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Suggest Ways To Wean Off Clonazepam And Diazepam

Posted on Mon, 14 Nov 2016

Question: SIR AS REFERRED EARLIER INTERACTION U KNEW MY MEDICAL HISTORY AS I HAVE BEEN SUFFERING FROM BIPOLAR DISORDER AND I HAVE BEEN TREATING BY MY PSYCHIATRIST SINCE 1998. SIR NOW I HAVE BEEN TAKING 1 MG CLONAZEPAM INSTEAD OF 2 MG SINCE LAST 6 MONTHS AND STOPPED GABAPIN AT THAT TIME TO TILL THE DATE. NOW I AM TAKING 400MG QUETIAPIN PLAIN +15 MG DIAZEPAM +1 MG CLONAZEPAM. I AM STABLE ON THIS DOSE SINCE LAST 6 MONTHS. SIR I WANT TO QUIT CLONAZEPAM AND WANT TO REDUCE DIAZEPAM IN SUCH A WAY SO THAT MY SLEEP SHOULD NOT BE DISTURBED.NOW I CAN SLEEP 7 TO 9 HOURS WHICH ENABLED ME ENERGETIC AND KEEN IN MY PROFESSION. SIR WHAT DO U SUGGEST? HAVE I BEEN DEPENENT TO CLONAZEPAM AND DIZEPAM? IF YES THE WHAT SHOULD I DO?

Answered by Dr. Chintan Solanki (1 hour later)

Brief Answer:
reduce slowly

Detailed Answer:
Hello XXXX,

Thanks for contacting me directly. It is nice to hear that you are doing well. As you are taking benzodiazepine since long there is dependence but you can reduce/stop either of them slowly. You are better since 6 months on current dose that means you can reduce the dose.

I recommend reducing and stopping clonazepam first and then go for diazepam reduction. You can reduce clonazepam 0.25 mg every 15 days. You should go for 0.75 mg first and likewise reach to 0.25 mg. After taking clonazepam for 0.25 mg for 15 days you can take half of 0.25 mg for 20 days and then stop. By doing such slow reduction you can stop it without problem likely.

When you can stop clonazepam successfully, after 1 month you can go for reduction in diazepam dose.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Chintan Solanki (1 hour later)

Sir Though i m taking clonazepam since 1998 i have no cognitve decline.Even 1 mg clonazepam works for me.Should i increase quetiapin or not? Why?

Answered by Dr. Chintan Solanki (45 minutes later)

Brief Answer:
Cognitive decline is not there always

Detailed Answer:
Hi,

Thanks for follow up.

Cognitive decline is not always there with benzodiazepines. However in elder (age more than 60) it affects cognition more. You are already on diazepam so it is recommended to quit clonazepam. You have taken for almost 18 years without any problem that is good and if you take further for more than 10 years there should not be problems as from my and my seniors' clinical experience but two benzodiazepines together should be avoided when possible.

No need to increase quetiapine as you are stable since 6 months.

Take care.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Chintan Solanki (21 minutes later)

so sir u meant that i should start to reduce 0.25mg of clonazepam from today. so my dose would be 0.75mg clonazepam +15mg diazepam+400mg quetiapin plain for 15 days. after 15 days or 20 days i may gradually reduce clonazepam as per medication plan u suggested. Am i right sir ? any further advice to me for becoming normal in the rest life please.

Answered by Dr. Chintan Solanki (2 hours later)

Brief Answer:
Yes you can start reducing after informing your doctor

Detailed Answer:
Hello,

Yes you can reduce and stop clonazepam as I mentioned. I request you to inform your doctor about this before or soon as treating doctor should be aware about your medicines.

Considering your overall history you should continue one mood stabiliser like quetiapine or lithium for long time/lifetime to maintain stable mental health.

You are welcome if still any query there.

Happy Diwali.

Http://bit.ly/drchintansolanki

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chintan Solanki (12 hours later)

Sir Last night i took clonazepam 0.75mg and i could sleep for 8 hours. How much sleep i reqired at the age of 51 years? I have started the medication plan u suggested.Ofcourse i started to take one cup of warm milk at night.May i try any Aurvaidic medicine? If yes which one?

Answered by Dr. Chintan Solanki (43 minutes later)

Brief Answer:
6-8 hours sleep is adequate

Detailed Answer:
Good morning,

For an adult 6-8 hours sleep per day is adequate. You are getting enough sleep. After retirement sleep requirement reduces. It is good that you slept well with 0.75 mg.

No need for any ayurvedic medicine as you are stable. Just continue milk. You can add 1-2 spoon ghee in milk.

Have a great time.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar