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Benzo Accumilation - Help me understand this Please

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300THB

Bluelighter
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Oct 30, 2016
Messages
53
Hi guys

I have read recently that benzos accumulate in the body. One article states that after just 1 week of diazepam usage the body will have over 4 times the original daily dosage in it. And after 2 weeks the body will have a whopping 8 times the daily dosage accumulated.

Now i don't take diazepam. I take 2mg of Lorazepam broken into 2 daily 1mg dosages for stable levels. I have taken this for a very long time over a year and have been higher and lower on the dosage.

How does this work, can someone explain please? does it mean that my body has like 20mg of Lorazepam or something in it after using them for so long? Can you OD from benzo accumulation?

A while back when i was on my normal dosage, i taken it at night and super freaked out it felt like i had taken twice the dosage and i began questioning whether i had accidentally taken twice the dosage. I asked on forums and people said yeah its probably tolerance withdrawal because the body wants more of the drug. But now im thinking could this have been a accumulation overdose or something?

A bit confused here 8o
 
This does happen, and I'm sure they're are folk on here who will go deeper into the ins and outs of this process but just to quickly place at least some of your anxieties to rest this is highly unlikely to happen if your averaging 2 or a little more milligrams of lorazepam on a daily basis. You may have some level of dependency on the drug and would be unwise to take anything significantly less than what you are currently prescribed without medical supervision, but lorazepam is considered a medium duration benzodiazepine which eliminates itself and it's active metabolites from ones body fairly quickly, making any risk of the accumulation you describe unlikely in this case. It can happen with other benzodiazepines however.
 
You won't accumulate like 20mg of lorazepam, eventually you'll reach a steady state, meaning that intake and metabolism are in a equilibrium. Rule of thumb is steady state is reached in 3-5 half lifes



OD -> N&PD
 
Thank you for the replies, i have to admit i am a little anxious about taking my next dosage today of 1mg lol.

So i have been taking the 2mg daily split into 2 dosages for the last month or so. Will my body of reached its stable state by now? Just to point out i have had full hospital checks my kidneys and liver are working perfectly normal.

Is it really impossible for me to OD from accumulation after being on the 2mg steady dosage for a month? im seriously anxious about this lol.

Just to point out i have been on Lorazepam for the last 12 months and i have never missed a single day of taking them in that time. Accept for when i tried to stop and entered withdrawal but it was quickly fixed by my doctor about a month ago.
 
Just out of curiosity what will the average mg of accumulated Lorazepam be on a 2mg daily routine?
 
^ The half-life of lorazepam is about 0.5 days, which means that the amount of the drug in your body drops to 1/4 during one day. If 2mg of lorazepam is dosed once a day, you will get the maximum and minimum amounts at steady state from the following iterations:

max = (...((((2/4+2)/4+2)/4+2)/4+2)/4...+2) mg = 2.66 mg
min = (...((((2/4+2)/4+2)/4+2)/4+2)/4.../4) mg = 0.66 mg

One could also solve a first order differential equation that describes the chemical kinetics of the drug elimination/accumulation, but that's not something that most people are equipped to do.
 
polymath said:
^ The half-life of lorazepam is about 0.5 days, which means that the amount of the drug in your body drops to 1/4 during one day. If 2mg of lorazepam is dosed once a day, you will get the maximum and minimum amounts at steady state from the following iterations:

max = (...((((2/4+2)/4+2)/4+2)/4+2)/4...+2) mg = 2.66 mg
min = (...((((2/4+2)/4+2)/4+2)/4+2)/4.../4) mg = 0.66 mg

One could also solve a first order differential equation that describes the chemical kinetics of the drug elimination/accumulation, but that's not something that most people are equipped to do.
Click to expand...


LMAO. always awesome to see smart people
 
Wouldn't it be different based on the varying half lives of the two? Diazepam and it's metabolites are known for their long half lives. I would assume lorazepam would be different. How different I don't quite know as I'm not very familiar with lorazepam pharmacokinetics.
 
This thread doesn't seem to touch on the topic of lipophilic substances that accumulate in the CNS tissue which is different than cumulative plasma levels. You may say that some substances can get "stuck" in the brain relative to the periphery.
 
You can have affects greater than intended...but you can't really "OD" on benzos in the popular sense anyways...and tolerance is always going to increase faster than the drug accumulates in the body, especially with intermediate acting benzos like lorazepam. Even with people taking 10mg doses of diazepam every 12 hours, the first dose is going to feel stronger than any dose after that.
 
Diazepam has a very, very long half life, and plus it is then metabolized to (active metabolite) desmethyldiazepam (nordiazepam, nordazepam) and thence to oxaxepam, which is, I believe the terminal endpoint of its active metabolite chain)

Lorazepam...at that dose for that long there is every chance of a physical dependence. It isn't a huge dose, its an intermediate acting benzo, but I have myself ended up having seizures after coming off half that for less time.
 
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