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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by valene on September 15, 2006, at 8:35:54
Hi all,
I have heard that Trileptal (son of Tegretol) is often helpful for withdrawal symptoms while reducing benzodiazepine dosage.
I mentioned it to my pdoc who is willing to try it but she says that not many studies have been done? Has anyone had a good experience using Trileptal while tapering benzo? An online friend of mine swears that the trileptal really helped take away her w/d symptoms from ativan.
But then you need to slowly taper off trileptal, right? Any advice appreciated!
Val
Posted by valene on September 15, 2006, at 8:40:19
In reply to Trileptal to help taper down xanax, posted by valene on September 15, 2006, at 8:35:54
BTW, I tapered down from 3mg. xanax to 1.5 and now am on 1.75mg. daily. I used the valium taper and got down to 10mg. valium which is equivalent to .5 mg xanax, but with a crisis in my life went back to the xanax only 1/2 the dosage.
I would really like to taper off the xanax and have something else for anxiety. Don't know if it's possible to taper completely; have been on benzos for many years.
Thanks, Val
Posted by SLS on September 15, 2006, at 9:32:14
In reply to Trileptal to help taper down xanax, posted by valene on September 15, 2006, at 8:35:54
> Hi all,
>
> I have heard that Trileptal (son of Tegretol) is often helpful for withdrawal symptoms while reducing benzodiazepine dosage.That is an interesting strategy. I don't doubt that it would work.
Another anticonvulsant to look at would be Depakote. Depakote helps with alcohol withdrawal. Alcohol and benzodiazepines both interact with GABA receptors. I don't know. Looking on Google, I don't see anyone using it that way. Trileptal and Depakote are both sodium channel inhibitors, so there might be something there. Depakote is also more anxiolytic (anti-anxiety) than Trileptal.
After having said all of that about Depakote, it might very well be that Trileptal hits targets that Depakote does not, and is a better drug for benzodiazepine withdrawal.
My personal opinion:
Go with Trileptal. :-)
There have been a few reports of its being used successfully for benzodiazepine withdrawal.
Also, see below.
You can always try Depakote if the Trileptal doesn't help. Don't stop the Trileptal abruptly, though. If you choose to discontinue it, you should taper it, even if the taper is a rapid one. You can cross-taper with Depakote (taper the Trileptal while titrating the Depakote).
- Scott
------------------------------------------------
Pharmacopsychiatry. 2005 Sep;38(5):222-3. Related Articles, Links
Click here to read
Scheme-based benzodiazepine detoxification with oxcarbazepine -- a case report.Croissant B, Grosshans M, Klein O, Diehl A, Mann K.
We attempted to evaluate the tolerability and efficacy of the antiepileptic drug oxcarbazepine in benzodiazepine detoxification, by observing several cases. Detoxification followed a predefined dosage scheme. All patients detoxified with oxcarbazepine completed the withdrawal successfully, without withdrawal symptoms. The administration of oxcarbazepine according to the scheme proved to be tolerable. The dosage was sufficient. Though uncontrolled case observations must be interpreted with caution, oxcarbazepine appears to be a promising drug in inpatient benzodiazepine withdrawal. It should be examined in further randomized placebo-controlled studies including long-term follow-ups.
Publication Types:
* Case Reports
* Letter
PMID: 16189750 [PubMed - indexed for MEDLINE]
Posted by SLS on September 15, 2006, at 10:49:15
In reply to Re: Trileptal to help taper down xanax » valene, posted by SLS on September 15, 2006, at 9:32:14
Forget about Depakote.
Go with Trileptal.
- Scott
--------------------------------------
Drugs Today (Barc). 2004 Jul;40(7):603-19.Anticonvulsant drugs in the treatment of substance withdrawal.
Zullino DF, Khazaal Y, Hattenschwiler J, Borgeat F, Besson J.
Unit for Clinical Research, University Department of Adult Psychiatry, CH-1008 Prilly, Lausanne, Switzerland. Daniele.Zullino@inst.hospvd.ch
Although detoxification cannot, in itself, be considered a treatment for addiction, it is one of the most pivotal phases. In order to facilitate entry into recovery and/or rehabilitation programs, a detoxification treatment has to be experienced as easy and safe by the patient. In consideration of the many inconveniences related to standard withdrawal treatments, there is an interest in developing alternative pharmacological strategies. The main rationales for using anticonvulsants in substance-abuse patients are their lack of addiction potential, evidence support a role of kindling mechanisms in withdrawal syndromes and their efficacy in comorbid psychiatric disorders. The available data currently support the utilization of carbamazepine as a treatment for detoxification from benzodiazepines, alcohol and opiates, and as a useful agent to reduce cocaine consumption. The use of valproate is well corroborated for alcohol detoxification and it seems to be a promising treatment for the reduction of cocaine use; however, it has been found to be ineffective against benzodiazepine withdrawal symptoms. Some preliminary data suggest that lamotrigine could be useful in opiate and cocaine dependence. Gabapentin shows potential as a treatment for cocaine dependence, and some case reports have stimulated interest in this agent for alcohol and benzodiazepine detoxification. Due to its particular pharmacological profile, topiramate is one of the most interesting newer anticonvulsants. It has been found to be efficacious in opiate and possibly benzodiazepine detoxification and also has theoretical potential as a preventive therapy.
Publication Types:
* Review
PMID: 15510234 [PubMed - indexed for MEDLINE]
Posted by Phillipa on September 15, 2006, at 12:20:11
In reply to Re: Trileptal to help taper down xanax, posted by SLS on September 15, 2006, at 10:49:15
Valene what about the famous doc? Love Phillipa
Posted by rjlockhart on September 15, 2006, at 13:59:53
In reply to Trileptal to help taper down xanax, posted by valene on September 15, 2006, at 8:35:54
My stepdad takes Trileptal 600mg for Siezures. It acts on teh GABA receptors similar to the benzodiazepines but it doesnt bring relaxation or that relief. It mainly keeps down the electrical pulse in the brain. When coming off Xanax, i have read people do have some siezuires.
Good luck!
Posted by valene on September 15, 2006, at 16:39:17
In reply to Re: Trileptal to help taper down xanax, posted by Phillipa on September 15, 2006, at 12:20:11
> Valene what about the famous doc? Love Phillipa
I know he is a benzo-friendly doc. and recommends them for people who are very anxious and don't escalate the dosage, etc. no drug seeking or alcohol problems, but Phillipa I am tired of being so dependent on this drug.
I am hoping they come up with an anti-anxiety med taht does not cause dependency. I don't know if I will be able to taper off xanax completely after all these years. I just was so pleased that a friend of mind was able to decrease her ativan and come of it entirely (She was in tolerance w/d) and she was suffering terribly keeping upping the dose with no relief. She said that Trileptal along with neurontin and nortriptyline made the symptoms
quite tolerable.Val
Posted by blueberry on September 15, 2006, at 17:41:15
In reply to Trileptal to help taper down xanax, posted by valene on September 15, 2006, at 8:35:54
I don't know anything about trileptal.
I do know that when I started 500mg depakote extended release I was able to wean from 2mg xanax to zero in about 3 weeks pretty easily.
Posted by yxibow on September 16, 2006, at 0:53:02
In reply to Re: Trileptal to help taper down xanax, posted by rjlockhart on September 15, 2006, at 13:59:53
> My stepdad takes Trileptal 600mg for Siezures. It acts on teh GABA receptors similar to the benzodiazepines but it doesnt bring relaxation or that relief. It mainly keeps down the electrical pulse in the brain. When coming off Xanax, i have read people do have some siezuires.
>
> Good luck!One only has seizures coming off of a benzodiazepine if they have habituated to it and are coming off of it at a medically unsound rate (up to and including "cold turkey".) Seizures are very much more rare unless one has a hidden genetic tendency towards them in the management of withdrawal from benzodiazepines following a rational method of say 10% a week give or take granted the size of tablets available on the market.
But being a short half life medication, one can either make that less of a concern by either consolidating 2x or 4x / day dosing to Xanax XR (the only reason why I think that more expensive patent extender is valid, personally), or more cheaply convert it over to Valium and reduce from it, being 24+ hours in half life.
Posted by bassman on September 16, 2006, at 18:55:46
In reply to Re: Trileptal to help taper down xanax, posted by valene on September 15, 2006, at 8:40:19
I took 4 mg/day Xanax for a number of years and tapered off it just by decreasing the dose very slowly. Don't worry about not being able to go to complete Xanax withdrawal...you can do it, and I know how great I felt about it when I was done. But then I realized what was important was being functional, not seeing if I could be "independent" and get rid of the benzo. I take 0.75 mg Xanax now and never fret about dependence.
Posted by Phillipa on September 16, 2006, at 20:00:18
In reply to Re: Trileptal to help taper down xanax, posted by bassman on September 16, 2006, at 18:55:46
Why should anyone consider it different than being on any other psych med for ever if be? Love Phillipa
This is the end of the thread.
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