Need help with micro taper

[[Su...]]

Hi all, I’m new here but I was hoping for some help with a few questions I have. 
 

#1 how do I put my history in my profile? Lol 

Here is my story..I was prescribed Clonazepam for around 10 years for “GAD”  I was taking .5 mg twice a day for most of that time. I have been tapering for over a year. I have a psychiatrist who agreed to use the Ashton manual taper method with me. I switched over to diazepam early on and I was doing okay. I was doing the cut and hold method. Any time things started to get hairy I would hold after a cut. When I got down to 1mg I was having some increase in anxiety symptoms. I held there for around 2-3 months because I had a weird reaction happen with my eyes and wanted to get that cleared up 1st. Anyway at the end of August I saw my psych again and things were great, I felt awesome, better than I had in years. My husband said I was thriving. We agreed it was time to drop the dose again. I went home and dropped from 1mg to .5 but I was not very accurate in my dose because I was breaking pills and I was excited to be going down again so I went and broke them all at once to get that out of the way. When I realized I had broken them unevenly I said okay I’ll just start with the bigger ones and work my way down to the smaller ones. I went down on August 22 and on sept 6th I had the worst panic attack of my life. I then began sweating and throwing up. Since Sept 6th I started experiencing SEVERE symptoms of withdrawal. I was hot and cold, my arms and shoulders burning, my sleep went to pretty much nothing, my stomach was flipping, severe diarrhea, feeling intense panic, and many others but I went into a state of Dp/dr and felt so completely out of it and this horrible sense of terror like I’ve never experienced. I also started to experience SEVERE depression. I have been blue before but never like this. This was traumatizing and something else. I talked to my psychiatrist and she said that she was going to call in liquid Valium so I could be more accurate with dosing. Thank you Lord! When I crossed over to liquid Valium (5mg/5ml) 1:1 ratio from the 2mg pills I was breaking up I started it at .3 because I knew some of the pills I had broken and been taking trying to get to .5mg were less than that and I didn’t want to go up in dose so I just settled at .3ml liquid and have been holding there for about 3 weeks now. My symptoms have started to improve greatly and I am so thankful to Jesus!
 

My question is how would I go about doing a daily micro taper at this point with liquid Valium? My other question is, I saw someone had said that when you get below .5 you have entered acute because you’re below therapeutic levels and I’m wondering if that is what probably happened with this last drop?

I want to be smart about the rest of this taper, I’m a mom of two young children and a wife and this has not been easy as you all very well know. I’m wondering if when I drop again if it will go back to that horrible state I was in again or if now that I’ve stabilized there would be a way to avoid that.

Thank you all for your advice and help. Praying for you all throughout this difficult journey we’re on. 💛

Edited October 12, 2023 by [Su...]

[[je...]]

Hi @[Su...]

Welcome to BenzoBuddies!

Congratulations on the progress with your taper! I'm sorry to hear you've experienced these symptoms. In my opinion I kind of agree that at these low doses you're probably entering some level of PAWS. Prof Ashton said in the Ashton Manual that between 0.5mg- 1mg of Valium it doesn't have any therapeutic value anymore. I was on Clonazepam and I jumped at the Valium equivalent of 0.5mg. But some people need the psychological assurance of tapering all the way down to zero. At what dose were you thinking of jumping?

[[Su...]]

Hi @[je...] thank you for your reply! I honestly wasn’t sure. I’ve kind of been taking this one step at a time and with this last step down being just other worldly in terms of symptoms it has made me hesitate about taking further steps. That’s why I was wondering if I should start a micro taper now and how would I do that? My 1ml syringe goes down by .2 would I need to get a smaller one? Could you explain a little further about me entering paws? I guess when do acute withdrawals start if I’m still tapering, would it be once I jump or during the taper? Sorry about all of the questions sometimes it feels like you need to be a physicist to figure this stuff out. 🤦🏻‍♀️

Edited October 11, 2023 by [Su...]

[[je...]]

PAWS is technically the phase you enter right when you stop taking benzo's. But we theorize that maybe you experience some of it when you start losing therapeutic value. Some people experience different types of symptoms when they jump and enter PAWS, others, like me have the exact same symptoms as during tapering. 

If you're interested in micro tapering, the best would be to find a way that works with your symptoms. We call it a symptoms based taper. I don't know how slow or how fast you want to taper. It also becomes really tricky at the end because you want to maintain a steady pace but not overwhelm yourself. Each person has to experiment what works for them. I tried different approaches and finally found a way that got me off, but there's no guaranteed method. I'm really bad with liquid maths, hopefully somebody else will weigh in, otherwise I suggest you speak to your pharmacist to assist you in how fast/slow you want to go and help you with the math/syringes. You might also want to look through our old Titration board to see what others have done. (Just a side note: this board has been archived, and is read-only, you won't be able to post there).

[[Su...]]

@[je...] okay, so if I continue to taper will I just keep getting slammed with severe symptoms or does it usually even out from here? Ideally I’d like to be done with this medication yesterday but I’ve been trying to be mindful of my symptoms and trying not to rush. I’m terrible with the math of all of this, I thought that decreasing by .02 would be like a micro taper but maybe there are even smaller increments that I should use? Trying to take away the tiniest amount has been very overwhelming for me if I’m honest but the idea of dropping down again and having a repeat of what happened last time is nauseating to me. I hope someone who is good with liquid and micro taper can give me guidance. I’m hoping to be off in the next few months unless you think that’s too fast? 

[[je...]]

Nobody can predict how you will react unfortunately. My guess is it should be uneventful because I think you're not getting therapeutic doses anymore. I am really not well versed in what appropriate cuts are for low numbers of Valium unfortunately. Like I said, I jumped at 0.5mg Valium equivalent. I agree, I think you should be off in the next few months. There really is no reason to drag it out. You can have a look at this thread too.

[[Su...]]

@[je...] thank you so much for all of your kindness and advice! Can I ask do most people go through acute pretty severely then have symptoms get much better and they stay that way for months? I’m just wondering about when people say they’ve been protracted for such long periods of time are they better than being in severe acute? I know everyone is different but I guess I’m wondering what typical is. Also, how long ago did you jump? How long were you on benzos and how are you now? 

Edited October 12, 2023 by [Su...]

[[je...]]

From what I observe (but this is not set in stone), those who have a fairly manageable taper, seem to have an easier jump. I don't see a correlation between protracted and severely acute symptoms. It seems people recover in the same time frame regardless of the severity of symptoms when they jumped. (When we talk about protracted we refer to people who still struggle with symptoms after 18-24 months being benzo free). I'm 10 months benzo free, I was on Clonazepam for 2-3 years. I'm still feeling kind of the same as when I jumped, but I had other health issues these past months that mimicked withdrawal which makes it difficult to track my recovery cause I don't know which condition caused these symptoms. 

[[Su...]]

@[je...]oh wow, congratulations on being ten months free! I’m sorry you’re having other health issues, praying those will be removed in Jesus name!
 

I guess I was wondering when you are considered protracted or even just a few months out if people are dealing with acute like symptoms. 

[[je...]]

4 minutes ago, [[S...] said:

I guess I was wondering when you are considered protracted or even just a few months out if people are dealing with acute like symptoms. 

I'm not sure I understand this and whether I've answered it in my previous reply?

[[Su...]]

@[je...] I think maybe I’m not wording it correctly or I may not be understanding your answer.

What I am trying to ask is, at 3 months are people still dealing with “acute” symptoms. So intense symptoms like they were say 1 week post jump? And my question applies to people at 6 months and 18 months if they still have symptoms is it lingering or are they severe like right after you stopped the medication. I apologize for the confusion, I don’t want to blame everything on this withdrawal but I’ve noticed my communication hasn’t been very good lately. 

[[Su...]]

@[je...] Also, what do we think “stabilizing” is? If you drop down below therapeutic levels and have symptoms then stabilize, is that your brain using its own gaba receptors or is it that you’ve stabilized at your very low dose like me at .3 and your body is still using the medication to help you feel better? Basically how does your body feel better if the low dose isn’t therapeutic anymore?

[[je...]]

16 hours ago, [[S...] said:

@[je...] I think maybe I’m not wording it correctly or I may not be understanding your answer.

What I am trying to ask is, at 3 months are people still dealing with “acute” symptoms. So intense symptoms like they were say 1 week post jump? And my question applies to people at 6 months and 18 months if they still have symptoms is it lingering or are they severe like right after you stopped the medication. I apologize for the confusion, I don’t want to blame everything on this withdrawal but I’ve noticed my communication hasn’t been very good lately. 

No need to apologise, my cognition isn't the best either. The duration for acute varies for each person. However it gradually gets better. The intensity of symptoms will decrease as time goes by. I would guess for the majority of people acute symptoms would last around 3-6 months after jumping. However for some it can be longer and for others it can be a couple of weeks. Then there are others like me who never experienced an increase in symptoms after jumping. I think what you need to focus on is the fact that it gets better. Trying to compare yourself to others is futile because not a single journey is similar to someone else's. 

[[Su...]]

@[je...] you’re right, I’m feeling a little over whelmed by all of this. My psychiatrist is strongly recommending I start an AD before I go down again because of the intensity of the depression I experienced with the last cut. I’ve never felt anything like that before and thankfully it has lifted. I don’t however want to drop down again and have it come back.. is that typical? I know you said you wouldn’t expect an increase in symptoms but if I drop down again I don’t want to go back to the place I was with the last drop. Do you or anyone else have experience starting an AD at the end of your taper and being able to get off of it rather easily? I tried Zoloft at the beginning of my taper at a very low dose and broke it in half and I still felt like I drank a bunch of coffee so I didn’t continue. Now being even lower on the benzo I don’t want to get revved up but I also don’t want to be so incredibly depressed again. I have to be functional for my family. Thanks for talking with me, feeling like someone gets it and wants to help is a blessing. 

[[je...]]

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

@[je...] Also, what do we think “stabilizing” is? If you drop down below therapeutic levels and have symptoms then stabilize, is that your brain using its own gaba receptors or is it that you’ve stabilized at your very low dose like me at .3 and your body is still using the medication to help you feel better? Basically how does your body feel better if the low dose isn’t therapeutic anymore?

I'm not sure exactly how it works.  This is what Ashton said:

"In any case the 1mg or 0.5mg diazepam per day which you are taking at the end of your schedule is having little effect apart from keeping the dependence going. Do not be tempted to spin out the withdrawal to a ridiculously slow rate towards the end (such as 0.25mg each month). Take the plunge when you reach 0.5mg daily; full recovery cannot begin until you have got off your tablets completely."

She says the only effect it has is keeping the dependence going. My interpretation is the body still recognises the benzo but it does very little for symptoms management. I'm sorry I wish I can be of more help but I don't have enough scientific knowledge about this. 

[[je...]]

6 minutes ago, [[S...] said:

@[je...] you’re right, I’m feeling a little over whelmed by all of this. My psychiatrist is strongly recommending I start an AD before I go down again because of the intensity of the depression I experienced with the last cut. I’ve never felt anything like that before and thankfully it has lifted. I don’t however want to drop down again and have it come back.. is that typical? I know you said you wouldn’t expect an increase in symptoms but if I drop down again I don’t want to go back to the place I was with the last drop. Do you or anyone else have experience starting an AD at the end of your taper and being able to get off of it rather easily? I tried Zoloft at the beginning of my taper at a very low dose and broke it in half and I still felt like I drank a bunch of coffee so I didn’t continue. Now being even lower on the benzo I don’t want to get revved up but I also don’t want to be so incredibly depressed again. I have to be functional for my family. Thanks for talking with me, feeling like someone gets it and wants to help is a blessing. 

I understand your apprehension after what you went through. However the good thing is it settled down. It recovered by itself. You went through a wave and you got through. This happens to all of us in withdrawal. I don't know if depression is something you struggle with generally because withdrawal seems to target our weaknesses. My area is headaches and migraines. If I go through a wave I'll be guaranteed my headaches/migraines will be excruciating. But then when the wave passes it's gone again. On the one hand if you know it's related to a wave you also know it will pass at some stage. 

[[Su...]]

@[je...] I have never felt depression like what I experienced with this last drop. It was scary. I’ve had moments where I’ve felt a little low but not like that. I’m glad to hear it usually follows a pattern of lifting after a wave. Do you know of anyone who started an AD during or after their taper and if it helped? I was thinking of talking with my psychiatrist about amitriptyline. (sp) She thinks the depression may be a result of intense anxiety symptoms so if I did start one I’d like to try a more sedating one. 

[[Su...]]

@[je...] also do waves get less intense each time? 

[[je...]]

I have read one Success Story recently of someone starting an AD after jumping and it helped them recover from benzo use completely. I can't remember who it was though (it should be somewhere on the first two pages of Success Stories).

You can start a new thread in Health Matters and ask there for experiences on AD's. I read so much here daily and I don't retain all the information unfortunately. 

[[je...]]

Just now, [[S...] said:

@[je...] also do waves get less intense each time? 

Waves are unpredictable. Sometimes less intense sometimes more. Sometimes shorter, sometimes longer. Sometimes new symptoms. The only consistent thing about waves is they are unpredictable and they go away eventually. 

[[Su...]]

@[je...] thank you so much for all of your help! 

[[Su...]]

@[je...] so waves can feel like they did when I dropped down before and last even longer? 😔

[[je...]]

Just now, [[S...] said:

@[je...] so waves can feel like they did when I dropped down before and last even longer? 😔

Yes, there is the possibility unfortunately. But I'm also wondering like your doctor if it's anxiety/stress induced. I know with myself anxiety is my worst enemy. If you can manage stress and anxiety you'll have more control over waves. Not completely but the intensity won't be so bad.

[[Su...]]

@[je...] thank you again 

[[je...]]

You're welcome.