Seeking some clarity in among the uncertainty

I am currently tapered down to only 1mg Valium per day, (after low dose use up to 6mg per day for over 1 year).  When I read Prof Ashton's Schedule for Diazepam withdrawal, she suggests reducing by 1mg over 1-2 weeks.

What I also read in this forum is a recommendation to reduce Benzodiapines at a rate of 10% - which is a lot slower reduction than the last weeks on Ashton's schedule.

I have also read that the 10% taper applies mainly to the 'stronger' potency Benzo's like Clonapine, versus Diazepam itself.

I am aware that many people do a liquid taper at 1-10% for any/all of the Benzo's to reduce impact of withdrawal symptoms.

Can anyone please clarify or share their experience of tapering as per Ashton's Schedule for reducing Diazepam (versus other Benzo's) at 1mg per 1.2 weeks?

I know she also suggests to customise the taper to individual - so I am just trying to adjust as I go to what feels safe.

 

I decided to taper at a rate of .5mg per week and last week this meant I was taking a total of 1mg per day (2 X .5mgs). 

I noticed a lot more symptoms (than previously) that I would associate or put down to the withdrawal for the first couple of days but the worst ones (depersonalisation/increased irritability/depression/anxiety) seemed to have eased, for which I am truly grateful.  Now I just continue to feel utterly exhausted, sociophobic, agoraphobic, sensitive to sound and sunlight  and as if I have got the 'flu.  I am also getting numbness and pins/needles in my feet.

As a result of my symptoms I have decided to slow the rate of my taper.  I will continue to take 1mg per day for the next few days.  Then I am thinking that I will just file a small amount off the half of the 2mg tablet for a few days, then a bit more off for a few days etc until I am down to .5mgs and then reassess.

Some of the material I have read seems to say just jump at 1mg or less, but I'm guessing the point is to try to avoid the damage of being symptomatic, so of course it's a scary thing to do without knowing what might happen next.

I am so keen to be free of this drug, especially as even though I have been experiencing some tolerable withdrawal symptoms I also notice, especially last couple of days, a sense of 'returning to myself' - less brain fog, and a bit more hope.

Thank you in advance for any clarity you might be able to provide or sharing your experience/support.

I used Ashton as a guideline when I wasn't certain what to do.  I'm more sensitive to meds than most and  have had to follow the 10% rule.  I'm not certain I understand your current tapering plan as you mention the 10%, but state that you've dropped 0.5mg per week.  That's a tremendous amount of change. The symptoms you mentioned especially pins and needles are the GABA receptors not coping with the med drop.

 

The reason most changes are weekly is because Valium's half-life can be up to 200 hours- about 8 days.  Each subsequent dose can build on the residual of the last to some extent. It gives a hold-over effect. That means whatever dose you begin, in 8 days the full effect happens. Sounds like you've hit a time your body can't handle it. No problem to hold that 1mg dose.

 

If you were at 2mg then a 0.5mg drop is 25%.  That's a big change especially at a weekly schedule. The lower the dose, the higher percentage the 0.5mg becomes. You can hold at a particular dose for several weeks to see if symptoms lessen.  Some tell you to push through, but I couldn't, as if I tried it, the symptoms intensified greatly. It's not wise to torture yourself unnecessarily.

 

Using the additional dosage to "up dose" isn't usually a good idea as you cover old territory, and may not get any benefit.  Ashton's manual addendum addresses this.

 

Although Ashton says that you can drop from 1mg to 0.5mg, and then 0.5mg to 0 without problems, I didn't find that to be true.  I had to hold at 1.0mg for about 3 weeks.  I then dropped at 10% weekly. I dissolved the 2mg tabs in water and then used a syringe to dose.  Sounds ridiculously low, but I've read of others on the forum who had to do the same.

 

Additional help- buffered vitamin C and niacin act to dampen these effects.  I use the flush free niacin several times a day. It's very calming. Vitamin C is also calming. If I get shakey, I use the pseudo amino acid Taurine. It's a natural anti-seizure med so it helps the muscle tremors. Understand it lowers blood sugar, so take it with food.

 

Hope this is helpful.

Hohhot, Thank you for sharing your experience.  It's helpful.  I've ventured out to buy a syringe so that I can more accurately and more gradually reduce my dose, which is what I intend to do.

 

Symptoms like the pins and needles feel quite tolerable so I'm finding it difficult to gauge what is too fast versus unnecessarily slow.   

 

My (simplified) understanding is that the goal of trying to minimise symptoms during withdrawal is to give the body a chance to heal e.g. GABA receptivity.

 

Following on from what you said about up-dosing (which I don't intend), Ashton's supplement says:  The truth is that one never 'stabilises' on a given dose of benzodiazepine. The dose may be stable but withdrawal symptoms are not. It is better to grit one's teeth and continue the withdrawal. True recovery cannot really start until the drug is out of the system.

 

It was valuable for me to read that it was not true for you, what Ashton said about how the drop from 1mg to .5mg to 0mg can be done without problems.  It sounds to be the case for many others too, so I am just trying to work out how reliable/advisable Ashton's taper is at the end with these big % drops (much larger than the 10% per week of 1% per day I've read from others).

 

It's the difference between Ashton's large % drops at end of taper versus the >10% method that I was trying to address in my post.  Maybe the question I was asking was 'should I be ignoring Ashton in favour of some more compelling or updated information with respect the >10% taper?'  I realise the answer to this is to probably going to be to monitor my symptoms and adjust accordingly, and be prepared to hold where necessary.

 

Unlike the Ashton schedule I haven't yet been able to locate any (other than anecdotal) published material in respect of 10% drops.  I followed your CDC reference to the 10% reduction in another post and see that it is a guideline for tapering off Opioids (versus Benzodiazepines).  I'm just wondering if Opioids and Benzo's are treated as similar in this regard?  I guess they would be?

 

From what I'm reading, trying to benefit from others experience while individualising my own taper, even though I can understand the rationale for a slow taper, I'm not necessarily noticing that it co-relates with people having a smoother or shorter recovery at the other end (after last dose).  Maybe I've got that wrong.  Like everyone else I guess, I'm just trying to find ways to minimise suffering, in extent and duration.  I guess it's naive of me to expect that I might walk off the Diazepam without residual symptoms.  I'm coming to terms with the probable need to contend with the repair of homeostatic disruption/damage even after the long half life of Valium has tapered to nothing after the final dose.

 

I do understand that what I read most of all is to take it slowly.  And maybe I'm beginning to accept that I can't kick this dehibilitation in an aggressive way - but have to ease my way out of it gently and give way to it's timeframe, not mine.

 

Sorry what you've been through with all of this.  (Ps I have a sibling who was diagnosed with hashimotos age 12 so it's something I'm vigilant about having checked)

 

Many thanks again for your support in sharing your experience.

 

 

And remember, the guide is just a guide, and as wonderful and glorious as it is, a guide that is not for everyone. It's like anything else: people move at different rates. In the end it doesn't matter what potency something is, or what the recommended reduction is, it's how you feel that matters. Some people crawl through that last few milligrams. Some people jump at .5, some people need to go further down. You'll hear all kinds of doctrinaire reasoning behind this (oh its not therapeutic at that level, etc), they could be right, but all that matters for the individual is results. You seem to have an intuition that you need to move slower. Any intuition that stresses safety and patience seems like one that should be listened to carefully. If you go to the titration board they can give you specific advice on how to do that last bit slowly, if you want more guidance. You hear very few people complaining about jumping at too low a dose.

 

Here's the direct link to that part of the site:

http://www.benzobuddies.org/forum/index.php?board=164.0

 

The only evidence that truly matters in your tapering experience is what your body is telling you, so long as what you are doing isn't foolhardy or proven to be dangerous. And I can't see anything you are contemplating that isn't well thought out. I got to experience what listening to experts results in. It's not always pretty.

 

 

 

 

 

Thank you Quietquiet.  Really appreciate your response and supporr

Personally I started w/ Ashton’s suggestions as a rough guideline then as I got lower did roughly 10% every 7-10 days.. then speeded up at the end. Was done with prescribed Valium elixir and a 1mg syringe. It worked for me.

Thanks for sharing your experience JJ.  I'm going to try and 'updose' to some regular daily meditation as well.

This is a quote from another buddy that made great sense to me and stated very simply 

 

Cant quote on going slower

 

"It wasnt realy intensity levels that made me slow right down at the last, though there sure were moments, It was my intent to cushion the point where my body was transitioning onto its own chemistry........"

Thank you thank you all for voicing my concerns and teasing out all the information.  I am working my way down and have huge appreciation for those of you who are close to the jumping off point.  You are my heros. 

I agree with comments about the Ashton Manual's guidance on jumping the last 1mg to .5mg.  I thought she made it sound a bit easy breezy - jumping off. (bless her heart, tho',  for her body of work!)

 

Everyone is so different.  Younger/older,  fast metabolisms/slow, etc.  Different strengths and weaknesses.

I love it that we are all kind of shuffling our way along and listening to our bodies.  And sharing that information.  I too am feeling small windows of my old spirit - my old self.  I am feeling things a bit more.  I realize now how emotionally blunted I had become.  I know I have a long road ahead, but these small whispers of my old self (interspersed with hard time) give me hope.