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Suggest Ways To Wean Off Restyl

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Posted on Fri, 9 Jan 2015
Question: Hello Dr.,
i have been taking Restyl 0.5 mg( Alprozolam) for the last 10 - 15 years or more. by and large the dosage remained the same, though on same days( say 5-6 days in a month ) i took 0.75 mg also, when i did not get sleep. it gives me sound sleep, and i have no other side effects. I want to give it up, how one should go about doing it?
I am also taking Revlol 25 / 2.5 x twice a day for my BP for the last few years and Astor 10 mg. just fyi pl
rgds
doctor
Answered by Dr. Seikhoo Bishnoi (25 minutes later)
Brief Answer:
Gradual tapering of doses of Alprazolam to be done to prevent withdrawal

Detailed Answer:
Hello thanks for asking from HCM

You are taking Alprazolam 0.5 mg since last 10-15 years and this dose was giving you sound sleep. Now you want to quit the doses.

Alprazolam is a benzodiazepine drug which is used in control of anxiety. As the drug is short acting so it causes immediate effects and help in sleep. This is the reason of high abuse potential.

In my clinic I usually advise my patients to gradually reduce the doses of drug to prevent withdrawal effects. I advise them to taper the doses about 20-25% every two weeks and then stopping completely at about 6-8 weeks. But you are taking the drug since last 10-15 years so I am afraid it will take longer time. You are also taking low doses so it would not be convenient to reduce the doses accordingly.

To prevent such situation usually a beozodiazepine that is relatively longer acting is replaced with alprazolam. Diazepam is commonly used. The equivalent doses of Diazepam is 10 mg to 0.5 mg Alprazolam. So first of all substitution of Alprazolam will be done with Diazepam in about 2 weeks. Once you would become stabilised on Diazepam then gradual tapering of the doses of this drug will become easier. The doses can be reduced 20-25% each two weeks then and complete stoppage can be done at 6-8 weeks. Consult a psychiatrist for detailed prescription and for deaddiction.

Any change in your regular medications.. especially a circumstance like this where you want to taper an existing medication, must be done under medical supervision to prevent dangerous withdrawal symptoms.

Thanks, Hope this helps you.

If you have more doubts then you can ask again.

Dr. Seikhoo Bishnoi, Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Seikhoo Bishnoi (21 hours later)
Thank you Dr. for answering my question. Now since i have been taking it for several years now, if I continue for more years, will there be any repercussions or problems for me in the long run? So far this medicine Alprazolam has not done any harm to me except i have become dependent on that. I have not had any side effects.
Rgds
doctor
Answered by Dr. Seikhoo Bishnoi (21 minutes later)
Brief Answer:
It may increase risk of cognitive impairment in long term.

Detailed Answer:
Hello again, thanks for follow up

As per my opinion if possible you should consider quitting the drug. Currently you are able to sleep or get relaxed with low doses but in future it may cause tolerance and you may be compelled to increase the doses.

Currently you are 59 years old and chronic use of alprazolam may potentiate memory impairment and other cognitive impairment in future. Over all although the drug is safe to use and you are taking very low doses still theoretically there is risk of increased cognitive impairment.

Also in elderly persons (especially >70 years age) the drug may increase the risk of falls.

So if possible consider quitting the drug. Over all drug is safe to use but still it should not be taken for long term basis.

Thanks, hope this helps you.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5193 Questions

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Suggest Ways To Wean Off Restyl

Brief Answer: Gradual tapering of doses of Alprazolam to be done to prevent withdrawal Detailed Answer: Hello thanks for asking from HCM You are taking Alprazolam 0.5 mg since last 10-15 years and this dose was giving you sound sleep. Now you want to quit the doses. Alprazolam is a benzodiazepine drug which is used in control of anxiety. As the drug is short acting so it causes immediate effects and help in sleep. This is the reason of high abuse potential. In my clinic I usually advise my patients to gradually reduce the doses of drug to prevent withdrawal effects. I advise them to taper the doses about 20-25% every two weeks and then stopping completely at about 6-8 weeks. But you are taking the drug since last 10-15 years so I am afraid it will take longer time. You are also taking low doses so it would not be convenient to reduce the doses accordingly. To prevent such situation usually a beozodiazepine that is relatively longer acting is replaced with alprazolam. Diazepam is commonly used. The equivalent doses of Diazepam is 10 mg to 0.5 mg Alprazolam. So first of all substitution of Alprazolam will be done with Diazepam in about 2 weeks. Once you would become stabilised on Diazepam then gradual tapering of the doses of this drug will become easier. The doses can be reduced 20-25% each two weeks then and complete stoppage can be done at 6-8 weeks. Consult a psychiatrist for detailed prescription and for deaddiction. Any change in your regular medications.. especially a circumstance like this where you want to taper an existing medication, must be done under medical supervision to prevent dangerous withdrawal symptoms. Thanks, Hope this helps you. If you have more doubts then you can ask again. Dr. Seikhoo Bishnoi, Consultant Psychiatrist