Xanax interdose withdrawals? Cognitive issues?

[[Md...]]

Hello everyone. First post here. So I’ve been taking Xanax regularly for the last 4 months. I started taking it due to some extreme and unexplainable teeth and gum pain (that would radiate up my face) after complications of a tooth extraction. I was originally prescribed 1.5mg 3x a day, but the pain got so bad that I found myself taking up to about 2.5mg. Some of the pain seemed to settle, and so I dropped my dose back to 1.5mg, but I did this rather quickly, and have been experiencing “interdose withdrawals”.

 

The withdrawal symptoms are mainly cognitive: inability to focus, dizziness, massive brain fog, fatigue, and it honestly just feels like my brain is being yanked out or is just turning off.

 

These sensations just get worse and worse until I take my next dose.

I used to be able to go for 6, sometimes 7 hours in between doses, but now it feels like I can go no longer than 5 hours. I’ve been holding on this dose for about 2 months now.

 

I spoke to a psychiatrist about this yesterday and she said that I most likely experienced a benzo injury, and that it’s uncommon to have this type of tolerance reaction in such a short amount of time, even though it can and does happen to people who are sensitive to benzodiazepines. She was thinking that I should try to stabilize by switching over to a longer lasting benzo like Valium. It would be great if I could stabilize, as these interdose withdrawals aren’t ideal.

 

So I guess my question is how do we know that i most likely endured a drug injury, as opposed to experiencing tolerance, or just experiencing withdrawal symptoms from tapering? I went down from 2.5mg to 1.5mg, so I would assume that there would be some withdrawal symptoms occurring? Just a little confused as to how we differentiate those.

 

Finally, should I continue hold, or should i up my dose to try and re-stabilize? I was felt totally fine when I was taking the 2.5mg. So I’m just not sure at this point.

 

Thanks.

[Guest [...]]

Hi Mdfox1

 

Welcome to BenzoBuddies!

 

We’re glad you found us.

 

I think your issues (rather than tolerance) are the result of you developing a dependancy and now experiencing inter-dose withdrawals.

 

To avoid these inter-dose withdrawals, you will have to dose more than your current 3 x per day, possibly 5 - 6 x per day, or to ‘slowly’ crossover to a longer half life benzodiazepine like diazepam (Valium) following the guidance provided in the Ashton Manual (link below). For right now, you may have to try splitting your Xanax tabs in half and dosing 0.25 six times a day (assuming they are 0.5mg tabs). That would be the easiest way to divide your doses at this point, until you figure out your best option and make a decision. We can work through this with you.

 

You will find plenty of information and resources here on BB, including a friendly community going through similar experiences, all happy to provide support and offer feedback to any questions you may wish to ask on the forum boards.

 

If you have any other questions, please feel free to ask…

 

Again, welcome!

 

WS

 

Here are a few links to get you started.

 

Colorado Consortium Benzodiazepine Deprescribing Guidance

 

Planning Your Withdrawal (Taper)

 

Withdrawal Support (during your taper)

 

The Ashton Manual

 

 

 

 

 

 

 

 

 

 

[[Md...]]

Hi Mdfox1

 

Welcome to BenzoBuddies!

 

We’re glad you found us.

 

I think your issues (rather than tolerance) are the result of you developing a dependancy and now experiencing inter-dose withdrawals.

 

To avoid these inter-dose withdrawals, you will have to dose more than your current 3 x per day, possibly 5 - 6 x per day, or to ‘slowly’ crossover to a longer half life benzodiazepine like diazepam (Valium) following the guidance provided in the Ashton Manual (link below). For right now, you may have to try splitting your Xanax tabs in half and dosing 0.25 six times a day (assuming they are 0.5mg tabs). That would be the easiest way to divide your doses at this point, until you figure out your best option and make a decision. We can work through this with you.

 

You will find plenty of information and resources here on BB, including a friendly community going through similar experiences, all happy to provide support and offer feedback to any questions you may wish to ask on the forum boards.

 

If you have any other questions, please feel free to ask…

 

Again, welcome!

 

WS

 

Here are a few links to get you started.

 

Colorado Consortium Benzodiazepine Deprescribing Guidance

 

Planning Your Withdrawal (Taper)

 

Withdrawal Support (during your taper)

 

The Ashton Manual

 

Thank you for your reply, as well as the warm welcome!

 

Ok, so I will try to dose more frequently then, and see if that helps. Is this usually successful?

 

Also, what is the different between building a tolerance and dependence?

 

Thanks again!

[[je...]]

Tolerance means your body has become tolerant to the dose you are on and you need a higher dose of the drug to have the same effect. You will experience withdrawal symptoms at the same dose even though you're not tapering.

 

Dependence means your body is physically dependent on the drug to function normally. If you suddenly stop the drug your body will go into withdrawal. Here you don't require a higher dose to function and won't have withdrawal symptoms if you stay at the same dose.

 

Interdose withdrawal means the drug is short acting and works out quickly and since your body is dependent on it, it starts craving the drug before the next dose is due because the drug wore off so quickly.

[[Md...]]

Tolerance means your body has become tolerant to the dose you are on and you need a higher dose of the drug to have the same effect. You will experience withdrawal symptoms at the same dose even though you're not tapering.

 

Dependence means your body is physically dependent on the drug to function normally. If you suddenly stop the drug your body will go into withdrawal. Here you don't require a higher dose to function and won't have withdrawal symptoms if you stay at the same dose.

 

Interdose withdrawal means the drug is short acting and works out quickly and since your body is dependent on it, it starts craving the drug before the next dose is due because the drug wore off so quickly.

 

Thank you for clarifying!

 

So it seems that I am experiencing a combination of dependence as well as interdose withdrawal then.

 

Or am i experiencing a combination of all three categories? Because these interdose withdrawal windows seem to be narrowing the longer i hold my normal dose. I’ve held 1.5mg for about a month or so now and it just keeps getting worse. The interdose withdrawals are completely debilitating too.

[[je...]]

Most of us here are dependent. If not you would be able to simply stop the drugs without any complications. Like Winter Sun said, I doubt you have tolerance, it's likely interdose withdrawal because Xanax has a very short half-life so it wears off quickly. Lots of people on Xanax have interdose withdrawal.

 

The way you'll know is your symptoms will subside each time you take a dose.

[[Md...]]

Most of us here are dependent. If not you would be able to simply stop the drugs without any complications. Like Winter Sun said, I doubt you have tolerance, it's likely interdose withdrawal because Xanax has a very short half-life so it wears off quickly. Lots of people on Xanax have interdose withdrawal.

 

The way you'll know is your symptoms will subside each time you take a dose.

 

I guess what I’m asking is, why does this interdose window seem to continue to shrink? Not too long ago I could easily manage a 6 hour duration between doses. Now it’s like 4 to 5 hours, and even 5 hours is pushing it now. What is this narrowing window an indicator of?

 

And regarding upping the frequency to prevent interdose withdrawal, won’t my body just get used to that to the point where that won’t be enough anymore either? Much like like how i can only go 5 hours now between doses, if i up the frequency, won’t those interdose withdrawal windows also begin to narrow?

 

Hopefully that makes sense, and sorry for tall the annoying questions. Just trying to get an understanding of all this.

[[Li...]]

Have you started or stopped taking any medications or supplements that might be affecting how you metabolize the Xanax?

[[Md...]]

Have you started or stopped taking any medications or supplements that might be affecting how you metabolize the Xanax?

 

I’ve been taking supplements: multivitamin, vitamin B complex and l-glutamine together (to increase gabba), GABA (lozenges), L-theanine, Omega 3, and zinc.

 

Started taking all of those steadily about 3 weeks ago, but also recently stopped the gaba promoting ones, because I learned that more gaba doesn’t do anything, might even make things worse from over saturation.

 

Honestly wondering if I should just reinstate to 2mg from my current 1.5 to try and stabilize.

[[Md...]]

Have you started or stopped taking any medications or supplements that might be affecting how you metabolize the Xanax?

 

I’ve also been taking some sleep tinctures at night (mostly comprised of valerian root, passion flower, and kava), because my sleep is shit half the time. I usually don’t have a problem falling asleep, but I tend to wake up around 3-5am and have trouble going back to sleep.

[[je...]]

Have you started or stopped taking any medications or supplements that might be affecting how you metabolize the Xanax?

 

I’ve been taking supplements: multivitamin, vitamin B complex and l-glutamine together (to increase gabba), GABA (lozenges), L-theanine, Omega 3, and zinc.

 

Started taking all of those steadily about 3 weeks ago, but also recently stopped the gaba promoting ones, because I learned that more gaba doesn’t do anything, might even make things worse from over saturation.

 

Honestly wondering if I should just reinstate to 2mg from my current 1.5 to try and stabilize.

 

Why do you think you're not stable?

[[Md...]]

Have you started or stopped taking any medications or supplements that might be affecting how you metabolize the Xanax?

 

I’ve been taking supplements: multivitamin, vitamin B complex and l-glutamine together (to increase gabba), GABA (lozenges), L-theanine, Omega 3, and zinc.

 

Started taking all of those steadily about 3 weeks ago, but also recently stopped the gaba promoting ones, because I learned that more gaba doesn’t do anything, might even make things worse from over saturation.

 

Honestly wondering if I should just reinstate to 2mg from my current 1.5 to try and stabilize.

 

Why do you think you're not stable?

 

Mainly because the interdose withdrawals continue to happen sooner. I used to be able to go to 6, sometimes even 7 hours without my brains feeling like they were being ripped out. Now it’s like every 4 or 5 hours.

[[je...]]

When we here at BenzoBuddies define stable it means you are able to function and do what is expected of you on a daily basis. It doesn't mean you feel good or great, but you can function.

 

I would be very hesitant to increase the dose again since you get relief after dosing. This sounds like interdose withdrawal. If you were tolerant you would not get relief at a lower dose and your symptoms would be persistent. The reason I wouldn't updose is each increase adds several months of tapering and withdrawal symptoms to your taper. Those withdrawal symptoms might be the same intensity as what you're going through right now. If you feel you are suffering immensely, then yes, you can updose, but I didn't get that sense from your original post, but again this is ultimately your decision.

 

You might want to consider crossing over to Valium. It doesn't come without it's challenges but if these interdose withdrawals are a real struggle, then it's definitely an option to consider. It will be worthwhile to take some time to read  The Ashton Manual and also look at the Substitution Board to see what others have done who crossed over from Xanax. Professor Heather Ashton was a benzo wise doctor who understood withdrawal and crossed her patients over to Valium to help them taper. It is not a requirement to cross to Valium to taper, but many find it helpful with interdose withdrawal.

 

I'm sure Libertas will also weigh in with her opinions. She has a wealth of knowledge about the mechanisms of these drugs.

[[Md...]]

When we here at BenzoBuddies define stable it means you are able to function and do what is expected of you on a daily basis. It doesn't mean you feel good or great, but you can function.

 

I would be very hesitant to increase the dose again since you get relief after dosing. This sounds like interdose withdrawal. If you were tolerant you would not get relief at a lower dose and your symptoms would be persistent. The reason I wouldn't updose is each increase adds several months of tapering and withdrawal symptoms to your taper. Those withdrawal symptoms might be the same intensity as what you're going through right now. If you feel you are suffering immensely, then yes, you can updose, but I didn't get that sense from your original post, but again this is ultimately your decision.

 

You might want to consider crossing over to Valium. It doesn't come without it's challenges but if these interdose withdrawals are a real struggle, then it's definitely an option to consider. It will be worthwhile to take some time to read  The Ashton Manual and also look at the Substitution Board to see what others have done who crossed over from Xanax. Professor Heather Ashton was a benzo wise doctor who understood withdrawal and crossed her patients over to Valium to help them taper. It is not a requirement to cross to Valium to taper, but many find it helpful with interdose withdrawal.

 

I'm sure Libertas will also weigh in with her opinions. She has a wealth of knowledge about the mechanisms of these drugs.

 

Thank you for clarifying! That actually makes me feel a lot better. Yeah, after I dose, I can definitely function just fine for the most part. I guess I didn’t know what “stable” really meant around here, so again, thank you for clarifying that!

[Guest [...]]

Hi Mdfox1

 

Sorry I disappeared last night and didn’t get to respond to your follow up questions…

 

Big thanks to jelly baby and Libertas for helping out.

 

Let us know how you go with splitting the tabs and adding those extra doses…

 

WS

 

[[Md...]]

When we here at BenzoBuddies define stable it means you are able to function and do what is expected of you on a daily basis. It doesn't mean you feel good or great, but you can function.

 

I would be very hesitant to increase the dose again since you get relief after dosing. This sounds like interdose withdrawal. If you were tolerant you would not get relief at a lower dose and your symptoms would be persistent. The reason I wouldn't updose is each increase adds several months of tapering and withdrawal symptoms to your taper. Those withdrawal symptoms might be the same intensity as what you're going through right now. If you feel you are suffering immensely, then yes, you can updose, but I didn't get that sense from your original post, but again this is ultimately your decision.

 

You might want to consider crossing over to Valium. It doesn't come without it's challenges but if these interdose withdrawals are a real struggle, then it's definitely an option to consider. It will be worthwhile to take some time to read  The Ashton Manual and also look at the Substitution Board to see what others have done who crossed over from Xanax. Professor Heather Ashton was a benzo wise doctor who understood withdrawal and crossed her patients over to Valium to help them taper. It is not a requirement to cross to Valium to taper, but many find it helpful with interdose withdrawal.

 

I'm sure Libertas will also weigh in with her opinions. She has a wealth of knowledge about the mechanisms of these drugs.

 

And maybe I should re-clarify. I am functional for the most part, but NOT when the interdose withdrawals kick in. I’m barely even there mentally when that happens.

 

Btw, I was up too late last night and for the first time in a while had to take an extra .25mg of Xanax. Is one extra dose going to set me back several months now?

[[Md...]]

Hi Mdfox1

 

Sorry I disappeared last night and didn’t get to respond to your follow up questions…

 

Big thanks to jelly baby and Libertas for helping out.

 

Let us know how you go with splitting the tabs and adding those extra doses…

 

WS

 

No worries!

[[je...]]

A rescue dose won't harm you but it's not recommend to keep doing this. Brain fog is unfortunately part and parcel of withdrawal. I've had it now for 2.5 years and my mental abilities feel like half the capacity it used to be. My memory has gone to pieces and processing information is difficult. However the good news is all of these will return over time.

 

I think what you need to decide is whether you want to dose 4 times a day or whether you want to crossover to Valium.

[[Md...]]

A rescue dose won't harm you but it's not recommend to keep doing this. Brain fog is unfortunately part and parcel of withdrawal. I've had it now for 2.5 years and my mental abilities feel like half the capacity it used to be. My memory has gone to pieces and processing information is difficult. However the good news is all of these will return over time.

 

I think what you need to decide is whether you want to dose 4 times a day or whether you want to crossover to Valium.

 

Thanks again for the advice and wisdom, and sorry your memory/cognitive abilities have suffered. I’m glad to hear this stuff gets better over time though.

[[Md...]]

A rescue dose won't harm you but it's not recommend to keep doing this. Brain fog is unfortunately part and parcel of withdrawal. I've had it now for 2.5 years and my mental abilities feel like half the capacity it used to be. My memory has gone to pieces and processing information is difficult. However the good news is all of these will return over time.

 

I think what you need to decide is whether you want to dose 4 times a day or whether you want to crossover to Valium.

 

Btw, have you found anything that can speed up the recovery process when it comes to the cognitive issues?

[[je...]]

No, people spend lots of money on supplements but from all the Success Stories I've read, there's no real guarantee and some people react really badly to some of the supplements. The only constistent remedy is time.

[[Md...]]

No, people spend lots of money on supplements but from all the Success Stories I've read, there's no real guarantee and some people react really badly to some of the supplements. The only constistent remedy is time.

 

And you’ve noticed that yours has gotten better?

 

Btw, Sorry for all the questions, it just helps to talk to someone about this stuff.

 

I really appreciate it.

[[je...]]

You don't have to apologise for asking questions, that's what we're here for.

 

I'm just over 6 months off and some days are better than others but it comes and goes. I think I'll probably see more improvement around the 1 year off mark. I do however have acceptance of my journey, so I don't feel anxious or worried about it. I know I'll recover and this is just temporary. I tapered for 2 years and when I started my taper I thought I will never make it to jump. I do see slow improvement and I do feel I'm better than when I jumped and tapered, but I'm definitely not recovered yet and it's happening slow. 

[[Md...]]

You don't have to apologise for asking questions, that's what we're here for.

 

I'm just over 6 months off and some days are better than others but it comes and goes. I think I'll probably see more improvement around the 1 year off mark. I do however have acceptance of my journey, so I don't feel anxious or worried about it. I know I'll recover and this is just temporary. I tapered for 2 years and when I started my taper I thought I will never make it to jump. I do see slow improvement and I do feel I'm better than when I jumped and tapered, but I'm definitely not recovered yet and it's happening slow.

 

So glad to hear that you are recovering! Acceptance has been hard for me, and it’s been causing a lot of fear and depression, especially since I’ve been struggling trying to find the right help.

 

Again, thank you for answering all of my questions. I sincerely appreciate it!

[Guest [...]]

Everybody struggles with acceptance in the beginning, Mdfox1, and it can take some time to reach that place. But we do reach that place. It’s certainly not an easy thing to see others around you getting on with life… a life you also once lived, a life that appears to have now passed you by. It can be a deeply painful experience. You might even consider it a grieving process… grieving the loss of ones old life. It takes time. But, one of the upsides (if there are upsides) to going through this process, is that I know that once recovered, I will appreciate the simplicity of life so much more than I ever did prior to this experience. Just keep working your way towards that place of acceptance, Mdfox1.