Glowing colors from lorazepam ?

[Kdem]

I had been taking clonazepam for years, prescribed. My doc got the crazy idea to try to taper it with lorazepam (long story!). It was a direct switch, without any gradual crossover.

Colors now seem unusually bright and vivid. What could be causing that ?

I'm male, btw. I'm not used to this at all !

 

[serotonin2A]

Is that the only symptom you are experiencing?

 

[Kdem]

For the most part.

But it's a different drug, after all.
Changes in appetite, mostly an increase. Memory, perhaps ?

Up to a point, for a while after taking the dose: glowing lights.

 

[ebola?]

Lorazepam is known to induce zolpidem-like hallucinations in susceptible individuals. It could be that. Otherwise, it could be that colors have grown drab for you over the course of BZD therapy (this is a known but not particularly frequent side-effect), and lorazepam's narrower-spectrum activity has induced the opposite effect.

ebola

 

[Kdem]

Thanks for that !

I wish I had known. Are zolpidem-like hallucinations anything like zopiclone-like hallucinations ? Because I'm not familiar with the former, but somewhat with the latter. Although that was a long time ago.

Do you know how these substances manage to do that ?

 

[ebola?]

Yes, the two 'z-drugs' are very similar pharmacologically.

ebola

 

[serotonin2A]

Do you know how these substances manage to do that ?

The mechanism has not been investigated. It is thought to be caused by disinhibition (inhibition of an inhibitory neuron) but the specifics are unclear. The effect is probably similar to that of muscimol, although the z-drugs don't completely mimic the effects of muscimol because of their pharmacology.

 

[ebola?]

Muscimol functions primarily as a direct agonist at GABA-A, while the z-drugs are positive allosteric modulators at GABAA, like the benzodiazepines, but they are more selective (I want to say for the alpha1 subunit, but I know elsewhere as well). I'm not sure if activity outside of this function as a PAM has even been investigated. Basically, we don't know what underlies the hallucinatory effects, and researchers aren't particularly eager to throw resources at the problem.

ebola

 

[nAON]

I was reading recently about certain benzos having an affect in perceptual organization in the visual cortex, articles not published yet otherwise i'd link. Would indeed be interesting to know if such hallucination effects were due to some nonselective action at eg. 5HTR's or if it's more about local GABA/Glut balance. Considering that a lot of visual processing occurs through shit like GABA lateral inhibition it's almost unusual that GABAergics are uncommon in causing perception issues.

 

[adder]

Out of all benzodiazepines I took, lorazepam is quite different from the rest. Apart from colour enhancement I also experienced a pronounced mood boost and slightly manic thinking quite similar to what SSRIs produce or certain serotonin releasers. Lormetazepam was similar in effects albeit colours were "darker" and overall it felt like twice less potent. However, I experienced no hallucinations from either and I took lorazepam for over 2 years. BTW, I was later switched to clonazepam which wasn't a good idea, switching from clonazepam to lorazepam appears to me like an even worse idea, the latter was definitely more addictive to me and it's also fairly short-acting (I had to dose it 3 times a day while one dose of clonazepam easily held me for a whole day). I can't even imagine tapering down with lorazepam.

 

[Thato2001]

I hear from many people that they do not have any negative side effects from lorazapam. I take it myself and I have noticed slight distortions of my visual perception, but this is something that I would have to analyze myself to see. I do not know much about nuerophysiology so I can only speak to the subjective effects as I experience them. @ Kdem, do you take any other psychotropics in conjunction with lorazapam?

 

[Epsilon Alpha]

Clonazepam is rather unique among benzodiazepines as it blocks utilization of serotonin in the brain, perhaps what you're experiencing is a rebound effect of increased serotonin signalling which explains your visual changes. SSRI start up apparently produces this in some patients as well, so my $0.02 is its possibly rebound activation of serotonin receptors.

https://www.ncbi.nlm.nih.gov/pubmed/2418652

 

[ebola?]

Ooooh. I find this hypothesis a bit more credible than ambien-like activity (since its more consistent with serotonergic activation than typical zolpidem type hallucinations. I currently lack the full text to the article. What is the mechanism (putative or otherwise) for reduced 5ht signaling?

ebola

 

[Epsilon Alpha]

Ooooh. I find this hypothesis a bit more credible than ambien-like activity (since its more consistent with serotonergic activation than typical zolpidem type hallucinations. I currently lack the full text to the article. What is the mechanism (putative or otherwise) for reduced 5ht signaling?

ebola

There really isn't much literature on these older drugs, but they supposed the reduction in 5HT utilization was due to reduced firing of neurons in the raphe nuclei as they express GABA-A receptors. Now this isn't a well detailed theory as it doesn't explain why other benzo's don't produce similar effects, but I'm willing to attribute it to some kind of secondary affinity of clonazepam such as sodium channel blocking or some other unreported binding affinity. If there's one thing the last decade has shown us it is that benzo's are far less selective than we imagined.
There's also animal evidence of increased 5HT receptor levels in rats following clonazepam treatment, so I would take that as tentative support for a 5HT rebound kind of effect http://www.ncbi.nlm.nih.gov/pubmed/2418653.

Though it doesn't really explain why OP gets "glowing colours" above a certain dose if I read their posts correctly. Though visual side effects are documented with benzo's, "enhanced colours" or anything of the like don't seem to be reported in the literature I have access to. The visual side effects listed seem to be blurred vision or changes in intraocular pressure.
http://www.optometry.co.uk/uploads/articles/e5e5328ee4772fe94f2d6f229de5c48a_patel20030418.pdf

Hell, it might even have something to do with the bizarre "GABA is excitatory in the retina" bit, but that comes back to why did this specific change in medications cause it?

 

[serotonin2A]

Clonazepam is rather unique among benzodiazepines as it blocks utilization of serotonin in the brain, perhaps what you're experiencing is a rebound effect of increased serotonin signalling which explains your visual changes. SSRI start up apparently produces this in some patients as well, so my $0.02 is its possibly rebound activation of serotonin receptors.

https://www.ncbi.nlm.nih.gov/pubmed/2418652

Did they actually show that other benzodiazepines do not produce the same effect? At least from the abstract, they gave no indication that clonazepam has a unique action, rather it seems to be the only drug they tested. The mechanism they proposed (GABA-A mediated inhibition of serotonergic neuron firing) doesn't really make sense if other benzodiazepines don't do the same thing.

 

[adder]

I hadn't taken clonazepam prior to taking lorazepam and yet I experienced serotonin-like effects from the latter, so I can imagine lorazepam (and lormetazepam to a lesser extent) is quite unique among benzodiazepines in elevating serotonin levels via some mechanism which is either non-existent for other benzodiazepines or they're simply much much weaker at producing it. It's been known for some time that there's something unique about lorazepam (article).

 

[Dresden]

I've noticed color brightening from lorazepam (Ativan) as well. I chalk it up to its having two aromatic chlorines.

 

[Epsilon Alpha]

Did they actually show that other benzodiazepines do not produce the same effect? At least from the abstract, they gave no indication that clonazepam has a unique action, rather it seems to be the only drug they tested. The mechanism they proposed (GABA-A mediated inhibition of serotonergic neuron firing) doesn't really make sense if other benzodiazepines don't do the same thing.

Unfortunately the only source I have on that is my old British pharmacology professor, apparently there was a reason to suspect clonazepam had an odd effect on 5HT. Guy is ancient so I'm afraid unless we go digging around some unpublished data in these labs it will just be his assertion I'm going on.

Its looking to me like a possible case of opposing secondary effects for these two drugs.

 

[Kdem]

I've seen a few references to acetylcholine possibly being the cuplrit, but my knowledge of these matters is insufficient. Any chance ?

 

[yaesutom]

Certain benzo's enhance color perception for me. I don't remember if lorazepam does it but alprazolam definitely does as well as etizolam. For some reason clonazepam doesn't do this to me. The effect is like clearer vision and darker color contrast, and even increased "frame rate" type of effect.