How can I get off my sleeping pills?
Lorazepam (brand name Ativan), clonazepam, temazepam, and zopiclone are drugs historically used to help people sleep.
However, more and more research has come out showing that these pills, when taken for years rather than just a few weeks, can have major impacts on your brain.
In this article, we cover what you need to know about the drugs and what to talk to your healthcare provider about if you want to stop.
How do sleeping pills work?
They work by increasing the “sleep” signals in the brain, acting on what are called your “GABAnergic” neurons in your brainstem.
These neurons usually tell your brain to go to sleep by inhibiting the other neurons in your brain that keep you awake. For more on the neurobiology of sleep, check out this article.
Why are sleeping pills a problem?
Due to natural changes that occur as we get older, our brains become more sensitive to the effects of medications. They can also hang around in our bodies longer than they normally would due to natural changes in our kidneys and liver.
This means that sleeping pills often have MORE effect than intended.
This can lead to a number of problems (falls, motor vehicle accidents, daytime sleepiness), and even problems with your memory.
Studies have shown that people who take these medications are 5x more likely to have memory problems.
Medications can sometimes cause more harm than good.
How can I safely stop this medication?
The following advice applies to people who have been on these pills for many years for sleep or anxiety.
It is important not to stop these medications suddenly, and to talk to your doctor or your pharmacist first.
Stopping suddenly can cause withdrawal symptoms (worsened sleep, anxiety, sweating, or even general flu-like symptoms) because your body has become accustomed to the extra chemicals in your brain.
The good news is that as long as you stop slowly you can avoid most withdrawal symptoms.
It’s also important to talk to a healthcare provider because there are certain situations where you might need to take these pills for a short time, such as during a seizure, alcohol withdrawal, or panic attacks.
Always talk to your doctor or nurse practitioner before stopping any medications.
However, if you’ve been on these pills for many years for sleep or anxiety, and want to come off to protect your brain, here are some tips to review with your healthcare provider:
The longer you have been on the pill, and the higher the dose, the longer it will take to stop. Don’t worry if it takes you 6-12 months!
The goal is to make teeny-tiny changes every 2 weeks, so that your brain doesn’t even notice that a bit of the medication is missing.
If you find your sleep is worse, or you are more anxious, you simply need to go back to the previous dose where you felt fine, wait another 2-4 weeks, then try again at an even smaller dose reduction.
There are two ways to go slow:
Reduce the dose by tiny amounts (for example, you and your healthcare provider could decrease by just a quarter of a pill every week).
Make changes less frequently so your brain has time to adjust (for example, you and your healthcare provider could make changes every 4-6 weeks, instead of every 2 weeks).
Not all doctors know that you need to come off the drug very slowly. Show them this guide that has a suggested tapering program on page 11.
The below image also shows the tapering plan. Slow and steady wins the race - the race to clear your mind. We’re rooting for you!
Created by the researchers of the EMPOWER Trial.
For more on sleep, read:
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