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Old 01-17-2006, 11:05 AM   #1 (permalink)
 
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Default discontinuing benzo use

Hi, I have a question, mostly for those that have gone off of benzodiazepines after long term use. How did you go about discontinuing use of the medication? Especially those that suffered severe withdrawal effects.. did you cut it off cold-turkey, or did you taper down the dose over a number of weeks/months? Also, did you counter the withdrawal with another medication?

I only ask because I am considering long-term use but I have noticed quitting cold-turkey is a BIG no-no when it comes to discontinuing *any* medication thats been used for a long time. I've already experienced some withdrawal effects after 3 weeks continued use (stopped taking it cold-turkey, withdrawal lasted 1-2 days, doh). So, I do know that there is a concern as far as how to discontinue usage safely after long term use.

I've also wondered if its possible to switch among different benzos from week to week to prevent dependence on either one.. might sound crazy but I don't want to get dependent and have bad withdrawal effects hehe.

Anyway, I appreciate your feedback. thanks!
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Old 01-17-2006, 12:15 PM   #2 (permalink)
 
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I dont think switching will help

in general benzos are better taken only as needed as we all have calm days, always carry a few tablets with you when out and disolve 1 under the tongue for fastest help
the main risk from quitting cold turkeu is siezures, which may be confused with panic attacks, you should taper off slowly

it also helps to learn new ways of calming and relaxing yourself
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Old 01-18-2006, 08:01 AM   #3 (permalink)
 
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arthur, thanks for your input. I know the recommendation of many docs is 'as needed' but some will prescribe them to be taken everyday.

Benzos are the only thing that have worked for me so far, and I'm aware of the risks.. but I am just unsure about if I get to a point where I need to get off them, if there's a way to get off without suffering the same extreme withdrawal effects described by others on this site.
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Old 01-18-2006, 10:16 AM   #4 (permalink)
 
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When I went off of Valium, I had been taking 15 mg a day for ~ 2 months, and Klonopin 1 mg for a few months before that. I just wanted to try a med holiday. I decreased the Valium by 5 mg every week, if I remember right. I was off it in three weeks. I had some increased anxiety and insomnia, nothing unexpected.

I've gone on and off Valium in steady increments a few times since then, with no real problems.
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Old 01-18-2006, 11:40 AM   #5 (permalink)
 
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Default Re: discontinuing benzo use

Quote:
Originally Posted by shoe
Hi, I have a question, mostly for those that have gone off of benzodiazepines after long term use. How did you go about discontinuing use of the medication?Also, did you counter the withdrawal with another medication?
I've been using clonazepam and ativan for 4 years during school years. I stop abruptly (no tapering) during each summer and christmas holidays. Never had withdrawal or any problems.

Quote:
Originally Posted by shoe
I only ask because I am considering long-term use but I have noticed quitting cold-turkey is a BIG no-no when it comes to discontinuing *any* medication thats been used for a long time. I've already experienced some withdrawal effects after 3 weeks continued use (stopped taking it cold-turkey, withdrawal lasted 1-2 days, doh). So, I do know that there is a concern as far as how to discontinue usage safely after long term use.?
Here's some schedules for tapering for both benzos and other drugs (SSRIs):

http://www.benzo.org.uk/manual/bzsched.htm


Quote:
Originally Posted by shoe
I've also wondered if its possible to switch among different benzos from week to week to prevent dependence on either one.. might sound crazy but I don't want to get dependent and have bad withdrawal effects hehe.
Cross-tolerance occurs with most benzos. Xanax is perhaps one possible exception, although there's some debate. So perhaps rotating xanax with other benzos may have some effect?...not sure

Personally, I think worrying too much of the possibility of withdrawal will only increase the probability of getting withdrawal. It's been found that if you tell people that you decrease the dosage of benzo, they experience withdrawal symptoms even though experimenters didn't lower the dose. Conversely, giving them a sugar placebo during tapering decreased the incidence of withdrawal. So some of the effects of withdrawal are psychological. If you believe you're going to get withdrawal then you are more likely to experience them. There are also some patient characteristics that are more predictive of those who will get withdrawal... Personally, withdrawal is not that important for me. I care more about efficicacy, side-effects, quality of life and effect on longevity a given drug will have.

To date there is little evidence for any major side-effects of benzos or on longevity. At proper dose they are one of the most effective anti-anxiety drugs with few side-effects. Morever, unadreessed Anxiety has been shown to have a negative consequence on hypertension and heart disease. For me benzos have had almost nil side-effects, greatly improved my quality of life, work remarkably well on my anxiety. Should I want to quit one day and do experience withdrawal, I will just slowly taper. Success rates are close to 100% even in the most resistant individual's (those in Ashton's group) who had been on benzos for many years and had previous failure in quitting.
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Old 01-18-2006, 12:51 PM   #6 (permalink)
 
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Default Re: discontinuing benzo use

Wow, thanks guys for the help. I'm feeling a lot better now about going on benzos.

Scrotacles - that link is great, thanks so much! I'll have to discuss all this with a psychiatrist to see if they'd be willing to go that extra mile in prescribing diazepam when the time comes to taper off.

Quote:
Originally Posted by Scrotacles
Morever, unadreessed Anxiety has been shown to have a negative consequence on hypertension and heart disease.
You know, thats soooooo true. I've read plenty of articles about the negative effects of stress or anxiety on the body over time and I think its definitely worth it to do what you need to do to both feel comfortable and to take care of your health.

thanks again guys
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Old 01-18-2006, 09:16 PM   #7 (permalink)
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Quote:
Personally, I think worrying too much of the possibility of withdrawal will only increase the probability of getting withdrawal. It's been found that if you tell people that you decrease the dosage of benzo, they experience withdrawal symptoms even though experimenters didn't lower the dose. Conversely, giving them a sugar placebo during tapering decreased the incidence of withdrawal. So some of the effects of withdrawal are psychological. If you believe you're going to get withdrawal then you are more likely to experience them. There are also some patient characteristics that are more predictive of those who will get withdrawal... Personally, withdrawal is not that important for me. I care more about efficicacy, side-effects, quality of life and effect on longevity a given drug will have.

To date there is little evidence for any major side-effects of benzos or on longevity. At proper dose they are one of the most effective anti-anxiety drugs with few side-effects. Morever, unadreessed Anxiety has been shown to have a negative consequence on hypertension and heart disease. For me benzos have had almost nil side-effects, greatly improved my quality of life, work remarkably well on my anxiety. Should I want to quit one day and do experience withdrawal, I will just slowly taper. Success rates are close to 100% even in the most resistant individual's (those in Ashton's group) who had been on benzos for many years and had previous failure in quitting.
thank you. can i print that out and show it to my psychiatrist?
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Old 01-20-2006, 09:10 PM   #8 (permalink)
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Default Re: discontinuing benzo use

Quote:
Originally Posted by Scrotacles
Here's some schedules for tapering for both benzos and other drugs (SSRIs):

http://www.benzo.org.uk/manual/bzsched.htm
while i have some argument with parts of that site, i think the benzo tapering schedules are on the right track. i'm using them more or less -- i switched to valium, and am tapering smoothly.

the only part of the charts i think is off is that klonopin is way overrated compared to valium. i'm basing this on my doctor's opinion, my own experience as well as reports of friends, and on other charts i've seen.

i had been on 3.5mg klonopin plus 10mg valium per day. on the chart this would translate to a whopping 80mg valium. turns out 30 mg valium worked beautifully as a starting equivalent. i think dr. ashton may have doubled the stated power of klonopin?

once on my 30mg valium, i cut back by 2.5 mg every week or two till i got to 17.5. i'm holding there more or less till i get through a little more stuff. but i can tell that this taper will continue to work for me. my doctors support this and don't see a need to rush it. they say that the anxiety was far worse for me than the meds (i heartily agree!) and that the better i'm healed, the less i'll need, as has been true.

as always ymmv, talk to a good doc, etc.

good luck and aloha
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Old 11-02-2007, 08:57 AM   #9 (permalink)
 
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Default Re: discontinuing benzo use

Quote:
Originally Posted by Scrotacles
Quote:
Originally Posted by shoe
Hi, I have a question, mostly for those that have gone off of benzodiazepines after long term use. How did you go about discontinuing use of the medication?Also, did you counter the withdrawal with another medication?
I've been using clonazepam and ativan for 4 years during school years. I stop abruptly (no tapering) during each summer and christmas holidays. Never had withdrawal or any problems.

Quote:
Originally Posted by shoe
I only ask because I am considering long-term use but I have noticed quitting cold-turkey is a BIG no-no when it comes to discontinuing *any* medication thats been used for a long time. I've already experienced some withdrawal effects after 3 weeks continued use (stopped taking it cold-turkey, withdrawal lasted 1-2 days, doh). So, I do know that there is a concern as far as how to discontinue usage safely after long term use.?
Here's some schedules for tapering for both benzos and other drugs (SSRIs):

http://www.benzo.org.uk/manual/bzsched.htm


Quote:
Originally Posted by shoe
I've also wondered if its possible to switch among different benzos from week to week to prevent dependence on either one.. might sound crazy but I don't want to get dependent and have bad withdrawal effects hehe.
Cross-tolerance occurs with most benzos. Xanax is perhaps one possible exception, although there's some debate. So perhaps rotating xanax with other benzos may have some effect?...not sure

Personally, I think worrying too much of the possibility of withdrawal will only increase the probability of getting withdrawal. It's been found that if you tell people that you decrease the dosage of benzo, they experience withdrawal symptoms even though experimenters didn't lower the dose. Conversely, giving them a sugar placebo during tapering decreased the incidence of withdrawal. So some of the effects of withdrawal are psychological. If you believe you're going to get withdrawal then you are more likely to experience them. There are also some patient characteristics that are more predictive of those who will get withdrawal... Personally, withdrawal is not that important for me. I care more about efficicacy, side-effects, quality of life and effect on longevity a given drug will have.

To date there is little evidence for any major side-effects of benzos or on longevity. At proper dose they are one of the most effective anti-anxiety drugs with few side-effects. Morever, unadreessed Anxiety has been shown to have a negative consequence on hypertension and heart disease. For me benzos have had almost nil side-effects, greatly improved my quality of life, work remarkably well on my anxiety. Should I want to quit one day and do experience withdrawal, I will just slowly taper. Success rates are close to 100% even in the most resistant individual's (those in Ashton's group) who had been on benzos for many years and had previous failure in quitting.
This is so true.....and well said!!!!!!!!!!!
Micha
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Old 11-02-2007, 10:16 AM   #10 (permalink)
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Default Re: discontinuing benzo use

I don't post much anymore but am still subscribed to this thread. Since my entry (two posts ago as I'm writing this) I've continued to taper down to 7.5mg which works fine on most days. On days with more stress I round it up to 10. When I need more it's a sign I need more therapy (which I've also tapered but it's still great.)
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