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Low dose Xanax over 5 yrs


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I mistakenly believed (through the internet information) that i could cold turkey xanax and go through the withdrawals over a period of a few days.  Agh.

I had stopped ambien and codeine and those withdrawals did peak at 3-4 days and started to subside. After 7 days I was able to sleep without any aids and no longer have rebound headaches.

I dropped xanax from about 1mg -1.5mg a day to .75mg (.25 at 3x/s a day).  I’ve been at the current dosage for about 2 weeks. I’m not where i go from hear for tapering.  Everytime I drop the dosage down further, i get severe withdrawals, -that seem to get worse with every attempt at reduction.

Last week was very tough for me, as the anxiety was horrible, especially when anywhere away from home.- sweating, trembling, involuntary muscle movements, anxiety.  I really don’t want to add in diazepam or anything else.  Is it normal to feel extreme withdrawals inbetween dosages and should i go with the way I feel to slow down tapering or ride it out?

 

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Hello, Martineka.

 

Per the Benzodiazepine Information Coalition (link below), alprazolam/Xanax has a short half-life so some individuals find they need to dose 4-6 times a day (or more) to address interdose withdrawal.

 

If you have not already done so, you might want to check out our support group for individuals who are discontinuing alprazolam (link below). The group hasn’t been very active of late, but reading past posts can be helpful.

 

Links:

 

Interdose Withdrawal - Benzodiazepine Information Coalition

https://www.benzoinfo.com/interdose-withdrawal/

 

The Xanax Club

http://www.benzobuddies.org/forum/index.php?topic=74309.msg987285#msg987285

 

Edit: Added link to BIC interdose withdrawal

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Welcome Martineka. Congratulations on deciding the quit Xanax! 😃.

 

I just finished my Xanax taper 4 days ago.  I was on it daily for 23 years and started at .75 -1.0. My taper took a total of 30 months and it’s be “relatively” smooth.  Not, easy, but not unbearable ether .  I took it very slowly and reduced at about 10% every two weeks, depending on how I felt.  If I had a rough time I held it longer but never went backwards and updosed. There were a couple of times during stressful periods that I held it for months until I felt ready to start again..  That gave my system a long stretch to really adjust.

 

It’s good to space your doses evenly and go back and forth to cut a little off one and then cut a little off another and hold, etc, so that you’re  keeping the cuts even.  When they get small enough you can begin dropping the one you want to eliminate by stretching the dosing time out slowly while shaving it to nothing. 

 

It sounds like you reduced by quite a bit to get to the .25 3 times daily.  You might want to consider taking a break and holding however long it takes until you feel stable enough to begin again. Stay positive. You can do this. 

 

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Thank you very much for the input.

 

I’ve noticed that googling this issue isn’t the best idea.  The power of benzo’s over a long period, -in my case not very high doses- really plays tricks on your mind.  I’ve diagnosed and panicked in the last month-during a concerted effort to reduce/stop- myself with heart disease, tumors, lupus, ALS, MS, brain damage, parkinsons’- to name a few.

 

Forums like this are much better for encouragement and a reality check.

 

The involuntary muscle contradictions and movements are very alarming, typically it happens while I’m out in public.  It’s of course much worse when I’m in between doses. I’m going to hold at where I’m at now for awhile.  I take it that the inbetween doses issues is my body adjusting and healing???

 

I find that exercise works great, it’s when I have the least amount of symptoms.

 

I’m troubled and trying to accept that the weaning process is very slow- months maybe years- the medical websites say much different. 

 

I’m hung up on the fact that seizures can happen if tapered or stopped too quickly.  Has anyone experienced this?  I’m worried about going in loud busy public places right now over that possibility.  That position of course begins the vicious cycle of avoidance and limiting my exposure to the outside world.

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Hello again, Martineka.

 

Decreasing your dose from a range of 1mg to 1.5mg  to 0.75mg is a 25-50% reduction of a very potent benzodiazepine. Assuming your withdrawal symptoms continue to be tolerable, holding at your current dose is a sound decision.  (To give you an idea of the potency of alprazolam, Professor Ashton substituted 20mg of diazepam for 1mg of alprazolam when crossing her patients to the longer half-life drug.  Consequently, many/most members of this forum would not consider 1mg of alprazolam to be a ‘low’ dose.)

 

The interdose withdrawal you are experiencing is due to the short-half life of the drug and physical dependence.  Per the document from the Benzodiazepine Information Coalition I referenced upthread (linked again below), interdose withdrawal is typically resolved in one of three ways:  (1) increasing the frequency of dosing of the shorter half life benzodiazepine (2) switching to a longer half life benzodiazepine; (3) tapering off to reverse physical dependence.  To learn more, read the section titled ‘How To Resolve Interdose Withdrawal’.

 

Fear of seizures is quite common among members of this forum.  Based on the literature I’ve read, my understanding is the risk of seizures is highest for individuals who have been taking supra-therapeutic doses of a benzodiazepine and then discontinue the drug abruptly (i.e. ‘cold turkey’).  The risk of seizures is significantly lower for individuals who are taking therapeutic doses and discontinue (taper) the drug gradually over time.

 

Link:

Interdose Withdrawal - Benzodiazepine Information Coalition

https://www.benzoinfo.com/interdose-withdrawal/

 

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Martinika, Yes to everything Libertas said! Those who have seizures are typically those who have gone cold turkey.  Just go slow and take a break if you need to.  Those WD symptoms won’t last forever.

You might consider downloading a breathing app to help you keep calm. I just downloaded a cool little kindle book on my phone “A Pocket Therapy Guide to Anxiety “ by Dr. Edward Bourne.  It’s got useful exercises for stopping panic and anxiety episodes including an “emergency” chapter.  Please remember that most of us got hooked on these drugs because we were suffering with anxiety.  Oftentimes the anxiety we were initially treated for has long since resolved and the anxiety we’re currently dealing with us nothing more than inter dose withdrawal.  Either way,  there are much healthier and efficient ways of coping with anxiety and panic attacks.  By the time you’re done with your taper you’ll discover a new feeling of empowerment as you’ll have learned techniques to help you overcome this.  Very best wishes to you! 

 

Oh, and I advise to stay away from Dr. Google - He loves scaring the pants off people who have anxiety issues.  :)

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Thank you both.

The article was very helpful and insightful.  Not one time over the years did I ever think the symptoms that I experienced were related to tolerance or in between dose withdrawals -and it’s occurred off and on for a few years.  I really just chalked it up to an anxiety/panic disorder.

 

It’s really too bad that benzo are prescribed so freely and there really is a lack of knowledge about coming off of them.  I was originally prescribed them for a micro toxin I had that went undiagnosed for about a year that caused havoc.  Same symptoms of severe withdrawals except i had very high fevers and my white blood count was high and a lab results that showed the infections. Regardless, antibiotics likely resolved the underlying problem and today’s issue is to stop taking xanax.

 

I’m going to take it slower now that i understand what half life is and fast acting. 

 

Thanks again for the support, it really makes a big difference.  I’m probably not alone in looking to this forum for real help and am gratefully finding it.

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I’ve read the article links posted and have readjusted my tapering based on what is said about interdose withdrawal.

Since I’m working with .5 mg Xanax tablets, 2 days ago, I weighed a tablet, (13 grams), razored in half and shaved a small amount to get to .5 grams.  Although I reduced the dosage, I’ve increased the frequency,  I’ve noticed that at about 4-5 hours my body begins to vibrate and I tense up, especially if I’m around people or too much stimuli.  Am I building up Xanax by taking it more often, for the last month I’ve been taking 3 x’s a day, now I’m at 4 x’s a day. (Although it’s lower overall per day even though more frequency)?

 

My question is does this sound like the right approach and it is typical for the symptoms to subside or lessen has my body and brain adjust to the new regime?  If the symptoms persist and are intolerable for a period of time should I increase ?

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Martinika, Your plan sounds good to me. You’re shaving off just one (not all) of the doses right?  If you look at my signature you’ll see my starting daily dose was .75 and  I was dosing 4x daily. But I had been taking an extra.25 at bedtime so my first goal was to taper the bedtime dose to equal the other 3.  After that I tapered the early morning dose off till I reached 3 doses that were .125. 

 

Can you get your doctor to prescribe.25 mg for you?  It would make it a lot easier to cut.

 

Withdrawal between doses is uncomfortable but it shouldn’t be unbearable.  Listen to your body and go as slow as you need to between your cuts.

 

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Hi again and thanks for the response

 

I shaved all the doses so that I could add a 4th dose to my day without adding the total mg. I’ve noticed by early evening, i feel really good and could easily not take the evening dose but then I feel very bad in the morning.  Probably fortunately for me, as I CT ambien over a month ago, I’m sleeping well with sometimes taking a melatonin.

 

Like many people, the most critical and important time for me to function is during work hours.  I’m trying to figure out a way to achieve how I feel in the evening during the day.  Logically, the xanax is mostly out of my system by the time I wake up as it’s about 12 hours since my last dose.  Does it make sense to try to wake up with a stronger half life or adjust my morning and mid day dose?

 

It’s truly a shame I didn’t find this site or the Ashton manual until almost a month of doing my own tapering based on medical sites that really promote a fast taper.  Are we suppose to be feeling withdrawals symptoms while tapering is that a sign of healing or suffering for no good reason? :/

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Martineka, you’re doing a fantastic job!  The 12 hr interval would be too rough for me though.

When I was dosing 4 x daily I tried to stay on a pretty strict evenly spaced schedule - every 6hrs.  It meant getting up in the night.  Once I felt fairly stable I began tapering that wretched 4am dose off.  While tapering that dose  I gradually stretched the times of the other 3 doses so that by the time the middle of the night dose was gone the remaining 3 were 8 hrs apart. 

 

I think pretty much everyone here will tell you that we all experience WD symptoms while tapering.  Mine included anxiety, feeling edgy (cranky), fatigue, some dizziness, headaches.  Etc.  Typically  the WD symptoms are worse the first 3-5 days after a cut.  I determined that I would just be comfortable with being uncomfortable. 

 

I downloaded “Xanax Withdrawal” by Dr. Stuart Shipko - $5 on Kindle.  It really helped. He appreciates Ashton’s work and though his suggested taper schedule was too aggressive for me,  his book is excellent and really gave me confidence.

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Hi

The latest adjustment as already described has created new wd.  Full blown anxiety/panic attacks, tense muscles and shaking while standing- but only in public.  Before it was difficulty sitting and wanting to stand. I’m going to try to keep with the current dose for as long as it takes and try to interact with the outside world more since that is where symptoms get extreme.

Thanks for the suggestion on the book, it’s difficult to find addition materials that follow the Ashton method and it’s tragic that no one has picked up and expanded dr. Ashton’s work.

 

As for my doctor prescribing me .25mg, yes he happily would..lol. But he also believes that withdrawals are not so bad if it is even possible to become physically dependent on the “low dose” he has prescribed me.  Only in the last 2 weeks have i come to the realization it is NOT a low dose. 

 

I’m very grateful to have found BB.  All of us strangers connecting and helping each other anonymously for inadvertently getting addicted.  The medical establish has a long way to go.

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I wanted to show you this post, I happen to agree with it so I'm glad you've realized something your doctor has yet to understand. I also want to say that I'm glad you're going to push yourself just a little to interact with the world around you.  I know its difficult but its so important to preserve the life we had and want to live again.

 

 

Strength and potency are often used interchangeably, but they are not the same thing.

 

Strength is the amount of drug (active pharmaceutical ingredient or API) in a given dosage form (e.g. a 0.5mg clonazepam tablet contains 0.5mg of the API, clonazepam).

 

Potency is the amount of drug required to produce an effect of a given intensity. A highly potent drug (e.g., clonazepam) produces an effect at lower strengths (amounts) while a drug of lower potency (e.g. diazepam) produces an equivalent effect only at higher strengths (amounts).

 

Regrettably, some healthcare professionals do not understand the difference between strength and potency.  This is why members are sometimes told they are taking a ‘low dose’ or a ‘baby dose’ of clonazepam so don’t have to worry about becoming dependent on it.  The reality is that although the physical amount of drug they are taking is low, the potency and hence the intensity of the effects of the drug are high.

 

Addendum: Differences in potency are also why members need to be careful about adopting ‘one size fits all’ approaches to tapering benzodiazepines. For example, a 0.01mg reduction in dose of clonazepam is not the same as a 0.01mg reduction in dose of diazepam in terms of potency (effect).

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Thanks for reposting your. Post about potency vs strength.  I actually read it on the thread you posted.  I’m going through a lot of threads on here as everyone’s experience is of interest to me.

 

Because I’ve had an extreme reaction to interacting away from home since I started tapering, I make sure I leave home everyday, even if it’s for a drive.  It’s almost impossible right now for me to even go into a store due to an a sudden onslaught of various symptoms, but I’ll keep at it and a slow pace, hopefully I adjust to the tapering as I’m going to hold for a while.  I looked at many tapering schedules and realize slow and steady has the best chance of recovery.

 

When I was first prescribed Xanax, I requested a low dose of Valium, my doctor told me Valium was too potent and Xanax would be better since dependence was unlikely—- ya right!

 

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Hi martineka,

 

In one of your earlier posts you said you felt best when you exercised; when you had the least amount of symptoms. Yes, I think this is key. IF possible, push yourself to exhaustion. That will help so much with sleep and soothing the pent up anxiety and the "willies". I too had some rough weeks in social settings - I was very lucky to be self employed and able to hide for a time - but I did go to the grocery store and other necessary errands with full blown anxiety and paranoia eventually I realized it didnt actually show on the outside. Again, sort of pushing yourself through the discomfort makes things go faster. DO NOT get into a mind set of I

"i can't do X because im weird from xanax" Train yourself to speak only in terms of "you can. you will"  Many people on this board speak of the lies of benzo. Thats your brain telling you " i can't. im scared. I will never heal." You brain can't distinguish that program from reality and it will make it so. Every time I would fall into despair I would say, out loud, to myself, "thats not true. Im getting better everyday. This is going to end." over and over and over again.

 

I found the beginning of the taper harder than the end. If you look at my signature, you can see that I went from 3x daily dose to 2x daily. I never felt interdose WD at that point. I dry cut, and jumped after I was less than 1/4 of a .25.

 

You can do this.

 

I loosely followed the 45 day benzo taper - you can find it online - He cut every five days. I cut when I felt my CNS was stabilized. some cuts were longer than others.

 

Have a great weekend. Good luck to you. Dont be afraid.

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