Just read on Surviving AD forum its better to taper the antidepressant first?? Freaking out because I already started my taper.

[[la...]]

So I just started a taper from 20mg diazepam and feeling some WD effects. I've had a messy background coming off klonopin twice CT and ambien. I'm also on 20mg lexapro and 100mg trazodone. I went to survivingantidepressants.org and it recommends you taper off the AD first bc they can be stimulating resulting in worse akathisia etc. Now I'm anxious because I'm on such a high dose of antidepressants I'm thinking should I have tapered them first? But the kicker is my main benzo WD symptom is depression despite being on the other meds. I'm scared if I were to remove the AD, I would plunge. My husband keeps telling me the anti-depressants are the issue not the benzo. He doesn't realize how bad I was when I was switched from zoloft which I was on for years to lexapro overnight AND from 3 mg klonopin to 2 mg lorazepam AT THE SAME TIME ALL OVERNIGHT. This was in 2021. Finally switched to Valium and stabilized but it took about 4 months and I still have symptoms of course either from that extreme switch or tapering. or both.

I'm literally having so much forgetfulness, muscle aches and weakness and just feel mentally impaired. Not able to organize my house like I used to. idk I'm literally "just not here" if that makes sense. I don't feel present, trapped in my head to the point I get so stressed out by the outside world. Anyways, I'm just constantly second guessing myself. My thinking is that once I get to 15-10 mg valium (I plan on doing this as slowly as possible) rethink maybe hold for a few months. Idk....I'm just like is tapering the benzo first bad? 

[[Ka...]]

Hello @[la...] I’m not on any other forums & sometimes when researching we get conflicting advice.

This is what the Ashton Manual says in relation to which to taper first:

(5) Antidepressants. Many people taking benzodiazepines long-term have also been prescribed antidepressant drugs because of developing depression, either during chronic use or during withdrawal. Antidepressant drugs should also be tapered slowly since they too can cause a withdrawal reaction (euphemistically labelled "antidepressant discontinuation reaction" by psychiatrists). If you are taking an antidepressant drug as well as a benzodiazepine it is best to complete the benzodiazepine withdrawal before starting to taper the antidepressant. A list of antidepressant drugs and brief advice on how to taper them is given in Schedule 13 of this chapter. Some antidepressant withdrawal ("discontinuation") symptoms are shown in Chapter III

It can be so confusing & I hope this helps. 

[[Ma...]]

It is confusing indeed.

SA says to do the antidepr (AD) first because it can be ‘activating’ so the benzo can cover those withdrawal effects a bit.

While in more benzo-related fora/communities they’ll tell you to do the benzo first, because of possibility of tolerance-withdrawal (withdrawal symptoms while you’re still on your normale daily dose).

For me it’s not clear what the actual risk of tolerance-withdrawal is. But I chose to do the AD first. Not really a conscious choice btw: I started to taper my last 3mg of Paroxetine last year and got his with severe withdrawal…. did a micro-wise reinstatement after six excruciating months and at 11 months I’m about 80% healed. In that year was put on Lorazepam. 
But I’m not touching the Paroxetine again. Not in the near (ever?) future.

So, tapering Lora is what I just started to do. Despite the advice given on SA. And it feels hard to not go with that advice; makes me feel very insecure (because they feel like Masters of Knowledge). But you have to go with wat your gut feeling is telling you (you are the Master of Experience). The plan you’re suggesting makes total to me (also reading about your current symptoms, which fit Valium).
 

Start a taper, lower the dose gently, stabilize and see what is does for you. You can always change plans along the way (with some rest in between). 

[[Ch...]]

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

So I just started a taper from 20mg diazepam and feeling some WD effects. I've had a messy background coming off klonopin twice CT and ambien. I'm also on 20mg lexapro and 100mg trazodone. I went to survivingantidepressants.org and it recommends you taper off the AD first bc they can be stimulating resulting in worse akathisia etc.

This is just my opinion based on my knowledge. I am not a doctor...

Diazepam is known to cause severe depression. The antidepressants, especially the Lexapro, may be shielding you somewhat.

Of the two antidepressants, Lexapro would be more stimulating than Trazadone. In fact, some doctors prescribe Trazadone in an attempt to treat akathisia. Not all antidepressants are equally "stimulating."

I think you'll be okay tapering the benzodiazepine first. Second, I would do Lexapro. I would taper the Trazadone last.

Incidentally, when I was tapering Diazepam, my doctor prescribed high doses of propranolol, a beta-blocker,  to counteract akathisia. It was successful, thankfully.

What is your plan for tapering Diazepam?

[[la...]]

@[Ch...] That is exactly what I was thinking. Tapering in that order. I think I need the antidepressant because depression is a major benzo wd symptom for me. 

I'm taking it super slow. Right now I'm cutting 1/8 of one 5 mg tablet (So I take a little less than 2 in the morning 2 at night) every 4-6 weeks or until symptoms from the cut subside. I plan on doing this until I reach a threshold of symptoms, then microtapering. The second half of the taper I'll take it even slower but I don't have a hard outline. It'll take as long as it takes and I'm ok with that but it still sucks!! 

 

[[Ba...]]

 

 

I'm taking Pristiq antidepressant and Seroquel 50 mg, Mirtazapine ,15 mg and Buspirone 10 mg. Provider has me tapering from 3 mg Klonopin. I have been on these drugs over a year. I have been on benzos 40 years. Are all these meds going to make my taper worse? I'm feeling extremely anxious and wondering if I can find a caregiver to help me through this. Does anyone have suggestions and idea for how to find the proper caregiver? Does anyone have experience with the meds? I'm in a really tough spot bc I am a 67 year old widow with no family or support. 

[[Do...]]

Hi,

That is totally the opposite of what you should do.

You need to taper your benzo first cause the AD could help you with the wd symptoms and also cause is a million times harder to come off benzos and if you taper you AD first it will get twice as hard to taper benzos.

Is way easier to come off benzos while youre still in AD.

I am telling you from my own experience. I went cold turkey with my ssri and it was horrible but i would do it again 5 times in a row if i could get rid of my benzo taper wd hell.

Edited April 15 by [Do...]

[[Ca...]]

I would agree with the above replies. I have god awful depression and am on a low dose of lexapro. I'm tapering with Valium and am on a hold trying to stabilize at 14 mgs. Everyone has an opinion on what works. It seems to be an art and not a science. We are here for you.

[[No...]]

Same here, I quit sertraline CT, then quit Mirtazapine CT and 2 months later started cutting Klonopin.. 3 very bad ideas. 

[[...]]

17 hours ago, [[l...] said:

So I just started a taper from 20mg diazepam and feeling some WD effects. I've had a messy background coming off klonopin twice CT and ambien. I'm also on 20mg lexapro and 100mg trazodone. I went to survivingantidepressants.org and it recommends you taper off the AD first bc they can be stimulating resulting in worse akathisia etc. Now I'm anxious because I'm on such a high dose of antidepressants I'm thinking should I have tapered them first? But the kicker is my main benzo WD symptom is depression despite being on the other meds. I'm scared if I were to remove the AD, I would plunge. My husband keeps telling me the anti-depressants are the issue not the benzo. He doesn't realize how bad I was when I was switched from zoloft which I was on for years to lexapro overnight AND from 3 mg klonopin to 2 mg lorazepam AT THE SAME TIME ALL OVERNIGHT. This was in 2021. Finally switched to Valium and stabilized but it took about 4 months and I still have symptoms of course either from that extreme switch or tapering. or both.

I'm literally having so much forgetfulness, muscle aches and weakness and just feel mentally impaired. Not able to organize my house like I used to. idk I'm literally "just not here" if that makes sense. I don't feel present, trapped in my head to the point I get so stressed out by the outside world. Anyways, I'm just constantly second guessing myself. My thinking is that once I get to 15-10 mg valium (I plan on doing this as slowly as possible) rethink maybe hold for a few months. Idk....I'm just like is tapering the benzo first bad? 

@[la...], I'm not sure what is the best decision personally for you bc we're all different but the Ashton Manual says to taper benzo first and i believe H.Ashton) In my opinion and by what i heard from others, benzo is more difficult to part with and the antidepressants you take meant to support your sensitive NC while coming off benzo. When the acute phase of benzo withdrawal is over, it's supposed to be easier to come off antidepressants. 

I'm tapering an antidepressant now, which i've been taking for a year to smooth my benzo WD. It seems to be much more painless and simpler than the similar benzo experience, even though the actual benzo WD is still here.

Good luck to you and, first of all, listen to your body!)

[[la...]]

Thanks everyone for your responses!! I'm DEF staying with tapering the benzo first. It is what I originally planned to do, and did a ton of research. Survivingantidepressants did make me doubt myself bc i'm polydrugged but many of us are. Def going with my gut to taper the benzo first based on my symptoms and the other responses about first hand experiences!

And I have my doc's approval to taper this way, but we all know how docs are LOL.

Edited April 16 by [la...]