Liquid Diazepam

I’m glad your wife reinstated the bupropion and will hold until her symptoms stabilize (i.e. stop changing in nature and number, become tolerable).

 

It may well be that she will be able to taper the bupropion at a rate faster than 10% a month.  We’ve now learned that a 25% reduction was too large for her.  Surviving Antidepressants suggests beginning with a 10% trial reduction.  If she does ok with that, the next step would be to try something in between … perhaps a more frequent reduction (e.g. every two weeks instead of every month) or a larger percent reduction per month.  I also have a hunch that once she discontinues the bupropion, she’ll have an easier time tapering the remaining diazepam.

 

Have you heard back from the folks at Surviving Antidepressants?

Libertas,  we agree with you on the Bupropion assessment.  She actually did a 10% cut today and we will go with that for a while.

I did hear back from SA and they told me to post an introduction, which I did.  They said it may take several days for us to get responses.  We'll see.

But at least we have a more workable plan now and will stick to it without questioning ourselves about it.

Thank you.

You are most welcome, Helping Husband.  Bravo to your and your wife for devising a workable plan as well as establishing contact with SA.  You’ve been busy!

 

I’ve now learned a bit more about bupropion.  According to its drug label, the mean elimination half-life after chronic dosing is 21 (±9) hours.  Steady-state plasma concentrations are reached within 8 days.  This suggests it may take at least 8 days before you and your wife will get a clear read on the impact of the recent dosage changes.  I also am now wondering if your wife has been experiencing interdose withdrawal given her once-a-day dosing schedule and the half-life of bupropion. This would be a good question to ask the folks at SA. 

When I took Wellbutrin, I took the immediate release (once a day) because the XR kept me up at night. So I would think if there were inter dose WD it would be afternoon fatigue if anything.

 

That’s just my opinion as a prior consumer.

 

Thinking of you and your wife HH.

 

Thank you so much, Treelover.  I have zippo experience with bupropion so was just going by what I read in the drug label/information pamphlet. Your willingness to share your actual experience with this particular drug is incredibly helpful.

While we signed up with SA (under the name Jitterbug), we are getting emails that don't really apply to Bupropion or our situation.  One asked for a more complete medical history to be attached to our "Signature" (whatever that is) and I tried to do what they asked but it said my text was not according to the guidelines.

Ready to give up on SA.

We are in late 70s and early 80s and get frustrated by all this new technology and terminology.

But we tried.

Learning how to navigate a new technology platform can be beyond frustrating.  I’ve alerted the SA administrators to your situation and asked if they can provide additional assistance.

Thank you.  You've been very helpful throughout all of this.  Every time we have an issue, she asks, "What does Libertas say?" 

You are welcome, Helping Husband.  I’m glad I’ve been able to help.

Just to update:  My wife has been holding her Diazepam taper for several weeks now while trying to get off Bupropion.  She tapered only 10% and is going thru horrible anxiety and other symptoms.  Seems like there is no relief in sight.

Oh no.  I’m so sorry to hear this.  What do the folks at Surviving Antidepressants advise? 

SA advises 10% every 4 weeks, but they seem to lump all the antisepressants together, and they start at much higher doses.  The manufacturer suggest to wean off as quickly as possible.  A lot of conflicting advise. Very confusing.

If it were me, I would pay more attention to what SA suggests versus the manufacturer.

 

What is your wife’s current status?  Is she still tapering the bupropion/Wellbutrin and holding her diazepam dose constant?  If so, it would be helpful if you could update us on her bupropion taper.

 

Also, if she has been keeping a daily taper journal … has she discovered any trends or patterns in her symptoms and/or functionality as she tapers?

As was suggested, she went back to the 75mg of Bypropion on 4/5/22.  On 4/6 she taoered to 67.5 mg (a 10% reduction).  Still holding the diazepam at 0.78mg since late March.  Had bad reactions all along including sharp back pain that penetrates to her chest, sleepless nights, intestinal pain in the evening, high anxiety in the mornings, gas, diarrhea in the mornings, rapid heartbeat, and severe fatigue. No leveling off of these symptoms. SA says that magnesium and niacin may help with Bupropion withdrawal symptoms.

Have you heard of this?

By the way, the back pain she is experiencing is near her left shoulder blade and penetrates thru to the middle of her chest, which feels tight.  She has had this since she began her benzo taper two years ago.  Is this a common symptom of benzo withdrawal?

Thank you for the update, Helping Husband.  To help other members help you, I’ve summarized your wife’s medication history below.  (Please let me know if revisions are needed.)

 

I’m also including your two most recent questions in this post in hopes that other members will respond.  (I don’t have personal experience with bupropion withdrawal and believe it would be helpful for you to hear from other members about the type of back pain your wife is experiencing.)

 

Question 1: Surviving Antidepressants says that magnesium and niacin may help with bupropion withdrawal symptoms. Have you heard of this?

 

Question 2: The back pain she is experiencing is near her left shoulder blade and penetrates thru to the middle of her chest, which feels tight.  She has had this since she began her benzo taper two years ago.  Is this a common symptom of benzo withdrawal?

 

Medication History of Helping Husband’s Wife

2010: Rx’d temazepam 15mg prn for insomnia, took rarely.

2012: Rx’d Xanax 0.25mg prn for anxiety or sleep, took rarely. Began to develop digestive issues; tests negative.

April 2015: Rx’d Zoloft 100mg daily for anxiety.  Worked well. Digestive issues continued plus severe diarrhea.

June 2019: D/C’d Zoloft. Began buspirone/Buspar 15mg x 2 daily.  Developed chest pain, episode of A-fib, tests negative. Rx’d Metoprolol and Eliquis (still taking as of 4/21/22).

Oct thru Feb 2019: Rx’d clonazepam 0.5 mg, took 1/4 tab prn, D/C'd after 3 weeks. Rx’d Ativan 0.5 mg, took 1/4 tab prn, D/C’d after 4 weeks. Rx’d Xanax 0.25 mg, took 1/2 tab prn, D/C’d.  Rx’d bupropion/Wellbutrin 75 mg once daily.

03/04/20: Began crossover from 15mg temazepam to 7.5mg Valium.

03/13/20: Began Valium taper.

02/09/21: 1.9mg Valium; unsuccessful trial of Rx 1mg/mL oral solution; returned to pill-shaving.

3/30/22: 0.78mg diazepam (0.39mg in the am, 0.39 in the pm); currently holding at this dose while tapering bupropion.

3/30/22: Reduced bupropion to approx 56.25mg (25% reduction); intolerable w/d symptoms.

4/5/22: Reinstated to 75mg bupropion (takes once a day at 10am).

4/6/22: Reduced bupropion to 67.5mg (10% reduction).

4/21/22: Symptoms include sharp back pain that penetrates to chest, sleepless nights, intestinal pain in the evening, high anxiety in the mornings, gas, diarrhea in the mornings, rapid heartbeat, and severe fatigue; no leveling off of symptoms since 4/6/22.

Bumping this on behalf of Helping Husband …

 

We are still seeking member input regarding Helping Husband’s questions:

 

Question 1: Surviving Antidepressants says that magnesium and niacin may help with bupropion withdrawal symptoms. Have you heard of this?

 

Question 2: The back pain she is experiencing is near her left shoulder blade and penetrates thru to the middle of her chest, which feels tight.  She has had this since she began her benzo taper two years ago.  Is this a common symptom of benzo withdrawal?

 

Thank you in advance to any and all members who are willing to lend a helping hand.

 

(Tip of the hat to Pamster for updating Helping Husband’s signature with his wife’s medication history.)

 

Here is an update from Helping Husband:

My wife has been holding her Diazepam taper at 0.78mg (in two doses daily) since 03/30/2022.  Meanwhile she got off the Bupropion by 5/4/2022.  However, she is still experiencing anxiety, bloating, abdominal pain, belching, upper body burning (internal and external), back pain, chest pain and pressure, light headedness, and loss of apetite.  Belching relieves some of the pressure.  These symptoms seem to be getting worse.  All cardiac tests are negative.  Blood work is normal.  Discomfort is often unbearable.  Losing weight.

She has not yet resumed the Diazepam taper. 

Are these symptoms common at this stage of her taper?

Thank you.

 

I forgot to mention that she does the Diaphramatic breathing regularly.

Medication Update:

2010: Rx’d temazepam 15mg prn for insomnia, took rarely.

2012: Rx’d Xanax 0.25mg prn for anxiety or sleep, took rarely. Began to develop digestive issues; tests negative.

April 2015: Rx’d Zoloft 100mg daily for anxiety.  Worked well. Digestive issues continued plus severe diarrhea.

June 2019: D/C’d Zoloft. Began buspirone/Buspar 15mg x 2 daily.  Developed chest pain, episode of A-fib, tests negative. Rx’d Metoprolol and Eliquis (still taking as of 4/21/22).

Oct thru Feb 2019: Rx’d clonazepam 0.5 mg, took 1/4 tab prn, D/C'd after 3 weeks. Rx’d Ativan 0.5 mg, took 1/4 tab prn, D/C’d after 4 weeks. Rx’d Xanax 0.25 mg, took 1/2 tab prn, D/C’d.  Rx’d bupropion/Wellbutrin 75 mg once daily.

03/04/20: Began crossover from 15mg temazepam to 7.5mg Valium.

03/13/20: Began Valium taper.

02/09/21: 1.9mg Valium; unsuccessful trial of Rx 1mg/mL oral solution; returned to pill-shaving.

3/30/22: 0.78mg diazepam (0.39mg in the am, 0.39 in the pm); currently holding at this dose while tapering bupropion.

3/30/22: Reduced bupropion to approx 56.25mg (25% reduction); intolerable w/d symptoms.

4/5/22: Reinstated to 75mg bupropion (takes once a day at 10am).

4/6/22: Reduced bupropion to 67.5mg (10% reduction).

4/21/22: Symptoms include sharp back pain that penetrates to chest, sleepless nights, intestinal pain in the evening, high anxiety in the mornings, gas, diarrhea in the mornings, rapid heartbeat, and severe fatigue; no leveling off of symptoms since 4/6/22.

4/21/22 Bupropion reduced to 55mg.

4/28/22 Bupropion reduced to 27.5mg.

5/4/22  D/C'd Bupropion

5/15/22 Still at 0.78mg Diazepam

Thank you for the update, Helping Husband.  I am sorry your wife’s symptoms are getting worse.  My best guess is the rapid taper off the bupropion may be a factor. Does she plan to wait for a while before restarting her diazepam taper in hope that her symptoms will stabilize (as in stop changing, become more tolerable) or does she just want to complete her taper?

  She feels different after got off the Bipropion.  Symptoms are still present, but different.  It should be out of her system by now.

To answer your question, while she is still holding her Diazepam taper at 0.78 mg,  yes, she wants to get off of it as soon as possible.  It's been over two years of tapering off a relatively small dose (She started at 7.5 mg in March 2020).

Also, she is wondering when it will be safe to "jump" off the Diazepam.

The Ashton Manual said 1.0mg or 0.5mg, depending on her tapering method.

Any thoughts. 

My knowledge of discontinuing antidepressants is limited, but my guess is it can take a while for symptoms to subside, especially after a rapid taper.  (As you know, SA recommends reductions of 10% per month based on current dose; your wife’s taper was much faster than that.)

 

What does your wife mean by ‘safe’?  Does she mean safe from seizures?  Safe from post-withdrawal symptoms?  Something else?

 

Does she feel she is getting any effect from the two small doses she is taking?

 

 

Libertas,

Thank you for your patience with us.  I answer your questions as best I can.  Her attitude varies somewhat from day to day, depending on how much sleep she can get.  Her symptoms are somewhat better this week although back/chest pain and gas still get quite bad in the afternood/evening.  This is what usually prevents her from sleeping.  It is now 2 weeks since she got off the Bupropion.

As you mentioned, it is recommended to go off the Bupropion at a slower rate, but this whole thing has dragged out so long, the slow taper would have prolonged things even more.  When her prescriber, the pharmacy, the manufacutrer, and a phychaitrist who specializes in pharmacological management recommended a two week time frame in view of the low dose she was taking, she opted for that. (At our age, will soon to be  too late to enjoy a normal life again  )

By a "Safe" time to jump, she just doesn't want symptoms to worsen.  We realize that symptoms will not stop immediately and there will be protracted symptoms.

She does not feel any benefit from the 0.78 mg Diazepam she is currently taking.  Her next planned step is to taper to 0.72 mg for a while, then taper once more and then try going to one dose daily.  Not sure if the one dose should be morning or evening.  After that, if it goes well, she will continue to taper until she can stop it altogether.

We are very thankful and appreciativen for the guidance you and others on BB provide.  Every time she has a question that she can't figure out, she asks me to find out what Libertas says. 

 

Hello, Helping Husband. I’m glad I have been able to be of some assistance to you and your wife.  I admire both of you for the courage and tenacity you have demonstrated.

 

Thank you for clarifying what your wife means by ‘safe’ to jump — i.e. symptoms will not worsen.  Regrettably, we simply do not know how a given individual will fare after discontinuation.  However — on a more encouraging note — the post linked below summarizes anecdotal evidence from members suggesting that the first phase of recovery may be ‘smoother’ if the individual has completed a gradual taper.

 

Link:

Four Phases of Withdrawal [Recovery] Where Are You?

http://www.benzobuddies.org/forum/index.php?topic=156111.msg2089263#msg2089263