Clorazepate 89that the older a male was, the longer the same metabolite from a dose lasted,
but that effect was not seen in women.
Although clorazepate dipotassium is used against anxiety, the drug is gen-
erally considered unsuitable for depressed or psychotic persons. It has none-
theless been given with success for treating depression (even though
sometimes the drug can instead worsen that condition). The drug has helped
reduce nightmares caused by other pharmaceuticals and has helped alleviate
psychosomatic complaints. It has also been used against tetanus.
Drawbacks.People with severe breathing trouble or acute narrow-angle
glaucoma should avoid clorazepate dipotassium. Loosening of the nails has
been attributed to the drug in a case report, but that is unusual. Somewhat
less surprising is a case report of jaundice, less surprising because many drugs
add a burden to the liver. Oral overdose can provoke rage.
The drug routinely makes people sleepy, and users are cautioned against
operating dangerous machinery. In experiments the drug increases reaction
time and decreases attention. Nonetheless, a laboratory simulation of driving
showed no effect on operating a motor vehicle. One authority contends that
the substance should not impair driving performance but acknowledges that
trouble arises if a driver does not use the drug as medically directed or uses
alcohol simultaneously. Other unwanted effects occur less often: peevishness,
headache, stomach irritation, dry mouth, rashes, double vision, and unclear
speech. Therapeutic advantage sometimes comes from the drowsiness factor,
with patients instructed to take the drug at bedtime to help reduce insomnia,
a technique that then also allows them to obtain the long-lasting antianxiety
effect during daytime hours the next day. In one study people reported more
restful sleep, and measurements after they awoke showed little drug impact
on performance tests (illustrating the difference a few hours can make on how
well someone performs after taking a substance).
Abuse factors.If usage continues for a long time and suddenly stops, a
withdrawal syndrome can occur. Withdrawal symptoms can include trouble
with sleeping and memory, jitteriness and crankiness, sore muscles, and loose
bowels. Those discomforts are similar to what happens in alcohol or barbi-
turate withdrawal. Researchers suspect the problem may be worsened if a
person has taken some other benzodiazepine class drug off and on. The with-
drawal problem may be avoided by gradual discontinuation of clorazepate
dipotassium. Experiments with dogs and rabbits also show withdrawal symp-
toms. A canine test demonstrated that abrupt clorazepate dipotassium with-
drawal can cause fatal seizures. The kinds of well-documented dependence
mentioned above involve relatively brief withdrawal. Reportedly human with-
drawal symptoms may continue for months, which is an unusual persistence
of dependence. Long-term signs of withdrawal, however, are described as
reappearance of anxiety, sometimes accompanied by psychosis and convul-
sions. Such long-term “withdrawal symptoms” sound much like conditions
for which the drug is prescribed, raising a question of whether the victim is
experiencing long-term dependence or simply reemergence of conditions for-
merly controlled by the now-absent drug.
A group of recreational drug abusers was tested to determine their likings,