Jump to content

Urgent advice, At what point do you seek emergency care?


[Bo...]

Recommended Posts

Urgent advice needed, At what point do you seek emergency care?

I'm supporting a family member remotely, who has been on a very slow taper (on and off for 2 years now), 50% down, was “stable” at 2 mg valium, but accidentally skipped a dose 10 days ago. She had been feeling fine, so decided not to take the missed dose. But then about 7 days later, started having seizure like symptoms, tremoring, tachycardia and barely slept for 2 days. She decided to take 1 mg (of missed dose) so that she could sleep. Seemed okay for the day, but just called me, seizing and tremoring again, broken speech, uncontrollable movement, breathing sounds labored, skin burning sensations, blurry vision. These waves of acute symptoms seem to last about 5 minutes or so, and then briefly she can speak "normally." She is feeling extremely traumatized, and worried she's doing damage.

At what point do you seek emergency care? She's in a small town, with no adequate professional support, or anybody knowledgeable about benzodiazepine withdrawal/tapering.

She is determined to be done with benzos!

Thanks for your advice!

 

Link to comment
Share on other sites

I think seizures are are pretty good reason to seek medical care.  It's the one thing we all dread with our WD, the one thing we all try to avoid by tapering slowly.  I hope she'll be safe!
Link to comment
Share on other sites

it could also be that she's having kind of like a mixed akathisia state--- you can feel burning/tremoring/wanting to climb out of your skin along with terror/fear, etc   

how slow was her taper and from what to down to 2mg?

Link to comment
Share on other sites

also, has she come off benzos in the past?  on any other medications?  what is her med history ---

might help explain a bit of what she is going through

I wouldn't 'take seizures lightly either but to me it sounds like a rough withdrawal patch full of agitated dysphoria (like an inner akathisia -- where you tremor, shake, feel terror, etc)

Link to comment
Share on other sites

thanks so much for your responses

She finally fell asleep last night but awoke an hour later horrified and in convulsions, so took another 1mg Valium "catch-up dose."

She never lost consciousness, so not sure if she's having "siezures."

 

She's reallyconfused about how to proceed. Here is her account of it which I will post separately to address her main question-- what to do now w her tapering plan:

"I have been reducing by about 1% per week for the past year from 4mg Valium. I reached the halfway point (2 mg) about a week and a half ago and realized that when I went to record my dosage that I was off by a day meaning I had either skipped a dose some time in the previous week or just forgotten to record it. Since I wasn’t feeling especially symptomatic and I have two alarms in my phone to remind me to take my dose, I figured that I just hadn’t recorded it. About a week later (a few days ago) it became apparent that I had actually skipped a dose when I started having full body convulsions, burning skin and other symptoms that I haven’t had to this degree before. I decided to take an extra half dose hoping my symptoms would abate which they did somewhat for 2 days. And then the convulsions, burning skin, and speech and movement difficulty came back strong. I took another half dose but am concerned that I have further confused my system and that I will start convulsing again as soon as it wears off. I feel so demoralized. Has anyone had a similar dosage misstep and if so, how long did it take to stabilize? If I do up my dosage to reduce convulsions, is there an increase level that seems most reasonable? Any insights would be greatly appreciated."

 

Link to comment
Share on other sites

the word "convulsions" has me a bit concerned and certainly wouldn't want to minimize if she is having seizure activity

 

that said, body jerking and extreme agitation can be a part of withdrawal and adding in doses can confuse our symptoms -- I am curious though what her history is ---

 

meaning, for some reason she decided to go VERY VERY slow down from 4mg of valium - most people do not decide to do that unless they have a past history with having gone too fast, CT or something else.  has your sister ever been on/off benzos before, has she ever been on/off antidepressants?  how and why did she know to go so slow --

 

the reaon I am asking are there are several folks on this site who feel they are 'kindled" and even with a slow taper find themselves hitting a point in the taper where they just don't do well --

 

her history with benzos, psych meds and stops and starts is really important for us to know

Link to comment
Share on other sites

Yes, she 1st took Xanax 20 years ago, and then rarely, only as needed. (I may not have all the details right here, when she's a little more stable I will ask for a better record).

3 years ago during a stressful patch, she took it a few more times, but soon realized that it was making her feel worse, she'd hit tolerance and/or interdose withdrawal.

Without knowing the risks, she stopped entirely and went through a very frightening withdrawal. After doing a ton of research, she learned about slow tapering w Valium. (She was on this forum for some time, and found it very helpful, but also began to find it too triggering.)

I believe this is her 3rd attempt at a very very slow taper. She seems to be extremely sensitive. And is aware of the kindling effect she may have had with her previous attempts and in messing up her dose this week. At this point, doesn't know how to proceed. Definitely wants to stabilize before tapering, but not sure at what dose. Thanks so much for any input!

(has taken gabapentin before and currently on remeron)

Link to comment
Share on other sites

I have no advice, except that I think she needs to stabilize now, and take a consistent dose and then proceed the taper slowly in the future. But I really don't know much about tapering as I did mine too fast and to put it bluntly, has been a shit show. I don't know what that stabilizing dose would be, I hear some people updose a bit when they go through something like this. Oh gosh, I feel so badly for her and think she should get help, but the doctors in the ER won't know what to do...they'll just give her more drugs. I'm really pulling for her.

 

Link to comment
Share on other sites

so, she has been on some dose of benzo (Xanax then valium) consistently for three years with a few very slow attempts to come off,,

 

how long has she been on the remeron -- 7.5 or 15mg?  and when and why was she put on that

is she off the gabapentin now? 

Link to comment
Share on other sites

 

You all are amazing!!

 

Updated/Corrected History:

She became dependent on Ativan 1 mg (not Xanax) after two weeks of use in July 2019.

Switched to Valium for rapid taper 2019 (horrifying withdrawal)

Reinstated November 2019.

Been dry tapering off of 5 mg Valium since July 2020. 

Reducing by about 1% per week for the past year,  reached the halfway point (2 mg) about a week and a half ago.

Then accidentally skipped dose, 7 days later horrible withdrawal, took additional 1mg that evening, better for a couple days then crashed again took an additional 1 mg, very symptomatic.

Symptoms include cog fog, depression, anxiety, fatigue and most recently (due to missed dosage) convulsions, insomnia, burning sensations.

 

Took Gabapentin only briefly 2 yrs ago, off now.

On 30 mg Remeron since January 2020

 

Question now: how to proceed? Updose until stable? And at what dosage?

 

Link to comment
Share on other sites

hi, its hard to know what to do --- I am not sure that I would go with an updose - there is no way to know if that will actually help or create more of an issue.  My sense is that her best bet is to sit tight here for a bit and let her system calm down ---

 

is the insomnia new as well -- as she is on remeron which can aid with sleep? 

Link to comment
Share on other sites

an updose can be a good idea if you have made too large of a cut and you go back up to the last dose you were stable -- but she got down to 2mg, was still okay until she missed a dose -- now has taken two mini rescue doses --- it sounds like she has a very sensitive system (as evidenced by running into issues with Ativan so quickly back in 2019)......so my sense is that her CNS may just need a nice break from tapering for a bit and see if it can gain some stability

 

 

Link to comment
Share on other sites

Hi Something similar is going on with me at 2mg. I just believe it gets much harder this low. I did a rescue dose and became extremely stimulated from it and that set off a cascade of new symptoms . I am trying to hold at the same dose and let things resolve then will come down much slower to make it more comfortable. For many it get harder towards the end and they may slow there rate to 5% a month taken of each new remaining monthly dose. The inner compass.org has really good articles on stabilization periods and reducing amount from each new dose. Sorry I was unable to link them.
Link to comment
Share on other sites

×
×
  • Create New...