Benzodiazapines

[paul80]

Thanks @YippeeKi YOW !! and @Seadragon.

I can't read a lot without getting sore eyes and head at the moment but that Ashton Manual looks helpfull. It says the dosage difference between xanax and valium is x20, is that correct? somwhere else it said 10x.

@YippeeKi YOW !! "the hell of withdrawl whether actual or tolerance-based " This is something i've not understood. what is the difference here?
Thank you for the help btw, i really need it. I'll keep posting.

 

[YippeeKi YOW !!]

the dosage difference between xanax and valium is x20, is that correct?

XANAX VS. VALIUM: As an example, 1 mg of Xanax equals 15 mg of Valium or its generic, Diazepam. You get a different answer depending on the source, but I think that this conversion is pretty accurate. A poster on Quora said something like 20 mg, but not being able to evaluate the source, I wouldnt regard that as expert opinion.

The other difference, and this is really important, and why Valium/Diazepam is the taper medication of choice, is the difference in their two half-lives.

The half-life is the amount of time it takes for 1/2 of the medication to leave your body, which of course will vary to some degree from person to person, but this is a good rule of thumb: Alprazolam, or Xanax, has a very short half-life, about 4-7 hours, which means that you'll start needing another dose a lot faster.

Valium on the other hand has a very long half life, as much as 24 hours or even more if you're a slow metabolizer, which means that you won't need to re-dose as often and will be stable for longer periods and need less of the tapering drug.

"the hell of withdrawl whether actual or tolerance-based " This is something i've not understood. what is the difference here?

WITHDRAWAL VS. TOLERANCE WITHDRAWAL: There really isn't much difference, except for the genesis of the withdrawal, its purpose (accidental tolerance withdrawal versus purposeful tapering), and the degree and severity of the withdrawal, which will depend on what you were taking (some benzo drugs are worse than others, Xanax, sadly, is up there), and whether the loss of one drug, like Xanax, is balanced by the addition of another, like Valium. Withdrawal is withdrawal. It's a whole new world.

DRUG TAPERING: A planned and supervised taper is still going to produce withdrawal symptoms, but they won't be anywhere near as bad as, say, a stop-the-drug-cold approach, also known as cold turkey, which produces immediate and violent withdrawal symptoms which can result in PAWS, or Protracted Acute Withdrawal Syndrome, and can last for a very very long time. The damage it does to your brain, your neuro system, and your CNS is incalculable and can vary wildly from patient to patient.

TOLERANCE WITHDRAWAL is a slightly milder form of withdrawal symptoms, at least at its start, and occurs when your brain runs out of the drug and starts needing more to get the same result as it did on the smaller dose (often between doses as your system becomes more and more dependent on the drug for neuro balance). It needs the dose increases, because the Xanax has gradually reduced (down-regulated), and then killed, the number of GABA receptors in your brain and CNS dramatically.

GABA IS YOUR BRAIN'S NATURAL XANAX, and is the calming neurotransmitor that keeps you from falling apart under stress or grief, or going into severe protracted anxiety. Because you've been supplying an endogenous substitute for your own GABA, your brain shrugs its figurative shoulders, decides it's GABA services aren't needed anymore, and ceases production and distribution, as it were. So the point of a long, long, very very slow taper is not just to get you off the drug, but to do it in a way that gives your brain time to slowly (and I mean slowly) rebalance, and gradually start to produce its own GABA (gamma-aminobutyric-acid) again.

THE OPPOSITE OF GABA IS GLUTAMATE. GLutamate is essential for survival, for taking action, for learning, for taking risks, but unless it's balanced by GABA, it will cause deep, profound mischief. It stimulates brain cells, which is good under specific circumstances, and when its action can be interrupted by appropriate amounts of GABA. Without that, glutamate will stimulate brain cells endlessly, until they literally die from exhaustion. It's this action in part that creates and exacerbates withdrawal symptoms.

HOW SLOW IS 'SLOWLY': Opinions vary (when don't they). Ashton recommends a 10% cut, or at least I think used to. This is probably way too much for many, if not most, people. Two percent is better. The hard part is cutting down various mg-strengths of Valium into the required dose, which will have to be done 3 times a day, then maybe dropped to 2 times a day. Much like ME, the brain will go blank, wander, balk, freeze, rebel.

​

I know this is a lot for you to read right now, and that your ability to focus and absorb content is scattered and reduced. I've tried to break it down to bare-bones basics, but it's still a lot to deal with.

Believe it or not, this relatively short, compact little bundle of information had taken me almost 3 hours to put together, taking stuff out here, adding stuff there, taking it out again, making it shorter without losing the basics that may help you, elaborating on stuff that seemed too opague and/or threadbare to be of any value.

I'm running on close to empty right now, and I'm sure I'm leaving stuff out, and that you'll have questions about all this when you read it. Tag me. I'm here for you, tho some days it may take longer to get back to you than others, depending on how I'm doing at the time. Just know that I will get back to you.

Hang in. There's a way out. Even better, there's a way out that won't kill you or leave with PAWS and/or a form of PTSD, or actively wishing you were dead. Ain't easy, but it's definitely doable.

MAGNESIUM: As a footnote, while hating to contradict myself (Lord knows there's plenty of applicants for that job), it probably wouldn't hurt to try some magnesium. It blocks the calcium channels in the ..... oh, who cares, I can give you the longer, technical explanation later, right now, just know that calcium forms a critical link in the excitatory chain, and that magnesium (in my case, magnesium glycinate) can block calcium channel receptors and possibly reduce a little of what you're going thru right now. It's worth a try, and certainly won't do you any damage. I had success, finally and after much experimentation with dosages and dosing intervals, with 50 mg's every 45-60 minutes when my panic attacks were really, really, grotesquely bad, but YMMV. Experiment with it, see what your body seems to need or can work with optimally. Not a magic bullet at this point, altho it was for me under differenct circumstances, but definitely worth the time.

 

[Wayne]

Without that, glutamate will stimulate brain cells endlessly, until they literally die from exhaustion. It's this action in part that creates and exacerbates withdrawal symptoms.

Wow @YippeeKi YOW !! -- That was quite the post. Thanks much for all your efforts in putting it together. -- Just wanted to mention that I've heard lithium can be very good for "mopping up" excess glutamate. I take a couple doses a day for that purpose, but I can't really say whether or not it's affecting my glutamate levels. But it might be worth considering for those going through benzo withdrawal. I also like inositol for its calming effects.

Thanks again!

 

[paul80]

@YippeeKi YOW !! That was really helpfull thank you. I 'm going to stick to my current dose (1/2mg) but half it so it can work throughout the night as i need sleep badly. I have this nose/throat problem i get 3 or 4 times a year where you have to keep swallowing constantly, it's very irritating for sleep. Once my sleep is better and i'm more stable i'll think about reducing.

I actually bought that magnesium you reccomended a while ago so i'll see if that helps with the anxiety.

 

[YippeeKi YOW !!]

I've heard lithium can be very good for "mopping up" excess glutamate.

It did nothing for me when I was fighting thru some really intensely ugly panic attacks that just suddenly appeared out of nowhere and wouldn't go away, no matter what I tried, til I stumbled on the mag dosing. Can't say that it wouldnt work for anyone, but it certainly didnt work for me. I'm glad, tho, that it seems to be doing something good for you.

I'm not sure if it would be a good thing during benzo withdrawal or not, but again, it might be worth a try. Just watch your reactions

I also like inositol for its calming effects.

When I was battling aginst the panic/anxiety stuff, I found that inositol, for some reason, made it worse. I'd been taking inositol for sleep ever since chemo with beneficial effects, and then suddenly, KA-BOOM. The human nervous system is a deep, deep mystery.

Again, it might be worth tying while battling thru benzo withdrawl, but the only way to know is to try it out and be alert.

Am hoping that the pink boxes around quotes is working on my system again. They mysteriously stopped early yesterday morning, and it's really frustrating.

 

[YippeeKi YOW !!]

@Wayne
Yeah, they seem to be back.

Thank you, sweetie, for your kind comments on my post for @paul80. I'm really hoping that it helps, it's a tough battle

 

[paul80]

So if i'm on 0.5mg of xanax, then if i switched i would need to take 7.5mg of valium per day. I need to ask my doctor about this today when she phones me, but i doubt she will prescribe that. I might need to buy them online if possible.

Opinions vary (when don't they). Ashton recommends a 10% cut, or at least I think used to. This is probably way too much for many, if not most, people. Two percent is better. The hard part is cutting down various mg-strengths of Valium into the required dose, which will have to be done 3 times a day, then maybe dropped to 2 times a day. Much like ME, the brain will go blank, wander, balk, freeze, rebel.

Yeah that sounds hard to cut pills to 2% precision. I think my partner will help me with that though, hopefully.

 

[YippeeKi YOW !!]

if i switched i would need to take 7.5mg of valium per day

It might be better to start your taper at 10 mgs of Valium or Diazepam. It'll be easier to cut down and keep track of.

i doubt she will prescribe that. I might need to buy them online if possible.

I think you can pretty much count on no support, as I've mentioned before, from your prescribing Dr. In doing so, she'd be tacitly admitting to the damage that her prescription caused, and that ain't never gonna happen.

Taper Drs are a specialized area, require different and more rigid licensing, and from what I've heard, are hard as hell to find. But they're out there. You might inquire at your local VA facility, since they deal with a lot of this kind of problem.

If you buy online, there's no telling what you'll actually get, if you even can get Valium or Diazepam, and there's no way to know if the stated strength will be what the pill really contains. A 5 mg on line Valium/Diazepam could contain as little as 1 or 2 mgs of Valium/Diazepam, or even none.

You're going to have to do a lot of experimentation as you go thru this, since everyon's neuro system is different. You may be able to cut by more than 2%, but the nly way to know that is thru trial and error.

You should take a dose at least 2 times a day, say morning, and at night, which will help you sleep.

 

[2Cor.12:19]

@paul80 @Wayne @YippeeKi YOW !! -
Another great website for information on bezo dangers and tapering is https://www.benzoinfo.com/benzodiazepines/ They have an impressive board of doctors governing their efforts to raise awareness.

They incorporate Ashton’s info with other experts. The thing I like is they recognize that there are viable options to switching over to Valium as Ashton does in order to taper . Every person is different and not every success story is a “horror” story. Many people have successfully slow tapered off short acting benzos like Xanax without having to switch to a longer acting one.

For me personally, I would never buy a controlled substance online. Scary. I’d rather work with my doctor and insist that I be in control of the tapering process (since most doctors go waaaay too fast)

 

[YippeeKi YOW !!]

https://www.benzoinfo.com/benzodiazepines/ They have an impressive board of doctors governing their efforts to raise awareness.

That's a terrific link, thank you for posting it, more information leads to more success.

You're right. There's more than one way to skin a cat, and while the Valium taper is the best known and to date probably the most dependable method, others can be just as workable, especially when your only option is to try to get Valium online !!! Total YIKES !!!

For me personally, I would never buy a controlled substance online. Scary. I’d rather work with my doctor and insist that I be in control of the tapering process (since most doctors go waaaay too fast)

Not sure where ya'll live, but pretty much nationwide, and for decades, Drs have been denying the obvious, pretty much irrefutable, effects of the toxic nightmares they put their patients on, with the short acting benzos absolutely the worst, the most dangerous, and the most deadly. They're also the most remunerative for the prescribing physician.

So no Dr is going to get entangled in the lengthy, difficult, and time and patience consuming effort of tapering their patients off the very things they put them on in the first place. Eventually, it would be all that they had time for, and believe me, they know it.

Add to that the special licensing that's required for the large amount of benzos the Dr will end up prescribing, and the special licensing and training and certification involved, and the above is pretty much a guarantee.

However, the prescribing Dr may be willing to start writing prescriptions for lower and lower doses of the original drug, which can then, with patience and care, be cut down into tinier and tinier amounts. It's just the harder way to go, but can be successful with enough will and determination.

Thank you again for that link !!!

 

[2Cor.12:19]

@YippeeKi YOW !! You're very welcome.

Oh, and I might add that in my 33 years experience with having moderate-severe ME/CFS, NONE of my doctors have had near as much knowledge about ME/CFS as I do. However, that doesn't mean they've all been too arrogant to learn more about it. To the contrary. I've had wonderful doctors who listen, will gladly take and read articles I've printed for them, and then be willing to try anything that will "first, do no harm". I appreciate their knowledge and protection, because, despite "my" extensive knowledge about ME/CFS, I am still not a doctor.
I believe the same would be true with these kind of doctors when it comes to requesting a self-guided very slow taper, because there would be "no danger" in a very slow taper.

I totally get the frustration ME/CFS patients have with the medical community (especially 20-30 years ago!). But at the same time, I don't sell every doctor short just because they're uninformed. There's a lot of fine, dedicated doctors out there who are humble enough to listen and work with us.

 

[YippeeKi YOW !!]

There's a lot of fine, dedicated doctors out there who are humble enough to listen and work with us.

I agree with all the above, except fr the " ....a lot ...." part. I've found that Drs who are willing to learn with or from their patients are in short supply, and all the more prized therefore when one finds them.

You seem to have been more fortunate than many of us in these threads, at least as far as I've observed, and I think that's great !!!

 

[2Cor.12:19]

Well... I’ve also had more than my fair share of bozos too.(33 years is a long time) Lol!!!!

 

[Wayne]

Another great website for information on bezo dangers and tapering is

Thanks for posting the link. I found some articles at that site, but couldn't seem to find their interactive forum. Or do they not have one? -- Thanks.

 

[2Cor.12:19]

@Wayne You're welcome. No, just a lot of comments on the articles. Have you checked out BenzoBuddies - they have a very active support group. http://www.benzobuddies.org/

 

[2Cor.12:19]

@paul80 @Wayne @YippeeKi YOW !! @IThinkImTurningJapanese @Mary @Thinktank @Moof @geraldt52 @Rufous McKinney @Seadragon @Oliver3 (If I've missed anyone, I apologize)

I just want to thank everyone and say how much I've appreciated this discussion!. After 20+ years on Xanax I want to try and get off so I started a thread asking for success stories. I appreciate the Benzo Buddies support group, but having ME/CFS definitely complicates things. Right? Some of you have succeeded in getting off so if you feel like sharing how you did it and can offer any words of wisdom it would be great!

Here's the link to the new post. https://forums.phoenixrising.me/thr...al-success-stories-please.78239/#post-2240813

 

[paul80]

@YippeeKi YOW !!
So my doctor refered me to a drug clinic and they have agreed to come out to my house next friday as i am too weak to go there. They also said they can do the tapering off through my GP.

So good news so far. I'm just worried about my sleep once i start on the valium, because my muscles get so bad with messed up sleep, i struggle to get to the bathroom all day. I hope i can get to sleep at the beginning of the night like i can on the xanax.

 

[YippeeKi YOW !!]

So my doctor refered me to a drug clinic and they have agreed to come out to my house next friday

Am not sure what you mean by " .... next Friday ...". Does that mean this Fri, 11-15, or the Fri after that, 11-22?

Once you transfer to the Valium/diazepam ( Valium is unbelievably expensive, so the generic form, diazepam, might be your best bet), you ight find that it helps your muscle issues. I'm not sure what they are since you haven't mentioned any details (nor am I asking for any ..... dont want to intrude), but diazepam is a world-class muscle relaxant, and you may find that helpful.

OK. Soooooooo ...... Dont want to rain on the parade, but if you read some of your Ashton, she advises against most drug clinics, since they usually try to take you off whatever you're on as fast as possible, and often use outdated tranqs, like phenobarbitol, to do it. The faster and harder the taper, the more risk of adverse reactions, including PAWS, which is an indefinitely extended state of misery that you don;t need.

It sounds like this clinic is at least is willing to transfer you to Valium, which should take a few weeks. I'm leery of how willing your GP is to do what is critical for a successful taper: to go at the patient's pace, not the doctors. That's one of the reasons that taper 'experts' have discovered that there's a really remunerative niche here, if they're willing to go thru the training and licensing requirements to hang out their shingle. Not a lot are, judging by a quick search I did for that specialty when you stared posting.

Am also curious as to why the drug clinic isn't providing what you need for the taper, and what their function in this equation is, if your GP is doing the prescribing. DOes he think that their expertise is needed? Its an unusual Dr who'll admit to not knowing every little thing.

What have they, and your GP, told you about the taper they have in mind? I know that you're in a desperate place right now, and that anything that feels like help is immediately accepted as the answer, because any answer seems better than the absolute void you've been facing in terms of effective help.

WHen the drug clinic people come out, here re some possible questions for them that will give you a better idea of their plans for you. Keep in mind that the prescribing Dr generally knows nothing about tapers or their effect, and their primary interest is getting you off any medication as fast as possible.

1. Who's in control of the taper: you, the drug clinic, or your GP? In other words, who calls the shots on this?
2. How long to transfer to a Valium/diazepam equivalency before starting the actual taper .....
3. Are they willing to craft the taper to your reactions? A 10% cut can be more brutal than you can imagine, because it seems so reasonable, so small. It's not. I'd recommend starting with a 5% cut, AT MOST. Less if the drug clinic people are willing, or you react badly. If you handle the 5% well, stay on it til you're very sure you can handle a bigger cut.
4. Are they willing to halt the taper and hold you where you are if there are uncomfortable reactions, in order to give your brain/CNS time to catch up before cutting again?
5. Everyone's different and will react differently. Are they willing to be responsive to your reactions, or do they have a set plan that's written in stone and that's it .....

That's a good start. Throw in anything else you're concerned about. And tag me if you have any questions, I'll get back to you as soon as I can .....

 

[2Cor.12:19]

@YippeeKi YOW !!
So my doctor refered me to a drug clinic and they have agreed to come out to my house next friday as i am too weak to go there. They also said they can do the tapering off through my GP.

@paul80 - The 5 points @YippeeKi YOW !! make are all VERY important. I might add, read as much as you can but try not to get freaked out by all the horror stories. It’s as important to keep a positive attitude as it is to be well informed.

I’m currently dry tapering off Xanax but can’t see my doctor until January. I had carefully researched this before I started my plan.

Like you, I’m not sure what she’s going to suggest, but I will be (humbly) insisting that I take the lead. Plus I made a chart showing the dosage cuts I’ve already successfully made and the one’s I “tentatively” hope to make in the future. I’ll make it clear that I need to be free to hold my taper if necessary.

I purchased a jewel scale from Amazon to measure the doses when they become smaller. There are a number of tapering methods. Every person is different and needs to do what works best for them. But one thing is true for all of us . SLOW, SLOW, SLOW, is always the best choice.

For now, I’m wanting to stay on Xanax all the way through if I can manage as I know for a fact that it is quite possible. If it becomes too difficult, I’ll request a Valium crossover.

If measuring small doses becomes too difficult a task I may ask my doctor about compounding the lower doses.

Those of us with ME/ CFS have a double whammy because we’re battling multiple issues here. Our disease can make it impossible to know which of our symptoms are being caused by ME and which are being caused by benzos because the symptoms can be nearly indistinguishable. We won’t have those answers until we’re on the other side of this.

Please keep us posted- I’m on this journey with you. Holding a good thought for you.

 

[YippeeKi YOW !!]

Like you, I’m not sure what she’s going to suggest, but I will be (humbly) insisting that I take the lead. Plus I made a chart showing the dosage cuts I’ve already successfully made and the one’s I “tentatively” hope to make in the future. I’ll make it clear that I need to be free to hold my taper if necessary.

That's an incredibly tight, good plan 2Cor .... well thought out, logical, flexible. Just all-round excellent.

I purchased a jewel scale from Amazon to measure the doses when they become smaller.

Another highly perceptive smart choice. As the cuts get smaller, I would think they inevitably get a lot harder to parse down. A scale that measures quantities that small will be invaluable.

For now, I’m wanting to stay on Xanax all the way through if I can manage as I know for a fact that it is quite possible. If it becomes too difficult, I’ll request a Valium crossover.

I agree. It's not only totally do-able, but I;ve often wondered if it isn't less stressful on your brain, neuro, and CNS, since they don't have to adjust suddenly (and it would feel sudden to them, even with a long slow crossover period) to a new substance that functions slightly differently from the original one.

If measuring small doses becomes too difficult a task I may ask my doctor about compounding the lower doses.

Compounding pharmacies are great for this, but chose your compounder carefully, I just read recently that they're under even less supervision than large regular pharmacies, tho why that would be knows God. I think when you get down to the very end of your taper, a good compounding pharmacy would pretty much be the only sensible way to go, no? Tiny, teeny, inky-dinky little doses would be tough even with a jeweler's scale.

Those of us with ME/ CFS have a double whammy because we’re battling multiple issues here

Ohhhhhhh, you;re so right, Trying to determine which is causing what and how alarmed you should be makes this whole nightmare a whole lot more difficult, and takes it to Munschian levels.

I can;t tell you how much I admire you and @paul80 , and how loud and hard I;m cheering ya'll on. You've thought out your route and planned it so meticulously and intelligently that it can't help but succeed.

That's the thought I'm holding for you both. I'm a little more concerned about @paul80 , largely because of the insertion of a 'drug clinic' along with his Dr .... too many cooks, and someone who's a little apprehensive and too stressed by this whole thing to maybe stand firm and demand that the taper be done the right way, which is his way, not the Dr's, not the clinic's. I'm anxious to know how the first meeting with the clinic people goes, and how much information you can get from them, paul. Why we have to crawl, hat in hand, supplicating like a medieval priest, beats me, and makes me more than a little pissed off. But you're right 2Cor, humbly soliciting is the best, probably the only, way.

That's a hint, @paul80 ..... please post back with info, yes? I really need to know you're in good hands.

Please keep us posted- I’m on this journey with you. Holding a good thought for you.

Sign me up, too !!! I have the need to know