Q re baclofen [& gabapentin] use as adjunct meds to Ashton taper protocol

Hello,

About 2 weeks ago had a "blow up" of anxiety as I was tapering off valium (ended up in emergency room w/ massive blood pressure; have had severe/resistant BP issues independent of anxiety, though each can worsen the other.) Thanks to this board, I realized the most likely primary cause was excessively speedy cutting on the valium (and possibly over-consumption of (excitatory) glutamate rich foods). A psychiatrist prescribed gabapentin but I decided not to go beyond the 100 mg 3x/daily he said to start with as this will be just one more thing to taper off of, and it has clear zombifying effects, and I'm just kind of sheltering in place at home till I stabilize back at 15 mg valium w/ 300 mg gabapentin. (I had cut to 11 in under a month.) This psychiatrist said take 3 weeks to go up to 1000 mg gabapentin per day, then I'll be able to cut 30% per week - which, based on my reading of other posts on this board, seems either preposterous, or, if successful, will leave me w/ a nasty gabapentin taper to deal with.

In the process of researching help I came upon another psychiatrist who recommended the use of *baclofen* as an adjunctive medicine. I think his protocol is effectively to "substitute" the valium to baclofen. (FYI baclofen is a muscle relaxant/anti-spasm med that definitely has anxiety-reducing effects - used to take one here and there for spasms before my benzo use.)

I have seen very little on this board (I searched) about using baclofen for getting of benzos (valium in my case). [i have seen references elsewhere to use of baclofen to help people getting off alcohol addiction; alcohol as I understand is also a GABAa receptor drug.] His argument was the baclofen works on GABAb receptors whereas benzos work on GABAa receptors (gabapentin apparently works on GABAa also, but the Calcium channel instead of the chloride channel). Thus you deal w/ the side effects through baclofen's calming while allowing GABAa receptors to heal (re-emerge, I believe, from the neuron).

Seems like the general consensus opinion of Prof. Ashton and of this board (?) is not to add additional addictive meds if avoidable, but curious if anyone has any experience/opinions/knowledge about baclofen usage as an adjunct to Ashton protocol, as this psychiatrist described his approach to me. This baclofen-recommending psychiatrist held the theory that the problem w/ Ashton protocol on its own is you taper too slowly, and end up developing tolerance to the low dose and that's why you shoot back up. From my reading of the board here it seems like the consensus is you don't want to dilly dally in your taper, but that generally slow and steady is the way to AVOID spiking more anxiety. This psychiatrist estimated at my current levels he'd get me off everything in 3-4 mos, if I was able and willing to tolerate some side effects (I am - probably too a fault).

Thanks for reading & any opinions!

-AA

Following.  I'd really like to hear if others have experience with this.

I'm not adverse to a judicious use of meds to help us with w/d.  Glutamate rich food are definitely off my menu!

:smitten:

SS

Hi there,

I've just been prescribed (today!) Baclofen as a muscle relaxant and I am currently doing a Valium taper according to the Ashton protocol. I too would love some feedback from anyone if this addition of Baclofen helped anyone with withdrawal symptoms during taper or if it is not advised to add as it affects GABA receptors?  Also, my doctor told me Baclofen was not addictive and I could stop it any time-seems many of you would beg to differ!  Last thing I want is to go through another horrible withdrawal ordeal!

Much appreciate any thoughts, experiences,

Sheyoume

Hi Sheyoume,

I've used baclofen as a muscle relaxant pre-benzo days and had no problem taking 10 mg 3x/day for a couple weeks and stopping cold turkey. I sometimes use it for "excess" anxiety (my "excess" anxiety correlates w/ massive blood pressure spikes so it isn't just a matter of toughing it out, i have to balance competing interests of tapering off + not having a cardiovascular incident) and Ive had no problem using it say a few times a week; I try not to use it more than 3 days in a row, max 20 mg.

FYI I discovered an addiction doctor here in San Francisco who actually uses baclofen substitution off of benzos as his protocol. He explained to me baclofen affects GABAb receptors, NOT the GABAa receptors that benzos do, so you aren't hitting the GABAAR's with more stuff, so it shouldn't in theory interrupt the healing process of the GABAAR's. From feedback on this board, and from what this doctor said, taking it regularly a few months has a lower tolerance profile, though if you did use it *regularly* you could end up having to taper off it ... though from my research and what this doctor said that taper is much easier. I've also though had *many* doctors the last 2 years tell me a drug had no side effects or wasn't addictive and it turned out it was/did.

Bottom line: I don't think occasional usage will be a problem but monitor your own tolerance - does 10 mg work for a few days then you need 20? So maybe don't take it more than 3 days in a row, or no more than 4 days a week ... that would be my best advice, but as always your mileage may vary.

Thanks for the info, AccidentllyAnxious. Unfortunately after taking 10 mg of Baclofen last night I can hardly function today-so I can't take it anymore. Feel so wieed. I have normally low blood pressure and this drug can lower it further apparently according to side effect profile. Brought this to the prescribing doctor's attention but she didn't seem concerned. Anyway, must try another strategy. Good to know that it works on different Gaba receptors though.

Thanks again for your wealth of info!

Sheyoume