Benzos after benzo free

Dear all.

 

I´d like to know your opinion about:

 

Considering one is benzo free after a successful taper (no major withdrawal symptoms), how it´s gonna be if he or she need to take benzo again, for instance, before a surgery or even to make clinical tests, like stomach endoscopy (I´ve done some, because I´ve gastritis). I think the question is very important because if the answer is that one´s, after a taper, never can get any benzo, otherwise all the withdraw process have to be repeated, there´s no sense to go through this considering that we have to take benzos in the future, for medical needs, anyway.

 

Regards.

Sérgio.

Hi Sergio....this is from the Ashton Manual:  What happens if someone who is in the course of benzodiazepine withdrawal or has successfully withdrawn needs a surgical operation? Benzodiazepines are of value as premedication before major operations and for sedation and amnesia during minor surgical procedures. Yet many ex-users are terrified that if they are given a benzodiazepine for these purposes they will become dependent all over again. They can be reassured: a single dose of a benzodiazepine given for an operation does not bring back the addiction, although the stress of an operation may re-awaken the anxiety symptoms experienced during benzodiazepine withdrawal. Symptoms reported under these circumstances have usually been the result of fear. Many personally observed patients have had repeated doses of midazolam (Versed, Hypnovel), a short-acting benzodiazepine, for dental procedures (dental phobia is common in withdrawal), and other benzodiazepines including diazepam for major and minor surgery and have recovered without complications

 

I had to have surgery and asked that no additional benzos be used , and they accepted that.  I was calm before the anaethesia and I felt it better than if I had had the versed when I awoke.  Hope that helps.  Janus

Thank you Janus.

 

I already knew the version of Ashton Manual but, as a lot of issues regarding benzos, it´s best to know personal experience of people that went through withdrawal and experienced benzos again. Some sites regarding this issue are so close-minded that informs "one can never have any benzo after the last dose".

 

Sérgio.

I've heard this too, and it is simply untrue...repeated doses of benzos may cause problems and one must try not to succumb to the lure if a bit anxious.  I have had procedures during wd and didn't take any preanaesthesia and it worked out just fine. I had the option, I knew it was safe and okay to do, but decided to try and not have any and it worked out fine.  This is simply not an issue to worry about.  Janus

Sérgio,

 

We give similar advice if a member comes here and informs us that they took an extra dose because they felt anxious, and they are now worried about their taper. A one-off dose, so long as it is one-off dose, will have no lasting effects. I don't recall any of them suffering because off a one-off lapse to their taper.

 

In the case of surgery, the plus points may well outweigh the fear of taking this extra dose. I understand the fear, but it is unjustified.

What about a person who decides (like me) in the middle of a tper to go back ON a benzo on a semi steady basis?

 

Im an artist and have an art gallery that is only open 9 monhts out of the yeaar. My panic disorder is more prevanalnt around 'humans' and since I wasnt going to be around many(LOL) during the months off Jan- March I decided to try a taper. I went from 1 mg of Ativan a day to .5..then .5 every OTHER day. I was experiencing some major ANXIETY and panic reoccurrences soooo after talking to my doc we've decided that I should jsut go back on the ativan since I was feeling better on it.

Soon I will be going back to my gallery every day and its important that I am in a 'good mood' (NOT in a panicked state of mind), because my financial survival depends on it!

 

HOnestly I HAD been  sortof flipflopping a bit lately --going from .5 every other day to .5 every day. Now I want to start back on them every day on a seady basis.

 

 

 

SO now Im back ON my ativan (.5 mgs a day) and I want to go up to 1 mg a day. Is it ok to go up then down then up --or is it best to just stay on one 'course'?? I think I know the answer , which is to stay on one path.

 

Thanks for your answers. I am still a wee bit confused about this whole thing! 

It is your decision to stay on benzos of course.  Some of your anxiety may have come because of the withdrawal, which is to be expected.  Colin can give you a better answer than I...of course there is no answer.  I do not believe benzos are a good long term solution to anxiety.  They are not meant to be used for more than 2-4 weeks for anxiety...oftentimes a person has to up the dose to achieve the initial response they had .... and sometimes that initial response doesn't ever come back .... emotions can become blunted...there are many side effects...but the choice is always yours.  I wish you a lot of luck and best wishes.  Janus

My doc said that taking 1 mg a day of ativan is 'perfectly fine'. NO Long term affects of it at all. He almost laughed when i seemed concerned about my dosage. He said people are taking 3-8 mgs a day. Im only taking one mg. He said if its 'working' to keep taking it.

 

Ive decided to take .5 mgs a day instead of 1mg because of course

some day Id like to be drug free but for now I have to maintain-----

Unfortunately this is a common scenerio among doctors.  They laugh.  Mine said to me, "Why we give it to old ladies for sleep."  Well unfortunately they do and the elderly fall victim to the dependency as well.  As I said before, I wish you well, and we are here for you if and when you decide to stop and need support.  If you don't have trouble stopping then you will be fortunate. If you don't have to up your dose or switch to a stronger benzo you will also be fortunate.  Blessings.  Janus  Good luck with your gallery sales. 

Janus..so you feel .5 mgs a day is a HIGH dosage??

No this really is not a high dosage.  According to Prof. Ashton it is the equivalence of about 5 mg. of valium.  The problem is, and I will be honest with you, is that in time you probably will not be able to maintain this small dosage and have to up it because it no longer works for you.  You might (and I add might because I don't know) have to take more during the day.  Your anxiety may increase and you might think it is your original anxiety when in fact it is the drug causing it.  These are just a few scenerios that might, and I add, might happen.  Why don't you tackle the anxiety another way instead of a drug?  It is so much freer and you don't have to rely on a substance?  But if your problem is as such that you think a drug is the only way to manage, then you need to do what you need to do.  We make no judgments here and we will even walk with you while you are on the drug.  As I said, you may have experienced heightened anxiety due to withdrawal than it being situational.

 

Benzos blunt emotions, they blunt everything.  On a small dose you might not experience this.  Or you might.  Everyone is different.  There are side effects and you need to be aware of those.  More than what is said on the label.  Any other questions feel free to ask.  Take care and I really do hope you do alright.  Janus

Michelle, I don't think Janus is suggesting that 0.5mg of Ativan is a high dosage, but even quite modest amounts can cause problems, especially trying to withdraw.

 

When you are ready to taper again, it is better to take a small dose frequently rather than a large dose infrequently. This can be tricky with these small potent pills, but can be achieved by making up a liquid from a pill and drinking the appropriate proportion. Ativan is probably best taken at least twice a day during withdrawal.

Michelle,

 

I thought you might like this quote:

 

"It is our position that most of these patients did not require long-term benzodiazepine therapy - certainly not continuously for many years. In fact, we have unpublished data which demonstrate that many patients, once they have been withdrawn from their maintenance benzodiazepines, show more improvement on clinical measures of anxiety and depression than they did during their chronically medicated state".

--

Schweizer E, Case WG, Rickels K. Dr. Schweizer and Associates Reply. American Journal of Psychiatry 1989; 146: 1242.

COlin and Janus. Thankyou. I definitely 'hear' what youre saying.

 

I really do appreciate you saying youll be here for me no matter what. Thats very comforting actually..

 

Thankyou. .....

 

TO tell you the truth this whole thing is VERY CONFUSING. My bf and doc both think I was better "ON" the Ativan than off of it. Although they dont live in my HEAD.

 

I also didnt have to UP my dosage (from the 1 mg) like many 'addicts' do --the doc pointed out. I as pretty fine on the 1 mg.

 

My moods were overall stable and I wasnt a basket case at work, could deal with situations pretty rationally etc.

 

Now that Ive been doing the taper thing (approximately 2 months)---Ive had some REALLY bad panicked days where I want to hide from ALL HUMANS,get the shakes, nervous energy, slight buzzing in the head etc.

 

 

oops...didnt mean to hit enter.

 

Anyway.....since Ive been tapering I am SOOO tempted to go back to my steady dosage of .5 mgs a day because I

THINK I will get rid of those uncomfortable symptoms......and I recall how much more 'steady'I felt ON the drug.

 

BUT..on the other hand if I HANG IN THERE and stay WITH these uncomfortable symptoms they will eventually SUBSIDE? Is that what you are all saying?

 

 

Yes, the withdrawal symptoms will subside eventually - probably quite quickly, particularly if you have tapered off at a sensible rate. The key is to make small cuts, and keep your dosing as regular as possible.

COlin and Janus. Thankyou. I definitely 'hear' what youre saying.

 

TO tell you the truth this whole thing is VERY CONFUSING. My bf and doc both think I was better "ON" the Ativan than off of it. Although they dont live in my HEAD.

If you doctors do not understand wd then of course they will not accept withdrawal symptoms which it sounds like you were or are having.  

 

I also didnt have to UP my dosage (from the 1 mg) like many 'addicts' do --the doc pointed out. I as pretty fine on the 1 mg.

 

The better term here is dependency.  Not many of us chose the addiction....  Only time will tell if you have to Up the dose.  It takes time sometimes for tolerance to set in.  

 

 

Now that Ive been doing the taper thing (approximately 2 months)---Ive had some REALLY bad panicked days where I want to hide from ALL HUMANS,get the shakes, nervous energy, slight buzzing in the head etc.

 

 

 

 

I think that what yu have in the above is very common withdrawal symptoms which would abate over time.  Agorophobia (social isolating) can be a withdrawal symptom.  Don't get too shook about it.  Shakes, nervous, buzzing, all common for one recovering from the dependency.  

 

Whatever yuo choose it's your choice.  I hope we have been able to inform you in some ways.  Like I said, many docs don't get it at all.  The majority to be quite blunt.  You so want to hope they know, but they don't.  It's really a bad situation.  Janus

Thanks Colin and Janus for the timely responses.

 

Do you all think I should stay on my taper?? .5 mgs every other day ?

 

I was starting to go back to .5 every DAY (because like I told you I wa having those horrible symptoms).

 

Im wondering if this yo-yoing Im doing is not good? Should I just stick with one thing??

 

At this point its like I have one foot on the gas and one on the accelorater. My BF who is sitting right here--thinks I should go back to what WORKED (The ativan 1 mg) because he said he noticed a HUGE difference in my personality and coping skills. i tried explaining to him what you two just said )that the drug might be CAUSING me to want MORE and MORE dosages and also might be the cause of some of my current panic).

 

He then said 'well just go OFF Of it then'. Im very close to being 'off' of it now anyway by taking .5 every other day arent I???

 

I TRULY want to be able to cope WITHOUT any drug! Ive been reading some great meditation books, spiritual books and doing some new 'self talks' and walks. Ive also been limiting my caffeine to one cup per day.

 

What about if I stay on the .5 mgs every other day for a while longer?? Do you advise that plan?? Im not sure I want to go totally OFF of it ...yet. Like you said I want to do this slowly.

 

Right now I only have to be around humans at my art gallery one or two days a week, but starting in a month or so Ill be back to fulltime! That is what triggers my panic (being in social settings)..I dont get the panic as much at HOME with my BF and cats. Of course they dnt cause me as much 'panic' perse.

 

Its when I go out into the WORLD that the symptoms seem very acute.

 

Thanks for any and all responses here!

Michelle

I would suggest that 0.25mg every day is probably going to be better for you than 0.5mg every other day. This yo-yo effect is not a good way to take benzos. If someone takes a benzo just occasionally, this is probably not going to cause them too many problems (although they risk ending up taking it regularly), but taking it in this constant up-down fashion just confuses your GABA system - your brain chemistry will be constantly trying to adjust to the changing Ativan levels.

thanx Colin.

 

So starting tomorrow Ill go to .25 every DAY. Ill let you know how that goes!

 

Do you think I should stay at that level for quite a while then?? How long??

 

I am not running low on the pills. My doc gave me a prescription for 5 months worth so thats not the problem.

 

 

A couple of weeks should be more than enough to adjust to this. We can then help you with some titration system, or powdering your pills to make it easier to carry out sensible sized cuts.

Thanx Colin so much.

 

This is my second day on 1/4 a pill. Im feeling stable. Today I actually had one of my best days in a long time (mood wise).

 

 

My goal ultimately is to go totally off this med. So after a few weeks on 1/4 pill Ill come back here for more of your GREAT asisstance??LOL ;D

 

Thanx again COLIN!

 

QUESTION PLEASE Colin.

 

??

 

Ive been on the .25 mgs of ativan now for about a week. I have a few days before I have to go back to my art gallery so it would be a great time to TRY to wean off totally.

 

Im thinking of going down to ZERO pills today since I have some time to deal with any withdrawal symptoms..Id like to see how I DO without any drugs in me.

 

What is your feeling about this?

Hi Michelle,

 

Honestly, your dose is quite small - the bigger potential problem is withdrawal effects. The best way to avoid withdrawal effects is sensible gentle taper. You can powder your Ativan, and cut it with something like lactose to make smaller cuts. You could even obtain some empty capsules to make to to take with you to the gallery! Some very accurate scales would help, but some people do this by eye, and it should be workable if some care is taken, and the powdered tablets are cut with something to bulk up powder.

Colin..you said 'sensible gentle taper'... Im still not sure exactly how to do that?

 

Im tempted to just go down to ZERO pills. Isnt .25 mgs a very small dosage??

 

What about just going down to 1/8 of a pill from 1/4?? I have a pill cuttter so I probably can do that.

 

Thanks!