Revisiting "stabilizing" before taper

On advice of my Dr., I switched from 1.5 Ativan to now 16 mg Diazepam, prior to start taper. She had me start switch by immediately stopping Ativan (1.5mg) and taking 5 mg. Diazepam. Ouch. Went back and tried slower switch. Just stopped last Ativan dose two nights ago.

 

I do not feel "stable" at 16mg Diazepam, my Dr. wants me to be "stable" before tapering. I feel more brain fog, waves of anxiety, some skin burning sensation when I wake and insufficient and unrestorative sleep (around 7 hrs.). I wake up like coming out of sedation.

 

On 1.5 mg Ativan, I was already having interdose withdrawal (anxiety) and uneven sleep.

 

As you can see from my signature -- I did some irrational taper initiations last fall, out of fear of "staying on Ativan too long". This probably led to increased symptoms and tolerance.

 

Not sure what my next step should be. Just hold at current 16mg to see if nervous system calms down? Increase by a couple of MG to see if I "stabilize". I know I need a very slow taper due to PTSD and prior depressions, as well as having PD.

 

I am also still taking around 6mg THC/6mg CBD sublingual, which I don't know if I should taper first -- it does help me sleep at the moment.

 

Any suggestions appreciated.

 

 

 

 

 

 

 

 

How long have you been completely on diazepam and how long did you take to cross over from Ativan?

Completely on Diazepam only 2 days. Took two months to switch due to my fears and backtracking several times.

2 months is a reasonable timeframe to crossover. It may take some time for you to stabilize now that you’re only on Valium. I know it feels miserable, but it will level out.

So increasing it a bit to "stabilize" not a good idea"? Give it time? Also, I take it all at bedtime in hopes of getting better sleep. Does it impact sleep to take some of it during the day for daytime anxiety?

 

By level out, do you mean symptoms will decrease?

Yes, leveling out would be decreasing symptoms. It probably wouldn’t hurt to dose twice a day, but it’s not necessary. When I crossed over from 1 mg Klonopin to 20 mg Valium I dosed 10 mg AM and then 10 mg again at night. You could certainly try, maybe do 6 mg in the morning and 10 mg at night.

 

You crossed over to a reasonable equivalent dose of Valium, so I don’t think updosing is necessary. Also when it comes to Valium it takes a while to build up in your system so an updose won’t necessarily give you immediate relief.

Thanks.  I'll go out to exercise...

I'm starting this on a new thread since I don't know if continuing my thread from last week will be seen...

 

I crossed over from around 1.5 Ativan (taken for insomnia, already in tolerance) to 17mg valium and not stable. Slept some nights by taking valium at bedtime, then when I wake mid night took melatonin and cannabis tincture. But last night no sleep at all. Same happened a few nights ago, two nights in a row. That time I had a stressful event which triggered, but last night I'm not sure why -- maybe watching TV? I've been at this dose of valium since about 10 days ago. went to 16mg, then I realized calculated wrong and went to 17mg.

 

I don't see how I can start a taper from this level of instability. I am trying to disregard the fear as it's not helpful obviously. There have been some destabilizing events, and it doesn't help that my Psy-doc is on medical leave (I have an appt. Wednesday).

 

I have Parkinson's Disease. This is what worries me the most -- stress accelerates PD. I don't see a non stressful way to stop the benzos. Catch 22.

 

My doc suggested last time I saw her that I might try gabapentin while tapering. I'm already on celexa 20mg and mirtazapine 30mg (up from 7.5 to try to keep from getting depressed during taper).

 

I'm pretty sure my doc will want me to updose to stabilize before tapering.

 

Valium makes me sleepy and a lot of brainfog. I have PTSD from multiple life events, one of which was a prolonged period of severe insomnia.

 

Trying to be brave but can't see my way forward at the moment.

 

 

For your information, if you add a post to your old thread it will bump it up and people will see it.  It actually helps to use your old thread for purposes of continuity. 

 

I've heard great things about tapering from Diazepam if you can make it past the sedation it causes.  I feel the "destabilizing events" you mention have had an effect on getting stable, stress is the number one contributor to increased symptoms so if you can hold out at this dose for awhile longer you may see improvement.  Stress can affect you for longer than you realize, especially when withdrawing from benzo's so it could likely be why you're having so much trouble sleeping.

 

Your Parkinson's I'm sure is complicating your situation, you have so much going on, I'm glad you're working with your Dr, is this the same one who treats your Parkinson's? 

 

 

I don't really have advice, but wanted to offer solidarity! I was on lorazepam 1.5mg daily. I'm also on two antidepressants (an SSRI and mirtazapine), and my doctor also recommended gabapentin. I take 200mg gabapentin before bed. It usually helps me sleep. I haven't had any adverse side effects from it. I'm on a bunch of meds and have no idea if I'm unstable, or just having a bad withdrawal, or I don't know.

 

It sounds like you have other factors that cause you a lot of stress. Keep breathing! It's really hard, but you will get through this One day at a time. You will stabilize and you will be okay.

Thank you.

Is it possible to move this thread back to the original thread?

 

Not the same doctor unfortunately. I see a movement disorders doc for PD and a psychiatrist/ functional medicine doc. for everything else (including PD).

 

They have both been on leave, but i finally have an appt. With my psy-doc today.

 

I find everything stressful when i can’t sleep. Even small encounters with people who are not aware of my situation. Night before last i actually slept well, yesterday probably did too much because i had more energy, plus the brain fog gets in the way of remembering to take meds, supplements etc on time...

 

I have a hard time finding a balance between activity and rest. Plus some things came up that “had to be taken care of”. I’ e been trying to coear out everything that is unessential so that i can ficus on my needs.

 

 

I can merge this thread with your other one if that's what you wish, just let me know here.

 

Insomnia is a huge problem while going through this and most of us suffer with it.  I found social interactions very difficult, my confidence was non-existent and I found myself trying to fake normal, almost impossible to do when you're screaming on the inside. 

 

Brain fog is common as well, I had to make lots of notes and reminders to do what I needed to do, I hope you'll devise a method to keep track of your medications and other important things.

 

I hope you can find balance between essential and non essential tasks, listening to your body when you need rest is important so delegating to others is sometimes necessary.

 

 

I'm starting this on a new thread since I don't know if continuing my thread from last week will be seen...

 

I crossed over from around 1.5 Ativan (taken for insomnia, already in tolerance) to 17mg valium and not stable. Slept some nights by taking valium at bedtime, then when I wake mid night took melatonin and cannabis tincture. But last night no sleep at all. Same happened a few nights ago, two nights in a row. That time I had a stressful event which triggered, but last night I'm not sure why -- maybe watching TV? I've been at this dose of valium since about 10 days ago. went to 16mg, then I realized calculated wrong and went to 17mg.

 

I don't see how I can start a taper from this level of instability. I am trying to disregard the fear as it's not helpful obviously. There have been some destabilizing events, and it doesn't help that my Psy-doc is on medical leave (I have an appt. Wednesday).

 

I have Parkinson's Disease. This is what worries me the most -- stress accelerates PD. I don't see a non stressful way to stop the benzos. Catch 22.

 

My doc suggested last time I saw her that I might try gabapentin while tapering. I'm already on celexa 20mg and mirtazapine 30mg (up from 7.5 to try to keep from getting depressed during taper).

 

I'm pretty sure my doc will want me to updose to stabilize before tapering.

 

Valium makes me sleepy and a lot of brainfog. I have PTSD from multiple life events, one of which was a prolonged period of severe insomnia.

 

Trying to be brave but can't see my way forward at the moment.

 

Hi -  I switched from K to V and I didn’t go slow enough and it was brutal....I didn’t sleep for a while.  I was finally put on Topomax for the migraines/headaches I was getting from the c/o and for sleep.  Eventually I did stabilize somewhat, however I never did a hold, and continued to taper.  Looking back, I wish I had held until I felt stabilized. 

 

So I suggest “holding” until you stabilize and are sleeping before you attempt your step down’s.  I know there is a lot of discussion about medications pro’s/con’s while tapering.  There is a forum for that on here if you are interested.  Lot’s of good information.

 

I hope sleep finds you soon 

 

Marie

Thanks for all of the suggestions. PAMSTER, yes, please merge the threads.

 

I know my psy-doc will suggest I try gabapentin.

 

If it's a choice between adding gabapentin to an already heavy med load (citalopram, mirtazapine, valium, plus meds for Parkinson's), if I can't stabilize sleep on current valium dose (17mg at bedtime), would it be better to increase the valium to stabilize, or add gabapentin?

 

My inclination is to increase valium a bit to see if sleep returns, then do a very slow taper.

 

I have taken just about everything off my plate so I can focus on my healing. Supportive family (I am lucky and grateful).

 

 

I'm happy to hear you have a supportive family and are taking steps to set yourself up for success.

 

Increasing the Valium might be the better option here since you never felt stable to begin with, I can't remember, are you dosing twice a day so you can optimize the Valium for sleep?

No, just once a day. I generally don't get much anxiety during the day at this dose, although sometimes I do, especially if I don't take my PD meds on time (they also affect anxiety). for sleep, is it better once or twice a day?

So you take your entire dose at night?  If you do and you don't get anxiety during the day then you should probably leave it as is.

No, just once a day. I generally don't get much anxiety during the day at this dose, although sometimes I do, especially if I don't take my PD meds on time (they also affect anxiety). for sleep, is it better once or twice a day?

 

I would leave your dosing to the PM only.  Since sleep is your problem, I think if you take any of it away at the nighttime, it would only make things worse. 

 

Hopefully you stabilize soon 

 

Marie

Still not sleeping stably, I’m getting decent sleep about 50% of the time 6-, and 2-4 hrs 50% of the time. Emotionally I do feel more stable. But clearly tolerant to 17 mg Valium.

 

My question: is there any value to updosing to try to stabilize sleep before starting taper? Or do I just start very slowly tapering and try to accept that my sleep will not improve for a while, perhaps never?

 

I have Parkinson’s Disease, and stress and lack of sleep make the symptoms progress more rapidly. And sleep disturbance is a very common PD symptom. My neurologist would like me on klonopin, because it helps control REM  behavior Disorder, and she says it will help me to sleep more than valium. To date, melatonin has worked well for me for REM Behavior Disorder. I’ve read that getting off klonopin can be extremely difficult.

 

My psy-doc/functional medicine doc wants me “stable” before tapering. She thinks klonopin might be a better idea than valium, that it might help more with sleep.

 

Complicated pickle I’m in.

 

 

 

 

 

 

First I hate to see you switch to another benzo, you've been on so many and I know it takes a toll on you every time you switch to another one but if two of your doctors think its a better fit then they know your situation better than we do.  As for Klonopin being more difficult to taper, I've not found that to be true in reading member posts.  Sure, many think their benzo is the worst to withdraw from and I've read members say that about Klonopin but they're all the worst in my opinion.

 

I think we discussed on April 7th the possibility of updosing and yes that may still be what you need to do but it sounds like you're getting decent sleep. I know it's not enough but it's probably more than you'll be getting in the future if you decide to start reducing again.  When we become tolerant to, withdraw from and recover from benzo's, sleep is collateral damage.

 

I've heard Valium mentioned as a better sleep aid than Klonopin since it has sedation qualities but maybe it depends on the person.

 

 

Thanks, Pamster.

I feel my sleep is much better on Valium than it ever was on Klonopin. Just my take.

Thanks for your input...