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Planning to eventually dry cut taper alprazolam - initial concerns


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Hey all,

 

After spending a few days on BB and learning a lot about how others planned and coped. I have a few questions.

 

To start, my new doctor recently prescribed 1.5mg of alprazolam, which I am used to only taking 1mg every morning. The prescription isn't a long one and I plan on letting them know that I think 1mg a day is enough that I can get by on, whether or not this will become a reoccurring prescription is still to be determined. They've been trying to get me on antidepressants before fully committing to solely benzos, which I do agree with from an ethical point of view. Anyhow that is my current situation and I may need to end up tapering myself.

 

Some initial questions come to mind, some to which I did get answers for already by another member before but still looking for more feedback.

 

1.) I only take 1mg of alprazolam every morning. I have for around 7 years and never really had problems with the inter dose withdrawls. (I am also a long time cannabis smoker, which I think masked those withdrawls). With this information, is it typically better to remain consistent in doses, or should I first break up the 1mg to 4 times a day (those withdrawls will still suck I know). I tried a .25 reduction for 7 days, couldn't handle the rebound anxiety and insomnia. So that didn't go well and I went back to 1mg.

 

2.) This is the elephant in the room. I am a hypochondriac when I can't get my mind off a physical symptom, and while I've gotten good at breaking myself out of those thoughts, I am very concerned about the severe side effects that I wish I never heard of in the first place. Stokes, cardiac arrest, seizures and death being the biggest things on my mind. I already have high blood pressure and am on lisinopril to manage. This is also recent so I haven't quite nailed down if it's even working as between caffiene and nicotine it still tends to stay above normal. So am I at risk if I begin to taper with that in mind? I am good at being paranoid with intrusive thoughts.

 

3.) When tapering, is there ever a period where your body eventually adjusts to the new dose and you return to a mostly 'normal' state? After going back up to 1mg I've noticed I'm waking up early with my body feeling like crap until I take my daily dose. This never used to happen. My vision also seems to have been adversely affected and hasn't returned to what I'd call perfect 20/20.

 

4.) During the 7 day taper, I could not function at work as my mind dwelled on the symptoms and wave panics. Bosses probably thought I was crazy constantly putting cold water on my face and neck to help calm myself lol. They are aware that I want off this medication and are supportive. Well see how long that lasts if my work ethic continues to be affected. I handle a lot of day to day, complex tasks with short deadlines. I am very concerned about my next attempt to taper causing problems again. How have others gone about maintaining a good work ethic while tapering and dealing with intense anxiety?

 

5.) Another thing that I am concerned about is my doc switching me to a different benzo if they think it is more appropriate than alprazolam. Has anyone ever been through crossover with tolerance, and what can I possibly expect? Eventually stabilizing or constant withdrawls due to a longer acting, less potent benzo?

 

6.) I appreciate the information, and am so happy to speak with others about these things. I've found a lot of dread and comfort browsing these forums, and I want you to know I'm glad you're here!

 

Thank you.

(Excuse any typos).

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Hey Zurek

Excuse me for my typos as english is not my main language :)

I can only speak for myself and my own experience so dont take my word as the absolute truth as withdrawals as well as hitting tolarance is very individual.

 

1. I think it depends on how much cannabis you smoke and how regular. cbd has a pretty long half life with 25-36 hours. If you smoke every other day with a sizeable portion you can probably mask some of the withdrawals at least the physical ones. My grandmother actually is on a similar dose for almost 20 years now and also didnt experience interdose or tolarance withdrawal and no she doesnt smoke cannabis ;) Once I decided to taper I started to split my dose up as well because I acutually had some interdose withdrawal and let me tell you it was a very bad choice which wasnt sustainable as I started to have withdrawal symtoms all the time. Im not a fan of the idea of 1 mg of xanax once a day is the same as .25mg of xanax 4 times a day. it just doesnt work that way if you do the math of the actual plasma level. So you can actually get pretty bad withdrawal because your plasma level is acutally overall alot lower. I had to crossover to a longacting benzo  ergo diazepam. 0.25 mg reduction on xanax is way to high as it is equivalent to 5 mg of diazepam.

 

2. I see you are very scared of the like live threatning symtoms. These usually only occur in cold turkeys and from a very high dosage. If you taper properly you will still have symtoms but they wont kill you they are just very annoying and frustrating to deal with as they last for a long time. My bloodpreasure actually went down once I was about half way with my taper and it didnt really increase from the level where is was before the taper.

 

3. Once I was switched over to diazepam I was somewhat able to stabalize and actually had a pretty smooth sailing but there were always symtoms but the severity of the stabilize to some degree, but you probably wont be completly symtom free no matter how long you wait. You just have go with the mindset. If you feel like you can take it go on.

 

4. Your reduction was way to high to begin with people usually go with a 5-10% reduction per 1-4 weeks depending on how they are feeling. If you taper at a slower rate you will have these symtoms to some extend but probaly not as bad as you had them during that week. It usually gets a bit trickier once you hit lower doses. It is very impressive that you were able to work whit all those symtoms. I read from a few people that didnt quit there job during withdrawal and they usually went very slowly meaing microreductions over a longer period of time so they could stay "working". I myself wasnt able to stay consistent but I went pretty fast and rushed into this hole process and I didnt really know about the withdrawal before it was too late.

 

5. So Ive actually done a crossover from ativan to diazepam and in the beginning it didnt feel too good. Your doctor would probaly switch you on a longer acting benzo prob clonazepam or diazepam. They thing with the longer acting benzos is that they need time to build up a certain plasma level. I think it takes like 4 weeks to get to 99% of max plasma concentration. Do the crossover slow and wait for the plasma levels to build up, because before that you will acutally feel worse because you arent actually at the "equivalent" dose.

The crossover made feel overall more stable with less symtom spikes. But I still had symtoms they just were more even during the day.

 

6. Dont read too many horror stories on the web it is esp bad if you are hypochondriac. Its very important to keep a healthy and objective view of things as you go on. If you start hyping up your symtoms and nonstop thinking about them you will feel even worse. Use your mind on positive reinforcements and focus on the healing dont focus on the symtoms.

 

You should definitely talk to your doctor about the prescription but they usually wont just stop it esp. when you mention your fear of withdrawal. If you decide to taper make sure your suply is certain.

I also wanted to add that if you decide to taper that it will take time and you will probably not feel very well for a longer period. What I want to say is dont rush into it if you are stable and feeling somewhat good at the moment.

 

I hope I could help you a bit and I wish you all the best no matter what you decide

 

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Thank you Lemlon. I am still deciding if I can even realistically do this while working. The whole week of the taper and still to this day, I haven't felt good. I am functional but I went into a deep bout of depression after the anxiety subsided, and now I just feel nothing. It's like my body couldn't handle the stress and went into a shutdown mode. I really wish I had the financial well being to take a year or so off and just get this done hoping it falls into that timeframe but it just doesn't seem possible. Unless I come into some money or go back to living with my parents I just don't see how it's possible to do what I do with these symptoms.

 

That being said, I appreciate that you took the time to share your experiences and knowledge with me. Knowledge is power when it comes to getting off this poison properly. Just crossing my fingers I can find a way to get out of this without affecting my life to a severe degree, though it seems unlikely. Again, thank you so much!

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Hey all,

 

After spending a few days on BB and learning a lot about how others planned and coped. I have a few questions.

 

To start, my new doctor recently prescribed 1.5mg of alprazolam, which I am used to only taking 1mg every morning. The prescription isn't a long one and I plan on letting them know that I think 1mg a day is enough that I can get by on, whether or not this will become a reoccurring prescription is still to be determined. They've been trying to get me on antidepressants before fully committing to solely benzos, which I do agree with from an ethical point of view. Anyhow that is my current situation and I may need to end up tapering myself.

 

Some initial questions come to mind, some to which I did get answers for already by another member before but still looking for more feedback.

 

1.) I only take 1mg of alprazolam every morning. I have for around 7 years and never really had problems with the inter dose withdrawls. (I am also a long time cannabis smoker, which I think masked those withdrawls). With this information, is it typically better to remain consistent in doses, or should I first break up the 1mg to 4 times a day (those withdrawls will still suck I know). I tried a .25 reduction for 7 days, couldn't handle the rebound anxiety and insomnia. So that didn't go well and I went back to 1mg.

 

 

If you’ve always taken it once a day, I’d continue with that.  A .25mg cut is 25% of your total dose...I’d start with 1/4 that cut, which is .0625mg.

 

2.) This is the elephant in the room. I am a hypochondriac when I can't get my mind off a physical symptom, and while I've gotten good at breaking myself out of those thoughts, I am very concerned about the severe side effects that I wish I never heard of in the first place. Stokes, cardiac arrest, seizures and death being the biggest things on my mind. I already have high blood pressure and am on lisinopril to manage. This is also recent so I haven't quite nailed down if it's even working as between caffiene and nicotine it still tends to stay above normal. So am I at risk if I begin to taper with that in mind? I am good at being paranoid with intrusive thoughts.

 

 

Keep in mind the hypochondria and other thoughts may increase for awhile and that would be normal for this process.  The extreme symptoms you’ve mentioned are not common, in fact they are very rare.  As to your BP, your doc should continue to monitor it and will likely increase any BP meds to compensate. I would skip the caffeine for now...that will cause anxiety and elevated BP to some extent.

 

3.) When tapering, is there ever a period where your body eventually adjusts to the new dose and you return to a mostly 'normal' state? After going back up to 1mg I've noticed I'm waking up early with my body feeling like crap until I take my daily dose. This never used to happen. My vision also seems to have been adversely affected and hasn't returned to what I'd call perfect 20/20.

 

 

Yes. Operative word is ‘mostly’. I wouldn’t expect to feel great until this is behind you, to be honest. Vision issues are also common.

 

4.) During the 7 day taper, I could not function at work as my mind dwelled on the symptoms and wave panics. Bosses probably thought I was crazy constantly putting cold water on my face and neck to help calm myself lol. They are aware that I want off this medication and are supportive. Well see how long that lasts if my work ethic continues to be affected. I handle a lot of day to day, complex tasks with short deadlines. I am very concerned about my next attempt to taper causing problems again. How have others gone about maintaining a good work ethic while tapering and dealing with intense anxiety?

 

 

A much smaller cut should help immensely.

 

5.) Another thing that I am concerned about is my doc switching me to a different benzo if they think it is more appropriate than alprazolam. Has anyone ever been through crossover with tolerance, and what can I possibly expect? Eventually stabilizing or constant withdrawls due to a longer acting, less potent benzo?

 

 

I would try another, smaller cut first. This is doable.

 

 

6.) I appreciate the information, and am so happy to speak with others about these things. I've found a lot of dread and comfort browsing these forums, and I want you to know I'm glad you're here!

 

Thank you.

(Excuse any typos).

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Hello again Challis! Again thank you for your insight. I know you got through it and I am envious. I guess my bigger worry is having to taper from xanax. I could always ask my doc for smaller doses if they agree to support me on my terms. If not I may need to find another as I don't want to do this without some medical support. I don't live the healthiest of life styles, though since the taper I've made small changes such as less sugar and caffeine (likely down to a small cup of coffee for comparison and drinking decaf). Smoking is definitely on the chopping block as far as cigarettes, not sure if I can cope with those withdrawls without the cannabis. It actually helped me stay asleep lol.

 

I started Trazodone the other day when I got really depressed thinking it couldn't hurt. Now after 3 doses of 50mg I am strongly considering stopping it before I get hooked on another drug. It's made my vision even more blurry (everything on some type of display has 'glows') and I'm pretty sure I was having bad palpitations after taking it. Thinking my smoking gives me enough of that. After reading some other topics I've learned some folks are of the kind that benzos and AD just make a worse team for kicking either out.

 

It's possible I may just bite the bullet and CT my cigarettes and start exercising. I don't feel comfortable trying to taper with prehypertension/HT stage 1 BP levels. Hell it could just be interdose withdrawl.

 

What did you end up doing to taper below .25? By that point I'll be taking powder at 10% cuts lol.

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