Benzos Oxazepam used for withdrawal from long acting benzodiazepines ?

[Kdeem]

In my case, clonazepam (2mg a day, single dose), Klonopin/Rivotril. There are a few other truly long acting benzodiazepines, but not that many.

There is a difference between 'duration of action' and 'half life'.

What about oxazepam ? I made a reference to that drug in my other thread, but this is a question about the specific pharmacokinetics of oxazepam.
The half life seems highly variable, 4-22 hours. The 'duration of action' seems to be 6 to 9 hours.

Is that correct ? Some charts indicate that oxazepam is short acting, some call it 'intermediate'.

The onset of action seems to be rather slow, with a peak at two or three hours.

If I were to take it three times a day, there would be ups and downs ? How suitable is it as a 'detox drug' or drug for tapering from a long acting benzo ?

 

[adder]

A few weeks before I completely got off benzodiazepines, I switched from 0.5mg of clonazepam to 15mg of clorazepate and then down to 10mg. That's a much better option than oxazepam, it's effectively metabolised into nordazepam, which has an extremely long half-life, which is even longer than clonazepam's or diazepam's. I actually switched to clorazepate because I'd run out of clonazepam and my psychiatrist didn't want to prescribe me any more. A single dose kept me free from withdrawals for 2 days (no clonazepam taken for a few days before taking clorazepate, I was already in withdrawal when I started taking it).

 

[Kdeem]

I'm familiar with nordazepam/desmethyldiazepam. However, it's a partial agonist and I wasn't sure that this metabolite on its own would be 'enough'. Anyway, the doc was resistant to other benzos besides oxazepam and Librium. He didn't even like Librium.

But back to oxazepam, please.
I am concerned with the pharmacokinetics, the ups and downs. If any.
Theory, experiences, is it actually used often ? A local detox clinic uses oxazepam in at least some cases. But they have no experience with clonazepam.

 

[Erikmen]

I can´t feel any of those regardless of the dosage. Must be quite mild.

 

[adder]

What does it mean that your doctor didn't like Librium?

Also, do you have a source for nordazepam's partial agonism? I actually can't see a reason why oxazepam would have a higher intrinsic efficacy than nordazepam. Regardless of its efficacy it's one of the weakest benzodiazepines that are marketed and its half-life is relatively short. I have no idea why your doctor would opt for it. Anyway, if you want to taper off clonazepam, then I think you shouldn't be prejudiced against clorazepate for no reason. I used to be on 6mg of clonazepam for around 4 years, then for a year on 4mg and for a year on 2mg before I quit. Honestly, at the end of my dependence I could hardly differentiate between qualitative effects of classic benzodiazepines. 15mg of clorazepate worked for me just as fine as 0.5mg of clonazepam and the upside was it was longer-lasting. I can imagine nordazepam may have a lower intrinsic activity than clonazepam because it was a bit easier for me to get off clorazepate and it was actually another upside.

 

[Kdeem]

I don't know about your tolerance, but the 'equivalency' charts claim that oxazepam is equivalent to 2 mg clonazepam at 100-200 mg.

You would probably feel that ! But it is a 'mild' benzo. Again, in this situation oxazepam isn't used for therapeutic reasons or 'recreational use', but for tapering.

 

[Kdeem]

Librium ? I'm not sure, my memory isn't too good these days ... Lack of experience, supposedly short duration of action (except the metabolites!).

adder, 'intrinsic efficacy' ? You lost me there.

As for sources, check wikipedia for nordazepam/desmethyldiazepam. It described this compound as a 'partial agonist'.
I know, quoting wikipedia is a bad habit. But it has a reference to a source.

I don't claim to fully understand concepts like partial agonist, inverse agonist and such.
The addiction doc I talked to (not my doc!) used oxazepam in his clinic, he also stated it could be used at home.
It is a 'clean' drug in the sense that it doesn't accumulate or has active metabolites and in that way it is more a 'what you see is what you get' drug. He stated that most people could take it twice a day.

The GP seemed almost eager to copy that. He is almost benzo illiterate.
I tried explaining that clonazepam and oxazepam are two VERY different drugs. The former being an anticonvulsant with some peculiar properties, the second being a middle of the road benzo. In my experience, clonazepam is a very unique benzo. I have no experience with oxazepam whatsoever, mostly clonazepam and some hypnotics.

I may even need a source if I want to try a different benzo. Diazepam not being an option. Would you happen to have a formal reference/source ? Even so, I'm not sure it would work.

Oxazepam is used often by GPs, so they do have experience with that one. They just don't have ANY experience with clonazepam !

At the risk of repeating myself, I am concerned about jumping from one drug to another, each having different binding affinities to the subunits of the benzo receptors not to mention other differences. And about the 'ups and downs' of oxazepam, probably worse when you get to lower doses.
The charts come up with very different half lives for oxazepam, generally 4-22 hours. The best 'estimate' (?) for the duration of action is 6-9 hours, with a slow onset and a peak at two or three hours. Btw, it's doubtful if dosing three times a day would work, spacing it at 8 hour intervals would be inconvenient at best ! Twice a day ?
I get the feeling that the docs don't know what they are doing. That doesn't stop them from being almost autistic at times.