Should I reinstate??

Hello,

 

I am truly in need of some advice as I am suffering a lot. I was on ativan for 1.5 years and recently tapered. My first attempt at a taper was in early August when I was told to cut my .5mg dose in half. Within 4 days I was suffering with bad headaches, face pressure and ear pain. I went back on the ativan and the symptoms got better, although I did still have lingering days of sinus pressure. I then decided in September to taper more slowly. The way I did it was I replaced a little bit of valium (1.25mg) for .125mg of ativan and  tapered off the ativan from there. I make a cut every 3-4 days and I didn't have too many issues until I jumped off the last .125mg of ativan. I started to have the head/face pressure and ear pain. Even though I was getting withdrawal symptoms, I decided 4 days later to jump off the valium as well, since I was hitting the 2 week mark on the valium and was afraid of becoming dependent on that, too. So all in all, I got off .5mg of ativan in about a month's time.

 

I am 12 days off the ativan and 8 days off the valium. I am suffering pretty badly every day with bad ear pain and head pressure/pain. It got worse a couple days off the valium and has stayed realy bad. I am a mother to a 3 year old boy and I am having a hard time being present for him.

 

I think my last jump was too much for me. I should have listened to my body and went right back to my dose but I thought maybe I would stick it out and it should get better fairly quickly. I am almost at 2 weeks out and still suffering a lot. I am afraid I did bad damage to my system and that I will be suffering protracted withdrawals.

 

What do I do? Go back on and go more slowly? And if so, do I just go back to the .125mg of ativan and 1.25 mg of valium and go more slowly? I'm so afraid of this not helping or going back on, only to suffer anyway once it's out of my system. I can't suffer like this for months on end like I see some of the members here suffering.

 

Do I have any other options?? I've seen people using gabapentin or other things to aid withdrawal, but would those only work for anxiety or the physical pain? It's the pain that is making my life so bad right now. To describe the pain, it's a really bad burning/achy feeling in my ears and bridge of my nose. I get bad head pressure that I think makes the ears and nose pain much worse. It even hurts to put a q-tip in my ears. I went to the doctor and there is no infection.

 

Things I have tried so far: advil/tylenol for the pain (doesn't do much), Flexeril- as I was told by my doctor some of the pain could be from muscle contractions. I don't know that it's doing much at all. My symptoms get better when I lay down and go to sleep, but they just reappear once I am up and moving around. The face pressure is not really there when I wake up, but gets bad by mid morning.

 

Any advice would be greatly appreciated. I am new here and nobody I know has been through this.

One thing that is almost universally agreed to by benzobuddies is that a taper must be slow. Some cut 5% (or less) and hold for 1-2 weeks. Some do a very small cut daily (usually with liquid titration).  Do you think you might have come too gar too fast in September?

 

One idea might be to increase your dose some and hold to see if the symptoms let up a little. If they do, then you could try a slower taper.

 

I don't have experience with Valium, but I've seen many people say they had a rough time with Valium once they got down to 1mg or less.

 

As far as supplement go, there is no agreement on this forum about whether any supplements help, or which ones might help.

Hi HLS8810,

 

I'm sorry to hear you're having such a diffuclt time. I wish I could tell you that reinstating would help but the truth is, it may not. I have some information for you from The Ashton Manual Supplement regarding reinstatement:

 

Reinstatement, updosing

 

A dilemma faced by some people in the process of benzodiazepine withdrawal, or after withdrawal, is what to do if they have intolerable symptoms which do not lessen after many weeks. If they are still taking benzodiazepines, should they increase the dose? If they have already withdrawn, should they reinstate benzodiazepines and start the withdrawal process again? This is a difficult situation which, like all benzodiazepine problems, depends to some degree on the circumstances and the individual, and there are no hard and fast rules.

 

Reinstatement after withdrawal? Many benzodiazepine users who find themselves in this position have withdrawn too quickly; some have undergone 'cold turkey'. They think that if they go back on benzodiazepines and start over again on a slower schedule they will be more successful. Unfortunately, things are not so simple. For reasons that are not clear, (but perhaps because the original experience of withdrawal has already sensitised the nervous system and heightened the level of anxiety) the original benzodiazepine dose often does not work the second time round. Some may find that only a higher dose partially alleviates their symptoms, and then they still have to go through a long withdrawal process again, which again may not be symptom-free.

 

Updosing during withdrawal? Some people hit a "sticky patch" during the course of benzodiazepine withdrawal. In many cases, staying on the same dose for a longer period (not more than a few weeks) before resuming the withdrawal schedule allows them to overcome this obstacle. However, increasing the dose until a longed-for plateau of 'stability' arrives is not a good strategy. The truth is that one never 'stabilises' on a given dose of benzodiazepine. The dose may be stable but withdrawal symptoms are not. It is better to grit one's teeth and continue the withdrawal. True recovery cannot really start until the drug is out of the system.

 

Pharmacologically, neither reinstating nor updosing is really rational. If withdrawal symptoms are still present, it means that the GABA/benzodiazepine receptors have not fully recovered (see above). Further benzodiazepines cause further down-regulation, strengthen the dependence, prolong withdrawal, delay recovery and may lead to protracted symptoms. In general, the longer the person remains on benzodiazepines the more difficult it is to withdraw. On the whole, anyone who remained benzodiazepine-free, or has remained on the same dose, for a number of weeks or months would be ill-advised to start again or to increase dosage. It would be better to devote the brain to solving individual symptoms and to finding sources of advice and support. Advice about how to deal with individual symptoms is given in the Manual (Chapter 3).

 

 

I can't disagree with Ashton or with Hope, but it probably makes a difference how long ago you took the last dose. It is early October, and I'm not sure going back on a small dose this soon fits into what Ashton was talking about.

Thanks for the replies.

 

I do know when I reinstated after 4 or 5 days in early August the symptoms mostly went away, except once a week I was still having some weird sinus pressure that I never experienced before.

 

I have been off all ativan for 12 days and valium for 8 days. I was only on the 1.25mg of valium for about 2 weeks to help me taper down the ativan. So do you think the valium is even playing a part in my suffering? I figured since it was a short time, it wouldn't make as much of a difference since my body really didn't get much time to become addicted to it.

 

I am seriously considering calling a hospital. I know my prescribing doctor doesn't get why it is so hard. I guess maybe I am the only one he has seen have so much trouble.

 

Is taking 1 month to get off .5mg of ativan really outrageous? I realize now that it might have been too fast, but it's such a small dose. I figured I would have anxiety, etc.. for a couple weeks and then be OK.

 

Im so scared. I really don't know what to do. I'm scared of making things worse by going back on it, and I'm scared that I am going to suffer for months with this awful ear and head pain. Would being on a low dose make the withdrawl time any less? If symptoms are so severe like they are now, are they likely to let up any time soon?

Thanks for the replies.

 

I do know when I reinstated after 4 or 5 days in early August the symptoms mostly went away, except once a week I was still having some weird sinus pressure that I never experienced before.

 

I have been off all ativan for 12 days and valium for 8 days. I was only on the 1.25mg of valium for about 2 weeks to help me taper down the ativan. So do you think the valium is even playing a part in my suffering? I figured since it was a short time, it wouldn't make as much of a difference since my body really didn't get much time to become addicted to it.

 

I am seriously considering calling a hospital. I know my prescribing doctor doesn't get why it is so hard. I guess maybe I am the only one he has seen have so much trouble.

 

Is taking 1 month to get off .5mg of ativan really outrageous? I realize now that it might have been too fast, but it's such a small dose. I figured I would have anxiety, etc.. for a couple weeks and then be OK.

Im so scared. I really don't know what to do. I'm scared of making things worse by going back on it, and I'm scared that I am going to suffer for months with this awful ear and head pain. Would being on a low dose make the withdrawl time any less? If symptoms are so severe like they are now, are they likely to let up any time soon?

 

I don't know if I would use the word "outrageous", but my understanding is that .5 Ativan is equivalent roughly to 10mg valium, or maybe it's 5, have to check the chart, been a while.  In my case, I took 9 months to taper off 7mg valium, but everyone is different as to what they can tolerate.  I originally did a c/t off valium four years ago and at three weeks, got vertigo and high anxiety and reinstated.  I was very happy I did.  The vertigo went away within a few days and never returned.  It would not be unreasonable (in my opinion) to reinstate 5mg valium (in consolation with your physician) and take some time to stabilize and then maybe do a slow taper of at least six months to get off the valium more smoothly.

 

Best wishes,

 

Vertigo (no more!)

 

Thanks for the replies.

 

I do know when I reinstated after 4 or 5 days in early August the symptoms mostly went away, except once a week I was still having some weird sinus pressure that I never experienced before.

 

I have been off all ativan for 12 days and valium for 8 days. I was only on the 1.25mg of valium for about 2 weeks to help me taper down the ativan. So do you think the valium is even playing a part in my suffering? I figured since it was a short time, it wouldn't make as much of a difference since my body really didn't get much time to become addicted to it.

 

I am seriously considering calling a hospital. I know my prescribing doctor doesn't get why it is so hard. I guess maybe I am the only one he has seen have so much trouble.

 

Is taking 1 month to get off .5mg of ativan really outrageous? I realize now that it might have been too fast, but it's such a small dose. I figured I would have anxiety, etc.. for a couple weeks and then be OK.

 

Im so scared. I really don't know what to do. I'm scared of making things worse by going back on it, and I'm scared that I am going to suffer for months with this awful ear and head pain. Would being on a low dose make the withdrawl time any less? If symptoms are so severe like they are now, are they likely to let up any time soon?

 

I can't give definitive answers to your questions, but I generally agree with Vertigo. Because you had trouble coming off at the faster rate, you should try again. You didn't take the last dose very long ago, so It's not like going back on the drug after long time off.

 

As for the hospital, most people don't find that very useful except to have tests to rule out something serious. They will probably just put you back on some sort of tranquillizer anyway. You are better off supervising your own taper at your own pace. You have learned that the pace you chose was too fast.

Hi HLS881,

Don't jump on and off this stuff.

going up and down is one of the worsed things to do, Look up kindling wiki.

The kindling is an effect where WD symptoms get worse and the drug can even go paradoxical where it makes things worse as you take more of it.

Best to figure out what to do, and many here can help with that, and then go through the taper slowly and gently and put up with some level of symptoms.

There seems to be a general rule that if you've been off the benzo for 2 weeks or more regarfless of how you did it, that it's generally better to stay off and deal with the symptoms.

As I understand it, updosing or re enstatement should happen within that 2 week area to avoid a kindling wrisk.

Others will probably have better input on this one.

Good luck!

 

Hi HLS881,

Don't jump on and off this stuff.

going up and down is one of the worsed things to do, Look up kindling wiki.

The kindling is an effect where WD symptoms get worse and the drug can even go paradoxical where it makes things worse as you take more of it.

Best to figure out what to do, and many here can help with that, and then go through the taper slowly and gently and put up with some level of symptoms.

There seems to be a general rule that if you've been off the benzo for 2 weeks or more regarfless of how you did it, that it's generally better to stay off and deal with the symptoms.

As I understand it, updosing or re enstatement should happen within that 2 week area to avoid a kindling wrisk.

Others will probably have better input on this one.

Good luck!

 

It had been three weeks for me and I was much better off reinstating.  I don't know that there is a "general rule".  Each person must decide for themselves what they can handle, whether they are functioning, whether they are depressed and suicidal, not sleeping at all, so dizzy that they can't work or drive... I would generally agree though that if it's been more than a month, one might wish to consider kindling, although if one is experiencing severe life troubles as a result of c/t or rapid taper, reinstatement could be helpful and can always be discussed with one's physician.

 

V

Kindling applies to multiple cycles of addiction and withdrawal. I don't believe that applies in this case because of the short amount of time since the last dose was taken.  Someone who has completed the process of receptor upregulaton needs to worry about kindling. That's not the case here.

Thanks again for the replies.

 

If I were to reinstate, would I go to valium? I was only supplementing with that for 2 weeks. The ativan is what I've been on for a longer time.

 

Kindling is what I'm afraid of. So am I at a risk if I went cut down too much ativan in early August and went back on again 4 or 5 days later and then just went off it for 12 days? I guess I'm a little scared if making anything worse.

 

In anyone's experience here, how long did your worst symptoms last? Since I was on a small amount and technically did taper ( fast) would it be worth it to stick it out? This is the most scared I've been in my whole life.

The valium you were taking can remain in your system for 3, possibly 4 weeks but at lowering amounts as you process the remants out.  Valium is a slower benzo which is why many prefer it to taper off with. I am not sure what it is for Ativan, but being shorter acting benzo, it's likely less, maybe 1-2 weeks to process out of the body, you can probably look it up.  Supposedly some of the slower acting benzos like klonopin are out of the body within 12 or 24 hours, but I think I read somewhere that it still takes up to two weeks to fully metabolize or process out. I'm not a biochemist or pharmacist so I don't no the specifics.  It could explain why some folks feel on pins and needles, regardless of the benzo, some weeks after they stopped taking the last dose, particularly if c/t or rapid taper.  I would consider asking your doctor about increasing the valium back up to 5mg and see how you feel from there.  Since you've already been taking valium and tolerating it well, it should not be too difficult.  Some who were on other benzos found valium too sedating or different from other benzo they were taking.  I found that it did impact my memory and concentration some but I tolerated it ok. It may take an initial period of adjustment since the Ativan probably feels a little different and so you won't likely feel exactly how you felt when you were on both valium and Ativan (larger dose of Ativan), also because it takes valium a little longer to build back up in your system.  So even if you started up with valium now, it might be several days to a week before you felt some relief from the "shock" or perhaps intense withdrawal symptoms you may be experiencing to your system from a rapid taper.  Check with your doctor.  I would not be overly concerned about kindling, that's just worry that you don't need to focus on.  I can only say from my personal experience, I was doing much better after a few days back on valium, vertigo and dizziness went away, and the slow taper was the way to go for me.  If you are willing to gut out your rapid taper, that is also an option to consider.  Some prefer not to reinstate.  It's a personal decision to make with your doctor.

 

Best,

 

V

Based on my own personal experience I would suggest reinstating. It's a tough decision, I know. I found BB five weeks into w/d and asked that very same question. I didn't reinstate. I feel some regret, as I'm nearly seven months out and having a tough time. That's not to say that my story will be your future.

 

You've only been off a short time. Like vertigo said, the Valium barely got into your system and you were off. It's your call, but you asked, so my suggestion is to reinstate and stabilize for a couple months, then do a very gradual taper under doctor supervision.

Svenhoak,

 

What are you experiencing for symptoms this far out??

There's a group of us on here that are at the same withdrawal time and s/x. In short, it feels like I've gone crazy. Anxiety is moderate. Depression quite severe. I just feel generally disoriented, confused, vulnerable and have poor memory. Some physical s/x are muscle and tendon pain.

 

I've been off work since week six, and may try to return gradually in a month or so.

 

This has gotten very old and I'd love to spare anyone this discomfort!

Wow, I'm so sorry to hear that. Did you have those symptoms in the beginning, too, and they just never left?

My symptoms hit one week after my final dose. I was fine through my taper. More anxious than normal, but that's about it.

Well, I do hope you continue to feel better.

 

Has anyone else had really bad ear pain/ head pressure during withdrawal? I

don't know if mine had anything to do with the fact that I had an injury to my neck 1.5 years ago. I do notice the left side is worse than the right, which is the side that was injured. The head pressure is not something I've ever experienced before. It gets so bad that I feel out if it. Other than those physical symptoms, I'm doing ok. Anxiety gets bad as pain gets bad. But if I was not in pain I don't think my anxiety would be much of a problem.

 

Has anyone tried gabapentin? Does that help anxiety or physical symptoms of withdrawal?

Yes I have stabbing ear pain too. My right ear is bad. Left is ok. Sore neck too. I find that vestibular exercises help with the ear pain. Here is a link to the ones I practise.

 

http://www.umc.edu/uploadedFiles/UMCedu/Content/Education/Schools/Medicine/Clinical_Science/Otolaryngology__Communicative_Sciences/Handouts/VestibularExercise.pdf

It may not be what you want to hear, but since you've made the jump and have benzos pretty much out of your system, I'd suggest trying to tough it out. You didn't take a large dose of Valium for a long enough period for it to have really built up in your system, so I would suspect that most of the Ativan and Valium has left your body and what you are experiencing is the body's response to not having benzos in your brain.

 

I'd imagine you can expect w/d symptoms for 4-6 weeks and then gradual healing after that. I was on 30 mg. of Valium for 12+ years and came down 2.5 mg. every two weeks in January until I was at 5 mg. and really suffering. I was planning to come down lower, but I figured if I was going to be in agony I might as well do it without benzos in my system, so I jumped c/t from 5 mg. on May 26.

 

I'm now 133 days off benzos and the worst was the first 6-7 weeks (remember, I'm a long-term user...). After that things got better, then I hit a 3-week wave in early September and while it's passed, I'm still just feeling really kind of crappy. You shouldn't have as much trouble as me, since you didn't use for so long. However, my take on this is if I can deal with this, then you should be able to deal with something less intense. It's no fun, trust me, but it's nice to know I don't have a drop of Valium in my body...

 

Hang in there. It just takes TIME for your brain/nervous system to recover...

 

Thanks for the exercises, I'll check them out.

 

Tex, thanks for your reply.

 

I'm definitely confused ...some are saying to reinstate and some are saying to stick it out.

 

I have not been on this board for more than a couple of days so

I guess I'll ask this: judging from others who were on a low dose of a benzo for a year or so, is a long term withdrawal more rare rather than the norm ? I just know I can't suffer like this for months and months like I see some people suffering. The pain is constant and pretty darn bad. I could stick it out a couple more weeks if I knew it would get better, but to do this for 4 months or longer would be plain torture.

If I were to reinstate, would I go to valium? I was only supplementing with that for 2 weeks. The ativan is what I've been on for a longer time.

 

Kindling is what I'm afraid of. So am I at a risk if I went cut down too much ativan in early August and went back on again 4 or 5 days later and then just went off it for 12 days? I guess I'm a little scared if making anything worse.

 

In anyone's experience here, how long did your worst symptoms last? Since I was on a small amount and technically did taper ( fast) would it be worth it to stick it out? This is the most scared I've been in my whole life.

 

Hiya HL.  If I was in your position and if the symptoms were genuinely intolerable then I would go on to Valium.  If it was me I would expect the symptoms would last a month or two but that is just a very wild guess to give you some idea of the duration you might anticipate.

 

The main problem with Valium is that it takes time to build up in you,  So you may overshoot the dose you need if you don't wait long enough to see if the dose is already sufficient.  (If you see what I mean.)  It takes about a week or two to saturate and that can feel very slow when you're not well.

 

Kindling is much rarer than many people seem to think.  It takes many repeated stop/start cycles before it occurs and in some cases it may not occur at a noticeable level.  So please don't let that worry you because the reinstatement you are considering won't cause it.  As Hope's quote of Ashton says, the reinstatement may not cure all your symptoms - but that does not mean kindling has occurred.

 

Braban,

 

Thanks for your input. I was down to .375 of ativan before I even started using the valium. I ended up only supplementing with 1.25mg for two weeks as I tapered down the ativan. I didn't have too many problems at all. Just some lingering face tightness that would happen once a week since my last attempt to taper in early August. I really only had a problem getting off the last .125mg of ativan. I got the withdrawal effects even during the 4 extra days I was on the valium before I jumped off that, too. So my guess is that maybe I only need 2.5 mg of valium if I

Do reinstate? Does that make sense or no ? I worry that 5 mg might be too much seeing as I was ok on a lower dose of the ativan/valium mix.

Another question for those more knowledgeable out there...

 

Still deciding if I should reinstate or not. Yesterday's ear pain was not as bad as the days before, but I need to see how I feel today too before i make any decisions

 

One thing I've expressed over again is my fear of a long term or protracted withdrawal. Given my time on ativan (1.5 years) and my dose (started at.25mg and went up to .5mg) and the one month taper, am I at risk for protracted withdrawal? I worry that my rapid taper would cause it, even though I didn't taper off much of it. Any advice would be appreciated!!

Braban,

 

Thanks for your input. I was down to .375 of ativan before I even started using the valium. I ended up only supplementing with 1.25mg for two weeks as I tapered down the ativan. I didn't have too many problems at all. Just some lingering face tightness that would happen once a week since my last attempt to taper in early August. I really only had a problem getting off the last .125mg of ativan. I got the withdrawal effects even during the 4 extra days I was on the valium before I jumped off that, too. So my guess is that maybe I only need 2.5 mg of valium if I

Do reinstate? Does that make sense or no ? I worry that 5 mg might be too much seeing as I was ok on a lower dose of the ativan/valium mix.

 

Hi HLS.  If you decide to reinstate then it would be wiser to use the lower 2.5mg dose.  Allow a week to see if this gives you sufficient improvement.  Good luck!