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Urgent and sincere advice needed!


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Dear all,

 

I am in a pretty bad shape, with having been on more than 2mg of Clonazepam being taken several times a day for more than a year. Realizing much late that I was not only suffering with dependence but also not being helped out for the reasons I was taking it for.

 

After asking to withdraw it,  my doctor puts me on zolpidem tartrate at night for sleep but didn't substitute Clonazepam with a different Benzo to help with the onslaught of withdrawal symptoms. After reading through online about how delicately such situations should be handled, I asked him to substitute it some other med, like generally is the case.

 

Now, he's put me on Lorazepam .5 and 1mg during the day and Adviced 2 my Clonazepam at night for sleep.  IDK how correctly he's dealing with my problems but I myself continued zolpidem tartrate at night instead of clona, as Clonazepam makes me feel sick.

 

I need sincere word of advice and help with getting rid of this Benzo dependency once and for all!

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Hi musman79

 

What an ordeal you've been through! I'm really sorry this happened to you. I went from 2mg to 0.5mg Clonazepam and had a terrible time, so I can imagine what you've been going through!

 

To best assist you, we need an accurate summary of your benzo history and doses. Better yet, if you could update Add your history/signature we'll stop pestering you for it!

 

Can you let us know what is "more than 2mg of Clonazepam?"

When did you start taking Clonazepam and when did you stop?

When did you start taking Zolpidem?

When did you start taking Lorazepam? (Is my understanding correct your total dose is 1.5mg?)

Am I correct in assuming "Adviced 2 my Clonazepam at night for sleep" means you were also prescribed 2mg Clon but you're not taking it?

 

Sorry about the Spanish Inquisition, we just need to understand your whole situation to make sure we give you the best advice!

 

 

 

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Thanks.

 

I think some days it was more than 2 mg and some days less.

 

It's safe to say I've been on it for approximately 1.5 years.

 

Zolpidem tartrate I've been taking for 3 weeks now.

 

Yes, trying to substitute the Clonazepam cravings with 1.5mg Lorazepam & have started  Lorazepam just  2 days back.

 

Yes, my doctor did prescribe 2 mg Clonazepam at night for sleep but due to the fact I don't feel good with Clonazepam I am rather taking zolpidem.

 

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Thanks for the info musman.

 

It's quite a mix of drugs you were prescribed. I don't know if you're aware but Zolpidem Tartrate is classified as a non-benzodiazepine with similar effects, meaning "These drugs are chemically different from benzodiazepines but have the same effects on the body and act by the same mechanisms" as per the Ashton manual. Here at BB we consider them similar to benzo's.

 

What you probably need to know is that Lorazepam is generally not considered a good crossover/substitution for Clonazepam. Clonazepam has a much longer half life (18-50hrs) than Lorazepam (10-20hrs). In basic language this is how long the drug is active in your system. Usually when we substitute one benzo for another we crossover to a benzo with a longer half life, otherwise we run the risk of getting interdose withdrawal (the drug wears off too quickly and we go into withdrawal before the next dose). With Clonazepam, the best crossover benzo would be Valium.

 

Your substitution dose is also not the equivalent of your Clonazepam. If I have my Ashton convertions right, then 2mg Clonazepam = 4mg Lorazepam. So if you only take Lorazepam you are taking less than half your original Clonazepam dose. That to me says, you must be suffering greatly.  :hug:

 

I don't know what your Zolpidem dose is and how that interacts with the Lorazepam. I'm not too sure how different types of benzo-like drugs interact with each other.

 

If you are feeling really bad right now and having acute withdrawal and not functioning you might want to consider going back to Clonazepam. It might be easier to taper and you might not experience interdose withdrawal. Whatever you decide to do, we'll support you.

 

I hope this information makes sense and is helpful. I am very sorry this is happening to you. Please let me know if you have any more questions and how we can help you.

 

Edit:typos

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I am crying, can someone please come forward and make me a concrete plan which I can work on and get better!?
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I'm not sure what you want? What is your goal right now? I tried to give you information so you can make an informed decision going forward as you are currently on 3 benzo's.

 

Do you want to stay on Lorazepam and taper Lorazepam?

 

Do you want to stabilize and feel better?

 

I really want to help, but I'm not sure what you want to do as around here, we don't tell people what to do, we need you to make a decision and then we advice you based on that decision.

 

 

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I am crying, can someone please come forward and make me a concrete plan which I can work on and get better!?

 

I'm sorry you're so frustrated, and it's understandable.  At least your doctor didn't cold turkey you, which is what I was afraid you were going to say.

 

I just started out tapering from 2 mg Klonopin in March this year.  I bought a milligram scale, and weigh 2 days worth of doses every 2 days.  I don't cut down much and just go by how I feel and cut when I think I'm ready to again.  If it takes a couple of years, I'm good with that.  It will take a lot of patience. 

 

 

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I don't know if it's a good idea to substitute Clonazepam with Ativan? I don't know the Ashton manual or anything but if anyone could suggest a better strategy to follow like you mentioned Diazepam, please make me a plan I could work on!
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I don't know if it's a good idea to substitute Clonazepam with Ativan? I don't know the Ashton manual or anything but if anyone could suggest a better strategy to follow like you mentioned Diazepam, please make me a plan I could work on!

 

 

Here's a link for the Ashton Manual.  You can take it to your doctor.

https://www.benzoinfo.com/wp-content/uploads/2019/04/Ashton-Manual-BIC.pdf

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I don't know if it's a good idea to substitute Clonazepam with Ativan? I don't know the Ashton manual or anything but if anyone could suggest a better strategy to follow like you mentioned Diazepam, please make me a plan I could work on!

 

Great! I'm on it.  :thumbsup:

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I don't know if it's a good idea to substitute Clonazepam with Ativan? I don't know the Ashton manual or anything but if anyone could suggest a better strategy to follow like you mentioned Diazepam, please make me a plan I could work on!

 

Thanks glitter, but do you suggest I go back to Clonazepam and taper or substitute with Lorazepam and then taper?

 

 

Here's a link for the Ashton Manual.  You can take it to your doctor.

https://www.benzoinfo.com/wp-content/uploads/2019/04/Ashton-Manual-BIC.pdf

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Thanks for the info musman.

 

It's quite a mix of drugs you were prescribed. I don't know if you're aware but Zolpidem Tartrate is classified as a non-benzodiazepine with similar effects, meaning "These drugs are chemically different from benzodiazepines but have the same effects on the body and act by the same mechanisms" as per the Ashton manual. Here at BB we consider them similar to benzo's.

 

What you probably need to know is that Lorazepam is generally not considered a good crossover/substitution for Clonazepam. Clonazepam has a much longer half life (18-50hrs) than Lorazepam (10-20hrs). In basic language this is how long the drug is active in your system. Usually when we substitute one benzo for another we crossover to a benzo with a longer half life, otherwise we run the risk of getting interdose withdrawal (the drug wears off too quickly and we go into withdrawal before the next dose). With Clonazepam, the best crossover benzo would be Valium.

 

Your substitution dose is also not the equivalent of your Clonazepam. If I have my Ashton convertions right, then 2mg Clonazepam = 4mg Lorazepam. So if you only take Lorazepam you are taking less than half your original Clonazepam dose. That to me says, you must be suffering greatly.  :hug:

 

I don't know what your Zolpidem dose is and how that interacts with the Lorazepam. I'm not too sure how different types of benzo-like drugs interact with each other.

 

If you are feeling really bad right now and having acute withdrawal and not functioning you might want to consider going back to Clonazepam. It might be easier to taper and you might not experience interdose withdrawal. Whatever you decide to do, we'll support you.

 

I hope this information makes sense and is helpful. I am very sorry this is happening to you. Please let me know if you have any more questions and how we can help you.

 

Edit:typos

 

Thanks for your detailed response. Isn't it possible if I continue Lorazepam it might eventually substitute Clonazepam. Furthermore as I am taking lower dosage so eventually my body and mind will learn to come out of Clonazepam high dosage cravings?

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First off I would suggest you stop the Zolpidem and Lorazepam. Less benzos to deal with and to taper off.

 

Then I have 2 suggestions:

 

1. Go back to clonazepam and reinstate at a 1.75mg dose for 2 weeks. Let's see how you do after a couple of days. You will then continue tapering clonazepam until you are benzo free.

 

2. Get your doctor to prescribe valium. You'll need 40mg Valium per day initially to make the switch from clonazepam. This still means going back to clonazepam for now. It's only temporary until we have switched you over to valium. We do no recommend stopping one benzo abruptly and just switching to another or you’ll likely suffer. So you’ll go back to 2mg clonazepam to make the switch to valium.

 

Do you feel you could work with any of these options? Thanks for your patience. I know this can get frustrating.

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Thanks for the info musman.

 

It's quite a mix of drugs you were prescribed. I don't know if you're aware but Zolpidem Tartrate is classified as a non-benzodiazepine with similar effects, meaning "These drugs are chemically different from benzodiazepines but have the same effects on the body and act by the same mechanisms" as per the Ashton manual. Here at BB we consider them similar to benzo's.

 

What you probably need to know is that Lorazepam is generally not considered a good crossover/substitution for Clonazepam. Clonazepam has a much longer half life (18-50hrs) than Lorazepam (10-20hrs). In basic language this is how long the drug is active in your system. Usually when we substitute one benzo for another we crossover to a benzo with a longer half life, otherwise we run the risk of getting interdose withdrawal (the drug wears off too quickly and we go into withdrawal before the next dose). With Clonazepam, the best crossover benzo would be Valium.

 

Your substitution dose is also not the equivalent of your Clonazepam. If I have my Ashton convertions right, then 2mg Clonazepam = 4mg Lorazepam. So if you only take Lorazepam you are taking less than half your original Clonazepam dose. That to me says, you must be suffering greatly.  :hug:

 

I don't know what your Zolpidem dose is and how that interacts with the Lorazepam. I'm not too sure how different types of benzo-like drugs interact with each other.

 

If you are feeling really bad right now and having acute withdrawal and not functioning you might want to consider going back to Clonazepam. It might be easier to taper and you might not experience interdose withdrawal. Whatever you decide to do, we'll support you.

 

I hope this information makes sense and is helpful. I am very sorry this is happening to you. Please let me know if you have any more questions and how we can help you.

 

Edit:typos

 

Thanks for your detailed response. Isn't it possible if I continue Lorazepam it might eventually substitute Clonazepam. Furthermore as I am taking lower dosage so eventually my body and mind will learn to come out of Clonazepam high dosage cravings?

 

That's an excellent question! Exactly why you need all the information.  :thumbsup:

 

It is possible to try and stabilize on Lorazepam, but the question is at what price? You might end up with severe withdrawal symptoms because the crossover between the two with the interdose withdrawal might be severe. Like I explained the Lorazepam stays in your system for a shorter time and your dose is much less, possibly resulting in severe withdrawal. Depending on when you stopped Clonazepam you will feel start feeling the impact any time from 3-7 days.

 

You can absolutely try and stay on the Lorazepam if you want and wait it out to see how it goes. If it doesn't work and you struggle, you can go back to Clonazepam. That's why I gave you all the info and said it's YOUR choice. I don't want you to feel regret over a decision or feel you have been pushed to do something. You need to do what you are comfortable with. I still think it would be good to consider stopping the Zolpidem as that would add another layer to your taper and another benzo you will need to taper. This is probably the most difficult part when you are new to the process. I understand. Please keep asking if you need more information and help with your decision.

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Thanks for the info musman.

 

It's quite a mix of drugs you were prescribed. I don't know if you're aware but Zolpidem Tartrate is classified as a non-benzodiazepine with similar effects, meaning "These drugs are chemically different from benzodiazepines but have the same effects on the body and act by the same mechanisms" as per the Ashton manual. Here at BB we consider them similar to benzo's.

 

What you probably need to know is that Lorazepam is generally not considered a good crossover/substitution for Clonazepam. Clonazepam has a much longer half life (18-50hrs) than Lorazepam (10-20hrs). In basic language this is how long the drug is active in your system. Usually when we substitute one benzo for another we crossover to a benzo with a longer half life, otherwise we run the risk of getting interdose withdrawal (the drug wears off too quickly and we go into withdrawal before the next dose). With Clonazepam, the best crossover benzo would be Valium.

 

Your substitution dose is also not the equivalent of your Clonazepam. If I have my Ashton convertions right, then 2mg Clonazepam = 4mg Lorazepam. So if you only take Lorazepam you are taking less than half your original Clonazepam dose. That to me says, you must be suffering greatly.  :hug:

 

I don't know what your Zolpidem dose is and how that interacts with the Lorazepam. I'm not too sure how different types of benzo-like drugs interact with each other.

 

If you are feeling really bad right now and having acute withdrawal and not functioning you might want to consider going back to Clonazepam. It might be easier to taper and you might not experience interdose withdrawal. Whatever you decide to do, we'll support you.

 

I hope this information makes sense and is helpful. I am very sorry this is happening to you. Please let me know if you have any more questions and how we can help you.

 

Edit:typos

 

Thanks for your detailed response. Isn't it possible if I continue Lorazepam it might eventually substitute Clonazepam. Furthermore as I am taking lower dosage so eventually my body and mind will learn to come out of Clonazepam high dosage cravings?

 

That's an excellent question! Exactly why you need all the information.  :thumbsup:

 

It is possible to try and stabilize on Lorazepam, but the question is at what price? You might end up with severe withdrawal symptoms because the crossover between the two with the interdose withdrawal might be severe. Like I explained the Lorazepam stays in your system for a shorter time and your dose is much less, possibly resulting in severe withdrawal. Depending on when you stopped Clonazepam you will feel start feeling the impact any time from 3-7 days.

 

You can absolutely try and stay on the Lorazepam if you want and wait it out to see how it goes. If it doesn't work and you struggle, you can go back to Clonazepam. That's why I gave you all the info and said it's YOUR choice. I don't want you to feel regret over a decision or feel you have been pushed to do something. You need to do what you are comfortable with. I still think it would be good to consider stopping the Zolpidem as that would add another layer to your taper and another benzo you will need to taper. This is probably the most difficult part when you are new to the process. I understand. Please keep asking if you need more information and help with your decision.

 

Hi, thanks.

 

I did cold turkey the first 15 days with only zolpidem tartrate in the night. Yes, it was horrible.

 

Now, it's been 26 days and I've lessened the suffering by adding 0.5mg ativan morning and 1mg evening, which is also quite in line with my doctors prescription. To my utmost surprise though, he prescribed a short acting Benzodiazepine to substitute a long acting one. I don't know much about Benzodiazepines but he's the doctor, maybe he knows what he is doing.

 

IDK if I am walking the right direction. Yes, I've managed to drastically reduce Clonazepam at the expense of Lorazepam and zolpidem. Does that sound like a good deal, I have no idea.

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Thank you so much for this information. It makes a lot more sense now. If you've been off Clonazepam for almost a month and you feel the Ativan is helping you stabilize then maybe it's best to just stick to Ativan for now.

 

In one of your posts you said you've only started Ativan 2 days ago, is that correct? If so I suggest you stabilize on your current Ativan dose by taking this dose for a period of approx 10-14 days or until you feel you are functional again. Then you can start tapering the Ativan.

 

I'm still not sure how the Zolpidem interacts with that. Hopefully someone else will stop by and offer some insight.

 

How do you feel about stabilizing and then tapering Ativan?

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Thank you so much for your kind words, jelly baby!

 

Yes, it's just been three days now since i've started Ativan at the dosage i mentioned. As for Zolpidem: my doctor started it at the onset where we decided to stop Clonazepam. He meant, even if I developed Zolpidem dependency and improve on Clonazepam, Zolpidem dependency is not as severe. My second visit 3 days back when I said, I couldn't handle the Clonazepam withdrawal symptoms anymore, he suggested these low dosages of Ativan.

 

Hopefully, it does work and I do stabilize without Clonazepam eventually as I wouldn't want to go back on it in any case.

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This sounds like a good plan musman.

 

Then we'll attempt to get used to and stabilize on Ativan first, then taper from there. And keep the Zolpidem for now.

 

You also sound more confident and relaxed about this. And that is important when moving forward.  :thumbsup:

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Thank you Jelly Baby for all your hard work helping musman79 to consider their options.

 

Everyone is different, so while I have opinions similar to Jelly Baby's about the difficulties involved in tapering benzos with shorter half-lives (zolpidem is 2hrs! lorazepam I think is 6-12hrs; their active durations often being even shorter), I defer entirely to what the taperer is experiencing and decides to explore next. I am grateful musman79 that you have chosen a next-step, as this is the only way we learn what works for us.

 

If it wasn't mentioned already I suggest keeping a daily tapering journal, with at a minimum the date, your doses of each medicine, any withdrawal symptoms and their severity. This can be very helpful for making future tapering decisions, communicating with doctors and on the forum. The goal is to learn out bodies well, so that we can self-advocate for the next and best care that we require; in my experience, nothing is simple about health or medicine. While less medicine is the goal we share here, getting there is a very individual journey.

 

Also, I hope this doesn't overwhelm you, but an important way many taperers manage their WD and improve their taper success is by doing skill-building practices (meditation, psychotherapy, self-help, etc), specifically aimed at de-escalating the nervous system during episodes of anxiety. This can sometimes be the longer process, even though slow tapering can take years. So I suggest to start looking into skill-building as soon as possible, and include it as part of your evolving tapering plans.

 

Thanks Jelly Baby for keeping up with this and staying flexible!

Please keep us posted musman79 and we'll do what we can to help.  :thumbsup:

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Thanks for the input slownsteady. I'm sure musman will appreciate any support and suggestions. Please keep checking in.  :thumbsup:
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Hi Musmsn, so sorry for your pain and it looks like you are getting good support on this forum. I have experience going off a Benzo and substituting with Zolpidem. I’m convinced Zolpidem triggered all the terrible withdrawals I experienced and still do. If you can, I would try to taper off Zolpidem and then deal with a single med to begin your longer journey. In my experience, don’t try to taper off more than one drug at the same time. Maintain your Benzo dose and taper the Zolpidem first. Then go for the second one. Best of luck to you. It’s rough but thank god for the people on this forum.
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Hi Musmsn, so sorry for your pain and it looks like you are getting good support on this forum. I have experience going off a Benzo and substituting with Zolpidem. I’m convinced Zolpidem triggered all the terrible withdrawals I experienced and still do. If you can, I would try to taper off Zolpidem and then deal with a single med to begin your longer journey. In my experience, don’t try to taper off more than one drug at the same time. Maintain your Benzo dose and taper the Zolpidem first. Then go for the second one. Best of luck to you. It’s rough but thank god for the people on this forum.

 

Thanks for your input, John.

 

It's been around a month now, since I've been on Zolpidem. Doctor prescribed this medication, saying tapering it off is relatively easier than Clonazepam. If it's withdrawal is so terrible, do you think I should stop? It's not been proper four weeks since I am taking it,  so it shouldn't be that bad, right!

 

I just wanna wean off all these Benzodiazepines once and for all and I am trying as hard as I can.

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Hi Musmsn, so sorry for your pain and it looks like you are getting good support on this forum. I have experience going off a Benzo and substituting with Zolpidem. I’m convinced Zolpidem triggered all the terrible withdrawals I experienced and still do. If you can, I would try to taper off Zolpidem and then deal with a single med to begin your longer journey. In my experience, don’t try to taper off more than one drug at the same time. Maintain your Benzo dose and taper the Zolpidem first. Then go for the second one. Best of luck to you. It’s rough but thank god for the people on this forum.

 

Thanks for your input, John.

 

It's been around a month now, since I've been on Zolpidem. Doctor prescribed this medication, saying tapering it off is relatively easier than Clonazepam. If it's withdrawal is so terrible, do you think I should stop? It's not been proper four weeks since I am taking it,  so it shouldn't be that bad, right!

 

I just wanna wean off all these Benzodiazepines once and for all and I am trying as hard as I can.

 

I agree with John Hunter's concerns about continued zolpidem use.

 

The non-BZD hypnotic zolpidem (Ambien) is a newer sleeping agent that is thought to work on more specific subdivisions of the GABA receptor complex than, for example, some of the older benzodiazepine agents. It is indicated for short-term insomnia and is generally limited to seven to 10 days of use.

https://www.encyclopedia.com/medicine/drugs/pharmacology/tranquilizer

 

Ambien is for short-term use only. Tell your doctor if your insomnia symptoms do not improve, or if they get worse after using this medication for 7 to 10 nights in a row. Do not take this medicine for longer than 4 or 5 weeks without your doctor's advice.

https://www.drugs.com/ambien.html

 

musman79, I do not personally agree with or trust the advice you describe receiving from your doctor. A switch to a short-acting benzo and a very short-acting z-drug, is not a solution I would accept for wanting to taper clonazepam. I don't want to concern you or cause a panic, but this is a very unusual course of action in my limited experience.

 

There is nothing in my experience to suggest that either lorazepam or zolpidem are easier to taper from or would cause less withdrawal symptoms after becoming physically dependent on clonazepam. There appears a significant disconnect between my understanding of benzo withdrawal and whatever your doctor is thinking. I understand benzo withdrawal symptoms to be the body struggling to exercise the neuroplasticity necessary to rebuild the deficient GABA receptors and prune the excess glutamate receptors, both conditions that exist as a result of the regular use of a benzo.

 

We do not currently have a medication, that I am aware of, that speeds up this process of neuro-regenesis; switching to a short-acting benzo or z-drug doesn't make this process any faster or easier, otherwise everyone on the forum would be trying to do this. Instead, if you read around, I think you'll find that buddies making progress are either tapering their benzo directly or trying to crossover to a longer-acting benzo.

 

My suggestion is to consider ceasing the zolpidem and the lorazepam, and trying to stabilize on a lower dose of clonazepam than you were taking previously, ideally a dose roughly equivalent to the benzos you're trying to use now. I think it's fairly safe to transition relatively quickly between these three medications, with clonazepam likely taking 3-5 days to reach it's full potency (the layering of previous doses, due to it's avg 30-40 hr half-life); there may be a few days of additional discomfort if you do this all at once, or you could do it in stages.

 

If you could reiterate your current doses of zolpidem and lorazepam, myself or someone else could convert this to a suggested clonazepam dose. I'm having trouble finding this information in the thread.

 

I understand that the clonazepam was making you feel unwell. Sometimes it seems this type of symptom can be relieved by lowering the dosage, sometimes it cannot. In the case that you're unable to stabilize on clonazepam enough to begin tapering, or you'd rather not resume this medication, I suggest considering a gradual, step-wise crossover to diazepam. No transition between benzos is without risks, but the generally successful trend I've witnessed on the forum is crossing from a short-acting benzo to a longer-acting benzo and tapering from there.

 

I hope you understand that my suggestions are just suggestions; whatever you decide is the next step on your journey. I hope you will keep us updated if you can, and ask any questions that you have about this or other suggestions.  :thumbsup:

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S&S’s advice seems solid. Yes, I would get off the Zolpidem. I began experiencing horrible symptoms from the transition from the first day of using that. I had missed the occasional day of the Benzo I was on for nine years previously with not ill effects. The first day I switched to Zolpidem was my my downfall. The horrible impact was immediate. I stupidly started using it again two months after jumping from all meds so I could sleep in order to keep up with job challenges. It took more and more for it to work and suddenly I found myself in tolerance withdrawals worse than my first go around and I wasn’t even tapering. Felt like I CT’ed. Now tapering off that crap, uncertain if I can return to work in my current state. Of course everyone is different and I do not want to alarm you, but I would get off it and follow S&S’s wise counsel.
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