Reinstated/ up dose

[[md...]]

How many people reinstated or updosed to a higher amount to start of after cutting and tapering down to fast and did it work? Wondering if I should just continue while in acute w/d, or up dose and chance it to feel better, get some sleep and start over (which I really do not want too...)

[Guest [Cl...]]

Never ever reinstate or updose unless your situation is life-threatening. Kindling is a way worse problem.

[[co...]]

Myself and other people have updosed before.  It  typically happens when you have either tapered too fast or switched over at too low of a dose.

 

I am very sorry to read about your suffering.  I will write what I have written before in response to your situation. 

 

First, you switched over from .75 of Klonopin to 8 mg of Valium.  That is a bit more than half of the amount that Ashton recommended in her book for the switchover.  That would seem to set you up for problems.  For .75 of Klonopin her book would indicate 15 mg of Valium.

 

Second, it seems that after your switchover to Valium you started dropping immediately after a week without giving yourself time to get stable, then continued to do 11-12% drops every two weeks.

 

If that were me and my doctor was agreeable I would consider going to a much higher dose of valium, perhaps even to 8 mg or more, and then wait until you stabilize somewhat, which might take anywhere from a week to over a month, and then begin a symptom based microtaper.

[[md...]]

Thank you for your response.

 

I was on .75 mg of klonopin for only less than a month and then went down to .62 before the crossover. I did also cut to much and agree and wish I could go back in time! The only thing that freaks me out about up dosing is that I was tolerant to klonopin and the valium at 8mg when first started. I'm nervous to go back and then find it did not help and I have a longer time to taper off. I did up dose 1 mg for 3 weeks and it did not help. I wonder if the best thing to do know is to keep going and tough it out and get off this as the real healing does not start until you get off?

 

Do you think this is possible?

 

 

[[Ch...]]

Never ever reinstate or updose unless your situation is life-threatening. Kindling is a way worse problem.

 

Clara,

 

Please don’t tell anyone what he or she should do. Support is phrased as your experience or your opinion. 

 

I up-dosed, reinstated, and healed.  I am not the only one. 

 

Guidelines Regarding the Giving of Medical Advice

 

Thank you,

Challis

[[md...]]

Challis99,

 

Can I ask your feedback from your experience?

 

I was c/t multiple times (kindled) and put on o=various sleep meds before reinstating and being transitioned and tapered to fast. Do you think this could impact on up dosing not being helpful in my situation? How do you know how much to up dose to if you decide to do it?

 

Thanks for your feedback?

[[Ch...]]

Well, what I found in up-dosing was that xanax didn’t have the same effect as it did before I started tapering, so it wasn’t of much help to me.  I didn’t try going up much, though, just a little increase.

 

No one can know how much someone would have to up-dose for relief, not even the doctor or the patient.  It’s trial and error. Any increase in a long-acting benzodiazepine would take up to two weeks to be fully effective, so it’s a long process, too.

 

Short-acting benzodiazepines are much easier to up-dose or reinstate.

 

Here’s Ashton’s feelings about these subjects:

 

Coping with Benzo withdrawal:  Coping with Benzo Withdrawal

Reinstatement, updosing

 

A dilemma faced by some people in the process of benzodiazepine withdrawal, or after withdrawal, is what to do if they have intolerable symptoms which do not lessen after many weeks. If they are still taking benzodiazepines, should they increase the dose? If they have already withdrawn, should they reinstate benzodiazepines and start the withdrawal process again? This is a difficult situation which, like all benzodiazepine problems, depends to some degree on the circumstances and the individual, and there are no hard and fast rules.

 

Reinstatement after withdrawal? Many benzodiazepine users who find themselves in this position have withdrawn too quickly; some have undergone 'cold turkey'. They think that if they go back on benzodiazepines and start over again on a slower schedule they will be more successful. Unfortunately, things are not so simple. For reasons that are not clear, (but perhaps because the original experience of withdrawal has already sensitised the nervous system and heightened the level of anxiety) the original benzodiazepine dose often does not work the second time round. Some may find that only a higher dose partially alleviates their symptoms, and then they still have to go through a long withdrawal process again, which again may not be symptom-free.

 

Updosing during withdrawal? Some people hit a "sticky patch" during the course of benzodiazepine withdrawal. In many cases, staying on the same dose for a longer period (not more than a few weeks) before resuming the withdrawal schedule allows them to overcome this obstacle. However, increasing the dose until a longed-for plateau of 'stability' arrives is not a good strategy. The truth is that one never 'stabilises' on a given dose of benzodiazepine. The dose may be stable but withdrawal symptoms are not. It is better to grit one's teeth and continue the withdrawal. True recovery cannot really start until the drug is out of the system.

 

Pharmacologically, neither reinstating nor updosing is really rational. If withdrawal symptoms are still present, it means that the GABA/benzodiazepine receptors have not fully recovered (see above). Further benzodiazepines cause further down-regulation, strengthen the dependence, prolong withdrawal, delay recovery and may lead to protracted symptoms. In general, the longer the person remains on benzodiazepines the more difficult it is to withdraw. On the whole, anyone who remained benzodiazepine-free, or has remained on the same dose, for a number of weeks or months would be ill-advised to start again or to increase dosage. It would be better to devote the brain to solving individual symptoms and to finding sources of advice and support. Advice about how to deal with individual symptoms is given in the Manual (Chapter 3).

[[md...]]

Thank you,

 

It's so hard because it is so 50/50, you just do not know. It's a gamble.My Dr also suggested switching back to klonopin, but that seems like the same as updosing and she is is the one who helped get me into this mess.

[[Ch...]]

As long as you switched to an equivalent amount of benzodiazepine it wouldn’t be an up-dose. It sounds like your doctor is at least offering you options. Many do not.

[[bu...]]

Never ever reinstate or updose unless your situation is life-threatening. Kindling is a way worse problem.

 

Reliable  evidence for benzo kindling is non-existent, or weak, at best.

 

And even the general definition is repeated withdrawals/discontinuation...  Updoses/dosage changes don't meet that criteria.

[[md...]]

 

 

Idk, I wish I could have a better idea of if it is worth it to up dose to to 8, or 9 mg and if it would be effective in the long haul. Its been 2 months that I have been between 5 and 6 mg, and I am sure it would take some time to adjust. My Dr also suggested Ativan (or Klonopin), however Ativan is the drug that got me into this mess.

 

I also wonder if my current symptoms that I experience at every night (Chronic insomnia/micro sleeps, sweats, hot/cold, flu symptom , bladder retention ) are just part of the normal wd process that I need to go through to get off as I work down? Who is to say I will not have these same symptoms if I go up, or if they will re-occur when I get back down?

 

I appreciate everyones insight, suggestions and feedback. 

 

[[co...]]

I would consider this a correction rather than an updose, since it seems like you crossed over at too low of a dose of valium which was not a comparable dose to the Klonopin that you were taking. 

 

 

 

 

[[md...]]

Builder,

 

I’m trying to debate if up dosing and trying to stabilize is rihh go t for me? I’m having horrible insomnia and flu symptoms at night, but feel better the next evening before my next dose. I feel like I just need to get off of this. If I keep going, would that make my healing process more difficult or cause pws? I don’t want to make things worse?

[[bu...]]

Builder,

 

I’m trying to debate if up dosing and trying to stabilize is rihh go t for me? I’m having horrible insomnia and flu symptoms at night, but feel better the next evening before my next dose. I feel like I just need to get off of this. If I keep going, would that make my healing process more difficult or cause pws? I don’t want to make things worse?

 

Tapering from a benzo is just a procedure to try to keep the rate of reduction in synch with the body's ability to adjust/recover.  And a little fine tuning is often needed. 

 

If you have very little discomfort, or very few sxs, then it might be appropriate to try to increase your taper rate.

 

But if you become significantly symptomtic, that's a pretty good indication that your taper rate/recovery rate are out of synch.  If you tapered to fast, then you can either 1) wait for your body to catch up (it will)  and be miserable, or 2)  you can try to match your dose to your body's need (updose).

 

Some one called it a correction, instead of an updose, but I I would actually agree.  That's what it is, a correction.

[[Fr...]]

How many people reinstated or updosed to a higher amount to start of after cutting and tapering down to fast and did it work? Wondering if I should just continue while in acute w/d, or up dose and chance it to feel better, get some sleep and start over (which I really do not want too...)

 

This is my second attempt. I would never endorse someone to reinstate because of my personal experience.

 

I was on 3mg of Klonopin 16 years ago. My shrink at the time got me off in 2 months. WHAM I was hit with the worst symptoms. It was hell. I immediately reinstated to 3mg daily. Fast forward 15 years and 4 different shrinks later I was then on a Rock-Star amount of Klonopin (5mg a day prescribed by shrink). The irony here is I had the worst anxiety. Worse than at 3mg a day, heck, worse than when I ever started taking a benzo.

If I could go back to my old self (when I THOUGHT I was going through hell) I would say Just stay off and let your body heal. But back then, I did not know of benzo withdraw. I did not know of my dependence on this drug. And I certainly (and my shrink at the time) didn't get me off in a "safe" taper.

 

This time around I'm going much slower, longer holds and I have a great doctor who has worked with benzo withdraw. I'm hopeful this time. Scared...but hopeful.

 

Good luck and I hope you feel better quickly.