Been on benzos for about a year

[[da...]]

I have been on Clonazepam; then Etizolam for about a year.

 

Initially, Clonazepam .25mg gradually increased to 1.25mg till around Dec 2023 for anxiety/insomnia. Around Dec 2023, it was tapered by pdoc over a week and switched to Etizolam 1.5mg/day; then gradually increased to 2mg/day as I had bad anxiety which wasn't improving. Now, I am on 1.125mg Etizolam spread over 9 doses throughout the day every 1-2 hours to reduce intra-dose withdrawal.

 

Over the last one year, I have had a long history of trying different meds. I have a thread about it: https://www.survivingantidepressants.org/topic/27136-dangerous7-tapering-amitriptyline-after-one-week. It all started after cold-turkeying Clomipramine + Tramadol about an year back. Initially, I had insomnia and anxiety; then depression; then panic/fear each coming on after 1-2 months after the previous symptom.

 

Currently, I am also on Clomipramine (tri-cyclic antidepressant) 50mg and Olanzipine (anti-psychotic) 5mg in addition to Etizolam.

 

Now, I have many symptoms; not sure which ones is my original disease vs which ones is caused by my meds over the last 1 year.

 

- Depression

- Anxiety/Panic/Fear. Continuous/Repeated thoughts of "How will I spend my day; I am feeling anxious/depressed/bad now; I will continue to feel this way." Start getting very restless/panicky just thinking these thoughts continuously. Is it akathisia? When anxiety reduces (probably due to Etizolam), then I get bad depression. Depression reduces when anxiety peaks. I have never had a panic attack.

- Blunted emotions; Very difficult to cry. Feel distant from family members and friends.

- Hyper-awareness (almost a pang of fear) of some words that I read/hear(like thief/police/theft/disclosure/income tax/cheating/record/... - anything that signifies power/authority/persecution) or see cctv cameras

- Hyper-awareness of seeing people coming towards me or walking outside or laughing (Triggers thoughts like: Are they laughing at me? Do they know about my condition? Can they tell that I am a mental patient?)

- Generalized fear of not sure what (especially of security guards in uniform.)

- Avoidance going out (due to fear?)

- Background thoughts

- Difficulty focusing on my work due to background thoughts. I am a software engineer and need to concentrate/focus while writing/reading code.

 

1) Should I taper the antidepressant/anti-psychotic first? Is it recommended to taper all three together?

2) Should I switch to a longer-acting benzo like Clonazepam/Diazepam before tapering the benzo? Etizolam has a half-life of 3.5 hours. My pdoc doesn't want to support a Diazepam switch and wants to taper Etizolam first.

 

PS: Is there any one here from India/Bangalore? Do you know of any doc who can help in tapering psychiatric meds?

[[Zi...]]

Hello, my situation was very similar- was on tricyclic AD (Amitr), antipsychotic (Tisercin) and benzo. I decided for multiple taper 3 years ago. I made 2% cuts of all meds weekly. After 10 months I held AD and benzo and finished AP taper as I found them as most dangerous.

I made crossover to Diazepam (from Oxazepam), it helped me.

I finished AD taper September 2022.

Now have been tapering Diazepam (0,64 mg) and the very last will be Zolpidem.

Multiple taper is not recomended in most forums. But I decided for it after doing own research and with all risks.

[[da...]]

Thanks @Zirafa.

 

After watching

, I am leaning towards just continuing Etizolam i.e. no Valium taper. Let's see.

 

Can Etizolam be tapered faster than other benzos as it has a short half-life?

 

I am suspecting that being on benzo for a year has caused depression. These days, I don't feel like doing anything or enjoy the company of my family members or anyone else. Nothing feels good. I sleep/lie in bed for hours to escape life. Sometimes, I find myself staring at the computer screen (not doing anything). My pdoc wants to increase Clomipramine to 62.5mg/day from 50mg/day but I am not doing it hoping that reducing the benzo will relieve the depression. Passing each day is a challenge, to say the least. My life situation is very good - loving family, good finances but I still feel sad for a large part of the day.

 

Should I increase Clomipramine to control depression? Eventually, I want to wean off all the pills. Which one of should I taper Etizolam/Clomipramine/Olanzapine first?

 

My wife feels that I am suffering from PAWS of Clonazepam cold turkey (Dec 2022) and/or Prozac/Vortioxetin/Venlafaxine CT within the last 1 year.

[[Pa...]]

Your wife could be right, recovery from long term benzodiazepine use is typically between 1-2 years. 

 

I don’t believe the half life of a drug has any bearing on how fast you can taper from it.

 

As for which drug to taper first, I’d suggest the benzo but others may have a different opinion.  Do you tolerate the Clomipramine well, if you increase it, you might want to postpone the benzo taper until you’ve stabilized.

[[da...]]

This is a case study of a girl in Japan who was a long-term user of 5mg Etizolam per day:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149439/

 

She was tapered at 0.3mg/week. Do you think I can follow a similar schedule? Basically, I will be going from 1mg to 0mg in a 4 weeks.

 

[[Pa...]]

The only way to know is to give it a try, with the short half life, you should know fairly quickly if you’re going to suffer extreme symptoms.  I’d suggest paying attention to them and adjust your taper as necessary.  The purpose of a taper is to hopefully remain functional as you rid yourself of the drug because once off, you won’t have it to help minimize your symptoms.