Benzos If you have tapered/ are tapering clonazepam with diazepam ...

[Kdem]

Are you experiencing interdose withdrawal if you take only one or two doses a day ?
I know that dosing three times a day would prevent that for the most part. But that´s not ideal either.

 

[speedballs_over]

I dose 2x a day, same situation as you (from 3-mg clonaz over to diaz and then to zero over a long ass period). No interdose problems except very, very light anxiety some days. Most days no. Half life is long enough for me. Watch for food interactions with diazepam that do not occur with clonazepam. High fat meals and Valium reduce it's blood levels, etc... so empty stomach is better. I'm in the middle of it right now. Going very well. Best of luck, it is an easy taper for most.

Mental part is hardest, don't psych yourself into panic, or thinking you're feeling w/ds. Stay physically active and do not read too much about benzo w/ds, most of it is not about how we are doing it, most is about more abrupt drops. Stick to reading Ashton and ditch the rest, she''s got it right ime, imo.

 

[Kdem]

'stay physically active'

Not to be rude, but straight to the point:

Why ?

 

[speedballs_over]

Because it reduces anxiety, increases natural endorphins and is just plain good for you. It'll help you rebound from stressful situations easier and more readily. I could on, but hopefully you get the point.

 

[deos68]

Because it reduces anxiety, increases natural endorphins and is just plain good for you. It'll help you rebound from stressful situations easier and more readily. I could on, but hopefully you get the point.

in general this is very good advice for anyone nothing bad comes from it when dealing with anxiety it can help quite a bit
anxiety can build into emotional and physical stress when you work out, go running or a bunch of physical activity it can greatly reduce many types of stress
less stress= less anxiety
for a long time i thought it was bs myself
but recently i started lifting weights, doing yoga, hitting the punching bag my anxiety has reduced greatly i used to be straight up agoraphobic although i still suffer from GAD i can now go out and tolerate many things

 

[Lorne???]

Your having inter-dose problems because Diazepam has such a short duration of action.

2 doses a day simply isn't enough, until you are at the end of the taper. Otherwise your better off just tapering clonazepam directly, with just a single dose per day(you can go from 1mg, to 0.75mg, to 0.5mg, to .375, to 0.25, to .125, and off over a reasonable period.)

There is also the conversion problem. Clonazepam is generally toted as 20x as potent as diazepam, , so 0.5mg clono=10mg diazepam, though some sources use a 0.5mg=5mg conversion.

The problem either way is that chronic clonazepam is more potent than just a single dose, due to accumulation. The standard conversions don't take this into account, or the fact that Diazepam simply doesn't last as long.

My point with that, I that even with standard conversion rates, a mere 0.125mg clonazepam = 2.5 diazepam, though really it can be closer to 5mg, taking accumulation into account.

Without knowing more details, that is all I'll say.

What to do about interpose withdrawal is a matter of what part of it is actually bothering you. Being active can certainly help, if you're physically capable.

If severe, you could try taking 50% of your regular dose in between(IE: if you take 10mg BID, take 5mg in between) otherwise, if a third dose isn't ideal, nothing is going to make it hold any longer.
Your body should eventually adjust though, if it is just mild.

Best of luck.

(And, FTR, I don't like the idea of tapering clono with Diazepam, not a statement against the OP, but in general. It should be used (if at all) as the final step, to step off of a weaker benzo, but personally I think if you can get down to the equivelant microgram doses of clono, your better off that way)

(Also, they make a 0.125mg Klonopin, though I've yet to encounter them IRL.)

 

[Kdem]

Hey Lorne???,

Some good points.

I'm not in good shape, so being physically active all day is not feasible.

The clonazepam is taken once a day. Splitting up never worked. Weird effects. It's such a unique drug. I have tried taking both, but that's really weird. Clonazepam has some dose-dependent effects.

I don't like the idea of tapering clonazepam with diazepam either. When I did try a direct taper (again!) recently I got some weird effects. I'm not sure what is going on physically, and what to do about that. I'll see what I can come up with.

Clonazepam and diazepam, two completely different drugs.
Can I say something like: clonazepam is for physical anxiety, diazepam for mental anxiety ?
Dousing myself with 40 mg diazepam a day, each dose having relatively little effect, the main effect will have to come from the diazepam and desmethyldiazepam built up in my fat cells over several weeks/months ... it's not doing anything useful (therapeutically) and what will await me when I develop tolerance to and dependence on the diazepam ... There is no such thing as a fast diazepam taper.

Diazepam (before tolerance/dependence): sedating during the day, getting sleep at night is hard.

When I try to taper, either with clonazepam in the mix or a straight clonazepam taper is a lot, but to put it simply: cramps. Muscle contractions, skeletal muscle, intestines, possibly bladder/ that influences a lot.
Mostly when trying to taper clonazepam with diazepam in the mix. Less with only diazepam, but then I get other things in return, like insomnia.
Those cramps when tapering clonazepam with diazepam (mixed): diazepam simply does not touch that. Replacing clonazepam with diazepam actually causes some muscle rigidity.

I think that hormones are a big part of the issue.

If you have any ideas for better alternatives to taper clonazepam, they are welcome.
I was thinking about a nice, mostly neutral, long acting benzo ('duration of action'). One that doesn't excessively accumulate in fat cells for an indefinite amount of time.

 

[Lorne???]

For me personally, Ativan(Lorazepam) has alwys seemed an ideal benzo for tapering. A LOT of people will disagree with me though, but, for me personally, lorazepam is a very neutral, almost "bland" benzodiazepine, that has a good duration of action, yet only a moderate half-life of 10-20 hours. Compared to diazepam, it lasts longer, yet has a shorter(and far less variable) half-life.

It also ha a very slow onset, similar to clonazepam, except that the initial onset is even slower, though the peak effect occurs about the same time.

And it's medium potency; I mean, it's fairly potent by weight,(1mg lorazepam= 0.5mg alprazolam, 5-10mg diazepam, or 0.25*-0.5mg clono(chronic-acute)).

And it doesn't accumulate, yet two doses a day will generally hold you. But most p all, for me, and practically everyone I know IRL, lorazepam simply has no euphoria, whatsoever. Alprazolam is pretty relaxing and euphoric, and even diazepam can bring some euphoria with it's very fast onset; yet lorazepam just has such a slow onset, and it doesn't pack the unique punch of clonazepam(not to mention it doesn't infinitely build up, making it easy to abuse, suprisingly.)

If it wasn't for it's fairly good duration,(anywhere, 4-12 hours) and th fact that it actually is an effective benzodiazepine, in regards to the "core" benzo effects(anxiolysis, sedative, and of course it completely covers benzo WD) I wouldn't like it at all, but, it's these very properties that could make it a good benzo to taper from;

We seem to have similar idea's about benzo's, and lorazepam to me is very neutral, in nearly all aspects.

But, some people think it's horrible for tapering, and you can find their reasoning for yourself. A lot of people look at the half-life, but with diazepam, half-life is practically useless, it just builds up in fat tissue, like u said. I've even herd doctors claim to someone I know (while handing them a script for 15mg of clonazepam at an ER) "Oh, I would never write Ativan, it is much more abusable than clonazepam" I was like WTF?

I do know the logic behind shorter T1/2=harder WD, but the point is, you're not supposed to WD, but taper. I certainly wouldn't recommend switching to lorazepam and running out.

More people have traditionally has success with Valium, though, I'm just offering my thoughts with an alternative.

(Oh, and on last advantage of lorazepam; it is NOT metabolized by the P450 system. Obviously, this reduces drug-drug interactions, but, perhaps more importantly, it has a more consistent profile, with less individual variability in it's metabolism.)

 

[Kdem]

I already tried lorazepam. Bad idea.
At first I was fine, but when I developed dependence and tolerance to some of its effects (that can happen quickly!) and I got a lower doses I could really feel the interdose withdrawal. It seemed to last for about 12 hours in the beginning, but I got to the point when I could feel a rebound about four hours after the onset/peak. Just no stability and lots of issues.

At some point I tried dosing three times a day but by then I was I already messed up.

I guess everyone is different, lorazepam felt a bit hypnotic and sedating in the beginning. Also the onset seemed to be reasonably fast, within one hour. A peak maybe within 1-2 hours at most. I went by 2 mg clonazepam = 4 mg lorazepam, which worked. Doctors insisting on the lowest possible dose, not understanding tapering ...

That drug had its own withdrawal, I just complicated things.

If I knew of a neutral benzo with an appropriate duration of action that does not accumulate excessively that could be used ...

 

[Lorne???]

There are RC's, clonazolam is very similar to clonazepam, but a faster onset and slightly shorter half-life(less accumulation)
And then there is etizolam, which I have heard great things about, but alas, I know little o these substances, and RC's in general, well...

Yeah everyone's different, other people have said tolerance to loeazepam seemed to increase faster for them as well.

I'm not sure of a much more neutral benzo, other than very mild ones. Something like oxazepAm(though I'd be weary of that). Chlordiazepoxidw is in the same class. I'll holler if I think of anything. Other than roughing it out with diazepam, or forcing a once daily(or twice daily, with smaller doses of clono) it's hard to say.

What is the appropriate half-life, and duration? Would a drug with long half-life be ok if it also had a long duration to back it up?

Sounds like you want an intermediate-acting benzo for tapering, but AFAIK, they are mostly pretty bad at it(I mean Xanax or temazepam seem Ike bad ideas to me.(

You could hypothetically taper with alprazolam, starting with 3, and then dropping to two doses per day, and then gradually decreasing until finishing with another Benz with an easier WD profile. But it generally can be very hard to control yourself with alp, and besides, it has a short to intermediate duration, an a longer half-life(it lasts 4-8h, vs a t1/2 that averages around 12h(range 8-20)

 

[Kdem]

RCs are not ideal ...

Clonazolam doesn't have clonazepam's serotonergic properties, does it ? Clonazepam is very unique. It would seem that I have to replace clonazepam with a benzo does not act on serotonin (the way clonazepam does), or that I would have to 'modify' the serotonergic properties of clonazepam. Clonazepam, especially when tapering, causes issues ...

It seems little is known about etizolam and especially clonazolam, aside from subjective experiences.

I did try oxazepam, much shorter acting than lorazepam.

chlordiazep (Librium or Tranxene) is a diazepam-like drug. With the associated accumulation, although it should be less for Tranxene than diazepam.

'What is the appropriate half-life, and duration? Would a drug with long half-life be ok if it also had a long duration to back it up?'
Sure, as long as you don't get the excessive accumulation of diazepam and desmethyldiazepam. I don't like my cells to soak in benzos, long term.

I would prefer a neutral long to medium acting benzo that does not accumulate in fatty tissues like diazepam. Without a very long half life/excessive accumulation of the drug.

 

[Lorne???]

I'm sorry, but of all the common benzo's(the ones you will actually encounter) lorazepam is the on lye one with an appropriate duration, that doesn't accumulate.

I wouldn't worry about desmethyldiazepam(aka: nordazepam, much easier to type!) it is a partial agonist, and is less potent than diazepam itself.

Librium produces nordazepam, but Librium itself has a short half life. I'm just saying, I wouldn't worry about nordazepam, unless your taking very high doses, it's effect would be negligible, even at steady state.
(I'm not suggesting Librium, making an observation about desmethyldiazepam.)

I'll look around, I'm half sleep.

Clono is unique, true, but it's not the only ser

 

[Kdem]

Have you woken up yet, Lorne???