Can tolerance withdrawal cause kindling?

[[Da...]]

I'm just wondering if taking a short acting benzo like Xanax or Ativan can cause kindling even when taking the same dose for a long time? Every morning I wake up in withdrawal until I take the dose but now even taking the dose isn't enough to curb the withdrawal. It seems like my brain and body has completely had enough of daily withdrawal. Someone I spoke to then said kindling can occur from taking short acting benzos everyday. I also read on the BIC website that kindling can occur from once daily short acting benzos. Just interested if anyone had thought of this?

 

I need to try the switch back to diazepam again, I'm waiting for some input from my doctor as she wasn't on board for the second try as she wanted me to try lamotrogine first. I can't try any new medication in this state so I'm going to have to try the diazepam again but I'm concerned about the sedation/shallow breathing and severe depression(it's already bad) I had with it.

[[Re...]]

I had this happen to me. I have no idea about kindling as this is a debated term in medicine.

 

Did your doctor try to taper you and then reinstate you? I believe that this is what caused interdose tolerance for me. He tapered me too quickly a few months prior then reinstated and BAM the tolerance emerged. I recently put two and two together on this.

 

What is the medical wisdom behind Lamictal? How in the world does the doctor think that can help benzo tolerance?

 

Shallow breathing is a concern. What about Klonopin? Have you tried a cross-taper to Klon? Librium? (I am not as familiar with Librium but I know it is used in some cases with success.)

[Guest [...]]

Hi Dark-cat7

 

Just in relation to the once a day short acting benzo’s - I personally believe inter-dose withdrawals of any length of time causes kindling. It’s no different than a doctor prescribing a benzo’s prn (to be taken as needed). It’s fraught with danger. Once dependence sets in and inter-dose withdrawals emerge (even slightly), I believe you automatically begin to kindle. One should always make sure they are dosing adequately throughout the day to avoid inter-dose withdrawals from short acting benzodiazepines.

 

I experienced the depression and over sedation after a ‘direct switch’ (never advisable) from clonazepam c/t to diazepam, but it subsided as I went through withdrawal from the clonazepam beneath the diazepam dosing and gradually acclimated to the diazepam over a period of time.

 

I’m not sure about any issues with shallow breathing… as I’m not sure whether you’re alluding to pre-existing issues, or if it’s just a general concern. Most of my own breathing issues are related to SIBO (small intestinal bacteria over-growth) and food chemical intolerances which cause bloating (gases) and can restrict breathing, especially when lying down. As the gases push upward when asleep (or anytime), it can interfere with one’s depth of breathing, causing anything from increased snoring to sleep apnea. However, personally I have never seen this as a side affect of diazepam… only gut impairment, as it was exactly the same on a variety of benzo’s and various other medications. Talk to your doctor…

 

You might like to update/expand your history/signature also… the more information you provide, the more accurate the feedback from members.

[[Da...]]

I had this happen to me. I have no idea about kindling as this is a debated term in medicine.

 

Did your doctor try to taper you and then reinstate you? I believe that this is what caused interdose tolerance for me. He tapered me too quickly a few months prior then reinstated and BAM the tolerance emerged. I recently put two and two together on this.

 

What is the medical wisdom behind Lamictal? How in the world does the doctor think that can help benzo tolerance?

 

Shallow breathing is a concern. What about Klonopin? Have you tried a cross-taper to Klon? Librium? (I am not as familiar with Librium but I know it is used in some cases with success.)

 

Hi Rebecca,

 

I was on diazepam 2mg for about 8 weeks in November 2021 which I then stopped myself as it wasn't helping. My anxiety and depression got so bad by April 2022 I wasn't eating properly and dangerously thin, that's why they put me on lorazepam to help the anxiety so I could eat..I was on 1mg for a few weeks, had a hospital stay for malnutrition and lorazepam was increased to 1.5mg per day to get me out of the hospital. I then took between 1 and 1.5mg per day but started to experience withdrawal in-between doses(I didn't know that this was happening, thought I was having physical health issues and was up and down the a and e every week). I then paid to go into a mental health hospital in August 2022 and lorazepam reduced to 1mg split into two doses. I've been on this since and the interdose wd has got so bad.

 

Lamictal would be for depression and I was recently diagnosed with bipolar 2 but with all the haywire lorazepam is causing I haven't got a clue what's actually me and what's being caused by the lorazepam.

 

I also thought about klon but there's a lot of people here that seem to have difficulty reducing that too. However I need to stop the interdose as it's destroying me..

[[Da...]]

Hi Dark-cat7

 

Just in relation to the once a day short acting benzo’s - I personally believe inter-dose withdrawals of any length of time causes kindling. It’s no different than a doctor prescribing a benzo’s prn (to be taken as needed). It’s fraught with danger. Once dependence sets in and inter-dose withdrawals emerge (even slightly), I believe you automatically begin to kindle. One should always make sure they are dosing adequately throughout the day to avoid inter-dose withdrawals from short acting benzodiazepines.

 

I experienced the depression and over sedation after a ‘direct switch’ (never advisable) from clonazepam c/t to diazepam, but it subsided as I went through withdrawal from the clonazepam beneath the diazepam dosing and gradually acclimated to the diazepam over a period of time.

 

I’m not sure about any issues with shallow breathing… as I’m not sure whether you’re alluding to pre-existing issues, or if it’s just a general concern. Most of my own breathing issues are related to SIBO (small intestinal bacteria over-growth) and food chemical intolerances which cause bloating (gases) and can restrict breathing, especially when lying down. As the gases push upward when asleep (or anytime), it can interfere with one’s depth of breathing, causing anything from increased snoring to sleep apnea. However, personally I have never seen this as a side affect of diazepam… only gut impairment, as it was exactly the same on a variety of benzo’s and various other medications. Talk to your doctor…

 

You might like to update/expand your history/signature also… the more information you provide, the more accurate the feedback from members.

Hi Winters sun,

 

Thanks for the reply. I am on lorazepam 0.5mg twice daily. Last dose of day is 2-3pm then again at 9am so a big gap between dosing but I have no choice.. interdose withdrawal starts at 2pm and I am taking the lorazepam to then function for my daughter. I feel kindled, if that's makes sense as the daily withdrawal is severely painful at this point and the lorazepam is doing nothing. My immune system is also completely defunct.

 

The shallow breathing I believe was from the sedation of the diazepam, I'm very slight so the diazepam was probably too much but I had to take the equivalent dose to stop the withdrawal from lorazepam. Sometimes I get a tight chest and breathing difficulties even on the lorazepam, this started last summer stopped in the winter but started to experience again when we have humid days. Never had a problem with breathing issues before benzos(I used to be a competitive cyclist) and oxygen always above 97% so maybe it is stomach related. I also noticed the last time I had shortness of breath it started after lying down.

 

I did try a straight swap to diazepam initially but , like you, was probably experiencing lorazepam withdrawal underneath the diazepam side effects. I need to try again but I'm scared now..

 

I'll try and expand my signature, thank you for the suggestion..

[[Re...]]

I had this happen to me. I have no idea about kindling as this is a debated term in medicine.

 

Did your doctor try to taper you and then reinstate you? I believe that this is what caused interdose tolerance for me. He tapered me too quickly a few months prior then reinstated and BAM the tolerance emerged. I recently put two and two together on this.

 

What is the medical wisdom behind Lamictal? How in the world does the doctor think that can help benzo tolerance?

 

Shallow breathing is a concern. What about Klonopin? Have you tried a cross-taper to Klon? Librium? (I am not as familiar with Librium but I know it is used in some cases with success.)

 

Hi Rebecca,

 

I was on diazepam 2mg for about 8 weeks in November 2021 which I then stopped myself as it wasn't helping. My anxiety and depression got so bad by April 2022 I wasn't eating properly and dangerously thin, that's why they put me on lorazepam to help the anxiety so I could eat..I was on 1mg for a few weeks, had a hospital stay for malnutrition and lorazepam was increased to 1.5mg per day to get me out of the hospital. I then took between 1 and 1.5mg per day but started to experience withdrawal in-between doses(I didn't know that this was happening, thought I was having physical health issues and was up and down the a and e every week). I then paid to go into a mental health hospital in August 2022 and lorazepam reduced to 1mg split into two doses. I've been on this since and the interdose wd has got so bad.

 

Lamictal would be for depression and I was recently diagnosed with bipolar 2 but with all the haywire lorazepam is causing I haven't got a clue what's actually me and what's being caused by the lorazepam.

 

I also thought about klon but there's a lot of people here that seem to have difficulty reducing that too. However I need to stop the interdose as it's destroying me..

 

If you were recently diagnosed and didn’t have these issues prior to a benzo I personally would doubt the diagnosis. It’s very common that people get misdiagnosed in benzo wd. Winters Son is a better advisor on tapering than I am so I’m glad WS is here.

[Guest [...]]

Hi Dark-cat7

 

Just in relation to the once a day short acting benzo’s - I personally believe inter-dose withdrawals of any length of time causes kindling. It’s no different than a doctor prescribing a benzo’s prn (to be taken as needed). It’s fraught with danger. Once dependence sets in and inter-dose withdrawals emerge (even slightly), I believe you automatically begin to kindle. One should always make sure they are dosing adequately throughout the day to avoid inter-dose withdrawals from short acting benzodiazepines.

 

I experienced the depression and over sedation after a ‘direct switch’ (never advisable) from clonazepam c/t to diazepam, but it subsided as I went through withdrawal from the clonazepam beneath the diazepam dosing and gradually acclimated to the diazepam over a period of time.

 

I’m not sure about any issues with shallow breathing… as I’m not sure whether you’re alluding to pre-existing issues, or if it’s just a general concern. Most of my own breathing issues are related to SIBO (small intestinal bacteria over-growth) and food chemical intolerances which cause bloating (gases) and can restrict breathing, especially when lying down. As the gases push upward when asleep (or anytime), it can interfere with one’s depth of breathing, causing anything from increased snoring to sleep apnea. However, personally I have never seen this as a side affect of diazepam… only gut impairment, as it was exactly the same on a variety of benzo’s and various other medications. Talk to your doctor…

 

You might like to update/expand your history/signature also… the more information you provide, the more accurate the feedback from members.

Hi Winters sun,

 

Thanks for the reply. I am on lorazepam 0.5mg twice daily. Last dose of day is 2-3pm then again at 9am so a big gap between dosing but I have no choice.. interdose withdrawal starts at 2pm and I am taking the lorazepam to then function for my daughter. I feel kindled, if that's makes sense as the daily withdrawal is severely painful at this point and the lorazepam is doing nothing. My immune system is also completely defunct.

 

The shallow breathing I believe was from the sedation of the diazepam, I'm very slight so the diazepam was probably too much but I had to take the equivalent dose to stop the withdrawal from lorazepam. Sometimes I get a tight chest and breathing difficulties even on the lorazepam, this started last summer stopped in the winter but started to experience again when we have humid days. Never had a problem with breathing issues before benzos(I used to be a competitive cyclist) and oxygen always above 97% so maybe it is stomach related. I also noticed the last time I had shortness of breath it started after lying down.

 

I did try a straight swap to diazepam initially but , like you, was probably experiencing lorazepam withdrawal underneath the diazepam side effects. I need to try again but I'm scared now..

 

I'll try and expand my signature, thank you for the suggestion..

 

Hi DC7

 

I completely agree with Rebecca…

 

Based solely on the limited background information you’ve provided here… I wouldn’t be putting much weight in the bipolar 2 diagnosis. Often doctors will lump you into the closest category they can find, based on your symptoms. The ‘fact’ that they have little to no knowledge/understanding of the potentially devastating effects of benzodiazepine medications, clearly, they are often missing the most crucial piece of the puzzle. These rash uneducated diagnoses naturally lead the doctor/doctors to prescribe even more unnecessary additional (potentially harmful) medications which often only ever compound the problem.

 

I would never advise you to not listen to your doctor, as I am not a doctor myself, but we have seen this over and over again… so, I would just suggest you be very careful and please use your intuition before buying into any diagnoses made without ever factoring in such a crucial missing piece of the puzzle. You certainly don’t want to have to deal with the addition of any potential adverse interactions between multiple medications, nor do you want to have to taper off any potentially unnecessary additional medications.

 

In relation to you current inter-dose withdrawals and your desire to taper off the medication… let’s just simplify it.

 

You cannot taper whilst experiencing these inter-dose withdrawals, so, if I were in your position… I would take care of that inter-dose withdrawal issue first.

 

I understand you are dosing at 9am and then again between 2-3pm, but, before I go any further…

 

1) Do you experience intensified inter-dose withdrawals at anytime between the 2-3pm dose and the 9am dose the next morning? (18-19hrs)

 

2) How is your sleep?

 

 

 

 

 

 

 

 

[[Da...]]

Thank you for both your replies. The private psychiatrist I spoke to is in agreement that the benzo is causing some of this but I also was quite unwell before going on it but I didn't feel anywhere near as bad as I do now. The bipolar 2 diagnosis is still being debated but the private psych is more interested in the benzo issue. My GP wants me to follow the orders of the mental health team(NHS, I'm in the UK)which was to try lamotrogine first. I'd been on lamotrogine before lorazepam and could only tolerate the smallest dose. I haven't tried again.

 

Winters sun,

I wake up with severe wds every morning but also the wds can start in the evening so I go to bed in a very bad state and wake up in a worse state. I take mirtazapine to sleep but that's no longer helpful. I'm just in constant wd, I occasionally get some relief and windows but not often and the next day I cannot really remember them. My memory has become atrocious when it was once very good..I cannot sleep tonight it is 1am, I fell asleep then woke up after 15 minutes with hypnogogic hallucinations and pounding heart. This is happening most nights. I don't feel like myself whatsoever, it's very scary. What do you suggest I do? Thank you in advance..

[Guest [...]]

Thank you for both your replies. The private psychiatrist I spoke to is in agreement that the benzo is causing some of this but I also was quite unwell before going on it but I didn't feel anywhere near as bad as I do now. The bipolar 2 diagnosis is still being debated but the private psych is more interested in the benzo issue. My GP wants me to follow the orders of the mental health team(NHS, I'm in the UK)which was to try lamotrogine first. I'd been on lamotrogine before lorazepam and could only tolerate the smallest dose. I haven't tried again.

 

Winters sun,

I wake up with severe wds every morning but also the wds can start in the evening so I go to bed in a very bad state and wake up in a worse state. I take mirtazapine to sleep but that's no longer helpful. I'm just in constant wd, I occasionally get some relief and windows but not often and the next day I cannot really remember them. My memory has become atrocious when it was once very good..I cannot sleep tonight it is 1am, I fell asleep then woke up after 15 minutes with hypnogogic hallucinations and pounding heart. This is happening most nights. I don't feel like myself whatsoever, it's very scary. What do you suggest I do? Thank you in advance..

 

Hi DC7

 

Okay, so it’s fair to assume you may have had a pre-existing condition prior to the lorazepam, but given the very poor lorazepam dosing schedule… once you reached dependency, the inter-dose withdrawals would have begun to exacerbate any symptoms from the pre-existing condition. So, it’s really important right now that you adjust your dosing schedule to avoid any further inter-dose withdrawals before any further steps are taken…

 

I’m not sure whether it’s your GP who is prescribing the lorazepam, or your psychiatrist, but I’m assuming it’s your GP, as it sounds like your consultations with the psychiatrist are relatively new.

 

Is your GP willing to increase your total daily dose and spread it over 3 or 4 daily doses, or, if not, can you talk to the psychiatrist and (since they see potential issues with the lorazepam) will they themselves prescribe…, or alternatively, talk to your GP about prescribing a higher total daily dose to avoid continually putting you through inter-dose withdrawals. Possibly, you could begin by up-dosing from 1mg daily to 1.2mg daily (dosing 3 x 0.4mg daily or 4 x 0.3mg daily) and see how that goes. This would call for you to start a thread on the ‘Planning Your (taper) Withdrawal’ Board to discuss various options to divide your doses accurately (as you would no longer be able to simply dose 1 whole tablet twice a day…), instead, having to calculate and weigh your doses using a precision jewellers scale… to break the tablets into 3 or 4 equal daily doses.

 

The idea of this may seem overwhelming at first, but I assure you, you have all the information and guidance on hand here to support you make any necessary changes to your taper practice. At some point, nearly all members have to educate themselves on alternative tapering practices. We will help you through this, and it’s not nearly as difficult as it may sound.

 

The question is - how many doses per day do you need to avoid the inter-dose withdrawals (3 or 4), and what size do these individual doses need to be to keep you stabilised throughout the day and get you to a point where you are ready to taper? It’s better to make small increases in your daily dose and work up… rather than make an overly large increase…

 

You don’t want to up-dose any more than necessary, as obviously this would mean a longer taper off the medication, but you do need to stabilise on the right size doses and dosing schedule before you can move forward with your taper.

 

Much of this will depend on the willingness of your doctors/psychiatrists to work with you… understanding you need to end these continual inter-dose withdrawals. You really can’t taper while these inter-dose withdrawals remain.

 

You do have the option to try another crossover to diazepam, but it would have to be done in a slow and sensible manner… as per the Ashton Manual Guidelines. The crossover can be rough, some even finding it too rough, so you would have to be prepared… expect that it may take considerable time to withdraw from the lorazepam as you adjust to the diazepam. Of course… there are also those that find the crossover too difficult and choose to abort, so there is no guarantee of success.

 

You also have your concerns when it comes to over-sedation, depression and shallow breathing…

 

My personal experience is that the over-sedation only lasted for about 3 or 4 weeks, and the depression also decreased and resolved as I acclimated to the diazepam. I can’t really give you any advise on the shallow breathing, other than my own personal experience of having gut related issues and how an overabundance of gases can cause restrictive breathing, especially when lying down, as the gases more easily push up the digestive tract when lying down and the upward pressure can cause breathing to become restrictive. Any food chemical intolerances also have shallow breathing listed as a common symptom. Personally, I haven’t linked any of my shallow breathing directly to the diazepam, but I can’t speak for any other members. If any digestive issues were behind your shallow breathing… I would expect you to be experiencing bloating or distension.

 

Just in regard to the lorazepam dosing… you want to be spacing all doses out equally throughout the day… if dosing 3 times daily is enough… dosing should be 8hrs apart. If you need 4 doses daily to avoid the inter-dose withdrawals… doses should be 6hrs apart.

 

Please feel free to voice any concerns and ask any further questions you may have.

 

WS

 

 

[[Da...]]

Hi WS,

 

Thank you for your time in replying to me, it really means a lot.  The mental health team psychiatrist is the one who recommends the prescription then my GP prescribes it. There is absolutely no way they will increase it. Legally they have covered themselves because they have put on the prescription -to take as needed. My GP knows I have been taking it everyday and am dependent on it, she took over the prescription when I moved doctors surgery last June. I have told her about the interdose wds and that I'm extremely sick with it. She says I must try the lamotrogine first, but I cannot take any other meds. I have become so frightened to take anything else in the state I'm in.

 

After I tried the diazepam I had some extra lorazepam left so I did updose to 1.5mg for a week to see if I felt better but the psychosis symptoms didn't resolve and I was still waking up with wds. I guess the drug has truly turned on me or I am infact dealing with a severe mental illness alongside tolerance and interdose wds. Then I had further wds going back to the 1mg, further kindling myself no doubt.

 

I want to try the diazepam again but I may have to go into some kind of rehab facility because I can't put my family through much more.

 

When I was taking the diazepam I did notice the psychosis symptoms were better, my derealization was improved but physically I couldn't do anything, had trouble standing/walking etc.  I also tried taking lorazepam am and diazepam pm in an attempt to cross over but then I got a horrible virus and I went back to lorazepam. Slowly the psychosis symptoms came back.

[Guest [...]]

Hi WS,

 

Thank you for your time in replying to me, it really means a lot.  The mental health team psychiatrist is the one who recommends the prescription then my GP prescribes it. There is absolutely no way they will increase it. Legally they have covered themselves because they have put on the prescription -to take as needed. My GP knows I have been taking it everyday and am dependent on it, she took over the prescription when I moved doctors surgery last June. I have told her about the interdose wds and that I'm extremely sick with it. She says I must try the lamotrogine first, but I cannot take any other meds. I have become so frightened to take anything else in the state I'm in.

 

After I tried the diazepam I had some extra lorazepam left so I did updose to 1.5mg for a week to see if I felt better but the psychosis symptoms didn't resolve and I was still waking up with wds. I guess the drug has truly turned on me or I am infact dealing with a severe mental illness alongside tolerance and interdose wds. Then I had further wds going back to the 1mg, further kindling myself no doubt.

 

I want to try the diazepam again but I may have to go into some kind of rehab facility because I can't put my family through much more.

 

When I was taking the diazepam I did notice the psychosis symptoms were better, my derealization was improved but physically I couldn't do anything, had trouble standing/walking etc.  I also tried taking lorazepam am and diazepam pm in an attempt to cross over but then I got a horrible virus and I went back to lorazepam. Slowly the psychosis symptoms came back.

 

Hi DC7

 

Okay… we now know the practitioners won’t prescribe a suitable total daily dose to take care of the inter-dose withdrawal issue, but given how you’ve described your experience with crossing to diazepam… I believe there’s enough evidence that given enough time to acclimate, you should be able to crossover and stabilise. The tricky thing about crossing to diazepam (based on my own personal experience) is that, I believe a number of those who attempt this crossover abort the crossover before they’ve allowed enough time for the underlying withdrawal from the previous benzo to run its course whilst they acclimate to the new medication, however, I cannot dismiss the possibility that a number of members may not do well on diazepam even after giving enough time to ride through the transition. The diazepams therapeutic effect can feel very different from other medications. All benzo’s differ in this way. It also takes quite some time to build up your blood serum level because of the very long half life, so it’s very important to crossover slowly via the Ashton Manual Guidelines, to which I’ll provide a link below. I don’t know how much your doctor understands (if anything at all) about the necessity to make it a slow crossover, so that’s something you will have to discuss with her. You can provide her with a printout of the Ashton Manual (crossover) Guidelines from lorazepam to Diazepam. It’s important she understands the reason behind this, especially when crossing from a very short half life benzodiazepine to a very long half life benzodiazepine. If you were to just jump from the lorazepam to the diazepam, the lorazepam would leave you body very quickly and the diazepam wouldn’t cushion the lorazepam withdrawal because it takes days to a week for the diazepam to build up in your body before your blood serum levels reach a therapeutic level to cover for the lorazepam and cushion you through the transition.

 

Your 1mg lorazepam is equal to about 8mg diazepam, but because you up-dosed to 1.5mg for a week or so, I would personally look at crossing over to about 10mg diazepam (1.5mg lorazepam = approx 11mg diazepam) to make sure I’m not under medicated and give myself the best chance to acclimate and stabilise on the diazepam.

 

I really don’t see why your doctor would think the lamotrogine would have any therapeutic effect whatsoever, when it comes to alleviating your inter-dose withdrawals. It makes no sense whatsoever, and only points to a clear lack of understanding around benzodiazepine medications.

 

Just in relation to the diazepam… the overwhelming sedation will only last for a period of time. It was 3-4 weeks for me. I could barely even lift my chin off my chest after dosing and often had to just go to bed for the first several weeks, but you do acclimate, and I believe it will resolve completely within those initial several weeks. I would also expect any depression to lift as you gradually recover from the underlying withdrawal from the lorazepam and acclimate to the diazepam.

 

Once you have completed the crossover and acclimated to the diazepam, you should experience no inter-dose withdrawals at all, and this will eventually see you stabilise, from which point, you can then begin a much easier taper because of the long half life of the diazepam. Some members choose to only dose diazepam once a day, whereas others (like myself) dose twice per day, 12 hrs between doses.

 

The only other option you have, is to split your current 1mg lorazepam into 3 x 0.333mg doses or 4 x 0.25mg doses, but my concern is that you would still experience inter-dose withdrawals because your total daily dose would still be the same, and the lower doses would dip below their therapeutic affect quicker.

 

Personally, I would look at crossing to somewhere between 10 - 11mg diazepam, know that it could be considerably uncomfortable for that period of time whilst you withdraw from the lorazepam (underneath) and acclimate to the diazepam.

 

Again… if you want to discuss this further… have any questions or concerns… please feel free to ask.

 

The Ashton Manual

 

WS

[[Da...]]

Hi WS,

 

Thank you again for your reply. I think the NHS psychiatrist/GP thought that the lamotrogine would boost mood (I'm already very depressed) to make dealing with the benzo issue easier but I have tried so many meds I have become too frightened to try. I haven't put all the meds I've tried in my signature but I've also tried going back on paroxetine, I also tried quetiapine, olanzapine and pregabalin as well as different anti-histamines.  I'm pretty sure the lorazepam has caused such a perpetual state of fear that I'm fearing everything and cannot rationalise anything. I cannot believe such a tiny tablet could cause this.

I still have some diazepam left, I could potentially add in 2mg in the evening for a week to let it build in the system then see my gp again regarding the cross over to then add in another 2mg in the afternoon and stop the afternoon dose of lorazepam. I'm not sure if this is going to help or cause more withdrawals but I need to do something. I don't think I could tolerate 10mg of diazepam, I only lasted four days on 7.5mg.

 

I think you're right that splitting it into three doses would just cause the therapeutic dose to not reach potential and then I'd be dipping in and out of wd even more. I would have tried but knowing that the 1.5 dose split into three doses also did not stop symptoms tells me that the lorazepam isn't helping even at a higher dose.

[Guest [...]]

Hi WS,

 

Thank you again for your reply. I think the NHS psychiatrist/GP thought that the lamotrogine would boost mood (I'm already very depressed) to make dealing with the benzo issue easier but I have tried so many meds I have become too frightened to try. I haven't put all the meds I've tried in my signature but I've also tried going back on paroxetine, I also tried quetiapine, olanzapine and pregabalin as well as different anti-histamines.  I'm pretty sure the lorazepam has caused such a perpetual state of fear that I'm fearing everything and cannot rationalise anything. I cannot believe such a tiny tablet could cause this.

I still have some diazepam left, I could potentially add in 2mg in the evening for a week to let it build in the system then see my gp again regarding the cross over to then add in another 2mg in the afternoon and stop the afternoon dose of lorazepam. I'm not sure if this is going to help or cause more withdrawals but I need to do something. I don't think I could tolerate 10mg of diazepam, I only lasted four days on 7.5mg.

 

I think you're right that splitting it into three doses would just cause the therapeutic dose to not reach potential and then I'd be dipping in and out of wd even more. I would have tried but knowing that the 1.5 dose split into three doses also did not stop symptoms tells me that the lorazepam isn't helping even at a higher dose.

 

Hi DC7

 

Do you still experience a therapeutic effect after dosing? … when you went to 1.5mg 3 x per day, did your symptoms decrease for a time after each of those doses. Was it still a case of doses wearing off and causing inter-dose withdrawal?

 

When you switched to diazepam the first time… did you make a direct switch, or was it a slow crossover? The reason I ask, is because a slow crossover will give your body time to adjust to the sedative effects of the diazepam as it builds up, rather than being hit by a large dose (equivalent to the lorazepam) of the new benzo.

 

I would try to cross to at least 7.5mg of diazepam daily, or you may experience severe acute type withdrawal symptoms by crossing too low.

 

I’m concerned that you don’t have a clear understanding of how bad things can get if you remove either of the lorazepam doses and replace them with an insufficient dose of diazepam. I’m also concerned that you don’t quite understand that the diazepam will provide very little therapeutic effect until it’s had sufficient time to build up in your body… the lorazepam will leave your body almost immediately on cessation, and the diazepam won’t provide cover/relief until your blood serum level builds up over days to a week. Your interdose withdrawals will get worse because initially it’ll be like going from dosing the lorazepam twice per day to only once per day, without any cushioning from the diazepam until it’s have time to build in your body. You may think that because you notice a considerable affect from the the diazepam after dosing that it is already playing it’s role… but this is not so… it has to build up in your body to cushion the blow from the sudden loss of the lorazepam, and then you have to consider the drop to only 2mg of diazepam from 0.5mg of lorazepam is like a very big decrease in dosage. These two issues combined could make things extremely painful. I just don’t want you to go into this unaware of the potential repercussions. Most members will tell you that lack of knowledge and understanding early on (whether on the part of the doctor, or themselves) caused them so much unnecessary suffering, and as a result, often only makes the taper process more difficult because of those mistakes.

 

If your doctor didn’t initiate a slow crossover the first time… please don’t fall into the same trap again.

 

We’re always here to provide you information and support, so please use any of the resources here at BB to educate yourself… to avoid any unnecessary mistakes and suffering.

 

Always here to answer any questions…

 

WS

 

 

[[Da...]]

Hi WS,

 

Thank you for your reply

I do understand some of the issues with diazepam having to build up in the system to cover the lorazepam.

I don't get much relief from the lorazepam now, the anxiety and panic attacks have been getting worse regardless of the lorazepam. It's actually causing me to become impulsive and I'm losing my memory from it, I'm also underweight regardless of what I eat and I think it's affecting my hormones. I tried adding diazepam 2mg for two nights as well as my usual 1mg lorazepam to see if this would calm the anxiety and if I could take it for a week to build it up in my system to then reduce the lorazepam. Unfortunately it made things worse the next day as I literally couldn't remember anything from the day before. So much for my idea of adding in 2mg.

 

The private psychiatrist also said I could swap to Clonazepam instead of diazepam. Is Clonazepam less sedating or depressing? Does it cause more issues with memory?  can't go on with this level of depression with the anxiety and I'm waking up everyday in an absolute state. I'd put myself in hospital if I could.  Most people on here and reddit seem to be coming off Clonazepam and I'd read somewhere that Clonazepam binds more tightly to the receptors. Not sure how true this is.  I'd also seen a video of Dr.Heather Ashton say that lorazepam is the most difficult to come off of. Argh.

[Guest [...]]

Hi WS,

 

Thank you for your reply

I do understand some of the issues with diazepam having to build up in the system to cover the lorazepam.

I don't get much relief from the lorazepam now, the anxiety and panic attacks have been getting worse regardless of the lorazepam. It's actually causing me to become impulsive and I'm losing my memory from it, I'm also underweight regardless of what I eat and I think it's affecting my hormones. I tried adding diazepam 2mg for two nights as well as my usual 1mg lorazepam to see if this would calm the anxiety and if I could take it for a week to build it up in my system to then reduce the lorazepam. Unfortunately it made things worse the next day as I literally couldn't remember anything from the day before. So much for my idea of adding in 2mg.

 

The private psychiatrist also said I could swap to Clonazepam instead of diazepam. Is Clonazepam less sedating or depressing? Does it cause more issues with memory?  can't go on with this level of depression with the anxiety and I'm waking up everyday in an absolute state. I'd put myself in hospital if I could.  Most people on here and reddit seem to be coming off Clonazepam and I'd read somewhere that Clonazepam binds more tightly to the receptors. Not sure how true this is.  I'd also seen a video of Dr.Heather Ashton say that lorazepam is the most difficult to come off of. Argh.

 

Hi DC7

 

I’ve read the same thing about the binding of clonazepam to the receptors, but I’m not aware of any evidence to support this… that’s not to say it isn’t true. It may well be. I just haven’t researched it.

 

All benzodiazepines will cause cognitive impairment and strip you of your memory, in my experience.

 

Clonazepam has a relatively long half life, so I see why your doctor would make the suggestion. It’s very different to the diazepam, and NO… in my experience, it doesn’t cause anywhere near the same initial over-sedation or depression as the diazepam. But it does have its issues…

 

1) the ‘potential’ binding issue… we’ve already covered.

 

2) it’s twice the strength of the lorazepam… so, you will have to learn how to calculate and execute smaller reductions in your taper, which we can help you with here. You can’t just split tablets into halves or quarters… you are past that being an option… whether you taper from the lorazepam or clonazepam. You simply wouldn’t tolerate the withdrawal after such sizeable reductions.

 

3) Many members express that clonazepam can be a “Beast” of a drug to taper off.

 

The fact that there seems to be so many people tapering clonazepam isn’t a reflection of it being a more desirable benzo from which to taper… it’s simply because of its growth in popularity amongst prescribing doctors over the years.

 

These are all just things worth considering, but you are in a situation where you are left with few options.

 

Your best option would be to find a benzo wise doctor who understands that you first need to be up-dosed and start dosing 3 or 4 times per day to end the inter-dose withdrawals and stabilise before you begin tapering from the lorazepam. There’s something to be said for tapering from the benzodiazepine your body is already comfortable with, and it seems the only reason you are not comfortable is because your doses are too small and infrequent.

 

Failing that, clonazepam may potentially be a more comfortable benzo for you… as it doesn’t seem to pose the same issue of over-sedation and depression, in addition to its relatively long half life.

 

 

[[Da...]]

Hi WS,

 

I will try and speak to the private psychiatrist again about the Clonazepam, she's also spoken to a colleague of hers that does private home support for benzo detox who's going to be in touch. I just don't want to end up on something that's even more difficult to come off and like you said, it would have to be microtaper from Clonazepam. I just can't deal with anymore depression, and diazepam never suited me which was why I ended up on lorazepam instead (I didn't know how potent it was). I'd read that Clonazepam doesn't cause as much depression but there's no scientific evidence of this, just seems anecdotal.

 

Waking up in wds everyday is destroying me, the confusion and crying is awful.

 

Thank you again for your reply, it really means a lot to have the support.

[Guest [...]]

You’re welcome, DC7

 

I’m so sorry your e having such a rough time of it. It can be really brutal.

 

I do understand your reservations in crossing to the clonazepam. Please let us know how it goes with the psychiatrist, and if there’s anything you want to discuss… please reach out.

 

We’re always here! 

[[Da...]]

Hi WS,

 

How did you find Clonazepam compared to lorazepam? As I see by your signature that you have been on both

 

been back at the emergency department feeling faint again, difficulty standing, POTs symptoms and crying constantly. I can't believe this drug has done this to me. I'm completely overwhelmed, my nervous system is a wreck. Are there any supplements I can take to mitigate some of this craziness or other lifestyle changes which have helped you or that you have seen has helped others?

How do people with severe anxiety cope when they hit tolerance with these benzos? I can't believe how negligent various doctors have been by prescribing this to me.

 

Thank you 

 

 

[[ni...]]

you say to avoid kindling you need to get rid of interdose withdrawal, however, im on diaz 3 times a day and getting it pretty quickly now. i can;t really split dose anymore... can i?

[Guest [...]]

Hi WS,

 

How did you find Clonazepam compared to lorazepam? As I see by your signature that you have been on both

 

been back at the emergency department feeling faint again, difficulty standing, POTs symptoms and crying constantly. I can't believe this drug has done this to me. I'm completely overwhelmed, my nervous system is a wreck. Are there any supplements I can take to mitigate some of this craziness or other lifestyle changes which have helped you or that you have seen has helped others?

How do people with severe anxiety cope when they hit tolerance with these benzos? I can't believe how negligent various doctors have been by prescribing this to me.

 

Thank you 

 

Hi DC7

 

It’s difficult to remember any difference between the two benzo’s you mention, except that the clonazepams therapeutic effect lasted much longer and although I dosed twice a day, I was able to switch to one per day without inter-dose withdrawals. I had to dose the lorazepam at least 3 times per day. I was only on each medication for a relatively short amount of time, through which, both provided similar relief and eventual stabilisation from the inter-dose or c/t symptoms.

 

I really don’t believe in supplements to mitigate symptoms because of the risk of the body rejecting them, increasing symptoms… potentially only making things worse. That’s not to say that certain members don’t find some supplements helpful, but our bodies are all so very different, so, what works well for one member, may not work so well or have the complete opposite affect for another member. It’s all trial and error. It can be a considerable risk.

 

When it comes to the terrible anxiety, I think it’s really important for you work with your practitioners to find a medication and/or dose to smooth things out (stabilise you), so you can eventually begin a sensible taper off the medication. You need to stabilise, and your options are to either switch (crossover) to a longer half life benzo like clonazepam or diazepam, or find a benzo wise practitioner who understands the necessity of relieving interdose withdrawals from the lorazepam before you can really begin to taper off. I really hope you can either shake some sense into these doctors, or find another doctor with a modicum of sense around getting you stabilised on a dose/doses before you taper.

[Guest [...]]

you say to avoid kindling you need to get rid of interdose withdrawal, however, im on diaz 3 times a day and getting it pretty quickly now. i can;t really split dose anymore... can i?

 

Hi NP

 

Honestly, I can’t imagine why you would be experiencing interdose withdrawals when dosing 3 x daily. It really doesn’t make sense. Are you sure what you’re experiencing can’t be attributed to something else?

 

How bad are your symptoms? What are your symptoms? How long after dosing do they come on?

[Guest [...]]

you say to avoid kindling you need to get rid of interdose withdrawal, however, im on diaz 3 times a day and getting it pretty quickly now. i can;t really split dose anymore... can i?

 

Hi NP

 

Honestly, I can’t imagine why you would be experiencing interdose withdrawals when dosing 3 x daily. It really doesn’t make sense. Are you sure what you’re experiencing can’t be attributed to something else?

 

How bad are your symptoms? What are your symptoms? How long after dosing do they come on?

 

Do you ever hold for periods during your micro taper?

[[ni...]]

ive felt worse every single day for last year. every day without fail. ive been microdosing daily totalling under 5 percent and have held at variou stages, done 13mg in 24 months. now im completely destabilised and disabled. i dont know what to do. updose, longhold? change back for dz to clz , i get awful withdrawal all day but obviosuly slight better for first 2-4 hours of taking the dose. what does this mean?

[Guest [...]]

ive felt worse every single day for last year. every day without fail. ive been microdosing daily totalling under 5 percent and have held at variou stages, done 13mg in 24 months. now im completely destabilised and disabled. i dont know what to do. updose, longhold? change back for dz to clz , i get awful withdrawal all day but obviosuly slight better for first 2-4 hours of taking the dose. what does this mean?

 

Hi ninja

 

I would be leaning towards your taper rate of 10% per month now being too fast. It sounds like your reductions have been piling up on you. I would be holding for as long as needed. Potentially, you may be able to go back to a 10% reduction per month once you’ve had time to recover from the pile up, or you may have to go at a slightly lower percentage once you resume. If I were you, I would be just holding to give your brain/body plenty of time to catch up with repairs.

 

WS

[[ni...]]

I've been tapering at under 5 percent a month. taken me 24 months to taper 13 mg. im stuck at 7mg mark not able to move up or down as so destablised and disabled.drs dont think ill make it like this and wana reinstate my whole dose and back on K.