Can I take gabapentin while I am tapering off my diazepam?

[[Zi...]]

Lately I am struggling big time with my diazepam taper. I think all the symptoms I am feeling are from the taper. If you read my profile you can see my taper schedule so far. I might be going to fast and now have lots of anxiety, tiredness all the time, insomnia and my blood pressure is much higher than ever! I have had many tests done and blood work to see what else could be my issues. I have a condition called cervical dystonia which affects my neck and shoulder muscles. I was prescribed clonazepam and baclofen about 26 years ago and as of late last year I finally said to myself it is time to come off the benzos!! My memory and brain fog was really getting bad. 
Anyway fast forward to today as I saw my family doctor about all my issues and tapering. She said I should try Lyrica or gabapentin to help with my insomnia. I am really nervous about adding another drug into my life! I am just struggling daily! I can barely get out of bed for a few hours a day. I force myself to go for short walks to keep my muscles some what active. I could lay in bed all day and not even sleep or nap. 
I started my taper in January of this year and have pretty much cut 2/3 of the dosage! I went from 30mg/day of diazepam down to 13mg/day now. I wonder if splitting my dose back into three times a day would be better? It is kind of an odd dosage I am doing now. 3mg morning and 8mg evening. 
I have the prescription for the gabapentin and she said take one 300mg cap at bed time. I want to try it but also not sure if it will be worth it in the long run? Should I just hold my dosage now rather than continue cutting it down? I don't want to increase my dose to feel better. I am wanting off the benzos after 27 years of being dependent on them! 

Any thought would be appreciated. If you need any clarifying also comment. Maybe I am confusing to some of you? 
One more thing is that I have been feeling depressed lately and think it is a combo of the taper and just not knowing what to do and feeling horrible. 

[[Fa...]]

 

Hi, Zippo,

I just wanted to reply to your post and acknowledge that I can relate.  I agree with your assessment - that all the symptoms you are experiencing are from the taper.  I have the same symptoms (mainly insomnia and broken sleep).  You have asked quite a few questions, however, I will try and answer the basics below.  Hopefully you find something in it useful/beneficial.  

1) I would hold your dose and implement a long hold (1-3 months) to see if you stabilize better.  You have tapered fairly quickly for most people thus far.  The increasing symptoms you are describing are your body's way of telling you to slow down.  I agree regarding not increasing the dose, as I doubt it will do much for you at this point, and you will just have to come back down from the increased dose.  

2) I would hold off on the gabapentin for now if possible, and see if you are able to get stabilized and functional by holding for a bit.  I added 7.5mg mirtazapine during my taper to aid with sleep.  I doubt it is helping much, regret the decision, and will have to taper off of it at some point. 

3) I would not split your dosing back to 3 times a day.  I too was at 3mg morning and 8mg evening at one time.  I am now dosing once in the evening.  Most people tapering diazepam only need one dose per day (2 doses max) due to the long half-life of diazepam.  So if anything, I would move over to one evening dose once you stabilize.

4) Once stabilized, I would begin tapering more slowly.  You want to get off the medication, but not recklessly.  Most people find Dr. Ashton's protocol too fast (especially the last 10mg).  I have left you 2 links below to help in regards to resuming your taper once stabilized.  You have been on the medication for 26 years, so an extra few months, or year, of tapering is not going to hurt you.  Once your body gives you the green light to start tapering again (symptoms stabilized and no longer improving), I would recommend tapering no more than 5-10% per month going forward.  Obviously at some point down the road, you will have to move to more of a hyperbolic style taper vs. exponential (essentially the same, however, an exponential taper in theory never ends - a hyperbolic taper does).  The youtube video below should help explain this.

https://corxconsortium.org/wp-content/uploads/Benzo-Deprescribing.pdf

 

 

 

[[Zi...]]

Faith Hope Love thank you so much for the really great reply and advice! Your comments make me feel a bit better going through this horrible taper! It's nice to know I am not crazy in how I have been feeling for the last month or so. 

I will hold my taper but it might be at 2mg morning and 8mg at night as my family doc just prescribed me my diazepam for the next taper drop which I was planning on starting tomorrow. I have some left over diazepam and could continue another week at 3mg and 8mg. I will see how I feel tomorrow. For some reason today I feel a bit better than yesterday. Maybe it is a fluke. 

I am going to hold off taking the gabapentin as I really don't want another drug to deal with. My insomnia and sleep issues are bad but I guess I won't die from it. I do lay down quite a lot during the days as I am so fatigued I don't feel like doing anything some days. 

As for the dosing I will try my best to make it a once per day in the evening. I have just been so used to popping pills 3 times per day I feel I have to split it up. If it is better to lump sum it in evening for the final 10mg taper I will do it. 

I am not sure if my family doctor will be able to help with the hyperbolic taper. I am in British Columbia, Canada and not sure what options I have for doing a taper that is not exponential. I don't know anything about those micro tapers I guess that is why I was dropping too quickly with my method. (Ashton Manual). 

Thanks for the links and I will read and watch the video. 

Again I appreciate you and hope anyone else reading this can gain knowledge too or share. So happy to be part of this community even though we are all struggling! It helps greatly!! 

I am a little more at ease with this new knowledge. My family doc is understanding but she lacks awareness about the safest way to get off these drugs! I

 

[[Gl...]]

@[Zi...] this is what happened to me when I started taking gabapentin to help with sleep and withdrawal.  My prescription was 100 mg, and it was great at first.  I slept like a baby, but I became immediately tolerant to it.  I didn't even realize what was happening, so I started taking 200 mg every day.  They quit working, and then I had to taper them, which was very hard and took me a year or so.  

I still take it occasionally for sleep, about once a week (100 mg), and it works great that way.  If I were you, I would only take it occasionally.  I do the same with trazodone, and I get to sleep at least two nights a week.

 

[[Zi...]]

1 minute ago, [[G...] said:

@[Zi...] this is what happened to me when I started taking gabapentin to help with sleep and withdrawal.  My prescription was 100 mg, and it was great at first.  I slept like a baby, but I became immediately tolerant to it.  I didn't even realize what was happening, so I started taking 200 mg every day.  They quit working, and then I had to taper them, which was very hard and took me a year or so.  

I still take it occasionally for sleep, about once a week (100 mg), and it works great that way.  If I were you, I would only take it occasionally.  I do the same with trazodone, and I get to sleep at least two nights a week.

@[Gl...] oh wow! Thank you for your reply! I am sorry you ended up having to taper off the gabapentin! This is what I fear will happen to me too. I want sleep but maybe not to the point of becoming dependent on gabapentin to make it happen. My doc went with a 300mg dose for me. No idea why she chose the higher dosage to start. I honestly am now grateful to hear from you and Faith Hope Love too. If my insomnia becomes so bad I might try it. I think a lot of my fatigue is from the taper itself, sadly. 

Thanks again for your reply and I hope you are doing well! 

[[Gl...]]

Yikes, 300 mg would put me in a coma.  I can't believe she started you at such a high dose.  When I started with 100 mg, it gave me two nights of great sleep from just one dose.

I'm sorry for your fatigue, and I feel your pain.  I'm the same and spend a lot of time in bed.  Hoping you get feeling better and get stabilized. 

 

[[Zi...]]

Yeah I guess my doctor probably thinks I need a bigger dose for some reason. I might ask her for the smaller dosage if I go down the route of taking them to sleep. Wow you got two good sleeps from one 100mg dose! That is good to know too. Anyway I guess we are all different is how we tolerate meds. Thanks again for replying! Nice to know I am not alone! Really helps! 

[[Fa...]]

@[Zi...] Perhaps, you could ask your prescribing doctor if you could hold your dose for a bit and then resume/slow down your taper when you hopefully feel a bit better?  I would recommend staying at 3mg morning and 8mg evening (as you have been taking it) for 1-3 months and not add another medication to the mix.   This would allow you to hopefully stabilize to a degree before resuming your taper.  

I'm glad you are feeling better today, however, dropping down to 10mg from 11mg is another 9.1% reduction in an already destabilized state.  I just don't want to see you suffer needlessly if you could hold for a bit, catch your breathe, and get a game plan for tapering off the last bit.  I have re-attached the link to a benzo deprescribing guideline that was published by a group using lived experience and much research.  Perhaps you could share with your prescriber as well, as she sounds receptive and may allow you to control your taper based off your own symptom severity and other's lived experience.

https://corxconsortium.org/wp-content/uploads/Benzo-Deprescribing.pdf

[[Zi...]]

@[Fa...] I can stay at 3mg morning and 8mg evening and will let my doc know when I see her August 3rd. I think I have enough meds on hand plus my new prescription that is the 2mg/8mg one will help until I see her. Yeah I had no idea dropping even 1mg at this stage is pretty significant! I have to get stable indeed. I have been going too fast I am certain. 

I will print out the pages from the link you sent and show the doc. I just don't know how we will taper once I can. In Canada we don't have liquid diazepam and I don't know if I can do the micro dosing thing with the scales and all that jazz. It seems way too complicated for my brain. 

I wonder when the time comes I could cut the 2mg pills into quarters? I know that is also tricky and could become a crumbly mess to deal with. I just don't know.

I will worry more once I get stable and feel like doing more in a day. I get tired very easily. 

Thanks again for the info and advice! 

[[Fa...]]

@[Zi...] That sounds like a good plan.  Try not worry for now as you have a plan in place (to hold at 11mg for at least a month) .  I am off to bed, however, there are numerous ways we can help you figure out the best “next step” for when you resume your taper down the road.  I hope you are able to gain some stability by holding for a bit in addition to your doctor working with you.  Keep us posted and wish you the best! 

[[PE...]]

On 7/25/2023 at 4:38 AM, [[Z...] said:

Lately I am struggling big time with my diazepam taper. I think all the symptoms I am feeling are from the taper. If you read my profile you can see my taper schedule so far. I might be going to fast and now have lots of anxiety, tiredness all the time, insomnia and my blood pressure is much higher than ever! I have had many tests done and blood work to see what else could be my issues. I have a condition called cervical dystonia which affects my neck and shoulder muscles. I was prescribed clonazepam and baclofen about 26 years ago and as of late last year I finally said to myself it is time to come off the benzos!! My memory and brain fog was really getting bad. 
Anyway fast forward to today as I saw my family doctor about all my issues and tapering. She said I should try Lyrica or gabapentin to help with my insomnia. I am really nervous about adding another drug into my life! I am just struggling daily! I can barely get out of bed for a few hours a day. I force myself to go for short walks to keep my muscles some what active. I could lay in bed all day and not even sleep or nap. 
I started my taper in January of this year and have pretty much cut 2/3 of the dosage! I went from 30mg/day of diazepam down to 13mg/day now. I wonder if splitting my dose back into three times a day would be better? It is kind of an odd dosage I am doing now. 3mg morning and 8mg evening. 
I have the prescription for the gabapentin and she said take one 300mg cap at bed time. I want to try it but also not sure if it will be worth it in the long run? Should I just hold my dosage now rather than continue cutting it down? I don't want to increase my dose to feel better. I am wanting off the benzos after 27 years of being dependent on them! 

Any thought would be appreciated. If you need any clarifying also comment. Maybe I am confusing to some of you? 
One more thing is that I have been feeling depressed lately and think it is a combo of the taper and just not knowing what to do and feeling horrible. 

Gaba drugs as you mentioned have horrific withdrawals. If you can take them 2-3 times a week you are fine. But don't start taking them everyday. Long and rough withdrawal 

[[PE...]]

I take lyrica a couple of days a month. Benzo withdrawal totally vanish so it's easy to get hooked on.

[[Fa...]]

@[Zi...] I'm not sure how you are currently splitting your 2mg pill, however, I would recommend purchasing the attached pill splitter.  I have also attached a youtube video that will show you how to use the pill splitter.  It will allow you to cut to 10.5mg from 11mg when the time comes as well.  This would be a 4.5% reduction, and I think a good place for you to start once you are stabilized.

https://www.amazon.com/EqualSplit-Splitter-Crafted-Medical-Aluminum/dp/B07MH6XTL7/ref=sr_1_1_sspa?crid=283USG76A9LN1&keywords=equal+split+pill+splitter%2C+double+blades&qid=1690387737&sprefix=equal+split%2Caps%2C105&sr=8-1-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1

 

[[Gl...]]

4 hours ago, [[F...] said:

I would recommend purchasing the attached pill splitter.

Thank you so much, @[Fa...].  Finding a good pill-splitter is hard.

[[An...]]

5 hours ago, [[F...] said:

@[Zi...] I'm not sure how you are currently splitting your 2mg pill, however, I would recommend purchasing the attached pill splitter.  I have also attached a youtube video that will show you how to use the pill splitter.  It will allow you to cut to 10.5mg from 11mg when the time comes as well.  This would be a 4.5% reduction, and I think a good place for you to start once you are stabilized.

https://www.amazon.com/EqualSplit-Splitter-Crafted-Medical-Aluminum/dp/B07MH6XTL7/ref=sr_1_1_sspa?crid=283USG76A9LN1&keywords=equal+split+pill+splitter%2C+double+blades&qid=1690387737&sprefix=equal+split%2Caps%2C105&sr=8-1-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1

I have a pill splitter like this. You still get crumbs sometimes no matter how careful you are. I just wish the government or some other entity would make the drug companies make all these pills in 1/4 and 1/8 increments for tapering purposes.

[[An...]]

6 hours ago, [[p...] said:

I take lyrica a couple of days a month. Benzo withdrawal totally vanish so it's easy to get hooked on.

I don't quite understand peppe. Are you saying you took Lyricia for benzo withdrawal?

[[Zi...]]

On 7/26/2023 at 8:52 AM, [[p...] said:

Gaba drugs as you mentioned have horrific withdrawals. If you can take them 2-3 times a week you are fine. But don't start taking them everyday. Long and rough withdrawal 

Hey peppe! Thanks so much for the reply! I will definitely keep your advice in mind! I appreciate it big time! I just picked up my prescription for the gabapentin today. My doc said to take one 300mg cap before bed. I want to try it tonight and see how it goes but I also feel like I should wait longer. I guess if I just try one it shouldn't be bad. I might even sleep?! I have such bad insomnia I am tired all day everyday! 

Thanks again!  

[[Zi...]]

On 7/26/2023 at 9:19 AM, [[F...] said:

@[Zi...] I'm not sure how you are currently splitting your 2mg pill, however, I would recommend purchasing the attached pill splitter.  I have also attached a youtube video that will show you how to use the pill splitter.  It will allow you to cut to 10.5mg from 11mg when the time comes as well.  This would be a 4.5% reduction, and I think a good place for you to start once you are stabilized.

https://www.amazon.com/EqualSplit-Splitter-Crafted-Medical-Aluminum/dp/B07MH6XTL7/ref=sr_1_1_sspa?crid=283USG76A9LN1&keywords=equal+split+pill+splitter%2C+double+blades&qid=1690387737&sprefix=equal+split%2Caps%2C105&sr=8-1-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1

@[Fa...] thanks so much for the links and video on the pill splitter! That would be great to try! I will look into it and see if I can get one! I have a pill splitter already. It cuts the pills in half easy enough but I fear cutting any smaller pieces. I will try and attach image of my current splitter. I really appreciate your help!! 

[[PE...]]

29 minutes ago, [[Z...] said:

Hey peppe! Thanks so much for the reply! I will definitely keep your advice in mind! I appreciate it big time! I just picked up my prescription for the gabapentin today. My doc said to take one 300mg cap before bed. I want to try it tonight and see how it goes but I also feel like I should wait longer. I guess if I just try one it shouldn't be bad. I might even sleep?! I have such bad insomnia I am tired all day everyday! 

Thanks again!  

And also they have huge tolerance and make you hungry. When I take them i take 900mg. They are the same thing as lyrica just much weaker. So if you don't sleep on on, take two or three. But with two or so breaks.

.

[[Pa...]]

44 minutes ago, [[p...] said:

And also they have huge tolerance and make you hungry. When I take them i take 900mg. They are the same thing as lyrica just much weaker. So if you don't sleep on on, take two or three. But with two or so breaks.

.

Hello peppe from sweden,

Its important we don't venture into the area of providing medical advice, we do our best to avoid using prescriptive language, please review our guidelines. 

Please adopt a non-prescriptive writing style. Relating your experiences, stating options, or posting suggestions of what other members might do are all welcome. However, advising members of what they should or must do is against the ethos of the BenzoBuddies Community. Nor should you attempt to 'diagnose' medical problems or suggest medical treatments to other members. This policy also applies to members with medical qualifications. A more detailed explanation of this policy can be found in our Guidelines Regarding the Giving of Medical Advice document.

Guidelines - BenzoBuddies Community Forum

[[PE...]]

Ok

[[he...]]

If it were me, I'd stay FAR away from gabapentinoids. They have a terrible withdrawal syndrome of their own and can exacerbate the problems you already have from the benzo.

Also, I used the Equal Split pill splitter for my entire taper. It blows the razor-blade splitters out of the water.

[[Fa...]]

@[Zi...] Although I am not currently splitting my diazepam tablets to taper, I have in the past and used a similar splitter to what you are currently using.  As @[he...] stated, the equal split pill splitter worked much better for me as well.  I was easily able to cut my tablets in half, and quarters, as shown in the youtube video.

[[Zi...]]

3 hours ago, [[h...] said:

If it were me, I'd stay FAR away from gabapentinoids. They have a terrible withdrawal syndrome of their own and can exacerbate the problems you already have from the benzo.

Also, I used the Equal Split pill splitter for my entire taper. It blows the razor-blade splitters out of the water.

@[he...] thanks for your opinion. I think I will stay away from the gabapentin for now. Yeah I don't need to add another withdrawal syndrome into my life. 

So far I have had good luck with the razor blade splitter. It seems to do a good job for cutting pills in half. I haven't tried quarters yet but I might buy the Equal Split one to have on hand in case I have issues. The razor one I bought was a lot cheaper than the Equal Split.  In Canada the Equal Split costs like $40CAD. 

[[kl...]]

This may be off topic but maybe some of the experts would know. My main question is are we healing and withdrawing as we taper or does healing and withdrawal only occur once we have jumped? It seems that I have never been able to get an answer to that in all my research.