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What shall I do after not stabilizing from cut 3 months ago? Need advice


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I still have a tingling/crawling feeling on my skin on my chest/belly, although it's not constant. Social situations make me feel panicky and my voice shakes. I now have fear sometimes. My tinnitus is not abating. Although my fatigue has decreased and many of the early symptoms such as headaches, stomach aches, and adrenaline rushes have subsided, overall I still don't feel good. I did when I was on higher doses and I was hoping I would feel good again after some time on my current dose.

 

I don't know if waiting longer will achieve any improvement. Shall I start microtapering?

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Hi Maugham1 :smitten:

 

I laid your taper history on a spreadsheet:

 

TVMDr1m.png

 

I realized that following a presumably successful cut on 08.13.2018 where the reduction was still reasonable (between 5-10% every 10-14 days), you have waited 15 days and then made a strong cut of 25%. Viewed from a different angle, in the space of 15 days you have cut a total of 36%. As a consequence symptoms kicked in and you hold. After 92 days your body has not been able to recover from the huge reduction and you continue to experience rough symptoms and wonder if you should continue to taper anyway.

 

Should this be your very first taper off drugs then higher would be the chance for the symptoms to subside after all this hold time. A number of buddies actually recovered pretty well after (improperly) tapering by tablet splitting (25%, 33%, 50%). Your past experience of using Xanax, Ambien, Flunitrazepam, regularly and as needed, in different stop/starts have contributed to turn your organism hyper sensitive to the now Clonazepam taper. Those seemingly easy stop/restart experiences in the past are actually playing against you to make every successive taper a little more difficult.

 

While you are having symptoms the last thing you must think of is to further cut to quickly arrive to the last dose. You are perhaps imagining that the last dose you have a glimpse of at the near horizon will fix all your symptoms. It will not. While everybody who taper wish to see the drug out of their organism in less time possible, reducing improperly can play against them. Remember that the last dose is just a symbolic milestone and nothing more. It does not mean that you are benzo free. It does not mean that you are healed. Long time after your last dose, your CNS continues to pedal unrelentingly to restore its equilibrium after been forced to live together with a drug for years. The taper should not be to get rid of the drug as soon as possible (otherwise a cold-turkey would be fine!) but ultimately be a matter of getting out of the drug while remaining functional in the daily life and overall with no protracted symptoms months/years after the last dose.

 

What to do? Since there is no point to up-dose nor to take new additional ADs, hold until you stabilize may it take 6 or 9 months until your symptoms start to recede. Then resume the taper. SLOWLY and GENTLY. Slowly means for instance 5%/14 days. Gently means you will hold the time it needs when symptoms arise. You will jump when you are symptoms free and when your daily dose is "small" enough. Just for information, the jump dose for Clonazepam suggested by Ashton's manual is 0.025 mg/day. But there are buddies who jumped at lower dose.

 

Hope I answered your questions.

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Hi,

As Jim mentions, I would also suggest you consider holding longer.. 

 

I pill split V, and pretty slowly at that... A few months ended up being a normal hold period that suited my bodys ability to adjust... It may take quite a lot longer If one is quite unstable.. But it seems that most people, once committed, have great success...

 

I dont think we ever get symptom free from holding, but we sure can take the bite out of it.. Most people find they can function quite well most of the time, Once they have gotten stable and found their personal taper rate..

 

I hope things pick up for you soon...

:)

 

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What to do? Since there is no point to up-dose nor to take new additional ADs, hold until you stabilize may it take 6 or 9 months until your symptoms start to recede.

 

Why not?  Withdrawal sxs are the result of discrepancy between the amount of drug your taking, and the amount your body needs to feel "normal".  The easiest/quickest way to relieve the discomfort is to go back the last dose you felt OK at.  Or you can hold  and be miserable while you wait  for your body and dose to get back in sync. ::)

 

I updosed several times during the C&H portion of my taper, and once during DLMT.  It always worked, and then I was able to start again at a slower rate.

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What to do? Since there is no point to up-dose nor to take new additional ADs, hold until you stabilize may it take 6 or 9 months until your symptoms start to recede.

 

Why not?  Withdrawal sxs are the result of discrepancy between the amount of drug your taking, and the amount your body needs to feel "normal".  The easiest/quickest way to relieve the discomfort is to go back the last dose you felt OK at.  Or you can hold  and be miserable while you wait  for your body and dose to get back in sync. ::)

 

I updosed several times during the C&H portion of my taper, and once during DLMT.  It always worked, and then I was able to start again at a slower rate.

 

I believe you. However, everybody is different. There is no guarantee that updosing will help or I may have to go way up. Also, even if I go slower, I will probably experience discomfort. Maybe I could switch to Valium, but I will just wait for now and see if I can stabilize. I'm hoping the discrepancy will lessen soon, and then I will start a daily taper. No more cut and holds for me.

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There is no guarantee that updosing will help 

 

There also is really no risk. 

 

Withdrawal sxs, by definition, is the discomfort caused by your body needing a higher dose of the drug.  If an updose doesn't give you relief, then what your experiencing is not withdrawal.

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There is no scientific support for most aspects of benzo withdrawal, and everything is anecdotal. For now, I will stay put. I appreciate your help and at some point I may updose. I hope I will stabilize so that I can start a mostly asymptomatic slow daily taper similar to yours.
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Hi Maugham1 :smitten:

 

at some point I may updose

When you first take Clonazepam, a complex mechanism is set in motion in your CNS. By introducing this drug to your body you change the chemistry of the brain and as consequence the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to re-stabilize the chemistry. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off other genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When you cut from 1.5 mg to 0.5 mg Clonazepam, we have a brain that has designed itself so that it works in the presence of 1.5 mg of drug; now it can't work properly without the missing 1 mg because it's designed itself so that this 1 mg drug is part of its chemistry and structure. When this 1 mg is removed, the remodeling process has to take place in reverse. It's a matter of having to grow a new brain. This growing-a-new-brain happens throughout the taper process if the taper is slow enough. If it's too fast, then there's not a lot of time for actually re-balancing things, and basically the brain is just pedaling fast trying to keep us alive. It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

Allow me to over simplify with this example: At day 0 you were at 1.5 mg then you cut to 0.5 mg. Your CNS realized there is a change and to survive it must adapt itself and started to pedal to cover the 1 mg "distance". After 1 week, it managed to cover say 0.1 mg over 1 mg, week 2 to 0.2 mg, week 3 to 0.3 mg and so on...With no idea where you actually are, for our example let's say your CNS has managed to cover now 0.7 mg (over 1 mg) after 3 months. During all this time symptoms are rough. How can they be otherwise when the CNS must produce huge efforts to pedal? At some days depending on your conditions at the moment symptoms might become so unbearable that huge was your desire to up-dose with the hope that it will give you some relief. With that in mind, you set off to increase your dose. But to how much? Now the first thing you may think of is the dose when you last cut and when you last felt stable. It was 1.5 mg. If you go back to that dose then, unaware that your CNS is no longer the same as it has long shifted, you are now forcing your CNS to make an U-turn and pedal back from the current (minus)-0.7 mg against the excess of drug. If you decided to go back to 1 mg instead of 1.5 mg, the same story repeats again. If you decided to go back this time to the not-yet-reached -0.9 mg then symptoms are still there but this time they are due of lack of drug and worst you HAVE NO IDEA whether your symptoms are from a lack of drug or from an excess of drug.

 

From the posts I happened to read in here and in the Internet, up-doses can work under strict conditions: when it occurs within 10-15 days from the last cut when the concentration of drug in the bloodstream is still high. Some literature talked about 1 month max but I rarely read cases of successful up-doses when more than a couple of weeks have gone by. And when people decided to up-dose at any cost after months then the recommendations are to increase very small amount at a time with no certainty that one can feel relief with that.

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... up-doses can work under strict conditions: when it occurs within 10-15 days from the last cut when the concentration of drug in the bloodstream is still high. Some literature talked about 1 month max but I rarely read cases of successful up-doses when more than a couple of weeks have gone by. And when people decided to up-dose at any cost after months then the recommendations are to increase very small amount at a time with no certainty that one can feel relief with that.

 

Any documented studies or research that you can share to substantiate that would be appreciated.

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... up-doses can work under strict conditions: when it occurs within 10-15 days from the last cut when the concentration of drug in the bloodstream is still high. Some literature talked about 1 month max but I rarely read cases of successful up-doses when more than a couple of weeks have gone by. And when people decided to up-dose at any cost after months then the recommendations are to increase very small amount at a time with no certainty that one can feel relief with that.

 

Any documented studies or research that you can share to substantiate that would be appreciated.

 

I don't think there's any evidence one way or another. Unfortunately, there's not much research done on benzo withdrawal.

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Hi builder,

 

When in BB we recommend to reduce between 5-10% every 10-14 days this is NOT something written on a medical paper. When in survivingantidepressants.org/ they recommend to reduce 10% every month with the percent applied to the last dose, this is NOT an information found on a scientific paper. Should we need a medical research to establish what we can and cannot do, very likely I'm still taking my night dose of benzo, probably filled and intoxicated with other ADs or God knows what, instead of been free 15 months ago. Here and elsewhere where scientific research has not yet reached all  aspects of the so complex behaviour of the CNS when it comes to benzo withdrawal, the experiences on the field of taperers are essential and used to provide guidelines for others. I have benefited from the experiences of my buddies predecessors and not having my own experience I reported what I have learned from their errors and success.

 

I have to say another thing. After this experience of mine and the ones read from many buddies, I've now looked at doctors/professors/experts/researchers with a very RESERVED set of mind. After all, hadn't they given me all these scientific supported benzo prescriptions I would have been definitely in better shape today.

 

Again I reported what I have read and synthetized over several thousands of posts read on the net. If this results in some relief to taperers then it's all that matters to me. 'document studies and research' can wait.

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Builder

 

This has worked for me when my cuts were too much, so today I took 8 mg. of Valium because the symptoms would not abate from the last too-high cuts and I couldn't handle another day like the past ones.

 

Already, just one hour after the increase, symptoms are lifting.

 

The way I'm looking at it--could be wrong, of course, is that just reinstating to where I was didn't work because my body had been deprived too fast, so increasing the dose, 'putting back' what had been taking out wasn't enough.

 

I'm not going to keep the 8mg. going, i.e. not going to be at 20 mg Valium now, but if this works; if it helps my body ease back to 12 mg. Valium, I'll be satisfied, and by satisfied I don't mean I have to feel good, just not this eye, sinus, over all body pain, extreme mental confusion and the rest.

 

Then hold...

 

And Liquid Titrate.

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Unfortunately, there's not much research done on benzo withdrawal.

 

Tragically, this is a major issue.  Lack of research, lack of interest in research by the medical community, and lack of knowledge by the medical community.

 

 

 

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The biggest problem I see is that we are all so different in body and situation..

I just cant see ANY studies reflecting my situation and history...

 

But there are/have been many here that I can relate to in some ways, eg. Sensitivity, pollydrugging, etc..

This has helped me formulate MY own tapering parameters... There would be no use in me following the footsteps of say, someone that claims they could have easily jumped from several mg of V... -The issues we both faced may have been very different indeed...

 

I will say, That once we work out our own tapering "guide lines" -This whole thing gets that much easier.. Its worth investing some time into...

 

:)

 

 

 

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The biggest problem I see is that we are all so different in body and situation..

I just cant see ANY studies reflecting my situation and history...

 

But there are/have been many here that I can relate to in some ways, eg. Sensitivity, pollydrugging, etc..

This has helped me formulate MY own tapering parameters... There would be no use in me following the footsteps of say, someone that claims they could have easily jumped from several mg of V... -The issues we both faced may have been very different indeed...

 

I will say, That once we work out our own tapering "guide lines" -This whole thing gets that much easier.. Its worth investing some time into...

 

:)

 

I'm trying to do that. It's encouraging to hear that it gets easier after we work out the rules for our tapering.

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I will say, That once we work out our own tapering "guide lines" -This whole thing gets that much easier.. Its worth investing some time into...

 

:)

 

absolutely!  :thumbsup: 

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Hi Maugham1 :smitten:

 

What to do? Since there is no point to up-dose nor to take new additional ADs, hold until you stabilize may it take 6 or 9 months until your symptoms start to recede. Then resume the taper. SLOWLY and GENTLY. Slowly means for instance 5%/14 days. Gently means you will hold the time it needs when symptoms arise. You will jump when you are symptoms free and when your daily dose is "small" enough. Just for information, the jump dose for Clonazepam suggested by Ashton's manual is 0.025 mg/day. But there are buddies who jumped at lower dose.

 

Hope I answered your questions.

 

Maugham...my heart goes out to you. It’s so hard to imagine holding longer with terrible symptoms...

My question is to Jim...thank you for the thorough explanation....so are we saying that everyone or most everyone will eventually stabilize by holding ?

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Offandon, thank you, I appreciate it. I'm now trying to change the distribution of my daily K so that I now take three equal doses. I had this idea that I couldn't stabilize because I took most of the K at night and much less during the day and this caused a fluctuation in blood levels, which made it impossible for my brain to come to terms with. Let's see if this works. I've been on this new schedule for about a week and I will need more time to see whether it works.
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Offandon, thank you, I appreciate it. I'm now trying to change the distribution of my daily K so that I now take three equal doses. I had this idea that I couldn't stabilize because I took most of the K at night and much less during the day and this caused a fluctuation in blood levels, which made it impossible for my brain to come to terms with. Let's see if this works. I've been on this new schedule for about a week and I will need more time to see whether it works.

 

I’ve been thinking about the same thing. I take most of my k in the morning.  I’ve been thinking about increasing mirtazipine from 7.5. Has it helped you? Forgive me if I’ve already asked that.

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The mirtazapine increase definitely helped me.

 

I used to take 0.25 mg of K in the evening and 0.125 during the day in two doses. Usually, my symptoms got worse in the afternoon, where I thought the K levels were lowest. So one night I only took 0.125 and then 0.125 in the morning and 0.125 in the afternoon. I can tell you when I got up the first morning after taking only 0.125 mg of K, I had a headache and felt stiffness in my neck, symptoms that I only experienced when I wanted to CT Xanax. I think that indicates that I metabolize K faster than I thought. Whereas many people are OK with taking K once, I'm not sure I am. So from now on I will take 3 equal doses for a while and wait to see what happens. So far I can't tell if it's better; I will need more time for that. But I've seen it in other places that some people need to take it 3 times a day.

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The mirtazapine increase definitely helped me.

 

I used to take 0.25 mg of K in the evening and 0.125 during the day in two doses. Usually, my symptoms got worse in the afternoon, where I thought the K levels were lowest. So one night I only took 0.125 and then 0.125 in the morning and 0.125 in the afternoon. I can tell you when I got up the first morning after taking only 0.125 mg of K, I had a headache and felt stiffness in my neck, symptoms that I only experienced when I wanted to CT Xanax. I think that indicates that I metabolize K faster than I thought. Whereas many people are OK with taking K once, I'm not sure I am. So from now on I will take 3 equal doses for a while and wait to see what happens. So far I can't tell if it's better; I will need more time for that. But I've seen it in other places that some people need to take it 3 times a day.

 

I used to be ok with k once a day but not for a long time. I will keep you in my thoughts that it goes smoothly.

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What to do? Since there is no point to up-dose nor to take new additional ADs, hold until you stabilize may it take 6 or 9 months until your symptoms start to recede.

 

Why not?  Withdrawal sxs are the result of discrepancy between the amount of drug your taking, and the amount your body needs to feel "normal".  The easiest/quickest way to relieve the discomfort is to go back the last dose you felt OK at.  Or you can hold  and be miserable while you wait  for your body and dose to get back in sync. ::)

 

I updosed several times during the C&H portion of my taper, and once during DLMT.  It always worked, and then I was able to start again at a slower rate.

 

You definitely give lots of great advice, but this updosing is risky. It might have worked for you, but for someone who hasn't felt better after a three month hold, the prognosis for updosing is not good imo. I vote for initiating a microtaper. 

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