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Starting taper from .5 Xanax Help me please


[Ma...]

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Hi everyone, I found this site recommend on Reddit so I'm brand new. And honestly I'm sitting awake at 4am just crying.

I began taking Xanax about 2 years ago intermittently. .5-1mg/day usually to help me sleep but also for bouts of anxiety.

Within the past 2-3 months I've lowered that to .5mg/day with the occasional slip up to 1mg. But for the past 3 weeks I've had .5mg/day max.

Ive been attempting to not take any at night and obviously I've failed. I have managed 1-2 days cold turkey. Then back to .5mg. Realizing I have a problem I naturally went online and now I realize just how dangerous quitting cold turkey can be. I am terrified of the life threatening consequences and talking of seizures to the point I feel as though I'm having heart palpitations and I cannot sleep and I'm crying. Please help me!

Am I over reacting? Is .5mg/day once a day nothing? I've made a list of all these supplements to help with taper and withdrawals, but as I said I'm brand new and scared shitless.

Here is my list:

 

Black seed oil
Magnesium L-theonate, aspartate, orate, taurate, lysinate, glycinate, etc (not oxide or citrate)
Skullcap (bc it contains bacailin)
Etifoxine (if you can find it)
Ashwaganda
Tianeptine (caution, it can be addictive?)
Rhynchophylline (found in cats claw bark)
Chamomile tea (strong)
Magnolia bark extract (twice a day)

I'm looking for support, advice on a tapering plan and timeline, notes on supplement list, and maybe just a friend?

Thank you for taking the time to read this and help me.

 

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Hello @[Ma...] Welcome to BenzoBuddies.

Since you take Xanax regularly, and have done so for some considerable time, I suggest that you first stabilise your dose and stick to that for a couple of weeks. Assuming that your desire is to quit benzodiazepines, I further suggest that you take a dose which is good enough for you to function reasonably well. What I mean by that is not a dose which means that you symptom-free. Rather, a dose which allows to you sleep well enough (even if you suffer the occasional night of poor sleep), and for you to manage your everyday activities without suffering crippling anxiety.

If sleep is a major problem for you, you probably will take part of your dose just before going to bed. Xanax does not have a very long half-life, so taking it once per day is probably not a great option for you if you suffer both from insomnia and daytime anxiety.

Once you are feeling reasonably stable for a couple of weeks, you might then start to taper your dose in a controlled, considered manner. Yo-yoing your dose is rarely a successful path to becoming benzodiazepine-free.

Does this approach seam reasonable to you?

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My current bout of insomnia and anxiety is related not to my lower dose of Xanax but the anxiety from reading everything about just how dangerous and possibly life threatening quitting can be. I know that sounds naive, but... I'm scared.

.5-1mg/day is the most I've ever taken. .5mg/day is my dose and has been for 3 weeks without issue. It is the dose that allows me to "function"/sleep.

And yes I am ready to quit. That is my goal. I will not go back over .5mg. That approach seems reasonable to me.

My questions are if I've been at .5mg/day for 3 weeks is it time to go to .25mg/day and see if it works? If not/if so what is the timetable going forward? I need help with a specific taper plan and advice on supplements/activities to help me succeed.

Or are those questions/advice that shouldn't be answered until I try .25mg/day and see how I fair?

Thank you Colin for replying to me so quickly. I apologize for any noob/stupid questions. Sincerely, it means the world to me that there are people like you willing to help people like me.

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Hi @[Ma...] No need to apologise. And you have asked no stupid questions.

Given that your dose is relatively low (and was never high), and unless you suffer from a seizure disorder, your taper rate falls well within what doctors usually direct and is considered safe.

What you should consider is how you feel and if you are ready for another cut. If you have adjusted to your present dose and feel OK, then yes, a new cut is entirely reasonable. You might experience some difficulties with any new cut. But within reasonable limits, if you tough it out, you will probably adjust to the new dose after some days or a week or two.

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Thank you for your kind words. You really have no idea how much this means to me.

To be clear I don't suffer from a seizure disorder but all the seizure talk has me terrified. You never clarified if any of those supplements will actually help and/or reduce seizure risk. Do you have any take on that?


So .5 to .25 isn't too much? And if it is just stay at .5 longer? How long do I stay at .25 if it works?

If I'm cutting pills, how do I taper below .25 if I have 1mg pills? Do I stay at .25 longer and then go a day between doses?

And what kind of time table should I be planning for realistically? I won't hold you to it, promise haha. But given your best guess? Like I don't know when I should STOP. Do I quit at .25 after so long. Do I keep tapering somehow down to like .05?

I'll stop apologizing for asking questions. But I won't stop thanking you for giving me hope and comfort, as well as important knowledge during this scary time. So thanks mate. Sincerely.

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1 hour ago, [[M...] said:

Thank you for your kind words. You really have no idea how much this means to me.

To be clear I don't suffer from a seizure disorder but all the seizure talk has me terrified. You never clarified if any of those supplements will actually help and/or reduce seizure risk. Do you have any take on that?

I understood that. I was not very clear. I meant that only those who suffer from a seizure disorder might your particular taper rate be a consideration. And in those cases, they really should be tapering under the direction of a neurologist.

1 hour ago, [[M...] said:


So .5 to .25 isn't too much? And if it is just stay at .5 longer? How long do I stay at .25 if it works?

Stick at each dose until you feel ready for the next cut. For the most part, people probably allow 1-2 weeks between cuts. But some require longer. But I suggest leaving a minimum of one week between cuts so that you are reasonably sure that you have adjusted to the previous cut without too many difficulties before proceeding to the next.

1 hour ago, [[M...] said:

If I'm cutting pills, how do I taper below .25 if I have 1mg pills? Do I stay at .25 longer and then go a day between doses?

Generally, you do not need to make cuts smaller than a quarter-pill of the smallest dose pill in your particular benzodiazepine. You might well struggle making cuts at lower doses and/or your final cut zero. I appears that use 1mg tablets. In most (or all) regions  0.5mg and 0.25mg tablets of Xanax are available. You can probably divide those tablets in half - you might even be able to quarter them. Though, you should always check with your pharmacist about splitting pills.

If you find the cuts too large, yes, allowing longer between cuts is an option. Though, generally speaking, more frequent, smaller cuts to dose are better tolerated that less frequent, larger cuts to dose. Even if the overall taper rate is similar. But, again, if smaller cuts are impractical, and you feel you need, allowing more time between cuts is an entirely reasonable approach.

Some members grind their tablets and weigh the powder to make smaller cuts. And some even attempt making liquids. This can have hit or miss results. But if going down this route, it is better to have a pharmacist to compound a liquid for you. (You probably require a specific prescription for this). But, really, from what you have written, these options probably will not be a consideration for you. Instead, I'd recommend asking your doctor for a prescription for 0.5mg and/or 0.25mg tablets. In all likelihood, that's all you will need to complete a successful taper.

1 hour ago, [[M...] said:

And what kind of time table should I be planning for realistically? I won't hold you to it, promise haha. But given your best guess? Like I don't know when I should STOP. Do I quit at .25 after so long. Do I keep tapering somehow down to like .05?

If you have not suffered significant problems so far, and you source smaller dose tablets, allowing 1-2 weeks between cuts is a realistic aim. I cannot be more specific than than this. Ideally, making cuts in the region of 10% of the previous dose is recommended. But when at lower doses, making cuts that small is not achievable (not via pill-splitting at least). However, at low doses - and you are at a lower dose - the benzodiazepine is having only a more marginal effect upon the brain. So even if the cuts (in percentage terms) are rising, this is generally not a problem.

1 hour ago, [[M...] said:

I'll stop apologizing for asking questions. But I won't stop thanking you for giving me hope and comfort, as well as important knowledge during this scary time. So thanks mate. Sincerely.

You'll be OK. Just taper at a rate which feels manageable for you. Do not leave longer between cuts than is reasonably necessary. But only cut again when you feel reasonably recovered from the previous cut and feel ready to continue. And don't overthink it. Oh, and again, get those lower dose tablets!

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Hi @[Ma...],

I just wanted to mention some of the supplements in your list are either GABAergic or increase the serum level of benzo in your blood.

You should use great caution when taking these items and know some have caused some people severe setbacks, but not everyone reacts the same way.

These are the supplements of concern:

Black seed oil, skullcap, ashwagandha, chamomile, and magnesium (though many can tolerate this well and say it helps).

Also, I’d be very careful with tianeptine.

Many people do best when their bodies are allowed to heal naturally without any added stuff.

Just wanted you to know if you didn’t already.

HFH 

 

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Hello @[me...]

Generally speaking, you make a small cut to your dose and stay at that dose for a week or two until your feel ready to make a new cut.

If you do not already have 0.5mg tablets, I suggest you ask your doctor for prescription, as this will allow you to make smaller cuts to your dose just using a pill-splitter.

As a rule of thumb, most of our members make cuts of around 10% of their dose. This is the cut you make from the dose you take at the time of your new cut, not the dose you from which you started your taper.

When at lower doses, it is not practical to reduce your dose by around 10%. But that's OK. The clonazepam is having less of an effect anyway.

What I suggest is that you obtain the 0.5mg pills, and take 1 & 3/4 pills per day. And if that goes OK, plan on making a new cut 1-2 weeks later. We usually suggest waiting at least one week so that you can properly assess how you reacted to the previous cut to your dose.

Do you take all your dose once per day, our do you split into two or more doses?

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I'm tapering from Xanax too. I have .25mg tabs and cut them in half.  I would recommend asking for a script in the lowest dose, and then only cut them where it is scored. Be careful to make sure you cut on the line. I cannot stress enough how important it is not to cut pills where there is no score mark. I strongly recommend not quartering pills. The rule is "Only cut if you 'half' too." That is because if the pill is scored the active medication is assumed to be (relatively) evenly distributed on each side. However, that does NOT mean that each half of a half has an even distribution of meds in it. You may get a quarter that has just the filler and no med and a quarter with the active med and some filler. You cannot rely on them being homogenous at that point- the dosage is too small and the pill is too small. Once you get to a half of .25 tab, (.125) you can step off- there is no benefit in taking .125mg. The symptoms you are experiencing at that point are related to the upregulating of the receptors and not a decrease in dosage. They will exist even if you stay on that tiny amount for another few weeks or a month. A half of a .25mg is not pharmacologically significant-- .25mg is the lowest therapeutic dose.  Research studies have shown that even pills that are scored will differ anywhere from 5-72% in dosage distribution. That is why cutting at the score is critical, so you get as close as possible a "equal" distribution. Also, never cut small or irregularly shaped pills.  

I'm at taking a .25mg pill and a .125mg pill right now (I cut from two .25 pills). I cut again in 2 weeks and will stop taking .125mg, leaving only the .25mg pill.  Then, I'll cut the .25 into halves, hoping for equal distribution, and step off from .125mg.

Expect to experience some discomfort as your receptors upregulate. I frame it as my body healing, I'm experiencing sensations again that were previously dulled w/ the drug.  

Also, some of the supplements you mentioned are GABA  agonists, which will prolong the withdrawal by countering the tapering. 

Go slow w/ the taper, and do not underestimate the importance of fluids, nutrition and exercise. All 3 are saving me from complicated withdrawals.  Walking and yoga are the most tolerable. On good days, I lift weights or use the elliptical.

 

 

 

Edited by [Be...]
Typo
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I was helped by an e-book from amazon by Dr. Stuart Shipko called Xanax Withdrawal. It costs less than $5.

In the USA you can get alprazolam (i.e., Xanax) as a liquid, which makes it easier to measure small, accurate doses. I switched to a liquid script when I was tapering.

It also helped me tremendously to split my once/day dose into 4 equally spaced doses. As Colin said, X is short acting and can cause interdose withdrawal symptoms if dosed only once/day even if you are not tapering. 

Perhaps you could bring these things up with your prescriber?

I was really worried, too, when I first decided to taper and read all kinds of scary things. Much of what you read doesn't apply to you. Colin gave good advice about this. I suggest gathering information, making a plan, and then stop reading scary things online. The best thing to do is put your mind on other things most of the time. 

I started from a much higher dose than you are on and got off. You can do it, too!

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