Brief Answer:
Dose of Clonazepam should be increased

Detailed Answer:
Hello thanks for asking from HCM for your health related queries

I can understand your concern. Your dad is on alcohol dead diction treatment since last 8 weeks. He is currently taking Haloperidol 0.25, Neocalm, Clonazepam 0.5 and Topiramate 25 mg per day. He is having the symptoms like difficulty in speaking, feeling that throat is jammed, not talking to any one.

Considering the history you have mentioned there are two possibilities for his symptoms-

- One likely possibility is withdrawal effects of alcohol. He is on 0.25 mg of Clonazepam only and is also taking little amount of alcohol. In my opinion this amount can't replenish the alcohol in brain and this has resulted in withdrawal symptoms. A lot of alcoholics show withdrawal in form of restlessness and some individuals also show chocking sensation in throat, dryness of throat and difficulty in speaking. Please talk to his doctor and ask for increased doses of Clonazepam. Increase in dose of Clonazepam would make him relaxed and he would feel better. I'd also advise you to request him to quit alcohol completely. As he is on replacement therapy so alcohol use with these drugs is not beneficial.

- Second possibility though the chances are less, is side effects of the drugs he is taking. He is taking Haloperidol and Trifluperazine both of which can cause dystonia and this may result in chocking sensation in throat, difficulty in swallowing, difficulty in speaking. Though the dose of haloperidol he is taking is less but even such low doses in some individuals can cause dystonia. As his violent episodes are reduced so in my opinion the dose of haloperidol and neocalm can be reduced. He showed violent behaviour due to withdrawal and he is not having any psychotic symptoms so no use of giving these drugs to him. Increased dose of Clonazepam would help in good sleep and relaxation.

Thanks, I hope this helps you. Please don't hesitate to ask again for more doubts. Take care

---

Brief Answer:
Doses of Clonazepam should be increased from 0.5 to at least 1 mg or more

Detailed Answer:
Hello again, thanks for asking a follow up question

I am sorry it was a typing mistake, I read 0.5 only but typed by mistake 0.25 mg. The dose of Clonazepam 0.5 is really less, as he is an alcoholic the doses should be at least 1 mg in evening and doses of 0.25-0.5 mg can be given on PRN (as needed) in day time or even in evening if he develop any restlessness or anxiety. Give the drugs with proper prescription only. Increased doses of Clonazepam would make his relaxed and his symptoms will reduce.

Liver functions tests can be done to rule out any effects of alcohol on liver but deranged liver function doesn't cause the symptoms he is having. His LFT (serum bilirubin, SGOT, SGPT, GGT) should be done. Thiamine deficiency is not the cause of his symptoms so no need to worry, still to remain on safe side give him multivitamin supplements.

Thanks, still have more doubts please ask again. Take care

---