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What does it mean if a benzodiazepine is more sedating during the day than at night ?

K

Kdem

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Mar 14, 2015
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Well, I'm not sure this question belongs in this section but here it goes.

It seem that for me benzodiazepines are more sedating during the day than at night. That goes for clonazepam, lorazepam, diazepam. There is tolerance and physical dependence.
Maybe this has something to do with the circadian rhythm.

I don't know, ordinarily sedatives are more powerful in the evening/at night ? Is there any known cause for this phenomenon ?
 
I take clonazepam 1mg/3 day. I find if I have a lot of things going on during the day, the effects seem stronger because it is effecting everything I do. at night when I'm just chilling with less activity it isn't effecting that many things, so the effects are less obvious. Remember, it seems less obvious in your head, but its actually working just as much as it did before. I don't understand your post completely, but it's real interesting. Good post.
 
Good question. I have experience with this prior to a major depressive episode when I was treating insomnia.
You are on the right track with circadian rhythm. More specifically you are probably experiencing the effects of a slightly inverted diurnal cortisol rhythm. I found a lot of articles at the time telling me this was what I had but I didnt believe it was happening to me... Until it was too late and I had a blowout major depressive episode. Soon after I had a 24 hour cortisol test done and sure enough my night time cortisol was 3x higher than the max range and my midday cortisol was below normal. So even though I had higher plasma levels of the lorazepam at night, it wasnt until around 2pm the next day when I felt like a pile of rocks.

If you are too zonked the next day I would perhaps try a mild energizer like modafinil, a nootropic, or low dose adderall.
You might also try alprazolam ( I cant believe I am saying that it is very addictive )
Another option is to get a full hormone panel done to check your cortisol... If that is the problem you can always nuke yourself with Ketoconazole.. Ketoconazole is an old school antifungal that suppresses cortisol production. I stopped benzos, was on it for 3 weeks at night (400 mg), quit cold turkey and have never had insomnia since.
Finally if all else fails, before considering taking an ssri (poison), see if you can obtain some tianeptine or better yet agomelatine. Both are awesome antidepressants with no side effects that drastically improve sleep and anxiety
 
Are you taking the benzos for anxiety or to sedate / for sleep? Do you refer to hangover effects on the day after that seem stronger than they were at night?

The circadian rhythm is powerful and somewhat hard to grasp ... and to unwind from drugs / lifestyles effects...

@PlayDoughBrain: Sorry, I´m a little confused- did the lorazepam trigger your cortisol cycle inversion, or the insomnia?
 
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The idea was tapering from clonazepam. Which I took once a day (evening), as a muscle relaxant.
 
For me, clonazepam is not sedating. In fact, I get so much more done during the day when I take one. And as soon as I hit the pillow, I'm gone--which says a lot because I suffer severe insomnia. It just so happens it's the one benzo that keeps me awake when I need to be and knows when to shut me down. I have no idea how it does it. Alprazolam, on the other hand, I'm out.
 
Is it possible that it is due to one or more metabolites (here 7-aminoclonazepam) being formed (slowly I might add) with other side-effect profiles, that combined with your time of day of dosing amount to relatively significant daytime sedation? I'd say that means it is indirectly related to your circadian rhythm, but perhaps not in the way you had in mind.
 
It also may be the fact that during the day your up and about, thus having your b/p higher than it would be at night when resting. So when taken at night it feels less sedating because your sympathetic nervous system isn't as active (for lack of a better phrase) than during the day. I have felt the same with both lorazepam and alprazolam. I'm out cold during the day, but at night I slowly drift into sleep.

Have you been checked for higher blood pressure? Benzo use is associated with hypertension. As I stated, it may be because your b/p is higher in the day than night.

http://www.ncbi.nlm.nih.gov/pubmed/16683404
 
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