Looking for some advice and input on tapering

Hi,

I've been on 1.5mg alprazolam for 5ish years with a .5mg K booster to keep me asleep through the night.

Prior to that the X was 2mg and K was 5mg gradually getting to the 2 mg before the K was added about 15 years ago.

 

I had a bad K generic experience several months ago, 3 1/2 weeks very little sleep. Ugh

Got some good K and took it for 5 days and slept.

Then, as I only had one month's worth left, I started a taper faster than I knew was generally done hoping I could pull it off. Crap sleep for another 3 weeks. I realized then I was about to crash hard. I went to my doc, he consulted with a friend who has helped people with this before and they suggested leave the K at .5 and taper the X by .25 2 days a week. Sounds fairly reasonable. :/

 

However, first I needed to sleep and it's been an entire month and I think I'm just starting to stablize to my old dosage.

 

I want this done and I also want to sleep and the increasing inability to obtain K is throwing more wrenches into the works.

 

 

(And as I've been thinking about this I remembered that prior to using X to sleep I had been on several courses of benzos and stopped when I was finished, librax, tranzene? and xanax in my 20s/30s... probably a couple of years a piece.)

 

 

There are a couple of things in your post I want to address.

 

First, I think your doctors are correct in having you taper the Xanax first. However, I don't necessary agree with the speed of the taper. Xanax has a much shorter half life than K, so we always suggest tapering the short acting benzo first as it leaves the long acting benzo to help you carry through the other withdrawal. If you taper K first it might leave you with really bad interdose withdrawal on the Xanax.

 

 

I want this done and I also want to sleep and the increasing inability to obtain K is throwing more wrenches into the works.

 

 

That's what everyone wants coming off benzo's, but it might just not be realistic. Most people (especially if you struggled with insomnia before) have huge problems with this. I'm into year 3 now (2 years of tapering and now my first year of recovery) and I'm still not sleeping. But I have accepted the fact that this is temporarily part of my life now and I just deal with it. Sleep will return eventually.

 

Since you're just starting to stabilize now, I think you should give it a couple more weeks before you start tapering again, just see how you feel? You need to give your body enough time to properly recover.

 

I don't know how you feel about tapering the Xanax first?

There are a couple of things in your post I want to address.

 

First, I think your doctors are correct in having you taper the Xanax first. However, I don't necessary agree with the speed of the taper. Xanax has a much shorter half life than K, so we always suggest tapering the short acting benzo first as it leaves the long acting benzo to help you carry through the other withdrawal. If you taper K first it might leave you with really bad interdose withdrawal on the Xanax.

 

 

I want this done and I also want to sleep and the increasing inability to obtain K is throwing more wrenches into the works.

 

 

That's what everyone wants coming off benzo's, but it might just not be realistic. Most people (especially if you struggled with insomnia before) have huge problems with this. I'm into year 3 now (2 years of tapering and now my first year of recovery) and I'm still not sleeping. But I have accepted the fact that this is temporarily part of my life now and I just deal with it. Sleep will return eventually.

 

Since you're just starting to stabilize now, I think you should give it a couple more weeks before you start tapering again, just see how you feel? You need to give your body enough time to properly recover.

 

I don't know how you feel about tapering the Xanax first?

Thank you, jelly baby!

 

I'm alright with tapering the xanax first. My worry about it is the difficulty to find any K. Otherwise, I really like xanax better as it works as a muscle relaxer for me. All these years taking a loading dose at night hasn't served me well.

 

Would you go slower than .25mg twice a week once I'm stable?

That seems maybe doable??

 

The thing with the K is I don't like it, lol. It doesn't relax muscles, though, the longer half life helps prolong sleep.

My other concern is the sleep issues started in my 20s and spend many years managing with Valerian, chamomile, passion flower, hops... I used to have a really nice formulation that didn't stink to high heaven.

Ideally, I'd like to add some of those in while tapering to soften the effects. Gosh, I know this is doable. I also think a few more weeks to level off and get some sleep in and then have ago at it.

 

I do have an appointment with a neurologist (who does sleep disorders) next month and am hoping he'll be someone that can work with me.

For tapering I would stick to our guidelines of 5-10% cuts every two weeks. I would not go faster than that because you've been on these drugs for such a long time.

 

What are the pharmacies saying regarding getting K in stock again? Is it a short term problem?

 

It's interesting you're not getting any muscle relaxing properties from K. I got prescribed K due to severe muscle spasms and it was specifically prescribed for that and it helped tremendously. I guess we all react differently.

For tapering I would stick to our guidelines of 5-10% cuts every two weeks. I would not go faster than that because you've been on these drugs for such a long time.

 

What are the pharmacies saying regarding getting K in stock again? Is it a short term problem?

The pharmacies either have only the Teva brand (which doesn't work, at all, on me) or they're back-ordered with no idea when or if they can get some. This is an ongoing issue and getting tighter month by month.

 

11 pharmacies and multiple calls to see if they had other strengths, brand name, etc...

I finally got a pharmacist at a CVS who checked his manufacturer list and can special order a different generic in a blister pack. The original prescriber has refused to transfer the script. Primary is waiting for records transfer so he can write.

Sorry for the long story. 

 

The taper my doc has suggested is lowering the 1.5x to 1.25 two days a week while maintaining the K dose.

So I take, total combined, 2mg/night and 2 days/week I'll take 1.75mg. Those days will not be consecutive, lol.

That sounds like a little taper, right?

 

Thanks again

 

 

I don't understand the logic behind your doctor's tapering suggestion. The purpose of a taper is for your brain to gradually adapt to a lower dose. If you're going down two random days a week and then going right up again it's like a yo-yo. You're not tapering, you're just skipping doses and updosing. To me it doesn't make sense and most people around here, don't taper like that. But this is your taper and we don't prescribe or tell people what they should do. So whatever you feel comfortable with, we'll support you. 

For tapering I would stick to our guidelines of 5-10% cuts every two weeks. I would not go faster than that because you've been on these drugs for such a long time.

 

What are the pharmacies saying regarding getting K in stock again? Is it a short term problem?

The pharmacies either have only the Teva brand (which doesn't work, at all, on me) or they're back-ordered with no idea when or if they can get some. This is an ongoing issue and getting tighter month by month.

 

11 pharmacies and multiple calls to see if they had other strengths, brand name, etc...

I finally got a pharmacist at a CVS who checked his manufacturer list and can special order a different generic in a blister pack. The original prescriber has refused to transfer the script. Primary is waiting for records transfer so he can write.

Sorry for the long story. 

 

The taper my doc has suggested is lowering the 1.5x to 1.25 two days a week while maintaining the K dose.

So I take, total combined, 2mg/night and 2 days/week I'll take 1.75mg. Those days will not be consecutive, lol.

That sounds like a little taper, right?

 

Thanks again

Well, it's all moot, now. There is no K available but the Teva. Can't take that again.

 

My doc will be In tomorrow. Out of options and no way to taper having 5 pills left. Hmmm...

The only thing left, as far as I can see, is switching the K to Valium. I don't know if he'll do that and don't know if that's available either.

 

 

 

 

Oh gosh I'm sorry. If he can switch both K and Xanax to Valium it might not be a bad option. Do you think you can convince him to only prescribe one benzo?

Oh gosh I'm sorry. If he can switch both K and Xanax to Valium it might not be a bad option. Do you think you can convince him to only prescribe one benzo?

 

I asked that last month. He's a primary and can't get around the state's restrictions. He isn't able to generate a 4mg V dose out of thin air. He might be able to explain away the unavailability of the K for now. I'll see tomorrow.

 

Otherwise, I don't know what happens...

I thought most doctors are not keen to prescribe two benzo's so only prescribing one might look like a better option.

 

I really hope he doesn't just leave you without a K substitute. It's not your fault there's no stock.

 

If all else fails your last resort could be increasing your Xanax dose. K and Xanax have the same conversion so you could substitute K for Xanax but there's a huge difference in half-life. Having a direct switch to Xanax because you ran out K might leave you in lots of pain and you could struggle with interdose withdrawal during your taper but it's still better than nothing and going cold turkey on the K.

 

But once again,  first push for the Valium and see how it goes. Good luck, hoping for the best! 

I think switching to V would be best.

I did try upping the x by .5mg last month. It was a fail as far as getting any sleep but it may be what little I can do to keep the withdrawal sx down some. :/

I really hope he doesn't just leave you without a K substitute. It's not your fault there's no stock.

 

If all else fails your last resort could be increasing your Xanax dose. K and Xanax have the same conversion so you could substitute K for Xanax but there's a huge difference in half-life. Having a direct switch to Xanax because you ran out K might leave you in lots of pain and you could struggle with interdose withdrawal during your taper but it's still better than nothing and going cold turkey on the K.

Update...

Doc said no to the only other K I could find (oral disintegrating) I asked for that or V. They refused on Friady and insist I retry through Teva. Heh, saying it might have been a bad batch.

No other choices! Wanted me to try it for the weekend and call Monday.

 

I filled it, having run out of options.

 

Friday night 11:30 took 1.5 x and. 5 K teva.

At midnight I was speeding, jittery, constant foot tapping...wide awake.

1:30am  Still wired.

Dozed off around 2:00 (very poor sleep) unti 5:10

  Woke and sweating, exhausted and achey, every cell humming, muscle spasms, burning swollen eyes, swollen hand, palpitations, loud ringing in ears, shooting nerve sensations, twtching, shaking, muzzy headed, a little breathless(more like it took too much effort to breathe), headachy...

 

So... 5:30 I chew .25 X and then another .25 swallowed. Waited 45 minutes and took 1/2 dropperful of valerian root. I could feel the edge coming off. Stating to relax a bit.

Did a 45 minute guided meditation.

Fell back to sleep 8:30 and slept 1 hour.

Seems to me I had a reciprocal reaction and an allergic one combined. Oh, Joy. 

 

 

Last night I took one (of the 3 I have left) .5 K from other manufacturer. Slept 1:30-4:10

  then 4:30-10:30

 

There's something very wrong with the Teva, still.

 

I don't know what the doc will do Monday. I am gearing up to CT the .5K if I have no other options. I will up the X .5 or1mg if I do so. I have a little X stock.

 

I'll know for sure Monday morning what I have to do.

 

Can't think of any other options.

Hi Aress

 

I am deeply sorry your doctor is leaving you in this situation. I truly don't understand why though. Could you possibly find another doctor to prescribe?

Hi Aress

 

I am deeply sorry your doctor is leaving you in this situation. I truly don't understand why though. Could you possibly find another doctor to prescribe?

Thanks, it's ok. No, this is my primary and have been trying to find some one else to get this off him for 2 years. I have an appt with a neurologist mid-June. Honestly, I don't believe he'll abandon me. I believe he'll step up when I call him back.

It feels to me like he had to do it this way so it can be documented as such. The state, I'm in, is so restrictive doctors' hands are tied. Most docs in their 50's or older have or are closing their practices. That's a big part of not being able to find a prescriber.

 

Whatever happens next... I've got this.

This is not my first rodeo with the failing/failed medical system. It's just been difficult to find other options (just moved here over a year ago). So don't know what hiding in the nooks and crannies.

 

And jelly baby, thank you.

Needed to tell the story to be able to more easily process. That helped me step more fully into my  power. 'Everything will be fine in the end; if it isn't fine, it isn't the end.' 😉

I absolutely love your empowerment of this situation and refusing to be a victim. You are right, you've got this! It's probably not going to be easy, and it will be tough, but you are stronger than this and it will serve you well. Now and right into the future. It's so wonderful chatting with someone who refuses to let this get the better of them.

 

And you are not alone. You've got this and we've got you!

I absolutely love your empowerment of this situation and refusing to be a victim. You are right, you've got this! It's probably not going to be easy, and it will be tough, but you are stronger than this and it will serve you well. Now and right into the future. It's so wonderful chatting with someone who refuses to let this get the better of them.

 

And you are not alone. You've got this and we've got you!

Thank you for all of that!

I don't do victim well. 😀

Made me tear up. Not so used to others getting me, if ya know what I mean. 💗