Failed taper back in 2014, in tolerance withdrawal, ready to try again. Help?

Hi Buddies, been a long time! I could really use some input here as I’m about to take a taper plan to my psychiatrist tomorrow.

 

You can see some of my history in my signature. Long story short, my last psychiatrist ended up ruining my taper when she put me on Tegretol despite my insistence that it would throw me into withdrawal. She threatened to take away my Valium entirely if she tested my blood and found no Tegretol in my system so I took it. Third day on it, full blown withdrawal and I fired her and tried to restabilize myself but failed and ended back where I started - 20mg a day.

 

I have drawn up a taper plan based on the Ashton Manual that I want to show my new psychiatrist tomorrow. My Medicare plan covers 2mg pills so this time it should be a lot easier working with Teva generics as opposed to the horrible Mylan ones that I had last time which I still swear are not doses correctly.

 

Anyway, I’m in mild tolerance withdrawal right now. Nothing too severe other than the agoraphobia but from what I have been reading, it seems that I am actually going paradoxical so it is time to get off.

 

My plan is simple. 1mg roughly every 2 weeks only this time I will cut my morning dose first and not touch my night dose until the morning is gone. I think that was one of the major screw ups I made last time was alternating morning and night cuts.

 

I have worked out a plan down to how many pills I will need and I am going to sell it to my doctor by explaining it in terms of milligrams. Right now she is giving me 625mg a month (5 extra 5s for breakthrough anxiety and 60 10s for morning and night 10mg doses). I’m going to propose to her 90 5mg and 60 2mg for a total of 570mg or 19mg a day. I already made an entire chart and that combination of pills would get me through even if I had to hold along the way.

 

Here is my question though - I’ve been on benzodiazepines for basically 13 years. Is 1mg every two weeks two fast? I compared my plan with Ashton’s 40mg plan started at the halfway point and I have 20 stages of 2 weeks instead of 16. I’m hoping the extra 2 months is enough.

 

Any help is appreciated my fellow Buddies!

 

I’ll attach a picture of my plan. The math on the right is how many of each pill I need for the two week period.

 

-Rob

 

http://i65.tinypic.com/2dwbyi0.jpg

 

Nobody has any input?

 

My appointment is coming up in about an hour and a half and I’m freaking out... Gotta love anxiety. 

I'm so sorry that no one has replied to you Ether and I'm just an inexperienced newbie that knows zip about tapering PROPERLY just want to send you my good wishes because I know how terrible it is particularly when psychiatrist has not been onside. 

 

They can so remove our power by denying  the drug needed UNLESS we  take another, and good thing you fired her.

 

Perhaps with this new doctor she will be more onside to fitting with your plan as an initial goodwill approach in deveveloping rapport.  What we have to endure! 

 

My post is probably too late but hope you get to read it and everything worked out as you planned.  In my inexperienced view it sounds a little fast in 1mg every two weeks but as I say I really do not know in any real sense.

 

As you say, you can always hold. 

 

Wishing you all of the very best Ether and well done on embarking on setting yourself free.  Time is on your side. 

 

Dee 

 

 

 

 

 

I'm so sorry that no one has replied to you Ether and I'm just an inexperienced newbie that knows zip about tapering PROPERLY just want to send you my good wishes because I know how terrible it is particularly when psychiatrist has not been onside. 

 

They can so remove our power by denying  the drug needed UNLESS we  take another, and good thing you fired her.

 

Perhaps with this new doctor she will be more onside to fitting with your plan as an initial goodwill approach in deveveloping rapport.  What we have to endure! 

 

My post is probably too late but hope you get to read it and everything worked out as you planned.  In my inexperienced view it sounds a little fast in 1mg every two weeks but as I say I really do not know in any real sense.

 

As you say, you can always hold. 

 

Wishing you all of the very best Ether and well done on embarking on setting yourself free.  Time is on your side. 

 

Dee 

 

Thanks for the reply Dee, I really appreciate it. I haven’t seen the doctor yet, my therapist is picking me up in a bit to take me. I don’t like this new doctor but she at least agreed to give me my Valium to begin with which is no small feat when you’re going to a county doctor so I’m hopeful I can get her on my side.

 

The taper is pretty rapid, at least at the 5mg mark. I’ll probably have to slow down and readjust my plan between the 7mg and 5mg mark but the first 10mg drop shouldn’t be too horrible (I’ll be starting at 5% every 2 weeks and I’ll be at 10% by 10mg) but when I start working on the night dose, that’s when it will get rough I think. And unfortunately I can’t take trazodone or mirtazapine for sleep because I’m paradoxical to both. Hydroxyzine might be an option though.

 

I’m determined to get this done this time. And if I can’t get my doctor on board, I have other options but it would be nice to not have to hide what I’m doing from my treatment group. We will see what they say... My therapist and case manager are backing my plan and I have long term care right now which means that I can be totally unable to function and they will send someone out to check my vitals, cook, clean, etc.

 

I know I’m in for a long recovery but the benzodiazepines aren’t doing anything positive at this point so something has got to give.

 

I’ll post an update after the appointment.

 

Thanks again for the reply Dee, anything helps with what I’m about to do. I’m a strong person but benzos just break me down to nothing.

 

-Rob

It took some work but my doctor prescribed me 19mg for the next month then I have to go see her and go from there. If I’m going to have to see her every month, it’s going to slow me down with my agoraphobia being so intense but starting Thursday I’ll officially have embarked on my taper.

Hi Buddies, been a long time! I could really use some input here as I’m about to take a taper plan to my psychiatrist tomorrow.

 

You can see some of my history in my signature. Long story short, my last psychiatrist ended up ruining my taper when she put me on Tegretol despite my insistence that it would throw me into withdrawal. She threatened to take away my Valium entirely if she tested my blood and found no Tegretol in my system so I took it. Third day on it, full blown withdrawal and I fired her and tried to restabilize myself but failed and ended back where I started - 20mg a day.

 

I have drawn up a taper plan based on the Ashton Manual that I want to show my new psychiatrist tomorrow. My Medicare plan covers 2mg pills so this time it should be a lot easier working with Teva generics as opposed to the horrible Mylan ones that I had last time which I still swear are not doses correctly.

 

Anyway, I’m in mild tolerance withdrawal right now. Nothing too severe other than the agoraphobia but from what I have been reading, it seems that I am actually going paradoxical so it is time to get off.

 

My plan is simple. 1mg roughly every 2 weeks only this time I will cut my morning dose first and not touch my night dose until the morning is gone. I think that was one of the major screw ups I made last time was alternating morning and night cuts.

 

I have worked out a plan down to how many pills I will need and I am going to sell it to my doctor by explaining it in terms of milligrams. Right now she is giving me 625mg a month (5 extra 5s for breakthrough anxiety and 60 10s for morning and night 10mg doses). I’m going to propose to her 90 5mg and 60 2mg for a total of 570mg or 19mg a day. I already made an entire chart and that combination of pills would get me through even if I had to hold along the way.

 

Here is my question though - I’ve been on benzodiazepines for basically 13 years. Is 1mg every two weeks two fast? I compared my plan with Ashton’s 40mg plan started at the halfway point and I have 20 stages of 2 weeks instead of 16. I’m hoping the extra 2 months is enough.

 

Any help is appreciated my fellow Buddies!

 

I’ll attach a picture of my plan. The math on the right is how many of each pill I need for the two week period.

 

-Rob

 

http://i65.tinypic.com/2dwbyi0.jpg

 

ER, well done with the new doctor, one step at a time, eh? 

 

I've checked your math, and it's correct.  Also correct by Ashton's method, to do 1mg cuts per 2 weeks or so with the Valium.  That looks right, and it doesn't seem too fast on paper.  Getting into the actual taper may prove a little different, though, so from what I've learned so far, I'd say start with the taper as you've planned, then watch for symptoms and if they rev up, consider slowing down the rate of taper. 

 

I have 2 questions for you about the bolded text above: 

(1) What made you think you were going paradoxical?

(2) What was the problem with alternating morning and night cuts in your previous taper? 

 

delta1

 

 

ER, well done with the new doctor, one step at a time, eh? 

 

I've checked your math, and it's correct.  Also correct by Ashton's method, to do 1mg cuts per 2 weeks or so with the Valium.  That looks right, and it doesn't seem too fast on paper.  Getting into the actual taper may prove a little different, though, so from what I've learned so far, I'd say start with the taper as you've planned, then watch for symptoms and if they rev up, consider slowing down the rate of taper. 

 

I have 2 questions for you about the bolded text above: 

(1) What made you think you were going paradoxical?

(2) What was the problem with alternating morning and night cuts in your previous taper? 

 

delta1

 

Hi delta,

 

Thanks. My therapist was actually really impressed with the way I advocated for myself and handled the whole situation, even when the psychiatrist was giving me push back (she wanted to taper me off by changing my dosage to three times a day for 3 months, 2 times a day for 3 months, and 1 time a day for 3 months which would have been a complete disaster). When I set my mind to something, there’s no changing it.

 

So the reason I believe I have gone paradoxical is because I have developed symptoms I didn’t have before I took benzodiazepines. For example, I have agoraphobia now even though I’m not actually scared of anything, I just panic. Also other medications have paradoxical effects on me, a common side effect of GABA receptor downregulation from what I’ve read - gabapentin and even other benzodiazepines actually trigger panic attacks in me now, even ones I’ve taken before. Alcohol also now causes me to have panic attacks when it used to be what I would turn to in order to cope in social situations. I can’t even take a Tylenol without feeling like I have the flu and I can’t take B vitamins or D either (despite my D levels being dangerously low) because they overstimulate me - as does fish oil. The only thing that seems to mellow me out is CBD which knocks me out cold (and it shouldn’t do that either, CBD should have no psychoactive effects but in my system, it does, I’m out like a light without fail and hungover every time).

 

As for the night and day cuts, I tend to have much more anxiety when I haven’t slept. I have suffered from insomnia since I was a kid which has made Valium a godsend (it still retains its sedative properties at the same 20mg dose I’ve been on since 2011 - if I am asleep when my alarm goes off for meds and I take my Valium and lie back down, I’m out cold for another 3-6 hours) so it stands to reason that my best bet for succeeding in my taper is to eliminate the morning dose first. Also there’s the plasma level changes. My brain is so programmed for my Valium dosage times that I start getting anxious about 30 minutes before it’s time for my next dose, even if I haven’t checked a clock all day. If I wake up at 9, I’m anxious as hell even though I should actually still have a steady plasma level from my 8PM dose. This drug has a strong hold on everything, it’s going to take all my brain power to trick my own brain into letting go of it.

 

I did do a thorough check on my math as well but I am concerned about the 8-5mg and under range. I may need to switch to .5mg cuts at that point or switch to liquid diazepam but the beginning should be easy enough (comparatively speaking since there is nothing easy about benzodiazepines).

 

-Rob

I just want to chime in here and say I do think it is too fast to always expect to cut again after two weeks.  I really think you should be listening to your body on the way down and you might need to hold for longer than what Ashton's original plan says.  I don't remember where she says it, but she does say that the taper should be patient lead, because you have to go slower if you find that the symptoms become intolerable. 

I just want to chime in here and say I do think it is too fast to always expect to cut again after two weeks.  I really think you should be listening to your body on the way down and you might need to hold for longer than what Ashton's original plan says.  I don't remember where she says it, but she does say that the taper should be patient lead, because you have to go slower if you find that the symptoms become intolerable.

 

Yeah I agree completely. The plan is just a guideline. My doctor gave me 19mg a day for a month and then we are going to see where I am next month and so on. I will hold if I have to but since I have tapered before and I’ll be going much slower (last time I did 2.5mg and 1.25mg cuts because my doctor wouldn’t get on board with 2mg pills or liquid), I don’t expect to hit the wall of hell that I did last time. I’m starting off at 5% cuts and not reaching 10% until 10mg. Last time my cuts started at approximately 13% and I also had the Mylan generics which are utter garbage. I have compared them to the Teva generics I take now and the difference is night and day. I don’t feel well on the Mylan generics at the same dose, it was such a marked difference I changed pharmacies.

 

I basically drew up something to present to my doctor but I do expect that I will have to change it and even hold at points. My best guess after 13 years of benzos is probably 13 months of tapering and then quite a long healing period afterwards, likely another 13 months before I get back to where I started but there’s always the chance that my brain will adapt quickly since I have been in tolerance withdrawal for who knows how long now as it is. Let’s face it - 7 years of Valium at the same dose in someone who gained such a rapid tolerance to Xanax and Klonopin that he’s got a permanent tolerance to them, chances are the Valium isn’t doing anything except making my symptoms worse at this point.

 

If you look at my last taper log in my signature, you can see just how far I got with huge dose cuts mandated by my doctor. I don’t have to worry about that now - I have enough Valium to switch it up and do titration if I have to.

Ah okay, that sounds good that you have a doctor who will listen to you.  I am always shocked how long my taper is taking.  I wish you luck with yours!

Ah okay, that sounds good that you have a doctor who will listen to you.  I am always shocked how long my taper is taking.  I wish you luck with yours!

 

Well to be fair, Klonopin is a bitch. It’s by far the most addictive drug I’ve ever taken. Even cutting over to 80mg of Valium from 4mg of Klonopin, I still had Klonopin withdrawals that persisted even after I got my Valium stable at 20mg. Most people struggle to cross over to another benzo when they are taking Klonopin which is why I did a straight cut from it instead of a substitution crossover.

 

My doctor wasn’t given much of a choice in the matter. I dictated the terms and I had my therapist and case manager there with me in the room, she knew she couldn’t fight me on it but either way, as long as I am going down, she really shouldn’t care how long it takes.

 

With that said, I don’t need her to get the Valium, it’s just much easier working with her than going around her but I am prepared to do so if I need to.

 

Keep up the good fight, we will all make it to the end! 

Man, this so sucks just posted reply to you Ether but it got lost. 

 

Starting my taper in 6 days and well done on self advocacy. 

 

We can always default to the HOLD position if worse comes to worse.  BUT IT WONT, were going to make it! 

 

Dee 

Man, this so sucks just posted reply to you Ether but it got lost. 

 

Starting my taper in 6 days and well done on self advocacy. 

 

We can always default to the HOLD position if worse comes to worse.  BUT IT WONT, were going to make it! 

 

Dee 

 

Unfortunately that’s a problem that SMF has had for years, I used to run a forum with SMF and people lost long posts all the time. I got in the habit of doing select all and copying my post before submitting it when I had a long one.

 

Even if we have to hold, it’s the finish line that counts.

 

Best of luck to you Dee, I’ll be tapering right along with you.

 

-Rob 

Hi Rob, 

 

I'm new here and am beginning my taper (from 5mg), so I'll be right there with you man. I haven't been on them as long as you but due to never having a consistent dose and beign on/off, I have kindled and get quite a few symptoms. I am having troubles with sleep recently, so we'll have to keep each other posted on anything that works for sleep. 

 

I think you are very wise in keeping the initial cuts at 5% and increasing to 10%. From what I've seen over my months of researching, people tend to do OK with cutting higher doses but as they get lower down at doses such as 5mg or 7mg, it catches up with them and gets more difficult. You will see a lot of people slow down or updose when they hit these doses.

 

You can't go wrong with going as slow as you can. Giving yourself enough time between cuts, especially early on in your withdrawal, allows you to link it to the cuts. If you are cutting every two weeks, it might not really hit you until your fourth cut and then you might be stuck as to whether it was the second, third cut etc. Leaving more time like 4 weeks, allows more time to stabilise and also link symptoms to cuts.

 

But I'm with you mate, I want off as soon as possible but it's resulted in my going too fast twice now. So I wasted a good month

 

Best of luck mate, I'll be keeping tabs on your progress.

Hi Rob, 

 

I'm new here and am beginning my taper (from 5mg), so I'll be right there with you man. I haven't been on them as long as you but due to never having a consistent dose and beign on/off, I have kindled and get quite a few symptoms. I am having troubles with sleep recently, so we'll have to keep each other posted on anything that works for sleep. 

 

I think you are very wise in keeping the initial cuts at 5% and increasing to 10%. From what I've seen over my months of researching, people tend to do OK with cutting higher doses but as they get lower down at doses such as 5mg or 7mg, it catches up with them and gets more difficult. You will see a lot of people slow down or updose when they hit these doses.

 

You can't go wrong with going as slow as you can. Giving yourself enough time between cuts, especially early on in your withdrawal, allows you to link it to the cuts. If you are cutting every two weeks, it might not really hit you until your fourth cut and then you might be stuck as to whether it was the second, third cut etc. Leaving more time like 4 weeks, allows more time to stabilise and also link symptoms to cuts.

 

But I'm with you mate, I want off as soon as possible but it's resulted in my going too fast twice now. So I wasted a good month

 

Best of luck mate, I'll be keeping tabs on your progress.

 

Well so far it’s going fine. I’m down to 18mg at the moment. The only thing that has me anxious is I got my first continuing disability review from Social Security. Got the paperwork yesterday and filled it out but I had a hard time sleeping because my brain kept going to the worst case scenario - losing my benefits and then all the crap that would follow that.

 

As far as tapering goes, from past experience it takes me 10 days after a cut to feel the symptoms so a two week period should be okay for these first few cuts. Where it gets difficult is going to be when I get down to 10mg and thus start cutting my night dose but honestly, I think I’ve been in tolerance withdrawal for so long now that I’ll start feeling better a lot faster than if I tried boosting my dose til I was out of tolerance withdrawal and then started the taper because my GABA receptors are already irritated. They’re probably already healing so stabilizing would have just lead to more downregulation and a worse taper.

 

We will see how it goes, just wanted to post an update.

 

So far I’m handling everything the same as I did before I started tapering which tells me that the Valium hasn’t been doing anything for awhile except keeping me in hell. My mind and body are done with the drug, it’s not done with me.