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Xanax taper. Which way to go?


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Hello everyone. I've been on Mirtazapine 15 mg since September 2020, and xanax 1 mg for anxiety. Until last November I only used the xanax occasionally, sometimes to calm down anxiety, sometimes for sleep, but I could go days without using it and felt absolutely fine. Last November I was in an accident that left me with a few physical issues. I developed panic attacks, had to quit my job for health reasons, and started taking xanax daily. The Mirtazapine was also increased the month prior to 30 mg, because I felt it wasn't working as much as it used to.

 

In early February I decided with my psychiatrist to reduce the dose of mirtazapine back to 15 mg, because 30 mg was doing nothing at all for me if not giving me more side effects which I barely had at 15 mg. I followed his taper plan and reducing the dose was surprisingly easy, which I didn't expect as I heard stories of people really struggling to reduce mirtazapine.

 

Somehow that convinced me I could go back to using xanax only occasionally as I used to do, since I wasn't getting daily panic attacks anymore. Again, in the beginning, that went quite smoothly. I started taking 0.50 after lunch every day and other than some manageable anxiety especially close to my next dose, my tinnitus being a bit louder and some intrusive thoughts I was doing ok. That went on for about 2 weeks, and it was going so well that I thought I could reduce the dose further and try 0.25. First day all good. Second day, I'm shivering, I couldn't think straight and I couldn't sleep, not even with mirtazapine which usually allows me to sleep really well. I ended up taking the rest of the pill, and felt better. I immediately asked to speak with my psychiatrist, but I couldn't get an appointment until Monday the 7th (which is next Monday now). Unfortunately, since then I've been feeling like crap, even after I got back to 0.50. From the moment I wake up, I feel dizzy, nauseous, I have a strange feeling in my head, and I feel like I can't think straight. At times, my throat feels like it's closing up. The worst is the dizziness because it prevents me from doing most things, and I end up just having to sit if not lie down. Sometimes the 0.50 dose makes me feel better, but not always.

 

I realise now that I have been hasty and overly positive about this. I thought it would be easy like with mirtazapine, but it really wasn't. I also wrongly assumed 1 mg of xanax was a small dose since my psychiatrist told me I could take up to 3 mg a day and I never did, I assumed I was safe. I was wrong about everything.

 

I have 2 questions now:

- Did I do some damage by attempting to taper so quickly? Or will I feel better eventually?

- What is the best way to taper xanax? The pills are already teeny tiny. Splitting in half is easy, splitting in quarters sort of ok, but other than that it's complicated. Do most people who take xanax taper with it, or cross over to something else?

 

I will indeed also be speaking to my psychiatrist on Monday to hear what he says and come up with a plan, but if anyone could offer any advice I'd be grateful  :smitten:

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Hi redvi,

 

Let me assure you didn't do any damage, you're uncomfortable but these are just symptoms and not the product of damage.  As for feeling better, yes, you can but it probably won't happen until you're free from the Xanax and recovered from its use.  I'm not saying you're going to be miserable every minute of every day but this process is very challenging and it takes a long time to recover from it.

 

We have many members who are tapering from Xanax so it can be done, it can be tough because of it's short half life so some will cross over to a longer acting benzo but its best to see if you can taper directly off of this drug before attempting another method.

 

Some questions for you and a request.  Could you fill out your signature, this would be your medication history so others can see at a glance what you're dealing with, that way we won't have to ask as many questions.  If you need help with this, you can leave the info here and a team member can input it for you. Add your history/signature 

 

How often do you dose during the day, many of our Xanax users have to dose 4 times a day to avoid interdose withdrawal, are you experiencing any of this?

 

Since you're seeing your doctor on Monday I wonder if he would be receptive to looking at this document, many in the medical community aren't familiar with the proper way to taper their patients.  This isn't because they don't care of course but many of their patients don't have the problems we do, we're in the minority so if they haven't seen people like us they tend to dismiss our challenges.  Colorado Consortium Benzodiazepine Deprescribing Guidelines

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Thanks so much for your reply. I thought I did add my medication history in my signature, I can definitely see it, but maybe it doesn't appear? What I wrote is:

 

Mirtazapine 15 mg for 1 year, increased to 30 mg from October 2021 then back to 15 mg since February.

 

Alprazolam 1 mg at need for a year, daily from November to February, currently at .50 but struggling.

 

As for my dose, I take 0.50 mg once a day. And yes, in between doses, especially from the time I wake up till my dose around lunchtime at like 1 pm I feel pretty dreadful. Then I slowly get better, although I definitely don't feel at my best. Is it better to split doses? The problem is that as I mentioned the xanax pill is so small, it's hard to cut in smaller pieces other than half...

 

Thanks for that link, I'll check it out and mention it to my psych. I also assumed coming off would be relatively easy, because lowering my dose of mirtazapine was quite straightforward so I assumed it would be the same with the xanax. Alas, it wasn't the case.

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I may have overlooked your signature, my apologies.  What size are your pills?

 

Would your doctor be willing to prescribe you the .25 mg pills, this would make tapering a little easier.  I would suggest you dose more often, it looks like you're experiencing interdose withdrawal so dosing more often would help.  If you do this, its a good idea to allow a week or two for this change to settle because in the short term your body will see it as a reduction, any change seems to affect us.

 

Many of our members will use a razor blade or pill grinder to actually make little piles of the pill then eyeball them, some use jewelers scales to weigh their dose.  If you have .5 mg pills and you wanted to split your dose you could crush it and as long as you take the entire .5 mg in a 24 hour period, you can be assured you're getting your full dose. 

 

To let you know the various methods for tapering, this Titration FAQ's document is helpful.

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My pills are still 1mg, so I cut them in half which is easy because they have the line in the middle. I did try to cut them in quarters, I have special scissors for it, they don't come out quite perfect though, so yeah I should probably ask to be prescribed the .25 instead to take in 2 doses if I'm understanding correctly?

 

What I don't quite understand is why I felt relatively well and managed for a whole 2 weeks, before feeling quite ill. Is that common?

 

Thanks so much for the link on titration, I really need all info now.

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Yes, if you could get the .25 mg you could take two a day to start out, hopefully that would even things out for you, and you can always add more doses during the day if you need to by cutting them into halves or quarters.

 

I didn't taper so I can't speak from experience but I've heard from members that reductions can accumulate, you think everything is fine so you make another cut but then you get slammed with symptoms.  This is why we suggest waiting a couple of weeks before making another reduction, and why we suggest making smaller reductions, its easier to reduce a little bit more the next time because pulling out of the symptoms of a too rapid taper is difficult, as you're dealing with now. 

 

Because we're all so different in how we react to these medications, its difficult to say with certainty what is really happening, the only thing we have is our common denominator, difficulty taking and withdrawing from benzo's.  The trouble is our symptoms, our tapers and our recovery times vary so we reach out to others who are traveling a similar path to ours in hopes of finding answers to when we'll recover, its frustrating and scary but its all we have.

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