I’m thinking about a plan

I am thinking that once I am re-stabilized on .75-1.0 mg X per day in generally 3 doses of .25 mg every 8 hrs:  I would like to suspend 1.0 mg X in 300 ml water, divide into 4 doses every 6 hrs. Then each day remove and discard additional 1 ml. Stay for a day or two if withdrawal is difficult and then press on. Minimum 300 day microtaper. Need input. Question: Does body heal as taper progresses?  Is there personal experience with similar taper approach. I want to do X because my attempted transition to K was so traumatic.

Hi LadyLiberty,

 

It’s doable, but there are certain aspects regarding Xanax and the water suspension that we should discuss. Just focus on stabilisation and we’ll work through this all in good time. I will get back to you!

 

WS

Hi LadyLiberty,

 

3 points to cover -

 

1) Is your practitioner on board with supplying you with 1mg of the medication per day for the duration of the taper?

 

2) Generally it is advised to keep as much of your daily dose in tablet form and just suspend one of your doses from which to taper because there are questions surrounding the bioavailability of the API in a DIY suspension. However, because of the short half life of Xanax, my concern would be, if you taper from just the one suspended dose, at some point you would be end up with 3 doses per day, and does this then create inter-dose withdrawals going from 4 to 3 doses per day?

 

3) Suspending the whole 1mg and splitting in to 4 doses does allow you to evenly disperse the 1mg reduction over the 4 doses, but will the unknown level of bioavailability in this form cause increased withdrawal issues?

 

Not saying it won’t work for you, it’s just that these are a few things to think about. Hopefully someone familiar with both Xanax and using this particular method will chime in soon.

 

WS

Winters sun is correct that the impact of drug manipulation on the bioavailability of the active pharmaceutical ingredient (API) in a regular tablet is unknown.  (In this case, the drug manipulation involves dispersing a solid dosage form — i.e. a tablet — in water to form a do-it-yourself liquid.)

 

Perhaps an even greater concern is that we also do not know the impact of drug manipulation on the accuracy of the dose (or reduction amount) being measured.  Per Richey et al (citation below), manipulating a tablet by dispersing it in water can result in highly variable dosing, especially if the API involved has low solubility in water.

 

For a more in-depth discussion of the above issue with a member who is making a do-it-yourself liquid using regular alprazolam/Xanax tablets:

 

http://www.benzobuddies.org/forum/index.php?topic=269733.msg3387711#msg3387711

 

Citation:

Richey RH, Shah UU, Peak M, et al. Manipulation of drugs to achieve the required dose is intrinsic to paediatric practice but is not supported by guidelines or evidence. BMC Pediatr. 2013;13:81. Published 2013 May 21. doi:10.1186/1471-2431-13-8

 

Well. Looks like there’s no real solid alternative. Thanks Big Pharma. The problem not ever the cure. But as interesting as it is to consider API and equal suspension and solutions and alcohol vs water. Are there any more reliable methods?  For all of the possible problems with my plan is there a better solution I should consider? 

 

I don’t have a commitment from any doctor yet. But I have to see. If no one will help me I’ll just end up dying or in hell anyway. So I have to think there’s a solution. So I’m thinking ahead and hoping so far.

Oh yeah. Has anyone talked about simply extending time between doses over a long period of time. I can see the interpose issues but if I were to take .25 mg tablets in half so 8 doses a day, every 3 hrs, the every 3hrs and 5 minutes, then 3hrs 10 min etc etc. Just thinking out loud.

Oh yeah. Has anyone talked about simply extending time between doses over a long period of time. I can see the interpose issues but if I were to take .25 mg tablets in half so 8 doses a day, every 3 hrs, the every 3hrs and 5 minutes, then 3hrs 10 min etc etc. Just thinking out loud.

 

This sounds labor intensive and a terrible disruption to your sleep, have you considered using the liquid version of Xanax (Alprazolam)?  https://dailymed.nlm.nih.gov/dailymed/

Hi LadyLiberty,

 

It isn’t our intention to dismiss any one taper method, simply to provide you with the information to make the most informed decision possible. Please don’t feel defeated, there is always a way forward, we just have to find your way forward. Which taper method you use will often come down to whether you have a benzo wise doctor on board who is open to the various taper methods. As Pamster mentioned, would your doctor be open to prescribing you the liquid version of Xanax along side your tablets? You would make your reductions from the liquid Xanax.

 

I don’t know if you’ve read the stickies at the top of these titration threads, however, here’s a link

 

http://www.benzobuddies.org/forum/index.php?topic=231363.msg2969123#msg2969123

 

Please don’t feel disheartened, Lady, we’ll work through this. I think it’s important to take a look at all the options and then see where your practitioner stands in relation to these options. Once we know that, we’ll know which options you have to work with.

 

Chin up!

 

WS

We’ll I’ve given up thinking that any md has much clue around here. They all claim to but when I make Appt and meet them they are clueless.  Psychs are worse and addiction docs are worse than that. Everyone wants to throw me in a tank. Even had a crisis counselor yell at me and tell me I didn’t want help if I didn’t do what she wanted. So there’s an answer. I want to do this myself.  Liquid X isn’t available here.

Ok!

 

So that moves us forward…

 

Please know that you’re not the only one in that boat, regarding the inadequacies and lack of knowledge around the de-prescribing of medications they have no problem with prescribing. Believe me, it’s a battle with arrogance and ignorance every time I visit the doctor, and yes, even the hospital psychs are no more knowledgeable. It’s very frustrating when you know so much more than they do about tapering safely.

 

I don’t have any experience with tapering Xanax, so hopefully we can get some feedback from those who do, or those who are in the midst of their taper.

 

It may be worthwhile checking out this following link to get some feedback from others tapering Xanax while we work towards figuring out your best option/options.

 

The Xanax Club

 

Just remain patient and continue to work towards your stabilisation. It’ll all come together in good time!