on your mark... get set...

Hello everyone

i will probably be startin my taper on th 26th of this month and i was wonderin what you guys who have been there feel about some thing.

you may have already read that i  have been very regular on my dose to this point not swaying up or down once in 2 years.

my concerne though is where i am at with my stress and ANXIETY.

in the two and a half years i have had anxiety, its only been about a 3 month period where i felt as if it was leaving me and things were returning to normal.

that ended in mid february and has been severe for the last 30 days.

i manage to work everyday regaurdless but it is really giving me the business just like when i first got sick.

my world has gotten very small and phobias are runnin rampant as well as physiologically if there is a symtom to be had im sure ill have it one time or another and at times i feel theres some more to the problem other than anxiety but my dr says no.

so i guess what im askin is... good time to start or no?

is there really a good time to start or in my situation i think its time to man up because i never felt this cruddy before the benzos and wont be satisfied till i know.

Let's see what Colin has to say.

 

Normally, we do not recommend updosing, but it is important to be stable before beginning your taper. If your anxiety is severe, I wouldn't call that stable.

 

Maybe you need to stabilize at a higher dose of Ativan before crossing over to the Valium.

 

Colin?

It sounds as though you have become tolerent of your dose. Yes, raising your dose is likely to relieve these tolerance withdrawal symptoms, but it will only make things worse in the long run. You will become tolerant of the new dose too - you will have to keep raising your dose.

 

If I understand correctly, you are thinking that if you raise your dose, and feel better, you would be in better position to start your taper - yes? Wrong, I'm afraid! You will still have to taper down through the level that have become tolerant of. There is no way around this. I understand that you feel lousy, but the solution is to get off benzos in a controlled manner. The chances are that you will begin to feel better before your taper is finished, as you will at least be able to think more lucidly. I understand where you are comming from, but you just have to bite the bullet, and go for it. You will get through this!

I was the one wondering about updosing to stabilize before the taper, not Budz.  Thanks for clearing things up! 

Thanx Therse and Colin.

 

2morrow begins what will prove to be an intresting week. i  see my psychiatrist and then my gp on wednesday.

 

i will post the results from my visits and see what you guys think.

 

thanks again for all your support.   

 

KARL

Hi Therese,

 

Stability is important before we start. However, raising our dose to relieve tolerance withdrawal symptoms only increases the dose we must taper from. We may gain short-term relief, but we must still taper on down and through the doasae to which we have become tolerant. The only time I think it is of any benefit is when we make a quick reversal of a cut that was too severe or too soon after our previous cut - a correction rather that an updose!

Ok...

Just got back from a visit with my psych and i dont think I like the plan. But I kinda anticipated that goin in today. She had three months to read the ashton stuff I gave her and she knows my backround and her approach is as follows. Direct taper from ativan of which i take 1 mg a day at a cut of .25 every three weeks. no valium at this point as she feels its more addictive, she also added pamelor or nortrypteline into the equasion. NOt to excited. But my gp who I see on wednesday is the one who commited to my healing. Thoughts?

 

 

KARL

You can taper off the Ativan using titration. You can basically follow the 0.25mg cut every three weeks, but instead of those relatively large cuts, you could instead make frequent tiny cuts that add up to the same figure. How does that sound? It should be far easier to tolerate.

 

I will have to get back to you tomorrow, as it's gone 1am here.

 

Take care.

Hey Colin

 

kinda thought thats what you might say and i think i can roll with that. i have three months of ativan and dont see a problem there. im not to sure about the pamelor. good time/ bad time or not at all? she said it would help with the w/ds and also relieve some nerve pain and depression? before i begin when you have time we need to go over the proceedure of titration for me. not sure what kinda measuring devices are needed and the volumes involved.

thanks again

karl

Yep, one of us will follow up with some instructions.

Budz,

 

I'm sorry about how your doctor visit went. But psychiatrists can be that way. Let's see how your GP reacts before heading into the Ativan taper.

 

I would be sure to ask your GP about anticonvulsants when you go. Did you psychiatrist say anything about that at all?

 

About Pamelor...personally, I would recommend you not take it yet. Ashton says that antidepressants CAN be of help during the taper, but I don't think it's wise to start one at the same time you start a taper. A/Ds can have all kinds of side effects, some of which mimic withdrawal--for instance, they can cause anxiety. So it will be very difficult to see what symptoms are coming from where if you start the Pamelor now. Are you feeling very depressed?

 

And about Valium being more addictive than Ativan...that is plain nonsense.

Hey Therese

 

i totally agree about the valium thing. so yes i am anxious to see how wednesday goes. my anxieties manifest itself in the form of physiological mayhem. normally i am emotionally fine with rare bouts of depression so i dont think im gonna start the pamelor now and possibly at all depending. i think there is a good chance my gp will grant me the opportunity to withdraw shall we say on my terms which would be great. but she also mentioned something along the lines of adding an a/d. and i hate to say it but there is more then one way to skin a cat if she refuses.  i did remind my psych what happened on the .50 taper and that i felt .25 was to much and she would have nothing to do with altering her approach. she felt anti convulsants are not an issue. sooo. thats where that ends for now.

 

thanks again to all of you .

 

KARL

GOOD NEWS

 

My GP kept her word and read the ashton manual and has agreed to go ahead with the valium taper for me. And she had no problem goin on Colins recomendation of .10 every 2 weeks. Wow what a difference from my psychiatrist and my GP. Also my stress test indicated my heart is in very good shape reinforcing the theory that my physiological suffering is due to tolerance w/d. The only difference in her method is that she is incorporating the .10 cut during the switch over process. So the 1mg of ativan equivalent for weeks 1 and 2 will be .5 mg ativan and 4 mg valium. If i am good there weeks 3 and 4 will be 8 mg valium. weeks 5-6 will be 7 mg valium and so forth...

Your input is always appreciated. 

 

KARL

And she had no problem goin on Colins recomendation of .10 every 2 weeks.

 

Not sure where I recommended that! It wasn't in this thread. Bud, can you go into your profile and add a signature with your med details. It makes things easier to follow. I have a very poor memory.

Sorry Colin

 

Think ive been reading to much.

i confused someone elses thread with what you said to me.

 

HI,

 

Just to say, try to get 2mg tablets, as they will allow you to make much smaller cuts!

 

sorry

Hi, Karl,

 

Glad to see your GP was open to Ashton and is switching you to Valium. This really does give you more flexibility than the Ativan.

 

It's a little unfortunate that she is incorporating the first cuts in the crossover process. Your brain has enough to deal with as it switches to Valium without having to deal with a cut. So your crossover may be somewhat rocky. When do you start?

 

I think that 1 mg cuts every two weeks might soon prove to be on the large side, also. That's what Ashton recommends, but it can be very ambitious for most of us. But it sounds like your GP is willing to let you slow down if you're having a hard time. I'm sure you will probably revisit the amount you'll want to taper after you've crossed over.

 

Glad to hear that the stress test turned out well!

Hey Therese

 

When i was in my GP's office waiting, the first thing i saw was the manual in her hands. she told me that she reviewed it and we can use it. She really liked the fact that it is recommended not to go back up if you hit a rough spot but to stay where you are for a bit. So there will be no problem there. She also felt that because of its longer half life that we would step down during the switch over. I made her aware that the switchover can be a little rocky and we will let my response be the judge. I will be monitored closely by seeing her every two weeks and will delay the start of my taper one week so there will be some cusion as well. She is new to this as well but liked what she saw in the ashton manual. She aslo put me on the board for some acupuncture and a visit with the nutritionist. I'm certain that i am in the best care that i can probably find up here. Funny though how my psychiatrist was given the same manual and she only made a vague reference of it one time and that was it. DIRECT TAPER FROM ATIVAN AT .25 EVERY THREE WEEKS. Thanks but no thanks.

 

Karl 

I think that GPs are generally more open to approaches such as Ashton's. It appears that UK doctors are more open to prescribing Valium too. Some American doctors will prescribe Clonazepam for sunstitution purposes, but I think that drug has too many problems associated with it - not just that the pills are far more potent and have a shorter half-life than Valium.

Hey, Budz,

 

I hope I didn't come across as being upset with your GP. Any doctor who listens to her patients and reads the Ashton manual with an open mind is a rarity. So it does sound like you are in good hands.

 

About the crossover...I see her reasoning, but I believe part of the reason to not cut during the crossover is to give the Valium metabolites time to build up in your body. I believe Ashton has taken that into account when figuring out the equivalencies. That's why cutting at this time is not a good idea. If the crossover becomes difficult, you can mention this metabolite thing to your doctor, because it may make more sense to her.

 

I know there was one person on this forum who highly recommended acupuncture to deal with w/d. I hope you have good experiences there. I haven't tried it--too expensive.

 

I agree that your psych had already made up her mind to not have an open mind about benzos. I think psychs are some of the worst when dealing with benzos because they prescribe so darn many of them. That means that if you are right and you are badly dependent, there are many other of their patients who are in the same boat. And they can't accept that.

thank you Therese!

 

I will keep that in mind if I have a problem.

 

Karl

About the crossover...I see her reasoning, but I believe part of the reason to not cut during the crossover is to give the Valium metabolites time to build up in your body. . . . That's why cutting at this time is not a good idea.

 

Yes, it will take far longer for bloodstream concentrations of Valium to reach equilibrium (where we are metobolising Valium at the same rate as we are ingesting Valium). I suspect it will be many weeks.

GO....

 

WOW. 2 doses later and its already on. I had a major anxiety attack yesterday after feeling abit sedated during the crossover and my body has already picked up on that and is letting me know it. I was actually wired after that and didnt get to sleep till 2am. just woke up now its 6 am here and there are a host of undesirable things goin on.  The weather is supposed to be beutiful today and I hope that I can get out of here and go fishing as it is something that holds me together. But this anxious feeling must subside b4 I can evan attempt to get in the car. I really hope this switchover levels out somewhere soon or OH BOY... This is goin to be the most difficult thing I have ever faced in 44 years on this planet. Again, I cant say how thankful I am to find all of you here and for the members who stuck by me In the lounge last night. You are all appreciated more than you know! I HATE BENZOS...

 

KARL

 

http://youtube.com/watch?v=6o31RG4vCGQ

Hi, Budz,

 

When I crossed over from Klonopin to Valium, I crossed over with the recommended amount of Valium (per Ashton) and I had a hard time with that--mainly panic attacks and sleeping problems. So I'm not surprised you're having trouble, seeing as your doctor is also reducing your dose during the crossover.  

 

Therese

Hey Therese and Colin!

 

Well... Its to early to say but so far so good. Its not been fun but it is tolerable. I start the work week here in an hour and this week will say alot. Thanks again for all your support!

 

Karl

A few seem to have a tougher time crossing from Klonopin to Valium - but I don't have good idea of why. At the same time though, Klonopin binds particularly tightly to GABA receptors and it appears that Valium competes to bind with the GABA receptors, so dislodging the Klonopin - this is a good thing. Switching is a bit of a double-edged sword with Klonopin, but Ashton still found it useful for patients to make this switch. So, the switch can be a bit tricky, but should be well worth the effort.