Daily Micro-Tapering Support Group

[Guest [ba...]]

I understand what you're saying. But then why would it take so long to feel better when I updose back to the last level I felt good at? Could it be blood levels have fallen and take time to build up again? Or something else?  I just don't understand why it might take 4-5 days after a cut to feel sx's but than much longer than that to feel better after updosing to the last level I felt good. Any explanation? Or any idea how to feel better faster. I hate holding and waiting and would rather feel good and taper more slowly. The holding and waiting brings on the anxiety and despair.

 

There are a couple of things competing here - the 'demand' dose and the 'therapeutic' dose.  When you fall below your demand dose, symptoms are likely.  When you are above the minimum therapeutic dose, you feel relief.  Between 'demand' and 'therapeutic', you would normally feel nothing, but since you're in the middle of this long (and lousy) taper, the 'nothing' that you would normally feel is compromised by doubt, anxiety, fear, residual muscle/joint pain, etcetera.  Add to this that the 'demand' and 'therapeutic' dose levels are slowly changing.  In theory they 'should' both be declining, but there are a lot of folks who have found that reinstating to a previously effective level no longer works for them.  In other words, the therapeutic dose requirement has actually increased (the paradoxical response that some people experience).

 

So when you up-dose, it's like you aim for a target, but the target has moved a little bit, and you're all tired and flustered and achy from days or weeks of withdrawal.  It's not entirely unexpected to me for the recovery (from up-dosing) to take longer.

 

In theory, you can bring the level of benzo back up more quickly than the 3-4-5 days that it usually takes to build up.  However, you need to be able to do some first order decay calculations to predict how much extra is required. 

[[bu...]]

Just FYI, when I repeatedly got slammed trying to drop from 9 to 8.5 (C&H) when I updosed I went to 12-11-10-9 on consecutive days.  This "jumpstarted" the cumulative effect of the updose.

[[...]]

So which is higher- demand or therapeutic dose?

This is so darn complicated!

I just know that it takes me soooo long to feel better when I updose. It takes really really long if I wait to updose. I know some ppl say do it w/in a wk. I guess it takes me feeling really bad to accept an updose and by then I'm feeling really bad...

 

If I'm feeling bad now, should I do a significant updose and then start a slower taper? Like 0.015 mg/day. Or just wait it out?

[[li...]]

Anne--updosing has worked for you?  I'm just so unsure because it's been hell since I crossed from A to K a year ago. I totally felt better with every A updose but klonopin sucks rocks.

[Guest [ba...]]

Just FYI, when I repeatedly got slammed trying to drop from 9 to 8.5 (C&H) when I updosed I went to 12-11-10-9 on consecutive days.  This "jumpstarted" the cumulative effect of the updose.

 

Probably a little overkill.  A single dose of 10 would have (theoretically) compensated for multiple days @ 8.5.  But it worked for you, and that's all that really matters.

[[li...]]

I'm at 1.19 mg K and doc won't prescribe more than 1.25. What is the equivalency in Valium?  11.9 and 12.5?  That doesn't leave much room to updose so if 1.25 doesn't work im screwed

[[ca...]]

Your dose of 1.19 k would = about 24 mgs v that`s Ashton`s thoughts a lot of Doc`s say it to high mine did say 1mg k = 10 mgs v  ~~~~ BIG  confusion on this subject !

[[bu...]]

I'm at 1.19 mg K and doc won't prescribe more than 1.25. What is the equivalency in Valium?  11.9 and 12.5?  That doesn't leave much room to updose so if 1.25 doesn't work im screwed

The generally accepted conversion is 20X, (.5K=10V) so 1.19 and 1.25K would be ~24 mg V and 25mg V.

 

http://www.benzo.org.uk/bzequiv.htm

[[Ul...]]

If C&H works for you, that's what I would do if I were you.

Thanks. I am glad MT worked so well for you and others. Who knows I may try it much later on in my taper. 

 

You won't have "much later" in your taper...you're about done, girl!! Congrats. Oh...I love the shirt (Benzo Awareness Day). I participated in that too.

 

Bless ya!

 

Jeff

[[Sh...]]

Libr if its taking so long then maybe you dont updose enough. I dont get why people do tiny updoses that dont make much difference and then stress about why things arent working and why they dont feel different.

 

When I updosed, if I was feeling terrible at 1.5mg V Id go back up to 2mg, or 2.5. That got the job done.

[[Ki...]]

I think everyone is different with that equivalency chart. My ambien/xanax equivalency should have been an Ashton level of 13.6 V. I crossed over slowly and quite bumpy but was having hideous symptoms from tolerance anyway so I just took a little less V each day than recommended during my cross and ended up at 11 V not feeling perfect but pretty good. Metabolism must have something to do with it as well since some people say they couldnt even get up to a 1/10 ratio much less 1/20. I think the lucky slow metabolizers get to take less from what I read. Since everything I was taking I metabolized fast I was kinda screwed from the beginning. So you just start out at Ashtons high level but if you cross slowly you should day by day be able to tell what dose feels right and hopefully end up in a decent place.

[[Ma...]]

If C&H works for you, that's what I would do if I were you.

Thanks. I am glad MT worked so well for you and others. Who knows I may try it much later on in my taper. 

 

You won't have "much later" in your taper...you're about done, girl!! Congrats. Oh...I love the shirt (Benzo Awareness Day). I participated in that too.

 

Bless ya!

 

Jeff

Jeff,

You are the best! To klonopin people I am lower than Valium people think becasue they don't end up on our crazy doses. Imagine 160mgs of Valium  Thank you. I am so glad you participated. I hope you are feeling well. You are always in my thoughts and prayers. I don't check threads as much, but I do check PMs. I am always here if you want talk. Sending lots of love, healing hugs, and light to you and your wife

XO Maya

 

Gard

Hi!  :smitten:

 

Kittybeanbag,

I am guessing you did more genetic testing. If you metabolize rapidly like me then maybe you would do better with cut and hold. I had to taper slower and felt worse with MT. I know many people do well with MT. My body doesn't like a lot of changes at once. I guess because feels things so quickly. I have also tried to not worry about how I metabolize anymore. I drove myself crazy at times. I just dose more, feel cuts quicker and recover quicker, and know that I have less benzo in my system than most at my dose. None of that affects my cut rate for me. I also did not mess with grapefruit juice or other inhibitors. I thought about it briefly and SG made a good point about not being sure how much it will affect me etc. Also you can add another dose to help ID WD. I also have some tips for ID WD if you want. I know not many can relate. I hope your taper goes well!

 

XO Maya

 

[[ga...]]

I don't think there's any guarantee that holding will resolve all of your symptoms.  It would be nice, but...    fwiw - I don't monitor the long hold thread - maybe there are people who benefit that much from multi-month holds.  It's just hard for me to believe that they reach 80-90% baseline very often.

 

Don't hold 'stability' to too high of a standard.  '65' may have to be a good enough baseline for your taper for a while.

 

Finally, your symptoms may resolve if you up-dose, but you'll have to come back down through this dose eventually.

  I know that long holds seem to be the preferred response here to emerging/worsening symptoms, but lets look at the processes that cause, and resolve, withdrawal discomfort.This is tolerance...the therapeutic effect of the drug is diminished

When you take a benzo over a period of time, the body makes changes to respond to its presence...it lowers the response to the med by down-regulating the receptor system.  .  So when you reduce the amount of drug, the body will begin to respond by repairing the receptor system.

 

Emerging or worsening symptoms are almost always the result of reducing the drug faster than the body can restore the receptor network.  And a hold is simply a time delay to allow the body to upgrade the GABA response to match the current dose level.  But it means you will be symptomatic and distressed while waiting for that to happen.

An updose, OTOH, means you are restoring the dose to a level that matches the body's current GABA response capability.  It will very likely resolve your sxs much more quickly than a long, unpleasant hold.  And since it will allow you to stabilize much more quickly, it not only reduces discomfort, it allows you to proceed with your taper much sooner.

 

With each of my repeated failures while doing C&H, I updosed, and was back to baseline after about 5 days.  When I hit the only real hurdle during my microtaper (at 3.5mg) I 1) held for 10 days and got no relief, then 2) I updosed and  quickly recovered, and was able to continue my taper.

 

JMHO

 

This sounds somewhat similar to what Shipko says when he talks about using emergency doses in Xanax Withdrawal. He gives lots of examples of his patients using emergency doses to get their feet back under them so they could continue to taper. I read his book when I was tapering Xanax. I couldn't never quite get my mind around his directions about when and how much to use, though. Benzo brain again!

 

Gard

[Guest [Jo...]]

Journey--so you're saying don't hold, just reduce your cut size?  I was nano tapering and crashed and then someone suggested holding

Everyone has their own way of tapering.

Sadly, the doctors are deciding my taper, they wont let me have two years to taper 75mgs valium, as they haven't got the funds to keep me under their care for that long.

So, because of money I will suffer through too rapid a taper.

I already have bad diarrhoea and no appetite and they want me to push on through to the end.

Its up to you, but if I had my way, I would be cutting daily, and if sx emerged or got worse I would be reducing my cut, but that's just my way.

[[Va...]]

  I know that long holds seem to be the preferred response here to emerging/worsening symptoms, but lets look at the processes that cause, and resolve, withdrawal discomfort.This is tolerance...the therapeutic effect of the drug is diminished

When you take a benzo over a period of time, the body makes changes to respond to its presence...it lowers the response to the med by down-regulating the receptor system.  .  So when you reduce the amount of drug, the body will begin to respond by repairing the receptor system.

 

Emerging or worsening symptoms are almost always the result of reducing the drug faster than the body can restore the receptor network.  And a hold is simply a time delay to allow the body to upgrade the GABA response to match the current dose level.  But it means you will be symptomatic and distressed while waiting for that to happen.

An updose, OTOH, means you are restoring the dose to a level that matches the body's current GABA response capability.  It will very likely resolve your sxs much more quickly than a long, unpleasant hold.  And since it will allow you to stabilize much more quickly, it not only reduces discomfort, it allows you to proceed with your taper much sooner.

 

With each of my repeated failures while doing C&H, I updosed, and was back to baseline after about 5 days.  When I hit the only real hurdle during my microtaper (at 3.5mg) I 1) held for 10 days and got no relief, then 2) I updosed and  quickly recovered, and was able to continue my taper.

 

JMHO

As a Guinea pig for long holds, I have to agree with this. I got hit with sxs by cutting way too fast. At the start of this taper I would stabilize after a week to a couple of weeks but the last cut found my sxs increasing in intensity until I was close to disabled by withdrawal. Since the common theme of Ashton and several others is to never go backwards I felt the only way out was to hold for as long as it took. I ended up holding for 6 months and did get back to a 90-95% stability level but suffered throughout the hold. I tried updosing a couple of times but had already held for quite a while and the attempted  updoses were too small combined with my ignorance that it usually takes more than 3 days to feel better after updosing. 

 

Don't get me wrong, I absolutely believe in the power of long holds and will continue to use them as a tool but now believe getting stable as quickly as possible is the key to a successful taper and then holding after stable if needed to give the body some additional healing time. I hate to quote one of the benzo "experts" but Peart stated most don't updose quickly enough or updose high enough to avoid bad withdrawal (I didn't see this until I'd held for 3 months). Going forward I will definitely use all the tools available to make this as painless as possible. I know everyone does what feels right and am a firm believer in listening to what your body is telling you. All we can do is what works best for us individually. I wish all success in this journey!  --V

[[ga...]]

V, SG, builder, or anybody who knows,

 

I switched to liquifying 3 capsules on 7/10 (half of each dose). I cut 1% on 7/24 (2 weeks ago). I have felt pretty awful this whole time and think I want to updose to get back to even capsules (no liquifying). My doctor does not want me tapering at all right now because of some major changes in my life right now. I could just hold, but if I am going to hold I'd rather be at even capsules. It would make my life so much simpler. And I really need simple right now.

 

Is it too late to go backwards or should I just try to hold where I am? I've never reinstalled the L before, I've just held and held and held. And is updosing and going back to capsules at the same time making 2 changes and too much to do? I know you're just giving me your best guess, but I'll take it!

 

Gard

[[Va...]]

V, SG, builder, or anybody who knows,

 

I switched to liquifying 3 capsules on 7/10 (half of each dose). I cut 1% on 7/24 (2 weeks ago). I have felt pretty awful this whole time and think I want to updose to get back to even capsules (no liquifying). My doctor does not want me tapering at all right now because of some major changes in my life right now. I could just hold, but if I am going to hold I'd rather be at even capsules. It would make my life so much simpler. And I really need simple right now.

 

Is it too late to go backwards or should I just try to hold where I am? I've never reinstalled the L before, I've just held and held and held. And is updosing and going back to capsules at the same time making 2 changes and too much to do? I know you're just giving me your best guess, but I'll take it!

 

Gard

I personally think you'll be fine going back to solid pills for the time being gard. The only real change would be the increase as going back to solid pills shouldn't have any negative effect IMO.  --V

[[ga...]]

V, SG, builder, or anybody who knows,

 

I switched to liquifying 3 capsules on 7/10 (half of each dose). I cut 1% on 7/24 (2 weeks ago). I have felt pretty awful this whole time and think I want to updose to get back to even capsules (no liquifying). My doctor does not want me tapering at all right now because of some major changes in my life right now. I could just hold, but if I am going to hold I'd rather be at even capsules. It would make my life so much simpler. And I really need simple right now.

 

Is it too late to go backwards or should I just try to hold where I am? I've never reinstalled the L before, I've just held and held and held. And is updosing and going back to capsules at the same time making 2 changes and too much to do? I know you're just giving me your best guess, but I'll take it!

 

Gard

I personally think you'll be fine going back to solid pills for the time being gard. The only real change would be the increase as going back to solid pills shouldn't have any negative effect IMO.  --V

Thanks. Is it too late after 2 weeks to updose?

[[an...]]

Hi Gardner,

 

From my experience with up doses, I do not think it will be a problem.  It is a 1% up dose.  With liquefying and measuring, you can easily be off by 1 or 2% or even more depending on your measuring devices.  I would go for it.  It will make it much easier to take the whole capsules while holding rather than liquefying and removing 1% each day. 

 

Anne

 

 

[[ga...]]

Hi Gardner,

 

From my experience with up doses, I do not think it will be a problem.  It is a 1% up dose.  With liquefying and measuring, you can easily be off by 1 or 2% or even more depending on your measuring devices.  I would go for it.  It will make it much easier to take the whole capsules while holding rather than liquefying and removing 1% each day. 

 

Anne

 

Well, let's see, if one of my measuring devices is letting my daughter do it most days....yup, could easily be off by 1% even using a graduated cylinder and oral syringe.

 

Yes, the liquifying is a nuisance and only worth it if I am making progress. But if I am holding, it's just a depressing reminder that I am taking so much time and trouble for nothing.

 

I'm a bit nervous because when I updosed on the Xanax (so very long ago) it was a tiny amount (probably too tiny) and I did it after 2 days, not 2 weeks.

 

Can you tell I'm nervous if I'm checking the boards every 10 minutes?!

 

One other thing is I'm seriously considering cutting my Q even further, maybe to nothing, before my L. I go back and forth on this decision. Doctor and pharmacist do not agree on which med is more dangerous. If I do continue to cut the Q, I definitely want to be at even capsules of L during the process.

 

Gard

[[Va...]]

One other thing is I'm seriously considering cutting my Q even further, maybe to nothing, before my L. I go back and forth on this decision. Doctor and pharmacist do not agree on which med is more dangerous. If I do continue to cut the Q, I definitely want to be at even capsules of L during the process.

That's what I would do. I agree with Anne.  I wouldn't worry about the updose give its only 1%. It's so small you may not even feel it.  --V

[[ga...]]

One other thing is I'm seriously considering cutting my Q even further, maybe to nothing, before my L. I go back and forth on this decision. Doctor and pharmacist do not agree on which med is more dangerous. If I do continue to cut the Q, I definitely want to be at even capsules of L during the process.

That's what I would do. I agree with Anne.  I wouldn't worry about the updose give its only 1%. It's so small you may not even feel it.  --V

 

Thanks, V. I've been very conflicted about the Q vs L thing. I'm already cutting those darn little Q tablets because the smallest they come is 25mg, but at least I can do 2 weeks at a time and get it over with. My pharmacist was very alarmed to hear how long I had been on Q, even at 25mg and told me to ask my doctor to substitute in another sleep aid, such as Remeron. She said I could taper the Q and add the Remeron at the same time, but, frankly, I'd rather just see how low I can get on the Q rather than introduce yet another drug into the mix. My poor brain has enough to deal with!

 

BTW, the big change is a trauma therapist my doctor wants me to see, and I have turned in the biggest chicken ever just thinking about it, let alone making an appointment!   I kind of prefer my stuffing and ignoring method of therapy. After all, it worked well for me for years! No wait, that's how I ended up on the Xanax.  Scratch that. (Ha, ha, ha. Can you count the poultry references in this post, V?)

 

 

[[bu...]]

V, SG, builder, or anybody who knows,

 

  I could just hold, but if I am going to hold I'd rather be at even capsules. It would make my life so much simpler. And I really need simple right now. 

 

Absolutely agree.  I did several "convenience holds" to accomodate travel plans, and always worked it out so I would be a even tablet doses.

 

Is it too late to go backwards or should I just try to hold where I am?

 

You can updose anytime.

 

And is updosing and going back to capsules at the same time making 2 changes and too much to do? 

 

Its all the  same med.  "...going back to capsules" isn't really any change.

Gard

[[Va...]]

One other thing is I'm seriously considering cutting my Q even further, maybe to nothing, before my L. I go back and forth on this decision. Doctor and pharmacist do not agree on which med is more dangerous. If I do continue to cut the Q, I definitely want to be at even capsules of L during the process.

That's what I would do. I agree with Anne.  I wouldn't worry about the updose give its only 1%. It's so small you may not even feel it.  --V

 

Thanks, V. I've been very conflicted about the Q vs L thing. I'm already cutting those darn little Q tablets because the smallest they come is 25mg, but at least I can do 2 weeks at a time and get it over with. My pharmacist was very alarmed to hear how long I had been on Q, even at 25mg and told me to ask my doctor to substitute in another sleep aid, such as Remeron. She said I could taper the Q and add the Remeron at the same time, but, frankly, I'd rather just see how low I can get on the Q rather than introduce yet another drug into the mix. My poor brain has enough to deal with!

 

BTW, the big change is a trauma therapist my doctor wants me to see, and I have turned in the biggest chicken ever just thinking about it, let alone making an appointment!   I kind of prefer my stuffing and ignoring method of therapy. After all, it worked well for me for years! No wait, that's how I ended up on the Xanax.  Scratch that. (Ha, ha, ha. Can you count the poultry references in this post, V?)

Don't leave out the turtle lol. BG would be offended. 

[[ga...]]

One other thing is I'm seriously considering cutting my Q even further, maybe to nothing, before my L. I go back and forth on this decision. Doctor and pharmacist do not agree on which med is more dangerous. If I do continue to cut the Q, I definitely want to be at even capsules of L during the process.

That's what I would do. I agree with Anne.  I wouldn't worry about the updose give its only 1%. It's so small you may not even feel it.  --V

 

Thanks, V. I've been very conflicted about the Q vs L thing. I'm already cutting those darn little Q tablets because the smallest they come is 25mg, but at least I can do 2 weeks at a time and get it over with. My pharmacist was very alarmed to hear how long I had been on Q, even at 25mg and told me to ask my doctor to substitute in another sleep aid, such as Remeron. She said I could taper the Q and add the Remeron at the same time, but, frankly, I'd rather just see how low I can get on the Q rather than introduce yet another drug into the mix. My poor brain has enough to deal with!

 

BTW, the big change is a trauma therapist my doctor wants me to see, and I have turned in the biggest chicken ever just thinking about it, let alone making an appointment!   I kind of prefer my stuffing and ignoring method of therapy. After all, it worked well for me for years! No wait, that's how I ended up on the Xanax.  Scratch that. (Ha, ha, ha. Can you count the poultry references in this post, V?)

Don't leave out the turtle lol. BG would be offended. 

 

Oh, dear, my brain is just too s-l-o-w to come up with any turtle references.