Prednisone and benzo taper- please help

[[Bo...]]

** updated to include med dosage and times

 

Ok a friend is stuck having to be on prednisone between 5-10mg due to adrenal issues….  No way around messing with that right now. She’s having severe withdrawals stuck on Ativan (doses morning and night) and Librium

 

Current doses-

7.5mg prednisone - 5am (she falls back asleep ok after this, not much issue)

.7 mg Ativan 9:30am (liquid compound switched from pill format in Sept)- severe aka rage hell, physical sx galore, begins each day at this dose)

1.5mg prednisone - 11:30am (sxs worsen)

30mg Armour thyroid - 11:30am

10mg Librium - 2pm (lots of physical pots sxs, weak, aka continues badly all day, screaming, head pain)

10mg Librium - 4pm (she has felt very sick after each Librium introduced last summer)

1mg Ativan- 9:30pm (lots of the head sensations etc)

 

Her story summary-

I was put on Ativan in June 2022 (1mg x twice a day) to replace my Fioricet (barbiturate) which I was taking since 2020.

I quickly started experiencing interdose withdrawal and doctors added another 1 mg at noon.

It didn’t go well (I think it was too much), so doctors suggested to cut it to 0.5mg x 6 times a day.

It didn’t go well, so doctors suggested switching to Valium.

Valium didn’t go well at all with me, and noon dose was replaced with 25 mg Librium: better reaction than Valium, but still worse than Ativan.

Then I tried to add a second 25mg dose of Librium and it didn’t go well.

So I went back to Ativan + Librium + Ativan

 

 

Please any thoughts on how to move forward. She’s paradoxical and any tiny cut down she makes she gets worse. So she feels so stuck on what to do. She’s been holding now for 2 months thinking she might stabilize some but appears things are just getting worse. Mods- do y’all recall people who have mannaged thru this scenario? I’ve read some after searching steroids and prednisone on here and not sure how people knew what to moved forward with.

 

I’m waiting on some recs for a neuroendocrinologist from my Dr this week 4/3/23. Just so she maybe can get guidance on which to taper first bc her adrenals have crashed which at hospital they have to give steroids. Adrenal crisis is a severe deal so that makes this tough to navigate especially when her drs she’s seen in NYC say they don’t understand the benzo component and how they can help guide her.

 

Thank you so so much!