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I was doing a milk and Valium Titration.  I started at 40 mg and was dosing 3 times/day.  I was doing great with a VERY SLOW taper.  My Dr. wouldn't prescribe liquid Valium and suggested when I hit 30 mg, I taper only my middle dose to 25 mg.  So he game me 2 ten mg pills and 5 two mg pills.  When I hit 27 mg...even at a very slow taper rate, I started having what feels like interdose withdrawal.  I am taking 10 mg in the morning before work, 7 mg in the afternoon, and 10 mg before bed.  I have been holding for just over a week, but the symptoms are still there - pain in the legs, irritabiility, shakiness, anxiety, like I said, feels like withdrawal. 

 

Question:  Since I was doing so well, do you think making my doses more even would help i.e. 9 mg in the morning, 9 in the afternoon and 9 in the evening?  My Doctor has ruled out this approach and basically said valium has too long a half-life and what I am experiencing is withdrawal...or the return of my anxiety.  I don't think it is my anxiety coming back.  BUT I was wondering if 9-9-9 dosing would be better than 10-7-10.  Or what about 7-7-6-7?  I was also considering updosing, but I cannot see coming down any slower.  I am only reducing 0.02mg/day. 

 

If making my dosing more even would help, I would have to do it by splitting 10 mg pills into 5 mgs (I take most of my dose in pill form and only titrate what I need to...It reduces the amount of milk and at 27 mg...that's a lot of milk!).  Would there be an issue splitting 5mg pills?  They are scored and look like the break fairly evenly, but my doc won't give me 5 mg pills and won't prescibe liquid V. 

 

Any help would be appreciated.

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I was doing a milk and Valium Titration.  I started at 40 mg and was dosing 3 times/day.  I was doing great with a VERY SLOW taper.  My Dr. wouldn't prescribe liquid Valium and suggested when I hit 30 mg, I taper only my middle dose to 25 mg.  So he game me 2 ten mg pills and 5 two mg pills.  When I hit 27 mg...even at a very slow taper rate, I started having what feels like interdose withdrawal.  I am taking 10 mg in the morning before work, 7 mg in the afternoon, and 10 mg before bed.  I have been holding for just over a week, but the symptoms are still there - pain in the legs, irritabiility, shakiness, anxiety, like I said, feels like withdrawal. 

 

Question:  Since I was doing so well, do you think making my doses more even would help i.e. 9 mg in the morning, 9 in the afternoon and 9 in the evening? My Doctor has ruled out this approach and basically said valium has too long a half-life and what I am experiencing is withdrawal...or the return of my anxiety. I don't think it is my anxiety coming back.  BUT I was wondering if 9-9-9 dosing would be better than 10-7-10.  Or what about 7-7-6-7?  I was also considering updosing, but I cannot see coming down any slower.  I am only reducing 0.02mg/day. 

 

If making my dosing more even would help, I would have to do it by splitting 10 mg pills into 5 mgs (I take most of my dose in pill form and only titrate what I need to...It reduces the amount of milk and at 27 mg...that's a lot of milk!).  Would there be an issue splitting 5mg pills?  They are scored and look like the break fairly evenly, but my doc won't give me 5 mg pills and won't prescibe liquid V. 

 

Any help would be appreciated.

  In this case, I really think your doc is correct.  Most V users do fine on 2 doses per day.  And certainly a 10-7-10  daily dosing is not going to cause interdose WD.
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I think evening out your dose would be a good idea, but I agree with Builder that it is unlikely that it is interdose with a 10-7-10 split of V.

 

You need to determine what is happening.  Is it interdose, regular withdrawal, or perhaps a low level of V caused by something else like a food or med.

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Yeah, I tried to increase my taper rate, but after about 3 weeks it caught up to me.  I know most people taper much faster.  Maybe I do have anxiety issues which need the medication.
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I knew a guy who was at 35mg and he could not get beyond .025mg per day.  He would taper along for a few months then keep trying the higher rate.  He did this several times and last I knew he was not able to make it work, but I guess my point is we don't know that we can't go higher so it makes sense to give it a try once in a while.

 

Have you tried .025mg?  Just that small increase would shave ten months off.  Each .001mg is worth two months.

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I could try it, but right now - like I said, I'm having symptoms and have been holding over a week.  The only thing I can think of that could be contributing are:

1)  Stress of the holidays

2)  I started taking vitamin E supplements.

 

That's it.  I'm dumbfounded as to why the symptom came on so suddenly and severely.  And like you said, SG...I don't want the symptoms to escalate.

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You are smart to deal with it this way.  You are doing the right thing by holding.

 

On another forum (the old BDR) they were big on benzo metabolism effects.  The vitamin E could be the problem.  Foods and medicines can affect the rate benzos are cleared from our bodies.  They do this through the CYP450 enzymes.  V is metabolized by enzymes 1A2, 2C19, 2C8, and 3A4.  So substances that "induce" these four enzymes are ones you need to watch for.  Common ones are the broccoli family of veggies, charred meats, and smoking.  Do any of these ring a bell?

 

http://www.edhayes.com/CYP450-1.html

 

I searched "Vitamin E cyp450 inducer" and it is not clear if it is one or not.  It might be.  So it might be a good idea to stop the vitamin E and see if the problem goes away.

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SG57 :

    I know you and Builder were from the old BDR forum.  I was "fishy".  I am aware of the "usual suspects" i.e. cruciferous vegetables, smoking, chargrilled meat, etc.  Not sure if Vitamin E is on there, but my Dr. wants me on it for another issue...but I can do some more research and see if it may be the culprit.

 

Thanks!

Mark

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Hey Fishy!  How are you.  You are "the guy" I was referring to who could not seem to go at a reasonable pace.  You've made a lot of progress if you are at 27mg now.  Good job.  I did a quick search for vitamin E and nothing jumped out to clearly indicate it is an inducer.
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That's funny SG that you were referring to me.  Yes, I tried to go up to 0.25mg/day about 3 or 4 times...always crashed about 2-3 weeks into it.  Holding is helping a little.  I am by no means feeling good like before, but I am not as symptomatic.  You don't have to tell me, but who were you on BDR?  Anyway, I've been tapering over 2 years and although my progress has been slow, I have been happy with it and come to terms that it will be a LONG taper.  But to have symptoms flare up like this is really bizarre.  I really don't think it's the vitamin E.  Feels like I took a big jump in dose reduction, but I haven't. 

 

Hopefully, it will resolve itself. 

 

Mark

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Hate to bump this but it is almost 2 weeks I have been holding with a daily titration taper which is a long hold.  Symptoms have gotten slightly better, but are waxing and waning throughout the day.  I'm starting to think the holding won't help anymore and I do not think it wise to continue the taper with these side effects since I think they may spiral out of control.  So would updosing be the way to go?  If so, How much?  I could try to go up to 28 mg and see how that works...29 mg  is also an option.  Just don't want to get too high because I'm wondering since my taper is so slow if coming back down, I won't hit this same place...I mean typically the idea is you updose and come down more slowly.  Problem is I can't really go a whole lot slower.  Any suggestions?
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2 weeks really isn't a long hold. I once held for 2 months. If you are starting to see some improvements I would personally keep holding until those improvements become more stable.
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