help with Xanax taper

Hello everyone....

I have been taking .125mg of Xanax 1-3/day (very sporadically as I believed in the "as needed" Rx) for 16 mos.

Accidentally went CT for 36 hours while dealing with a headache because I had no idea my body is dependent on this evil drug (see my intro for symptoms etc.). After reading the posts on here, I believe my headache was a symptom of this drug as well...my guess is inter-dose withdrawal?

I really have no exact "starting dose", which makes this all very hard to figure out, especially in my current state of mind.  I believe my daily average was .25mg however I have been taking that dosage for the last few days and I still feel awful.

Tolerance?

I'm really struggling with how to figure out a tapering plan. Any help is appreciated.

If your average has been 0.25 mg/day, I would stick with that, broken into two doses or more if possible. Three or even four doses would be best, if possible, but if you are just breaking pills that may be hard to manage.

You are still recovering from the 36 hours c/t, which can take a while to resolve. Most people find that adjusting dose during this period doesn't resolve symptoms, and you don't want to make your path longer than it has to be, so I suggest holding where you are. Be patient.

In the meantime, most people who taper directly from Xanax do well with a liquid taper, so you might want to read some posts on the titration board to start learning about that.

Ok so I started a taper of .0625 3x daily on Saturday. I have a lot of symptoms, not God awful.

Please bear with me as this whole thing is a lot to take in.

My question is this: my 3 doses are morning, mid-day, and night.

Do I need to take them at the same times exactly?

What if I don't feel like I "need" anything? Should I still take the dose?

For instance my mid-day dose was due over an hour ago but I don't feel as though I need it.

I never felt like I needed this drug unless I was under stress and to sleep.

I never took a morning dose. 3-4 days/week I took a late afternoon of .125.

My largest dose was always at night. And that was normally .125 - .25.

What is the benefit of spreading out the dosage 3-4 times per day?

This is all so hard for me to comprehend. Can someone please explain this to me in simple terms?

I would appreciate it so much.

Keeping doses spread out evenly throughout the day will help maintain an even benzo level and help stave off inter dose withdrawal. This will help your taper.

Whether you choose 2 or 3 doses, is up to you.  The days total dose needs to be the same regardless if it's taken 2 or 3 times throughout the day.

Quartering a .25 mg Xanax pill is not reliable nor is it accurate.

I personally would of started a taper from a slightly higher dose and after a bit of a hold to stabilize.  You have mentioned experiencing body/muscle jerks and grasping for air in your other post.

You're trying to taper too fast, without stability or a proper taper plan. .

Thank you everyone. I appreciate the feedback.

I am in no rush after the symptoms I have dealt with in the last few weeks.

I had chance read through the liquid tapering. I travel for work and wonder if this is possible?

Thank you everyone. I appreciate the feedback.

 

I am in no rush after the symptoms I have dealt with in the last few weeks.

 

I had chance read through the liquid tapering. I travel for work and wonder if this is possible?

Sure.  Your liquid is just the same as any liquid medicine.  It does not need refrigeration, just carry it with you and dose when convenient.

Whew. Thank you, Builder. That's a relief.  If I wanted to make a two week solution using .25mg Alprazolam what will my alcohol and water ratios be?

Regarding the taper plan found at http://benzo.alwaysdata.net/titration/titrationForm.php

Can I get some feedback on which method has better results fixed reduction quantity vs. percentage?

Thank you.

Whew. Thank you, Builder. That's a relief.  If I wanted to make a two week solution using .25mg Alprazolam what will my alcohol and water ratios be?

 

Regarding the taper plan found at http://benzo.alwaysdata.net/titration/titrationForm.php

 

Can I get some feedback on which method has better results fixed reduction quantity vs. percentage?

 

Thank you.

If your current dose is 1.375mg/day (per your siggy)...

combine 15mg + 30ml vodka + 120ml water.  That will give approx a 10-12 day supply.

You can divide up the full days dose into periodic doses as you choose.

Whew. Thank you, Builder. That's a relief.  If I wanted to make a two week solution using .25mg Alprazolam what will my alcohol and water ratios be?

 

Regarding the taper plan found at http://benzo.alwaysdata.net/titration/titrationForm.php

 

Can I get some feedback on which method has better results fixed reduction quantity vs. percentage?

 

Thank you.

Fixed percentage is gentler on the system but fixed quantity get you there faster. Fixed percentage, if entered correctly, will give you a gentle curved line on the graph, whereas fixed quantity gives you a straight diagonal decline. You can also choose fixed quantity and then choose "attenuated ending", which will create a bend in the line toward the end so it doesn't get going too fast. If you choose fixed quantity and start having too many symptoms, you can always switch. If you choose fixed percentage and are feeling great, you can always re-run your schedule at a higher percentage. Lots of good options here, as long as you don't start too fast.

Whew. Thank you, Builder. That's a relief.  If I wanted to make a two week solution using .25mg Alprazolam what will my alcohol and water ratios be?

 

Regarding the taper plan found at http://benzo.alwaysdata.net/titration/titrationForm.php

 

Can I get some feedback on which method has better results fixed reduction quantity vs. percentage?

 

Thank you.

 

Fixed percentage is gentler on the system but fixed quantity get you there faster. Fixed percentage, if entered correctly, will give you a gentle curved line on the graph, whereas fixed quantity gives you a straight diagonal decline. You can also choose fixed quantity and then choose "attenuated ending", which will create a bend in the line toward the end so it doesn't get going too fast. If you choose fixed quantity and start having too many symptoms, you can always switch. If you choose fixed percentage and are feeling great, you can always re-run your schedule at a higher percentage. Lots of good options here, as long as you don't start too fast.

And the "hybrid" (which is probably what most folks actually do ) is the listen to your body method.  Do a fixed quantity taper until and if you feel sxs emerging, then adjust to  a lower fixed quantity rate.  What you actually doing is adjusting the quantity as needed to stay within your percentage tolerability limits.

Thank you both.

Waves...how are you doing your dry taper in terms of ingestion? Gel caps?

Also, to be clear I'm trying to stabilize at .25mg at the moment after my unintentional CT.

My symptoms are brain fog and I fall asleep ok but wake up to my muscles twitching like crazy throughout my body several times per night. They continue to twitch during the day, but less so. Normal? I was worried this was a seizure. Also, some mild pain and burning in the odd places (like the tip of one finger).  The muscle jerking thing frightens me the most...

I read many post stating Alprazolam is incredibly hard to taper off.

Then I read a few successful A stories. I see my MD tomorrow and I still don't know what to do.

I worry about switching to V (after stabilizing) and I worry about not switching.

How long does stabilization typically take?

Thank you both.

 

Waves...how are you doing your dry taper in terms of ingestion? Gel caps?

 

Also, to be clear I'm trying to stabilize at .25mg at the moment after my unintentional CT.

My symptoms are brain fog and I fall asleep ok but wake up to my muscles twitching like crazy throughout my body several times per night. They continue to twitch during the day, but less so. Normal? I was worried this was a seizure. Also, some mild pain and burning in the odd places (like the tip of one finger).  The muscle jerking thing frightens me the most...

 

I read many post stating Alprazolam is incredibly hard to taper off.

Then I read a few successful A stories. I see my MD tomorrow and I still don't know what to do.

I worry about switching to V (after stabilizing) and I worry about not switching.

How long does stabilization typically take?

Hey LaLa,

I am using a sharp little craft knife to cut and shave my pills, and a gem20 scale to weigh them. I make 7 days worth of doses (3 doses per day, so 21 doses total) in about an hour on average, sometimes a little longer if I am distracted. I put my doses in little tiny pill boxes that I bought at a craft store (I think they are intended for beads or something? Lip balm? I don't know). My dose is usually just one piece of a pill, but I try to use up scraps as I go so sometimes I will have one or two doses that are 2-3 smaller chunks instead of one bigger one. A lot of people criticize this method because they are religious about the method that works for them, but this method is working well for me. I think people should do whatever works for them, and I think it is important for people to know that they have options.

Xanax is a little more challenging for a dry taper, because many people dose 4x/day and are only working with 0.25 or 0.50 mg strength pills. It's a shame that they don't make them in 0.125 like they do with klonopin, since Xanax is just as strong. But of course, the pharmaceutical company has no interest in making it easier to stop using their product.

This is the reason people say that Xanax is hard to taper off of, because of logistical issues. If you can master those, though, it is actually maybe the easiest benzo to come off of because of the short half-life. I can't vouch for this due to no experience, and anecdotal evidence is scarce because so many people are told they have no choice but to cross to a longer acting drug, but I have heard a number of doctors and pharmacists state this opinion, one of who tapered directly off of Xanax himself. I have also seen some success stories here. When asked about cross-over for tapering, Bella Amis says it is not advised unless you have already determined it too difficult to taper directly from your original drug, and I think this is good advice. You haven't yet had a proper opportunity to try a slow symptom based taper, so I would not jump to Valium just yet.

Sorry you are having the muscle jerks. It is scary but it is not a seizure. If you Google "myoclonus", this is a more apt description. When it happens during sleep it is referred to as "hypnic jerks". It is very common in acute withdrawal after a c/t or large cut. It can also be caused by sleep deprivation, so it can be a secondary withdrawal effect following insomnia. For me, this symptom lasted about 3 weeks, and was the scariest one for me, or maybe tied with the insomnia. I can't explain why, and it may be coincidence, but I followed some random advice which helped me, and I have passed it on and others have said it helped them, so it's worth a try. What I did is start drinking electrolytes before bed. It seemed to lessen the intensity of the jerks. Again, not sure why but who not try it?

As to your question on a time line for stabilizing, I recently shared what I have observed on this site, in another thread, so I am going to quote myself here, in hopes it might help answer your question. Of course, there is no science behind this. Each person is unique, I am just expressing a sort of average experience as I have observed from reading hundreds of accounts on this site.

Hope something here is of help to you!

Things I've observed:

 

Ativan and Clonazepam seem to have a longer recovery time after large cuts/dose changes/brand changes than diazepam or xanax. It also seems that people on those drugs react more slowly and less favorably to an updose, specifically. I have no idea why this would be, based on my understanding of the differences between the drugs, but it is what I have observed here.

 

Updosing after a cut on xanax and diazepam often seems to resolve symptoms in 1-2 weeks, whereas with Ativan and Clonazepam it seems to be more like 3-8. I am talking about large cuts only, here, cuts under 10% resolve in 5-10 days for most people on any of the four.

 

Another variable to consider is the time elapsed since the cut. An updose made a week after a cut is a rather simple readjustment for the body, so in some cases, recovery is quicker. A month or more of time elapsed means a bigger adjustment, and thus can take longer to stabilize.

 

The third thing to consider is the healing that happens between the cut and the updose. As soon as part of the dose is removed, the Gaba upregulation begins, or struggles to. The theory is that this is why we suffer. As time goes on, your own Gaba is starting to be produced to fill the hole left behind by the drug. By this theory, if we reinstate the same amount we removed after too much time has elapsed, we sort of overshoot the goal, and this can serve as a second shock to the system, leaving your GABA receptors, which were working so hard to recover, struggling to figure out what comes next.

Waves,

This is all incredibly helpful. Thank you so much.

I realize the pill splitting is an issue. Is there any downside to crushing the pills, weighing the doses out and using gel caps?

In comparison to pill cutting, it takes a little more time, more equipment, and more care, due to the nature of working with a powder and getting an exact amount into a capsule (without spilling or losing powder on the tray, spoon, funnel, etc. These are the reasons I decided not to use this method for myself.

Pill cutting and reducing to powder/capsule making both share one drawback in comparison to a proper liquid solution, which is less accuracy. Personally, I think crushing a bunch of pills at once and stirring them up and counting on randomness to evenly distribute the medication in the powder is slightly less accurate than pill cutting, but not by much. Even liquid is not perfect if you make it yourself. Even if you follow all the rules and create a little lab in your kitchen, each of your tablets can have between 80-100% of the stated active ingredient in them, so every batch you make can be of varying strength.

This is not something that should make us MORE anxious about tapering, though. It should make us LESS anxious. Because perfect is not possible, there is no need to strive for perfection. ANY METHOD that allows you to steadily decrease your dose over time will work, and staying with the same method is more helpful than finding the "best" one.

Hi lalaland77!  I am tapering off alprazolam doing a daily liquid micro taper. I have done what builder said, reducing by a fixed amount until symptoms started to appear, then reduced the fixed amount. I know that doesn't make sense. I'll elaborate later.

I started at 1 mg per day (had been taking that for 2 years) last August, and now I just passed 0.06 mg as I reduce more. There were a few hiccups where I held, as you can see from my signature. But it certainly has not been debilitating. And I have been working the whole time, with an hour plus commute each way.

I started at 1 mg a day, and reduced 0.01 mg every day, until I got to 0.8 mg.

Then I reduced 0.008 mg every day, until I got to 0.6 mg.

Then I reduced 0.006 mg every day, until I got to 0.4 mg.

You get the idea.

Now I am reducing 0.002 mg every day. I should have - and hope I have - only 30 more days to go in my taper. I will not  be reducing my cuts anymore if I can help it. I plan on reducing 0.002 mg every day all the way to the finish.

Tapering from alprazolam is possible. Several people recommended I switch to valium or clonazepam to taper, saying it would be "easier." I'm very glad I did not switch.

There were some symptoms during my taper. Especially at the beginning, there was brain fog. I swear I forgot how to drive because it seemed difficult to do. I had to remember all the steps for changing lanes. And it was hard.

One change I made during my taper was to get rid of the set dosage times. While I was taking pills I took 1 mg in the morning, and 1 mg at lunch. So when I switched to liquid I did the same, one dose in the morning, and one dose at lunch. I ditched that method at some point. Now I just pour my whole daily dose into one bottle, and I take swigs from it every few hours during the day. It seems to work for me.

Here's hoping you do this.

(edited to correct typos.)

Even if you follow all the rules and create a little lab in your kitchen, each of your tablets can have between 80-100% of the stated active ingredient in them, so every batch you make can be of varying strength.

 

 

Actually, each tablet can have 85-115% of the stated active ingredient.

If an entire batch of pills were tested, it would all average out to 100%. But that would entail testing one million pills!

Whew. Thank you, Builder. That's a relief.  If I wanted to make a two week solution using .25mg Alprazolam what will my alcohol and water ratios be?

 

Regarding the taper plan found at http://benzo.alwaysdata.net/titration/titrationForm.php

 

Can I get some feedback on which method has better results fixed reduction quantity vs. percentage?

 

Thank you.

 

Fixed percentage is gentler on the system but fixed quantity get you there faster. Fixed percentage, if entered correctly, will give you a gentle curved line on the graph, whereas fixed quantity gives you a straight diagonal decline. You can also choose fixed quantity and then choose "attenuated ending", which will create a bend in the line toward the end so it doesn't get going too fast. If you choose fixed quantity and start having too many symptoms, you can always switch. If you choose fixed percentage and are feeling great, you can always re-run your schedule at a higher percentage. Lots of good options here, as long as you don't start too fast.

 

And the "hybrid" (which is probably what most folks actually do ) is the listen to your body method.  Do a fixed quantity taper until and if you feel sxs emerging, then adjust to  a lower fixed quantity rate.  What you actually doing is adjusting the quantity as needed to stay within your percentage tolerability limits.

👍🏻

Even if you follow all the rules and create a little lab in your kitchen, each of your tablets can have between 80-100% of the stated active ingredient in them, so every batch you make can be of varying strength.

 

 

 

Actually, each tablet can have 85-115% of the stated active ingredient.

 

If an entire batch of pills were tested, it would all average out to 100%. But that would entail testing one million pills!

I was referencing your own previous post, hopetodothis!

When tested, each pill must contain 80% to 100% of the label claim.

 

The average of 10 pills or 20 pills (my memory fails me here) must be 90% to 110% of the label claim.

 

So each pill can be off by 20%. A whole batch can be off by 10%.

Am I misunderstanding something here? I want to be able to explain this correctly. Thanks.

And congrats on you nearing the end of your taper! Great news!

Even if you follow all the rules and create a little lab in your kitchen, each of your tablets can have between 80-100% of the stated active ingredient in them, so every batch you make can be of varying strength.

 

 

 

Actually, each tablet can have 85-115% of the stated active ingredient.

 

If an entire batch of pills were tested, it would all average out to 100%. But that would entail testing one million pills!

 

I was referencing your own previous post, hopetodothis!

 

When tested, each pill must contain 80% to 100% of the label claim.

 

The average of 10 pills or 20 pills (my memory fails me here) must be 90% to 110% of the label claim.

 

So each pill can be off by 20%. A whole batch can be off by 10%.

 

Am I misunderstanding something here? I want to be able to explain this correctly. Thanks.

 

And congrats on you nearing the end of your taper! Great news!

Oh my faulty memory!  Let me look it up in the USP when I get to work tomorrow. My memory from 10 years ago working with tablets was they had to have 80 - 120% of the label claim. But builder corrected me somewhere, and I took his word for it. I will verify the current requirements tomorrow.

I do know that when 10 tablets are tested, their average must be 90-110%. But that doesn't help when it takes 5 days to take a full tablet.

And thanks! I'm quite excited to be nearing the end.

I am so grateful for all of you. I have no idea what I would have done without finding this forum and people willing to take the time to help.

Hope...When you are "swigging" what are you drinking out of exactly?

Also, when you cut and hold are you holding at the dose at which you are feeling discomfort?  What are some of the symptoms you are having? (if you don't mind sharing.)

Waves...if/when I stabilize how long after should I begin my taper?

I am so grateful for all of you. I have no idea what I would have done without finding this forum and people willing to take the time to help.

 

Hope...When you are "swigging" what are you drinking out of exactly?

Also, when you cut and hold are you holding at the dose at which you are feeling discomfort?  What are some of the symptoms you are having? (if you don't mind sharing.)

 

Waves...if/when I stabilize how long after should I begin my taper?

Lala,

It really is a personal choice. Some people pick a random amount of time for themselves to hold, some people start tapering as soon as they feel stable, and some (including me) start a slow taper while still in withdrawal. I'm not convinced it makes any difference. If you are planning a slow symptom based taper you aren't going to further destabilize yourself, regardless. Again, no science here, just my thoughts.

I bought one of those 90 mL travel bottles from CVS and take it with me to work. My batch is made up in a 500 mL bottle. I pour out my daily dose into a graduated cylinder and pour it into this little plastic travel bottle that's made for like shampoo or something. So you can get through the TSA with your liquid.

I don't do a cut and hold. I am reducing every day. Until some symptoms arise. Foggy head mainly, which feels like nicotine withdrawal. I had tension headaches for awhile, but those were dealable. And there was the tinnitus phase between 0.5 and 0.2 mg, which was also dealable. Sometimes a little panicky feeling, but nothing major. The foggy head and the panicky feeling are when I hold, which is, I stop reducing for a bit. Then when I feel better I start reducing again. My longest hold was like 2 weeks or so, which I completed a few weeks ago. I am reducing again now. I'm down to 0.056 mg today. It will be 0.054 mg tomorrow. And so on.

Waves,

 

This is all incredibly helpful. Thank you so much.

 

I realize the pill splitting is an issue. Is there any downside to crushing the pills, weighing the doses out and using gel caps?

If your going to do a dry taper, that is absolutely the best procedure.  It helps overcome the tablet-to-tablet variance, and the uniformity of distribution problem

Waves,

 

This is all incredibly helpful. Thank you so much.

 

I realize the pill splitting is an issue. Is there any downside to crushing the pills, weighing the doses out and using gel caps?

 

If your going to do a dry taper, that is absolutely the best procedure.  It helps overcome the tablet-to-tablet variance, and the uniformity of distribution problem

Yes. I’m nearly 100% sure that the lack of a consistent dose is why my journey got SO ROCKY. Do whatever you can to maintain consistency of your dose as you taper.