Tapering while in severe tolerance, advice needed

Can't make it will have to updose.  The anxiety is so severe and insomnia so bad I will have to quit my job to continue.  Walk away from a $175K/yr career.  I don't know what happened.  I crossed from .375mg Klonopin to 10mg Valium but tapered down to 7.5 over a few days which should have been an exact match for .375 KPin.  Each day is getting worse.  I'm not stabilizing on that dose.  I have been in CBT for a year and none of those skills are helping me cope.  I stopped taking my 5mg of Ambien I had been doing for several years when I started the Valium as I was sleeping OK.  Maybe that is part of the problem...but read all the stuff on "no Ambien during taper."

My body aches and muscle pains went down 75% with Valium but my psychological symptoms are the worse they have ever been in my life.  It's like I can feel my body trying to heal but my mind is going fast.

Any advice on how much to updose?  I can't get a Dr appt until the 26th of January, the guy is out of the country.  I will be dead by then if this continues.  I'll try updosing once and if it fails I guess I'm screwed. 

I innocently raised my hand and called out for help with my lifetime of anxiety and insomnia.  Now I feel like I am dying.

If I could just sleep....I would have a shot.

I think we have to work out the difference between "tolerance" and "withdrawal". In a lot of cases what people keep calling tolerance is really just withdrawal symptoms. I believe Need2Heal was never in "tolerance". All this has been brought about by reducing his dose too quickly. So what to do now? Seeing as you still haven't stabilised I really think you will probably just have to take a punt on updosing, but how much should you updose to? That's the $64,000 question.

Are you still on 7mg? Maybe try going back to 10mg and see what happens, but please don't give up straight away. It does take a while for the increase of valium to work, and you may have to slowly increase that dose to see at what point you do start to feel a bit better.

I don't know a lot about Ambien, but it is called a "Z drug" and has virtually the same effect as a benzo. Sometimes you do just have to resort to using other medications to help during withdrawal though. A lot of people find benefits from using low dose antidepressants, as some of them can be sedating in the low doses. Also some people find benefits from using an OTC antihistamine called doxylamine which is also very sedating.

I personally used doxylamine and a low dose amitriptyline AD on and off throughout my taper to help with insomnia, which was always my worst side effect.

Today I pulled out every Rx bottle since starting Xanax April 24th.  I checked the dates of every refill/new Rx and counted remaining tablets.  Highest dose of Xanax reached was in the Jun-Jul timeframe at 1.5MG/day but only for about 3 weeks.  From Aug 13th - Oct 3rd I worked down to .75 and switched to Klonopin .75.  Easy switch, did it in one day and felt better.  From there I worked down to .375 crossing to Valium 7.5 on Nov 19th.    (I was on 10 MG Valium for a few days at first to ease some severe muscle tension). I updated my profile.  Bottom line is I have been on a 7.5 MG (or equiv) does of this poison since late October.  I almost immediately got the feeling back in my hands and feet and some other things resolved starting Valium.  I was actually able to ride my bike for 4 miles this week.  I couldn't walk beyond the mailbox most of the summer.  I couldn't even mow my lawn.  But, now the anxiety has heightened and insomnia and tinnitus are returning...the reasons I went on this shit in the first place. 

I started getting all the strange neurologic symptoms while on the highest dose of Xanax in July.  I thought it was due to other physical problems and didn't start to complain to Drs until Sep...it wasn't until early Nov that I knew there was nothing wrong with me...it had to be the pills.  I also think that Valium is just not as potent as the others.  This dose range is a just a huge sticking point.  When I tried to go from .375 Kpin to .25 for a week I felt pretty bad and had to go back to .375.  My gut says to hold at 7 MG awhile longer and not go backwards.  I also think these meds all have differing side effects even though they all target GABA.

Talked to Pdoc today.  He says HOLD and see if the sx's will reduce some and then we will make smaller cuts.  Does not advocate micro tapering in my situation yet.  Wants me to hold and see if things will settle down a bit and then continue the taper with smaller cuts.

I was hoping he would updose me...he says it will simply deepen the dependance and prolong the suffering.

I'm not sure why your doctor would say not to microtaper "in your circumstances". What does that even mean?

Your dose is under 10mg right? IMO that is the perfect time to consider a daily taper (or microtaper if you prefer). I have no idea what difference it would make to your doctor anyway. You need to taper the way you feel is right for you.

If you decide you want to daily taper, then you daily taper. Your doctor doesn't even need to know you are doing it, because you can make your own titration liquid with your tablets. If you decide you want to cut and hold, then that's fine too, but ultimately how your taper is YOUR decision, not your doctor's.

Hey Diaz-Pam

The guy is an addiction specialist with 32 years experience.  From our phone call I think he is of the mindset that trying to micro-taper in this much agony is really going to prolong the suffering.  I think he believes in going at a sensible rate while at the same time getting folks off in a reasonable time period.  He claims that very few patients have trouble with the 10% every 2 week method, those who can't are a small minority.  I can certainly micro-taper...Ive got the graduated cylinder, syringe and the whole milk ready to roll.

My fear is that I'm really suffering and I dont think I could make it through such a long taper with this level of pain.  If I was having just a few managable symptoms I would be all in on the slow go. 

The reason you are suffering is because you've brought your dose down too quickly. Before you start doing any cuts at all you need to stabilise first, and there's really no telling how long that will take, because your body has a lot of catching up to do. 

He may well be right that a minority of people can (edit - originally had "can't") cope with the 10% cuts, but I would say that the majority of people on BB can't cope with 10% cuts. The problem is that getting off a benzo quicker does not mean you will feel better quicker. You may just end up extending the amount of time you feel like crap.

Need2Heal, if you're in tolerance (or "relative") withdrawal, I think your doctor is right.

Here's what Colin (owner of BenzoBuddies) wrote about tolerance/relative withdrawal:

If you are unfortunate enough to develop Relative Withdrawal symptoms, you will not gain relief through stabilising your dose. If you experience withdrawal symptoms before starting your taper - that is to say, Relative Withdrawal symptoms - all you can do is withdraw at a sensible taper rate. If once you have started your taper you then develop withdrawal symptoms, it can be difficult to determine if you are suffering withdrawal symptoms because your withdrawal is too rapid, or if it is the result of developing Relative Withdrawal. If you experience no relief after stabilising your dose for some time, you have probably developed Relative Withdrawal symptoms. In this unfortunate situation, all you can do is continue to taper off at a reasonable and tolerable rate.

Tolerance withdrawal may be rare, but it does happen. It happened to me and it's happened to a number of others on the forum since I've been here. It's a bad situation that micro-tapering, unfortunately, can make worse.

Need2Heal, if you're in tolerance (or "relative") withdrawal, I think your doctor is right.

 

Here's what Colin (owner of BenzoBuddies) wrote about tolerance/relative withdrawal:

 

If you are unfortunate enough to develop Relative Withdrawal symptoms, you will not gain relief through stabilising your dose. If you experience withdrawal symptoms before starting your taper - that is to say, Relative Withdrawal symptoms - all you can do is withdraw at a sensible taper rate. If once you have started your taper you then develop withdrawal symptoms, it can be difficult to determine if you are suffering withdrawal symptoms because your withdrawal is too rapid, or if it is the result of developing Relative Withdrawal. If you experience no relief after stabilising your dose for some time, you have probably developed Relative Withdrawal symptoms. In this unfortunate situation, all you can do is continue to taper off at a reasonable and tolerable rate.

 

Tolerance withdrawal may be rare, but it does happen. It happened to me and it's happened to a number of others on the forum since I've been here. It's a bad situation that micro-tapering, unfortunately, can make worse.

Are you saying that Need will be better off using step cuts?

Need2Heal, if you're in tolerance (or "relative") withdrawal, I think your doctor is right.

 

Here's what Colin (owner of BenzoBuddies) wrote about tolerance/relative withdrawal:

 

If you are unfortunate enough to develop Relative Withdrawal symptoms, you will not gain relief through stabilising your dose. If you experience withdrawal symptoms before starting your taper - that is to say, Relative Withdrawal symptoms - all you can do is withdraw at a sensible taper rate. If once you have started your taper you then develop withdrawal symptoms, it can be difficult to determine if you are suffering withdrawal symptoms because your withdrawal is too rapid, or if it is the result of developing Relative Withdrawal. If you experience no relief after stabilising your dose for some time, you have probably developed Relative Withdrawal symptoms. In this unfortunate situation, all you can do is continue to taper off at a reasonable and tolerable rate.

 

Tolerance withdrawal may be rare, but it does happen. It happened to me and it's happened to a number of others on the forum since I've been here. It's a bad situation that micro-tapering, unfortunately, can make worse.

 

Are you saying that Need will be better off using step cuts?

Sorry I wasn't clear. No, I'm not saying that.

I posted because I feel worried when I see someone in severe tolerance withdrawal who's advised to updose or taper more slowly. While that may be good advice for most people, it can be bad for people who are experiencing severe withdrawal symptoms while on a full dosage. That's my experience and what I've seen from others on the forum, at any rate.

I understand that a taper can be accomplished by reducing daily, but not necessarily more slowly. If that's what you mean by step-cuts, then yeah, that might be a feasible option for someone in tolerance withdrawal. It wouldn't have helped me, I don't think, as I felt better as I got lower in dosage with 0.5mg weekly cuts, but I also had a paradoxical reaction, so it's hard to sort out what's what.

Need2Heal, if you're in tolerance (or "relative") withdrawal, I think your doctor is right.

 

Here's what Colin (owner of BenzoBuddies) wrote about tolerance/relative withdrawal:

 

If you are unfortunate enough to develop Relative Withdrawal symptoms, you will not gain relief through stabilising your dose. If you experience withdrawal symptoms before starting your taper - that is to say, Relative Withdrawal symptoms - all you can do is withdraw at a sensible taper rate. If once you have started your taper you then develop withdrawal symptoms, it can be difficult to determine if you are suffering withdrawal symptoms because your withdrawal is too rapid, or if it is the result of developing Relative Withdrawal. If you experience no relief after stabilising your dose for some time, you have probably developed Relative Withdrawal symptoms. In this unfortunate situation, all you can do is continue to taper off at a reasonable and tolerable rate.

 

Tolerance withdrawal may be rare, but it does happen. It happened to me and it's happened to a number of others on the forum since I've been here. It's a bad situation that micro-tapering, unfortunately, can make worse.

 

Are you saying that Need will be better off using step cuts?

 

Sorry I wasn't clear. No, I'm not saying that.

 

I posted because I feel worried when I see someone in severe tolerance withdrawal who's advised to updose or taper more slowly. While that may be good advice for most people, it can be bad for people who are experiencing severe withdrawal symptoms while on a full dosage. That's my experience and what I've seen from others on the forum, at any rate.

 

I understand that a taper can be accomplished by reducing daily, but not necessarily more slowly. If that's what you mean by step-cuts, then yeah, that might be a feasible option for someone in tolerance withdrawal. It wouldn't have helped me, I don't think, as I felt better as I got lower in dosage with 0.5mg weekly cuts, but I also had a paradoxical reaction, so it's hard to sort out what's what.

Agree. Some plans do not work for others. The fact that I was sick for years in tol wd prior to tapering and never could stabilize drove me to cut weekly no matter what. It was the only way off this poison. This does not work for everyone but in severe cases it's the only option. Bc there was no stabilizing for me so it was get off with a reasonable taper....this reasonable taper is coming up on a yr now and I had severe syx all the way. Although, I couldn't work and have been pretty much bedridden, I cont my taper regardless.

G 

Agree. Some plans do not work for others. The fact that I was sick for years in tol wd prior to tapering and never could stabilize drove me to cut weekly no matter what. It was the only way off this poison. This does not work for everyone but in severe cases it's the only option. Bc there was no stabilizing for me so it was get off with a reasonable taper....this reasonable taper is coming up on a yr now and I had severe syx all the way. Although, I couldn't work and have been pretty much bedridden, I cont my taper regardless.

 

G

Yes, me, too. I was in tolerance withdrawal for years. Then I up-dosed and started to have a paradoxical reaction. Ugh! If I'd waited for "stabilization" or for my symptoms to subside, I'd still be waiting (and suffering).

So, I did what you're doing. I finally decided to cut every week, regardless of symptoms. My only regret is that I didn't do it sooner.

I feel especially bad for anyone in this tolerance-withdrawal predicament. It's so difficult. But it gets better--really! I felt better as I got lower, and jumping was pretty much a non-event (much to my surprise).

Need2Heal, if you're in tolerance (or "relative") withdrawal, I think your doctor is right.

 

Here's what Colin (owner of BenzoBuddies) wrote about tolerance/relative withdrawal:

 

If you are unfortunate enough to develop Relative Withdrawal symptoms, you will not gain relief through stabilising your dose. If you experience withdrawal symptoms before starting your taper - that is to say, Relative Withdrawal symptoms - all you can do is withdraw at a sensible taper rate. If once you have started your taper you then develop withdrawal symptoms, it can be difficult to determine if you are suffering withdrawal symptoms because your withdrawal is too rapid, or if it is the result of developing Relative Withdrawal. If you experience no relief after stabilising your dose for some time, you have probably developed Relative Withdrawal symptoms. In this unfortunate situation, all you can do is continue to taper off at a reasonable and tolerable rate.

 

Tolerance withdrawal may be rare, but it does happen. It happened to me and it's happened to a number of others on the forum since I've been here. It's a bad situation that micro-tapering, unfortunately, can make worse.

 

Are you saying that Need will be better off using step cuts?

 

Sorry I wasn't clear. No, I'm not saying that.

 

I posted because I feel worried when I see someone in severe tolerance withdrawal who's advised to updose or taper more slowly. While that may be good advice for most people, it can be bad for people who are experiencing severe withdrawal symptoms while on a full dosage. That's my experience and what I've seen from others on the forum, at any rate.

 

I understand that a taper can be accomplished by reducing daily, but not necessarily more slowly. If that's what you mean by step-cuts, then yeah, that might be a feasible option for someone in tolerance withdrawal. It wouldn't have helped me, I don't think, as I felt better as I got lower in dosage with 0.5mg weekly cuts, but I also had a paradoxical reaction, so it's hard to sort out what's what.

 

Agree. Some plans do not work for others. The fact that I was sick for years in tol wd prior to tapering and never could stabilize drove me to cut weekly no matter what. It was the only way off this poison. This does not work for everyone but in severe cases it's the only option. Bc there was no stabilizing for me so it was get off with a reasonable taper....this reasonable taper is coming up on a yr now and I had severe syx all the way. Although, I couldn't work and have been pretty much bedridden, I cont my taper regardless.

 

G

I agree with you, some plans don't work for others. I was years in tolerance not knowing what was wrong with me.  I never stabilised, i was bedridden and symptomatic pretty much all the way.  Like the The Grinch it drove me to stick with my plan of 10% every 2 weeks and keep moving forward.

I did cut less at the low doses 5% every 2 weeks until i was free. Whatever works for you , we are all different.

It does get better, hang in there Need! and do what you feel is best for you!

Magrita 

Need2Heal

Just curious as to why you decided to switch from klono to valium. From what I have read not everyone handles the switch to valium very well and it can create new problems. I was adamant about switching from .50mg clonazepam to 10mg valium to start my tapering process because of the available dosages valium offered. That was before I found BenzoBuddies and learned about the liquid titration plans. If you read my reply on page 2 I did fail 3 attempts at tapering because I was to aggressive at the daily reductions. The reason I even considered the taper plan was because of the tolerance to the dose I was taking and the unwillingness to get trapped in becoming an addict by continuously having to increasing my dose to obtain the same effect per my Doc's recommendation.

It did take many days to stabilize before I was ready to start my 4th attempt. For me my main wd symptom was insomnia and after days of little to no sleep this triggered all the rest of the symptoms (anxiety attacks, heart palps, elevated heart rate etc.)

Thanks to SG57's advice of starting my taper at 1/10th of what I was doing on my last failed attempt I am starting to see the light at the end of the tunnel. The first 3 weeks of my taper seemed hopeless after the withdrawal hell I was experiencing.

I am still  going with the 1ml alcohol to dissolve the clonazepam then add the 49ml of water. After almost 3 weeks I have zero wd symptoms and have been able to obtain 6-7 hours of sleep daily. I am now up to reducing .20ml. I have had to hold on occasion to some of my taper increases but usually only for a couple of days at the most.

I have been able to resume working again which is very encouraging for me. I know it is going to be a long road but the end result will be worth it.

When necessary I alternate between double doses of Yogi KavaTea and Traditional Medicinal Valerian Tea (Amazon has the best pricing) on those occasions when I wake up in the middle of the night and cannot shut my mind off. This usually knocks me out within an hour.

FYI My Doc also wanted to add more drugs for the insomnia I was experiencing in the beginning. No thanks I want to get off the drugs not add more to the mix.

I also agree with Diaz-Pam about taking control of your own taper plan. Your body will let you know when your going to fast, when you need to hold and when it is ok to reduce again. The Docs do not really know how awful some of the wd's can be. Most are ignorant to benzo withdrawal and their ego's prevent them from really listening to the some of the knowledge the patient has to offer.

The reality though is I don't think Need is in "tolerance". So many people use that word, when in reality it's just withdrawal. I'm not saying that people can't be in tolerance when they are tapering, but if you look at Need's history, and how fast he has brought his dose down, I don't think it is doing him any good to keep telling him it's "tolerance".

He only started taking Xanax in April. He was on 1.5mg X in June and now in December he is down to 7mg V, and in that time he's also fitted in 2 cross overs. It is far more likely that his problems are being caused by a rapid taper and not stabilising, than by "tolerance".

Wow, i sure appreciate the long responses here.  Must mean that people care.

Let me give you all some context and excuse the length.  I was a high speed Mach 2 Air Force guy for 25 years in an ultra high stress job.  I was damn good at what I did.  I retired 5 years ago entered the commercial sector where I continued the stress.  I developed insomnia then and began using Ambien...but only to break bad cycles.  Soon it became 5 mg per night and sometimes 10.  In the Fall of 2012 I finally went to my GP and said its time to treat the underlying problem...anxiety and depression.  He put me on Wellbutrin and 11 days later I wound up in the ER unable to swallow.  I also developed tinnitus in my left ear...that freaked me out and put me over the edge.

I waited 2 months to get into a real psychiatrist and thus began the merry-go-round of meds....Cymbalta, Effexor, Pristiq, Lexapro, Celexa along with a bottle of .25 Xanax which I used sparingly and rarely out of fear.  I couldn't tolerate the sx's from the ADs.  Fast forward to May of this year when a nurse practioner rapidly halted me from Cymbalta.  Through all this time I had one coping mechanism...I ran and ran and ran.  I think I went into protracted SSRI withdrawal.  I got a new Dr and he wanted to treat my anx and tinnitus with Xanax.  About 3 weeks into daily Xanax I developed pain in my low back and neck.  MRIs came back clean.  I then started getting neurologic symptoms, perception of weakness, unable to exercise, unable to even mow my lawn.  Burning sensations all over.  1.5mg of Xanax did nothing...my anxiety was worse then than now.  I couldnt stand for more than 5 mins, got jelly legs and the pain worsened.  My Dr switched me to Kpin in Sept and I fealt a little better.

I was referred to one of the top neurologists in the US in Oct and was diagnosed with a rare neuromuscular disease called CMT.  Nerve testing revealed no nerve function below my knees.  She could not diagnose the neck and back pain or other neurologic deficits.  Well...I did.  I figured out it was benzo withdrawal...tolerance or otherwise.  There is no other cause for the pain. Last month I demanded valium and the pain ended.  I got the feeling in my feet and hands back...pain free for the first time in 7 mos!  I rode my mountain bike 4 miles.  Heck, I even ran for a bit.  Today the PAIN IS BACK.  Valium's short 3 week period of muscle tension relief was short lived.  My physical therapist said I am rigid again all over and dry needled my neck today.  A week ago I was loose as a noodle.

So here I am in severe pain.  8 on a scale of 1-10.  Staring at months of a drug taper followed by withdrawal is so overwhelming I can't even process it.  Other than the return of pain I fealt pretty good today.  I know beyond any shadow of doubt that the medicine is causing the pain and that it will not abate until this crap is out of me.  I can hold all I want and the pain will not abate...it is 100% muscle tension related. I am trapped...i cant stop the med yet i can't bear the suffering of chronic debilitaing muscle pain.  I just want my life back. Sooner rather than later.

Today my Dr prescribed Tramadol for pain.  I don't want to take it but not sure what else to ask for.

HELP!

Still think it's just a much too fast taper, and not stabilising, but that's just my opinion.

Where in my taper profile did I go too fast?  Just curious so I know.  I will keep holding for a bit.  Too bad I can't press it a bit since I have no commitments until Jan 5th.