How long should a taper be?

[[dr...]]

When you take a benzo, it supplements or replaces some of the body's natural GABA, a "feel good" chemical that helps calm or relax you, and counteract some of our natural stimilant chemicals, like cortisol.  But your body/mind system has a process called homeostasis which normally keeps everything in balance.  So when you add chemical from an external source, your body will 1) produce less of on its own, and 2) probably more of the opposite, stimulatory chemicals.

 

So when you try to stop taking that external agent, benzo,  your body is 1) not producing enough of the "feel good" GABA, and a surplus of the excitatory chemicals, like cortisol.  This is what your body had to do while you were "interfering" with its natural control mechanism. So to avoid or minimize the discomfort and sxs that would/will result, you need to slowly reduce the level of that external chemical ("taper"), and allow your natural homeostasis gradually correct that chemical balance ("heal, or recover").

 

You gradually reduce your benzo intake ("taper") , while your body tries to return to a normal balance ("heals, recovers")  If the healing was not taking place while you tapered, you might as well just CT. 

 

This process is not unique to benzo, and in fact, isn't unique just to psyche meds.  And time you introduce an external factor to alter or influence the body's normal balance, the body will make adjustments ("homeostasis") to compensate for that external influence.  If you take a PPI to lower stomach acid porduction, you need to taper off the PPI so your body can return to normal levels.  If you take a beta-blocker to lower heart rate/bp, you need to taper off so your body can return to regulating those normally, etc.

Yeah, but healing can be painful. When it starts to feel like betterness is different for diff people. (and occurs differently within the same person too!) There is no general rule for how anyone of takes to this. And there isn't a universal response to C/t or tapering.

I'm finding that I'm really just improvising and trying to report fully to my MD to try and do it right.

DD

  No, healing is NOT painful.  The pain is the result not matching your taper rate to your recovery (healing) rate. As I said, when you begin to reduce your intake of the med, your body will begin to adjust to the new conditions.  If your in pain, then you are tapering faster than your body can respond. 

 

When folks experience sxs, they typically reduce their taper rate, or hold.  Both of those strategies are aimed at letting your healing catch with your lowered dose.

 

Don't know that's a fact. I think there's a variety of experiences.

There is a lot of pain among taperers here though.

  Absolutely, but is NOT caused by healing/recovery.  Its caused by withdrawal.

 

How could there be a knowable difference between those two things? You can say that anyone who is in pain is in withdrawal, but you can also say they are healing.

[[La...]]

I know the standard answer is going to be "everyone is unique," and I understand that.

 

But are there guidelines? For me, I took ativan for 2.5 months.....I want to make sure I don't do an unnecessary long drawn out taper,  but at the same time, I have to listen to my body.

 

Any input is appreciated , thanks

 

Dan

 

I took 1 mg ativan for 5-6 weeks, got hooked baaaaaad. Took 3.5 months to taper, jumped at 0.02mg. Did really well post jump for the most part (>90% baseline), but getting ftom 95% to 100% healed has been slow and dragging on. Still, many days I'm 100%.

 

laser

[[cr...]]

I just read the thread.  How long should a taper be?.....twice.  I am so confused I just didn't understand about pain and healing and basically the whole conversation. Does someone have a take away for me? Thank you.

[[sh...]]

I just read the thread.  How long should a taper be?.....twice.  I am so confused I just didn't understand about pain and healing and basically the whole conversation. Does someone have a take away for me? Thank you.

 

How long have you been taking your K?  The length of time you have been taking the meds will help determine what your taper rate should be.

 

Stay strong!

sharkey

[[dr...]]

I think it's pretty individual about how long a taper is. look at all the variety here. Have a good Dr. You don't want to linger, but you don't want to rush. Of course its confusing. I am feeling my way through this. There is no way to say what you can tolerate not knowing you and keeping in mind that even Drs who meet you might have crummy advice or be ignorant. Do you want to cross over? It may be more comfortable. do you want to try other meds? It all plays into this. Keep us posted.

DD

[[by...]]

I just read the thread.  How long should a taper be?.....twice.  I am so confused I just didn't understand about pain and healing and basically the whole conversation. Does someone have a take away for me? Thank you.

 

W/d symptoms are usually the same symptoms that the medicine treats

 

Benzos are used to treat anxiety, insomnia, panic, OCD, and sometimes pain

 

Therefore, the symptoms of w/d are anxiety, insomnia, panic, OCD, and sometimes pain  ( not necessarily all inclusive )

 

Pain is an uncommon w/d symptom, just as the members of this board are not indicative of the overwhelming majority of people using benzos.

 

Members of BB commonly end up here because they have symptoms that fall far outside the norm in people that have w/d from benzos -- either in intensity, symptomology, duration, or all three.

 

Based on studies done by Heather Ashton, the majority of w/d s/x resolve within several weeks to a few months in the majority of people .  A slow taper using a long acting benzo (valium or Librium) will minimize both the length and intensity of the w/d syndrome, as well as symptoms during the taper.

 

I personally tapered this last course of benzos from 15mg to 1 over the course of 8 months -- then held at 1 mg for a month before I stopped 6/1/2015

 

I had almost no symptoms other than night sweats (which I am prone to -- heavy drinker for over a decade) slight anxiety , etc EXCEPT when I cut from 4 mg to zero in 1 month (March) which caused significant symptoms.

 

I reinstated and tapered no problem.

[[La...]]

bbv:

 

I dont doubt your personal account at all, but in regards to:

 

"Members of BB commonly end up here because they have symptoms that fall far outside the norm"

 

I have yet to see credible quantitative evidence for this. There are a lot of valid reasons why accurate reporting on this issue is hard to come by. And I have witnessed some of these reasons myself.

 

I might be inclined to accept language such as "a minority of benzodiazepene users," but "far outside the norm" implies a much lower fraction.

 

[[...]]

Hi Dan

I think you've gotten some very good advice on this thread. In my case, I never payed any attention to the question about how long a taper should be. I just first got to a dose where I had minimal symptoms and then tapered at a rate close to my healing rate. I believe this enabled me to feel pretty well during the taper and arrive at 0 fairly close to healed. It's not really rocket science but it did take a lot of trial and error to find how fast I could taper and still feel well. The details are in my posts. For me, after using Ativan for only 7 weeks, it took close to two years to taper and heal. In hindsight, I was surprised at the total length of time it took. Maybe yours will be different.

Good luck

 

Bart

[[by...]]

bbv:

 

I dont doubt your personal account at all, but in regards to:

 

"Members of BB commonly end up here because they have symptoms that fall far outside the norm"

 

I have yet to see credible quantitative evidence for this. There are a lot of valid reasons why accurate reporting on this issue is hard to come by. And I have witnessed some of these reasons myself.

 

I might be inclined to accept language such as "a minority of benzodiazepene users," but "far outside the norm" implies a much lower fraction.

 

 

15,000,000 people a year use benzos in the US alone

 

Most have no trouble at all with w/d

 

 

The number of people who have registered for BB over the 10 years it has been operating is ~17,000

 

"Symptoms falling far outside the norm" -- makes no statement regarding the percentage -- simply the intensity, duration, and symptomology ( as I clarified)

 

Ashton places the % of protracted w/d at 10%-15% of long term chronic users

 

"For some chronic benzodiazepine users, withdrawal can be a long, drawn-out process. A sizeable minority, perhaps 10% to 15%1 develop a "post-withdrawal syndrome,"2 which may linger for months or even years."

 

http://www.benzo.org.uk/pha-1.htm

 

Chronic users are a minority of benzo users.

 

Multi-year severe protracted w/d is rare even within the protracted w/d population

 

[Guest [yo...]]

Of course, of those minority who suffer the worst of withdrawals, and it is a minority of 15%ish, it's likely they'll all collect in places like this, and since there isn't really another benzo support forum like this, a very high proportion of people being hard-hit by benzos are very likely to be found on this forum.

 

So, to say ON THIS FORUM that most of the people here can't be in withdrawal (the remaining 85%) because the math used says the overall percentage of people is low, naturally that massive proportion who don't get symptoms don't post here, so the proportion of people in society who suffer the worst will be far higher on this forum than in the broader society, which is where that figure is derived from.  Applying it to BB's could be unintentionally misleading, but certainly unreliable.

 

J

[[cr...]]

THANK YOU, I APPRECIATE THE RESPONSE. sorry, didn't notice the caps

 

 

I just read the thread.  How long should a taper be?.....twice.  I am so confused I just didn't understand about pain and healing and basically the whole conversation. Does someone have a take away for me? Thank you.

 

W/d symptoms are usually the same symptoms that the medicine treats

 

Benzos are used to treat anxiety, insomnia, panic, OCD, and sometimes pain

 

Therefore, the symptoms of w/d are anxiety, insomnia, panic, OCD, and sometimes pain  ( not necessarily all inclusive )

 

Pain is an uncommon w/d symptom, just as the members of this board are not indicative of the overwhelming majority of people using benzos.

 

Members of BB commonly end up here because they have symptoms that fall far outside the norm in people that have w/d from benzos -- either in intensity, symptomology, duration, or all three.

 

Based on studies done by Heather Ashton, the majority of w/d s/x resolve within several weeks to a few months in the majority of people .  A slow taper using a long acting benzo (valium or Librium) will minimize both the length and intensity of the w/d syndrome, as well as symptoms during the taper.

 

I personally tapered this last course of benzos from 15mg to 1 over the course of 8 months -- then held at 1 mg for a month before I stopped 6/1/2015

 

I had almost no symptoms other than night sweats (which I am prone to -- heavy drinker for over a decade) slight anxiety , etc EXCEPT when I cut from 4 mg to zero in 1 month (March) which caused significant symptoms.

 

I reinstated and tapered no problem.

[[dr...]]

Cross:

  Could you update your sig so that it reflects your current state? it looks like you updosed 40 days ago to 2 mg K and tapered off that since/ How long exactly? I can't tell if you were really out of it or relatively symptom free.

[[by...]]

Of course, of those minority who suffer the worst of withdrawals, and it is a minority of 15%ish, it's likely they'll all collect in places like this, and since there isn't really another benzo support forum like this, a very high proportion of people being hard-hit by benzos are very likely to be found on this forum.

 

So, to say ON THIS FORUM that most of the people here can't be in withdrawal (the remaining 85%) because the math used says the overall percentage of people is low, naturally that massive proportion who don't get symptoms don't post here, so the proportion of people in society who suffer the worst will be far higher on this forum than in the broader society, which is where that figure is derived from.  Applying it to BB's could be unintentionally misleading, but certainly unreliable.

 

J

 

Never said they can't be in withdrawal (where do you get that from anyway?) -- i said that BB membership over-represents persons with protracted and severe w/d with respect to the rest of the world.  It's like all the 4,5, and 6 sigma outliers have congregated here.

 

Protracted withdrawal hits a minority of 15% ish of the small percentage of benzodiazepine users that are Chronic (multi-year) users.

 

Based on Ashton's work -- 35 out of 50 patients that had a mean length of BZD use of 9.76 years (Chronic) -- had excellent or good results between 11 -32 months.

 

So even with chronic users that have protracted symptoms-- success is 70%

 

 

Yet here, on a board that usually has only a few to several hundred (at most) of the same people posting; almost all are suffering from significant severe or protracted w/d.

 

That does not mean I marginalize their suffering. 

 

It just means that BB paints a very skewed picture with respect to the realities of Benzodiazepine withdrawal, and that the experience of most BB posters does not reflect the experience of most Benzodiazepine users.

[[bu...]]

 

 

... BB paints a very skewed picture with respect to the realities of Benzodiazepine withdrawal, and that the experience of most BB posters does not reflect the experience of most Benzodiazepine users.

 

:thumbsup:

[[dr...]]

Of course, of those minority who suffer the worst of withdrawals, and it is a minority of 15%ish, it's likely they'll all collect in places like this, and since there isn't really another benzo support forum like this, a very high proportion of people being hard-hit by benzos are very likely to be found on this forum.

 

So, to say ON THIS FORUM that most of the people here can't be in withdrawal (the remaining 85%) because the math used says the overall percentage of people is low, naturally that massive proportion who don't get symptoms don't post here, so the proportion of people in society who suffer the worst will be far higher on this forum than in the broader society, which is where that figure is derived from.  Applying it to BB's could be unintentionally misleading, but certainly unreliable.

 

J

 

 

 

Never said they can't be in withdrawal (where do you get that from anyway?) -- i said that BB membership over-represents persons with protracted and severe w/d with respect to the rest of the world.  It's like all the 4,5, and 6 sigma outliers have congregated here.

 

Protracted withdrawal hits a minority of 15% ish of the small percentage of benzodiazepine users that are Chronic (multi-year) users.

 

Based on Ashton's work -- 35 out of 50 patients that had a mean length of BZD use of 9.76 years (Chronic) -- had excellent or good results between 11 -32 months.

 

So even with chronic users that have protracted symptoms-- success is 70%

 

 

Yet here, on a board that usually has only a few to several hundred (at most) of the same people posting; almost all are suffering from significant severe or protracted w/d.

 

That does not mean I marginalize their suffering. 

 

It just means that BB paints a very skewed picture with respect to the realities of Benzodiazepine withdrawal, and that the experience of most BB posters does not reflect the experience of most Benzodiazepine users.

 

That's not a new point. If you're canvassing the site for what your experience will be like it's relevant that there are outliers here. If you are here for support I don't think it makes a difference at all. Everyone here is part of the reality of Benzo users. It's a drug that you can't just stop taking, and for most people that is serious business whatever their outcome. Who are you tilting at by saying this again and again?

[[by...]]

 

That's not a new point. If you're canvassing the site for what your experience will be like it's relevant that there are outliers here. If you are here for support I don't think it makes a difference at all. Everyone here is part of the reality of Benzo users. It's a drug that you can't just stop taking, and for most people that is serious business whatever their outcome. Who are you tilting at by saying this again and again?

 

You just proved my point.

 

Benzos ARE actually a drug that many people DO stop taking and have NO significant W/D.

 

People just stop taking benzos every day -- and have no withdrawal -- in fact -- MOST people who use benzos have no withdrawal.

 

The literature states that between 30% and 45% of people that use BZD will have withdrawal syndrome. That means  55%-70% DON'T

 

 

[[pi...]]

 

That's not a new point. If you're canvassing the site for what your experience will be like it's relevant that there are outliers here. If you are here for support I don't think it makes a difference at all. Everyone here is part of the reality of Benzo users. It's a drug that you can't just stop taking, and for most people that is serious business whatever their outcome. Who are you tilting at by saying this again and again?

 

You just proved my point.

 

Benzos ARE actually a drug that many people DO stop taking and have NO significant W/D.

 

People just stop taking benzos every day -- and have no withdrawal -- in fact -- MOST people who use benzos have no withdrawal.

 

The literature states that between 30% and 45% of people that use BZD will have withdrawal syndrome. That means  55%-70% DON'T

 

I have to disagree. I have spoken to many doctors over the course of my benzo "experience", each of them indicated that everyone goes through some kind of withdrawal.  How severe it can be is the variable here.

 

FYI:

 

The title of this thread is "How long should a taper be". It has gone completely off topic so if you do not have a response related to the original topic please refrain from posting here.

 

pianogirl

[[Ju...]]

A taper may be very, very long.  I have been tapering from 15 mg. of Valium for two and one-half years.  That does seem excessively long, but I have a good bit of fatigue, and so I think that, for me, the slow way is best.  I have had very few symptoms except for the fatigue, and, right now, no-doz tablets (equivalent of one cup of coffee) are helping me deal with the fatigue.

 

I got very demoralized recently when I realized that I might be reducing from 2.25 mg. of Valium for more than a year ahead, maybe two.  This just made me feel awful.  But I am trying liquid titration, which is faster, and I hope for the best.  I did hold today at two-fifths of the .25 reduction that I am currently doing.  I hope that my symptom of fatigue will reduce shortly.

 

This web site is invaluable.  You are my only source of support.