Am I likely to face withdrawals with non-daily use of low dose diazepam?

[[Ra...]]

 

Am I likely to have withdrawal from low dose non-daily Diazepam use?

So I’ve been prescribed 14x 5mg tablets of Diazepam per month for about two years or so. There are times when I have needed to take doses more often, and times when I’ve only taken two tablets in a week.

Currently I don’t feel like I need them unless I’m facing an anxiety inducing task (I.e. i had dental appointments recently, on both days i took 15mgs total). Generally I’ll take a 5mg every few days, occasionally needing to take them a couple of days in a row, or taking 10mgs in a day, but then usually followed by anything from a day to a few days before taking another dose.

I’ve not felt like I’ve needed more, my use hasn’t really increased per se, although I’ve always felt a bit more immune to the sedative effects of Diazepam - it’s rarely made me feel sleepy, it just takes the edge off the anxiety a bit. 

Basically, having taken 14x 5mg tablets per month at various dose amounts throughout each month (but never really exceeding that frequency of use), am I likely to face withdrawals if I try to lower or even stop taking them?

I have an upcoming dental treatment with IV sedation (Midazolam) and I’m keen to feel the full effect of the IV drug so I feel like reducing my diazepam use will help with this. But also, I want to reduce my need to reach for Diazepam and find other ways of coping with anxiety inducing scenarios. 

I’m also super emetophobic so the gastrointestinal effects of withdrawal are terrifying to me.

Any help, advice, shared experiences, or actual love is gratefully received ❤️

 

[[Pa...]]

Hello @[Ra...], welcome to BenzoBuddies,

Using benzodiazepines PRN can lead to dependence but not everyone will succumb to this so perhaps we can help you determine if your body is dependent.

Have you ever gone longer than 7 days without taking the diazepam?  Since it has such a long half life, its difficult to know whats what unless you’ve allowed time for the medication to leave your body.

What many have noticed is that once our body is dependent, the medication begins to cause the problems we went on them to correct such as anxiety, panic and insomnia.  Have you felt that the drug may be causing this for you?

It might be helpful to do a little experimenting before making a decision to taper from the diazepam, to find out if you’re dependent.  If you are, then we suggest reducing your dose by about 5-10% every couple of weeks or whatever your symptoms will allow.

Let’s keep talking so we can figure this out, we’re glad you found us.

Pamster

[[Ra...]]

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

Hello @[Ra...], welcome to BenzoBuddies,

Using benzodiazepines PRN can lead to dependence but not everyone will succumb to this so perhaps we can help you determine if your body is dependent.

Have you ever gone longer than 7 days without taking the diazepam?  Since it has such a long half life, its difficult to know whats what unless you’ve allowed time for the medication to leave your body.

What many have noticed is that once our body is dependent, the medication begins to cause the problems we went on them to correct such as anxiety, panic and insomnia.  Have you felt that the drug may be causing this for you?

It might be helpful to do a little experimenting before making a decision to taper from the diazepam, to find out if you’re dependent.  If you are, then we suggest reducing your dose by about 5-10% every couple of weeks or whatever your symptoms will allow.

Let’s keep talking so we can figure this out, we’re glad you found us.

Pamster

Hey! Thank you. I don’t think I have very often gone more than 7 days without a dose as far as I can recall, but certainly close to it numerous times. Tomorrow will be 3 days since my last 5mg dose and so far it’s hard to tell if I feel different. 

 

i haven’t noticed any increase in anxiety etc, though I do often find it gets worse seasonally (this time of year tends to be rougher than summer).

 

Maybe I’ll try seeing how the next couple of days go and see if I find myself feeling like I need to reach for a tablet or not.

 

i think there’s definitely a psychological dependency right now even if not a strong physical one, so that may be a factor. They really do help me calm down from a panic attack or better manage panic inducing situations…

[[An...]]

I agree with what Pam said due to Valium's long half-life. Personally, I would still do a taper but perhaps not an Ashton-based one since you were not taking the valium daily.

Hopefully, any w/d effects will be mild and short-lived.

 

[Guest [...]]

Hi @[Ra...]

I agree with both @[Pa...] and @[An...]

Here is what you should be asking yourself… 

Am I really this susceptible to anxiety when a seemingly stressful event arises, or is my CNS destabilised and vulnerable because of both dependence and dosing PRN? 

If you are even slightly dependant on the Valium and you go for any length of time without dosing just before a seemingly stressful event arises, your CNS will overreact and you can be easily tricked into thinking that you are just naturally vulnerable and prone to increased anxiety when these events arise, when, potentially, it’s just your CNS is somewhat destabilised because of a lower level withdrawal and a dependance that hasn’t quite become clear to you just yet.

It becomes a cycle…

You may even feel somewhat relaxed on a daily basis… until something triggers your CNS… it could be a harsh word from someone, a problem arises, or a trip to the dentist… and then your CNS overreacts to the situation because your Gabba receptors (which play the calming role in your nervous system) are down-regulated by taking benzodiazepines over time… If dependence is in fact the case, and you are only dosing prn, you could often be in withdrawal because you simply don’t have enough of the drug in your system to cover for your receptors… to play that calming role on your CNS.

Each time a stressful event arises, you dose the Valium and reinforce the dependence, trapping you in an endless cycle of feeling as though you continually need the drug whenever these random triggers or events arise. 

Here is where you would decide whether you are in a position to cease taking the drug and ride through symptoms until your CNS recovers (repairs are made and gabba receptors up-regulate) or if you need to take a small dose daily to keep your blood serum levels balanced and then make reduction in your daily dose every two or so weeks until you have ceased the drug altogether.

WS  

 

 

 

Edited January 13 by Guest

[[ve...]]

Don't tempt the devil and make plans to stop it.  When you feel you no longer need it, flush them down the toilet or dispose of them in a more eco-friendly way.

[[Ra...]]

Thanks so much for the thoughts and advice.

I think I must have a dependence, especially when I consider what @[Wi...] says. I think I’ve convinced myself that my anxiety and panic tolerance is just much lower than it used to be, when in reality it’s probably exacerbated by the therapeutic effect of diazepam leaving my system and leaving me vulnerable to all kinds of exaggerated symptoms of anxiety and panic.

 

Today is day 3 of no diazepam and I don’t feel too bad. No notably higher anxiety or anything as yet, but I’m on long term Mirtazapine for anxiety and panic disorder which usually means I sleep well and have an okay appetite, so maybe that is helping me through it too.

 

I guess my best option is to see how things develop with taking none and if I feel something significant happening, consider a minor taper with what I have.

 

I also know I’m so liable to face psychosomatic symptoms, so I’m going to try and disconnect from attributing worries and feelings to withdrawal unless it becomes really evident that’s what’s happening.

I’ll try to keep this post updated for others in a similar position too.

 

Thanks all for the advice ❤️

 

[[WU...]]

"I think I’ve convinced myself that my anxiety and panic tolerance is just much lower than it used to be, when in reality it’s probably exacerbated by the therapeutic effect of diazepam leaving my system and leaving me vulnerable to all kinds of exaggerated symptoms of anxiety and panic."

@[Ra...]Yep, that's pretty much what happened to me, and the doctor reinforced this idea and tried to prescribe more pills in addition to the diazepam.

My case has similarities in that I was prescribed 28 x 5 mg every three months or so for quite a few years (before that I took it on and off but with bigger gaps in between but I think the brain remembers everything ! ). It was a very gradual process of increasing nervousness over things, bearing in mind I took it for muscle spasm in my neck and never for an anxiety issue.  Always carried them in my bag just in case!  When it hit me all of a sudden that it was the pills I went cold turkey.  I couldn't see how I could taper when my use had been intermittent.  Got hit hard on day 11, like a ton of bricks fell on my head.  Probably best to find a way of tapering though if you can, others here may have some good suggestions.

[[Ra...]]

40 minutes ago, [[W...] said:

"I think I’ve convinced myself that my anxiety and panic tolerance is just much lower than it used to be, when in reality it’s probably exacerbated by the therapeutic effect of diazepam leaving my system and leaving me vulnerable to all kinds of exaggerated symptoms of anxiety and panic."

@[Ra...]Yep, that's pretty much what happened to me, and the doctor reinforced this idea and tried to prescribe more pills in addition to the diazepam.

My case has similarities in that I was prescribed 28 x 5 mg every three months or so for quite a few years (before that I took it on and off but with bigger gaps in between but I think the brain remembers everything ! ). It was a very gradual process of increasing nervousness over things, bearing in mind I took it for muscle spasm in my neck and never for an anxiety issue.  Always carried them in my bag just in case!  When it hit me all of a sudden that it was the pills I went cold turkey.  I couldn't see how I could taper when my use had been intermittent.  Got hit hard on day 11, like a ton of bricks fell on my head.  Probably best to find a way of tapering though if you can, others here may have some good suggestions.

Maybe I’ll see how I feel at 7 days and take a 5mg dose to keep a level in my system. Hopefully because of the intermittent use and relatively low dose, it’ll just be some rebound anxiety - which I can absolutely deal with. The only thing I think I’ll really struggle with is any gastro withdrawals, but I guess I can take antiemetics to help combat those…

[Guest [...]]

@[Ra...]

Just keep in mind that if you are going to dose in order to keep your blood serum level balanced and avoid withdrawal, as opposed to immediate cessation, you will need to dose ‘daily’ as diazepam has a half life of 30 - 200 hrs. 

Since you are prescribed 14 x 5mg tabs per month,  you could dose 2.5mg per day (at the same time daily) which would cover you for the entire month until your next prescription is filled. 
 

It is generally recommended tapering no more than 5 - 10% from your total daily dose every 10 - 14 days, but you may be able to taper a higher percentage than this, depending on your withdrawal symptoms. Eg. You may be able to taper  0.5mg every 2 weeks or so until you are completely off the medication. This will come down to how your system responds to tapering in terms of the intensity of withdrawal symptoms. Only you will know the right course of action… immediate cessation or tapering at a rate that is most comfortable for you. 

You may wish to ask your prescriber if you have 2mg tabs available to you where you live, as this will make it easier to taper (split tabs) into smaller doses without using a jewellers scale. 

Again… You may be able to just immediately stop the medication altogether, but be aware that this will most likely mean you will have to endure some level of uncomfortable withdrawal symptoms which you will have to ride through until your system gradually adjusts over a period of weeks to months. 

You would have to keep reinforcing and reminding yourself that whatever symptoms you are experiencing are only temporary and will ease and resolve as time passes. 

We will also be here to support you through the withdrawal phases. 👍