sweats, tremors, brain zaps, dizziness, dissociation, and sometimes I would have seizures. Because I missed that 1MG one time. So sometimes, it's a wise decision to stop and take some time.

And even though it was sarcasm (or maybe it was anger towards me?) about 'what was the point in telling me the country you lived in', I am going to ask - what country do you live in?

He doesn't have a clue, since it was (mostly) his idea to taper the clonazepam by switching to lorazepam, which turned out to be a disaster. I'm still dealing with the 'withdrawal' from lorazepam.

It is now clear to me that he considers this 'mental', mostly having the same attitude as my former GP.

Actually, there is a local addiction service. I talked to a very experienced addiction specialist, who had zero (!) experience with clonazepam. 'a benzo is a benzo'. He offered tapering the clonazepam with oxazepam in 4 weeks inpatient  !I I actually tried that at home and it turned out that oxazepam was very short acting.

I can't get any help from the GP beyond that what is 'common'. No referrals. Actually, he was willing to refer me to a local mental health facility, but not for tapering purposes. I think he's fed up with me, and I'm fed up with him.There is a local unwritten rule that you can switch GPs only once as long as you live in the same city. Presumably, a new GP would continue where the other one left off.

I actually told the former and my current GP that this required specialist help, with zero luck.

(referrals are mandatory)

At this point I feel mentally and physically broken. Physically I'm in really bad shape. I could try diazepam again. Any particular reason why you think I shouldn't ?

I could tell you the name of the country I live in, but what would be the point ?

Once, while I was very sick I considered the concept of 'tapering while lying in bed'. Too bad I didn't.

The situation has escalated far enough to become 'intolerant' to symptomatic treatment of some issues. Medically-technically there are things that can be done, but because it is considered 'mental' I can't get treatment that is a bit out of the box.

Not sure what else I could add.

This drug and subsequent mostly untreated health issues have made me very sick. Does it really make sense to taper like that ? Let's not forget the lorazepam withdrawal ...

As far as asking for help is concerned, the doc thinks it's 'mental' so aside from some very minor symptomatic treatment with drugs he is familiar with I can forget about that.

I guess your neurologist helped you taper ? Anyway, my GP can write presciptions based on indication, but he doesn't have a clue as to how drugs work. A third world country indeed.

I actually tapered from my psychiatrist. At that time I didn't even have a regular Neurologist; because all the Neurologists I saw didn't believe I had any "real Neurological issues" that all my issues (meaning Seizures) were just "mental illness" related. All of of that has nothing to do with where you live in the world, but plain ignorance from medical professionals and mental illness stigma. My GP also had nothing to do with my Clonazepam taper - I told my Psychiatrist  (who was my Clonazepam prescriber) that I was dependent and explained that I wanted to taper and asked if he was willing to help, and he said yes. And his knowledge of prescription psychotropic medications, his psychotherapy skills, and our history together (he was my Psychiatrist for 3 years), we were able to make it happen.

Obviously our background, resources, and symptoms are different - no 2 stories are going to be a like. And I do have a habit of being over optimistic, and naive - as far as what you are able to accomplish with what resources you are able to obtain. As well as completely uneducated to how the protocol works in the health system where you live.

Some things I want to say also:

1.) Nothing you are experiencing is "just mental". Benzodiazepine dependency is a physical and chemical syndrome, that only some people are susceptible to and experience; and it's a shame that is the way you are being treated. It's a misunderstood syndrome, which is why so many people and professionals alike are ignorant about the facts and treatment. 2.) You are dependent on one benzo (Clonazepam), withdrawing from another (Lorazepam), my opinion is to stay clear od stay away from Diazepam (which also a benzo). At least that is my personal opinion. Diazepam is another benzo that can cause you a lot more trouble than it's worth, and just add more unnecessary fuel to the fire.  

Your GP is flat out refuses to give out referrals? And is a Psychiatrist really out of the question? A Psychiatrist medically is a M.D, and knows more about how medications work (especially chemically) than most regular medical doctors. Like I said - I am uneducated to where you live and the system there, and I am having trouble understanding your situation. But I really am trying to help.

[Breenn]

Sloane, thanks for responding and I hold no anger towards you

I did get something for the side effect of 'nocturia', but much, much too late. Can you imagine sleeping for only two to four hours a night ? Or falling asleep late in the morning, waking up exhausted ?

First the insomnia, then the general exhaustion. That in combination with the clonazepam was not good ...

It took so much effort to get something prescribed. Such a struggle. And I had to switch GPs first. What I got is internationally a regularly prescribed drug for the issue, but in this country it has no such indication and at the level of GPs it is uncommon.

The country I live in is called 'The Netherlands'. In the official rankings it has one of the best healthcare systems, but in reality ... I guess it avoids some overmedication by refusing to treat and refer patients ... I suspect many things are covered up.

There is no dual private/public system, just a monolithic whole. If I wanted to really go private I'd need to visit doctors abroad, which is something I cannot afford. It's a very closed system.

In theory I could try a private psychiatrist in a different city. But those waiting lists ... Scarcity of doctors ... I'm in pretty bad shape now. And one of the things doctors do, is covering for other doctors. So it's all my fault ... A lot went wrong, I never should have been prescibed this drug. In this country the only indication is epilepsy. I couldn't get treatment for side effects, there was no real help available when I wanted to discontinue the drug (former GP: no treatment for nocturia ('it's mental'), just stop taking the drug ...). Worse.

Psychiatrists know nothing about dealing with long term clonazepam use. 'a benzo is a benzo'. They don't know anything about the uncommon issues associated with this particular drug. The first psychiatrist referred me right back to the GP. It's not regulary prescibed for long term use like in the USA.

My current GP is willing to refer me to the local government sponsored 'mental health facility', for what he thinks is the issue.  In my experience, specialists strongly rely on GP's referral letters. A recipy for further trouble.

I suspect that 'top level' medical care could really help me, but I don't see how I should get that.

Do you have any particular reason for saying that I shouldn't switch to diazepam ?

 

Edited June 17, 2015 by Breenn

[Wooster]

Diazepam is a shorter acting benzo and will likely function more like lorazepam and oxazepam.

for tapering, longer acting benzod generally work best because there are fewer "peaks and valleys" of the drug's concentration in your system.

long slow tapers (over months to more than a year) and going down 0.25mg or even 0.125mg at a time and staying at that level for more than a month is how I tapered from 3mg per day to nothing a couple of years ago.

i recently restarted 0.5mg at night for sleep and tried to reduce to 0.25mg. That was too big of a jump, so I went back up to 0.5 for a bit. My prescriber and I are going to try again once my sleep has been stable for a couple months, but decreasing by 0.125 mg or less at a time,

both of these tapers were done under  psychiatry and not GP or neurology. I wonder if a referral to your local MH service might not help you access a psychiatrist sooner if a mental health professional gives you a referral or asks your GP for a referral because their training can help assess if a referral to a psychiatrist would help.

yes, I feel your pain on the insomnia. My sleep was like that (very interrupted and less than 5 hours a night) for about 6 years. However, crazy boards is not the "suffering Olympics". Your suffering is unpleasant and uncomfortable and super sucky for you. My suffering is as unpleasant and uncomfortable and super sucky for me.

what do you want to do to move forward? It seems you are shutting down options before trying them because you believe they won't help.

[Breenn]

Wooster,

You call diazepam short acting. In a way, you are right.

Presumably you are familiar with the famous 'Ashton method' ? The idea is to let diazepam and desmethyldiazepam levels accumulate, providing for a stable blood plasma level of these drugs. Of course, there is a difference between 'duration of action' and 'half life'. Again presumably, after taking diazepam for long enough the 'duration of action' of a single dose won't matter that much because of the stable blood plasma levels.

In theory. Ashton doesn't really discuss 'duration of action' vs 'half life'. And there isn't much, if any, scientific support for that method or variations on that method.

What do you think of this ? I have never done a slow and long diazepam taper.

That local mental health service does employ psychiatrists. But for the reasons mentioned in the previous post, I wouldn't expect anything good to come out of that. The shortage of psychiatrists, the leading role of the referral letter (the GP and I have wildly different views), the attitude of 'it's just a pill', 'it's mental', being unfamiliar with the drug (the first psychiatrist I talked to told me he didn't know much about clonazepam, 'just a benzo'), the strong role of protocols, the attitude of psychiatrists losing interest if it is not an interesting 'psychiatric illness and more. I'm well aware that all over the world psychiatrists are employed in helping people withdraw from benzos, but in this country people have their own way.

What I want to do ? That is under consideration.

Edited June 17, 2015 by Breenn

[melissaw72]

That local mental health service does employ psychiatrists. But for the reasons mentioned in the previous post, I wouldn't expect anything good to come out of that.

You will never know unless you try.

[Breenn]

Melissa,

I have a lot to lose. You haven't seen his crazy referral letts. In retrospect, they are not hard to interpret at all.

He thinks that my symptoms can be explained by a 'story', and that if I tell that story (to a psychiatrist) I will get help. He doesn't believe these symptoms are phsycial. There is a story in the sense that I would not be in the position I am in today if I had made different choices in the past, but I cannot change the past.

 

[Breenn]

As a side note, has anyone experiences with benzos being more sedating during the daytime than at night ?

I'm not sure what it is, perhaps some adverse reactions to benzos (clonazepam, lorazepam) in general ?

Wooster, any ideas for longer acting benzos ? I don't react well to clonazepam at all, and I don't know many other options.

Edited June 17, 2015 by Breenn

[jt07]

What do you mean by saying you have a lot to lose? I don't understand.

[IcePrincess88]

As a side note, has anyone experiences with benzos being more sedating during the daytime than at night ?

I'm not sure what it is, perhaps some adverse reactions to benzos (clonazepam, lorazepam) in general ?

Wooster, any ideas for longer acting benzos ? I don't react well to clonazepam at all, and I don't know many other options.

For some reason, my Xanax seems to be more potent during the day. I think that's because I'm used to taking at least 1 every night to help me sleep. I have been on it for almost 10 years, so Xanax is no longer "sedating" for me. It just relaxes me. As long the longer acting benzos(even though you weren't asking me, and I'm sure Wooster has more knowledge), Xanax has a XR version so it'll last longer. 

[Sloane]

Breen, I think I have said everything that I can that I believe could be helpful to you. I feel you have rejected everything I have said, or ignored, because you just don't feel like trying or refuse to believe that it would work before giving it a chance.

If you don't know what you want to do, if you refuse to try anything, and don't wan't to get help, then there's nothing more I can say or help you with.

If you have anymore specific questions, my PM box is still open.

Sloane

Edited June 17, 2015 by Sloane

[Wooster]

The only two benzos I have experience with are lorazepam and klonopin.

Sorry I don't have more to offer.

[Breenn]

What do you mean by saying you have a lot to lose? I don't understand.

Almost everything this GP has done made things worse.

I don't know how to explain this in a clear and brief manner.

Edited June 18, 2015 by Breenn

[Breenn]

Sloane,

It was not my intention to be dismissive. It's just that it can be incredibly difficult to get things done.

[WinterRosie]

Can you tell your GP "I feel that you have done all that you can to help me. I feel that I need a second opinion?"

[Breenn]

Can you tell your GP "I feel that you have done all that you can to help me. I feel that I need a second opinion?"

 

That local mental health service does employ psychiatrists. But for the reasons mentioned in the previous post, I wouldn't expect anything good to come out of that.

You will never know unless you try.

Response to this post and previous posts.

In a previous post I stated that 'He thinks that my symptoms can be explained by a 'story', and that if I tell that story (to a psychiatrist) I will get help. He doesn't believe these symptoms are phsysical. There is a story in the sense that I would not be in the position I am in today if I had made different choices in the past, but I cannot change the past.'

Or put in a different way, he thinks I'm somatizing. He doesn't believe it's the drug. He has (almost) no experience helping people withdrawing from benzos (not to mention clonazepam !) after long term use. His 'help' was based on his experience hellping people withdrawing from antidepressants. More than once, I asked him for referrals. What I got was too little, too late, crappy referrals. I'm in bad shape, generally.

A 'new' doc (second opinion) would probably heavily rely on my medical records. I'm rather certain there is a lot of junk in those files. My current GP is well liked and respected, he holds a prominent position in a local doctor's union/association (?). That I already switched GPs once does not help. (there is a bit more but I like to keep it brief) If I wanted to be taken seriously I'd need a GP out of town (probably without the file, or it would have to be cleaned up which could be a lengthy process), something that is not easily done. And even then, in this country healthcare is considered a cost, not a service as an expat one described it. More than once I asked for an endocrinologist. Rejected. 'not logical' (and too expensive, but he didn't state that on that occasion)  What is logical in his opinion? Psychiatry. In this city there is only one private psychiatrist, that's the one who rejected me and sent me back to the GP and gave bad advice to the GP.

As my GP put it when I stated that I wouldn't get any treatment for my physical issues in that local mental health service he stated 'because it's mental' (paraphrasing)

I could ask for a second opinion. But I feel the help I can get that way is very limited, like a referral to the local addiction service (discussed in a previous post), or a referral to the local 'mental health clinic'. (Actually, in the latter case the odds are that I would be reffered back after many months of waiting 'quitting benzos', or that they would diagnose me and employ the 'mental disease' model while assuming that the clonazepam is 'just a pill' and try to prescribe drugs according to the protocols and formal indication)

I don't want to be dismissive and appreciate the responses but it is so hard.

Right now I'm spent and for the moment I'll leave it at that. I suppose you could summarize all of this with 'it's a mess'

Edited June 18, 2015 by Breenn

[Breenn]

As it was -sort of- suggested (by the GP, after a conversation) and as it more or less the national protocol, I decided to give diazepam another try. Yesterday and today. Straight switch.

Awful stuff. First I feel drunk and about six hours later my heart is pounding in my chest. I do not look forward to saturating my body with this stuff to do a gradual taper.

I'll see if I'll continue, it's not something I look forward to. I've had to deal with a lot this year and last year.

The Ashton method. One of the drawbacks is that 'a benzo is not a benzo', and that the effects of both drugs are so different. Ashton's schedules assume a gradual crossing over (GP and addiction doc advised differently), she considers clonazepam a short acting drug and her schedules assume people taking three doses a day ! I can't swap one dose of clonazepam for just one dose of diazepam at a time.

What a mess. It seems that virtually nobody in this country knows how to handle problems with this drug. Both my GP and I agreed that there are probably only a handful of docs in this country who know how to handle issues with this drug. Too bad that the GP didn't even want to look for them, even when I requested so ...

 

[Breenn]

Briefly: I got referred back and forth, was asked to just stop the drug, taper, wait, etc.
Other health issues that I won't get into. No referrals, wrong referalls, back-and-forth. Asked to wait with taper, GP couldn't handle it, etc.

I learned that almost no doctor has any actual experience with this drug in this country.

At this point I can understand that some of my posts cause some frustration or annoyance.
 

EDIT: too much information

 

Edited July 2, 2015 by Breenn
too much information

[Sloane]

I'm going to reply, and I want you to read it without automatically responding. I want you to read it carefully and actually take it in.

1. From your previous post you stated you "Straight switch/ed" from Clonazepam to Diazepam. You CAN NOT expect the same results from a straight switch than from a taper. Because you are exactly right, "a benzo is NOT a benzo". Diazepam is there to take the edge off, NOT to replace the Clonazepam.

2. This...

The way clonazepam affects me: it's not 'just' a sedative. Profound neurological, endocrine and mixed sedation/stimulation. I used to take it during the day because otherwise I'd have trouble sleeping at night. It affects circadian rhythm. Plasma levels account for something, the 'duration of action' does a lot too. It clearly is a serotonergic drug. Just like antidepressants it affects body weight but in a very different way.

Stop this. You are NOT a doctor and you ARE NOT A SPECIAL SNOW FLAKE. I'm sorry Breen, I' was trying to be supportive and nice but this is bullshit. Okay, I get it - your actual GP doesn't do all the blood work, and the nerve tests, and the scans that could show how Benzodiazepines dependency effects your body. TRUST ME I GET IT. I was IN that SAME boat. When I FIRST took Clonazepam it WORKED and I was in Social Anxiety free heaven!!! However as that dependency grows and your brain starts to NEED that medication just to function (as in, it mistakes that Clonazepam as a "natural" subtance so you MUST put it in your body OR ELSE) your ENTIRE system starts to function differently. Neurological, intestinal, muscular, nerves - EVERYTHING.

But STOP googling shit and DO SOMETHING about it.

3. Tapering SUCKS. Sometimes you feel like you are going to die. But guess what? You are NOT going to die, and these physical effects of Benzodiazepines are NOT PERMANENT. If you taper properly and under medical supervision (if you tell your GP you are tapering, he WILL oversee it) you will come out healthy. It may take a very LONG time, and it WILL suck, but it CAN temporary. It IS scary, it WILL be painful, and you WILL wan't to stop and try to find something that will "just make the dependency go away". But I'm sorry, that doesn't exist.

To stop medication dependency you have to taper slowly. And during tapering hell there there's just medications/institutions/support groups/people to help you through it.

I mean, what are you expecting to find out there anyway, even in the states? A nice comfortable beach manor, with doctors that pass out dependency-no-more pills? Or maybe you are waiting for someone to tell you that tapering is worthless because your system is "too special"? Sorry, no. I had the SAME physical symptoms as you, and I tapered. My doctor did NOTHING except prescribe be Congentin in the end (which I took for MAYBE a month?). And after a while, I was back physically and functioning even better than ever.

4. some resources:

• Benzodiazepine withdrawal syndrome - it's called a syndrome for a reason. It affects every part of your body.
• Clonidine (Catapres) - can be used for withdrawal of alcohol, opiates, and benzodiazepines
• Acamprosate (Campral): is a drug used for treating alcohol and benzodiazepine dependence.

[San]

We've been beating a dead horse for pages now.

It's not going to kill you. It sucks for a while. You're obsessing about this, and being a Google MD, and it's getting you nowhere fast!

What is your diagnosis? What other meds are you on? 

[jt07]

Breen, I don't understand why you keep talking about the healthcare system in your country and comparing it to the US. There's no special knowledge that doctors in the USA have that doctors in your country don't. Ultimately, it is going to have to be a taper. Sloane has given good advice. It can suck, but you can and will get through it.

Edited July 2, 2015 by jt07

[Breenn]

There is a bit more going on than simple dependency, but I'll keep it brief.

jt07, as far as the 'other' issues are concerned I ran up against a wall of medical bureaucrazy. Well, I meant bureaucracy, but that word is fine too. At least in the USA you're not dependent on a GP for referrals, waiting lists are not that extreme, the system is more customer oriented. You can switch doctors more easily if you're not poor. Let's leave it at that.

Obviously I have to do something, but I did something a few times and the effects were either a disaster or horrible.

I think I have said all I could say or ask at this time. I guess my previous post was a bit out of despair. For the time being anyway, I'll leave it at that.

[melissaw72]

There is a bit more going on than simple dependency, but I'll keep it brief.

jt07, as far as the 'other' issues are concerned I ran up against a wall of medical bureaucrazy. Well, I meant bureaucracy, but that word is fine too. At least in the USA you're not dependent on a GP for referrals, waiting lists are not that extreme, the system is more customer oriented. You can switch doctors more easily if you're not poor. Let's leave it at that.

Obviously I have to do something, but I did something a few times and the effects were either a disaster or horrible.

I think I have said all I could say or ask at this time. I guess my previous post was a bit out of despair. For the time being anyway, I'll leave it at that.

Most people ARE dependent on GPs for referrals in the US.  Waiting lists for pdocs can be VERY long also.  And switching DRs is not always as easy as it may seem in the US.

[San]

I'm currently tapering down from 1.5mg of clonazepam a day (0.5 3x's) and am at 0.25 in the morning and 0.25 at night.

I'm a bit shaky, nauseous, and anxious. It's really not that big of a deal.

Don't play the "I'm not American" card. Because a lot of people here aren't from the US.

[crtclms]

Breen, have you ever been on another med? Did it cause side effects? Did you quit them immediately? Because you sound like that kind of patient.

It seems like you don't want to really stop benzos. So don't. Titrating off means you will have side effects. That's life. Bite the bullet, and stop acting like you are a special snowflake. Or stay on it, and stop with the dithering.

AND stop with the "in the US." We have members from all over the world, including countries where English is not generally spoken.

[San]

Anyone else want to continue beating a dead horse?

Seriously.

[newlife186]

Wooster,

You call diazepam short acting. In a way, you are right.

Presumably you are familiar with the famous 'Ashton method' ? The idea is to let diazepam and desmethyldiazepam levels accumulate, providing for a stable blood plasma level of these drugs. Of course, there is a difference between 'duration of action' and 'half life'. Again presumably, after taking diazepam for long enough the 'duration of action' of a single dose won't matter that much because of the stable blood plasma levels.

In theory. Ashton doesn't really discuss 'duration of action' vs 'half life'. And there isn't much, if any, scientific support for that method or variations on that method.

What do you think of this ? I have never done a slow and long diazepam taper.

That local mental health service does employ psychiatrists. But for the reasons mentioned in the previous post, I wouldn't expect anything good to come out of that. The shortage of psychiatrists, the leading role of the referral letter (the GP and I have wildly different views), the attitude of 'it's just a pill', 'it's mental', being unfamiliar with the drug (the first psychiatrist I talked to told me he didn't know much about clonazepam, 'just a benzo'), the strong role of protocols, the attitude of psychiatrists losing interest if it is not an interesting 'psychiatric illness and more. I'm well aware that all over the world psychiatrists are employed in helping people withdraw from benzos, but in this country people have their own way.

What I want to do ? That is under consideration.

Believe me or not, if you really want to get off the benzo, then you CAN do it UNLESS, there is some special cases, someone has to stick with it for life due to Dr. order!!!

I had been with Benzo since 1998 until Feb, 2015 ( More than 15 yrs).  The benzo that I took  was Klonopin for anxiety disorder, then I switched to Valium based on the UK Dr. guideline to withdraw with lits onger half life of Valium.  Not sure just only me or the Valium did not help me to tapper off following her schedules.  I lived in hell in past 6 months after and gave up.... I took some SSIs but did not help.

These information that I would like to share are the key factors that have helped me to overcome the withdraw and now stay out of Klonopin since 02-2015 until now.  During my 1 first attempt in 2010, I stop working and just stayed home do nothing to scope with the Valium withdraw that I have thought that this is the best plan which was a BIG mistakes of doing that.

This is what I did for my 2nd attempt and have saved me of benzo-free now.

First, you need to find sport activities that make you become active at least 3 hours per day during the time you prepare to withdraw ( 6 months ahead) NOT when you  are tapering off the Benzo.  Swimming, walking, volley ball, etc. THIS IS THE REQUIREMENT.  In my case, started playing table tennis (ping pong) 3 hours per day.  Beside this, need to create a 2 nd day to day hobby such as planting, gardening, etc.  What I did for my 2nd daily hobby was taking care of my garden and my fish aquarium

When you are actively engaging in those 2 hobbies that I've mentioned above, you are building up a stronger health, stronger mind, and immune system to cope with the benzo withdraw symptom. 

I have switched back to klonopin 2 mg 2 times per day from Valium since 2011. I started to cut back 0.25 mg 2 weeks.

Also, I found out that Lexapro (or generic one) is the best of SSRI to treat for anxiety disorder + anti depression (compared to Zoloft Paxil, Effexor, etc.) that I have tried during the time I have withdrew from Valium with NO success.

After taking Lexapro at doze 20 mg after 4 months, at the same time, my Klonopin dosage was down to .50 mg twice a day.

I slowly tapered off my klonopin from .5 mg to .25 mg and NONE in a month.  When I had no Klonopin in my blood, that is where the withdraw symptom started bothered me.  This is where the critical moments in 1 or 2 weeks you should overcome by distracting all your discomforts to your daily sport activities and hobbies.  In my case, when I felt miserable in those 2 weeks, I went out to the pingpong club and played for 3 hours.  Chit chat with my players to forget all the discomfort moments.  I did a lot of gardening activities and my fish aquarium.  NEVER SIT OR LAYING IN BED TO THINK about your withdrawing symptoms.   The LEXAPRO really helped me also to suppress my anxiety at peak during my 2 weeks off - benzo.

Now, I am down from 20 mg to 10 mg Lexapro.  My plan is to stop it in the next six months.   I have been off from Zoloft and Paxil with no difficult at all.  SSRI is 100 time easier to get rid off comparing to Benzo.

At least now, I DO NOT depend on Benzo, I am very happy that when I travel somewhere, I am not scared of not having my BENZO with me.  I am BENZO free now, something that I have stuck for more than 15 years and now and no longer depend on this killing medication.    Good luck to all that has or will plan to quit on Benzo.   With share my experience with all if you need any advices

 

[Wooster]

Really important here to not cross the line into giving medical advice.

what works for you might be detrimental to someone else.

perfectly ok to talk about what works for you. Not ok to tell other people you know what they should do.