Benzos Clonazepam or Nitrazepam?

[Anacat]

I suffer from an anxiety disorder, something in between panic attacks and GAD. I usually have 1-2 episodes per year, that are solved w SSRI - used Seroxat and Cipralex for some 12 years now, w small pauses.
When in an episode, I also have trouble sleeping for which I used Clonazepam (up to 6 mg per night sometimes, like last night) Imovane (up to 2.5 pills of 7,5 mg - no longer) Tritico, 1/3 pill (last night).
Now in anxiety episode for about 2,5 weeks, using clonazepam and tritico (plis a slight increas in SSRI Cipralex from 15 to 20 mg) and not really working. I usually take 3-4 mg of Clonazepam and 1/3 Tritico and I sleep, but often for just a few hours, waking up at 5-6 in the morning. If I wake up earlier, I take another 2 mg Clonazepam, and usually sleep for another 2 hours. A medium total of 6 hours. Now this affects my day, which is anyway suffocated by anxiety.
Recently my psychiatrist suggested I might try Nitrazepam, but I was afraid and passed it off.
Now I start wondering if it might work better.
My questions are:
-can I experience withdrawal when switching the 2, from Clonazepam I mean? Should I continue with a small dose of it while introducing Nitrazepam?
-anyone who's been through this switch? what are the possible effects in terms of reducing anxiety and aiding sleep last longer without waking up?
-anything I should know?

 

[sekio]

If 3-4 mg clonazepam doesn't solve your anxiety, I wouldn't expect nitrazepam to.

 

[Anacat]

Thanks for your reply sekio, though it's scary.
I do not take anything during the day, I only take them at night for sleeping, w/ clonazepam diminishing the anxiety and maybe inducing sleep, as well as the Tritico for sleep (which is weird, cuz it's normally an antidepressant, but reports show that it does not work for it's original purpose but it does induce sleep).
I am looking on Nitrazepam because I wish to sleep all night long... and from discussions here people seem to find it helpful.
I worry about the switch, as I said, because of possible withdrawal from Clonazepam when switching the 2, and wondering is I should mix them, like continue with a small dose of Clonazepam while introducing Nitrazepam...

 

[Morphling]

Nitrazepam is far more sedating than clonazepam, so it would be better for sleep, and the half-life is long enough to last into the next day, so it would help with anxiety. There wouldn't be any withdrawal syndrome while switching from clonazepam I would think.

Clonazepam isn't the best sleep aid, six mgs a night is really a very unreasonable dose. Nitrazepam or temazepam should be of more use, as they're actually hypnotics.

 

[Anacat]

Thanks Morphling! So what do you say about the following?
1 mg clonazepam for relaxing, then after 1 hour the nitrazepam? What dose of nitrazepam should do if from clonazepam I get a decent effect (in 50% cases) after 3 mg?
Thanks again for ur support!

 

[Morphling]

Heya

According to the benzo equivalency charts, 10mgs of nitrazepam is equivalent to .5mgs clonazepam, but in my experience nitrazepam packs quite more of a punch than that.

So if you're used to dosing 3mgs clonazepam, theoretically an equivalent dose would be 60mgs nitrazepam. I would try half of that though, perhaps starting with 20 to 30mgs nitrazepam to begin with, and see how you feel with that. As I mentioned before, it's really very sedating.

Good luck Ana! Check back in and let us know how everything goes for you :D

 

[THE_REAL_OBLIVION]

Nitrazepam all the way, a lot better for sleep and you wake up still feeling it and it really melts your anxiety away in the smaller doses (5mg).

While just taking a lot of clonazepam (like say 4-5mg) before sleep will make one wake up with much difficulty feeling dumb as a brick, I took it for 4 years everyday and its what was happening, especially at the apex of my dosing (3.5mg a day), it's very amnesic too, some people do dumb stuff on it more than other benzos from what I've read in years and also from experience (trading some to my xanax fiend would have him lose it).

Mogadon doesn't have clonies' super muscle relaxing action but it is strong too. It's one of the best benzo available in my country for sure. I don't know about Romania, but here it comes in 5 and 10mg doses. Morphling are you sure 30mg isn't too much ? ;p

I got a script but wasn't able to get the 10mgs. I take 3 5mg to sleep and have a couple 10mg valium during the day for general anxiety and i'm all set.

 

[Anacat]

Well, spoke to my doc.
He said that I can combine the 2: daytime 0,5 mg clonazepam, morning and afternoon, and before sleeping 1 mg clonazepam, followed in half hour by the sleep inducers: nitrazepam 5 mg (seems that this is standard dose, at least here) and 1/3 Trittico (btw, this is an excellent discovery, I take 1/3 of the minimal dose, is not as addictive and I did not notice any tolerance in 1.5 years - usually helps me sleep quite well).
I hope it works, though I never took benzos during daytime. Maybe I won't, since I don't want more of them, except in case of harsh anxiety. Normally, I would just try to distract my mind from the panic inducing thoughts and just suffer through it... Sometimes light activity like translating stuff or other simple tasks have a way to diminish my anxiety.

Now, this is all in waiting for the increase in Cipralex dose to take effect (from 15 to 20). I'm a bit frustrated... ok, more like a lot frustrated... since normally the good effects w/ SSRI take 2 weeks to settle (and I have 15 years experience with them, Seroxat and Cipralex), and I just made 2 weeks and nothing (thanks God, no side effects meanwhile though)... Or, maybe something: a 10 scale panic attack yesterday, and an 8 scale short anxiety episode today. Up to now, in a day it was mostly at a 4-5 anx level, with short peaks of 6-7 but also with good hours like 1-2 anxiety and and even 0 (!) for just a few hours. So... frustrated, right?

Anyone here experienced a late onset of SSRI, specially Cipralex? And with a (maybe) paradoxical reaction after 14 days?

I also started cognitive therapy, but cannot expect too much after 3 sessions, when I have to fight 15 years of bad thinking patterns...

My plan is to try the nitrazepam and Trittico, calm down if needed w/ small dose of clonazepam, keep expecting Cipralex to take effect and live as good as I can meanwhile. Also keep doing therapy and some sports. I need to stay involved and active!

Will keep you updated on how this works.
Thanks for being there!

 

[Anacat]

Well, things were not too well.
Took 2 mg clonazepam, then after 40 minutes 5 mg nitrazepam and trittico. you were right, nitrazepam has a punch!
I slept though only 4 h, panicked, took another 2 mg clonazepam, 2,5 nitrazepam, slept another hour.
at 7 woke up and moved on the sofa, then surprise, slept just like that 2 more hours.

For tonight I concocted another plan: start also like last night, but then if I wake up after 4 hours swich for 1 mg clonazepam and 5 nitrazepam, maybe it will help with more that 1 hour sleep.

Reported all to my doc, now waiting for his reply... I know it's an abuse of benzos, just hope the ssri will pick up finally and then sleep will follow as well at smaller doses, like it happened many times before.

Anybody there? What do you think?
Thanks for any reply!

 

[madonit]

Hi anacat i cant give an opinion on clonazepam i have never had it but nitrazepam is probably the strongest benzo's available for sleep after flunitrazepam. Compared to valium nitrazepam is probably equal on a mg to mg basis maybe a little stronger possibly but valium is a better muscle relaxant and nitrazepam is a better hypnotic. hope that helps peace out

 

[THE_REAL_OBLIVION]

the hell is trittico btw, some antihistamine ? what is the generic name for this medication?

You should try 10mg one shot before bed, the 10mg pills are highly sought after here, as much as the 30mg temazepams if not more, i think you'd sleep much longer this way.

 

[sekio]

Tritco is a generic name for trazodone 100mg

 

[Anacat]

Trittico is a non-SSRI antidepressant that does not work too good for that, but works well for sleep. I used to take at night 2 mg clonazepam and 50 mg trittico when I was well and I was sleeping very well. That does not apply though in a full blown anxiety episode.
Now I tried what I mentioned yesterday: 2 mg clonazepam, after 20 min 5 mg nitrazepam and 75 mg trittico, slept 4.5 h, woke at 4.30 AM, took another 1 mg clonazepam, 5 mg nitrazepam and slept for another 4 hours. Better for now, but i don't want to do it for more than a few nights, before tolerance/ dependance kicks in
Waking up in the middle of the night is a common problem for me, so that is why I do not take 10 mg nitrazepam from the beginning, Then if I would wake, what could I take? it would be too much to add to that.

Now I experienced a very strong diarrhea, dunno if it's related to nitro, but... well. Hope that does not influence my SSRI dose too much.

I still wait for the increase in SSRI Cipralex to take effect, though it's a small one, from 15 to 20 mg, but it helped in other cases.That sleep would go back to normal.
My doc (psychiatrist) says that I concentrate so much on my anxiety level that I cannot even tell if the increase works or not after 16 days.. That I do, since my psychologist said to keep a journal of my moods, to see how it evolves and use thoughts to rationalize in a positive manner the anxious ones.
Confused here..
It may be something, since I never had an episode to last this much and not cede to the SSRI increase....

Meanwhile, my doc says keep busy, activity that focuses my attention helps keep down anxiety, and do workouts which I try - 30 min daily on my elliptic bike, till I'm all sweaty.

I do have a question here:
anybody experienced WD when switching from clonazepam to nitrazepam? Dunno, if they hit different gaba receptors? I am afraid of that, since the doc said to switch at night from clona to nitro.... Now I'm taking both, though clonazepam in diminished from 5-6 mg all at night (for only some 5-7 nights) to 3...

Appreciate any reply on this if somebody did it.

Thanks for being there!

 

[tricomb]

They're both super sedating....

I backup Sekio's answer. 4mg Clonazepam is a rather large dose given it's potency, which would come out to being equipotent to about 4/5/6mg of alprazolam depending on various generosities with equipotency charts, since some list clonazepam, and some list alprazolam alongside being as potent as clonazepam, both being 0.25mg = 10mg diazepam = 1mg lorazepam = 0.25-0.5mg ALPRAZOLAM (my benzo of choice for panic disorder hence why I've converted equipotent doses into it by default, but it would come out to equaling a grand total of about 40mg/80mg/160mg diazepam (sorta the universal benzodiazepine I think, depending on each person's unique body chemistry, history taking benzodiazepines, which subclasses have worked best, for example with me, the nitrobenzodiazepines such as nitrazepam and clonazepam are completely useless, and produce nothing but mild sedation. However, the much more potent, albeit slower acting triazolobenzodiazepines (triazolam, alprazolam) and for anti-emetic and hypnotic, and antiemetic and muscle relaxant responses I've found the 3-alphahydroxybenzodiazepines work great (temazepam, lorazepam sometimesss, the diazepam metabolite and oxazepam, etc)

 

[Cyanoide]

-can I experience withdrawal when switching the 2, from Clonazepam I mean? Should I continue with a small dose of it while introducing Nitrazepam?

Some minor, but IME switching benzos from one to another (even straight just switching, without tapering) is fairly painless. I've not switched from Clonazepam to Nitrazepam, but from Clonazepam to Diazepam (and from Alprazolam to Clonazepam), and I didn't notice much at all in terms of withdrawal. Just that switching to Diazepam made me more tired.

I've been on quite a few benzos through the years (oxazepam, alprazolam, temazepam, clonazepam, diazepam prescribed and then non-prescribed pyrazolam, etizolam, phenazepam, diclazepam) and clonazepam has always been the best for anxiety and panic for me. I'd never switch from it if I would get it prescribed again. I haven't used Nitrazepam, but is is considerably more hypnotic and amnesic than clonazepam, very rarely prescribed for much other than insomnia (not common to use Nitrazepam for daytime anxiety/panic). So almost certainly you will be more tired, and possibly you'll feel the amnesic properties (hypnotic benzos like Nitrazepam tend to impair memory more than the other benzos) more strongly.

Clonazepam has fairly strong muscle relaxant and anti-seizure properties, hence also used for epilepsia. When I've switched to or from Clonazepam, I've mostly noticed that it has quite strong muscle relaxant properties (the difference to especially alprazolam was felt).

 

[THE_REAL_OBLIVION]

I recommended 10mg nitrazepam because it's made to fall asleep and stay asleep.

So trittico is Desyrel ? Ewwwww.....enjoy the mCPP it metabolize into I hope.

 

[Transcendence]

They're both super sedating....

some list clonazepam, and some list alprazolam alongside being as potent as clonazepam, both being 0.25mg = 10mg diazepam = 1mg lorazepam = 0.25-0.5mg ALPRAZOLAM (my benzo of choice for panic disorder hence

I have a real hard time believing that 0.25 clonazepam is equal to 10mg of valium, no matter what the flawed equivalency tables say.

0.25 klonopin is the smallest dosage interval available, while 10mg valium is the highest. I have extensive experience with both and I'd estimate that 10mg of diazepam = 0.5mg clonazepam = 1mg loraz = 0.25 alprazolam.

 

[Psychonauticunt]

-can I experience withdrawal when switching the 2, from Clonazepam I mean? Should I continue with a small dose of it while introducing Nitrazepam?

Highly unlikely. When switching between benzos with profoundly specific and different effects profiles you may sometimes experience mild withdrawal; eg. going from a strong hypnotic benzo to a mainly anxiolytic one may result in rebound insomnia. However in this case I doubt you should expect anything of the sort.

-anyone who's been through this switch? what are the possible effects in terms of reducing anxiety and aiding sleep last longer without waking up?
-anything I should know?

You should maybe know that at least in my experience (and as I gather from my general impression of reading and hearing people's experiences) nitrazepam is a lot more sedative than clonazepam. Clonazepam is one of my general go-to benzos for daytime anxiety, whereas nitrazepam is one of the heaviest hypnotics I've ever tried. I wouldn't take it during the day, but for sleep, it's been one the most effective drugs I've tried. Great for providing long and uninterrupted sleep, but it can make you quite groggy.

 

[Morphling]

Mogadon doesn't have clonies' super muscle relaxing action but it is strong too. It's one of the best benzo available in my country for sure. I don't know about Romania, but here it comes in 5 and 10mg doses. Morphling are you sure 30mg isn't too much ? ;p

Yeah, you're right. I was thinking about it later and realized that just because she has a really large benzo tolerance it doesn't mean she'd have a large hypnotic tolerance. I also somehow missed the part where she said she'd be taking 3mgs clonazepam before dosing the nitrazepam. Whew! Glad she took other people's advice rather than mine. I was thinking about this post a few hours later, but couldn't get on a computer, then forgot about it the next day.

I also find, at least for myself personally, that the benzo equivalency charts are rather useless and not very accurate.

Ana, it seems unlikely that you'd have withdrawals, but of course anything is possible. They do have different sub-receptor affinities, all benzos being different. Clonazepam has moderate a1 affinity, high a2 affinity, high a3 affinity, high y2 affinity; nitrazepam has high a1 affinity, high a2 affinity, high a3 affinity, high y2 affinity, and high β3 affinity.

 

[MusicFiend420]

As having an affinity with both (they are very similar chemically, nitrazepam is more hypnotic). The conversion charts have never matched my experiences. Perhaps mg for mg it's right or whatever but nitrazepam (Mogadon) is FAR more recreational than Clonazepam and you will only have to take 1 or 2 tiny 10mg pills and will have a very floaty evening compared to clonaz. I like clonazepam (3 or 4 mgs) in the morning and that'll coast me through work on stressful days though I have a bit of a tolerance. I would never risk taking nitrazepam before work though. Too impairing and I'd be busted. That being said, try to keep it at once a week. Benzo to benzo switches usually don't cause too much discomfort due to cross tolerance in the brain aside from moving from a long half life one to a short hald life one. The w/d are very serious and I've lucked out not to have anything serious other than hellish headaches and insomnia and nightmarish fears of seizures which thankfully never came to pass. But if it's soley for GAD, 5mg of nitazepam in the morning will last all day, not really be intoxicating and more anxeity reducing than clonaz. Both go great with weed too.