How long does it take for benzos to leave your system?

[[Re...]]

Hi, Colin - I read through this thread, as I am at .25 mg ativan and hoping to be both jumping and better by the mid to end of January. A while back in the thread you said (if I remember correctly) that with ativan, because it has such a short half-life, that the point where it is out of your system could be as fast as a week.  Did I understand that correctly?  Also, from your experience, what are the most pronounced w/d symptoms (most common, I guess I'm asking) with it after that last amount has left the body?  So far during my taper  I'm having anxiety and some depression, mild visual blur, what feels like nasal allergies, and mild stiff neck.  Oh, and insomnia but it seems to respond ok to valerian root, melatonin, a few other herbs and l-theanine and benedryl if needed (not every night). 

 

Thanks!

ReadyToBeWelll

[[Co...]]

Hi,

 

The decline in blood levels follows a curve, so that greater reductions occur at first, with smaller and smaller reductions over time. The rate of decline is relative to blood levels at the time, so as blood levels drop, so do the absolute amounts. The upshot is that it probably takes some considerable time for all the benzo molecules to clear the system, but for a benzo like Ativan, with a rather short half-life, blood concentrations (in my estimation) probably drop to undetectable levels within a week or two (there will be some considerable variability, as individuals metabolise benzos at different rates.

 

Withdrawal symptoms occur any time your blood levels drop faster than your brain can compensate. Some people can withdraw very quickly (even after protracted use), whereas others might have to withdraw very slowly, even after just a month or two of taking benzoduiazepines.

 

Taper at a rate where withdrawal symptoms are manageable for you. Any suggested taper rates are just ball park guidelines of what works for the majority of people - you should tailor the rate you withdraw according to how you react.

 

Here's a list of withdrawal symptoms, roughly blocked according to frequency of occurrence: http://www.benzobuddies.org/benzodiazepine-information/withdrawal-symptoms

[[Re...]]

Thank you, Colin!!

[[Re...]]

My problem is a bad one in this case: I am not patient. I can be patient w/ a child all day but as far as in things I feel I should control, I'm crappy at it.  And in this case, I am sick thanks to bad advice and poor treatment from a doctor, so it is very accidental, and I'm not only not real patient, I'm angry, too.  However....that doesn't help does it?  What is gonna help is being patient, smart and gentle with myself. 

 

Thanks again.

[[pe...]]

Question for Colin: is temazepam a fast, slow, or medium-acting benzo? I'm just starting my taper and received the 100-day plan earlier today. Does recovery from chemo, radiation, surgery mean that I should take this slower?

 

Patsy

[[Pa...]]

Hi Patsy,

 

I'm not sure if Colin will see this, so I wanted to let you see this table which gives you information about Temazepams half life.  http://www.benzo.org.uk/bzequiv.htm

 

Your general health should always be taken into account before starting and deciding upon your taper.

[[pe...]]

Wow. You are super fast. What would be your recommendation for me re: the timing? Surgery in March, chemo from March to August, radiation from September to October, and surgery in December. I feel pretty stressed out about the benzo thing, but I know I need to start, and I want to do this as easily as possible. Help.

 

Patsy

[[Pa...]]

Hi Patsy,

 

When you start should depend on how it's affecting your life.  If you're uncomfortable and you suspect it's from the drug, then it makes sense to start now.  If you feel you can wait until you feel more confident with the process, then you can begin this at a later date.  By the time most folks get here, they're pretty miserable from inter-dose and tolerance withdrawal symptoms, so they start straightaway.  This is a long and for most a painful process, so being ready for it emotionally, mentally and physically is key.  Having support in your real life is important as well, so you might want to ensure your family is ready too.

 

Pam

[[pe...]]

Thanks, Pamster. Right now, it's hard to tell what part the temazepam is playing in my fatigue and lack of energy, etc., because of all the treatment. But I am hoping that if I remove that part of it, at least I will know--and hopefully feel better.

 

Patsy

[[dr...]]

Hi Patsy,

 

I too take Temazepam and feel fatigued some days. I'm very interested in hearing how your taper is going. I wish you the best of luck.

 

Shell

[[al...]]

I think that the topic should take into effect that the half life can be as long as 200 hours for valium based on half time duration after taking it for a couple days.It is out of our systems  quite quickly but after taking it for months or years its the effect on the gaba system in the brain that has been altered that takes time to recover..That in my opinion is the real withdrawal problem is that the system is atrophed some what.Gabba is the most wide spread nuerotransmitter in the body.It has a calming effect and is found in every area of the body.So my answer is its no longer  the half life of your benzodiazapine of chose but how long after you discontinue until your gabba system will return to normal.With me it took about 6 months and still would say after 9 months I feel like my brain is slowly returning to normal and the w/d is almost gone.Now I took benzos for 25 years so you can hope you will recover quicker my freinds.

[[re...]]

its my birthday tomorrow, and all i wanted was to be back in reality

guess not.

the d/r for me and burning arms till about 2 pm is really making me nuts. want to talk to the doc about permanent addiction- yes, i was on clonazepam -K for maybe 4 years or more... Damn. we know that's not the thing to do.

 

now i see the time frame i really feel bad about that but have no real choice. the docs told me about the narcotic w/d i said i can have the sniffles for 3 weeks and did- but not 6-18 months of Benzo Hell. would like to ride my motorbike this summer, but the further i go the less likely that looks now.

[[xe...]]

The whole thing is flawed.. Half-lives don't really apply after 6 or 7 cycles.. it's plasma half-life which isn't the end-all for "benzos in your system" (especially after taking them for months/years).. it doesn't even really reflect receptor half-life, which is typically much longer.. and you totally forgot about active metabolites

 

But I think I am only supporting your point here Colin in that.. don't bother trying to figure it out!

 

It might be a little more interesting to try and figure ranges for your plasma levels to drop to the new cut's level, but there are too many variables, and theoretically, if you are only using plasma half-life math, if you are on Valium or Klonopin, as they have a half-life of well over 12 hours, your plasma levels are beyond measure and shouldn't actually drop at all while tapering as your dose is still stacking. Only further goes to show you how far half-life math will get you.

[[Co...]]

Hi Xenofears,

 

This thread was posted because people often ask this question. It is not meant to be a realistic guide of what will happen to a member in specific circumstances; it is certainly a simplified model. Because the half-life value varies so much within individuals (even for a specific benzodiazepine), and because of the cumulative effect of half-life over several cycles after their last dose, actual blood levels will vary enormously across individuals, even if they took the same dose of the same benzodiazepine and quit at the same time. I have demonstrated this effect in my examples.

 

The half-life figures I use reflect the published half-life figures, which generally take into account the overall half-life figure (including metabolites). This guide is only meant to demonstrate that it can take some considerable time for longer half-life benzos to leave your system; that short half-life benzos drop to undetectable levels really quite quite quickly; and that it is not possible to know the specific blood levels in any particular case (not that it is important).

 

What probably is a more important issues associated with different half-life figures is that many people (including some doctors) fail to appreciate that it can take some considerable time for long half-life benzos to reach steady-state levels. That is to say, it takes time for the benzo to build up in the patient's system. And, even less well appreciated by patients and doctors is that when a patient switches from a short half-life benzo to a long half-life benzo, blood levels will drop quickly for the short half-life benzo being dropped, and blood levels will be slow to build with the long half-life benzo. This can result, in the short-term, in the patient suffering withdrawal symptoms, even if the equivalent dose if correct for them*. For this reason, substitution should be carried out gradually, as the equivalent (short-term) drop in blood levels will be a proportion of the amount substituted. Clearly, if only a small proportion of their dose is substituted, and they allow some time for the substitute benzo to build up in their system, their (short-term) withdrawal symptoms will be limited.

 

Different benzos also have differing therapeutic profiles. So, similarly, this is another reason for substitution to be carried out gradually, allowing the patient to adjust to the substitute benzodiazepine.

 

Although I do not know this for sure, I imagine that the half-life value might increase with higher doses (and accumulation), because from my layman's perspective, there my be limits on how much benzodiazepine can be efficiently metabolised by the body. Is this is what you mean by "Half-lives don't really apply after 6 or 7 cycles"? Or some other effect? Either way, because we cannot know the half-life value for an individual, and it will vary according to other meds they might take, the food they eat, etc., it was only ever meant as the roughest approximation.

 

I think this does point to a possible better method for substitution: tests to determine blood levels before substitution**; substitution carried out gradually to limit problems with differing therapeutic profiles; a tailored substitution dose extrapolated from the blood levels of the original benzo blood levels test***; and a loading dose for benzo taken in substitute to avoid a drop in (equivalent) blood levels.

 

I cannot imagine such a method happening, because I cannot imagine anyone going to the expense or trouble. I'm just theorising and chewing the fat (I should probably have posted this reply to the Chewing the Fat board).

 

*Equivalent doses will vary across individuals. This is largely dependent upon how quickly they generally metabolise benzodiazepines.

 

**Probably best achieved by two tests between doses, to properly determine how fast the benzo is metabolised by the individual in question. I imagine a single test would not be sufficient to determine half-life accurately (although a rough extrapolation from daily dose to blood levels might be possible, especially for longer half-life benzos). Having said this, it usually would be the case that this figure would be required for a shorter half-life benzo, so two test would be required.

 

***I am assuming that individuals will metabolise all benzodiazepines similarly quickly or slowly. So, we could extrapolate the half-life value of a particular benzo for an individual, if we know how quickly the individual metabolises another benzo.

[[xe...]]

This thread was posted because people often ask this question. It is not meant to be a realistic guide of what will happen to a member in specific circumstances; it is certainly a simplified model.

 

Woah, I know that Colin.. sorry if I didn't make that clear. My overall point was to agree with you, yes no matter how you try to figure it you aren't going to get any useful information. I was just having some fun for more technical discussion, that's all.

 

The half-life figures I use reflect the published half-life figures, which generally take into account the overall half-life figure (including metabolites).

 

I'm nearly certain the half-life for diazepam itself is 20-100 hours with another 20-200 hours for the metabolites, but I'll go look it up later.

 

What I meant by half-lives aren't meant to apply after 6-7 cycles, is that a drug is considered eliminated at that point (from plasma.. from a single dose.. at least).. half-lives aren't meant to do perfect math even if we had an exact half-life number down to unmeasurable levels.

 

Might have some fun chewing of the fat to do with you, but not so early..

[[Co...]]

This thread was posted because people often ask this question. It is not meant to be a realistic guide of what will happen to a member in specific circumstances; it is certainly a simplified model.

 

Woah, I know that Colin.. sorry if I didn't make that clear. My overall point was to agree with you, yes no matter how you try to figure it you aren't going to get any useful information. I was just having some fun for more technical discussion, that's all.

 

I know - that is how I took it. I saw your post a few days ago when you published it. If I had a problem with it, I'm sure I would have responded at the time.

 

The half-life figures I use reflect the published half-life figures, which generally take into account the overall half-life figure (including metabolites).

 

I'm nearly certain the half-life for diazepam itself is 20-100 hours with another 20-200 hours for the metabolites, but I'll go look it up later.

 

According to Ashton, 20-100 hours for diazepam, and 36-200 hours for the active metabolites. I've always understood that the 36-200 hours includes the unmetabolised benzo - I could be wrong, but I don't think I've ever come across the upper limit, for diazepam, expressed as anything other than 200 hours (except in the hepatic impaired).

 

What I meant by half-lives aren't meant to apply after 6-7 cycles, is that a drug is considered eliminated at that point (from plasma.. from a single dose.. at least).. half-lives aren't meant to do perfect math even if we had an exact half-life number down to unmeasurable levels.

 

I had suspected that the half-life would vary within an individual for various reasons (probably for a lot of reasons of which I am totally unaware). I think, 6-7 cycles is probably not enough for those on high does, unless, of course, the half-life figure decreases as blood levels drop, and the shortening in the half-life figure is not taken into account. I'm just musing - I accept what you are telling me.

 

Might have some fun chewing of the fat to do with you, but not so early..

 

Like the titration discussion, I think this a subject where we need a specialist - this time, a pharmacist.

[[xe...]]

Like the titration discussion, I think this a subject where we need a specialist - this time, a pharmacist.

 

Nah, we'd need a (good) pharmacologist and the only way we'd really get anything definitive is if they ran blood tests on people going through benzo tapering and w/d... chronic dosing is quite different from single dosing for sure. Still that only tells us what's going on in the plasma though. There might be some interesting studies to look for out there already though. I know I saw a study where they tested the blood of people on clonazepam and the levels varied over 10 times person-to-person!

 

Urine tests might be interesting as they are somewhat reflective of blood levels as well, and there are urine tests that can actually come with a little (relative-only) dipstick for levels, I think I posted this idea somewhere on the board to see if anyone was curious enough to spend the money to chart the decrease of levels but no one responded.

[[sp...]]

 

According to Ashton, 20-100 hours for diazepam, and 36-200 hours for the active metabolites. I've always understood that the 36-200 hours includes the unmetabolised benzo - I could be wrong, but I don't think I've ever come across the upper limit, for diazepam, expressed as anything other than 200 hours (except in the hepatic impaired).

 

Another thing to keep in mind is that benzos are fat soluable; it's reasonable to expect that actual eliminaton time is somewhat depenant on BMI. I'm 6'1", 140lbs, and am thus likely to eliminate benzos faster than someone who's 5'7" 140lbs.

 

Past a point, though, you're right that it's not really worth thinking about this stuff any more than you have to. I'm trying to go about my normal daily life as much as possible without ruminating on my benzo situation, because I find for me that the more I think about symptoms, the worse they are. There are probably psychological and physiological reasons for this. For example with tinnitus, tinnitus is heavily correlated to muscle tension in specific craniofacial muscles even among people with no benzo issues. When I really think about my T, I tend to tense those muscles, which literally makes it worse. I also suspect that focusing mind on a particular nerve can literally increase the amount of activity at that nerve, and this is something which is to some degree supported by research.

 

I'm not at all trying to imply that benzo w/d is "in your head", clearly it's an insidious mechanical process happening at the lowest level of intercellular interaction. My point is just that mind is incredibly powerful, mind creates reality, and reality is not the immutable thing that most people deem it to be in their day to day lives. You can't think yourself out of benzo w/d, but I for one can certainly make things worse by ruminating on them.

 

That's probably a subject for a whole other thread.

[[Co...]]

Another thing to keep in mind is that benzos are fat soluable; it's reasonable to expect that actual eliminaton time is somewhat depenant on BMI. I'm 6'1", 140lbs, and am thus likely to eliminate benzos faster than someone who's 5'7" 140lbs.

 

As far as I know, BMI is not an issue, but weight will affect the dose required for a particular blood concentration (as will how efficient an individual metabolises benzos, of course). Even if BMI does have an effect, it will be one effect amongst many that will determine the dose required by the individual to achieve a particular therapeutic effect.

 

I'm not at all trying to imply that benzo w/d is "in your head", clearly it's an insidious mechanical process happening at the lowest level of intercellular interaction. My point is just that mind is incredibly powerful, mind creates reality, and reality is not the immutable thing that most people deem it to be in their day to day lives. You can't think yourself out of benzo w/d, but I for one can certainly make things worse by ruminating on them.

 

Agreed. This is why we try to take a positive approach around here. It can't hurt, and it might help. Whereas, as we all know, a pessimistic approach, dwelling upon withdrawal symptoms, worrying about what might happen, etc., never helps.

[[xe...]]

Another thing to keep in mind is that benzos are fat soluable; it's reasonable to expect that actual eliminaton time is somewhat depenant on BMI. I'm 6'1", 140lbs, and am thus likely to eliminate benzos faster than someone who's 5'7" 140lbs.

 

As far as I know, BMI is not an issue, but weight will affect the dose required for a particular blood concentration (as will how efficient an individual metabolises benzos, of course). Even if BMI does have an effect, it will be one effect amongst many that will determine the dose required by the individual to achieve a particular therapeutic effect.

 

Benzos do, for sure, build up in fat cells (specific tissue types I can't remember the name of.) But this is probably irrelevant to w/d. It stays there and is released extraordinarily slowly, so slow that it shouldn't really have an effect on blood concentrations at all.

 

Benzo metabolism seems to vary wildly based on many factors we don't know.

[[Co...]]

Benzos do, for sure, build up in fat cells (specific tissue types I can't remember the name of.) But this is probably irrelevant to w/d. It stays there and is released extraordinarily slowly, so slow that it shouldn't really have an effect on blood concentrations at all.

 

Xenofears, I'm glad you mentioned this.

 

I have posted quite a number of times - to correct what is quite a common myth - that although benzodiazepines are absorbed by and collect within fat cells, this does not affect withdrawal. If the benzo is permanently tied up in the fat cell, it cannot affect GABA receptors. If is released from the cell, it will be metabolised into non-active compounds and expelled from the body. And if, as you suggested Xenofears, it released extremely slowly from fat cells - so that benzos remain in our blood stream for a very protracted period - blood concentrations must be extraordinarily low and will have no effect. Whichever way we look at it, this is not a problem.

[[xe...]]

Benzos do, for sure, build up in fat cells (specific tissue types I can't remember the name of.) But this is probably irrelevant to w/d. It stays there and is released extraordinarily slowly, so slow that it shouldn't really have an effect on blood concentrations at all.

 

Xenofears, I'm glad you mentioned this.

 

I have posted quite a number of times - to correct what is quite a common myth - that although benzodiazepines are absorbed by and collect within fat cells, this does not affect withdrawal. If the benzo is permanently tied up in the fat cell, it cannot affect GABA receptors. If is released from the cell, it will be metabolised into non-active compounds and expelled from the body. And if, as you suggested Xenofears, it released extremely slowly from fat cells - so that benzos remain in our blood stream for a very protracted period - blood concentrations must be extraordinarily low and will have no effect. Whichever way we look at it, this is not a problem.

 

Yep. I'd be concerned with the possibility of it getting "stuck" in your brain itself, but not a darn thing you can do about it, so.....

[[Pe...]]

One more thing that I wanted to add is that w/d symptoms from benzos happen differently than with other types of addictive drugs.  The benzo doesn't mimic the neurotransmitter (aka as an agonist) like other addictive drugs.  The benzo actually adheres to the GABA neurotransmitter receptor site and makes the receptor site itself more efficient.  The brain sees this, and in an attempt to maintain homeostasis says to itself, since these receptor sites are now so efficient lets eliminate the ones we don't need to maintain the same level of efficiency.  So your brain actually down-regulates, or, eliminates GABA receptors in the brain and they are absorbed into the neurones.  These receptors are slowly reinstated after drug withdrawal.

 

So when you take away the benzo you now have a) no more super efficient receptor sites and b) less receptor sites than you had before taking the benzos.  You can read about this in the 2011 Supplement to the Ashton Manual at:

 

http://www.benzo.org.uk/ashsupp11.htm

 

So it is not a matter so much of being recovered when you get all of the benzo out of your system as it is your brain returning to normal after changes it made due to the benzo.  That is also why tapering is better because it allows your brain to start reinstating these receptor sites as you loose super efficient ones.

[Guest [Si...]]

Mathematically,

 

To explain this I am working on a graph.

The Graph basically deals with Exponential Decay.

http://en.wikipedia.org/wiki/Exponential_decay

 

I will publish the graph, as far as the equation, they are not relevant.

(Differential Equations).

 

S#

[[Cr...]]

I have a question on this.  Once you have tapered off Benzo's.  The one I am on is Valium.  How long does the effects stay in the body or brain neurons.  I was rejected from a meditation group.  The requirement no meat (or animal products, cigarettes or alchohol for 3 months.  That's no biggie for me (well I would miss some feta in my salads - small price).  Then I told them I was on a Valium.  They check with a doctor in LA who doesn't even know me and said it take 3 years to have this medication out of body.  I looking so forward to being a part of learning meditation as my former therapist before retiring gave me their number.  I thought yes finally inner peace.  Some guidance to control mind chatter.  Mind chatter will chatter with chatter....  I felt so dirty and ashamed. Had I have known ahead of time I would never had taken meds.  I was in fear of non compliance.  So I am curious. Once a person is free of benzo's how long is it in the body?