Carbamazepine and diazepam

[MagickalKat777]

Okay so I know that these two don't really play nicely together but my psychiatrist is insisting that I give carbamazepine a try.

I don't understand to what extent I'm looking at for additional diazepam clearance or how to offset it. Is this even something that is serious enough to worry about?

I am starting at 100mg XR once a day and moving up to 300mg XR twice a day. I currently take 7.5mg of diazepam a day in two divided doses. It *barely* keeps me from full blown withdrawal which is why I'm nervous about this.

My question is... Just how big of a deal is this? Would changing my dosing to three times a day (2.5mg) improve the situation? I'm assuming that it shortens the half life as well. I basically need to maintain my plasma level or it gets really nasty.

I don't have a choice but to take it. She will be testing my levels to make sure that I took it and I have a feeling if I don't take it she's going to yank my diazepam and leave me screwed so I could really use some advice E here.

She did bump my diazepam up to 10mg a day but as I've been tapering, I don't want to go up unless I have to.

I'm really hoping I'm just freaking out about nothing but the interaction is listed as being serious between the two while clonazepam is only listed as moderate so I have to assume that its worse with diazepam.

I am not happy with this choice she made (I suggested oxcarbazepine instead and was shot down because she thinks it's inferior when everything I've read says to use oxcarbazepine first and carbamazepine as a last resort) but I don't have the luxury of being able to change doctors.

Thanks everyone. Kind of freaking out here, just took my first pill tonight.

 

[DL-ark]

If you think it would be better to change your dosing schedule because you want to prevent withdrawl, as long as you are not taking any higher of a dose, your doctor should understand. Unless I am missing something.


That said, if two doses of 3.75mg every day is barely keeping you up, switching to doses of 2.5mg is quite risky. Your first dose of 2.5mg may not be enough until you redose, even then I don't really know.

 

[MagickalKat777]

That's exactly what I'm afraid of. I have gotten into it with her before about my dosage patterns and how 12 hours works best for me. She had me splitting it up 3 times a day and I was even worse.

I guess I'm just going to have to see how it goes. She started me at half the normal dose and only plans to have me on 2-300mg if it helps so maybe I'm just overreacting. When it comes to benzos though, I get extremely nervous about messing with them.

 

[sekio]

diazepam is so fat soluble that it'll keep showing in your urine if you keep taking it at any dose.

play it by ear and mess with diazepam dosing as needed. don't expect massive problems by adding carbamazepine

 

[MagickalKat777]

diazepam is so fat soluble that it'll keep showing in your urine if you keep taking it at any dose.

play it by ear and mess with diazepam dosing as needed. don't expect massive problems by adding carbamazepine

Thanks sekio, i feel a bit better about it now.

Benzo paranoia is real. :/

I was actually reading and it seems like people have an easier time coming off of benzos when they are put on carbamazepine anyway since it appears to function like bacopa on steroids, up-regulating GABA quite quickly.

I can tell you that I slept better and actually had some REM sleep. I am not really worried about the rest of the side effects. Anxiety aside, I am extremely healthy and we are going up so slowly in dose that it shouldn't be problematic at all, especially with the XR pills.