No one heard me - help! - please read and advise!!!

[[Du...]]

I am getting zero replies to my posts so am reposting - EXPERIENCED MEMBERS, PLEASE HELP! I AM JUST STARTING!

 

 

On Sept 1, 2016, my MD and I designed a titration plan that would take me from my then [Aug 2016] 3 mg. Xanax a day to 0 benzos January 1, 2018. Fifteen months.

 

The plan is simple: use 1 mg pills and .25 pills to go down .25 mg each day for 4 weeks (October). I had no problems with my daily 2.75 mg October dosage. My Nov. dosage will be 2.50 mg/day.

 

Dr. Ashton's "Withdrawal from 4 mg Xanax" schedule is 17 1/ months. Her schedule is very different from mine because she  introduces Valium in Week 1, and Valium plays a big role in the titration. It is very surprising to see that she stops the Xanax altogether at the third month.

 

I will see my MD on Monday. But I would like to be better informed than I am now before I see him. Is my 15 month Xanax titration fine as it is? Should I learn from you why Ashton's plan which heavily substitutes Valium is better? What if he has a reason to not introduce Valium? I feel fine on Xanax but I've never taken Valium.

 

From what I had read, my 15 month titration seems to be on the long side (which is fine with me). Are there any negative consequences of a long titration? I am reading from The National Center for Post Traumatic Stress Disorder leaflet: " Prolonged taper (more than 6 months) may worsen long-term outcome." But it does not go on to say how and why? Any input here?

 

Twenty-five years ago, Ativan calmed me for 6 months; since then, taking one or another benzo has had no mental or physical affect that I can discern. (Yes I've read what it's done to my brain). Am I lucky? I had no anxiety or panic attacks before or during benzo use. No mental slowness, confusion, memory loss, etc. No physical impairments.

 

Believe it or not, my bottle says "Take 3 tablets at bedtime" [for sleep; for no apparent reason I was finishing my night's sleep at 2 am. And 3 mgs Xanax is the answer?]. So I have taking THREE of these short-activing benzos for over two years. Recognizing that inter-usage and tolerance withdrawal may lie ahead, on my own I have spaced out the 3 during the day all September. Do you agree, this makes sense, given the short half life of the Xanax? Yes I was taking 3 mg at 8 pm in one gulp. So, why over these years have I not had withdrawl symptoms of any kind? I have been taking benzos steadily for 25 years.

 

Like I said, I will be seeing my MD on Monday....but I have no faith in him or any psychiatrist at all!!!! That's why I'm asking you. I am sure that the seasoned readers here know much more than the MDs.  I have been harmed by these MDs who saw a woman going from one painful, monumental life event to another, gave her poison instead of steering her to support groups and therapists who had time to listen and advise. Thank you!!!

[[Sh...]]

Hi Duchess

 

Welcome to BenzoBuddies.  I'm sorry you find yourself in a situation to need us, but glad you came here.  You will find lots of info and support here.

 

I think I am reading your withdrawal plan right.  First of all, sounds like you have a good doctor who is willing to work with you and design a reasonable and slow taper plan.  The time frame of 15 months sounds reasonable and may work fine, or it may need to be adjusted and lengthened based on your needs.

 

It is recommended to taper no more than 10% with each drop.  By cutting .25 mgm each time, your first cut for October was an 8% cut so that was well within the Ashton recommended cut.  Your November cut of .25 will be a 9% cut.  Then your December cut will be 10%.  So far so good.  As your taper proceeds, if you continue to cut a flat .25 each time, the % cut will get bigger each time.  You might want to decrease the amount of your cuts as the taper progresses to keep you well within that 10% window.

 

The reason it is often recommended to cross over to Valium is that it is a long acting benzo, unlike Xanax which is very short acting.  You can run into problems having withdrawal symptoms between doses.  With Valium, it stays in your system longer and allows you to dose once per day and there is less inter dose withdrawal.  However, many people have tapered directly off Xanax without problems.  You can see how it goes and if you run into problems, you can consider asking to cross over to Valium.

 

The only other thing I would hope is that your doctor's taper pan is not written in stone.  It should be flexible and allow for slowing down the time frame or adjusting the cuts based on how you feel.  You need to be in charge of the details if you can.

 

Good luck to you!  Come here often for advice and to both give and receive support.  I am sending you good vibes for a smooth taper and getting completely off the Xanax.

 

She

 

 

[[bu...]]

I am getting zero replies to my posts so am reposting - EXPERIENCED MEMBERS, PLEASE HELP! I AM JUST STARTING!

 

 

On Sept 1, 2016, my MD and I designed a titration plan that would take me from my then [Aug 2016] 3 mg. Xanax a day to 0 benzos January 1, 2018. Fifteen months.

 

For clarification and to avoid confusion, here on BB titration means using liquid med to make small dose changes.  That is NOT the conventional definition, but folks here on BB will think a titration plan means you using liquid.

 

The plan is simple: use 1 mg pills and .25 pills to go down .25 mg each day for 4 weeks (October). I had no problems with my daily 2.75 mg October dosage. My Nov. dosage will be 2.50 mg/day.

 

There is an obvious problem with your numbers here.  If you cut .25mg/day, you would be at zero in just 11 days.  (2.75/.25=11)

 

Dr. Ashton's "Withdrawal from 4 mg Xanax" schedule is 17 1/ months. Her schedule is very different from mine because she  introduces Valium in Week 1, and Valium plays a big role in the titration. It is very surprising to see that she stops the Xanax altogether at the third month.

 

Xanax can be a more  difficult benzo to taper.  Valium is often preferred because of its long half-life, and the availability of lower dose tablets.  (2mg Valium is the equivalent of .1mg xanax.)  But others have successfully tapered directly from xanax.

I will see my MD on Monday. But I would like to be better informed than I am now before I see him. Is my 15 month Xanax titration fine as it is? Should I learn from you why Ashton's plan which heavily substitutes Valium is better? What if he has a reason to not introduce Valium? I feel fine on Xanax but I've never taken Valium.

 

From what I had read, my 15 month titration seems to be on the long side (which is fine with me). Are there any negative consequences of a long titration? I am reading from The National Center for Post Traumatic Stress Disorder leaflet: " Prolonged taper (more than 6 months) may worsen long-term outcome." But it does not go on to say how and why? Any input here?

 

That has certainly NOT been the common experience here.  Most folks who have done a long, slow taper have fewer WD sxs, and are less likely to have any significant residual sxs.  FWIW, my taper lasted 2 years, I had very limited WD sxs, and zero residual sxs after jumping at .5mgV

 

Twenty-five years ago, Ativan calmed me for 6 months; since then, taking one or another benzo has had no mental or physical affect that I can discern. (Yes I've read what it's done to my brain). Am I lucky? I had no anxiety or panic attacks before or during benzo use. No mental slowness, confusion, memory loss, etc. No physical impairments.

 

Believe it or not, my bottle says "Take 3 tablets at bedtime" [for sleep; for no apparent reason I was finishing my night's sleep at 2 am. And 3 mgs Xanax is the answer?]. So I have taking THREE of these short-activing benzos for over two years. Recognizing that inter-usage and tolerance withdrawal may lie ahead, on my own I have spaced out the 3 during the day all September. Do you agree, this makes sense, given the short half life of the Xanax? Yes I was taking 3 mg at 8 pm in one gulp. So, why over these years have I not had withdrawl symptoms of any kind? I have been taking benzos steadily for 25 years.

 

Like I said, I will be seeing my MD on Monday....but I have no faith in him or any psychiatrist at all!!!! That's why I'm asking you. I am sure that the seasoned readers here know much more than the MDs.  I have been harmed by these MDs who saw a woman going from one painful, monumental life event to another, gave her poison instead of steering her to support groups and therapists who had time to listen and advise. Thank you!!! 

 

BTW, you can do a LIQUID titration with xanax.  There is an Rx liquid xanax (Roxane Alprozalam Intensol).  Liquid titration is almost certainly  the easiest way to taper, especially from high potency benzos like xanax.

[[Du...]]

Hi She who must and Builder,

 

She, your totally got where I am at and your comments, recommendations and foresight are right on target. I feel much relief.

 

Builder, I made my plan unclear in the sentence "reducing .25 mg/day"[wrong] where elsewhere I had outlined that this was ".25 mg/day for 30 days [October,correct]." So, every day this month, I have been taking 2.75 mg/day Xanax. Come September, that will drop to 2.50 a day, and so on... But thank you for your sharp eye to give me a caution if I need it!

 

Builder, you wrote that you had a two year taper. Bravo for jumping off! Please tell me what benzo(s) and how you did it - Xanax by itself? Xanax with liquid titration? Xanax with Valium? Other benzos? Thanks!

 

She, thank you for showing me how the percentage of tapering goes down each month. I don't have the math skills or the plain old logic to have seen this. I will bring this to my MDs attention (in fact I am printing out your whole text). When the cut goes below 10% in January I will discuss with him how to proceed (Valium? Liquid Titration?) and touch base here.

 

Builder, thank you for telling me about Roxane Alprozalam Intensol. Is it available in the US?

 

You also wrote this - thanks:

 

From what I had read, my 15 month titration seems to be on the long side (which is fine with me). Are there any negative consequences of a long titration? I am reading from The National Center for Post Traumatic Stress Disorder leaflet: " Prolonged taper (more than 6 months) may worsen long-term outcome." But it does not go on to say how and why? Any input here?

 

That has certainly NOT been the common experience here.  Most folks who have done a long, slow taper have fewer WD sxs, and are less likely to have any significant residual sxs.  FWIW, my taper lasted 2 years, I had very limited WD sxs, and zero residual sxs after jumping at .5mgV

 

That is reassuring.

 

Yes, I used the terms tapering and titration synonymously - that's corrected.

 

Yes, this MD is a good guy. I go to a clinic; the changeover has been high. I think he will stay. He recognizes that my benzo adventure started 25 years ago when I was simply given an antidepressant and Ativan after my child died (I DID NOT have trauma, PTSD, anxiety, or panic attacks - I had stress, little support, and grief). Each life calamity that followed brought with it higher benzo orders, but again, I had no anxiety, just STRESS. Family members looked the other way, no Social Worker was around to point out support groups.  In 2013, I was the sole caregiver for a year to my abusive dying mother and cried a lot (and drank a lot). So that @#$%^& MD gave me 3 MG Xanax.Imagine that with a bottle of wine. (I've stopped drinking alcohol and coffee.) Curiously, this seemingly-much-better MD is very intelligent and intuitive....but after I read about how harmful benzos were in August and I asked him, "I've been so well since my mother died....why didn't you suggest I taper off the Xanax? I've been stress-free for two years." He replied, "Well, lets map out a taper now."

 

Please look for me if I need more help! Thank you.    xxxxxooooo

 

More insight most welcome! 

[[bu...]]

 

 

Builder, you wrote that you had a two year taper. Bravo for jumping off! Please tell me what benzo(s) and how you did it - Xanax by itself? Xanax with liquid titration? Xanax with Valium? Other benzos? Thanks!

 

I was on Valium for about 7  years, including the 2 year taper.  At one point I was at 15mg/day and did a cut-and-hold taper (.5mg/2weeks) until I got down to 9mg.  From 15 down to 9 was difficult, but at 9mg, C&H became impossible.  Once I started a daily taper with liquid, I have only occasional minor sxs.

 

 

 

Builder, thank you for telling me about Roxane Alprozalam Intensol. Is it available in the US?

 

Yes.

 

 

 

 

Yes, I used the terms tapering and titration synonymously - that's corrected.

 

In the rest of the medical universe, titration simply means small dose adjustment.  Not sure how it came to be associated with liquid tapers here on BB.

" The continual adjustment of a dose based on patient response. "  https://www.google.com/search?q=titration+med+definition&ie=utf-8&oe=utf-8

 

 

[[Sh...]]

 

Dr. Ashton's "Withdrawal from 4 mg Xanax" schedule is 17 1/ months. Her schedule is very different from mine because she  introduces Valium in Week 1, and Valium plays a big role in the titration. It is very surprising to see that she stops the Xanax altogether at the third month.

 

I will see my MD on Monday. But I would like to be better informed than I am now before I see him. Is my 15 month Xanax titration fine as it is? Should I learn from you why Ashton's plan which heavily substitutes Valium is better? What if he has a reason to not introduce Valium? I feel fine on Xanax but I've never taken Valium.

 

IMO, there is not a good reason for you to cross over to Valium at this point, for several reasons.  3 mgm of Xanax = 60 mgm of valium.  Most doctors are unwilling to prescribe that high of a dose of valium.  Perhaps as your Xanax taper gets farther along, you can consider the cross over if you start having problems tapering the Xanax.  So far, you are doing fine on the Xanax and it is an unknown how you might react to Valium.  Valium too has its challenges, as many people here who have crossed over can attest.  Please let us know how your Monday doctor's appointment goes.

 

She

[[Du...]]

Hi Builder...I was so dumb, all I had to do was call my pharmacy to find out that yes, they can easily order the liquid Xanax here in my State, although they do not stock it. Thanks for reinforcing that. And I asked you what meds you took while they were right there in the signature. [sigh].Distracted. I drove to my MDs office and gave his receptionist an envelope of the best authoritative writings I could find on benzo tapering including the two scenarios: Xanax with liquid or Xanax shifting over to Valium, with a note asking him to look the pages over before I see him on Monday (sessions are brief).

 

I  share your outlook, She, on my staying on a slow taper of the Xanax...for the duration if possible. I have had no side effects from any of these benzos...once prescribed, MDs recognized, I conjecture, that maintenance was necessary, so almost at whim they've moved me from Ativan to Klonopin to Xanax. No reaction/no benefit/no side effects. A waste of effort, time, and money. I have never taken Valium so I prefer not to try, although whether I need it during my taper won't show up for months yet.

 

Here is the Xanax only (tablet and liquid) titration schedule (25 months) I just left at my MDs office. Thanks for asking--I'll update on Mon.

 

10 percent reduction method- XANAX tablets and Alprazolam Intensol Oral Solution (Concentrate), C-IV

 

2016  September – 3 mg/day Xanax

October – 2.75 mg

November – 2.50 mg.

December – 2.25 mg

2017 January – 2.15 mg

February – 2.05 mg

March – 1.95

April – 1.85 mg

May -  1.75

June – 1.65 mg

July – 1.55

August – 1.45

September -  1.35

October – 1.25 mg

November – 1.15

December – 1.05

2018 January - .95

February - .85

March - .75

April - .65

May - .55

June - .45

July - .35

August - .25

September - .15

October - .05

November – BENZO FREE

 

 

[[Sh...]]

Duchess, this looks like a really good taper plan.  Using the combination tablets/liquid makes it so much more doable, and with a higher degree of accuracy than trying to dry cut tablets.  Kudos to you and your doctor for working together to come up with a working plan. 

 

I will reiterate my advice to let the plan be flexible according to your needs.  Listen to your body.  There may be times when you have to hold a bit longer or make the cuts smaller.  Also adjust the plan according to what might be going on in your life.  Life events that bring added stress, unforeseen illnesses, challenging travel schedules, etc. are the time to hold and not cut until things have settled out.

 

Good luck, and keep us updated as you go along.  Sharing your personal experience is helpful to others going through the same thing.

 

She