Have had series of stressful setbacks to my taper

[[Ed...]]

 

I recently went through an unprecedented series of crises - deaths of very dear ones, relationship catastrophes, financial crisis (having paid for the hospitalization and surgery of a loved one who was uninsured...who died anyway) - and during all this, the loss of my wonderful long-term drug manager/therapist (she transferred out of state). Her replacement was a rude therapist with little experience with benzos, not well-informed about their withdrawal; he started to make big fixed cuts in my dosage (and I've been on xanax for 20 years - my body has become far too dependent on it to taper as fast as he was cutting me, especially during this traumatic time in my life).

[NB: I have bad reactions to both klonopin and valium.]

So very fortunately, I discovered an old bottle of xanax (undoubtedly degraded) which I had backlogged in the fridge, so when his latest Rx ran out, I left this harsh new drug manager, as major withdrawal with his steep tapering had set in - my blood pressure, anxiety, and despair had skyrocketed. In desperation, I upped my dosage of the old xanax.  I really had no idea how much active alprazolam I was actually getting from the old stuff. But major symptoms continued:  insomnia (bad) and when I did sleep from exhaustion, waking up in a soaking sweat around my neck and chilling, also experiencing scary derealization, pressure in my head, and weeping, burning eyes. At first, I thought this was because the old generic was poisoning me, but I researched and alprazolam doesn't degrade into anything toxic. But now that I've upped the dosage again (can't get to see a new, expert drug manager/CBT for another week and a half), these symptoms have lessened considerably.

I just dread that I've ruined my hard-won taper (during which I had dropped from 8mg to 2mg in two years), because of this "rescue updosing" (now up to 3.5mg, not knowing exactly what effective dosage I'm actually getting with these old pills). I guess we'll find out when I resume with the new practitioner.

Edrek

 

[[pi...]]

Hello @[Ed...],

All is not lost. You’ve had a tremendous amount of stress and grief in your life.

Sadly, it’s not uncommon to have less than quality medical care in terms of benzos and the proper way to taper. It leaves people in very dire circumstances. I’m glad you have an upcoming appointment. When is it? Do you have enough Xanax to tide you over until you can get a prescription? 

[[Br...]]

Hello and welcome @[Ed...] - I'm so sorry you've been through so much loss and stress, and suffering from withdrawal symptoms as well.  I'm glad you've stabilized with the updose.

I hope your new practitioner warms up and you're able to work collaboratively on your taper.  Did you start the taper with your former therapist? 

 As @[pi...] asked, do you have enough Xanax to last until you get a new prescription?  We sometimes suggest members consider printing these guidelines out to bring to an appointment to help persuade your practitioner to support a slow, cautious taper. https://corxconsortium.org/wp-content/uploads/Benzo-Deprescribing.pdf

The symptoms you describe are indeed common withdrawal symptoms: insomnia, night sweats & chills, head pressure and derealization.  You might find it helpful to look at The Ashton Manual list of withdrawal symptoms https://www.benzoinfo.com/ashtonmanual/chapter3/  When I was in the thick of withdrawal I found it very comforting to see my symptoms listed.  

I think you'll find the support and information invaluable as you go through this process.  BenzoBuddies has been a lifeline for many, including me.

Please continue to ask questions and reach out for support.  We're glad you found us!

Brighterday

[[An...]]

On 28/11/2023 at 05:58, [[E...] said:

I recently went through an unprecedented series of crises - deaths of very dear ones, relationship catastrophes, financial crisis (having paid for the hospitalization and surgery of a loved one who was uninsured...who died anyway) - and during all this, the loss of my wonderful long-term drug manager/therapist (she transferred out of state). Her replacement was a rude therapist with little experience with benzos, not well-informed about their withdrawal; he started to make big fixed cuts in my dosage (and I've been on xanax for 20 years - my body has become far too dependent on it to taper as fast as he was cutting me, especially during this traumatic time in my life).

[NB: I have bad reactions to both klonopin and valium.]

So very fortunately, I discovered an old bottle of xanax (undoubtedly degraded) which I had backlogged in the fridge, so when his latest Rx ran out, I left this harsh new drug manager, as major withdrawal with his steep tapering had set in - my blood pressure, anxiety, and despair had skyrocketed. In desperation, I upped my dosage of the old xanax.  I really had no idea how much active alprazolam I was actually getting from the old stuff. But major symptoms continued:  insomnia (bad) and when I did sleep from exhaustion, waking up in a soaking sweat around my neck and chilling, also experiencing scary derealization, pressure in my head, and weeping, burning eyes. At first, I thought this was because the old generic was poisoning me, but I researched and alprazolam doesn't degrade into anything toxic. But now that I've upped the dosage again (can't get to see a new, expert drug manager/CBT for another week and a half), these symptoms have lessened considerably.

I just dread that I've ruined my hard-won taper (during which I had dropped from 8mg to 2mg in two years), because of this "rescue updosing" (now up to 3.5mg, not knowing exactly what effective dosage I'm actually getting with these old pills). I guess we'll find out when I resume with the new practitioner.

Edrek

Hi Edrek, welcome to benzobuddies friend. I don't think all is lost either. You had a series of stressful events in your life so this was probably not the best time to make any drastic changes in Rx medications like benzodiazepines that are prescribed to treat anxiety disorders, insomnia, and stressful life events that make anxiety and insomnia worse. How much have you recovered from this series of life crises?  The stress from major life stressors like the death of a loved one or relationship breakups is usually relieved with time after the event, much like the withdrawal when you stop taking benzos, but the financial stress can linger unless you are able to change your financial situation.

Quote

Her replacement was a rude therapist with little experience with benzos, not well-informed about their withdrawal; he started to make big fixed cuts in my dosage (and I've been on xanax for 20 years - my body has become far too dependent on it to taper as fast as he was cutting me, especially during this traumatic time in my life).

I totally agree with you here. What kind of therapist was this who was able to prescribe benzos? Do you also have a primary care doctor? If you do, have you made him or her aware of your current situation? You definitely want to keep close tabs on your blood pressure and may need to take meds (temporarily) for this while you attempt the Xanax detox. When you say expert drug manager, what does this mean? Is this new person you will be seeing a psychologist with prescribing privileges who also does talk therapy and CBT? It is good you had a backup of Xanax even tho it was old. How big of a stockpile do you have? Experts say benzos like Xanax have a shelf life of approx. 3 years but many other experts say these drugs still maintain their potency long after they have expired as long as they are properly stored and I have found this personally to be true. I recall reading somewhere that some pills and capsules can even be stored in a freezer and extend the shelf life indefinitely. IDK if this is true or not tho.

Even if you are now back up to 3.5 mgs, you have made considerable progress coming down from 8 mgs so I would not stress about this too much. How confident are you that this new expert drug manager will continue to Rx you the Xanax until you are able to complete your taper?

8 mgs is a lot of Xanax. You would like to come off completely right, not just get the dose down? You had clearly become tolerant over the years.

[[Ed...]]

On 29/11/2023 at 08:21, [[p...] said:

 

 

On 29/11/2023 at 12:26, [[B...] said:

 

On 29/11/2023 at 14:02, [[A...] said:

 

 

Edited December 2, 2023 by [Ed...]
Accidentally posted before answering all the multiquotes.

[[Ed...]]

@[pi...] I so appreciate your understanding. I never thought I could go through - much less bear - such anguish all at once. Losing my dearest friends - two who suddenly died (one for whom I charged thousands to save, but in vain - money I can't afford to pay back any time soon, a cause of great anxiety as I'm 72 with little income); another very close old friend who is succumbing to a paranoid mental illness that causes them to believe I did something terrible to them, which never happened. All in the course of the last few months. It has all left me in such a state of shock, painful loneliness, and grieving. And during this time, having my xanax supply and counseling suddenly cut off.

I'm distressed that I have "shut down" - feel in a sort of psychological paralysis - can't keep myself washed or groomed, finding housecleaning unbearable - now living in a filthy, messy house - but need to sell it and move to get my finances "above water". Dread even the thought of packing and moving....

Yes, one very fortunate thing - I do have enough old xanax to last me until I see my new psychiatric nurse practitioner on 12/12. I just dread that she may not be amenable to tapering xanax as I had been successfully doing before all the above happened.

 

@[Br...] Thank you for your kind words and the documentation to help me with the new therapist! Also for the reassurance that my symptoms are typical benzo w/d. I believe the old xanax is just less potent and a milligram of it is not as potent as it is supposed to be.

As for tapering, I started that back in 2020 on my own and got down to 4mg (without changing my 8mg prescription - that's how I amassed the backlog of xanax I'm using now), and since June of 2022 I've had two drug managers (prescribing psychiatric nurse practitioners) in the same clinic, who had gotten me down to 2mg, before everything fell apart at that clinic (they are now going out of business due to insurance fraud, etc. - sadly, no fault of the two practitioners who helped me).

@[An...] And my sincere thanks to you for your comforting confirmations! I find that the recovery from traumatic loss like I've just had is not a steady improvement at all. There are moments - triggered by so many little things - when it feels like the painful loss was only yesterday. Other days that I just feel numb, blank, "paralyzed". But I never feel close to full recovery these days - it's only been a little more than a month since the worst happened. The very beloved friend I lost - despite the great expense incurred - died on October 20th. I have never gotten over any loss like that in just a couple of months. Alleviating the financial stress will require great energy for major changes in my life, which I simply don't have at this time.

Before the prescribing nurse practitioners, the person who was making brutal fixed cuts in my tapering was my PCP - a full MD. He knew far less than the prescribing nurse practitioners, who had years of experience with benzos. He had next to none and was not receptive to any expert information about tapering xanax. I have since stopped seeing him and dropped him as PCP.

Yes, the new practitioner I am to see deals with a full range of emotional issues, including CPTSD, which I have dealt with since childhood (that was the basis for a former PCP starting me on xanax back in 2004 - with the support of a full psychiatrist who actually increased the dosage) though it was not labeled as CPTSD in those days - rather, abused child syndrome, developmental trauma disorder, etc. I attend meetings of an AA affiliate - Adult Children of Alcoholics and Dysfunction Families (ACA or ACoA for short); however, I find that the histories of the members in my area don't even come near the abuse I suffered as a child and adolescent. They are shocked to hear the things that my parents did to me - meaning they are more sympathetic audience than fellow survivors, which is not a situation I have found helpful.

And yes, I want to get off of xanax completely! I've been held prisoner to this drug too long. I want out of this prison for a few years before I die.

I do have a question to ask at this point. During the intake interview for my upcoming session with the psychiatric nurse practitioner, it was suggested that I might consider electromagnetic brain stimulation and/or in-clinic ketamine therapy during CBT (it supposedly enhances neuroplasticity allowing the CBT to be more effective). Any experience or reports of the effectiveness of this?

Edited December 2, 2023 by [Ed...]
Eliminated irrelevant explanation of earlier misposting which is now deleted.

[[pi...]]

@[Ed...],

It makes me sad that you had to suffer such horrible abuse as a child. No child should have to endure this. 

I see there are changes you need to make to help your financial situation. Benzos and withdrawal can cause anhedonia  , where simple every tasks become monumental. Many of us, myself included kept a journal thought this process. I tried to start mine with something positive, even if it was that I got dressed by sometime in the afternoon. Is there anyone you and ask to help you get the house in order to sell? Making bug changes like this can be challenging during withdrawal.

I can’t comment about the 2 therapies suggested to you. Hopefully someone can give you some feedback.

I congratulate you for wanting to be Xanax free after so many years. I’m also in my 70’s and tapering off benzos was very important to my future wellbeing.

[[Ed...]]

@[pi...]What you say about anhedonia gives me such a clear definition for my absurd and demoralizing issue with simple everyday tasks seeming so overwhelming. I now recall another very scientific word: avolition.

It's been said that it's easier to cope with an ailment when you have an official name for it - and I've always found this to be true for me. If I know that some expert has recognized and labeled my maddening lack of motivation, it seems easier to handle. Now I also remember a thread I read long ago on a website similar to this one which was titled something like "How Long Has It Been Since You Last Took a Shower?"

Helping me remember that made me laugh with some relief - that was a funny thread about this troubling benzo behavioral problem, with members seeming to try and top each other with the length of their inability to accomplish everyday tasks. Misery has always loved company.

It is also so valuable to me that you are in your 70's. This proves to me that I'm not too old to get a genuine life back. I will be patient but resolute with my taper. Henry Kissinger died at 100. Rosalynn Carter at 96. I may have a long time to live a happier life before I have to leave this plane of existence. More motivation to keep on keeping on.

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

Is there anyone you can ask to help you get the house in order to sell? Making big changes like this can be challenging during withdrawal.

Oh, you're so very right about that! At this time, my house is in such squalor and disorder that my pride would prohibit me from having anyone come to clean it up unless I pre-cleaned it. I'm working toward that - bringing it from squalid to just dirty. Perhaps after my new therapy begins, I will more quickly find the motivation necessary to make things less mortifying for me to let others see. Xanax doesn't rid me of my stupid pride.