Benzos Diazepam failing to substitute for zopiclone

[4DQSAR]

If you can get by by using Meprobamate (Prodrug of carisoprodol)

Meprobramate is a really dangerous old-fashioned sedative BUT the thing that kept the stuff in use was the fact that it isn't as active as a hypnotic.

The issue is that while the prodrug you mention has a relatively short half-life of 1-2 hours, the active has a half-live of 11-17 hours i.e. it WILL produce a hangover and will accumulate. Add to that the fact that metabolism is CYP2C19 mediated means that genetic variability makes those times merely an estimate and given how old it is, I would treat any figures with a pinch of salt which is to say it's a certain bad idea on several obvious levels and that uncertanity figures arrived at 70 odd years ago are subject to adds an extra level of uncertainty.

I cannot see a clinician prescribing a patient what is after all supposed to be a skeletal muscle relaxant to abate the AWS of a Z-drug.

I don't think the psychiatrist is insane for thinking diazepam is appropriate - merely lacking experience of treatment and almost certainly no understanding of how Z-drugs work beyond knowing that first-line treatment ALWAYS seems to be diazepam. Because it's so safe. I've stated so many times that I'm not fan of nitrobenzodiazepines but I admit to being a little surprised that it would seem clinicians are now shy of them.

If a patient takes their entire diazepam prescription, the very worst outcome is the patient being spark out for a long time but nitrobenzodiazepines are not as forgiving. I'm just guessing as nitrazepam and clonazepam used to be use to treat clients who were gobbling Z-drugs every few hours day an night. We would put them on a blue prescription (daily pickup) so in theory at least they would never have enough of the stuff to harm themselves.

I don't think the OP is in that catagory but it's a sad truth that clinicians (and indeed HR workers) soon learn that the patient/client who tells the full story on day one is pretty much a zebra.

 

[shreddedlettuce]

I cannot see a clinician prescribing a patient what is after all supposed to be a skeletal muscle relaxant to abate the AWS of a Z-drug.

His whole "rational" seems off. (OP i mean not you).

No doctor would prescribe hypnotics for daytime use, EVER.

So I said my say here and hope the Original Poster can find what he his trying to achieve, which is alluding me.

Carisoprodol is a prodrug of meprobramate,

Edited my post as you are correct and I meant to type it the other way around.

so we aren't off to a great start, are we?

The above wasn't necessary and could be confrontational to many, ANYWAY, I did correct my error in typing, even though in my head it was the right way around.

Said as much as I am prepared to, will not looking at this thread anymore as it is confusing to me to the point where ignoring it is the best way forward for my attempt to try and help.

It's like trying to eat a bowl of soup with a fork.

 

[4DQSAR]

@shreddedlettuce - If you read my posts, I always provide references where possible, risks, potential benefits BUT I am at pains to make it clear that I'm not a doctor, I'm a medicinal chemist.

Anecdotal suggestions are depricated unless YOU also provide that same objective risk/benefit information and make a firm statement of your own limits of knowledge. I ended up having to supply information on a medicination NO clinican would ever prescribe because YOU suggested it without so providing.

I'm having to fix up what amounts to random anecdotal suggestions.