Reinstated and now going to have to taper...thoughts?

[[ra...]]

Last night I ended up in the ER.  It was the worst night of my life.  It seemed like I was going to suffer an horrible heart attack - my vitals got so bad, I could not think or speak and I was near delirium.  My fiancee finally broke and and called 911.  They came and took me to the ER.  My vitals were all over the place.  My fiancee, who has been going through this with me, was brutally honest and told them what was going on.  I was so out of it, but they brought me an injection of Ativan 2mg intramuscular.  I freaked out and protested but they gave it to me.  So, I stabilized.  It took hours, but, I did. 

 

They sent me home with two days' worth of Librium.  (25mg 4x per day.)  This, they said, was to stabilize and is often used to treat alcohol withdrawal which they said was similar.  I feel much better, with the extreme anxiety not gone but at least down to a manageable baseline. 

 

So, my having gone cold turkey - which had happened 10 days ago, we calculated last night, at the absolute maximum, possibly not even that much time - was stopped with reinstatement sort of decided for me by the ER staff.  Tomorrow I see a new doctor.  I have decided to ditch the old doctor, who handed out the clonazepam like candy, basically asking you how much you wanted.  So now that I've reinstated, here's my questions:

 

-Now that I've gotten stuck reinstated, what is your opinion on what to do?  Do I now get stable and then work out a tapering plan with my new pdoc?  Is that the best course of action?  I want to minimize my chances of withdrawal as best I can.  Luckily, I've not been consistently on the benzo - intermittently over the past year, with periods of time (a month or more) off of them.  But clearly I've become susceptible to some level of withdrawal symptoms.

 

-Are there any other meds that I can investigate for anxiety symptoms that might help me as I work on my taper?  An AD or something, perhaps? 

[[be...]]

I am biased against ADs. I tried just about all of them pre benzo days and they did NOTHING to help with my anxiety, except to increase it by 10-fold. I have found that Seroquel acts like an anti anxiety med for me. In lower doses, it acts like a sleep aid. If you want to try it, stick to a lower dose at first and then if need be, increase it. Take it at bed or you'll be a walking zombie throughout the day. The only dose I found effective was 150 mg.

[[pi...]]

You've been off and on benzos so much and recently at very high doses so your nervous system is really confused.  I think personally the best way to keep withdrawal symptoms minimized is a slow, gradual taper. I hope your new doctor will help you with that.  Tapering 5-10% every 10-14 days is recommended.

 

I'm sorry you had such a rough night but ct can be brutal, I have experienced it myself.

 

pianogirl

[[ra...]]

The doctor today wants me to now taper off the Librium the hospital gave me for the next two days, and gave me Neurontin 300mg to try to assist with any anxiety and whatnot that might go along with it.  I have to go back to her on Friday for a further treatment plan. 

 

Is it even possible for me to get off this stuff at this point?  Apparently I had detoxed from the clonazepam but was experiencing severe rebound anxiety and that turned into extreme sleep deprivation which eventually just made my vitals go insane.  I feel much better than I did then - I can eat, I slept a full night last night, etc.  I guess I'm basically stabilized now.  So a taper makes sense now?  I so strongly fear a bad reaction as I try to get off of it completely, but I suppose by the time I went to the ER there wasn't anything left in my system at that point.

[[ea...]]

If I were in your shoes (and I have been-) I would taper off the Librium and TRY the Neurontin. That's a fairly low dose, I think. Most people don't have trouble getting off it and it may relieve withdrawal symptoms.

Why do I think you should taper the Librium? Simple. You already know you have trouble getting off benzos, and this will be your second withdrawal, which means you may be kindled. IMO your plan should be to be off benzos entirely and never take them again. You went cold turkey last time, and you are not doing that now, so that should minimize symptoms. Its time to start learning new ways of coping with anxiety, since that seems to be your "weak spot."

 

You can do this. Don't be fearful....try to think about how good it will feel to be free of these drugs, and know you stood up to them.

east

[[pi...]]

I'm glad you are feeling much better, that is good news. One thing that doctors don't recognize sometimes is that even though the drug is chemically out of your system, the GABA receptors take time to recover from being down regulated. I won't comment on the medications because I have no experience with them.  I agree with Eastcoast as far as finding ways to cope with anxiety.  Withdrawal anxiety can be very intense because the cns is in hyperdrive. 

 

Try some deep belly breathing if you feel anxiety creeping in. Breathe in slowly for a count of 3, hold for a count of 3 and slowly exhale for a count of 6.  See the anxiety leave with each exhale.

 

pianogirl

[[ra...]]

I'm doing my best to find other ways to cope with the anxiety while I am dealing with this.  I am starting a journal - so I can write my irrational thoughts down and name them as irrational, and counter them with rational thoughts.  I've always been into music so I am going to try to get back into that and possibly pick up the guitar again as a creative outlet.  Write and play as a way to cope.  Make myself face the anxiety as opposed to put a band aid on it with a pill, which has been what I've been doing.  My anxiety is existential, which translated into psychosomatic anxiety when I lost my cousin at age 32 (he was only a few years older than me) to a heart defect.  As opposed to just having anxiety about death in a nebulous way, it then went into fear of death from illness.  I never figured out how to deal with it.  Taking a pill meant I didn't have to.  But now I do.

 

Now, of course, I fear having a seizure.  I'm hoping that won't happen, even though, as you said, I've probably kindled due to multiple withdrawals.  I've never abused any drugs or medications.  I'm not an addictive person - in fact, I'm terrified of substances, and I remember 7 1/2 years ago when I was first given clonazepam, I was terrified to take it and refused at first, but my anxiety and panic were so debilitating that I did.  And that was it for me I guess.  But I don't even drink, not even once a year.  I don't do substances.  But this one is so easy to updose.  Which is what I did.  And I took more than I should have. 

 

Have I screwed myself by being reinstated?  It was taken out of my hands by the ER, and then giving me the librium to stabalize afterwards.  I have taken the absolute bare minimum - in fact, less than they advised, because I did not want to get stuck on something else again.  But I could not continue with the withdrawal.  Am I going to be okay?  If I am kindled, does that mean I'm never going to be able to get off this stuff, or if I do try to taper, will I just end up sick again and having a seizure?

[[ea...]]

No, you havened screwed yourself by reinstating. Not at all. You sound completely rational, and are doing everything you can to deal with things without taking pills.

The chances of your seizing are very, very low. They usually happen when a person cold turkeys off a high dose of a benzo or from alcohol.

I love it that your journaling, and writing down the "counter thoughts"!!! This is an excellent tool, one that many therapists suggest.

Are you going to taper off the Librium?

east

[[ra...]]

I did cold turkey off a benzo, about two weeks ago - that's what got me in this mess.  I had a tendency to updose my clonazepam to try to get the anti-anxiety and sleep-aid effects until I took much more than prescribed and ran out very early - so I went cold turkey.  The anxiety kicked in almost immediately, but ramped up slowly until I was so anxious I ended up in the ER.  That's where I got a shot of ativan to stabilize me and that effectively reinstated me.  Once I reached almost two weeks out from going cold turkey, I was going to try to continue since I assumed the med was out of my system.  (Luckily, I guess, I did not take benzos regularly - I've taken them on and off over the years, but never felt withdrawal symptoms before.)  But I got so bad and because my anxiety is health-based, I ended up in the ER!

 

Is it possible for me to seize from the benzo even though the high dose one I was taking I stopped almost/about two weeks ago?

 

Yes, I am tapering off of the Librium.  The new doctor told me to do that - the ER only gave me enough for a few days anyway - and then I go back Friday to be re-evaluated.  I'm not sure if I will have to continue to be reinstated on something so I can taper safely for a longer period of time or not.  The fear I have is that after I taper off of the Librium that I will be right back where I was on Monday when I had to go to the ER.

[[ea...]]

Seizures are more likely to happen to people who go off benzos or alcohol cold turkey and they usually happen within the first two weeks. Let me put this another way: When a  person stops a benzo or alcohol abruptly, seizures happen (but only rarely-) usually starting within 24 hours after the last dose (or drink). The chances lessen each day and by the two week mark, are VERY unlikely to happen. So, Yyou are VERY unlikely to seize now. I think you can put this worry aside.

 

I appreciate your honesty in admitting you abused the clonazepam. Admitting this is such an important step in recovery....admitting our mistakes isn't easy! but - you're doing it.

You say you were on benzos for years, on and off, but never felt withdrawal - I wonder if that's really true. You may have been in tolerance withdrawal, and that was one of the sources of your anxiety. That happened to me, and I didn't see it until well after I got off benzos.

 

Im glad your tapering off the Librium...although if they only gave you a 2 day supply, Im not sure if a taper is even possible.....or necessary. In my opinion, you would be wise in staying off it (not reinstating) and start learning how to cope with your anxiety in safer ways. You can start doing that now, and get a jump on it.

east

[[ra...]]

So a seizure is more likely to happen very close to the last dose taken?  With clonazepam, it stays in your system longer, correct?  But even after a couple of weeks, I'm probably out of the woods on that particular risk?

 

That's my biggest fear, I suppose.  They hypochondriac in me.  I, of course, fear never feeling better or "okay" again.  But that won't kill me.  Death has always been my biggest fear.  So much so that I don't actually live the life I'm afraid to lose.  It's a really strange and terrible contradiction, one that I know is a contradiction rationally but that doesn't necessarily stop the anxiety.  It sucks.  I assume I'm not the only person who has that particular anxiety.

 

The doctor I'm now seeing wants me to taper the Librium I was given - it was a "two day supply" but can be stretched out - to make sure it leaves my system slowly.  She was concerned that it was in my system now and being a long-lasting med, just because I felt relatively stable now, didn't want me to end up where I was.  So I promised to actually follow the doctor's advice, since it was already in my system, so I guess I will.  I am definitely going to work on my anxiety.  I am not going to reinstate on a benzo to deal with the anxiety - the only reason I would reinstate would be to stabilize and minimize withdrawal symptoms.  I don't know what the doctor will have me do when I go back on Friday to follow-up. 

 

It seems like I'm really lucky, reading posts from other people on here.  I didn't end up, even after abusing it, and then going cold turkey after a couple of weeks of high doses, with horrific symptoms - and yes, I have no problem admitting I abused it, and taking responsibility for it (the doctor "not telling me of the dangers of it" is NOT good enough - I am an adult and savvy enough to have researched it myself, and also regardless of what the doctor told me, I KNOW BETTER than to take more than prescribed, and I did it anyways.  That's abuse.  I went through a 30 day supply in two weeks.  That's on me and me alone.).  I'm trying to make sure I am thankful and mindful. 

 

Thank you so much for your replies.  It really helps.  It seems like you were on a benzo for a very long time and were able to get off of it.  I was off and on it for some years, but I never had withdrawal - and some of the times I was off of it, I was off of it for months at a time and a couple of times even as much as a year.  I suspect this last experience got me kindled somewhat - I don't know, will having been reinstated by the ER doctors screw me more, or after two weeks of cold turkey and detox was it okay for me to be stabilized by it and then tapered a little, is that something that is common and doable?