Hey buddies, how do I get stable?

[[Fr...]]

Hi SS,

Thank you for your reply.

I currently dose 3 times a day, 8 hours apart. I don’t think I have interdose withdrawal because I feel terrible 24/7 and taking Ativan gives me no relief. I think I have tolerance withdrawal and withdrawal as I taper and I’ve been on Ativan a few times now.

I have tried other meds and they did not agree with me. I deteriorated rapidly after trying to cross over over to Valium. Ever since then I haven’t been able to function much. I tapered off Valium and then held my Ativan dose for 12 weeks, no improvement. It wasn’t until I started DMT I improved slightly at times. Even before the failed c/o I was a little more functional but I still had many disabling symptoms.

When I did a quick taper off 2mg in July 2019 I was like this. I feel like I’m in acute all the time. When I reinstated Dec 19 @ 4mg, it gave me very little relief.

For these reasons I’m not comfortable updosing because it does not give me any relief at any dose rate.

I do value your opinion but I don’t know what to think anymore because I have tried many techniques, meds, supps etc.

This process has been torturous and long already. The plan was to get stable then it really didn’t matter how long my taper took as long as I could function. I’ve never found stability and now I’ve lost hope.

 

I’m

 

I hear you. It sounds like this has been a long and frustrating journey.

 

Nothing I suggested was specifically to treat interdose withdrawal; my intention was to offer you strategies that I believe improve neurological stability with lorazepam.

 

I suspect that your judgement is impaired in ways by the impact that these drugs and drug adjustments have had on your nervous system. I have found that impatience is a common withdrawal symptom, and can lead to poor decision-making during patient-led tapering once the taper has gotten out of hand; this instability is what I am suggesting to treat, if at all possible, and the methods to do this may go against your current pattern of thinking.

 

I understand that you were on 2mg/day ~25 days ago, and your description of your current dose suggests you may have taken a 25% reduction during this time, a reduction which I suspect would not be well tolerated by someone who is already unstable. Tolerance or not, rapid reductions seem to carry a heavy cost and may be compounding your suffering more than you realize.

 

This is your taper. I know how hard it can be to make decisions in the midst of mental instability. You may have a different way of doing things that works for you, and I respect the journey you are on. I stand by my suggestion of an updose, but if there's any other way that I can help you going forward please don't hesitate to ask.

 

You will find a way.

 

Hi slowandsteady Whatbif you have tried a couple up doses and it is extremely stimulating to you? Hold where your act in hopes to stabilize?

[[sl...]]

Hi slowandsteady Whatbif you have tried a couple up doses and it is extremely stimulating to you? Hold where your act in hopes to stabilize?

 

Hi FruityPop,

Updoses that cause an increase in withdrawal symptoms sound to me like a paradoxical reaction to the benzo. I have not had this experience but it's estimated to happen in 1-2% of cases. Here is a read:

https://www.benzoinfo.com/paradoxical-reactions/

 

Failure to diagnose that the patient is experiencing this reaction may lead to a progressive increase of the benzodiazepine dose, in an attempt to “control” the misdiagnosed emerging symptoms of the paradoxical reaction leading to an increase or worsening of the paradoxical reaction symptoms, as opposed to their improvement, while simultaneously significantly lengthening the time the patient may have to spend tapering off the benzodiazepine.

 

From this material, I would suggest not updosing further, and instead considering beginning a slow taper schedule (5-10%, unless past experience and symptoms suggest otherwise). I also suggest searching the forum for buddies who have managed paradoxical reactions to learn more about what may or may not work in this situation.

 

It looks from your signature like you're very low on your Librium dosage FruityPop. Is this information up to date?

[[Fr...]]

Hi slowandsteady Whatbif you have tried a couple up doses and it is extremely stimulating to you? Hold where your act in hopes to stabilize?

 

Hi FruityPop,

Updoses that cause an increase in withdrawal symptoms sound to me like a paradoxical reaction to the benzo. I have not had this experience but it's estimated to happen in 1-2% of cases. Here is a read:

https://www.benzoinfo.com/paradoxical-reactions/

 

Failure to diagnose that the patient is experiencing this reaction may lead to a progressive increase of the benzodiazepine dose, in an attempt to “control” the misdiagnosed emerging symptoms of the paradoxical reaction leading to an increase or worsening of the paradoxical reaction symptoms, as opposed to their improvement, while simultaneously significantly lengthening the time the patient may have to spend tapering off the benzodiazepine.

 

From this material, I would suggest not updosing further, and instead considering beginning a slow taper schedule (5-10%, unless past experience and symptoms suggest otherwise). I also suggest searching the forum for buddies who have managed paradoxical reactions to learn more about what may or may not work in this situation.

 

It looks from your signature like you're very low on your Librium dosage FruityPop. Is this information up to date?

 

Yes it is. Just under 5mg or 2 mg V. I went 14 days up in my micro taper because I though I should go back to 5mg and hold. I was becoming to weak to get out of bed. The increase stimulated me so bad and I have had a very high heart rate and waking two adrenaline every two hours since then. I wish so bad that the first day it stimulated me I would have went back down but I thought I just needed to get used to it. It's been three weeks holding here with no improvements. Some say paradoxical isn't a thing and hold to stabilize but I wasn't having these symptoms before doing the 14 day dose correct on my micro taper.

[[sl...]]

Paradoxical IS a thing. I suggest resuming your micro taper from where you are now. It sounds to me like your time might be running out on this drug.

 

At ~5mg you're at about 4x the Ashton equivalent quit dose, so not far from a jump depending on how you manage your taper. I don't encourage rushing but I suggest just proceeding as best you can, and relying on other methods (ideally non-medication options) to mitigate symptoms in the future.

[[Fr...]]

Paradoxical IS a thing. I suggest resuming your micro taper from where you are now. It sounds to me like your time might be running out on this drug.

 

At ~5mg you're at about 4x the Ashton equivalent quit dose, so not far from a jump depending on how you manage your taper. I don't encourage rushing but I suggest just proceeding as best you can, and relying on other methods (ideally non-medication options) to mitigate symptoms in the future.

 

This is helpful. Thank you! I had taken the advise of the long hold group but it just didn't feel right to me. I felt better tapering and getting it out. I pray so bad as I resume taper some of the stimulation goes away but I won't know unless I try. I have been stuck in fear about what to do just coming out of my skin which is a symptom I didn't have before the small increase. I have never been well on the drug and holds have always made me worse. Nothing has helped but a slow daily micro taper. When I started this MT years ago I started to slowly heal over time but the taper got away from me. I am not sure if there was anything I could do to make it better as I got lower because I tried slowing my rate from 9% to 6% and I felt worse toxic sick more stimulated after 6 weeks somI went back to the rate I was doing and felt better but once under 2.5 When the rate got above 10% a month I became bed bound most of the day with physical and mental fatigue. I was not adjusting the amount I took out with each new dose if that makes sense so as I wen down the rate got bigger. I tried that towards th end before the dose correct and every two weeks when I adjust the rate down I felt so bad for like a week. It seems more body doesn't like many changes but don't know how I can taper at a fixed rate without the rate going up. Adjusting the rate each month based on dose is a more toxic stimulating sick and keeping the rate the same and letting % get bigger is like a crashed out can bet out of bed feeling not sure which way to go on taper rate.

[[sl...]]

Hi FruityPop,

Have you considered using Jim Hawk's DMT schedule generator? It does all the math for a percent-based reduction schedule. I wrote an instructional for how to use either the wet or dry versions of his generator here:

http://www.benzobuddies.org/forum/index.php?topic=254653.5#post_generator

 

I prefer a steady percent-based reduction schedule myself; it seems more symptomatically consistent from my experience than a linear reduction schedule. I don't know why, but it works. 6%/14 days is still as fast as I can go, even at 43% of my original dose.

 

If you have questions about using the generator or adapting your tapering method to it, please don't hesitate to ask. Or alternatively, I can tell you the math to calculate your discard or dosage based on a desired percent-based reduction rate; just tell us a little more about how you're measuring your dosage, how often you take reductions, and what percent-rate you'd like to taper at.

 

I hope this helps!

[[Fr...]]

Hi FruityPop,

Have you considered using Jim Hawk's DMT schedule generator? It does all the math for a percent-based reduction schedule. I wrote an instructional for how to use either the wet or dry versions of his generator here:

http://www.benzobuddies.org/forum/index.php?topic=254653.5#post_generator

 

I prefer a steady percent-based reduction schedule myself; it seems more symptomatically consistent from my experience than a linear reduction schedule. I don't know why, but it works. 6%/14 days is still as fast as I can go, even at 43% of my original dose.

 

If you have questions about using the generator or adapting your tapering method to it, please don't hesitate to ask. Or alternatively, I can tell you the math to calculate your discard or dosage based on a desired percent-based reduction rate; just tell us a little more about how you're measuring your dosage, how often you take reductions, and what percent-rate you'd like to taper at.

 

I hope this helps!

 

I do like this. I think you sent it to me on a different thread also. I dry cut with a scale and use the 4th number on the scale to reduce a minascule amount of Librium powder daily. Is there a way to have this chart do that showing my new weight to reduce my the 4th number each time? My scale weighs to .0001g

 

Also what is a good way to come up with a good rate? When I crashed I was inching above 10% a month once it was at 11% -12% a month I could not function at all. Looking back I was good around 9% so maybe do 4.5% every two weeks? Also as I said before when I tried to change the reduction rate every two weeks to stay with in the percentage as a last ditch effort before I up dosed every time I made the change then sleep was off for a week with each change. So I was never really that stable changing the reduction amount every two weeks. Is there some way to have a set rate and then watch it to make sure it doesn't get away from you above a certain %? Maybe start at 7.5-8 for the month and in a month or more once it gets beyond 10% readjust it down again?  I am not sure if that would be any different in symptoms. Just trying to come up with something I can tolerate.

[[sl...]]

Hi FruityPop,

It's awesome that you have a 0.1mg scale! I think that's an awesome tool for dry tapering, and I'm glad you were able to make this investment in your tapering accuracy. Jim's generator will assume you have a milligram scale, but this is good because I don't think you want to be making weight adjustments in the 0.1mg range regardless.

 

I don't understand the problem you're having with percents. I thought you were doing linear reductions (i.e. fixed quantity reductions), and so the percent reduction climbs with each fixed quantity reduction. But Jim Hawk's generator has the option to do a percent-based reduction schedule; the percent rate you set stays the same through the entire DMT taper schedule that is generated. You can adjust the percent rate if it's too fast or too slow by creating a new schedule, but otherwise the percent rate will not change on a given schedule using the percent reduction planning option.

 

Am I misunderstanding your problem?

[[Fr...]]

Hi FruityPop,

It's awesome that you have a 0.1mg scale! I think that's an awesome tool for dry tapering, and I'm glad you were able to make this investment in your tapering accuracy. Jim's generator will assume you have a milligram scale, but this is good because I don't think you want to be making weight adjustments in the 0.1mg range regardless.

 

I don't understand the problem you're having with percents. I thought you were doing linear reductions (i.e. fixed quantity reductions), and so the percent reduction climbs with each fixed quantity reduction. But Jim Hawk's generator has the option to do a percent-based reduction schedule; the percent rate you set stays the same through the entire DMT taper schedule that is generated. You can adjust the percent rate if it's too fast or too slow by creating a new schedule, but otherwise the percent rate will not change on a given schedule using the percent reduction planning option.

 

Am I misunderstanding your problem?

 

So are you saying not to use the 4th number .0001g on the scale to reduce by.? How do you make small daily cuts when you are in the low numbers without a scale like that? Would do several days at the same third placed number on the scale .001 and then hold several days at the same dose in order to make up the rate? I am stumped on this?

 

Also I was doing a fixed rate and not a percentage reduction. The problem I am having is with the % reduction you are altering the daily amount sometimes every two weeks to every month in order to make up the new percentage.i feel every change bad so when I readjust the daily rate every two weeks I get hit with a lot of symptoms unlike when I keep the daily rate the same I am hit with huge symptoms over the course of 4-6 weeks weeks as the percentage gets away from. I can see either way symptoms and no easy answer. I just think I am to far sensitized and need to hold to get things to calm. I am in bed not functional with raging adrenaline all day and night.

[[sl...]]

You can use the 0.0001g digit on your scale, I'm just saying it's the least accurate value on that display. I personally wouldn't want to be relying on that number unless the scale cost thousands of dollars.

 

This is the same reason why people mix filler with crushed tablets to get out of the milligram measurements on their milligram scales; they still use the milligram readout for reference but they don't make single milligram reductions because the cheaper scales just aren't this reliable. Maybe your scale is better than these and you can trust your 0.0001g reading; if you do and it's working to taper this way, I'm happy for you.

 

You might not be understanding how the schedule generator calculates percent reductions. These reductions happen on the day-to-day dosage changes. This might be confusing because we put in the percent reduction as something like 6% every 14 days, but this doesn't mean that 6% is reduced once every 14 days. To my understanding, it's actually the same as 3%/7 days or 12%/28 days, because the generator is just reducing these fractions to 0.42857%/day or thereabouts. As far as I know, for every day the schedule the generator take the previous daily dose and multiplies it by (1-(percent reduction as a decimal) = current days dose.

 

Ex. 5mg * (1-(0.0042857)) = 4.9786mg

 

Then it does the same calculation for the next day using 4.9786mg as the previous daily dose, and so on. This is fairly easy to reproduce with an Excel spreadsheet if you know how to use formulas. The percent reduction is the same from one day to the next. This is the whole point of doing a DMT, and the whole point of using a percent-based reduction schedule. A steady slope. And if this steady slope is still too fast, lowering the percentage rate, IME, is an effective solution to lower symptoms.

 

Am I making sense? Or have I missed what you're talking about?

 

 

 

 

[[Fr...]]

You can use the 0.0001g digit on your scale, I'm just saying it's the least accurate value on that display. I personally wouldn't want to be relying on that number unless the scale cost thousands of dollars.

 

This is the same reason why people mix filler with crushed tablets to get out of the milligram measurements on their milligram scales; they still use the milligram readout for reference but they don't make single milligram reductions because the cheaper scales just aren't this reliable. Maybe your scale is better than these and you can trust your 0.0001g reading; if you do and it's working to taper this way, I'm happy for you.

 

You might not be understanding how the schedule generator calculates percent reductions. These reductions happen on the day-to-day dosage changes. This might be confusing because we put in the percent reduction as something like 6% every 14 days, but this doesn't mean that 6% is reduced once every 14 days. To my understanding, it's actually the same as 3%/7 days or 12%/28 days, because the generator is just reducing these fractions to 0.42857%/day or thereabouts. As far as I know, for every day the schedule the generator take the previous daily dose and multiplies it by (1-(percent reduction as a decimal) = current days dose.

 

Ex. 5mg * (1-(0.0042857)) = 4.9786mg

 

Then it does the same calculation for the next day using 4.9786mg as the previous daily dose, and so on. This is fairly easy to reproduce with an Excel spreadsheet if you know how to use formulas. The percent reduction is the same from one day to the next. This is the whole point of doing a DMT, and the whole point of using a percent-based reduction schedule. A steady slope. And if this steady slope is still too fast, lowering the percentage rate, IME, is an effective solution to lower symptoms.

 

Am I making sense? Or have I missed what you're talking about?

 

Ok this does make sense and is helpful. I guess I would have to do xcel in order for it show my weights by the 4th number. Do you know the formula? I do have a very expensive scale and is very reliable at 4th number.

[[sl...]]

I guess I would have to do xcel in order for it show my weights by the 4th number. Do you know the formula? I do have a very expensive scale and is very reliable at 4th number.

 

I'm not sure if this will work, but I've put an example of how to do this in Excel into a service I just found called Offidocs.com. If you explore the spreadsheet at the link below you will see the formulas I used, and how the cells relate to each other; I only mapped out the first 10 days because I found Offidocs annoy to use. You can highlight, copy and paste this whole spreadsheet right into Excel and work with it there. I suggest doing this before making changes.

 

https://www.offidocs.com/loleaflet/dist/loleaflet.html?service=owncloudservice04&file_path=file:///var/www/html/weboffice/mydata//7478668569/NewDocuments/FruitPop.xlsx&username=7478668569&ext=yes

 

It was easier to demonstrate this way than describe in text how to use Excel. The basic formula is (current dose)=(previous dose)*(1-(decimal percent of daily reduction)). I also use a formula to turn a 14 day % into a daily percent at the top, so you can just put in 6% or whatever based on the 5-10% forum guideline into the 14 day box and it generates the daily percent reduction that gets used in the rest of the cells. Lastly, to create more days than 10, in Excel you can highlight the last cell in each of the columns Day, Dose, and Reduction, and click and hold the corner dot (right bottom of highlighted area) and just drag down until you get as many days as you want. You can also change the starting milligrams on the first day.

 

Let me know if this works for you. 

[[Fr...]]

I guess I would have to do xcel in order for it show my weights by the 4th number. Do you know the formula? I do have a very expensive scale and is very reliable at 4th number.

 

I'm not sure if this will work, but I've put an example of how to do this in Excel into a service I just found called Offidocs.com. If you explore the spreadsheet at the link below you will see the formulas I used, and how the cells relate to each other; I only mapped out the first 10 days because I found Offidocs annoy to use. You can highlight, copy and paste this whole spreadsheet right into Excel and work with it there. I suggest doing this before making changes.

 

https://www.offidocs.com/loleaflet/dist/loleaflet.html?service=owncloudservice04&file_path=file:///var/www/html/weboffice/mydata//7478668569/NewDocuments/FruitPop.xlsx&username=7478668569&ext=yes

 

It was easier to demonstrate this way than describe in text how to use Excel. The basic formula is (current dose)=(previous dose)*(1-(decimal percent of daily reduction)). I also use a formula to turn a 14 day % into a daily percent at the top, so you can just put in 6% or whatever based on the 5-10% forum guideline into the 14 day box and it generates the daily percent reduction that gets used in the rest of the cells. Lastly, to create more days than 10, in Excel you can highlight the last cell in each of the columns Day, Dose, and Reduction, and click and hold the corner dot (right bottom of highlighted area) and just drag down until you get as many days as you want. You can also change the starting milligrams on the first day.

 

Let me know if this works for you. 

 

Thank you so much. It's more than my brain can comprehend but I will have my husband look at it.