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Flumazenil? a detox solution for Klonepin


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Has anyone heard of or tried detox from Klonepin with Flumazenil?

 

I contacted a treatment center for my husband who is in final stages of taper from Klonepin (now on Valium) and they have a 7-10 day detox using Flumazenil. Any experience or knowledge??

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Detox and/or treatment centers have very sparse knowledge - if any at all - when it comes to benzo withdrawal.  Your husband would be better off, IMO, continuing on with a slow, sensible taper, and steering clear of any so-called quick fixes, because there simply aren't any.
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The detox center is called The Coleman Institute.  http://www.thecolemaninstitute.com/index.aspx 

 

I am not sure this is the right direction to go.  Just looking for a doctor versed in Klonepin detox and ran across this.  Seems there are no doctors in the US that know squat about the Ashton Method or benzo withdrawal symptoms.  Every doctor I called to get info about asked "well, why does he want to go off it!"  That says to me, they have no idea about the drug! 

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Detox and/or treatment centers have very sparse knowledge - if any at all - when it comes to benzo withdrawal.  Your husband would be better off, IMO, continuing on with a slow, sensible taper, and steering clear of any so-called quick fixes, because there simply aren't any.

 

Don't even get me started on the lack of knowledge of Detox centers!  They will tell you everything you want to hear on the phone to get your $$$$$!  That was my real life experience.

 

Mine did not use Fumazenil, but I did Google that drug while I was investigating Detox and some pretty scary results came up.  It was over 6 months ago, so I don't remember the specific information I found...I would be EXTREMELY careful!

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Hi 4lovofpat,

 

I found this info from the Ashton Manual, if it can help...

 

Flumazenil is thought to act by "resetting" GABA/benzodiazepine receptors (See Chapter I) so that they are more receptive to the inhibitory actions of GABA. The results suggest that some protracted symptoms are due to the failure of the receptors to revert to their normal state after they have become unresponsive to GABA, due to the development of tolerance (See Chapter I). The response to flumazenil also shows that benzodiazepines can cause longer-lasting pharmacological effects than previously believed.

 

Unfortunately, flumazenil does not at present offer a practical cure for protracted symptoms. The drug has to be infused intravenously and is very short acting so that symptom relief is only temporary. The drug cannot be given to a person who is still taking benzodiazepines as it precipitates an acute withdrawal reaction. However, although protracted sensory and motor symptoms may sometimes seem to be almost permanent, they do in fact decline in severity over the years, even without flumazenil, and they do not signify a major neurological illness. Such symptoms may be partially alleviated by relaxation techniques; some motor and sensory systems may respond to carbamazepine (Tegretol) and motor symptoms may respond to propranolol (Inderal).

 

I also found these threads with opinions from other buddies...

 

http://www.benzobuddies.org/forum/index.php?topic=29473.0

 

http://www.benzobuddies.org/forum/index.php?topic=15865.0

 

http://www.benzobuddies.org/forum/index.php?topic=21764.0

 

I hope this helps  :)

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Don't even get me started on the lack of knowledge of Detox centers!  They will tell you everything you want to hear on the phone to get your $$$$$!  That was my real life experience.

 

Mine did not use Fumazenil, but I did Google that drug while I was investigating Detox and some pretty scary results came up.  It was over 6 months ago, so I don't remember the specific information I found...I would be EXTREMELY careful!

 

Perseverance, one detox place I called literally said "well we could surely use your money"  ::)

 

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Perseverance, one detox place I called literally said "well we could surely use your money"  ::)

 

 

Yeah, I'm sure they could!  lol!!  At least they admitted it! lol!  Probably the only true thing they said, right?

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[80...]

Please do not go to detox. I went and was given all of the false promises...that I would be "well" in 30 days, that they would monitor me so that I did not have a seizure, that they would address my "addiction" (that I didn't have), etc, etc, etc...ALL LIES to get my money. I came home broken and in a HORRID state of affairs. SO bad that my own father threatened to take me to a Psych ward. I have since reinstated to to a taper, as I lasted 4 months in C/T W/D from the rehab center and I was getting worse.

 

At 4 months out, prior to reinstating, I tried flumazenil. It did NOT work. It did NOTHING for my Benzo W/D symptoms whatsoever. I have heard disastrous results from people who went to this center and who used flumazenil to detox. You can get rid of the drug quickly, but a terrible w/d syndrome would remain.

 

If he HAS to get off ASAP and can't finish the taper, I would find an addiction medicine specialist to put him on Phenobarbitol to get him off of the last bit of the drug. Dr. Reg Peart states in his work that if one has to detox from Benzos C/T, that they can be on Pheno for 3 months and then taper over another 3 months (six months total). He, of course, recommends a taper as opposed to this method...but if you have to do something to get him off, I'd do this as opposed to the C/T w/ Flumazenil. Just a thought.

 

Best of luck to you and your husband.

Much love, Nicole

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Thanks for all your replies.  So sorry to hear what you went through Nicole.  The more I research the less I think the detox center is the answer.  I was just hoping for a quicker relief for him.  I think slow and steady will win the race even though it seems to totally suck.  I don't want to make things worse.

 

This forum has been very helpful for me.  It is sad to see so many of you suffering from what I consider medical ignorance.  I am so very grateful for those of you who have shared your experiences and advice.  It lets me know he is not alone and we can fight through this.

 

I wish you all well in your journeys and appreciate the guidance on ours...

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Found this study:

 

Flumazenil (FLU), a benzodiazepine (BZD) partial agonist with a weak intrinsic activity, was previously found unable to precipitate withdrawal in tolerant subjects submitted to long-lasting BZD treatment. The potential use of FLU to treat BZD withdrawal symptoms has also been evaluated tentatively in clinical studies. In the present experiment, FLU (treatment A) was compared with oxazepam tapering (treatment B) and placebo (treatment C) in the control of BZD withdrawal symptoms in three groups of BZD dependent patients. Group A patients (20) received FLU 1 mg twice a day for 8 days, and oxazepam 30 mg in two divided doses (15 mg + 15 mg) during the first night, oxazepam 15 mg during the second night and oxazepam 7.5 mg during the third night. FLU was injected i.v. in saline for 4 hours in the morning and 4 hours in the afternoon, in association with placebo tablets. Group B patients (20) were treated by tapering of oxazepam dosage (from 120 mg) and with saline solution (as placebo) instead of FLU for 8 days. Group C patients (10) received saline instead of FLU and placebo tablets instead of oxazepam for 8 days. FLU immediately reversed BZD effects on balance task and significantly reduced withdrawal symptoms in comparison with oxazepam and placebo on both self-reported and observer-rated withdrawal scales. The partial agonist also reduced craving scores during the detoxification procedure. In addition, during oxazepam tapering, group B patients experienced paradoxical symptoms that were not apparent in FLU patients. Patients treated with FLU showed a significantly lower relapse rates on days 15, 23 and 30 after the detoxification week. Our data provide further evidence of FLUs ability to counteract BZD effects, control BZD withdrawal and normalize BZD receptor function. The effectiveness of FLU may reflect its capacity to upregulate BZD receptors and to reverse the uncoupling between the recognition sites of BZD and GABA, on the GABA(A) macromolecular complex, that has been reported in tolerant subjects.

 

 

 

I think that the treatment actually uses the principles of upregulation and downregulation...the effect is upregulation of the benzo-receptor which persists after the treatment, although how long this lasts is uncertain. However, this is something to  keep an eye on I believe.

 

also found:

 

To examine whether the benzodiazepine antagonist flumazenil can reverse tolerance to benzodiazepines but without precipitating withdrawal seizures, the antiepileptic effect of flumazenil itself and its ability to reverse tolerance at a dose that would leave sufficient receptors free for the binding of benzodiazepines were investigated. Electroencephalographic studies in 6 patients with partial and 6 with generalised seizures showed that flumazenil had a short (20 min) non-dose-dependent suppressant effect on epileptic discharges in those with partial seizures. Receptor occupancy studies in 12 patients showed that 1.5 mg flumazenil given intravenously occupied 55% receptors, whereas 15 mg occupied nearly all receptors. When 3 patients with partial seizures who had become tolerant to clonazepam were given 1.5 mg flumazenil, they were seizure-free for 6-21 days after the injection. The value of intermittent therapy with a benzodiazepine antagonist for preventing or reversing tolerance to benzodiazepine agonists ought to be investigated further.

 

 

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