Need serious help with Xanax taper

[[Buddie]]

Hi,
I am from Canada, and a senior and suffered with anxiety/panic disorder all my life.
I am currently tapering off of Xanax 0.5mg @ about 8 mg a day, which was prescribed to me 20+yrs ago and am now being forced off them by a new doctor as my old doctor moved  in 2021.(( I seem to be adding up the mg per day I was on and currently on.... wrong, I was going by tablets per day.))  Any one with good math skills needed!
I was suddenly told this past July  that I had to come off the Xanax as my new doctor is telling me they cause dementia in people over 60. I will be 65 soon and have never had any issues with my meds until this recent abrupt change. The doctor reduced my daily script from roughly ,6-8 mg a day down to 2 mg a day in July of this year. He expected me to be at this daily dose by Nov 2022 from July 2022(4 mths) He had forced me into withdrawal and I am not doing very well. He assumes that I should have no withdrawals his way, but I have been on these darn things for 20+ yrs, so yes, I am having withdrawal symptoms .
I came across Heather Ashtons manual by a complete accident and after reading almost the whole manual, I am finding that help with my tapering is near impossible to find here. I am in  phone sessions with a therapist once bi-weekly, but not really finding a lot of actual support with that and not a lot of support from my doctor.
I have managed to lower my daily dose down to about 3.5- 4 mg , spread out through the day , but still experiencing withdrawal symptoms. Shakes, nervousness,jaw clenching,bouts of extreme fear, worse anxiety, panic attacks almost daily, brain zaps,some odd feeling of jitters from a sudden loud noise/noises and light sensitivity which are both new to me, increase in the volume of my tinnitus, along with the worries of failing in my efforts to get my daily dose to almost zero by the doctors instructions of ""no further scripts after Spring 2023''. After a recent conversation with him Nov 8  via phone appointment, I told him that the way he was tapering me would end up failing and causing far too much in withdrawals and my fears of possibly a seizure or worse . I begged him to please taper me slower as Ive obviously been on these meds for far too long and was totally unaware that there could be terrible consequences if I continued. he had also said he was going to change or switch me over to Clonazepam 2 X's a day ( no idea of what dose) which was suppose to start last month but never did as I found out that that was too quick of a switch. I could have had a bad reaction with the sudden change and these withdrawal symptoms were and are still there from the X.
I unfortunately got loud and upset with him. I told him about Dr Ashton and her manual but he never heard of it or Dr Ashton and was going by the medical guides in Canada and the U.S. ( And they are way off plus Ive learned a ton of other information through the benzoinfo site recently). He is pretty much sounding like he has no interest in helping me get through this properly. As of late it sounds to me like he wants to be rid of me since I can't seem to tolerate these horrid withdrawals and cutting back as rapidly as he wants me to. He actually said to me, "that if I didn't like the way he was doing this that I was free to look for another doctor, no hard feelings , he said", and THAT just put me in a state of shock & panic. Going to a new doctor ( if I can find one) would mean starting all over again with this crazy tapering, which this old body would not be able to handle.Yet he still expects me to be down to zero mg of this X by spring 2023, than said he would only prescribe enough to last  6 mths or to about April 2023, but I was to REDUCE my daily by one tablet per month until I was down to 2 or less by then. That would be about 1mg or less a day or 30 mg a month ( if my math is right.) The scripts are as follows...Dec 2022--30 0.5 mg tabs taken 1-2 3x's a day, then 5 a day for the next 30 days ( January 2023), then 4 tabs a day for the next 30 days( February2023 and so on.)
I am trying and its really got my body and my mind in a huge whirlwind. I had to stop in early August with his crazy taper program, and went back to the way I was taking it minus 2 mg a day. So that would have been about 7mg a day. ( still think my math is buggered up )I know that sounds like a lot and it is, but none of my previous doctors bothered me with this, never said a word about withdrawals ,  or the possibility of a seizure,that scared the heck out of me.
But I have managed to reduce my daily dose to approximately 3.5mg-4mg a day since about late Oct 2022. A very slow taper of sorts.This so far has been very hard. I can't believe Ive even made it this far. I read that a slower taper is needed and I will be going in to see the doctor in person rather than these uneventful phone chats. I have some good info sheets that I printed out and am now trying to keep a good daily dose diary. I know all this  is probably the worst way to go about it, but I am so unsure how I should be doing this. The doctor is saying and continues to say that I should have NO withdrawal symptoms at all, but I am.
As of this past week or so, I am remaining on a steady daily dose of the 3.5 mg -4mg daily until I can get this right without having to suffer all these horrid sensations and feelings. My sleep is not too bad but I wake early, around 4 am or 5 a.m. every morning now. I am getting late to bed (12am) and not getting the decent sleep I need. My weight has dropped and I'm not eating as much as I used to although I do need to lose some unwanted weight anyway since covid started. :/
I am trying and doing my best to keep busy. I am still speaking with a therapist but she sometimes just keeps cutting me off when I am trying to get out all this pent up anguish and stress from this whole thing. I have a few meditation apps on my tablet and music that I use to help me relax at night. I hate night time and Christmas has me a nervous wreck as I continue to worry about whats to come in the new year. I am terrified. I dont have anyone to talk to about it and am feeling pretty isolated, even though my husband is here, but he doesnt quite see the problem. he also assumes I can just quit like I did my smoking. I quite smoking about 4 yrs ago now , but I did that without any smoke aids , I just tapered them slow. I counted every cigarette butt in the ash tray each day and removed one a week until the cravings and withdrawals slowed down. Eventually quitting completely. This was done in my own way and I wish to GOD that this doctor would allow me the same privilege with my tapering of the X. ( Sighs) I am hoping I can get this right from someone here. I could use the help. Thank you and sorry for the long drawn post.

[[Buddie]]

I'm so disappointed in your doctor, why does he discount your pain, why is he insisting on torturing you, why is he so callous about your misery, I don't understand!

We know your pain, we understand how horrific this process is and how badly you feel, I'm so very sorry you're in this situation, how can we help?

[[Buddie]]

Hi,

I need a plan, something that will guide me through this tapering without all this horrible withdrawal symptoms. I know there are lot of people here that have gone through this and may be able to help me with this crazy tapering. Its just a matter of getting through to my doctor.
I have NO idea how he will respond to me asking him to go over the info I printed out for him to read about slower tapering and allowing me to lead my way through it as symptoms dictate, I've already had to beg him not to cut me off by the end of last month. I had to literally inform him that the way he wanted to do this was all wrong. I told him that there is others out there that are suffering needlessly, and I said that his way would drive me into a downward spiral. So he would only budge to giving me enough to have 6mg a dayfor Dec. 2022 and then after that I will have to go down one tablet per month, which in essence and rough calculations, at least be about 30mg a month less until spring 2023. I was told this is too fast or rapid. I know it and now I am lost so much right now ,Ive no idea what to do. Can this change hurt me, or  add back a small amount for now and wait and see what he says?
I was told I need to go slower. So does this mean going back to some what of a higher dose..as in close to where i was a few months ago?
Or do i continue as I am now and ride out these horrible feelings and sensations?
Im just a mess right now. And I am scared. Please forgive me if at times I make no sense as Im getting that brain fog that was never there until all this began a few months ago with the new doctor.

Thank you for any help.

presently taking 5.5-6mg daily of X. that I reduced from 8mg daily since 1997.

[[Buddie]]

Okay, lets work on that plan but I'm going to need you to help me by being specific.

What size are your pills and how many times a day do you dose?

What information did you print for him to look at?

[[Buddie]]

Im taking 0.5 mg tablets of X several times daily...., morning i take 1/2  0.5 mg tab, then 2 tabs midday..1 mg,  then 2 tabs ...1 mg, late afternoon,  then 3/4 - 1mg  tablet late evening. Its hard to stabilize on the morning and late evening dose as my withdrawals seem worse then , so i may increase those by a very small amount, like a tiny piece of the shaved edge of a 0.5 mg tablet. So at this point since about Nov 8 2022, im taking approximately 3.5 - 4 mg daily, in spite of the miserable withdrawal symptoms. Its been a jumbled mess actually trying to taper since July of this year. Ive been going down to fast and then having to go back up to a regular dose, so im attempting to keep them steady, dose wise. Very hard doing this the way I am since the doctor said i have no options but to follow his rapid tapering. Its exhausting. I think most will notice this from previous posts. Im just so bloody stressed trying to stick to one regimen. I am now keeping a diary of sorts on how many i take and what time during the day. Its what keeps me going but some days , its overwhelmingly hard,  at my age, sorry for any confusion. :/

Ive printed out the Benzodiazepine Deprescribing Guidance document from the Colorado  Consortium which WS suggested. Ive also the Withdrawing Prescribed Benzodiazepine Patients pamplet from the benzoinfo.com site, which has some clear points for clinicians on deprescribing and withdrawal symptoms better explained. I also found a myriad of info to help me get my points across to the doctor when i see him next week. Another one is from the Benzoreform.org site that has a lot of helpful insight on the withdrawals symptoms,  benzo tapering etc.

I wrote some of my own points on his rapid tapering and the long term effects on my body and brain. I know theres more to learn and understand but this is my * arsenal* so to speak for now. Hes been very non supportive with my pleas for his help by reading something , like the Ashton manual,   and i am worried he may not budge much more . Hes already made that clear last we spoke , but im hoping that this appointment with him in his office will be somehow be  more productive than just phone appointments alone. Hes suggested i see a psychiatrist last time, as well, but im slighlty hesitant about this. 

Trying to be positive,  but its hard.

[[Buddie]]

I'm still in disbelief he's being so cruel, you're not drug seeking, you're not an addict, you're someone who is asking for help, I don't get it.  The information you've printed out is good, I hope he'll read it and treat you like with dignity.

I'm glad you're keeping a journal, this is very important.  Keeping track of your symptom severity and reductions will help guide your taper, if your doctor lets you go at your own speed.  If he doesn't, we'll have to work this out.

I suggest for now getting on a steady dose and you don't seem to be doing that yet.  There is a huge difference between 3.5 and 4 mgs so if you decide to steadily take 3.5 mgs a day, we'd consider that your first reduction.  Its very important to not go back up in dose after a reduction so maybe your first reduction after holding the 3.5 mgs should be around the 5% range to prevent anymore updosing, what do you think?

[[Buddie]]

Hi [...],

Yes  I think this old body can handle the 3.5 mg per day. I mentioned the 3.5 -4 mg as I was having to take an extra piece of one 0.5 mg tab, but a very small piece. Its hard to tell exactly the amount since i don't have a scale or any proper way to truly calculate. I am merely going by the number of the whole tablet and the halves and the quarters. How much would 5% be of the 3.5 mg? I feel very dumb asking. ;/

I am still experiencing the withdrawal symptoms and as i said, mornings and early afternoons seem to be particularly difficult. I do get out and try to keep myself busy as much as I am able. Im also noticing some brain zaps, as Ive read some describe them. They have been coming and going. Also my tinnitus is much louder as of the past few weeks. Another crippling symptom.

I dont know why this doctor is being so hard on me but the doctors in the clinic where I go , are all the same. They must have convinced him that it was his job or duty to get me off these X's asap, who knows. TBH I think I would be better off getting away from there but Ive no one else to help me through this and he's the prescriber. Ive no idea whats to happen next week but right now I am terrified of the whole thing. I know I have to go as I understand that its my health and sanity at stake and I am determined to beat this and I hope I come out of it with very little scars.

Thank you for your help and guidance.

[[Buddie]]

I have a terrible time with math and since I didn't taper so its difficult for me to advise others so I'll usually start like I have with you then ask someone else to step in, hopefully I can find someone for you but we'll give it a shot for now.

I've used this website to figure out percentages. https://www.calculatorsoup.com/calculators/math/percentage.php

We can figure out the percentage but then comes the task of cutting and measuring.  You could cut one of your .5 tablets into quarters and discard one of the quarters, this would give you a reduction of 5% (.175) and your dose would be 3.325 a day.

I'm surprised to hear afternoons are tough for you, typically mornings are the worst, is there anything about your dosing schedule that you feel you could manipulate to improve things?

[[Buddie]]

The calculator is confusing for me too , lol.

Im kind of going by breaking the tabs in half, and then quarters. Ive been having a little trouble during the day, early morning until i take the 1/2 tab, then usually fall asleep because my sleep is messed up. I have no problem getting to sleep, its waking up too early, after only getting 4 hours or so, and just feeling so tired i need to go back to sleep for another hour. Sometimes 1 1/2 hrs, then my day begins. I should mention that i don't always go back to sleep. I pretty much drag my butt out of bed and drag it some more through out the day. 

I will thrn take 2 tabs around noonish, between 11am to 12pm, then my nerves are just wreaking havoc with me, jumpy, anxious bloody bug eyed, kind of feeling. My tinnitus is louder, and has been driving me batty. Muscles tense up  jaw clenching.  I sometimes find myself wondering if this is worth all this suffering,  but i keep going, and read or get out and window shop. 

Manipulate my dose is one thing i have sometimes done.  I may scrape off a small bit from one whole tab so i can keep track of the amount, roughly. I suppose its best to keep track of the amount i ingest since the taper could possibly end up in disaster,  which i really dont want to happen. I am hoping to make it to the end of this and get through this dark, heavy , sickly mess of hell. Im so grim in my explanations so far, my gosh! 

[[Buddie]]

Hi [...],

Yes  I think this old body can handle the 3.5 mg per day. I mentioned the 3.5 -4 mg as I was having to take an extra piece of one 0.5 mg tab, but a very small piece. Its hard to tell exactly the amount since i don't have a scale or any proper way to truly calculate. I am merely going by the number of the whole tablet and the halves and the quarters. How much would 5% be of the 3.5 mg? I feel very dumb asking. ;/

I am still experiencing the withdrawal symptoms and as i said, mornings and early afternoons seem to be particularly difficult. I do get out and try to keep myself busy as much as I am able. Im also noticing some brain zaps, as Ive read some describe them. They have been coming and going. Also my tinnitus is much louder as of the past few weeks. Another crippling symptom.

I dont know why this doctor is being so hard on me but the doctors in the clinic where I go , are all the same. They must have convinced him that it was his job or duty to get me off these X's asap, who knows. TBH I think I would be better off getting away from there but Ive no one else to help me through this and he's the prescriber. Ive no idea whats to happen next week but right now I am terrified of the whole thing. I know I have to go as I understand that its my health and sanity at stake and I am determined to beat this and I hope I come out of it with very little scars.

Thank you for your help and guidance.

Hi [...]

I think the best thing for you to do is to just stabilise as best you can on the 3.5mg right now, and then you can make a reduction somewhere between 5-10% using a symptoms based taper, only reducing again once symptoms from your previous reduction have settled to a tolerable baseline level.

As [...] mentioned in her last post, calculating reductions isn’t exactly her forte, as she never tapered, she c/t’d, and so I just noticed a slight miscalculation (so very easy to do), which is why we only provide taper advice and calculations on the open forum, so mistakes can be spotted by others.

At the moment, while you are reducing by halves or quarters of tablets (one half a 0.5mg tab (0.25) from a total daily dose of 3.5mg is about an 8% reduction, and one quarter of a 0.5mg tab (0.125) from that same total daily dose is about a 4% reduction), I think because you seem to be experiencing considerable withdrawal symptoms, the 4% (quarter tab) reduction seems to be the most sensible taper. You can start out your reductions this way, simply reducing by a quarter, but it’s important to understand that the percentage you are reducing by should be recalculated from each new lower daily dose so the overall reduction percentage never increases as your dose lowers. So I think it only makes sense for you to purchase a precision jewellers scale from Amazon so you can begin calculating your 4 or 5% reductions by the scale weight of the total daily dose of your tablets. This is a much easier way to reduce. If it sounds a little complicated, please know that it isn’t, and we will provide all the information you need to calculate your reductions using the scales as you move forward. Let’s just take one step at a time and begin with a 1/4 tablet reduction once you feel your symptoms have subsided and levelled out enough to allow you to do so. We can sort out the scales as we move forward. I’ll provide you with a link to some scales on Amazon. They aren’t expensive, so don’t be concerned with the price. One step at a time