Can updosing or holding be harmful?

Hi,

It seems the general consensus here on BB is to listen to what your body tells you, and hold/updose if necessary.

But, how about this concept: External cues modify the behavioral responses of organisms, like Pavlov’s dogs, who would salivate at the mere ringing of a bell after the ringing became associated with being fed.

When we begin to taper, one thing that begins to happen is that our benzodiazepine-gaba receptors begin, and continue to, up-regulate.

So, how does this sound: if we taper slowly enough that we don’t develop really serious symptoms (like seizures or inability to function) should we alter our behavior to adapt, or should we try and make our bodies adapt? By that I mean, should we hold, up-dose, or keep on going? Let’s say we just keep on going (but maybe reduce our rate). By doing this, are we telling our bodies “Nuh-uh, I’m not going to listen to you; you need to adapt to me!” Will our bodies then learn that to maintain homeostasis it has to keep up-regulating? If we up-dose (or possibly even hold) are we giving our bodies mixed-signals, like “Ok, Ok, down-regulate again if you must; I’ll give in.”

Any success stories or opinions on this?

I have a friend who, about 10 years ago, developed chronic undiagnosed neuropathy in her back. She was on high doses of pain medications. Then she saw a hypnotherapist. Over the course of about 2 years, she was able to cut her pain medication by about 2/3. In addition, she was taught various visualizing techniques, such as “glove anesthesia,” where you visualize a “healing glove” and rub it over the pain. It worked, and this is the basis for this post.

The following is from

http://www.benzo.org.uk/ashsupp11.htm

“Reinstatement, updosing

A dilemma faced by some people in the process of benzodiazepine withdrawal, or after withdrawal, is what to do if they have intolerable symptoms which do not lessen after many weeks. If they are still taking benzodiazepines, should they increase the dose? If they have already withdrawn, should they reinstate benzodiazepines and start the withdrawal process again? This is a difficult situation which, like all benzodiazepine problems, depends to some degree on the circumstances and the individual, and there are no hard and fast rules.

Reinstatement after withdrawal? Many benzodiazepine users who find themselves in this position have withdrawn too quickly; some have undergone 'cold turkey'. They think that if they go back on benzodiazepines and start over again on a slower schedule they will be more successful. Unfortunately, things are not so simple. For reasons that are not clear, (but perhaps because the original experience of withdrawal has already sensitised the nervous system and heightened the level of anxiety) the original benzodiazepine dose often does not work the second time round. Some may find that only a higher dose partially alleviates their symptoms, and then they still have to go through a long withdrawal process again, which again may not be symptom-free.

Updosing during withdrawal? Some people hit a "sticky patch" during the course of benzodiazepine withdrawal. In many cases, staying on the same dose for a longer period (not more than a few weeks) before resuming the withdrawal schedule allows them to overcome this obstacle. However, increasing the dose until a longed-for plateau of 'stability' arrives is not a good strategy. The truth is that one never 'stabilises' on a given dose of benzodiazepine. The dose may be stable but withdrawal symptoms are not. It is better to grit one's teeth and continue the withdrawal. True recovery cannot really start until the drug is out of the system.

Pharmacologically, neither reinstating nor updosing is really rational. If withdrawal symptoms are still present, it means that the GABA/benzodiazepine receptors have not fully recovered (see above). Further benzodiazepines cause further down-regulation, strengthen the dependence, prolong withdrawal, delay recovery and may lead to protracted symptoms. In general, the longer the person remains on benzodiazepines the more difficult it is to withdraw. On the whole, anyone who remained benzodiazepine-free, or has remained on the same dose, for a number of weeks or months would be ill-advised to start again or to increase dosage. It would be better to devote the brain to solving individual symptoms and to finding sources of advice and support. Advice about how to deal with individual symptoms is given in the Manual (Chapter 3).”

I think holding can help, small dose corrections are OK also but it is better to try and tease the receptors to up regulate even with token cuts... obviously people on updose when desperate, it all depends but as long as we get back at it slowly that is all that matters I think.

i dont suggest updosing. holding seems fine for people, not me personally, but i can't deny its validity.

i've updosed twice, and both times i've just ended up feeling worse. it built my tolerance really quickly up again, and i have to start from scratch. it's not a good plan. i would definitely look into micro cutting with the scale or holding til youre ready. micro cutting is what im doing now, and im hoping it will achieve results because i dont think my body can take .125 cuts even well. so.

good luck friend. i'll be rooting for you like everyone.

Updosing is a somewhat confusing concept because it means different things to different people, and therefore everyone has a different opinion on it. It also depends on the type of taper you are doing.

IMO "dose corrections" (with a hold) can be very helpful when you are doing a daily taper. I emphasise that this is probably different to what a lot of people would call an "updose". A dose correction is usually a very small amount, maybe no more than what you would have cut on a daily basis over the last week. I’ve done this twice and it has proved to be very beneficial. Sometimes with daily tapers even those tiny cuts can build up, especially if you aren’t attuned to the signals your body could be sending you. However, because generally you’ve only been making tiny cuts, you usually don’t need to correct your dose by very much to feel an improvement.

A larger "updose", when doing a cut and hold taper, could be a bit more problematic, because generally you would be increasing your dose by a larger amount. This may or may not be a good idea. I don't have an opinion on that because I'm not doing a cut and hold taper.

Updosing is a somewhat confusing concept because it means different things to different people, and therefore everyone has a different opinion on it. It also depends on the type of taper you are doing.

 

IMO "dose corrections" (with a hold) can be very helpful when you are doing a daily taper. I emphasise that this is probably different to what a lot of people would call an "updose". A dose correction is usually a very small amount, maybe no more than what you would have cut on a daily basis over the last week. I’ve done this twice and it has proved to be very beneficial. Sometimes with daily tapers even those tiny cuts can build up, especially if you aren’t attuned to the signals your body could be sending you. However, because generally you’ve only been making tiny cuts, you usually don’t need to correct your dose by very much to feel an improvement.

 

A larger "updose", when doing a cut and hold taper, could be a bit more problematic, because generally you would be increasing your dose by a larger amount. This may or may not be a good idea. I don't have an opinion on that because I'm not doing a cut and hold taper.

Oscar,  darkskywaves (great nickname!) and DP, routing for you all and everyone as well! DP, you seem to be doing quite well coming from a dose that is often difficult, so seems whatever you’re doing is working!

Steve