Tapering clorazepate (Tranxene, Tranxilium)

[[jo...]]

 

Hi all, I recently realized that I was addicted to a very difficult substance to stop. I knew since about 2 or 3 years in the treatment that I could not sleep without my benzo. I started with lorazepam, up to 3.75 mg, always followed my psychiatrist's advice and prescriptions, never took more. He simply did not inform me of the extremely strong addiction a drug like this creates. Similar to heroin, according to some users... I have read on different websites that you should not take it for more then 3 to 4 weeks. Apparently, even the manufacturers confirm this.

After about 4 years or something, I lower the dose gradually to 3.5 mg, if I remember well. Then, also gradually, switched to clorazepate 60 mg, which is less hard to stop, because of it's longer half life. All this maybe took a year, maybe less. Now, for about 3 to 4 years, been taking the same thing. That's about 7 to 8 years total of benzos.

I of course left my initial psychiatrist, who is a very dangerous person. I do not doubt that. Then, 2nd psychiatrist for the switch to clorazepate. Had to ask her 3 times to see an addictologist, which I eventually did, during a session with her. Seems like he was med student, according to his age... She never even spoke about reducing or stopping before I brought it up. Eventually left her, because she told me one day, when I started asking questions about an eventual diagnosis, that she had for a period prescribed some drug to treat a depression she thinks I have. Since the beginning, I told her that I did not believe I was depressive, but she took matters into her own hands. Unfortunately, in my country, Swizerland, this attitude from doctors is nothing unusual. Also, benzos have become a public health problem.

I left the second psychiatrist after maybe 2 years. I was of course extremely upset. Started asking my GP for the prescriptions. He encouraged me to find a new psychiatrist. I left that linger on, since I had lost a lot of trust in them. Eventually, I got tired of taking my meds every night, so I cut the dose in half by my self, without telling my doctor first. Backlash. After 6 weeks, I told my GP I needed help to cope. He simply told me that since it had been already 6 weeks, my body was used to it. My suffering was due to other problems in my life. As you can imagine, I panicked. I would have never lowered the dose if I knew I couldn't go back. So, I make some calls, explain my situation to different psychiatrists, ask them to contact my GP and push some sense into him. He eventually agreed to put the dose up from 30 gm to 45 mg of clorazepate. One of the most stressful experiences of my life. Of course, the pharmacy thought this was all very odd, which did not help things. How many times did I have to go see them or call them to explain all of this nightmare ? I went into an e-mail war with my GP. Dangerous man, also. I have come to realize a lot of doctors just don't care when it comes to benzos, or are not well informed at all about what they are doing.

Stopped seeing my GP. I am now followed by a new psychiatrist, since a year and a half, who seems like a decent person, although he told me once that an option would be that I stay on clorazepate, and never stop. I thaught I was dreaming... Anyway, I asked the advice of a nurse who has now become a full time artist. She was kind enough to let me use her workshop to do some art when I was, for a time, in art school. I wanted her advice, because she wasn't in the health system anymore. She had briefly warned me about tapering lorazepam, years ago. I just didn't realize the seriousness of the situation, back then. She advised me to tell my psychiatrist that I am now seeing that I want to stop clorazepate over a period of 2 years, with drops. There should be no side effects, normally, if it is done very slowly. My psychiatrist agrees, he says that he is not sure clorazepate can be made into drops, but I can easily switch to a similar benzo that can be liquefied. Same thing, according to him.

I was initially introduced to benzos because I had trouble sleeping. Maybe twice I couldn't sleep for 2 nights in a row, I did have some sleeping problems. I never needed meds every night, but that's what I was prescribed. Then, when I started art school, very stressful, my psychiatrist at the time kept encouraging me to higher the lorazepam. I didn't want to, but I was not informed of the risks, and I really wanted to sleep for my school... I have also been taking 150 mg of Trittico (trazodone chlorhydrate) for as long as the benzos, to sleep too (dropped to 75 mg with past GP when I cut my benzo down, then back up to 150 mg). Recently started taking sertralin 50 mg since a few months (started at 25 mg), to help cope with some side effects of the brutal reduction of clorazepate. My present psychiatrist is even willing to go back to the initial 60 mg so I can then stop very gradually, as said, with drops. That would be an other option, but at the moment I am trying to get a moped license, so probably not the best time to put doses up. I have a mobility problem, and need a better mode of transport then my e-scooter with seat on it.

Sorry for the long post. I never wrote about all this to anyone. I would really appreciate some opinions. Do you think my psychiatrist is giving me good advice ? Is he being too positive ? Any comments are welcome. I would like to thank the creators of this website, and also all the people who have partaken in it's use.

JD

[[je...]]

Hi @[jo...]

Welcome to BenzoBuddies!

It sounds like you've been through quite an ordeal with benzo's. I am so sorry. It is unfortunately quite common for doctors not to understand the withdrawal process, hence the existence of sites like these. I'm not very familiar with Clorazepate and in which doses it comes, but we do have general guidelines for tapering. Usually we recommend cuts of no more than 5-10% of each new daily dose every two weeks or so, but it's best to let your symptoms guide your taper rate. This should allow you to remain functional. Some people have to taper much slower if their symptoms are tough. 

1 hour ago, [[j...] said:

There should be no side effects, normally, if it is done very slowly.

This is highly unlikely if you are physically dependent on the drug. Unless you make minute cuts that will take you many many years to stop - it is extremely unlikely that you will experience no withdrawal symptoms at all if you are already dependent - which, from your post, seems to be the case. However, what we try to do here, is to make cuts that allow you to be functional. This means you are not necessarily feeling great or good, but you are able to fulfill your daily duties. 

I am very happy to hear though that you have a supportive prescriber now, that will allow you to take your time to taper. That is very good. My doctor knew nothing about tapering, but allowed me to taper at my own speed and with the help of the lovely people on this site, I was able to taper off and remain functional. 

We are glad you are here and happy to guide and support you. I hope someone else with more knowledge about Clorazepate will weigh in.

[[jo...]]

Hello, thanks a lot for your concern. Much appreciated.

It's very unusual that my psychiatrist, who is respected addictologist, tells me something very different... Oh well.. I guess I will have to try and see.

[[je...]]

9 hours ago, [[j...] said:

Hello, thanks a lot for your concern. Much appreciated.

It's very unusual that my psychiatrist, who is respected addictologist, tells me something very different... Oh well.. I guess I will have to try and see.

It might be because you’re not an addict, you have a physical dependence. Most doctors don’t understand the difference and very few have an understanding of the complexities of benzo withdrawal.

On 22/06/2024 at 16:39, [[j...] said:

I started with lorazepam, up to 3.75 mg, always followed my psychiatrist's advice and prescriptions, never took more.

The fact that you took your medication as prescribed tells me that you’re not addicted but that your body has developed a physical dependency. You can read more here.