Reinstated advice with this Valium

[[Ja...]]

Too intense.  Too hard.  Thinking of Er to help somehow?

 

Been there, done that. Most likely at the ER you will be given a benzo. Probably Ativan . . . that's their benzo of choice. It was for me. You will temporarily feel better. They will talk to you earnestly about getting a script for your anxiety/panic/distress from your doc. But hey, you already have one!!

 

I don't get why you would go the the ER. More magical thinking imo.

 

Look, if you want to go back on a benzo, DO IT!!!!!! You've had all our advice. There's nothing else we can share with you.

 

 

Katz

 

Katz,

      She’s in rough shape now. Take it easy on her. I know it’s frustrating as we all want what is best for her and she is suffering so bad right now that she just wants relief no matter the cost. I’m figuratively banging my head against the wall following this thread as well thinking “Is she really going to do this? I really hope she doesn’t do this.” and at the same time praying she gets a window of relief so she can catch her breath. Most of the rest of us have been the ER countless times. She has not had that experience yet. Maybe I’m reading something into it but when I saw your caps saying DO IT I thought maybe you were starting to get overly emotional. If so, maybe take a breather. Either way Summer has pretty much absorbed as much info as we can give her. She faces a tough decision now. We have all been there. I started Remeron as a hail mary and got lucky. That aas a tough decision that no one here could have made for me. Anyone who told me not to would have been wrong despite their best intentions. I made that decision long before I found this site and had to figure out my own way.

 

Summer,

            I have pretty much told you all I know on this subject. I hope you make the right decision. I can’t even tell you what is the right decision. We are all mostly making educated guesses. Our bodies are all so different physiologically. What hurts one can save another and what saves another can hurt someone else. Some people can digest milk and some can’t. It’s just the way it is.

[[Fr...]]

I don't get why you would go the the ER. More magical thinking imo.

 

People do it out of panic, fear and desperation, even if they know it's not going to offer a solution. Sometimes it's just the peace of mind from a qualified healthcare professional telling them that they're going to be ok, regardless of how intense the symptoms are. Peace of mind can help people to get through this when they're in a really bad place, even if it's not a cure all to the symptoms that they're experiencing in the moment.

[[or...]]

If so, maybe take a breather.

 

Yup. You're right.

 

Going to the ER is fruitless, but as Fraz says may provide some psychological relief.

 

I feel like I'm on the sidelines watching an about-to-happen car crash, yelling "OMG watch out!" and being helpless to do anything about it. I've seen too many people on here crash and burn by being advice-resistant.

 

I'm not coming back to this thread. It's frustrating for me and not helpful for the OP.

 

 

Katz

 

 

 

[[Fr...]]

If so, maybe take a breather.

 

Yup. You're right.

 

Going to the ER is fruitless, but as Fraz says may provide some psychological relief.

 

I feel like I'm on the sidelines watching an about-to-happen car crash, yelling "OMG watch out!" and being helpless to do anything about it. I've seen too many people on here crash and burn by being advice-resistant.

 

I'm not coming back to this thread. It's frustrating for me and not helpful for the OP.

 

 

Katz

 

Sometimes we get so caught up on the logistical advice that we overlook the emotional aspects of the problem. Which is very easy to do on an online forum to be fair. It's not the same as giving advice face to face when you have a wider context of the person and their situation to base the advice on.

 

Your advice on here is perfectly logical and sound and is very much valued and appreciated. They'll always be other members to provide the emotional angle for tackling the problem and this provides an overall balance of both the logistical and emotional aspects which are equally important to those seeking help and advice.

[[Ha...]]

I found an old post that might help you decide. (You might notice that Dr Peart recommends starting at 1mg and working up, but I'm not here to argue with Katz "scientific knowledge")

 

Hope it helps you make an informed decision.

 

http://www.benzobuddies.org/forum/index.php?topic=53305.0

 

Before I knew very much about how involved all of this is I was questioning whether or not I should reinstate and another buddy (thank you!) sent me these 4 links that helped me decide.  Wanted to share them with you so you can also make an informed decision for youself.  I bold highlighted things I thought were significant.  I personally decided not to reinstate based on how far out I was.  Hope this helps.  Good luck!

 

 

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

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.

 

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).

 

 

 

From http://www.non-benzodiazepines.org.uk/withdrawal-guide.html -

Updosing and reinstating

 

We have found that reinstating is most successful if it is carried out within 2 weeks after complete discontinuation of benzodiazepines. Generally reinstating is discouraged beyond 2 weeks after discontinuation as reinstating beyond this point in time may not always work and sometimes in rare cases may even make the individual feel worse. However, there may be circumstances where reinstating is required for example a person may have been cold turkeyed and is suffering extreme withdrawal effects such as psychosis or intolerable symptoms of anxiety or insomnia and may be acutely suicidal. However, due to the unpredictability of reinstating which may not always fully alleviate withdrawal symptoms the choice to reinstate beyond 2 weeks completely off of benzodiazepines must be made by the individual.

 

If a person is going to reinstate after complete discontinuation of benzodiazepines and have been off of benzodiazepines for more than a couple of weeks and have made the decision to reinstate, it is better to introduce benzodiazepines gradually rather than picking a dose out of thin air and going straight on it. One reason for doing it this way is that a person can judge what their tolerance level is. So a person may want to start off taking 1 mg of diazepam and increasing the dose by 1 mg each day until they find relief of intolerable withdrawal symptoms. This approach is recommended by Dr Reg Peart for people when they have decided to reinstate.

 

 

 

From http://www.benzosupport.org/notes_on_reinstatement.htm -

Notes on Reinstatement.

 

CAUTION: A person should always consult with their doctor before making any changes to their medication.

 

What is Reinstatement? Reinstatement is going back onto a benzo after a cold turkey, detox or very rapid taper.

 

What is the purpose of a Reinstatement?  The purpose of reinstatement is to bring very bad withdrawal symptoms under control so that a person can start a slower taper off benzos that will hopefully make the withdrawal process more bearable and allow the person to be more functional as they do it.

 

Does it work? Observation of people reinstating suggests that reinstatement after being off benzos for less than 4 weeks is more likely to work than reinstatement months or years after ceasing the drugs. However, these numbers are very variable and other issues, like being on other psychiatric drugs can factor in.

 

What benzo do people reinstate to?  People either reinstate to the benzo they were on or they talk to their doctor about reinstating to one of the benzos with a longer half life like Valium. The tapering advantages of Valium are discussed in the Ashton Manual. If someone is unable to use Valium, they would probably be better off using Klonopin, rather than Ativan or Xanax. Both Ativan and Xanax have extremely short half-lives and can produce difficult interdose withdrawal symptoms.

 

How much benzo do people reinstate to? The purpose of reinstating is to get the withdrawal symptoms under enough control so that a person can embark on a slow taper. The amount needed is likely to vary with the individual – it may be the same as they were taking prior to the cold turkey, a little more or a little less. Dr. James Thomas in Ohio has been known to reinstate people onto Valium 2mg every 3 hours until the person feels well. Dr. Peart, of VOT, suggests 1-2mg/day of Valium until the person feels better. We have no scientific data to support either approach so one must simply talk to their doctor about this.

 

Are there are problems with Reinstatement that should be considered?

 

Yes there are.

 

-    Reinstatement may make some feel better but the taper and recovery that follows may still be hard

 

-    Reinstatement may not make a person feel better and then they are faced with a difficult taper anyway.

 

-    In some cases a reinstatement can make a person feel worse than they did prior to the reinstatement. Anyone contemplating a reinstatement should discuss a plan for getting off again with their doctor in case they find themselves in this situation.

 

What is the general feeling about reinstatement at the Yahoo Benzo Group?

 

It is generally felt that if a person has recently come off benzos rapidly and is extremely unwell, then reinstatement may be an option to discuss with their doctor.

 

It is also felt that if a person has done a reasonable taper and is many months or years into recovery that reinstatement should only be considered if the person has absolutely no quality of life.

 

Is there any scientific evidence about effectiveness of Reinstatement? No, there doesn’t appear to be any scientific evidence that helps with the decision making about reinstatement.

 

 

And finally from a BB thread - http://www.benzobuddies.org/forum/index.php?topic=44288.20