Has anyone in UK come off Nitrazepam?

[Mags1]

Hello, I'm sorry, I wasn't aware my New Members post would appear in the same area as this, otherwise would have made the title clearer.

I've been on Nitrazepam for less than 10 years, was originally taking 2 x 5mg .... and now down to 1 x 5mg and it only gives me one hour's sleep.

I don't take a pill every night, I attempt to sleep naturally ... sometimes I get no sleep, sometimes I get 3 hours sleep, sometimes 5 hours sleep and on a good day, 6 hours sleep.

If I get no sleep or 3 hours sleep or even 5 hours sleep, I will then take a pill to get me through to 9am which is when I get up. I am retired and am now 64.

Has anyone in UK come off Nitrazepam successfully and how did you do it?

Thanks, Mags

[Dickon]

Mags, as you probably know Nitrazepam (Mogadon) is a member of the benzodiazepine family. Therefore any of the threads dealing with quitting benzos will be appropriate.

My cat used benzodiazepines, including nitrazepam, in fairly large doses for a number of years and managed to quit [It would be worth taking a quick look at the rules of Drugs-forum about self-incrimination. Even if the drugs you are taking are legally prescribed, there is a blanked restriction on talking about ones own drug usage...hence the cat]. That said his method was far from optimal, and I think in your case, as you've been using for nearly 10 years (ok, you say less than 10 years, but by that I assume you're talking close to 10 years) you probably should taper down.

Now, as my cat remembers it, the 5mg tabs are the standard nitrazepam pills, so it will be hard to cut those up very much more than in half. It would thus be better to switch to an equivalent dose of diazepam (the equivalence is usually quoted as 1-1, so 5mg nitrazepam will equate to 5mg diazepam). This is available both as 2mg pills, and as a liquid which can be diluted if needed to make gradual dose reductions. Diazepam (Valium) has the added benefit of a long half-life. The half-life of a drug, in case you've not come across the term, is the time it takes for the body to eliminate half of a quantity of a drug from your system. You should be less liable to experience between dose problems as you taper down if you do it this way.

That said, if you manage to go two or three nights in a row without any obvious discomfort (by which I mean, do you find yourself sleeping worse on nights after you've not had a pill for a day or so, or subject to anxiety or any other unpleasant feelings?) you may well be able to stop abruptly, although because benzodiazepine withdrawal can be dangerous it would probably be best to speak to a GP, if you plan to do this.

Let us know a little more about how often you take a pill, and how you feel when you don't take one, and maybe we can give more specific advice. Although, just to be boring and responsible, I should say impersonal guidance on an internet forum is no substitute for seeing a doctor who has access to your medical notes.

One final question. Why do you want to quit the nitrazepam now? I'm not saying you souldn't, in fact you probably should, but I'm just curious as to what has prompted your question.

All best wishes

Dickon

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Helpful and informative

[Dickon]

That's good news. I think sleep comes and goes, and perhaps the more you worry about getting some the harder it becomes. It might be interesting for the hamster to see if he can avoid pills as much as possible until seeing the vet. Even if this might be uncomfortable to some extend, getting an extra pill-free night or two might give a better idea of the task at hand.

Just a thought

Dickon

[Mags1]

"Dickon, what good advice", says this Lady Hamster.

"I've been thinking the same myself, the more one struggles to RELAX .. I MUST RELAX before I go to bed ... I must follow this CD, I must ..... the more one focuses on it.

Those 6 hours were Saturday night, but woke up craving a pill and resisted. The next night, 3 hours, shriek, took a pill, didn't work, took another one, that didn't seem to work or maybe it did, so I totally blew it. But Monday night, another 6 hours, no pill and again, woke up craving one ... ignore it, snuggle down a bit more, then struggle to get up. Will make notes for Lady Vet on Monday.

I will make no swift decisions, visit to Dr will be finding out how they do it at our local Vets ... had been getting a lot of nights with only 3hrs, but two nights (out of 3) of 6 hours is pretty good. It may not continue, so we don't hold our breath ... we toddle off into the garden and hunt for the sun..."

[Dickon]

Just one thing: I would advise against switching to lormetazepam. Although 64 isn't old, the metabolism at that age is probably not the same as mine at just shy of 40, which is not the same as someone half my age, and lormetazepam is not recommended for elderly patients, according to the wiki entry. Aside from this (and the reference given is a study only looking at this one benzo and two of the newer "z-drugs" zopiclone and zolpidem, so it might have little significance), lometrazepam has a shorter half-life, and generally when one is coming off benzos one opts for one with a long half life. The fact that you have been describing a semi-consistent, take pills one night, off pills the next night cycle seems to indicate there's a chance that the nightly pills are "holding you" for 48 hours or so.

If you have a good doctor or vet, that's the place to go! If you're going to live to 90+ it doesn't need to be done tomorrow, but the sooner a plan is put in place the better. The important thing for any plan is that it needs to be compatible with your personality. I had a friend do a slow taper over 18 months off another type of drug, but that was far too slow for me. From the same dose, my cat tapered down in 15 days. His overall taper was about 5 weeks, as cat was rather greedy and had to taper down to get to the same dose, but his psychology necessitated a different strategy from my friend. Neither is "better", as he'd probably not have got on with my cat's approach, and my cat would not have got on with his.

Oh, and let me expound my theory of sleep gravity once again! Withdrawing from certain things, benzodiazepines and opiates in particular, tends to mean bad or no sleep. I've done a week or more of all-but-complete sleep deprivation followed by a week of maybe 10 hours total. I'm guessing at the precise amount, but I'm talking getting to the point of hallucinating from lack of sleep. It is seriously unpleasant, it is beyond unpleasant. However, I believe in "sleep gravity". Every night of poor sleep makes it more and more difficult for the drug withdrawal effects to overcome the ever increasing tiredness. Eventually the body wins, and this is the principle of sleep gravity! Not rocket science exactly, but it's quite a good thing to cling to after the 10th night of little sleep and an exhaustion you can't believe hasn't left you comatose!

If the vet doesn't suggest switching to diazepam and tapering, it would at least be worth asking why, as this is the conventional way to get people off benzos. I'll see if I can get someone who's up on the medical side (she's a doctor, a real one, not like me) to take a look at this thread. But obviously advise given on a forum is no substitute for seeing a doctor who's got your medical records and can ask you questions, observe, etc. and all those other things doctors do!

Be well

Dickon

[yaba]

Only had a quick look at this tread and a friend of mine (yes really) got taken of nitrazepam and put on zopiclone after 20 years or so being on nitrazepam, he isn't happy but coping.

Also if swiy can break the pill taking habit its better then replacing it with another benzo.. It will take time but slowly things will get better !

[Mags1]

"Thank you Dickon and Yaba", says Hamster, '"I -did- zopiclone and zolpidem on the way up, or was that on the way down? Years ago. They didn't work, so that's how I came to be put on something stronger (I think?)

'Tis all a bit on hold until Monday 11th May when I see the Vet. Thanks for the advice about sleep deprivation .. another Mummy Hamster I know has had that for weeks and weeks with her new little baby boy. She's looked awful, but am sure it will improve.

The scary bit is coping with all these withdrawal symptoms when I have no family or partner support and most of my friends have their own problems ... hopefully someone will come out of the hat or the revolving wheel at the right time. Will discuss this all with Vet in the 20 or so minutes I'm allowed...........before 'next animal please'.

[yaba]

Swim done the zolpiclone, zolpidem and the withdrawals aren't as bad as with a normal benzo diazepam, nitrazepam and all the others.

Swims prescription for zopiclone and diazepam not due until the 12th, but he is going to try to not to take them (give diazepam away) or at least 50% of it.

The thing is swim sometimes works nights and needs to sleep at day time and will need his zopiclone or get some zolpidem. What he does is taking to much zopiclone with a drink to "knock" him out. And when the zopiclone is finished he can get zolpidem.. Nitrazepam hard to get as the Doctor doesn't want to give them out anymore and the people who got them wants to keep them.
But mum is on nitrazepam and will post them when asked..

Hope things will get better and hope swiy can abstain from it !!!

All the best

[Jatelka]

I have to say, I think Dickon hit the nail on the head in the second post in this thread, when he advised a conversion to diazepam and gradual taper.

Diazepam is perfect for tapering, because the long half-life/active metabolites mean that there's little rebound, it also comes in a liquid preparation, which means that dose reductions can be achieved in tiny stages (down to 0.125mg), allowing tapering to occur in a manageable fashion

Changing to another intermediate acting benzo, or a short acting hypnotic would be self-defeating in this situation, because of the issue of rebound (and potential for anxiety, with subsequent redosing)

Has Lady Hamster seen this...

http://www.drugs-forum.com/forum/sho...58&postcount=4? It could beasily be adapted to her purposes

When Lady Hamster goes to see the vet, she needs to make sure that she is clear in what she wants. If the vet doesn't want to convert to Diazepam, ask them why. Find out what experience they have with helping Lady Hamsters.

Tapering is something extremely personal, and needs to be taken at an appropriate pace for the individual. A supportive vet will understand that, and work with the Lady Hamster.

[tyranny4u]

TT never meant replacing Nitrazepam and staying wit Lormetazepam,
instead he thought of using Lormetazepam for the night and Diazepam
for the day and slowly withdrawing both.
And one thing according to the Z-drugs:
(also from wikipedia, the zopiclone article")

Zopiclone, a benzodiazepine-like drug was introduced and initially promoted as having less dependence and withdrawal than traditional benzodiazepine drugs. However, zopiclone may have an even greater addictive potential than benzodiazepines and has been described as a "benzodiazepine in disguise". Tolerance to the effects of zopiclone can develop after a few weeks. Long term use should be avoided. Abrupt withdrawal particularly with prolonged and high doses can in severe cases cause seizures and delirium.

[Mags1]

Thanks Yaba, Jatelka and Tyranny4u,

Yes, Jatelka, I have that regime printed off, with my notes to see the Vet ... I do NOT want to go onto Valium, but if this is the most recommended way and my Vet agrees, I will have to seriously get my head round this. Doesn't it cause constipation?!

Last night, I got 5 hours sleep and did NOT crave for a pill. But because of the fear of withdrawal, I thought I'd better take one ... well should have taken a half ... but thought, 'might as well get some sleep' ... well I didn't, so that served me right and damaged my brain further.

Talking of Anxiety, my Anxiety is so high ... there are a number of things I'm not doing or afraid to do and that's not good, so something HAS to happen. To think, in my younger days, I would whizz down the M1 to Kent ... now I'm almost afraid to drive (Vet said I could continue driving) ... but not sure I'll be able to on Valium..? mind's working overtime...

And CAN I do this living alone? What happens if I get the screaming habdabs .... when no-one's there ....?

And I'm Hamster poet too, so I need my good emotions back ...

[yaba]

Don't think diazepam (valium) will cause constipation and driving shouldn't be a problem. It makes some people drowsy and its given to kids in hospitals to calm them down before a operation. So its a "safe" drug but very addictive (so is nitrazepam) but like Jatelka said it can be tapered down in very slow doses.

For swim it doesn't do to much except for relieving anxiety, unless its combined with alcohol (not recommended !!!) and taken in large doses 50mg +

And when your hamster is of it she will have to try and cope with the anxiety's of life or stay on it...

All the best to you !!! And it might take a long time but things will get better.

[Mags1]

Hammy here..... "Yaba, you don't know how much I needed that encouragement today .... hugs..

I've spoken to people at Drugline in my City and people who man/woman the helpline at No-Panic and they all say that I should not have dropped from 10mg to 5mg Nitrazepam without support from my Vet in some form or another. They say that was too great a drop and has probably contributed to the anxiety state. My Vet's advice was taken Citalopram 10mg which is doing nothing at all (mind you, I'm not taking it every day, so that could account for something....)

Someone at No-Panic asked if, in the absence of a local support group, whether there was an online Forum which supports people through benzo withdrawal? I said I'd found a good forum called Drugs-Forum. Now I need a bit of advice, because if I use this thread if/when I do 'go for' withdrawal, it could get rather long ... so could someone advise me on this?

You guys are great ! Appt with Vets approaches and whiskers are twitching ....................... madly..."

[Jatelka]

In terms of documenting Lady Hamsters experience if/when she decides to take the plunge, it would be entirely appropriate to start a new thread, and choose the "journal" prefix

[Mags1]

Ahh...oooh ... oops....it was my pet hamster that was typing the first post. She's been on nitrazepam for all that time and they are prescription drugs from the Vet.

She thanks you immensely.

Her pattern may well be two nights on, one night off or at most, two nights off. On the nights when she takes none, she feels she has achieved something.

It depends on what has happened to her during the day or how she has spent her evening.

And she is currently experiencing a higher level of anxiety, which she has discussed with the Vet. She doesn't plan to stop abruptly.

How often she takes a pill is erratic, one week she took one for 7 days running, that felt really bad and that's not the normal pattern.

She wants to explore quitting and really would like to quit because she doesn't want to be on them when she's 90 (my hamster plans to live longer than many others).

And as one 5mg pill only gives her one hour's sleep, the damage it is doing is probably outweighing the benefits. But if she wakes at 3am or even 5am and knows she's not going off to sleep again, it's the 'what do I do while I wait until 9am without wearing myself out?' And what would happen if she had no pills to fall back on? Would she be permanently awake....

She's looked at the benzo site, it is really helpful and printed some of it off ...

Thanks again, Mags

[tyranny4u]

TT shows full respect to your hamster (must be your age, TT
guesses) !

TT* is talking to your Hamster now:
Well, you still have all the time of the world to get off the Nitrazepam.
Try to get professional help or visit some self-help-groups for addicted
Hamsters, maybe one of them is a place you like. In now way try to force
quitting the habit to fast. In nights where you feel the need for 10 mg,
why not taking 7.5 and try if that is enough?
And, by the way, how cooperative is your Vet? Would he change the
medication into Diazepam or Noctamide? TT considers Noctamid(e) to be
the better sleeping aid than Mogadan (Mogadon). Noctamid(e) is
Lormetazepam, it has mainly hypnotic effects, but poor anxiolytic effects.
And maybe you could have some low dose of Diazepam in the daytime
if necessary.

Talk to your Vet about Noctamid (is quite expensive, if you have to pay
for your meds) and an anxiolytic for the daytime, just for the case in need.

See, Nitrazepam has a quite long half life (time it needs your body to
get "rid of" the substance, this is up to 50 hours. Lormetazepam has
a shorter half life, up to 12 hours. And it is dosaged between 0.5 - 1 mg
2 mg maximum! So the substance keeps not as lonng in your system
and if you manage to sleep 2 days without pills, your "system" is al-
ready clean again.

* What is written in this posting was dictated to the tyrant by his
badger, sitting on the tyrant's shoulder and telling what to write.
So it is not to be considered as medical advice! Just what Badgers
think about Hamsters in that situation.

[Mags1]

Hammy here..

"Thank you TT's Badger. I have an appointment to see my Vet on 11th May and the decision to try and come off waxes and wanes, the fear of coming off is as great as the fear of staying on.

I have no family to help me out here .... self help groups seem to be in the city centre or a drive away and my anxiety is hampering me a bit in terms of accessibility. I was suggested one local counsellor, but I know she's very anti-hamsters, so that won't do. So finding psychological help locally is a priority but proving to be a bit difficult.

I only take 5mg, have cut down from 10mg. Last night, I woke at 3am, so tried a meditation tape and felt myself beginning to fall off but didn't quite succeed it. Was desparate to get some sleep, so took one 5mg and only got half an hours sleep.

The Vet is reasonably ok, but is sometimes a bit rushed as its a teaching practice, her advice was if I woke at 5am, to get up. Now, what would a retired hampster do at 5am..... for the rest of the day? So that wasn't very helpful. She suggested watch TV, I can't stand TV usually, or read.

I've looked up Noctamide and that also appears to need Diazepam to help one withdraw from it ... my knowledge of drugs is rather sketchy and most of my info I've gained from the Internet (I have my own little laptop). I don't have to pay for my meds. But have made a note and will see what she suggests on the 11th.

I didn't realise it was up to 50 hrs for Nitrazepam .... that's dire.

But I believe I must do something, for I am not the hamster I used to be. Not long ago, I was on Atarax for a little skin problem and that was wonderful for giving me 7 hours sleep, so that I needed less Nitrazepam and for a while, the Vet agreed to change the usage of it ... but they've withdrawn that now .... hence the current problems.

But maybe the current problems makes one WANT to do SOMETHING about it ... I feel really nervous....

Thank you from Hammy"

[Mags1]

Hammy slept for 6 hours last night with no pill ... WHY can't every night be like that? But then she was so comfortable, didn't get up til 10am.