Life in a mess (tried all of 'em Lexotan --> Xanax --> Ativan --> Klonopin --> Valium)

Hi everyone,

 

I really need your help and support. I had a rocky 1 year ride, that I would say is literally hell on earth. A serendipitous diagnosis of a critical heart problem was made in November last year, which I could have potentially died from, and got treatment early. But this is no fairy story, so please be patient listening to me tale of woes.

 

Once the surgery was over, I suffered tremendously with chest pain, choking, medication side effects and sleep deprivation as a result. It was like living with a heart attack (a pain that I hardly knew because it was detected before a heart attack) everyday. The doctors kept saying it's normal after such surgery, but I knew it wasn't.

 

Long story short, after miserably attempting to work and function like a normal human being, I succumbed to anxiety and depression. I was put on a myriad of antidepressants, none of which gave relieve (and withdrawal from each were absolute hell). It was then I was put on Xanax thrice a day and Ativan at night. It was at the height of my anxiety when I developed noise sensitivity that lingers till today.

 

None of these helped alleviate my symptoms and I had to take a break from the work I loved. It was heartbreaking, I was at the zenith of my career and it was so shortlived. The psychiatrist then put me on Klonopin at night which worked. So at that point I was on both Xanax and Klonopin. Not to mention Lexapro as well.

 

Fast forward to a few months, I began weaning off Xanax, which was a complete nightmare but thankfully had Klonopin cover. I experienced crippling agitation, deep insomnia and paralyzing rebound anxiety. All that came to pass and I am now 91 days free from Xanax.

 

However, my anxiety and depression never quite went away though.Currently, I am seeing a therapist to help uncover all my hidden traumas, which does help in a way (I highly recommend it). On day 89 of my Klonopin therapy, my psychiatrist decided it was time to wean off Klonopin, which I completely agreed to. We made a direct swap to Valium 5mg (from Klonopin 0.5mg). Wrong move; suffered panic attacks and had to rely on both Klonopin 0.25mg and Valium 5mg to tide things over. It worked, probably making me less miserable at the very least.

 

By this time, I still suffered noise sensitivity. I couldn't tolerate traffic noise outside my room window and would often flee to the nearest library till late evening when traffic dies down a little. After 2 weeks, I began weaning off Valium 5mg to 2.5mg. My sleep was disturbed but I was still functioning well. And after 1 month. My psychiatrist recommended I stop Valium completely. I was opposed to this idea and requested for a slow taper. She recommended I try Valium 2.5mg on alternate days.

 

I believe this (and other compounding work issues), made my life more miserable. I wake up having dozens of unnecessary thoughts upon waking up followed by terrible morning anxiety. I kept crying each day (I have never cried this much ever in my life), feeling totally unmotivated, and a distinct sense of melancholia. Regardless, I pushed myself, kept working on a book I was writing, speaking with friends and looking after my mom (who is currently unwell).

 

Strangest of all was that I began to feel calmer in the evening. I beat myself up everyday, what could be the cause and frustratingly enough, I live through the same loop of noise sensitivity, morning anxiety and melancholia everyday. It's like a scene from Groundhog Day.

 

I am now taking Valium 2.5mg daily and will resort to cutting it into quarter in the weeks to come. I have suffered a lot, I have lost all confidence in myself and now I am even thinking of fleeing where I stay (due to lots of traffic noise). I don't even know if I am making the right decision. 

 

Current medications - Lexapro 15mg, Pregabalin 50mg morning/75mg night, Valium 2.5mg night (stranded here).

 

Please help, please tell me this is temporary and it is common. What should I do? I am really at my wits end. Thanks guys

 

MrMeaner

Hi MrMeaner,

 

Welcome to BenzoBuddies!

 

We’re glad you found us.

 

I’m so sorry to hear how turbulent and painful your experience has been over this past year, also having to deal with a family unwell while you have been going through this. However, let me assure you, you have absolutely come to the right place to get yourself back on track. I see a number of problems with your taper which would be contributing to your ongoing issues in regard to symptom severity. Although I don’t know how you tapered from the Ativan, I can see by certain mistakes, that your psychiatrist has very little to NO understanding at all of how to safely taper a patient off benzodiazepines.

 

1) you should never have been directly switched from klonopin to Valium. It should have been a slow crossover where your klonopin dose was gradually decreased as your Valium dose was gradually increased.

 

2) klonopin is considered to be up to 20 times more potent than Valium (0.5mg k = 7.5 - 10mg valium), so your Valium dose was of an insufficient equivalency to the klonopin, which only compounded the mistake of a direct switch to the valium. So you were never stabilised to be then making reductions in your valium dose only 2 weeks later.

 

3) From your description, after that 2 weeks, it sounds like your psychiatrist had you reduce your valium dose from 5mg to 2.5mg in one reduction - is this correct? If so, your psychiatrist had you make a 50% reduction over night, which is ridiculous and potentially dangerous.

 

4) No doctor should ever advise stretching doses out to every second day, as this shows a clear misunderstanding of how the half life of benzodiazepines work, as it only creates a series of inter-dose withdrawals which no patient should be put through. Blood serum levels need to be kept as level and stabile as possible throughout a taper, and stretching out doses causes drastic falls in blood serum levels. Stretching out doses also causes something called kindling, meaning every time you experience inter-dose withdrawals, it can make your taper even more difficult because the more you kindle, the more difficult and intense your withdrawal symptoms become when you taper from your medication.

 

General guidelines recommend a 5-10% reduction in your current total daily dose every 14 - 28 days, however, many of our pmembers need to go slower than this, and we find it is best to follow a symptoms based taper where you would only make another reduction once your symptom severity has returned to a tolerable baseline level. Please take a thorough look at the Colorado Consortium Benzodiazepine Deprescribing Guidelines provided in the below links. This will give you a very good overview of how a sensible taper plan should look and be implemented.

 

If you would like some assistance in devising a sensible taper plan, we can help you with this. You can simply post to the Planning your Withdrawal (Taper) Board asking for help using the link provided below.

 

May I suggest you hold your dose where it is for the moment to allow yourself to stabilise and gain a better understanding of how to move forward from here. You have access to plenty of information and resources here, as well as a community of members who are very happy to share their experiences and provide feedback answering any questions you may wish to ask on the relevant forum boards. Please feel free to post any other questions to the Withdrawal Support (during your taper) board. You will gain feedback from other members also going through their withdrawal taper.

 

Please feel free to look around and familiarise yourself with the site.

 

If you have any other questions, please feel free to ask

 

Again, welcome!

 

WS

 

Here are a few links to get you started.

 

Colorado Consortium Benzodiazepine Deprescribing Guidance

 

Planning Your Withdrawal (Taper)

 

Withdrawal Support (during your taper)

 

Kindling - Benzodiazepine Information Coalition

https://www.benzoinfo.com/kindling/

 

Chapter 3 Ashton Manual - list of symptoms

https://www.benzo.org.uk/manual/bzcha03.htm

 

 

Dear Winters sun,

 

Your reply is just like the sun turning up in winter above the horizon - I was so desperate for a ray of light, and then you came along with this elaborate reply, like a salve to all my woes. You have my infinite thanks. I guess you are absolute right about how quickly tapering was done for me. I was literally in hell in the past few weeks. I will keep this information close to my heart, everything written here is so true that it is unbelievable. I am ever so grateful.

 

MrMeaner

Hi MM

 

Thank you for your kind words. They’re very much appreciated. I’m so glad we could provide you with that ray of light. 

 

As much as we’re here to provide information and resources, it’s also very important that our members feel understood and supported through what can often be such a misunderstood and extremely difficult experience.

 

WS

 

 

Hi everyone,

 

Just an update. My psychiatrist has recommended that I lower to Valium 1.25mg (from 1.875mg) a few days ago. She said the "extra" 1/8th of the pill was just purely psychological. I beg to differ but did not contradict her in person. After all, she is not the one going through this. I have been feeling despondent and morning anxiety levels have increased ever since. Am I tapering too quickly? Is it common to experience all this? Should I bite the bullet and keep going on? I need some reassurance please. Thanks.

 

MM

Hi MrMeaner

 

I’m so sorry your psychiatrist is causing you more unnecessary suffering through a lack of knowledge and understanding. It’s not psychological at all, but you already know that. Your psychiatrist just had you reduce your dose by more than 33%, and guidelines suggest no more that a 5-10% reduction at each new dose, meaning you continually recalculate that 5-10% from from each new lower dose before each new reduction so the percentage you’re reducing at never increases. Typically, tapering becomes increasingly difficult the lower you get in your doses

 

If you can’t find a more informed benzo wise doctor or psychiatrist to allow you to taper safely and sensibly, I would suggest you print out the the Colorado consortium benzodiazepine de-prescribing guidance from the links in my original intro above and take it to your psychiatrist to read. Highlight section 3 (tapering principles) on page 2, and ask your psychiatrist to read through it. Again, your psychiatrist should not be pushing you to taper at this rate, in fact your psychiatrist should not be dictating your taper at all. It should be a patient led taper, reducing at the rate you are comfortable with. Your suffering is clearly the result of ridiculously large reductions.

 

If you have any follow up questions, feel free to ask, MM.

 

We’re always here to support you.

 

WS

Hi WS,

 

Thanks for being a life saver, once again. I asked if my psychiatrist had 2mg tablets for Valium; no luck there. I'm going to print out  the Colorado consortium benzodiazepine de-prescribing guidance let her read it. As a patient, I tend to trust my doctor, but the rules have completely changed throughout my ordeal in the past 1 year; sometimes doctors (not ill-intended at all) just know what they "know" (a little bit of hubris I suppose) which is so much different from a "lived experience" as observed by the patient.

 

I was wondering how do I go about doing a liquid taper; honestly I have no other option but head this direction supposing I were to do a 5-10% reduction every fortnight. I know the de-prescribing guidance advises that we reconstitute the tablet into liquid form in a syringe, but I was just wondering whether this has worked for other sufferers like me (will water just deactivate the components of Valium, and how long can I store it)?

 

MM

Unfortunately doctors and psychiatrists have often been completely misguided when it comes to benzodiazepines. Much of the information you have access to here is Big Pharma’s dirty little secret in the name of profit, so medical professionals continue to have the wool pulled over their eyes and patients suffer accordingly.

 

I think the best thing you can do right now is post on ‘titration’ on the Planning your Withdrawal (Taper) Board (titration) and ask for information regarding your various liquid options and help in devising a sensible taper plan. We have knowledgeable people to discuss and help you with this next step.

 

Planning Your Withdrawal (Taper)

I just realised you already posted on the Planning your withdrawal board in direct simple tapers, but if you could just post on the titration board now, asking for information about liquid options, that will get the ball rolling 

Dear WS,

 

I have posted it in the 'titration' section. I am just perplexed; this is a sobering lesson for me, as a medic, I feel betrayed. I will wait for a response from the titration group. My infinite thanks, you made my day better.

 

MM

I can only imagine how perplexing it must be for a medic to experience the truth about benzodiazepine withdrawal syndrome, something that has been kept a secret and hidden for decades, even from the majority of the medical community. It’s truly criminal.

 

I will PM a member of the team much more knowledgeable in liquid titration options, and ask them to help you out on the titration board. Just be patient, as we are all operating at different times around the world, so it may be quite a while before they actually jump online. But rest assured, we will help you work your way through this and get you back on track. It’s simply not necessary to suffer the way you have been lately.

Hi WS,

 

Truly criminal indeed. In the past, I have been very reluctant to prescribe my patients with benzos unnecessarily, advising them that it's only for a very short term use to tide things over (2 weeks to a month max). Now, I understand the pain those patients who come to me with benzo withdrawal; I literally carry and feel their pain now.

 

I have reinstated myself on Valium 1.875mg for the next few days and hope my symptoms stabilizes. The mornings are the hardest part of the day (just too many unnecessary thoughts) but I will get through it somehow. I'll wait for their response on how to safely titrate my dose. It's tough but I have been longing for normalcy for the past 1 year. Let's hope this (and lots of patience) helps.

 

Thanks once again.

 

MM

For the past few days, I tried a dry cut taper from 1.875mg to 1.25mg Valium (tried it for 6 days). It was alright in the beginning but on the 6th day, I started losing a little sleep at night and noise sensitivity returned a little. I am still functional, but kind of low in mood. Was contemplating on going back to 1.875mg longer (I was on 1.875mg for 21 days), but want to keep up the good fight and find stability on 1.25mg (I know it's a 33% dose jump). Any advice?

 

MM

For the past few days, I tried a dry cut taper from 1.875mg to 1.25mg Valium (tried it for 6 days). It was alright in the beginning but on the 6th day, I started losing a little sleep at night and noise sensitivity returned a little. I am still functional, but kind of low in mood. Was contemplating on going back to 1.875mg longer (I was on 1.875mg for 21 days), but want to keep up the good fight and find stability on 1.25mg (I know it's a 33% dose jump). Any advice?

 

MM

 

If you feel you are functional 6 days after reducing to 1.25mg I would probably just wait this period out and allow myself to stabilise. I would just hold my dose where it is, and once I felt stabile again, I would then continue my taper within the guidelines of 10% reductions, as our systems commonly become much more sensitive to tapering once we are down in the lower doses. It would be very sensible to now slow your taper down from here on out. 

 

WS

Dear WS,

 

I will bite the bullet and hold on to this current dose. Will everyone posted on how this works. Thanks once again.

 

MM

If things get too distressing (remember, you are the only one who knows how much you are suffering) then you can up-dose slightly, but it’s best to avoid reductions that force you to up-dose in the beginning. It’s better to do smaller reductions where this doesn’t feel necessary. 

I agree WS. I really wish I could half those tablets to smaller proportions, but they always crumble into bits (1/8th of a 5mg tablet). I will try to somehow dilute this in water and spread it out over two doses if I can. Worth a shot.

 

MM

I agree WS. I really wish I could half those tablets to smaller proportions, but they always crumble into bits (1/8th of a 5mg tablet). I will try to somehow dilute this in water and spread it out over two doses if I can. Worth a shot.

 

MM

 

Hi MM

 

Just keep in mind you also have the option of buying a jewellers scale from Amazon and making much more precise reductions for this last part of your taper. They are quite cheap to purchase. 

Hi WS,

 

Yes, I am going to do precisely that right now. I can't sit back and keep whining. I am feeling alright now, but awhile ago I felt extremely lethargic. Coupled with my heart problem, I have this constant fear going on. Let's hope this works. I will keep you updated.

 

MM

Great to hear, MM