Updose, feel awful...will it even out eventually?

So I’m on day 4 of an updose and I’ve felt a little relief, not much, had a productive morning of housework and then just now in the shower it was like I am back to horrible withdrawal symptoms.  Was planning on going to the gym but I’m totally DR’ing and feel like I was hit by a truck.  Is this part of what happens when updosing sometimes?

 

Thank you all ❤️

 

MP

It could take sometime to settle, depending on how poorly you were feeling before the up-dose.

 

Also, with Ativan and depending on how you dose, I wonder if some of what you are feeling is inter-dose withdrawal.

Hi benzo-off,

 

I was feeling pretty crappy for a month after a 20% doctor advised cut (I know better now) so I updosed to 1.25 from 1mg.

 

I also started dosing 4 times a day because Ativan only seems to last about 5 hours for me.  I don’t feel interdose withdrawal like I used to though, just still feel like crap mind you.  Maybe this also has something to do with it?  I only started dosing 4xday a week ago.

It could be, for some, every little (or big) change, takes time or throws some off more than others, it's a very individual thing.

 

I believe A comes in .5/1/2 mg doses, so that would mean you are pill splitting, which I personally don't like to see, but understand you have to do what you have to do.

 

I would keep a daily log and track your symptoms, see if there is improvement or stability, meaning things are not getting any worse, giving a baseline of symptoms. 

 

ETA: If it is/was possible, I would suggest crossing over to either K or V and then doing a liquid titration off. 

Thanks again benzo-off, I’ll just keep on keeping on for the next couple days and try my best to keep as active/ distracted as possible.  I will start that log and see if it helps me, great idea.

 

You’re very kind, cheers!

 

MP

Oh, my doc or pharmacist don’t believe in a gradual crossover to V (K was horrible, did nothing but make me sicker years ago).  I tried a direct c/o to V as doc suggested and thought I was going to die the depression was so intense.  Once I stabilize on a Ativan dose I intend to go back to work to get stability before attempting a liquid taper.  Found a compounding pharmacist in a professional lab who is very benzo wise and will be going there.

Gotcha, and you will be able to get compounded A so that will be helpful in your liquid titration when you are ready.

That's great you found a compounding pharmacy Monkey! That will be a game changer!

 

Hope you are feeling better

Thanks SH ... still feeling like crap but tomorrow is another day and maybe a great one!

 

When you updosed how long until you felt better? 

I updosed from 2.5mg of V to 3mg and felt more stable in about 4 days.

Thanks Pete!  I realized it’s only been 3 days so I’m hoping tomorrow is a charm!

 

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.

 

What I have experienced:

 

In May of last year I started taking the klon daily. In July, I cut my dose by 2/3 (I know, but at the time, I didn't). Symptoms took a week to hit, and didn't reach a fever pitch for a month. At that point, I tried to updose back to 2/3 of my original dose, and felt much worse. I settled on a middle ground. I think if if had realized what was happening sooner, I could have updose to a higher dose and saved myself some (certainly not all, but some) suffering, but this is just a theory.  I have no regrets, but it is interesting to consider.

 

I hope tomorrow is the day it turns around for you, Monkey. But if you have good days and bad days for a while, that's still a lot better than it is for some. Don't panic, don't push yourself. Practice acceptance, and patience, and stability will come in time.

Great answer Waves (you should really be a moderator on this site)

 

Let us know how it goes Monkey. My up-dose got stable fast but I went back up in one day. And at the point I was (stupidly) making big cuts in Valium. Waves gave great info - you will get stable soon - stay in the game!

Thank you both for your support.  Waves this is great info.  I guess I’ll just keep being patient d hope for the best.  I’m tempted to go up to 1.5 but I guess that would just cause more problems, just want relief.

 

Cheers y’all and thank you sincerely

 

MP

Hey Waves,

 

So I just reread your post and am I right in assuming you updosed to .375 instead of .50 and got relief?

 

I’m hesitant to try any other changes as I’ve been up and down but your observation sounds plausible. 

Three to eight weeks is an insane amount of time to wait for relief...maybe updose to .125 is worth a try, middle ground I assume.

 

I would not want to updose to 1.5 and lose that progress.

 

 

 

 

Hey Monkey,

 

Yes, you understood correctly. I ended up settling on 0.375 on my dose and tapered from there.

 

I do not think that further updosing will help you, and yes, might make things worse. I would stick with the 1.25, and, honestly, if I were you, I would start tapering now, very slowly, so your body doesn't become too dependant on that additional 0.25. You were at 1 MG the majority of the time you have taken it so I would personally want to be moving in that direction, just very slowly, 5% / 2 weeks or less to start.

 

Your signature is great, very descriptive. I am going to type it out in a simpler way here for clarity's sake.

 

Date unknown: add Cipralex/Lexapro, cns destabilization

08/21: 1mg A

09/23: updose Lexapro

10/11: c/t A, add K (unknown amount)

10/18: c/t K, 1mg A

11/15: updose Lexapro, 1.5mg A

11/24: 1.25mg A

01/21: 1mg A

02/15: 1.25mg A

 

What I am about to say is no judgment on you. This is a perfect example of what is wrong with health care today. Your doctor put you on a drug that, for many, causes debilitating side effects, and is very difficult to withdraw from. Then, when you developed those side effects, instead of withdrawing you from that medication, he puts you on a second drug that can cause debilitating side effects, and is very difficult to withdraw from. Since then, his approach to solving these problems has been to c/t you off one drug onto another twice, increase the drug that caused the initial problem twice, and monkey around (sorry, had to say it) with your dose of the benzo, by too-large amounts. I guess the only thing we have to be grateful for is that he hasn't tacked on two or three more meds to treat symptoms.

 

Each one of these events was an injury to your central nervous system, like a concussion. That's a lot of concussions. It is not a surprise that you are not stable now, and I wouldn't be surprised if it took quite a while longer to get there. I do not think updosing either of these medications at this point would do anything but further injure you. It is a miracle that you are having good days, that you can manage scrabble. Most people with a story like yours are in much worse condition. I think you should hold onto the stability you do have, and start your taper immediately to prevent further harm from being done.

 

I am so sorry that you are going through this. None of this is your fault. You are not alone, even in your specific story. SSRI toxicity is the reason for many of the people here being started on benzos. But again, you are doing better than most, and that gives me hope, that you can fix this, and be you again. All you have to do is be gentle with yourself, don't make any sudden moves that will sink you deeper in the quicksand, and slowly start climbing out.

Holy crap Waves, thank you for all of what you wrote!  You really put some effort into looking over what has happened on my journey and this to me is priceless.  Thank you doesn’t seem enough.

 

I guess I haven’t had it as bad as some others and this is a huge boost to my confidence of which I have lost a lot since this all began.  I had a major concussion from a car accident when I was 16, in a coma for a month, but came through it with no apparent damage.  The first thing I said when I woke up was “I want ice cream”.  Maybe this affected the way I heal in a positive way?  Who knows.

 

I am a person who needs to do stuff, be involved, problem solve, be around and help people and for the past seven months I’ve been mostly at home taking care of housework and errands.  I need to get out and into a routine and going back to work is my first priority.  I’m going nuts without it.

 

I believe the updose is working as yesterday I took a long 1.5 hour walk, did groceries, started looking for summer clothes (looking towards the future) and I see this as a huge change from a month ago.  I was feeling this way before the 20% cut my doc suggested and I have visions of me at my job...confidence is slowly returning.  I awoke today feeling the same way.

 

All this to say, I want/need to get back into real life before I start my taper.  I understand the importance of getting off the A as soon as possible and I sincerely thank you for go graciously laying it all out for me (and I loved the monkey reference lol).  I just feel I have to get back into the groove before I can jump onto that taper wagon.  I’m also wondering how long my disability benefits will pay/ doctor will approve my leave of absence as, like many docs, she thinks it’s no big deal tapering benzos.  I’m stuck with her I believe cuz in Canada it’s hard to get a regular doctor and I have another unrelated health issue she manages for me. 

 

I found a professional compounding pharmacy and spoke with the owner/pharmacist and she said she’s gotten people off Ativan before, she assured me she knows what she’s doing and has been in business for 20 years.  I’ve got my ducks all lined up so when I’m ready, I’ll be really ready.

 

Tapering 5% A as you suggest is what I will go with first...having people like you to help is again priceless and I am so very grateful for your presence on my journey off this crap.

 

I wish I could hug you here and now.

 

I hope one day I can repay you for all you’ve done so far and it is a lot.

 

Cheers and healing Waves,

 

MP

 

❤️🐒🐷❤️🐒🐷❤️

 

P.S.  I really appreciate you simplifying my signature and have replaced it with what you created.  One thing I left out was Trazadone for sleep, started same time as 20mg Cipralex/Lexapro.