Benzodiazepines such as clonazepam have a fast onset of action, high effectiveness rate and low toxicity in overdose, but have drawbacks due to adverse reactions including paradoxical effects, drowsiness, and cognitive impairment. Cognitive impairments can persist for at least 6 months after withdrawal of clonazepam.
It is unclear whether a full recovery of memory functions can occur. Other long-term effects of benzodiazepines include tolerance, dependence and withdrawal syndrome. These occur in about a third of people treated with clonazepam for longer than 4 weeks. In reality, it becomes extremely difficult, if not impossible, to “just stop”.
Oscar stated that he didn’t like the way the drug made him feel and that he’s been trying to stop using it. His doctor told him to just taper down and quit. He can’t. He asked me how low he could go before he could stop altogether.
This is where the story gets sad.
First, a little history. We’ve worked with doctors and their patients by devising a liquid dosage form of clonazepam. We generate a detailed instruction map that shows how the person is to reduce the dose every week. The reduction is usually under 5% each week. At best, this takes about 20 weeks if it is going to be successful.
One of the first people we provided this to was convinced she wanted to stop using the benzodiazepine. Things were going well for about 12 weeks when the woman was faced with a test to take – an important one. Her anxiety level rose and she jumped off the protocol she had been following. Within 24 hours she had undone the progress she had made in kicking her drug habit over the preceding 3 months.
After several weeks of regular dosing, she said she wanted to try again – and her doctor agreed. So, we provided the liquid and the instruction map. This time, she stuck it out, but often found herself staying with a dose for longer than a week. If I recall correctly, it took over nine months to get down to a low enough dose where she could finally quit. We have not heard from her since then. That could mean she was fully successful, or had fallen back into using the drug and decided not to fight it again.
This doesn’t happen to everyone, but it is common enough that we’ve had several people ask us to prepare formulations for them.
One young man showed us that he could get down in dose, but not off the drug, clonazepam. We suggested getting as low as possible, then switching to another benzodiazepine, one that didn’t have as serious a dependency profile – diazepam (Valium), for example. It worked. After about 10 weeks of decreasing doses of clonazepam, the man switched to diazepam and started reducing the amounts – again, by about 5% per week. he was successful.
Oscar was stunned when I told him about this, but left our store determined to talk to his doctor about helping him with a protocol for reducing his doses. He wants to stop, but doesn’t think he can – based on his experience. He’s afraid, but hopeful he will be able to stop. I warned, though, not to try to stop without the direct supervision of a doctor – one interested in helping him quit.
The sad part about this kind of story is that using those dangerous drugs is all too common. Just think, one in three users will probably have very bad results – and might end up so dependent that they will never again have a day without the need for a drug. Some people have said that it is difficult to get off cocaine, but it is practically impossible to get off tranquilizers. The singer, Stevie Nicks has described the hell she lived through while using those prescribed mind-altering drugs.
To see a list of some of the Benzodiazepines and their side effects, click here.