Can anyone make sense of this to explain to a layperson?

[[Ma...]]

I know i am in way over my head with your guys discussion but i am just wondering there is a familiarity with Dave Asprey's podcast I found show 512 with Matt Cook to be the most interesting in terms of experiments on neuropathy I prefer not to try to explain it since it is complicated. But it should be pretty easy to find. In general  the discussion is in regard to stem cell therapies.

[[cs...]]

Been reading a bit about acetylcholine.

 

I wouldn´t be surprised if I felt more clear minded after my evening dose (one a day) because it boosts acetylcholine, possibly in the nucleus accumbens.

 

https://www.ncbi.nlm.nih.gov/pubmed/23040810

 

Maybe that´s why beign active is required for tapering ? I used to be more active during my first real tapers.

 

https://en.wikipedia.org/wiki/Neuromodulation#Cholinergic_system

 

´Cholinergic system

 

The cholinergic system consists of projection neurons from the pedunculopontine nucleus, laterodorsal tegmental nucleus, and basal forebrain and interneurons from the striatum and nucleus accumbens. It is not yet clear whether acetylcholine as a neuromodulator acts through volume transmission or classical synaptic transmission, as there is evidence to support both theories. Acetylcholine binds to both metabotropic muscarinic receptors (mAChR) and the ionotropic nicotinic receptors (nAChR). The cholinergic system has been found to be involved in responding to cues related to the reward pathway, enhancing signal detection and sensory attention, regulating homeostasis, mediating the stress response, and encoding the formation of memories.[19][20]

GABA

 

Gamma-aminobutyric acid (GABA) has an inhibitory effect on brain and spinal cord activity.[13] ´

The last sentence: yes, and there is no benzo that does that as much as clonazepam.

 

Given the fact that a certain opiate has muscle relaxing proterties, which would bring back clonazepam´s muscle relaxing properties to what it used to be and the general state of my muscle fibers, I wouldn´t be surprised if acute withdrawal meant extreme physical pain.

 

Not expecting any true answers here. I´m at the end of a medical  experiment that has been running for 5 years. With, for situations like these, the worst healthcare system in the world.

 

Interesting, especially about the pain.  I am in a bucketload of pain.  It's my most significant issue (followed closely by a wheelbarrow of others).  The burning body is not pleasant.  It started with the lorazepam, was mitigated (as was all my withdrawal originally) by the gabapentin.  But now, the piper needs to get paid, I guess.  I was so darned close to getting off the gabapentin last fall........  Aaaaggghhh. 

 

I was thinking that acetylcholine might be an answer too.  Unfortunately short-term dosing of citicholine didn't go well.  It boosted all my pain somewhat but REALLY messed with my thinking.  I had a very hard time for about a 2 week period after citicholine.

 

-Maybe I'll just give cannabis a go..........

 

:thumbsup:

 

On another matter of pain.  I have some corydalis yanhuoso.  It's mechanism of action is varied but one of the things it does is influence Dopamine receptors.  I took a little a few nights ago and a few hours later my pain was intense, intense, intense but particularly located where I have my predictable restless leg syndrome discomfort.  I find this particularly telling given the purported role of dopamine / dopamineR's in RLS. 

 

I know among everything else, you and I both wish we'd avoided the Lorazepam disaster!

 

-RST

 

Hi RST, add me to that list. Also affected by lorazepam.  Nowadays its bigger everything, and supersized everything, and turbo charged everything from our food to our cars, to the medications.  They decided to supercharge the Benzodiazaphine several decades ago, when they should have just left the valium and librium as it was.  More potent is not necessarily better

 

Your experiences with various GPCR modulators is consistent with the model.  They are very potent neuromodulators and they are what allow us to function, somewhat, even well into tolerance.  THey are more of those “knobs and switches”.  But the circuits can only take so much for some of us........

 

The cannabis is interesting. They have some very knowledgeable people on BB for this.  You probably already know about the thread on here.  They might help you prepare for it.

 

DM, you are so correct.  I don't do a lot of fiddling around with direct action supplements/drugs that often.  The citicholine was 4 months ago.  The Corydalis was a week ago and one dose.  You may know it is primarily defined as a pain medicine but, as we've discussed about so many of these supplements, multiple other mechanisms of action that are unpredictable can co-occur.

 

As a side note, I came across a very interesting recent study on α2δ-1 subunits and VACC's. 

 

https://reader.elsevier.com/reader/sd/84CE83480C24C1F28C6CBBA35D45CE22B83BF25DB6E95BCB68CFAA3C9236C0FEF9C47ABC608CB6B904FAD5244F5686DE 

 

This study makes some groundbreaking claims about gabapentin's main mechanism of action in nerve pain. 

 

"Gabapentin and pregabalin bind to both a2d-1 and a2d-2(Marais et al., 2001). Unlike a2d-1, which is mainly expressed in excitatory neurons, a2d-2 is predominantly expressed in inhibitory neurons (Cole et al., 2005; Taylor and Garrido, 2008) and may mediate some of the adverse effects of gabapentinoids, such as dizziness and sedation. We showed that the designed peptide targeting the C-terminal domain of a2d-1 effectively disrupted the a2d-1-NMDAR association and normalized the synaptic NMDAR activity and pain hypersensitivity induced by nerve injury. Because this sequence is unique to a2d-1, it is conceivable that drugs that target this domain may have fewer adverse effects than gabapentinoids. Both a2d-1 and NMDARs are coexpressed in many important brain regions. Because we demonstrated that a2d-1 can physically interact with NMDARs and increase their activity even in a cell line, such interaction is unlikely to be limited to the spinal cord. Thus, targeting a2d-1-bound NMDARs may be a promising strategy for treating neuropathic pain and other NMDAR-dependent neurological and psychiatric disorders such as epilepsy, neurodegenerative disease, anxiety, and alcohol and drug dependence."

 

So, chronic gabapentin use may very well influence gabbaAR's akin to long term low dose benzodiazepines modulation???  Looks like this could be the case and that all the focus on VACC's as the primary mechanism of action could be misleading.  There has been some vague sense of NMDA receptor influence on behalf of gabapentin for a while but it hasn't beren clearly elucidated.  However, this study seems to show some pretty powerful evidence of direct modulation of NMDAR's.  Good Grief!!!!!

 

In the authors' words.......

 

" Here we present our striking findings that α2δ-1, through its C-terminal domain, forms a heteromeric complex with NMDARs to potentiate their synaptic trafficking and excitatory synaptic transmission and that interrupting the α2δ-1-NMDAR interaction reverses the synaptic NMDAR hyperactivity associated with neuropathic pain. This new information redefines our understanding of the α2δ-1 function and the role of α2δ-1 in neuropathic pain development. Our findings also challenge the conventional perception about the molecular action of gabapentinoids, showing that α2δ-1-bound NMDARs, rather than VACCs, are the relevant target of gabapentinoids."

 

OK, so let's turn all the thinking upside down again....... 

 

-RST

 

Hi RST,

 

Gabapentin seems to be a very misunderstood drug.  The mechanism of action seems to change quite a bit, and they are always finding new information on this interesting drug.  It is turning things upside down again......

[[cs...]]

I know i am in way over my head with your guys discussion but i am just wondering there is a familiarity with Dave Asprey's podcast I found show 512 with Matt Cook to be the most interesting in terms of experiments on neuropathy I prefer not to try to explain it since it is complicated. But it should be pretty easy to find. In general  the discussion is in regard to stem cell therapies.

 

Hi Matt,

 

I jotted down the epsidose number and i am going to listen to it next week.  I’m always open to new ideas.  THere are a lot of quacks out there, but some of the information out there can be quite useful.

 

Thanks again for posting.....

 

Dm123

[[li...]]

https://www.ncbi.nlm.nih.gov/pubmed/11473860

 

'Our results show that large concentrations of midazolam, chlordiazepoxide, and diazepam displace the binding of [(3)H]-diprenorphine-an opiate radioligand from kappa receptors. In an in vitro functional assay, midazolam is a weak agonist at the delta-opioid receptor, whereas all three benzodiazepines are kappa-opioid agonists. These findings may partially explain the mechanism of benzodiazepine-induced spinal analgesia.'

 

Seriously ? It suggests benzodiazepines act on opioid receptors, but even that's open to interpretation. Some other sources that discuss the effects of buprnorphine and benzodiazepines.

 

https://www.jstage.jst.go.jp/article/jphs/110/1/110_08249FP/_article/-char/ja/

 

Odd.

[[cs...]]

https://www.ncbi.nlm.nih.gov/pubmed/11473860

 

'Our results show that large concentrations of midazolam, chlordiazepoxide, and diazepam displace the binding of [(3)H]-diprenorphine-an opiate radioligand from kappa receptors. In an in vitro functional assay, midazolam is a weak agonist at the delta-opioid receptor, whereas all three benzodiazepines are kappa-opioid agonists. These findings may partially explain the mechanism of benzodiazepine-induced spinal analgesia.'

 

Seriously ? It suggests benzodiazepines act on opioid receptors, but even that's open to interpretation. Some other sources that discuss the effects of buprnorphine and benzodiazepines.

 

https://www.jstage.jst.go.jp/article/jphs/110/1/110_08249FP/_article/-char/ja/

 

Odd.

 

Yes.  And I think they act on more receptors than we will ever know.  It’s all the more reason to get off the poison.  They are all bad news.  I don’t have any favorites 

[[li...]]

I don't want to pollute this thread.

 

But I'm not doing so well (!!!), and I wonder about getting off the drug quickly, while sensitized and not in good health, and not young. Also chronically stressed., truthfully. And I can't do the gymnastics with splitting doses etc.

Not good obviously, but there is no way to get off the 'good' way I guess. The last 5 years have been devastating. I'm still fishing a bit for some local medical help (open query), but I'm not optimistic.

[[cs...]]

I don't want to pollute this thread.

 

But I'm not doing so well (!!!), and I wonder about getting off the drug quickly, while sensitized and not in good health, and not young. Also chronically stressed., truthfully. And I can't do the gymnastics with splitting doses etc.

Not good obviously, but there is no way to get off the 'good' way I guess. The last 5 years have been devastating. I'm still fishing a bit for some local medical help (open query), but I'm not optimistic.

 

Hi liberty,

I’m not sure if anyone else can comment, but they are welcome to.

 

I would recommend getting to steady state dosing as soon as possible. This would be my most important piece of advice.

 

If you need to increase the total daily dose to achieve this, I would consult with a private doctor and work with him or her on the Rx.  (I did see in the other thread that you no longer have a GP.)

 

I hope this helps

 

Best

Dm123

[[...]]

I don't want to pollute this thread.

 

But I'm not doing so well (!!!), and I wonder about getting off the drug quickly, while sensitized and not in good health, and not young. Also chronically stressed., truthfully. And I can't do the gymnastics with splitting doses etc.

Not good obviously, but there is no way to get off the 'good' way I guess. The last 5 years have been devastating. I'm still fishing a bit for some local medical help (open query), but I'm not optimistic.

 

Hi liberty,

I’m not sure if anyone else can comment, but they are welcome to.

 

I would recommend getting to steady state dosing as soon as possible. This would be my most important piece of advice.

 

If you need to increase the total daily dose to achieve this, I would consult with a private doctor and work with him or her on the Rx.  (I did see in the other thread that you no longer have a GP.)

 

I hope this helps

 

Best

Dm123

 

What do you mean by "steady state", dm?  As opposed to what?

[[cs...]]

I don't want to pollute this thread.

 

But I'm not doing so well (!!!), and I wonder about getting off the drug quickly, while sensitized and not in good health, and not young. Also chronically stressed., truthfully. And I can't do the gymnastics with splitting doses etc.

Not good obviously, but there is no way to get off the 'good' way I guess. The last 5 years have been devastating. I'm still fishing a bit for some local medical help (open query), but I'm not optimistic.

 

Hi liberty,

I’m not sure if anyone else can comment, but they are welcome to.

 

I would recommend getting to steady state dosing as soon as possible. This would be my most important piece of advice.

 

If you need to increase the total daily dose to achieve this, I would consult with a private doctor and work with him or her on the Rx.  (I did see in the other thread that you no longer have a GP.)

 

I hope this helps

 

Best

Dm123

 

What do you mean by "steady state", dm?  As opposed to what?

 

Maintaining steady state serum levels of the Benzodiazaphine as opposed to single dosing high potency Benzodiazaphines.

 

In the case of clonazepam, single dosing its 20 hour half life in some people is not enough to keep the serum level of the Benzodiazaphine in the blood rock steady.  And the ability to keep doing that single dosing can deteriorate over time. 

Keeping serum levels as steady as possible reduces the stress on the nervous system.  All those “knobs and switches” don’t have to work as hard to keep the nervous system functioning.

 

For example

 

I got away with single dosing lorazepam for about 2 years, at which point I slowly went into interdose wd.  It started slowly, and progressively got worse, at which point I had to get outside help, crossover to librium , titrate up until stable , and then start a very slow taper.  Before I got the help we did not know what was wrong with me. 

 

Prior to getting help, At some point, several months into this interdose wd, I figured out it was the Benzodiazaphine.  I spilt the dose 1/2 at 4pm, 1/2 at night.  It helped with the nerve pain onset at night, but I knew it was only a matter of time before I would have to increase the total daily dose.  At this time I found help to do the crossover.  If you cannot do a crossover, just split the doses up on your current Benzodiazaphine.

 

Please see this other thread for more on steady state and how to approach it with valium or Librium

Please read through the entire thread.  It will give you an idea on the approach.

 

 

http://www.benzobuddies.org/forum/index.php?topic=208715.0

[[...]]

Will read it, thanks, dm.

[[li...]]

No criticism intended. Dosing clonazepam twice a day was problematic at best, many years ago.

 

Just an example, many years ago: when dosing twice a day the daytime dose was more sedating, the evening dose more stimulating. Interfering with sleep would be an understatement.

I haven´t been taking this drug because it was so incredibly useful, I was just stuck on it. Poor choice of treatment of the original provider.

 

Private doc ? You don't know the sorry state of this healthcare system ...  There is no dual public/private system. It has been stated the NL is in the top three of the most fanatical gatekeeping systems of the world. It just got much worse after about 2004. Doctors are above the law etc. It´s archaic. Americans wouldn´t stand for it.

 

Everybody is different, I had intended to taper or CT mostly based on physical stamina. That's my relationship with the drug.

I know you don´t have an answer ...

[[Fr...]]

Yes I take 1/2 tab every 4 hrs.  Can’t believe dr told me years ago these were safe drugs and to take them all together.  My nerve pain is worsening.  Am stuck at 12 mg of Valium also. Drs just keep wanting to add more drugs and I’m scared they will force me into rehab, which would kill me.  Family is over it al and don’t understand the depth of my pain and despair.  Thanks for always trying to help.

 

Hi freeme, i am glad i looked up soma.  I wish I knew more about the drug.  Is it possible for you to talk to your docs and ask them if you can hold on the valium and taper the soma first?

 

The soma is potentiating the GABAaR, at least from the little that i just read on it.  I hadn’t realized it has such a short half like.  Every 4 hours is good but the half life is so short that it’s difficult to keep your serum levels rock solid, especially if you are a fast metabolizer of soma. 

 

Another approach would be to go up on the valium, with your doctors permission, while decreasing the soma.

 

Are you on a high dose of soma?  What is considered a high dose of soma?

 

Hopefully we can get input from your doctors on the approach above.  For me personally, i would rather convert to valium and get rid of the soma first, then start going down on the valium.  But i cannot give direct medical advice. Please ask your docs about the above approach and if they will sign on.

 

Best

Dm123

 

Hi Dm 123

Can you explain more about titrating up to get stable before tapering. I was intolerance and trying to taper k. My brand was changed (Teva discontinued) it isn’t going well. Thinking up changing to Valium and updosing sime to get stable. But don’t know how much to do to get relief. I am also a fast metabolizer of v so thinking of dosing 4 times a day.

[[Re...]]

I don't want to pollute this thread.

 

But I'm not doing so well (!!!), and I wonder about getting off the drug quickly, while sensitized and not in good health, and not young. Also chronically stressed., truthfully. And I can't do the gymnastics with splitting doses etc.

Not good obviously, but there is no way to get off the 'good' way I guess. The last 5 years have been devastating. I'm still fishing a bit for some local medical help (open query), but I'm not optimistic.

 

Given your current circumstances, is there a clinic available where you could try an NAD drip infusion over an 8 hour period.  See if it gives you any kind of relief or change in symptoms?  If so, you might be able to create a regime to somehow taper.  I know that NAD is different for everyone and some people swear it has helped them taper benzos where previously it was 'impossible'.  It's very expensive and availability is a challenge.  I'm looking into it as a possibility but the 21 day program in Vancouver is priced at $17,000.00.  That's just crazy but when you feel like you are out of options.....

 

I'm sure sorry to hear of your suffering.  This is a horrible, horrible thing.  I know that eventually a treatment will exist to deal with this horror but waiting for it isn't the answer nor is it tenable for some of us.

 

Hang in there, Liberty.

 

-RST

[[li...]]

I don't want to pollute this thread.

 

But I'm not doing so well (!!!), and I wonder about getting off the drug quickly, while sensitized and not in good health, and not young. Also chronically stressed., truthfully. And I can't do the gymnastics with splitting doses etc.

Not good obviously, but there is no way to get off the 'good' way I guess. The last 5 years have been devastating. I'm still fishing a bit for some local medical help (open query), but I'm not optimistic.

 

Given your current circumstances, is there a clinic available where you could try an NAD drip infusion over an 8 hour period.  See if it gives you any kind of relief or change in symptoms?  If so, you might be able to create a regime to somehow taper.  I know that NAD is different for everyone and some people swear it has helped them taper benzos where previously it was 'impossible'.  It's very expensive and availability is a challenge.  I'm looking into it as a possibility but the 21 day program in Vancouver is priced at $17,000.00.  That's just crazy but when you feel like you are out of options.....

 

I'm sure sorry to hear of your suffering.  This is a horrible, horrible thing.  I know that eventually a treatment will exist to deal with this horror but waiting for it isn't the answer nor is it tenable for some of us.

 

Hang in there, Liberty.

 

-RST

 

I heard about NAD, but as a doc told someone else 'that won't help you' (polite translation).

There is something like that in the UK (not covered by insurance), I did contact them about two years ago and evaluated their answer ... nope. Wouldn't work, at best only as a mild adjunct.

[[Su...]]

I don't want to pollute this thread.

 

But I'm not doing so well (!!!), and I wonder about getting off the drug quickly, while sensitized and not in good health, and not young. Also chronically stressed., truthfully. And I can't do the gymnastics with splitting doses etc.

Not good obviously, but there is no way to get off the 'good' way I guess. The last 5 years have been devastating. I'm still fishing a bit for some local medical help (open query), but I'm not optimistic.

 

Given your current circumstances, is there a clinic available where you could try an NAD drip infusion over an 8 hour period.  See if it gives you any kind of relief or change in symptoms?  If so, you might be able to create a regime to somehow taper.  I know that NAD is different for everyone and some people swear it has helped them taper benzos where previously it was 'impossible'.  It's very expensive and availability is a challenge.  I'm looking into it as a possibility but the 21 day program in Vancouver is priced at $17,000.00.  That's just crazy but when you feel like you are out of options.....

 

I'm sure sorry to hear of your suffering.  This is a horrible, horrible thing.  I know that eventually a treatment will exist to deal with this horror but waiting for it isn't the answer nor is it tenable for some of us.

 

Hang in there, Liberty.

 

-RST

I did quite a bit of research into this NAD when I first started tapering.... There are several docs in Vancouver who work with this, none of whom  seem to know that much about benzo w/d.  (One of them thought I could be off in a month by switching to Valium and going down 1mg a week).  He has more experience now and works directly with Humiston but there is so much to know about benzo w/d!

The place in Louisiana that started the whole thing is pretty open to discussion but suggested that I use phenibut for insomnia -- that's a no go.

pm me if you want o know further details of who I researched and what I found. 

I'm going the slow route after all of that...

SS

[[cs...]]

Thanks everyone for pitching in.

Much appreciated.

[[cs...]]

Yes I take 1/2 tab every 4 hrs.  Can’t believe dr told me years ago these were safe drugs and to take them all together.  My nerve pain is worsening.  Am stuck at 12 mg of Valium also. Drs just keep wanting to add more drugs and I’m scared they will force me into rehab, which would kill me.  Family is over it al and don’t understand the depth of my pain and despair.  Thanks for always trying to help.

 

Hi freeme, i am glad i looked up soma.  I wish I knew more about the drug.  Is it possible for you to talk to your docs and ask them if you can hold on the valium and taper the soma first?

 

The soma is potentiating the GABAaR, at least from the little that i just read on it.  I hadn’t realized it has such a short half like.  Every 4 hours is good but the half life is so short that it’s difficult to keep your serum levels rock solid, especially if you are a fast metabolizer of soma. 

 

Another approach would be to go up on the valium, with your doctors permission, while decreasing the soma.

 

Are you on a high dose of soma?  What is considered a high dose of soma?

 

Hopefully we can get input from your doctors on the approach above.  For me personally, i would rather convert to valium and get rid of the soma first, then start going down on the valium.  But i cannot give direct medical advice. Please ask your docs about the above approach and if they will sign on.

 

Best

Dm123

 

Hi Dm 123

Can you explain more about titrating up to get stable before tapering. I was intolerance and trying to taper k. My brand was changed (Teva discontinued) it isn’t going well. Thinking up changing to Valium and updosing sime to get stable. But don’t know how much to do to get relief. I am also a fast metabolizer of v so thinking of dosing 4 times a day.

 

Hi Jlav,

That’s a great question.  I’m working on a piece for this thread specifically on the important of maintaining steady state during chronic Benzodiazaphine use and during taper. 

I am going to add a section on the titration up to that section.

 

Most this information on titration up is from my direct experience, having gone through it.  I know it is a very touchy subject, because we are basically increasing our total daily dosage (TDD), and yet we are trying desperately to get off the poison.  I had the same emotional response.

 

If you are in tolerance or kindled, titrating up may help you. It did help me.

 

My crossover was from 2 mg lorazepam single dosing each night, along with some z drugs.  So there was a very high serum peak that was occurring all at night and that is what kindled me and exasperated the tolerance.

 

The first thing to do is to break up the doses, which i see you have done since Nov.  Can you let me know how that went? Since it was 5mg i assume you did a 1.66, 1.66, 1.66.

One thing you want to do is establish consistency during this phase.  I would not switch from 2 to 3 and back to 2 times a day.  Pick a dosing schedule and try to be consistent.  If 3 is not possible due to work and job, do 2.  But i can tell you that 3 is ideal with clonazepam

 

In my case, we converted the 2 mg lorazepam to librium and i ended up at around 50% over the table conversion.  This was because i was kindled and in tolerance and because i was also on z drugs.  So the conversion is highly dependent on how much tolerance you have built up to the drug, if you are kindled (i don’t think you are, but cannot be sure) and what your total daily dosage of the drug is.

 

A table conversion of 5 mg clonazepam would convert to 100 mg of valium or 250 mg of librium.  Even though these are long half life benzos, you will still want to dose them ideally 3 times a day, because the more steady the serum level the better and early on in the taper your nervous system is in a very precarious and “agitated” state.

 

After the direct conversion, you will updose until your major symtoms start to fade.  THings will never be perfect, but your disabling symtoms that are preventing you from tapering need to abate.  Since valium and librium have such a long half life you will want to try updosing around every 3-5 days.  For valium you can use 2 or 5 mg increments.  For Librium they only go as small as 5 mg, so use 5mg increments.  You can usually get to the right updose in around a week or two.  Tolerance symtoms should start to fade.

 

Once you see symtoms abatement you want to hold that dose for at least a month, to insure the nervous system acclimates and to insure that no other symtoms start popping up.  Then, only when ready and when symtoms are fairly under control start a very slow symtoms based taper .  You will throttle the taper according to your symtoms and not on a fixed schedule. You will be in control.

 

I go into the physiological reasoning for the importance of maintaining steady state in part 3 of the current neural circuits paper.  I just wrote the section, but still have to post part2 , because some of the background material in part 2 is reaquired to understand the piece in part 3.

 

One thing that i noticed is that some people don’t react too well to valium or librium. You might want to do a piecemeal crossover to see if the valium agrees with you. It’s very tricky because as I said above, table conversions don’t necessarily hold when one is in tolerance.  Yoiu might have to approximate and try a 4.5 mg clonazepam + 10 mg valium schedule, just to determine if the valium does not make you sick. You would want to hold with this 4.5 mg clonazepam + 10 mg valium schedule to determine if the valium will not make you sick.

 

I did a 1 day all at once crossover, but was under strict medical care (MD) and had access to help if something went wrong. I don’t know if you have access to such resources, and if not, you might want to do an Ashton style piecemeal crossover substituting 10mg for each 0.5 mg clonazepam. Like i said, depending on how far into tolerance you are, 10 mg might not be enough of a substitution for each 0.5 mg clonazepam.

 

As i said earlier above, i went 50% over the conversion table.  It was the best decision in my life, because it stabilized me to a point where i could then do a slow taper on a long half life benzo.

 

Do you have access to a medical doctor to assist on the Rx ?

Since the conversion dosages are high you will need to work with a doctor.

Also note at higher dosages sometimes the conversion rate decreases, ie you might not need as much for each additional.5 mg clonazepam to valium at the upper end.  In the end ii is trial and error.

 

 

I won’t be posting that part 3 for a while yet, but i hope you will read it when it gets posted because it will explain in detail why steady state is so important relative to our innate physiology.

 

We have 3 ponts of leverage against our stronger enemy.  The weaker fighter does not necessarily have to lose the fight. A weaker fighter in martial arts and boxing does not always lose. We can outsmart the benzo via 3 ways

 

1. Maintain steady state. This negates a large part of the damaging effects of benzos

2. Listen to your body.  Use symtoms as a signal to back off. Only fight the enemy and throw a punch when you are ready. All other times, remain in defensive mode (ie, hold the taper)

3. We have time on our side. I understand we all have life commitments, but you must prioritize this at number 1 for the time during taper.  There is no rush once you maintain steady state.  The possibility of hitting tolerance is still there, but it is much less probable once you maintain steady state.  You want to go slow enough so that the nervous system barely recognizes that the benzo is being stripped away and flushed out.  That will help you recover during the taper , so that you don’t have to deal with a PWS.

 

I hope this helps a bit,

Dm123

[[cs...]]

Hi Jlav

Please note I edited the above to correct the dosage conversions.  As you know,  Table conversions are .5 mg clonazepam to 10 mg valium or 25 mg librium.  So please read with the edits.

[[Fr...]]

Thank you so much for posting this. All the information is very helpful.

 

Yes the switching to dosing clonazepam 3 times a day helped a lot. Before Clonazapam I was ion xanex and ambien at night which I now understand is what has caused me so many problems. I switched to clonazepam but didn’t do a good job of keeping a steady state for a year and didn’t really feel better. I lived from my bed for a year completely over stimulated not knowing what was wrong with me. January of this year I figured it was the benzos and splitting to three doses helped immediately. I then tried liquid to taper which my body did not take to as soon as I added the pills back in I felt better. I then tried  cut and hold At 10% every three weeks which was way to fast for my nervous system. . It wasn’t until I switched to a 3% a month daily MT things got better. A few months back my Teva brand of clonazepam was discontinued  and I had to go to a new manufacturer and I have not been able to stabilize. It’s been over 7 weeks.

 

I have always been scared to up dose because I had a thought that I might be kindled and didn’t want to make myself worse but in the state I am in there is no way I can taper without increasing. I did a test yesterday to see how I would do with more of the drug in me and at my afternoon dose of .13 I added an additional.4mg of clonazepam . It heavily sedated me and when it wore off I had extreme body pain nerve pain and headache but atleast I Knew I felt an effect and updosung would get me more stable so I could  start MT.

 

I believe the severe reaction after the sedation wore off was probably because I took way to much. I am still feeling that extreme hangover today. My plan is to increase by 20% maybe back to .5mg but make sure to increase it even through out the three doses and see if that brings relief in 3-5 days like you stated.

 

I am wondering about crossing over. I know Clonazepam is a nasty drug but v is not an option for me as I am a fast metabolizer of the drug due to my genomind test. I have tried it before and it drops out very quick for me after hitting for hard for about an hour then I feel nothing. I have thought about Librium but don’t know how you taper the capsules. Is it a problem to taper clonazepam directly?

 

I realize I should probably add some of this to many signature. I appreciate any thoughts you have.

[[Su...]]

Before Clonazapam I was ion xanex and ambien at night which I now understand is what has caused me so many problems.

Me too, not to steal this thread, but was on Xanax at night only for years with no interdose w/d, although my dose was going up steadily... well from .25 - 1mg in 16 years  not such a fast increase. 

Adding Ambien intermittently for about a year caused me to go off the rails  .... you can see where i am from my sig.  have a ways to go but am remarkable stable  -- it's all relative-- after my hold...no hurry to start tapering again.

 

It was the idea of adding a bit of a longer acting benzo and keeping a steady serum level Thank you dm123!! that made all the difference in my taper..

SS

[[cs...]]

Thank you so much for posting this. All the information is very helpful.

 

Yes the switching to dosing clonazepam 3 times a day helped a lot. Before Clonazapam I was ion xanex and ambien at night which I now understand is what has caused me so many problems. I switched to clonazepam but didn’t do a good job of keeping a steady state for a year and didn’t really feel better. I lived from my bed for a year completely over stimulated not knowing what was wrong with me. January of this year I figured it was the benzos and splitting to three doses helped immediately. I then tried liquid to taper which my body did not take to as soon as I added the pills back in I felt better. I then tried  cut and hold At 10% every three weeks which was way to fast for my nervous system. . It wasn’t until I switched to a 3% a month daily MT things got better. A few months back my Teva brand of clonazepam was discontinued  and I had to go to a new manufacturer and I have not been able to stabilize. It’s been over 7 weeks.

 

I have always been scared to up dose because I had a thought that I might be kindled and didn’t want to make myself worse but in the state I am in there is no way I can taper without increasing. I did a test yesterday to see how I would do with more of the drug in me and at my afternoon dose of .13 I added an additional.4mg of clonazepam . It heavily sedated me and when it wore off I had extreme body pain nerve pain and headache but atleast I Knew I felt an effect and updosung would get me more stable so I could  start MT.

 

I believe the severe reaction after the sedation wore off was probably because I took way to much. I am still feeling that extreme hangover today. My plan is to increase by 20% maybe back to .5mg but make sure to increase it even through out the three doses and see if that brings relief in 3-5 days like you stated.

 

I am wondering about crossing over. I know Clonazepam is a nasty drug but v is not an option for me as I am a fast metabolizer of the drug due to my genomind test. I have tried it before and it drops out very quick for me after hitting for hard for about an hour then I feel nothing. I have thought about Librium but don’t know how you taper the capsules. Is it a problem to taper clonazepam directly?

 

I realize I should probably add some of this to many signature. I appreciate any thoughts you have.

 

Hi Jlav

 

I am glad you clarified things. I misread your signature. You might want to put a space between the klonopin.5 mg.  I misread that as 5 mg of klonopin!!  Hence my conversions in the original post above.

 

So .5 mg clonazepam is much more manageable.  You will probably convert to 25 mg Librium and add 20-50% to that for the tolerance. You might end up at around 30-40 mg Librium. It sounds like a lot but it’s not a huge dose.  Librium is a nonpotent Benzodiazaphine which allows a finer tuned taper.

 

I think i know what happened to you.  Adding .4 mg to a .5 mg total daily dose is a large increase. If you are going to updose try to space it evenly across all three dosages, and use a smaller increment..  Clonazepam is so potent you must do this.  I’m sorry about the nerve pain its all part of tolerance and perhaps kindling.

 

I got kindled through very similar circumstances. Short half life benzo like you with ambien and lunesta.  It is the worst combination possible.  For anyone reading this, please do not do this. 

 

You are going in the right direction. I can help you with the details of the librium taper via PM if you need additional help.

 

I’m glad you are going in the right direction on this.

I think yoiu have a very good chance at recovery. There’s no permanent damage, and you just need to give your nervous system the time and the environment to settle down so that you can start a methodical taper.

Best

Dm123

[[cs...]]

Before Clonazapam I was ion xanex and ambien at night which I now understand is what has caused me so many problems.

Me too, not to steal this thread, but was on Xanax at night only for years with no interdose w/d, although my dose was going up steadily... well from .25 - 1mg in 16 years  not such a fast increase. 

Adding Ambien intermittently for about a year caused me to go off the rails  .... you can see where i am from my sig.  have a ways to go but am remarkable stable  -- it's all relative-- after my hold...no hurry to start tapering again.

 

It was the idea of adding a bit of a longer acting benzo and keeping a steady serum level Thank you dm123!! that made all the difference in my taper..

SS

 

Hi SS

Thank you SS.  Each time someone like you shares his or her story we are helping out other people.

 

I got into this mess the exact same way.  Add me to the list.  I don’t want to start on a diatribe against doctors but many of them have no idea how to dose these types of meds.

 

To everyone reading this thread, please do not combine a short acting Benzodiazaphine single dosing with a z drug or z drugs.  It has only one outcome and that is “not good”.

 

In the next postings on neural circuits we will find out exactly why our nervous system reacts the way it does to nonsteady state Benzodiazaphine dosing regimens.  Homeostasis is the key to making things easy for our nervous system, and that entails steady state dosing.

 

Best

Dm123

 

[[fr...]]

  Dm do you think in my case I should ask dr to substitute a longer acting muscle relaxant for the short acting soma.  I dose 1/2 pill every 4 hrs and the nerve pain is unbearable now.  I know this is only your opinion but I just cannot go on like this.  Thanks always for trying to help me.  I am so desperate and in pain I’m ready to go to ER today but that’s worthless.  God bless.

[[cs...]]

  Dm do you think in my case I should ask dr to substitute a longer acting muscle relaxant for the short acting soma.  I dose 1/2 pill every 4 hrs and the nerve pain is unbearable now.  I know this is only your opinion but I just cannot go on like this.  Thanks always for trying to help me.  I am so desperate and in pain I’m ready to go to ER today but that’s worthless.  God bless.

 

Hi freeme

 

Given that the soma acts on the GABAaR, you may have to increase the valium to pick up the shortfall when the soma is tapered.  You would have to do this slowly under your docs direction and clear it with your doc.  Slowly decrease the soma and increase the valium

I’m assuming that the muscle relaxant that you would use to replace the soma is not GABAergic, which is the objective.

I know that there are nonGabergic muscle relaxers out there, but it’s not my area of expertise.

 

I hope this helps

Dm123

 

 

 

ER won’t be able to help.  They will tell you to increase the Benzodiazaphine.

[[fr...]]

  Thanks, will have to ask him.  I hate to increase the Valium but I am too too sick and in pain to even think about tapering anything.  Will see what he says, I also had to start a cortisone ointment on my lip.  If the lump doesn’t go down I will have to get biopsy next week.  Maybe the steroid ointment is ramping the nerve pain but I have been using another for hemorrhoids and that didn’t seem to bother things.  Who even knows.  Now I have to worry about cancer of the lip but dr said he didn’t think I should worry about that.  I am though.  Thanks again.