• Neuroscience & Pharmacology Discussion Welcome Guest
    Posting Rules Bluelight Rules
    Recent Journal Articles Chemistry Mega-Thread
    FREE Chemistry Databases! Self-Education Guide

  • N&PD Moderators: Skorpio | someguyontheinternet

Methods of last-result to treat harsh benzodiazepine withdrawal

acidosis, eh? That's interesting.

I don't think opioid withdrawal causes acidosis, though, and that's the major cause of RLS for me.

But then again, most people aren't addicts.
 
Fwiw I went through a rapid in-patient withdrawal of alprazolam years ago (late 80s), using a high/medically supervised dose of carbamazepine. I believe I was off the benzos completely in about seven to ten days, and was discharged still on carbamazepine (which I remained on for quite some time, six months at least).

The good thing about in-patient treatment is they can observe you and quickly give you help if you seize. The bad thing is of course, if benzos aren't used or only used briefly, you'll experience other withdrawal symptoms. I went on to be treated for panic disorder after that, although it was the reason I went on alprazolam and didn't develop from withdrawals. Also, my memories from that time are all of nasty side effects from the carbamazepine (e.g. symptomatic low blood pressure), so the withdrawal couldn't have been that bad.
 
Do in-patient detox's use alprazolam for 'rapid' detoxes, or are other anti-epileptics used right away? I don't mean the non-recreational types, but like phenobarbital or valium, though it is my understanding that diazepam can't substitute for alprazolam withdrawal.
 
Try Epilim (Sodium Valproate) to get off Benzo's

It should help alot.

It also helps with Opiate withdrawl too, even comming off a big 10 year long Methadone habit.
 
the valproate will help with the seizures, but not with the anxiety. I've found even 1500mg a day useless for withdrawal of all sorts.
 
I cannot stress this enough: DO NOT TAKE ANY VALPROATE MEDICATIONS. I have had terrible experiences with it. Gained weight, lost some of my hair (has not come back after two years), inability to think, inability to feel many emotions, and inability to remember one set of five minutes to the next set of five minutes. There is 4 months of my life that I barely recall hazily.

If you want an anticonvulsant with anti anxiety (and anti-depressant) effects then I highly suggest to you Lamictal. I took it after I demanded my doctor take me off of Depakote, and I couldn't have been happier with it.
 
Oh, so because you had a bad experience with a drug no one else should take it? Wow, really hope you've taken into consideration all of the bipolar disorders out there for whom valproate is the only thing that works.

And then you go on to suggest a medication that causes a rash in 10% of users that has in some cases proven fatal?

Really good going
 
10% of all users? Mind presenting a statistic? Because the statistics I've read have stated that the fatal Lamictal rash is extremely rare.

I have taken into account the people out there with bipolar disorders who use Depakote to great effect. But I was under the impression we were treating someone for benzo withdrawal and not bipolar disorder, or am I mistaken?
 
No, you're not mistaken, but you didn't say "don't use this drug for this condition" you said don't take it at all. They're related, but distinct statements.

And the potentially fatal rash isn't what I'd call "extremely rare" but the 10% number isn't referring to the percentage of people who get a fatal rash, but rather the percentage who get *a* rash, hence "in some cases"- I'm not 100% sure of the latter percentage, though an allergist once told me that it's likely that the percentage of fatal rashes would drastically rise were it not for everyone stopping the medication once they developed any form of rash.
 
sorry, didn't mean to be a dick, but anyone who quits taking depakote after it's proven effective will be unlikely to find it effective after quitting and restarting.

or is that lithium? I might be confusing my anti-manics.
 
Provigil is that way, so I know what you're talking about happens, but I'm not sure if it happens with either of those two. I'd have to look into it. For whomever it may concern, www.crazymeds.org is a fantastic information site for psychiatric medications. More or less all the info you could ever want to know.

And is he already on Depakote? Because if he is and he's not getting these side effects, then you're right, he should stay on it. But if we're suggesting what he should try, then I advise trying Lamictal before Depakote, because Lamictal has much fewer debilitating (except for the rash) side effects.
 
It's part of an allergic reaction. As I recall, it kills by closing off the throat (the rash overs the face)
 
^Are you referring to a symptom of an anaphylactic reaction?

Under no circumstances should benzodiazepine withdrawal be attempted without a taper. While I don't enter into your forum often, benzodiazepines in lower doses are specifically indicated for withdrawal off other benzodiazepines. A low dose of a long-acting benzodiazepine to aid withdrawal is preferable to an abrupt withdrawal of any benzodiazepine.

I have never seen a benzodiazepine prescribed for mania in the absence of acute anxiety in a hospital setting. I have never seen ketamine used effectively in a clinical (or any other) setting for benzodiazepine withdrawals.

Show me some studies?

In the interim, I advocate open communication with your physician as to mg of use, type of use, and a livable decrease in dosage that will not lower your seizure threshold significantly.

Benzodiazepine withdrawal can be very dangerous and should not be undertaken alone. While you may not wish to trade one problem for another, you cannot quit these things without something that keeps your seizure threshold where it needs to be. There is no such thing as a "rapid detox" for benzodiazepines. There is only open communication with your doctor to develop a taper schedule you can live with.

My best to you.
 
^ Nice post gyllie :) You ought to bring your wisdom to the drug forums more often.

As for Ketamine - there simply isn't any scientific research on that matter that I am aware of. Most people researching Ketamine are idiots who insist on duplicating (again!) that ketamine produces schizoid-sorta-like-y symptoms. The sad part is that all they are discovering is simply that ketamine gets you... liek, OMGZ, HIGH!

I share my beneficial experiences with K simply as anecdotes.
 
References using flumazenil for BDZ withdrawal?

Do you have any references about using a benzodiazepine antagonist like flumazenil for benzodiazepine withdrawal? Because of the risky nature of even cold turkey benzodiazepine withdrawal, I cannot imagine a procedure equivalent to UROD with opiates where an antagonist is administered. Even using an NMDA antagonist like ketamine will likely not completely abolish all proconvulsant activity associated with this. Other proconvulsants like picrotoxin, PTZ and lidocaine (yes, in large doses lidocaine has proconvulsant activity) do not lose all of their activity when the NMDA receptor is blocked with a strong irreversible NMDA antagonist like ketamine or MK-801, although their seizure threshold does decrease.

It is also important to consider that inverse agonists like RO19-4603 exist for the omega (BZD) receptors. An inverse agonist causes the abstinence syndrome to occur even when there is no agonist around. The way pharmacologists have putatively accounted for this is by noting that receptors that have inverse agonists have an essential underlying basal level of activity, so a standard antagonist would appear to act like an inverse agonist, and a partial agonist would appear like an antagonist; thus flumazenil is likely a partial agonist at the omega receptor, having enough intrinsic activity that when it binds to the receptor, it stimulates it and then stays bound, blocking additional transduction until it dissociates from the receptor.

While I have used ketamine during opiate withdrawals very successfully to completely stop the withdrawal syndrome (except for their short duration of action, they would be ideal), I would expect it to help ameliorate benzodiazepine withdrawals, but I would still be concerned about seizures.

Clonazepam is a very good choice to use to taper off of benzodiazepines. Not only is it a benzodiazepine agonist, it also has serotonergic activity, and the 5-HT1a receptor (which is the one that Buspar binds to) helps alleviate anxiety. In addition, clonazepam has a moderate elimination half-life of the parent drug, is not very euphorigenic, has a high volume of distribution and a high alpha-distribution half-life: it is in essence the methadone of benzodiazepines.

The idea that all benzodiazepines and barbiturates all substitute for one another is being rethought. I taught this concept myself up until I tried to detox myself off of a 3 year alprazolam addiction. Staple drugs like phenobarbital and clorazepate (Tranxene) are not the best medications to use when dealing with issues like depression and rebound anxiety or panic disorder. Diazepam, which has a long half-life and a primary metabolite, desmethyldiazepam, whose elimination half-life is around 72 hours, may work well for patients who have GAD (Generalized Anxiety Disorder), but not for those who have had panic disorder. Plus Valium (diazepam) is one of the most euphorigenic benzodiazepines available. Clonazepam appears to be a good first line drug for benzodiazepine detox, and depending on the level of length of dependence, can be decreased slowly with a 20-25% decrease being well tolerated once a patient is stabilized at a given dose.

MobiusDick
 
MobiusDick said:
Do you have any references about using a benzodiazepine antagonist like flumazenil for benzodiazepine withdrawal? Because of the risky nature of even cold turkey benzodiazepine withdrawal, I cannot imagine a procedure equivalent to UROD with opiates where an antagonist is administered. Even using an NMDA antagonist like ketamine will likely not completely abolish all proconvulsant activity associated with this. Other proconvulsants like picrotoxin, PTZ and lidocaine (yes, in large doses lidocaine has proconvulsant activity) do not lose all of their activity when the NMDA receptor is blocked with a strong irreversible NMDA antagonist like ketamine or MK-801, although their seizure threshold does decrease.

It is also important to consider that inverse agonists like RO19-4603 exist for the omega (BZD) receptors. An inverse agonist causes the abstinence syndrome to occur even when there is no agonist around. The way pharmacologists have putatively accounted for this is by noting that receptors that have inverse agonists have an essential underlying basal level of activity, so a standard antagonist would appear to act like an inverse agonist, and a partial agonist would appear like an antagonist; thus flumazenil is likely a partial agonist at the omega receptor, having enough intrinsic activity that when it binds to the receptor, it stimulates it and then stays bound, blocking additional transduction until it dissociates from the receptor.

While I have used ketamine during opiate withdrawals very successfully to completely stop the withdrawal syndrome (except for their short duration of action, they would be ideal), I would expect it to help ameliorate benzodiazepine withdrawals, but I would still be concerned about seizures.

Clonazepam is a very good choice to use to taper off of benzodiazepines. Not only is it a benzodiazepine agonist, it also has serotonergic activity, and the 5-HT1a receptor (which is the one that Buspar binds to) helps alleviate anxiety. In addition, clonazepam has a moderate elimination half-life of the parent drug, is not very euphorigenic, has a high volume of distribution and a high alpha-distribution half-life: it is in essence the methadone of benzodiazepines.

The idea that all benzodiazepines and barbiturates all substitute for one another is being rethought. I taught this concept myself up until I tried to detox myself off of a 3 year alprazolam addiction. Staple drugs like phenobarbital and clorazepate (Tranxene) are not the best medications to use when dealing with issues like depression and rebound anxiety or panic disorder. Diazepam, which has a long half-life and a primary metabolite, desmethyldiazepam, whose elimination half-life is around 72 hours, may work well for patients who have GAD (Generalized Anxiety Disorder), but not for those who have had panic disorder. Plus Valium (diazepam) is one of the most euphorigenic benzodiazepines available. Clonazepam appears to be a good first line drug for benzodiazepine detox, and depending on the level of length of dependence, can be decreased slowly with a 20-25% decrease being well tolerated once a patient is stabilized at a given dose.

MobiusDick
Click to expand...

That very intersting never known a benzo had serotonergic activity. no wonder clonaz is one of my fav benzo'sa few under the tounge and i feel good.

I have been one for the rapid detox; taper not wokring cause it just puts u though hell for longer, i using gabapentin to stop seizures and rotating pines, major tranquilizersand catapres to sleep.

I worried about some of the pines and zines drugs interfearing with drugs like; 2c's and others phens and tryps.
 
You must log in or register to reply here.
Top