Tranxene | Suggestions for coming off

[[ni...]]

Hi all!

Sorry for my English in advance. Long story short, I have been battling with anxiety and insomnia since I was a kid (now 33 years old). Personal family issues (divorce of my parents (when I was 16), alcoholism and later suicide of my mother (when I was 21)) had led me to start having severe anxiety and insomnia. When I was 23 I started seeing a psychologist after a triggering event at the university that led me not to sleep for several days. She was a very good friend of my mother (I know it’s wrong, but I didn't have any money at that time). She started helping me a lot, but she was also giving me tranxene.

I started taking 5 mg up to 15 mg of Tranxene on and off, depending on my symptoms, for approximately three years (can't remember exactly). Then, I was completely off for one year. At some point the symptoms started reappearing (job related stress) and she said that she couldn't help me no more and sent me to a psychiatrist (I was 28). The psychiatrist prescribed 150mg of Trittico at night and 50 mg of Zolotrin in the morning with occasional use of 5mg of Tranxene in times of need. At that time, I stopped seeing my psychologist due to her behavior towards me and because I didn't like that I was not paying her (the relationship was not equal). 

After some time, I stopped taking Zolotrin and Tranxene and took only 150 mg of Trittico every day. I stuck with that for 4 years and I was more than ok. At some point I wanted to stop taking it and my psychiatrist said that I was ready for that. He started tapering me to 100 mg for 1 month and then 50 mg for another month. I was Ok until I completely came off it… After some days of stopping, I couldn’t handle it at all... I had severe insomnia and anxiety and my quality of life started deteriorating significantly. I also had and still have a very demanding job in the film industry (as a location manager) and couldn't afford not being able to work.

So now I come to this day. For the last 10 months I started taking 5mg of Tranxene every night to help with Insomnia (after my psychiatrist’s advice). Things were going great until I decided I should stop taking it 2 months ago. My psychiatrist suggested I start taking a natural drug called Sedistress before going to bed. After 2 weeks off, severe anxiety and insomnia started reappearing full force even though I was taking sedistress... I was really really scared. Again, I couldn't function at all...

Finally, before two weeks, my psychiatrist said that I have a psychological dependance on the drug, I should work it in therapy (I have been doing psychodynamic psychotherapy for the last 1.5 years), and that he couldn’t give me less that 5mg because that’s the least dose that I can take. I started taking 5mg of Tranxene and I’m on it for the last two weeks.

I’m truly and utterly desperate... I really don’t know what to do any more. I feel that I will never be able to stop taking it...During the last years I started physical training, I quit smoking, I eat healthy, don’t drink that much but whenever I try to stop Tranxene the cycle of insomnia, ruminating thoughts and anxiety reappears...I know I’m not on a high dose but I don’t want to feel that a psychiatrist controls my life.. What should I do? Should I try and tapper on the 5mg I’m on? Cut the pill in half? I really don’t want my life to be destroyed... I already didn’t have an ideal past..

Thank you, thank you..

 

 

 

 

 

 

 

 

 

[[Pa...]]

Hello @[ni...], welcome to BenzoBuddies,

First, you may have a "psychological dependence on the drug", but your body has adapted to it and in order to reverse this adaptation, a slow taper followed by period of recovery is necessary, this simplistic statement by your psychiatrist reveals their ignorance of this drug.

What we've found is its not the dose that causes us the greatest issues, its the time on the drug and you've certainly been on it long enough to have developed dependence and tolerance.

I would suggest a very slow taper, by using titration methods to ensure these small reductions, we typically recommend reducing your dose by about 5-10% every few weeks or when your symptoms let you know its time again.  A patient led, symptom based taper seems to work best.

Lets keep talking so we can help you feel better about this situation, we understand how devastating these drugs can be.

@[Pa...]

[[ni...]]

Dear @[Pa...] thank you very much for your answer.

I have two questions:

1) I've read that Tranxene is unfortunately not water-soluble. The 5mg that I take equal to 1/4 of the pill. What remains is a very small 1/4 pill. How can I reduce my dose by 5-10% by trying to cut it? Do I use a scale and a pill cutter?

2) The "period of recovery" is what I'm really scared of.. I don't want to put my life on hold because of anxiety, insomnia and all the withdrawal syndromes that come with getting of benzos.. I know its a silly question but from your experience have you seen people slowly tapering of benzos managing to sustain their lifestyle, relationships and mental stability?

Thank you in advance

[[Pa...]]

@[ni...], you're correct, its not water soluble but you can make a suspension that will allow you to taper slowly, or you can use jewelers scales to achieve small dose reductions. 

It sounds like you're familiar with how long this can take, the taper and recovery for those of us who will be negatively affected by this process can be brutal but it behooves us to do this sooner rather than later.  Tolerance, age, work and family demands and health are all things we need to take into consideration when deciding if the time is right but the longer we're on the drug, the more challenging the process becomes.

I've seen members remain functional enough to work and maintain relationships, we never know who will see severe symptoms, so try to keep a positive mindset going in, because you could be one of them.  

[[Li...]]

3 hours ago, [[n...] said:

I've read that Tranxene is unfortunately not water-soluble.

@[ni...]  You might want to double check this.  Per the official FDA Drug Label for clorazepate dipotassium from one of the generic manufacturers (link below):

“The compound occurs as a fine, light yellow, practically odorless powder. It is insoluble in the common organic solvents, but very soluble in water. Aqueous solutions are unstable, clear, light yellow, and alkaline.”

The notation that aqueous solutions are unstable also warrants further investigation. 

DailyMed - CLORAZEPATE DIPOTASSIUM tablet
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fb5c9e98-02b2-4c36-b436-25b58fe3c7d5