7 years of Tranxene (clorazepate) use

Hi everyone,

I have been on Tranxene (Clorazapate) for about 7 years, 50 milligrams every 48 hours.

I have tapered since february and have been off them for a month now, here is the schedule (dates are  day-month-year) I used:

18-2-2021 = 50mg

23-2-2021 = 50mg

28-2-2021 = 50mg

04-3-2021 = 50mg

09-3-2021 = 50mg

14-3-2021 = 50mg

20-3-2021 = 50mg

25-3-2021 = 50mg

30-3-2021 = 50mg

04-4-2021 = 40mg

08-4-2021 = 40mg

13-4-2021 = 40mg

18-4-2021 = 40mg

23-4-2021 = 40mg

29-4-2021 = 40mg

05-5-2021 = 40mg

11-5-2021 = 40mg

16-5-2021 = 40mg

22-5-2021 = 40mg

28-5-2021 = 30mg

03-6-2021 = 30mg

10-6-2021 = 20mg

15-6-2021 = 20mg

21-6-2021 = 20mg

26-6-2021 = 20mg

02-7-2021 = 20mg

06-7-2021 = 20mg

12-7-2021 = 20mg

18-7-2021 = 20mg

24-7-2021 = 20mg

30-7-2021 = 20mg

05-8-2021 = 20mg

11-8-2021 = 20mg

18-8-2021 = 15mg

23-8-2021 = 10mg

29-8-2021 = 10mg

06-9-2021 = 5mg

12-9-2021 = 5mg

17-9-2021 = 5mg

21-9-2021 = 5mg

26-9-2021 = 5mg

I have taken the last one about a month ago and things are becoming (more and more) unmanageable, any comments or constructive criticism? Thanks!

Hi GerryfromDerry,

Congrats on being benzo free!

It's a little hard for me to tell from your tapering dates, but it seems like you may have been speeding up your taper from time to time, especially towards the end. In hindsight, perhaps you would have benefited from going slower and spending more time holding, especially at the lower doses.

Clorazapate has a very long half-life, being a prodrug for desmethyldiazepam (similar in this way to diazepam, i.e. Valium) which has a half-life of up to 200 hours. You may have a slow drug metabolism, and you may be experiencing more of your withdrawal symptoms now than earlier in your taper as the drug is finally being substantially eliminated from your system.

The other factor I suggest considering is that 7-years of use could have taught you some habits of thought and lifestyle that you cannot sustain without more pro-active self-soothing skills. Relying on a benzos long-term appears to cause some buddies to experience a substantial delay before feeling the full brunt of their withdrawal symptom intensity; my theory is that this intensity has something to do with being unprepared to live without the sedative. I suggest exploring self-soothing, down-regulating skills and therapies to get more tools under your belt for how to handle life-stresses without medications.

What are your current symptoms and severity?

Do you have plans to reinstate at a lower initial dose and try a slower taper?

Are you considering non-medication options to better adapt to life without a sedative?

Let us know how we can help. 

If you would have asked me a year ago about my benzo use, I would have said I'd be taking it for the rest of my life, since I never imagined being able to get off them.

However, things had been going so well, that I was actually able to taper and get off them. So the fact I'm feeling so bad right now is only possible because life was (is) very good, does this make sense? I'd like to keep seeing things in this (positive) perspective.

The symptoms seem to go like a yoyo, like a swing, if that makes sense. Some days are very manageable, others are unbearable.

Alcohol is a major factor as well, my benzo usage for the last year has been to get drunk 2 nights in a row and then on the third day, because the (mental) hangovers were so strong, take benzo's and recover, the rest of the days no drinking, repeat once a week.

My background by the way = panic disorder with agoraphobia, but since it's been going so well for the last year, I've been able to travel again and panic attacks were reserved for hangovers only (pretty much).

Other than the Tranxene and the once or twice a week drinking described just now, I am on Zoloft ( Sertrfaline ) 150mg a day.

So yesterday I got drunk because this relaxes me greatly and I needed a "break", but right now I am paying for it.

Insane depersonalization (and derealization to a lesser extent) colours (especially red and blue!) are so bright my eyes hurt, dizziness and vertigo so bad I sometimes need to grab hold of something not to fall over, irritability as in every little thing is noticed and the slightest thing will set me off, for example if i type on my phone and 1 letter is wrong I feel like smashing it against the wall, sleeping problems, muscle tension, the works. I am very very scared of psychosis and or a seizure.

Other than this withdrawal life is great, but seeing the long half-life and the quick rise of symptoms (they started getting serious about 2 months ago) would you suggest getting back on and doing a slower taper?

Suggestions are VERY welcome, new taper schedules even more so, as I will call my doctor tomorrow if I continue feeling like this.

Speaking of my doctor,  he also prescribed me Dipiperone ( Pipamperone ) to cope but I haven't taken any lately since it's REALLY strong but maybe I'll take some today. I really really really hope this is over sooner than later (which is the reason I jumped a month ago, I thought symptoms couldn't get much worse anyway so why not quit now?) so please, anyone, help!!!

EDIT: It got unbearable just now so I took 20mg of Pipamperone and a 5mg capsule of Clorazepate, this is hell

Hi GerryfromDerry,

Thank you for sharing more details with us about your journey.

I personally would be hesitant to combine a benzo updose with a trial of an antipsychotic drug. Just from what I've experienced in my youth (poly-drugged for ADHD and depression) and what I've learned on the forum, taking and adjusting multiple psyche medications can make it quite difficult to determine what drug is causing which symptoms or relief.

Like benzos, I think antipsychotics have a nebulous and perhaps short-lived efficacy for the treatment of mental health disorders. I understand that you are struggling with alcoholism, and also anxiety and agoraphobia. Have you considered reach out for non-medicated support?

I suspect that you might have a history of childhood abuse and/or trauma; in my own journey long-term unexplained anxiety, agorophobia and depression eventually led me back to a lot of repressed memories from decades of emotional and physical abuse. It is an very big job unearthing and healing deep wounds, but I prefer this work over the wack-a-mole madness of trying to keep it all hidden with drugs or distractions. Of course, I honor however you choose to label and handle your own distress.

So it sounds like you've reinstated on 5mg clorazepate and you're trialing 20mg pipamperone; do you want to take these doses daily to see if you can improve your functionality?

A note, long-acting benzos like clorazepate can take a long time to build up to full potency; I'd think at least a week or two, but sometimes much longer. This is because the long-half life causes each dose to layer over the previous for many days, bringing the blood serum levels higher and higher. I expect that an appropriate updose will feel insufficient for many days until this compounding effect of daily doses has had time to accumulate.

Let us know what you're planning to do next, and how we can help. 

Old thread but OP was tapering this drug very wrong.

Sure clorazepate has a long half life,  but it's duration of action is short. It needs to be dosed at least 3 times per day,  especially when one gets into the lower dosage range it should be dosed 6times or even more.

Prazepam is sometimes also available in a liquid solution with 0.75mg per drop(=0.5 diazepam) so there is a way to make a liquid version of it,  contrary to clorazepate.

So basically prazepam is a slightly longer acting version of clorazepate. They are both inactive benzo's that metabolize purely into desmethyldiazepam which is only a partial gaba agonist, they should be easier to taper than diazepam which is why dr ashton does not have a clorazepate/prazepam to diazepam taper in her manual.