glutamate storm= (bzd withdrawal)

Accordingto some studies and what i have read on other forums. When withdrawing from benzodiazepines the withdrawal symptoms are caused by nmda releasing too much glutamate which leads to excitary neurons=withdrawal symptoms.

 

There are some studies, and even some facts that it is possible if not to avoid , but to alleviate the glutamate storm , meaning recovering would be speedier. In some cases, the withdrawal symptoms would not be so bad .

 

There are few compounds that act as agonist to nmda that should relieve some of the symptoms of withdrawal. Some legal, and some somewhat illegal. Starting with the legal ones, namenda (memantine), and dxm. Illegal or borderline illegal are  ketamine for example.

 

There is actually some stuff that using memantine and dxm simultaneously it would lower your tolerance to benzodiazepines. Anyhow using only memantine will lower your tolerance to all kinds of other stuff. Meaning every medicine you have ever taken, beer wine, tobacco whatever. The tolerance will lower to its baseline state. So you would get the effect of it like you were using it the first time in your life.

 

With memantine the dosage should be around 40mg. Im actually thinking of getting a dr to prescribe me memantine so i could make myself the subject of this scientific experience ;(. Im trying to ween off my 0.75mg clonazepam, but its really really hard. I have been on the drug for only 2 months. Memantine is also some sort of neuroprotector.

 

Im not giving any advice to anyone to try my route. Because its not sure it will work, its just one of the things that might work. If memantine would keep my tolerance low i could use baclofen to tackle some of the withdrawal symptoms of the benzo. It would also work as neuroprotector, so it would lower the risk of proctrated withdrawal.

 

Not sure if this is my route to go, but its possible. IF i can get a dr to prescribe me memantine.

Benzodiazepines do affect the Hypothalamic-Pituitary-Adrenal Axis.  To this date there is no proven method of easing withdrawal symptoms with medication. The process of healing can be a long one depending on the invidual and his or her genetic make up as well as medical history.

 

Homeostasis, or balance will return naturally.  As far as what we can do to make the process easler I believe the most effective things are a healthy diet, rest and sleep and being careful not over stimulate and already hyper excited central nervous system.

 

pianogirl

  Benzodiazepines do affect the Hypothalamic-Pituitary-Adrenal Axis.  To this date there is no proven method of easing withdrawal symptoms with medication. The process of healing can be a long one depending on the invidual and his or her genetic make up as well as medical history.

PianoGirl, as you probably know Perseverence wrote some detailed posts about the HPA Axis but I didn't understand mostof the science.  http://www.benzobuddies.org/forum/index.php?topic=44373 

 

The only thing I took away from that thread was that steroids interacted with benzos.  As I am not taking steroids I figured HPA Axis theory didn't apply to me.  Have I missed something?

I'm interested in Thefan's Namenda idea but mainly because it is used for dementia and my benzo symptoms were once convincingly diagnosed as dementia.  I was given the anti-dementia drug Aricept which doesn't work in the same way as Namenda.  I was too ill and my symptoms too variable to really tell if the Aricpet helped but it may have done.

 

-Zoner

I'm somewhat familiar with this stuff.

 

There is a certain forum for recreational drug use where people enthousiastically mention how the use of nmda antagonists 'lowers tolerance' so that they can get high again on their usual dose !

For some people, benzodiazepines are recreational. Since I don't know if I'm allowed to post the name of the forum I won't do that.

 

Lowering tolerance long term to restore homeostasis is a different matter.

 

Perhaps nmda antagonists can be an aid in the withdrawal process. But there are risks, don't ask me which ones because I don't know.

Benzodiazepines do affect the Hypothalamic-Pituitary-Adrenal Axis.  To this date there is no proven method of easing withdrawal symptoms with medication. The process of healing can be a long one depending on the invidual and his or her genetic make up as well as medical history.

 

Homeostasis, or balance will return naturally.  As far as what we can do to make the process easler I believe the most effective things are a healthy diet, rest and sleep and being careful not over stimulate and already hyper excited central nervous system.

 

pianogirl

 

There's some irony ! I haven't found homeostasis to return naturally long term, at least not yet.

And sleep, oh the irony. If only I could get sufficient sleep of good quality, everything would be different.

Liberty,

I don't personally know much about benzo or drug use on a recreational basis. I'm curious if you, or anybody else know if recreational users develop tolerance and withdrawal and how they deal with it. Are they quicker to attribute their problems to the drugs because them understand them better? Do they end up with protracted withdrawal or any other problems? I imagine if you use the drugs recreationally the dosage is all over the place which would cause more problems. Is there any evidence of this and if so, where are those people and why aren't they on this forum? It seems like these people would be in hell, but perhaps I'm mistaken.

  Benzodiazepines do affect the Hypothalamic-Pituitary-Adrenal Axis.  To this date there is no proven method of easing withdrawal symptoms with medication. The process of healing can be a long one depending on the invidual and his or her genetic make up as well as medical history.

PianoGirl, as you probably know Perseverence wrote some detailed posts about the HPA Axis but I didn't understand mostof the science.  http://www.benzobuddies.org/forum/index.php?topic=44373 

 

The only thing I took away from that thread was that steroids interacted with benzos.  As I am not taking steroids I figured HPA Axis theory didn't apply to me.  Have I missed something?

I'm interested in Thefan's Namenda idea but mainly because it is used for dementia and my benzo symptoms were once convincingly diagnosed as dementia.  I was given the anti-dementia drug Aricept which doesn't work in the same way as Namenda.  I was too ill and my symptoms too variable to really tell if the Aricpet helped but it may have done.

 

-Zoner

 

Yes Zoner, this is some pretty deep reading. I printed it out so I could reread it and write my own notes.  Benzos do disrupt the HPA axis causing it to be off balance. There is a hormone called ATCH that is instrumental in creating balance.  Its a complicated process, but in the end benzos inhibit the secretion of ATCH, thereby supressing the HPA axis.\

 

The fact you are not or were not on steroids is a good thing.  But, your HPA axis was still affected by the benzos, you just don't have a double whammy effect.

 

Steroids are cross tolerant to benzos so taking them while on benzos or during withdrawal can make symptoms worse or delay healing.  This is the case for me as I was given many steroid injections to avoid having neck and shoulder surgery. 

 

No matter what, with time the system will right itself.  The magic question is always "how long".

 

 

pianogirl

Interesting idea fan!

We're not really sure how much withdrawal symptoms are due to down regulation of GABA receptors and how much is due to up regulation of NMDA and glutamate pathways. Our bodies make these regulation changes in an effort to maintain homeostasis in the presence of benzos. Your idea has merit and deserves a try. There could be relief of symptoms but then this new drug would have to be tapered until balance is eventually restored. Good luck and keep us posted.

Fan

I read all about  Ketamine and memantine  and can tell you  , i will give this garbage  try  to my ex doctor .

I will stay with diet , exercise  , no  kill my self  with this .

Very dangerous 

Erika

Liberty,

I don't personally know much about benzo or drug use on a recreational basis. I'm curious if you, or anybody else know if recreational users develop tolerance and withdrawal and how they deal with it. Are they quicker to attribute their problems to the drugs because them understand them better? Do they end up with protracted withdrawal or any other problems? I imagine if you use the drugs recreationally the dosage is all over the place which would cause more problems. Is there any evidence of this and if so, where are those people and why aren't they on this forum? It seems like these people would be in hell, but perhaps I'm mistaken.

 

Typically they tend to binge, consuming huge doses in a short time, and then run out.

That they don't use them all the time probably means that certain problems won't occur.

They may not have medical problems they have to deal with, like anxiety or insomnia.

 

But some run into serious trouble.

I don't think they would feel very welcome or at home on this forum.

Illegal drug users end up one of three ways: clean, in prison or dead

FWIW, I was already taking memantine (Namenda) for an unrelated issue when I made my first couple of attempts to taper off Klonopin. It did absolutely nothing to ameliorate the effects of withdrawal. It does not and can not upregulate GABA receptors.

 

Sparrow       

We're not really sure how much withdrawal symptoms are due to down regulation of GABA receptors and how much is due to up regulation of NMDA and glutamate pathways. Our bodies make these regulation changes in an effort to maintain homeostasis in the presence of benzos.

 

Hello Bart.  I seem to recall reading that the down regulated GABA receptors have consequential effects on all sorts of other neurotransmitters.  You mention NMDA but I recall Ashton refers to other neurotransmitters too:

 

  As a consequence of the enhancement of GABA's inhibitory activity caused by benzodiazepines, the brain's output of excitatory neurotransmitters, including norepinephrine (noradrenaline), serotonin, acetyl choline and dopamine, is reduced.

 

Taken from http://www.benzo.org.uk/manual/bzcha01.htm

There is also a glutamate pathway that is involved. There may be others that we don't know about. We all just talk about

GABA receptors in our jargon but the reality is no doubt far more complex involving many other neuro-modulating mechanisms. Just keep going and all this stuff will sort itself out eventually.

 

 

There is also a glutamate pathway that is involved. There may be others that we don't know about. We all just talk about

GABA receptors in our jargon but the reality is no doubt far more complex involving many other neuro-modulating mechanisms. Just keep going and all this stuff will sort itself out eventually.

 

I agree.

There is also a glutamate pathway that is involved. There may be others that we don't know about. We all just talk about GABA receptors in our jargon but the reality is no doubt far more complex involving many other neuro-modulating mechanisms.

 

Hello Bart, there seems to be some significant oversimplification about benzos which gets repeated by many others who are tapering, so I'm interested to hear about glutamate pathways in addition to GABA.

 

One hunch I've got is that choline too may be involved.  I'm just a layman in these matters and this is just a lay guess but I sometimes wonder if we might be overlooking this connection too.

 

Just out of interest, do you think the benzos directly affect glutamate metabolism in addition to affecting GABA receptors, or is glutamate affected subsequent to GABA receptor down-regulation? 

 

(I've never understood why other neurotransmitters are involved in benzo addiction if their only effect is to down regulate the GABA receptor.)

 

-Zoner

It's all interconnected.

 

Gaba, glutamate, serotonin, choline, dopamine, epinephrine, norepinephrine, hormones, neurosteroids, cAMP, SERT (?), thyroid and more. (HPA axis, HPT axis, HPG axis).

 

There is a fairly direct relationship between GABA and glutamate. They are opposites, sort of.

interesting post ,,,i too have heard memantime can be useful in w/d but a pharmacist told me to be careful glutamate receptors are everywhere in the body and even in the heart.Soits dicey and new.

memantine is in many studies right now but curretly only off lable.

just what I know.

Katy

http://www.ncbi.nlm.nih.gov/pubmed/22503310

Zoner: You're right about choline. Good job. I had to look it up.

As I understand it, basically benzos down-regulate GABA receptors because it makes them a lot more potent and our bodies figure out we need fewer of them and is always trying to maintain homeostasis (balance). So we end up with fewer of them. GABA receptors carry inhibitory effects to the neuron as we know. So, in addition to downward pressure on GABA receptors our bodies  put upward pressure on neuro-excitatory pathways. The details of this seem unknown. There are a whole lot of excitatory pathways and transmitters. When benzos are withdrawn GABA receptors are still diminished and excitatory processes are still increased. This imbalance between too much neuro-excitation and too little neuro-inhibtion is what causes our withdrawal symptoms. We eventually recover at what I think is primarily a genetically determined rate. It's just my guess but it seems to me that frequent small reductions in serum benzo levels would provide for a more orderly, steady recovery than sudden large reductions. Maybe too much stress on this homeostatic mechanism makes it go haywire and repairs go improperly leading to prolonged symptoms. Again, there seems to be a huge variation among individuals

Do you know why you got more symptomatic when on such low dose valium? Isnt that a dosage people usually jump ? Im tapering off Klonopin now, so im just asking if people really get more symptomatic the lower the dosage goes...

 

thefan

 

for the Fan,I know someone who quit a 16 mg zanax habit with memanitine-you are compleltey right abut it -and it will protect as well.I for one will try memantine to get off benzos as well.it is in many studies now for many things -a very good drug in some ways.that is my opinion.

I've experimented with NMDA receptor agonists and did not see any improvement (although I was limited and tried both DXM and Methoxetamine).

 

Note that I've tried almost every drug under the sun at some point, so I'm more cavalier about this stuff than most people. Until some clinical work emerges, I'm going to be skeptical that this is a good idea during run of the mill benzo w/d. We know that these drugs are outright psychedelic at higher doses, and affect a lot of different receptor systems. I just don't think the science here is exact enough to be useful.

 

If anyone has clinical studies on the subject that I've overlooked I'd love to see them. Anecdotes are not that helpful. There are reports of people coming off extremely high doses of benzos with no withdrawal at all without any other drugs involved, which makes it impossible to look at someone else's experience and say "yes, memantine was helpful".

point taken Spengler but memantine is under clinical studies for several things....and scientists are serious about it.i cant discount it...trouble is they are still under study although some are completed and memantine si used -off label.

I get your point tho and No drug is best if possible.

Oh, memantine is absolutely a drug, I wasn't disputing that. Other things in the same class (NMDAR disassociatives) are also under various clinical studies. Ketamine has been and continues to be investigated for it's antidepressant properties, and Neramexane was being looked at as a possible tinnitus treatment last I looked.

 

I just don't think it's especially wise to muck with this stuff until there's a clearer understanding of how it works. It's one thing to take Ketamine under clinical supervision according to a treatment protocol, but pushing those buttons on your own seems sketchy. I know from experience that those drugs are powerful beyond belief in a way that benzos will never be, and I'd be pretty surprised to hear of a doctor handing them out as an experimental benzo treatment.

agreed