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Short-term/low dose, tapering now but NEED ADVICE


[su...]

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Hello. I am stuck, scared, and need help.  I was put on a short term, low dose benzo and have been tapering, but am now having serious withdrawals. Before the specifics of where I am in that timeline, it might be helpful to offer little context of how I got here. 

 

On June 24th I went for a run and in the middle of that run did not feel well.  I had difficulty bringing my pulse down the rest of the day and overall felt sick, and dizzy.  Chalked it up to dehydration or heat exhaustion and pushed fluids/Gatorade/cool showers.  The next day I continued to not feel well, had dizzy spells, rapid heart rate and a continued over all not feeling well.  I ended up having a panic attack that next day, likely from the fear of what was going on as I had a recent heart scare.  I was due for a 6 month follow up echocardiogram after having a similar situation back in December.  In December I ended up in the ER after having chest palpitations, dizziness, overall not well feeling, body shaking.  They admitted me because EKG then showed signs of left ventricular hypertrophy.  After having an echocardiogram, my heart showed no structural abnormalities or signs of LVH, so they sent me home with BP pills to control the palpitations and get my BP down.  At that time, I was suspect that hormones and anxiety might have been driving things (I am in mid 40s and had a late in the game baby 2 years ago, along with beginning to have symptoms of perimenopause).  I went back to my primary to discuss this and she suggested going on Lexapro, 5 mg.  I agreed as I was having difficulty with the symptoms.  I had never used any type of anxiety/depression med before, and other than a handful of panic attacks in my life, I had always managed quite well with exercise/running as an outlet.  Needless to say I took that first dose that evening and did not do well.  I first felt out of it, very tired.  A few hours later I began to have a burning sensation throughout my body and uncontrollable shakes.  I went to bed and woke up extremely sick, dry heaving and the body shakes got worse.  My husband took me to the ER again (mid December now) and they ended up giving me IVs of Benadryl and Phenergan, saying I had an adverse reaction to Lexapro and to not take anymore.  Returned to primary and discussed what happened.  I still felt awful then too.  She said perhaps to try a different anxiety medication and I said no thanks, that I didn't want to try a daily med at that point anymore given my reaction.  She then prescribed me .25 Xanax to take as needed while I worked through the cardiac issue.  I did take a couple over the course of a couple weeks that last part of December when symptoms got really bad.  Never more than one pill and never consecutively--after having 2 occasions where the Xanax actually made me feel worse, I did not take them anymore and put them away.  I also discussed that I felt the Diltiazem (the blood pressure med) was not a good fit, she agreed.  I followed through with a cardiology work-up with a stress echo and that came back fine.  Cardiologist wanted me to monitor my blood pressure at home as he felt I did need to be on a BP med but was willing to have me monitor for a month.  By mid January I felt back to me again, no palpitations anymore, no anxiety and felt generally well.  Blood pressure was okay at home.  Had another follow up in February and BP was up in office, so Cardiologist said white coat hypertension but to monitor and we would revisit this July along with echocardiogram.  I began my running regimen again and was feeling really good--world pandemic events aside. 

 

Fast forward to my run on June 24th.  I continued to feel dizzy/lightheaded, would get rapid HR out of no where, and generally felt like crap, so ended up going to urgent care that weekend.  The Dr there did an EKG and I did have some PACs, but nothing "scary" was showing up.  He suggested I go to my primary to have some labwork done given my perimenopause symptoms that it might be low iron/or a thyroid issue.  I did just that. I have a new primary as old one left the practice, so when I went to the appointment, we did discuss what had happened in December.  He ordered the labwork (which came back fine) and wanted me to follow up with cardiology sooner and to also have a Holter monitor put on.  He felt, however, that I was just having panic and wanted me to take that Xanax again.  I told him about how

it made things worse those few times back in December, but he was insistent that I needed to take it for at least 3 days to have reprieve.  He wanted to up the dose but I said no.  I began the Xanax July 1st (.25/3xs a day).  It was a rough go in the beginning as I felt a little worse, but by day 3 I did have some reprieve.  I stopped the Xanax.  On July 5th, I had a return of even stronger anxiety and my existing symptoms that I was already working through were worse (blood pressure went way up along with that HR).  It was a Sunday to I began the Xanax again but halved the dose .125/3xs a day.  Began to feel little better after two days and by Wednesday I had my cardiology appointment to have Holter put on and echocardiogram.  Cardiology said I could stop the Xanax.  I did.  July 9th I had no Xanax at all, but the next day I work up the sickest I have ever felt, with a tremor again, body shakes, and had the most intense panic attacks I've ever had.  I emailed my Dr. and told him I thought I was having an adverse reaction to stopping the Xanax again.  He insisted it was my anxiety that was coming out and to continue taking until I was to meet with cardiology for the results.  By Sunday night my body shakes were uncontrollable and I woke up at 2 am to fast HR and extremely high BP.  My husband took me to ER and they said it was panic attack and to stop the Xanax and they started me on Lorazepam (gave me 1 mg via IV in ER along with Zofran for the intense nausea).  The next few days I tried to only take the Lorazepam as needed (they prescribed me .5 mg).  By Wednesday, I had only taken 3 pills total but again ended up with no sleep, extreme flu-like feeling with dry heaves and the tremor.  I had a tele-visit with my DR to discuss the ER visit and he again wanted me to take the Lorazepam 3x's a day until I saw Cardiology (which was Monday July 20th) and that I should seek out a psychiatrist because it was beginning to be "beyond his pay grade."  I had waves of feeling okay those next few days, but also waves of knowing that this drug was not doing my body any favors and I felt very let down by my Dr's unwillingness.  I began to do more investigating and found some validation online that I was likely having interdose withdrawals even though I had only been on these benzos for a short period of time (and irregularly).  Over the weekend I began researching how to taper and looking for a psychiatrist/DR in Virginia who could possibly help if my DR was not going to be willing.  When I saw the cardiologist on July 20th, I was a wreck and a had a break down in his office.  He assured me that I was not in need of psychiatry but that yes, there was anxiety to what was all happening.  He wanted me on a BP pill now to regulate my high HR and high BP, so he put me on Coreg 12.5 mg 2xs daily and said to taper off the benzo.  I was very relieved to hear this.  My echocardiogram was again clear (another relief), but the Holter monitor results were not in yet, and we would revisit them in a month with my follow-up.  That evening, albeit feeling sick, I felt somewhat relieved to begin getting off this benzo.  I also reached out to a psychiatrist whom I found that was said to help with tapers. The cardiologist's taper was very fast (he wanted me to drop a third of a total dose every 3 days, so I ended up conferring with the psychiatrist who said that was a little fast.  He said I could prolong it a little more so we discussed via phone how to start and then I was to meet with him on July 30th.  I began my taper July 20th and began with dropping my middle day dose by .25 mg for three days then dropping my morning dose by .25 mg for another three days and so on. (I will write out schedule below).  I met with psychiatrist who agreed I never should have been put on the Xanax in first place for consecutive use especially given my reaction to Lorazepam back in December.  He understood my desire not to use this time as a bridge to start an SSRI, that I was going to move forward with Cognitive Behavior Therapy instead.  I just wanted off the Lorazepam.  He helped figure out the taper for me which is as follows:

 

Lorazepam .5 mg tablets

1/3 tablet three times a day for 3-7 days

1/4 tablet three times a day for 3-7 days

1/4 tablet twice a day for 3-7 days

1/8 tablet twice a day for 3-7 days

 

I did fairly decent that first week (July 20th) as the beta blocker the cardiologist put me on helped with the rapid HR. I had some slight withdrawl symptoms, but it was all doable.  I actually began to feel glimmers of me again last week (August 2nd).  Last week I was down to .125/3xs a day and was managing to drop my doses every three days until I hit the .125 2xs a day.  I had a great day on Wednesday (August 5th) and that was the day I dropped to .125 2xs.  On Thursday and Friday, however, I began to have some withdrawls again, namely anxious feelings, tightness across back with slight tremor.  I became emotional as well a few times.  On Friday I woke with a bad headache and some nausea with some anxiety.  It was doable though.  My husband I figured it was because I dropped to two doses instead of the three being spread out.  That Friday night I had a horrible night, woke at 3 am to intense back pain, some tremor, and extreme dry heaving. So on Saturday, instead of dropping a dose again, I took .25 again but broke it up into three instead off the two .125 doses.  I muddled through the day and managed to get sleep Saturday night.  Woke up yesterday (Sunday) feeling a little better with only a headache and mild nausea and anxiety.  Ended up doing my drop again but went up a little from what psychiatrist detailed.  Yesterday I went to roughly  .07/.06/.07 (doing best to dry cut and even things out).  Today it is the same.  However, last night was AWFUL.  Before bed I began to have strong anxiety and some shakiness again, so I tried to meditate and distract myself.  Ultimately I ended up only getting about an hour of sleep before waking up to uncontrollable shakes again and dry heaving.  I felt like I was dying again last night (much like the times early on when I stopped the meds and ended up in ER).  I am at a loss of what to do because I was managing things really well and looking forward to finally being off of this stuff. 

 

The psychiatrist initially said I could jump off once I got to .06 twice a day (which would have been end of this week), but I just don't know if I was tapering too fast or if this is just par for the course, that my body needs to stabilize a little before I do that last drop.  Are the withdrawals during taper like this?

 

For all intents and purposes I began benzos July 1st (first the Xanax then the Lorazepam) and started taper on July 20th.  l am three weeks into the taper and until this last drop, was managing it very well.  I had dark moments last night and my husband is very helpful about staying positive that I will be off, that it is hard, but I can do this.  I'm muddling through today with the kids, feeling shaky, nauseous, and a little hopeless .  I was not set to meet with that psychiatrist again (he is an hour away and not in our insurance network, so we paid out of pocket) and I don't know how helpful my primary will be at this point because he felt it was a low dose and I wasn't on it for so long. 

 

Apologies for the rambling here, but I am feeling so sick and desperate to be off this drug.  I'm so close but just unsure of how to proceed at this point.  Thank you for any help.

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[9c...]

I don't know how helpful my primary will be at this point because he felt it was a low dose and I wasn't on it for so long.

 

Different people have different reactions to drugs. Also, benzos are cross-tolerant with alcohol, so if you drank alcohol from time to time you've already kindled your CNS.

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sunshine75

 

Welcome to Benzo Buddies. So glad that you found us. I am so sorry for all that you have been through. The doctors seem to know so little about getting off these drugs and the withdrawal that comes with it. 

 

Please don’t feel hopeless. You have done an excellent job on tapering so far, especially mostly on your own!  You are in the right place for support and guidance. Your story is very similar to mine.  I started on Xanax and was switched to Lorazepam. I was also given Lexapro and had a very similar reaction and stopped it.  Benzo Buddies has been a wonderful help to me and I am sure it will for you too.

 

Normally it’s advised to cut your daily dose by between 5% and 10% every 10 - 14 days.  Some even find this a little fast. Taking it slow is the way to go with these drugs.

 

Please take a look around the site.  When you are ready feel free to post questions.

 

Here are some links that will be helpful.

The Ashton Manual  is a great resource. Full of information on Benzo withdrawal including recommended reduction rates and what is happening to us.

Withdrawal Support (during your taper)

 

Ativan Tapering Thread  This is a small very supportive group. I would encourage you to post here. Many have experiences similar to yours and experienced in tapering Lorazepam.

 

It's helpful if you create a signature with info on history-  medication/doses/cut dates etc. This allows members to give support specific to your situation.  Here's how. Go to the top of the page and select PROFILE then choose forum profile then insert drug history into the text box and remember to click change profile.

 

We are glad you are here. Please reach out for support. It really helps to know you are not alone.

 

JuJuBi

 

 

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I don't know how helpful my primary will be at this point because he felt it was a low dose and I wasn't on it for so long.

 

Different people have different reactions to drugs. Also, benzos are cross-tolerant with alcohol, so if you drank alcohol from time to time you've already kindled your CNS.

 

Hello pacenik,

 

Kindling, according to Wiki refers to the neurological condition which results from repeated withdrawal episodes from sedative–hypnotic drugs such as alcohol and benzodiazepines.  Each withdrawal leads to more severe withdrawal symptoms than in previous episodes. Individuals who have had more withdrawal episodes are at an increased risk of very severe withdrawal symptoms.

 

Could you point me to a resource which states that drinking alcohol from time to time will result in a kindled CNS? 

 

Thanks,

 

Pamster

 

https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hypnotic_withdrawal)

 

 

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I don't know how helpful my primary will be at this point because he felt it was a low dose and I wasn't on it for so long.

 

Different people have different reactions to drugs. Also, benzos are cross-tolerant with alcohol, so if you drank alcohol from time to time you've already kindled your CNS.

 

Hello, pacenik, I haven't had any alcohol since I've been on a benzo as aware of the interaction and as bad as I have felt on benzos since beginning, there is no way I would add to the mix.  Thank you though. 

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JuJuBi,

 

Thank you so much for that.  I really do appreciate any help as this weekend was a nightmare for me and today is not looking up.  Would asking my questions in the forum Ativan Tapering Thread be best then?  I'm still trying to figure out how to navigate this site (doesn't help that my clear thinking today is off).  I really am looking for best advice on how to proceed from today where I am dose-wise, if I should just stabilize and then continue dry cut method I was using since I am so low.  I called that psychiatrist and left a message to see how to proceed. 

 

Again, thank you,

 

sunshine75

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[9c...]

Could you point me to a resource which states that drinking alcohol from time to time will result in a kindled CNS?

 

I don't have one. But ethanol is like a short-acting benzo, except it doesn't have a half-life it is eliminated linearly, not exponentialy. So, like with Z-drugs, every time you drink alcohol you have a mini-withdrawal.

 

I think the reason why I could cold-turkey benzos so many times with impunity is because I haven't drank alcohol almost at all in my life. But this last episode with amitriptyline-caused-myclonus and humongous rescue doses are the straw that broke the camel's back.

 

 

Hello, pacenik, I haven't had any alcohol since I've been on a benzo as aware of the interaction and as bad as I have felt on benzos since beginning, there is no way I would add to the mix.  Thank you though.

 

I didn't mean during benzo use but before.

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Sunshine,

 

That would be a good place to start.  Post a hello and your questions. While you wait for response you can also beginning reading from the most recent posts backwards and will see some tips from those that dry cut to the end. And many other methods used.  It really is a very positive helpful group with several short term users recently successfully coming off that still stick around to offer support and guidance that is specific to your situation.

 

Lorazepam group recent posts

 

You have done great so far and I am sure you will continue to do well in your taper.  In the beginning of my taper I took some time to stabilize and a few other times as well.  sometimes our Brain and CNS need a bit of a rest from all this.

 

I see you already did your signature.  You got this :thumbsup:

 

JuJuBi

 

 

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