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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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What are the side effects of Diazepam?

Answered by
Dr.
Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Posted on Mon, 6 Jun 2016 in Mental Health
Question: sir I was taking 2 mg clonazepam since 1998 with other midicines like protheidin, mirtaze, nitrazepam, remitex, dicorate er , quetiapine sr ,gabapin and lithium. lithium did not set me and it affected my Thyroid profile badly so i had to stop it. Now i am put on 1 mg clonaepam with 300 mg quetiapine plain and diazepam 10mg for my CYCLONIC BIPOLAR DISORDER AS WELL AS FOR SLEEP DISORDER. Sir i m well with this dose.but sir i came to know that Diazepam caused many side effects like constipation etc. Sir I also want to quit clonazepam.IS Diazepam is banned by government? Please guide me with your advice.
doctor
Answered by Dr. Chintan Solanki 32 minutes later
Brief Answer:
diazepam is not banned by government, quetiapine causes constipation

Detailed Answer:
Hello,

Thanks for writing again.

Diazepam is benzodiazepine drug and it is time tested drug. There is no major side effect. It may cause sedation and one must not use before driving a vehicle or using heavy machinery. In long run (after use of 150 to 20 years) it may cause some cognitive impairment. Constipation is not a side effect of it rather it is very common side effect of quetiapine.

Diazepam is rather an essential drug and available at most of the government hospitals so it cannot be banned. But yes it is a strict prescription drug and it must be used as per doctor's prescription (preferably psychiatrist's prescription)and advise to prevent abuse.

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


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 33 minutes later
Sir XXXX. please tell me should I quit clonazepam 1mg and take Lorazepam 4mg as prescribed? or continue with this dose?quetiapine causes weight gain but my weight is still 70 Kg since 2013 though I have been taking quetiapine 200mg sR and then quetiapine plain 300 mg since January 2016. what amount of quetiapine plain can be taken per day. ? please guide me accordingly and advise me what u think proper and fit.
doctor
Answered by Dr. Chintan Solanki 2 hours later
Brief Answer:
quetiapine 300 mg per day is fine

Detailed Answer:
Hi,

Thanks for questions.

Lorazepam and clonazepam more or less same from effectiveness point of view. main difference is half life. Lorazepam has short half-life and clonazepam has long. 1 mg lorazepam is equivalent to 0.25 mg clonazepam. If you want less frequent dosing and good anti-anxiety effect without sedation clonazepam is better option in long run.

Maximum recommended dose of quetiapine is 800 mg. SR preparation helps to maintain constant drug level in body and avoid side effects of sedation and dizziness otherwise effectiveness of plain and SR preparations are same. Weight gain can be prevented by proper eating habits and exercise. If you are feeling better with 300 mg, you should continue in same dose.

Feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 24 minutes later
THEN SIR ...I SHOULD CONTINUE WITH RECENT DOSAGE I.E. 300MG QUETIAPINE PLAIN+1 MG CLONAZEPAM +10 MG DIAZEPAM AS IT SET ME. PLEASE CONFIRM MY PERCEPTION AND OBLIGE .THANKS A LOT!
doctor
Answered by Dr. Chintan Solanki 3 minutes later
Brief Answer:
yes you got it right

Detailed Answer:
Hello,

Yes you got it absolutely right. If you are stable on these doses you should continue the same for 6 months and later on diazepam can be reduced.

In future if you wish you can contact me directly on this site with following link:
http://bit.ly/drchintansolanki

by clicking on 'Ask me a question' on same page with three follow up questions.

All the best and take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 5 days later
SIR XXXX. AS U KNOW I M TAKING 1MG CLONAZEPAM+10MG DIAZEPAM+300 MG QUETIAPINE PLAIN. FROM LAST 3 DAYS I M TAKING QUETIPINE PLAIN 200MG +100 MG SR WITH SAME DOSE OF CLONAZEPAM AND DIAZEPAM THEN I CAN SLEEP AT 11 P.M. AND WAKE UP AT 5 OR 6 A.M.' SIR WHAT IS DIFFERENCE BETWEEN QUPIN PLAIN AND SR? HOW DO THEY WORK? PLAIN HELPS TO SLEEP WELL WHILE SR CAN NOT? WHY? SHOULD I TAKE PLAIN OR SR SO THAT I CAN SLEEP SOUNDLY? CAN QUPIN BE SUBSTITUTED BY OTHER DRUG LIKE LIMOTRAGINE ? PLEASE GUIDE ME?
doctor
Answered by Dr. Chintan Solanki 1 hour later
Brief Answer:
lamotrigine will not help in sleep

Detailed Answer:
XXXX,

Thanks for follow up.

Plain preparation will release the drug in blood instantly so there will be peak level of drug faster and drug will cause more sedation. In SR preparation drug is released slowly in blood slow there will be no acute peak level and drug will not cause sedation. So if someone wants sedation plain preparation of quetiapine is useful and when sedation is to be avoided SR preparation is used. That is why in your case plain preparation is useful for good sleep.
Lamotrigine can help as mood stabilizer but it will not give sedation so it is better to take quetiapine.


Regards,

Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 35 minutes later
SIR ..WHAT ARE THE SIGNIFICANT SIDE EFFECTS OF 1.QUETIAPINE 2.CLONAZEPAM AND 3. DIAZEPAM. WHAT SHOULD I DO TO PREVENT THESE SIDE EFFECTS? EARLIER WE HAD DISCUSSED ABOUT BECOMING TOLERANT TO CLONAZEPAM AS IT HAS BEEN TAKING SINCE 1998 .THE DOSE OF IT WAS 2MG UPTO JANUARY-2016, NOW IT IS 1MG PER DAY SINCE JANUARY-2016 ON WARDS.AS PER MY DOCTOR,S OPINION I M SUFFERING FROM BIPOLAR DISORDER.BEFORE THIS I WAS TOLD THAT I WAS SUFFERING FROM ANXIETY DISORDER SO INSOMNIA IS THERE.SOMETIME TOLD ME THAT I M SUFFERING FROM DEPRESSION. SIR WHAT IS FACTUAL DIAGNOSIS.?SO FAR IS MY HISTORY IS CONCERNED I AM HAVING BRILLIANT ACADEMIC CAREER. I WAS SELECTED AS CLASS-1 OFFICER BY GPSC IN 1992 AND I HAVE BEEN APPRECIATED BY GOVT. AS WELL AS BY MY SENIORS AND RECENTLY IN OCTOBER-2015 I HAVE BEEN PROMOTTED BY SELECTION TO SUPER CLASS_1 CADRE.AND MAY BE RETIRED IN 2026 IN IAS OR EQUIVELLENT CADRE.HENCE I M WELL WITH ALL MATTERS BUT THIS SLEEP DIS ORDER.PLEASE GIVE ME YOUR COUNCILMEN DETAILED REPLY WITH REASONS OF THIS BIPOLAR DISORDER OR ANXIETY DISORDER OR DEPRESSION AS WHY IT HAPPENED WITH ME? HAVE I BEEN TOLERANT TO CLONAZEPAM SO THAT THE DOCTOR ADD POTENT DRUG DIAZEPAM IN MY DAILY DOSE ?GUIDE ME SIR.
doctor
Answered by Dr. Chintan Solanki 53 minutes later
Brief Answer:
for diagnosis detail history and mental status examination are needed

Detailed Answer:
Hello Sir,

Thanks for asking your doubts.

First of all I want to mentioned that to clarify your diagnosis I need detail history form you as well as from close relatives and mental status examination personally.

Depression can be part of bipolar disorder. However, anxiety and sleep problem can be disorder itself or symptoms of bipolar disorder. Quetiapine is used in all mentioned disorder so it is difficult to say from that also that which disorder you have.

All disorders you mentioned has nothing to do with intelligence. However considering your achievements you should have bipolar disorder type 2.

Common side effects of your medicines:(with % of the patients usually suffer from)

Quetiapine:

Dizziness (1-18%)

Fatigue (3-14%)

Extrapyramidal symptoms (1-13%)

Increased diastolic blood pressure (41%)

Increased triglycerides (8-22%)

Increased total cholesterol (7-18%)

Increased appetite (2-12%)

Constipation (6-11%)

Dry mouth (9-44%)

Headache (7-21)

Somnolence (18-57%)


Clonazepam and diazepam:

Abnormal coordination (5-10%)

Ataxia (5-10%)

Depression (5-10%)

Dizziness (5-10%)

Fatigue (5-10%)

Memory impairment (5-10%)

Upper respiratory infection (5-10%)

Confusion (1-5%)

Dysarthria (1-5%)

Rhinitis (1-5%)

Coughing (1-5%)

Urinary frequency (1-5%)

Impotence (1-5%)

Decreased libido (1-5%).

Clonazepam and diazepam more or less are the same type of drug.

You might have developed tolerance to clonazepam but switching to other drug or reducing the dose may help to fight the tolerance.

Feel free to discuss further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki 35 minutes later
SO NICE OF U SIR. LAST FOLLOW UP QUESTION.
SIR... I HAVE BEEN UNDERGOING ALL NECESSARY MEDICAL CHECK UP REGULARLY. MY BP IS 80-124 ON TMT. MY SUGAR IS 84-120.BOTH ARE NORMAL WITHOUT ANY MEDICATIONS.THOUGH MY THYROID PROFILE , S.CREATINE, LIPID PROFILE, LITHIUM PROFILE, B-12 PROFILE,ARE NORMAL ,MY DOCTOR HAS PRESCRIBED ME TAB.ROZUCOR D 10 TO PREVENT THE EFFECT OF QUPIN ON MY CHOLESTEROL.MY HEIGHT IS 168CM AND WEIGHT IS 69 TO 70 KG. MY BMI IS 24.5.THOUGH I AM TAKING QUPIN 200MG TO 300MG SINCE LAST THREE YEARS THERE IS NO SIGNIFICANT GAIN IN MY WEIGHT BECAUSE I STRICTLY OBSEVE DIETARY CONTROL AND DOING WALKING EXERCISE AS WELL AS PRANAYAMS REGULARLY.I M FACING ONLY FREQUENT URINARY TO SOME EXTENT WHICH IS NEGLIGIBLE.NO OTHER SIDE REPORTED AS MENTIONED IN UR REPLY SIR. IN SHORT IF I WEANS OFF THE PSYCHIATRIC DIS ORDER I AM PHYSICALLY AND MENTALLY FIT DURING MY 50 YEARS LIFE.NOW PLEASE TELL ME SIR WHAT DOSAGE OF QUPIN SHOULD I TAKE SO THAT I MAY QUIT DIAZEPAM AND CLONAZEPAM GRADUALLY. IF QUPIN IS NOT SAFE DRUG ,AND IF IT CAN NOT HELP ME TO BE OUT OF BENZODEPINE GROUP WHICH DRUG CAN SUBSTITUTE QUETIAPINE?PLEASE CLEAR MY DOUBTS?
doctor
Answered by Dr. Chintan Solanki 13 hours later
Brief Answer:
no need of rozucor according to me

Detailed Answer:
Hello,

Sorry for delayed response.

You are physically absolutely fit and seems fit mentally also. You are living healthy lifestyles and considering all parameters there is no need of taking rozucor.

You can increase dose of quetiapine to 400 mg and add zolpidem to stop diazepam and clonazepam. However first of all you should try to reduce dose of clonazepam 0.25 mg every week and after stopping it try to reduce diazepam 2.5 mg every week.

Simultaneously try to follow some measures called 'sleep hygiene' which would help in sleep. You can find the same in below link.

sleepfoundation.org/ask-the-expert/sleep-hygiene

Drinking a cup of warm milk before going to bed helps in 30-40% of patients and they do not need medicines as per my clinical experience.

While reducing dose of benzodiazepine if you feel sleep disturbance you can increase the dose of quetiapine and later on can add zolpidem.

If you can continue healthy lifestyle, you can take quetiapine without any problem.

Hope this answer will help.


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