Author Topic: Are You Glad or Sorry You Updosed or Held?  (Read 5926 times)

[Buddie]

Are You Glad or Sorry You Updosed or Held?
« on: April 09, 2014, 09:44:01 pm »
Hi,

As a "newb" to getting off diazepam, I've asked questions re: updosing and holding, and received different opinions. I wonder if we can get a number of people's actual experiences with respect to this, which may help guide others.

Ashton doesn't agree with updosing, and seems kind of equivival about holding. She also says there are no hard and fast rules.

The following paragraph is from:

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

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 If they have already withdrawn, should they reinstate benzodiazepines and start the withdrawal process again?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 Many benzodiazepine users who find themselves in this position have withdrawn too quickly; some have undergone 'cold turkey'.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).



« Last Edit: April 09, 2014, 09:59:04 pm by [Buddie] »
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are you glad or sorry you updosed or held?
« Reply #1 on: April 09, 2014, 10:02:45 pm »
Ashton is crazy.

Grit one's teeth and push on is NOT a good idea unless one is clearly in a bad way in any case.

Small dose corrections have always helped me in the past, holds alone, hmm, sometimes, not always, sometimes a small updose or dose correction has been absolutely necessary for me... otherwise I would not be at the dose I am at now.

There was a post on here by someone who saw an Australian neurologist who said that some can taper benzo's in 1-1.5 years whereas others, sadly, needed as long as 6 years. It was his opinion that we do NOT need to suffer as much as we do and his advice was to make a cut and if one does NOT get stable after 2-3 weeks, to go BACK and hold and try again, he said that sometimes the brain is "just not ready" He also said that, in his opinion, 4 week holds were often necessary and that he did not agree that 1-2 week holds were anywhere near long enough between cuts.

This has probably been the ONE thing I have read on these boards that seemed to me to make sense.

I mean, let's face it, most of us are in a pickle one way or another aren't we?

I suppose none of us want to accept that this can take time... although all the evidence points towards increasing post taper recovery time if we do hurry but that rarely seems to deter some people...

As Tickety Boo said once: Quicker = sicker.

What the neurologist said seemed to me to be pretty bang on as the brain can take time to adapt and we can go slapping time frames on getting stable in between cuts but if we push ahead when the brain is not ready, it WILL complain.

I suppose it is pretty hard to say to anyone that this can take years, OK, many can taper far sooner and be healing well a couple of months off but this is rarely the case for the longer term users...


Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #2 on: April 09, 2014, 10:14:59 pm »
Hey [...],

So glad you replied. I'm hoping this thread receives many, which could then help others. I have seen others make "dose corrections," i.e. very small updoses, and do well. I do wonder about that, that, though, and particularly reinstatment and larger "updosing."

Take care, and best to you and all of us...

[...]
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #3 on: April 09, 2014, 10:30:13 pm »

For me, holding can help, this is a time thing, everyone is different so having a hold of 1-2 weeks, to my mind, is a little too simplistic.

Some heal faster than others, some organizations advise on 3 week holds, Ashton says 1-2 weeks, I say listen to your body and if a cut does not stabilize then hold longer and if still not, go back and do it again or just hold longer as long as symptoms are not worsening.

The golden rule is simply to never cut if highly symptomatic... it's just like pouring gasoline onto an already fierce fire.

Wait it out always... symptoms usually will start to calm down unless one is so ahead of one's own healing in which case it is a bit hard to say what to do really.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #4 on: April 09, 2014, 10:43:32 pm »
The updose finally, after weeks, helped with many of the physical sx's but she now has a new sx, depression.
The updose definately, created a bunch of new and old sx's initially, but gave some relief from the acute sx's.
The depression makes her breathing panics worse.
I still don't know if this is going to go away because it has been coming daily for the past 9 days.
I am holding for a month to see if things get better.
« Last Edit: April 09, 2014, 11:18:48 pm by [Buddie] »
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #5 on: April 09, 2014, 10:58:19 pm »
Tapering for 16 months off klonopin and halcion following horrendous undiagnosed tolerance and spontaneous withdrawals in October 2012.

Still tapering in pain.

Never up dosed once.

Holding provides only relief but its a roller coaster.

This is not fun or easy to me...it has been, so far, the ordeal of my life.

Sorry I can't be brighter.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #6 on: April 09, 2014, 11:24:31 pm »
Great thread....very interested to hear everyone's thoughts and advice. I am at a crossroads right now.

Felt good at 1.15mg held for 12 days, dropped to 1.10mg. Been holding for 18 days and 17 of them have been tough. Did a one time dose correction of 20%, didn't help.

Do I keep holding or go back to 1.15mg, hold, then try again?

One of my concerns, like Mr. mentioned, is up dosing and getting an influx of new sx, and still not really solving my problem. I'll admit, I'm nervous to updose, it's not so much about being stubborn.

I'm hoping this thread takes hold and lots of feedback comes pouring in.

Stevensy and Mr - good to see you guys here

[...] - we meet again

Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #7 on: April 10, 2014, 12:27:01 am »
Caught between a rock and a hard place.     Pretty sure valium is reacting really badly in my system.   Seeing a neurologist for terrible, severe nerve pain in buttock/trunk.  Cannot sit or lay on my butt and it's spreading - i am deteriorating daily.   Realise I will be ill all the way off - and ill after I'm off.   But if paradoxical to valium what can I do?   Not sure any other benzo would be any safer for me - am extremely senstive to many meds.     All I can think to do is to get off fast as is safe to do so.  Ashton taper rates were determined to be the safest against seizure and in the belief that the healing needed to start once off teh drugs.    If taking valium is a breeze then going slow is easy.   One Aussie BB is taking 6 months off taper to go on extended family holiday.    I am way too sick to go on a holiday.   Sitting in the car for doctors appointment is very painful.    I am even thinking C/t might be my only chance.      How shocking that doctors did this to us.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #8 on: April 10, 2014, 12:34:51 am »
I have put in a few very small up doses and several holds all during my taper and have not regretted any of them.  In every case it is just what was needed in my case and in my opinion to keep misery at bay while my brain's healing rate caught up to my cut rate.

I personally think each should do whatever they believe will help when things are rough.  I do not believe in cutting through the pain.

My opinion of course  :smitten:
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.

[Buddie]

Re: Are You Glad or Sorry You Updosed or Held?
« Reply #9 on: April 10, 2014, 12:41:44 am »
Hi [...],
I had updosed my mom 2 times.
The first time was from .68mg v (held for a month) to .86mg v (held for 15 days) to 1.2mg v (holding for a month) in order to get her sx's under control.
Most of the sx's are far better than what they were at .68mg, but she still is a ways from stable where we can go anywhere.
Technically, had she been cutting at 5% every 14 days, she would have been at 1.67mg v today.
This could be why she is not stable enuf yet but I only have enuf to go up to 1.4mg v if I have to.
Also, I dose her 3 times per day now to help with interdose wd's.
I am just gonna hold and hold until things get good enuf to cut.

Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication. Please read our Community Policy Documents board for further information.