Tapering Off Benzodiazepines
This article is for those people who have asked questions about tapering and what I'm doing or feel like.
Thing To Avoid During Benzo Withdrawal
The first wouldn't be don't cold turkey, go to a detox center or do even do a rapid taper, which is I initially tried to do over four to six week period. I have seen hundreds of people, thousands over the course the past year, who have gone through this and I don't see any difference between the people who cold turkey and the people who do a rapid taper or go to a detox center.
If you read the Ashton manual you understand that GABA receptors have been down-regulated. You can't force those to get back online by how quickly you get off your medication. our body is going to take as long as it's going to take up those GABA-receptors. The only thing that's creating a buffer between experiencing the full throes of a cold turkey withdrawal and not is the, unfortunately, the benzodiazepine.
Please, understand the benzodiazepine has already done its damage. There are people who are only on these drugs for a few weeks and they're still just as bad as those of us who have been on for years.
GABA receptors can become downregulated very quickly. Imagine that your central nervous system is like a big open wound. And the only thing that is keeping that wound from being exposed to all the elements is the benzo bandage that you have on. If you just rip that bandage, off you're going to experience so many more problems and for a much longer period of time, because you're gonna be dealing with more complications from doing that than if you just slowly remove a little bit at a time.
The second one is don't assume that taking other medications is going to solve this problem or make it any easier. It's between you and your doctor what course of treatment you want to take.
If you're trying to get off your benzo meds and experiencing horrible symptoms throughout the day, then it's very likely that you're one of those people who's not going to respond well to medications. A lot of doctors like to not only prescribe antidepressants, they like to also prescribe buspirone, gabapentin.
Using gabapentin almost makes sense because it affects GABA B receptors, whereas benzos affect GABA-A receptors.
Again, in my experience, I've never heard anybody say: "I'm so glad I got gabapentin! It made my withdrawals so much easier!". I have yet to hear anybody say that. Most of the time they say: "gabapentin carries its own set of side effects and problems. Now that I'm off the benzos buy have a face gabapentin withdrawals."
Our central nervous systems are so incredibly sensitive. Things like sound, touch, foods, caffeine, artificial sweeteners bother us so much.
If those kinds of things can set us off, imagine putting in another mind-altering chemical into your brain. What that's gonna do to you?
Supplements can have the same problems. There are a lot of good supplements that can really help through this process. However, please stay away from the more obvious supplements that people take to calm themselves such as the ragweed family, chamomile, valerian, St. John's wort.
The ones that you think should help you are actually GABA antagonists. According to Ashton and other resources, we need to stay away from anything that interferes with the up-regulation of GABA. It can just pull on the hailing and make it worse. Pease, be very careful to research any supplements that you decide to take during this process.
Useful Tips On Benzo Withdrawal
We advise you to read the Ashton manual, take that to your doctor, come up with a plan. We suggest coming up with a plan before you go to your doctor because you're very likely to get ripped off your benzo for various reasons.
When people go into their doctors and they say they want to get off a benzo, the doctor says: "ok, and you've got four weeks, after that, I'm not prescribing you benzo anymore and I'm gonna prescribe you Lexapro".
That is why make sure that you know exactly what you're doing before you go and tell your doctor that you're ready to get off your benzo.
The first thing of course that Ashton recommends is crossing over to a longer-acting benzo. The shorter acting benzodiazepines make it so that as soon as people start reducing them, they're feeling these really big inner dose withdrawal drops throughout the day. That is why it is really recommended that you switch over to Valium or Librium, which are longer-acting benzodiazepines.
Let's just for now say that you do have a doctor who's willing to work with you on a Valium taper. Please, remember again doctors are very reticent to prescribe Valium. I've never found one who's given me a good explanation as to why Valium is worse than the shorter acting benzos.
What Ashton has people do is a 10% reduction taper every four weeks. The way that I have been doing this basically from the beginning is a method called Micro tapering.
According to Ashton method, you make a 10% cut and wait for two weeks and then make another 10% cut of dosage. What Micro tapering is doing is making small daily cuts that still add up to 10% every month, but you're not having these huge cuts in and you-you're a little more functional.
There are three ways that you can do Micro tapering. The first is to cut your pill. This is the more difficult and complicated way of doing it. However, you can buy .001 scales on Amazon for $30.
You have to make sure to measure every single pill because each pill weighs differently. You would also need to get a razor blade and shave off the amount that you need.
The other method would be if you have a compounding pharmacy that you have access to, you can ask your doctor to order liquid value.
Just a warning here - the kind of liquid valium that comes from the pharmaceutical company is made in an alcohol suspension. For any of you who have ever read any of the warning labels on any benzos that say do not mix with alcohol.
That is why we advise you to ask for a compounding pharmacy to make liquid Valium for you in an almond oil suspension. There are a lot of pharmacies that do that.
It is a really great option because then all you have to do is start out taking whatever dose you're at and then reducing it by 10% each month. For instance, let's say that you were on 20 milligrams of Valium. You'll be reducing it by 2 milligrams every month.
The problem with short-acting benzos such as Xanax and Ativan, you can't get those in liquid form. You would either have to switch to Klonopin or Valium and do it that way.
If your doctor is willing to do that with you, what I recommend is splitting your dose in half. Taking half of the Valium in the morning and a half at night. Valium has such a long half-life of around 20 to 100 hours, why would I need to dose twice a day? The first metabolite of Valium breaks down after only 5 hours. So, you could start filling drops any time in between your last and the next. That is why it is much easier to break up your dose at the beginning when you're on a higher dose.
What to do if you're not able to do a Valium taper?
Some doctors just refuse for whatever reason to prescribe Valium. What you can do is break up your dose so that you have a steady flow of that through your in your bloodstream throughout the day depending on the half-life of the medication.
For instance, the half-life of Klonopin is 18 to 50 hours. They usually need to lose three to four times a day. Before you even start cutting or reducing in any way, break up your dose, get your body used to taking it that many times a day and then go from there to avoid withdrawals.
Ativan has a half-life of 10 to 20 hours. You would need to dose that four to five times a day.
Xanax has a half-life of six to twelve hours. That is why you have to take Xanax cuts 5 to 6 times a day. It is really better off switching to something else if you're on Xanax.
Xanax extended-release is a bit of a beast because there doesn't seem to be a way to cut it or to liquid titrate it. But if you have to you can try to dose that five to six times a day.
Let's say that you can't switch over to Valium or you can't get compound Valium that isn't an alcoholic. You need to do this on your own, which a lot of people do.
Your option is to do a liquid titration. It's really easy. All you do is you take your pill, your full dose, put it in 300 millilitres of water. This 300 will give you just a real nice easy exact way to do a 10% reduction each month.
Then you let your pill dissolve. Valium breaks up in a few seconds. There's no difference really between doing this and drinking it with a big glass of water.
Once you've dropped your pills in, you just take a syringe and you remove one millilitre on day one. After you've removed that, then you take it and you divide it into however many doses you need to divide it into. Use a little baby food jars or whatever you need to do. You can eyeball it or make a spreadsheet to get more exact measurements.
There are the medication tapering support and information group, our benzodiazepine withdrawal support group. We have someone who helps people with spreadsheets to do a micro tapering plan. It's actually fairly simple. If you have someone who knows how to do Excel and can do that.
You withdrawal plan should include how many milligrams of pill you're using, the date the milligram of pill you are using, how much water you're putting in, how much you're going to take out and discard, how much you're going to drink and what the adjusted dosage is.
The great thing about micro tapering also is that if you feel the symptoms are creeping up, you can just put it on hold for 2-3 days, even a week and let your body catch up and then resume your taper again.
I hope that was helpful for those of you who are asking for tapering tips and information. I just want to encourage you all to keep going.