Need to switch Benzo's

[BenzoGAD]

Hi, I am a new user here and have used the search button and found some good threads. However, I hope to get some personalized advice based on my situation. I suffer from Generalized Anxiety Disorder and have been on Cipralex and either Lorazepam or Clonazepam for 2 years now. I have not had a break from benzo's at all during the two years and my condition has vastly improved but recently been declining back to how it was before. My doctor also tried Abilify for several months, going from 2mg to 5mg to 10mg in conjunction with the Cipralex but it didn't seem to make a difference. The latest trial is adding Wellbutrin 150mg to the Cipralex (20mg) to see if that will help. To early to report on results.

As for Benzo's, I've been on either 1mg Clonazepam or 1mg Lorazepam for 2 years. Although I'm prescribed 1mg per day, I have always been taking at least 2mg and running out way too early and then having to wait at least a week sometimes two to get a refill.

Today I'm going to my doctor and I'll be letting him know that Lorazepam is no longer working as it once did and that I want to switch to another Benzo or at least increase the dosage. For my situation, what Benzo do you guys recommend and in what dosage (considering my tolerance has built up over 2 years)?

Thanks!

 

[Steady Scootin]

I'd think it best to see what your doctor has to say at your appointment today, wouldn't you?

 

[T. Calderone]

Hi and welcome to Bluelight. With the two depression medications you're taking, I would say that a benzo drug would be beneficial. Which one would be at the discretion of your physician like Steady said. Considering that bupropion and escitalopram put you at higher risk for seizure when taken together, on the days that you go without a benzo would increase that chance even more. That could be dangerous and you don't want to keep over using them, then going without now that you're also on Wellbutrin. Talk with your doctor and see what he recommends.

 

[loveofbenzosnstims]

Lorazepam is piss weak in terms of benzo effects in general and has half the potency of Clonazepam, my advice would be if you can tolerate Clonazepam use that, avoid anything like Alprazolam, pretty much anything short acting and potent. This is just my 2 cents after 15 years of benzo use and having tried every one of them. Another recommendation would be barbiturates, because if you're worried about seizurezs you want a long acting barbiturate, like phenobabrital, Clonazepam is only meant for relief of tonic-clonic seizures, and diazepam/midazolam only via IV are meant for fast relief of a grand-mal seizure.

Remember, benzos were never designed for everyday seizure control.

 

[BenzoGAD]

Hi and welcome to Bluelight. With the two depression medications you're taking, I would say that a benzo drug would be beneficial. Which one would be at the discretion of your physician like Steady said. Considering that bupropion and escitalopram put you at higher risk for seizure when taken together, on the days that you go without a benzo would increase that chance even more. That could be dangerous and you don't want to keep over using them, then going without now that you're also on Wellbutrin. Talk with your doctor and see what he recommends.

The doctor decided to temporarily increase my dosage to 1mg 3 times a day so 3mg a day and I got him to switch the pills to sublingual so they take affect quicker. This actually provided tremendous relief yesterday so I'm going to see if he'll keep me on 3mg longer term rather than a 10 day trial

 

[T. Calderone]

I'm glad to hear this, BenzoGAD. I'm hopeful that your new regimen works for you.
Remember what I said about not letting yourself run out and don't go over your allotted dosage.

 

[Lorne???]

Lorazepam is piss weak in terms of benzo effects in general and has half the potency of Clonazepam, my advice would be if you can tolerate Clonazepam use that, avoid anything like Alprazolam, pretty much anything short acting and potent. This is just my 2 cents after 15 years of benzo use and having tried every one of them. Another recommendation would be barbiturates, because if you're worried about seizurezs you want a long acting barbiturate, like phenobabrital, Clonazepam is only meant for relief of tonic-clonic seizures, and diazepam/midazolam only via IV are meant for fast relief of a grand-mal seizure.

Remember, benzos were never designed for everyday seizure control.

Clonazepam treats myoclonic epilepsy/jerks - and yes, they were,
as a safer alternative to barbiturates - and OP, SL Lorazepam doesn't really kick in any faster, it is a poorly soluble medication, which is mostly why is has a decent duration despite it's t1/2(a single dose holds longer than valium, despite the t1/2 difference)

Stay at least at 2mg per day, 1mg is silly unless it's long term prn
or something

Anyway good luck - and try SL, if doesn't work can simply take them by mouth

 

[BenzoGAD]

Clonazepam treats myoclonic epilepsy/jerks - and yes, they were,
as a safer alternative to barbiturates - and OP, SL Lorazepam doesn't really kick in any faster, it is a poorly soluble medication, which is mostly why is has a decent duration despite it's t1/2(a single dose holds longer than valium, despite the t1/2 difference)

Stay at least at 2mg per day, 1mg is silly unless it's long term prn
or something

Anyway good luck - and try SL, if doesn't work can simply take them by mouth

thanks! This was going to be my next question... I find that the SL tablets (tiny blue tabs) take forever to dissolve under my tongue (5-10 minutes) and sometimes I swallow them via saliva by mistake. Is there any difference between these SL tablets and normal oral tablets if taken by mouth?

 

[MrRoot]

Both the drug in your saliva and tablets will simply just be absorbed normally if taken orally instead of sublingual.

Have you got any therapy for GAD so you don?t have to take benzos all the time?

Just wondering as I have had GAD and CBT did wonders for me.