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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Phillipa on April 28, 2014, at 22:48:24
Has anyone withdraw from prescribed doses of long term benzos use? Seems docs now believe that cognitive decline occur after years of use. Phillipa
Posted by jono_in_adelaide on April 29, 2014, at 0:50:18
In reply to Who Has Successfully Withdrawn Fron Long Term Benz, posted by Phillipa on April 28, 2014, at 22:48:24
Phillipa, I think thats highly speculative, and not all docs beleive it, or even most.
If you want to stop your benzos, google The Ashton Protocol, it was designed by a British psychiatrist, Professor heather Ashton, to help long term benzo uses quit painlessly.
The general principal is that you transfer from whatever benzo to Valium, and get your script filled in the 2mg tablets, then reduce by 1mg every so often (between every week and every month, depending on how you go)
That said, if they are still working with few side effects, why withdraw?
Posted by tony p on April 29, 2014, at 2:09:00
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz, posted by jono_in_adelaide on April 29, 2014, at 0:50:18
I've been trying to withdraw from clonazapine / diazepam for three years now. Not a success story, I'm afraid - I get down to about 20 mg diazepam per day & then either get stuck or have an anxiety crisis and blow the program. I'm currently (once again) down to 25 mg diazepam/day and going very slowly - 10% every 2-3 weeks - and hoping....
I started withdrawing after I discovered that clonazapine (3 mg/day) was severely affecting my memory. I believe clonazapine is particularly bad for memory and cognition, and deceptive -- I didn't even know I was having what amounted to memory blackouts. BTW, I'm in my 60s, which may be a factor.
I have a theory that although all the benzos show cross-tolerance, switching to one you haven't taken for a long time can be beneficial - e.g. 30 mg of oxazepam is usually rated same as 10 mg diazepam, but I find it much stronger, not having used it much. I'm having trouble convincing the Drs, who have all bought into the diazepam-is-the-only-way route.
I respect Dr. Ashton's principles and agree with her general approach, but some of her dose equivalences have been questioned and don't agree with my experience.
I see a specialist on the 22nd - will see what she has to say (my experiments with oxazepam have been off-program, but maybe good ol' Librium might work better).
Posted by burial on April 29, 2014, at 5:59:57
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz, posted by tony p on April 29, 2014, at 2:09:00
i quit 7,5 mg of lorazepam cold turkey and man what a stupid move it was, extreme withdrawals for a week. Now withdrawals are gone, but i am experiencing extreme fatigue and energy lack. How can this be? I though benzos should be sedating?
Posted by klein on April 29, 2014, at 6:31:42
In reply to Who Has Successfully Withdrawn Fron Long Term Benz, posted by Phillipa on April 28, 2014, at 22:48:24
> Has anyone withdraw from prescribed doses of long term benzos use? Seems docs now believe that cognitive decline occur after years of use. Phillipa
Yeah, I've done it a few times. The last time I was stabilized on an SSRI and Klonopin; I got liquid Klonopin and lowered my dosage as fast as I could tolerate it (my marker was tinnitus, as soon as my ears started ringing I took a little clonazepam). It took me 2-3 weeks, no discomfort other than a bit of insomnia.
I was once a member of one of those anti-benzo websites; I sympathize with the people there who are struggling so much but I also wonder how many of them are suffering from re-emergence of their panic/annxiety syndrome.
I don't find the Ashton method convincing. Diazepam has a long half life, but it's only biologically active for a few hours. If you are going to take that route, you need to make sure that your body is saturated with diazepam before beginning the taper. I'm thinking that 2 weeks of Valrelease (if you can find it) should help in that regard - I'm taking it right now and it's great. Otherwise stabilize on a full dose of diazepam, taking it in divided doses for about a month before tapering. But, unless your symptoms are severe, the Ashton approach might be too conservative and may only prolong the "agony" (both physical and, more important, mental).
I'd use Klonopin or even Ativan for withdrawal, they're active for much longer than Valium.
Anyway, I agree with Jono, why withdraw? Are you experiencing cognitive problems? If so, memantine could help too.
Posted by ed_uk2010 on April 29, 2014, at 13:50:19
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » Phillipa, posted by klein on April 29, 2014, at 6:31:42
>I'd use Klonopin or even Ativan for withdrawal, they're active for much longer than Valium.
Only initially... the duration of action of diazepam gets longer and longer after repeated dosing for a few weeks and it's eventually much longer acting than lorazepam. The availability of low strength tablets (scored 2mg tabs) makes it very suitable for tapering.
Posted by Phillipa on April 29, 2014, at 20:22:43
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » Phillipa, posted by klein on April 29, 2014, at 6:31:42
No cognitive problems. The longer into the day I get the better I feel. I take the benzos at night only. I am not 68 years old this doc not a pdoc seems to feel that it is dangerous though for someone who has taken them for so long 44 years to withdraw and said stay on them. But if I could just stop them in the past before I knew they had withdrawal why can't I now do the same. When young and new on them I was told could have seizures if stopped total of 15mg a day. I did stop them. Was very tired. But didn't have a seizure? Phillipa
Posted by klein on April 29, 2014, at 20:50:54
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » klein, posted by Phillipa on April 29, 2014, at 20:22:43
> No cognitive problems. The longer into the day I get the better I feel. I take the benzos at night only. I am not 68 years old this doc not a pdoc seems to feel that it is dangerous though for someone who has taken them for so long 44 years to withdraw and said stay on them. But if I could just stop them in the past before I knew they had withdrawal why can't I now do the same. When young and new on them I was told could have seizures if stopped total of 15mg a day. I did stop them. Was very tired. But didn't have a seizure? Phillipa
Phillipa,
I'm a bit confused. Do you want to stop taking them?
I really see no reason why you couldn't do it if you tapered carefully. You've done it before withouit a problem. It's my understanding that seizures usually tend to happen to people who take excessive doses or abuse them for prolonged periods of time, or those who suffer from epilepsy.
DON NOT let the horror stories you see online affect you. I won't post my opinion about that here because I don't want to be rude. If you really want to stop the Valium, talk to your doc and ask for guidance, certain meds such as Tegretol and Lyrica can aid benzo withdrawal.
It has been proven that us patients who suffer from anxiety issues don't generally tend to abuse our medication (I'll have to dig around pubmed to find the studies).
As a side note, I resent people who take benzos recreationally, thanks to them we have a bunch of benzophobic doctors who won't prescribe these meds to those of us who legitimately need them =/
Anyway, why stop them? Personally, I no longer allow potential risks to stop me from taking my meds. For instance, I'm on Pristiq now which supposedly causes very bad withdrawal - I'll deal with that when the time comes, and if the Pristiq works I'll take it for as long as I need it.
If you don't like Valium, ask for a shorter acting benzo. Ativan is a good choice, it lasts longer than Valium but with less sedation and less general impairment. It does take longer to kick in though.
Keep us posted.
Warm regards
Posted by Phillipa on April 29, 2014, at 22:12:09
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » Phillipa, posted by klein on April 29, 2014, at 20:50:54
Sorry to confuse you. First typo was I wrote not 68 but I am. As for stopping the benzos seems when levels of stress are lower I just automatically take a smaller dose. Valium is fine. I even got approval for name brand from insurance. But found it stronger so am taking generic. I use the Xanax to fall asleep. When wake after about 4 hours take 2.5mg of valium and go back to sleep. So total 7.5mg of valium, sometimes, 5mg total a night with .5mg of Xanax. Now the trick is to get off the luvox that nasty 25mg just doesn't seem to want me off it. The 2.5mg of Lexapro I can just stop. And the thing is when start reading nook in bed sometimes I fall asleep. Then wake take the Xanax and back to sleep. I fear the withdrawal that yes I have read over and over again different places online. Phillipa
Posted by kirkglen on April 30, 2014, at 11:48:56
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » klein, posted by Phillipa on April 29, 2014, at 22:12:09
I have reached the point where Klein is. If the meds make me feel better I'm going to take them.
Many years ago I used Serax to help me through anxiety / depression. I became very addicted and thought I was losing my mind when I got off them. They were to short acting.
Once I found an AD that worked then I'd augment with Klonipin 1mg. It is awesome for me. I take 60mg Nardil and 1mg Klonipin. I don't think either would work alone but together "not bad". Prior to 2003 Nardil was fine by itself then it was reformulated.
Bottom line.....There are benzos that are scary but if they continue to work AND you do not have to keep upping the dose then stay where your at. As to your SSRI it sounds as they have the same effect on you as I. That's where I would look. You should be able to stop those fairly easy since you using benzos.
Posted by klein on April 30, 2014, at 12:57:48
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » klein, posted by Phillipa on April 29, 2014, at 22:12:09
> Sorry to confuse you. First typo was I wrote not 68 but I am. As for stopping the benzos seems when levels of stress are lower I just automatically take a smaller dose. Valium is fine. I even got approval for name brand from insurance. But found it stronger so am taking generic. I use the Xanax to fall asleep. When wake after about 4 hours take 2.5mg of valium and go back to sleep. So total 7.5mg of valium, sometimes, 5mg total a night with .5mg of Xanax. Now the trick is to get off the luvox that nasty 25mg just doesn't seem to want me off it. The 2.5mg of Lexapro I can just stop. And the thing is when start reading nook in bed sometimes I fall asleep. Then wake take the Xanax and back to sleep. I fear the withdrawal that yes I have read over and over again different places online. Phillipa
I know that you had a bad experience with Prozac, but maybe you could consider crossing over (just stop the Luvox and take the equivalent dose of Prozac, apprarently 10mg) for a few days, then stop and allow it to self-taper. If you have your benzos you shouldn't really worry about feeling anxious if you take a couple of Prozac pills.
Benadryl could help too.
Ask your doc, you might need to increase your benzos slightly because Luvox raises certain benzo's levels (Xanax, I'm not sure about Valium). Also ask about taking a bit of Luvox with the Prozac to withdraw more gently.
I can relate to what happened to you, Prozac triggered my first panic attack. It was pretty darn awful. But, since then, I've used Prozac several times, both as my main med (with benzos) and to taper off SSRIs.
The Prozac tapering method works well for me. The problem comes later, when I'm med free and plunge back into depression..
Posted by Phillipa on April 30, 2014, at 20:52:25
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » Phillipa, posted by klein on April 30, 2014, at 12:57:48
So then why change a thing? Phillipa
Posted by klein on May 1, 2014, at 21:30:38
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » klein, posted by Phillipa on April 30, 2014, at 20:52:25
> So then why change a thing? Phillipa
Oh, I'm on meds until further notice. My doc changes them often due to poop out. I need ridiculously high doses of most meds to achieve an effect. My liver and bloodwork panel is always fine, so I'm either completely AD dependent or a very rapid metabolizer. Last year my pdoc was toying with the idea of shipping me off to a hospital for a couple of weeks to take me off everything and detoxify, but I flat out refused. Whatever for?
Posted by tony p on May 10, 2014, at 22:47:06
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » Phillipa, posted by klein on May 1, 2014, at 21:30:38
>Last year my pdoc was toying with the idea of shipping me off to a hospital for a couple of weeks to take me off everything and detoxify, but I flat out refused. Whatever for?
I went through a "fast" Valium taper once at a detox/rehab centre: from 60 mg/day to 0 in 30 days. I was functional in the controlled environment, but still experienced a lot of anxiety at times. And I relapsed within a few days of leaving.
Posted by tony p on May 10, 2014, at 23:02:25
In reply to Re: Who Has Successfully Withdrawn Fron Long Term Benz » Phillipa, posted by klein on May 1, 2014, at 21:30:38
I guess this thread should really be on the Withdrawal board, but here goes anyway:
I've got myself into a Catch-22 situation where my benzo Rx has run out, my Dr doesn't accept telephone refills, and I'm too anxious to go in to the clinic to get a new Rx.
Luckily, a substitute is available OTC (at least where I live): Robaxin hits the GABA receptor (among others) and relieves the anxiety and physical shakes. I don't recommend the off-the-shelf compounds with acetaminophen or ibuprofen: you may need to take more than is safe. I take Robaxin 750, 2 tabs about every 2-4 hours. It's expensive but effective. Here in Canada/BC pure Robaxin is literally OTC: you ask the pharmacist for it.
Posted by tony p on May 11, 2014, at 17:43:25
In reply to Re: Who ...Long Term Benz: Emergency Substitute, posted by tony p on May 10, 2014, at 23:02:25
Please ignore my suggested dose for Robaxin in my previous post; I was typing faster than I was thinking. I have a high tolerance, so the dose I suggested is much higher than most people would need. Follow the directions on the bottle for dosing (up to 8 750mg tabs / 24 hr), but be aware that Robaxin has a short half-life so small frequent doses are best. The monograph says "For severe conditions 8 grams a day may be administered".
This is the end of the thread.
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