Clorazepate and withdrawal...

[[Li...]]

So, I've already introduced myself elsewhere on this forum.

http://www.benzobuddies.org/forum/index.php?topic=9550.0

 

I'm really trying hard to get started tapering off of my 15 mg/day of clorazepate (tranxene); that's 4 tabs of 3.75 mg a day. Two weeks ago, I saw a new nurse practitioner (since I moved away from the town where my old psychiatrist was) who informed me that I could go down one pill per week until I was off, in four weeks. Against my better judgment, and because I was feeling so good, I thought I'd try it and see what happened. What a terrible mistake.

 

I didn't follow her instructions to the letter, but I did three days at 3.75 tabs (~14 mg/day) and felt mildly tired and achy, but OK. So then I went on to 3.5 tabs/day (~13 mg/day) and felt OK for the first two days. After that, I started to feel completely sick to my stomach (alternating between diarrhea, constipation, painful gas bloating, and nausea), had terrible head/back aches, and was unable to eat much of anything (despite my stomach being in pain from lack of food) until tonight; it's been four days since the bad effects really started. On Thursday I immediately resumed taking my 4 tabs/day (15 mg/day) when it became apparent that going down so quickly was a really, really bad idea.

 

The NP didn't seem to think I'd have a problem with such a fast taper since I "haven't been on it that long" (~5 months) and because I'm on a relatively low dose of a weak, long-acting benzo. But I should have known this was a terrible idea, especially after reading everyone's stories on this forum. My old psychiatrist said to decrease by 25% every three to four weeks; or, in other words, one-quarter tab each week. Yes, this means it'll take four times as long for me to get off of this benzo, but honestly, after what I've been through in the past few days, I'll do it as slowly as I can. Even wikipedia acknowledges that "[a]brupt withdrawal from lower doses may cause depression, nervousness, rebound insomnia, irritability, sweating, and diarrhoea." http://en.wikipedia.org/wiki/Clorazepate

 

We'll see what the NP has to say about my not-so-fast taper and the pain and misery it's caused me the past few days. I can only hope the worst is over. However, I think the symptoms can't be ignored, and it's going to be a much slower road for me, because I can't have another relapse like this again (after all, I do have to keep going to work and such...).

 

I'll keep you posted...

 

Liz

[[Th...]]

Hi Lizzie,

 

Thanks for the update. We usually recommend 10% off your total daily dose every 7-14 days depending on how you are feeling. Most can handle these cuts with only minor to moderate withdrawal symptoms. Just remember as you stated, it's not a race! Take charge and listen to your body. Will look forward to your new update! Take care!

 

T2

[[Be...]]

Hello again, Liz. 

 

I wondered what had become of you.  From your reading here, you know we support a slow taper for most people.  Reducing 1/4 tablet/week may work well for you.  As you also probably know, Clorazepate(Tranxene) is long-acting, similar to valium but not as strong.  BTW, 5 months is NOT a short time to be on a benzo. 

 

Hope the visit with your NP goes well.  Few health care professionals understand or accept the realitites of withdrawing from benzos.  Some people have taken a copy of the Ashton Manual with them but few docs will bother to read it.  Just be firm about your need to go slowly.  As long as you are taking less of it every month you need a script filled, your NP should be okay with it.

 

Good luck. 

[[Li...]]

Thank you so much for the encouragement. I'm seeing my NP tomorrow and plan on having a printed out schedule to show her what my plan is; hopefully she will be supportive. I'm not in any hurry, and my health issues of the last week have shown me what can happen if you taper too quickly, and it's not good. So, at least I can say, "I tried your plan, and this is what happened to me...so I'd like to follow THIS schedule instead..."

 

I'm probably going to start with 2 weeks at each quarter-tab cut until I feel comfortable doing otherwise, per everyone's advice. I'm also delaying the start of my taper for another week to make sure I'm fully recovered health-wise from the events of the last week. I'm not quite ready to dive right in again just yet.

 

Thanks much for all your help, and I'll keep updating!

 

Liz 

[[Li...]]

So, what I thought would be an easy appointment today turned out terribly.

 

What I thought would happen is this: I'd go into my appointment, show my proposed taper schedule to the NP, and she's say, "OK, looks good. Come back in two more weeks."

 

Instead what happened was (and this is completely without embellishment or exaggeration):

1) I was accused of being an "addict" and "addicted;"

2) Told not to come back because she didn't want to "clean up someone else's mess;"

3) Told that because I sought a second opinion when I was prescribed Zoloft, I was going AGAINST my doctor's wishes by seeking a second opinion from a psychiatrist (a specialist, rather than the general practitioner who prescribed me Zoloft), and that by doing this I "chose" to become "addicted" to benzos;

4) Told that Remeron doesn't help with anxiety, and that Zoloft does, and this is something I (as someone not in this field) should have known, again, before I went AGAINST my doctor's wishes by seeking a second opinion (and, again, keeping in mind that last time I saw her, she told me that b/c I was on 45 mg of Remeron a day I would be able to taper off on her previously recommended too-fast schedule);

5) Told that the reason that my former psychiatrist didn't want to see me anymore (keeping in mind that she's never spoken or consulted with this person) was "because he didn't want to deal with [me]," since I was an "addict." She was too busy shooing me out the door for me to explain that the actual reason is that my psychiatrist won't see me anymore is because he was at a university health center, and they prefer to transfer their patients to new practitioners ASAP following graduation so they can adequately serve the student body.

 

I think you get the general idea. I walked out very calmly, but then totally broke down in the parking lot. My parents were there to pick me up, and I told them exactly what happened. My dad immediately went back into the place and demanded to speak with the NP, and if not her, the manager. About an hour later we ended up in the office of the director of the entire mental health center. I showed him my taper schedule, explained my situation, and he made a copy of it (saying it looked great) and told me to check back in with him for when I need further prescriptions. He was extremely sympathetic and was the one saving grace of the day; but still, being told all those things, being called an addict, accused of doing something wrong when I haven't done anything wrong, isn't so easy to erase. I cried for a long time and I'll probably be upset for a few days. I don't understand how you can be in a job that requires sympathy for people who are suffering and be so cruel.

 

Anyway, I'm now more committed to tapering off than ever. Probably way TMI, but I thought I'd share. What terrible things are going on out there.

[[Th...]]

Hi Lizzie,

 

I am so sorry this happened to you and I am crying with you.  :'(  This is outrageous  and I am glad your parents were with you to straighten things out.

 

T2

[[Be...]]

Outrageous is the word that came to my mind, too.  I found myself suspecting she had a drug or alcohol problem and was projecting on you. 

 

Isn't it something that we can know that what another person says is an absolute untruth but still it bothers us so much.  And you aren't the first Buddie to be accused of being an addict when they decided to taper off of their benzo.  I don't understand it, I can't explain it, but it does happen. 

 

I'm so glad your Dad was there to challenge that NP's treatment of you and that there was a good outcome.  Now you just need to concentrate on is getting past that awful experience and on with what makes you happy.  Don't give that jerk NP rent-free room in your head.  Get good and mad and do what you have to do and then let it go.  You will never have to deal with her again but I'll bet she got dealt with by the director. 

[[Li...]]

Thanks, all.  I knew you all would be just as outraged, if not more, at what happened. I am very glad we got to talk to someone who understood, and also agreed that her conduct was uncalled-for. He was going to have a "talking-to" with this person tomorrow, I believe. I was just even more angry though because I am so lucky to have a good support system and loving friends and family and a job, but for someone to say something like that to someone without all the blessings I have to back them up could be even more devastating. So I'm not just feeling sorry for myself, but also for anyone else who has had to deal with such people...and I'm sure there are thousands, if not millions, that have been treated this way. My heart and my family's heart go out to anyone who has been treated like this.

 

Thanks so much for your support. I'll of course keep you posted as things progress. 

 

Liz