Xanax taper and symptoms

[[Ni...]]

Hello everyone. This is my first time here. I have been tapering Xanax since Aug 2023. I started at .5mg three times a day. So 1.5mg a day total. I have worked my way down to .15mg a day. .06 twice a day and .03 once a day. I feel like i am so close and yet so far away. The symptoms don't stop. I experience pain, respiratory depression, premature heart beats, dizziness and cognitive issues all day every day. My last cut was 6 weeks ago and i haven't leveled out at all. I don't know if there are any changes i can make to make this easier on myself. Any help is appreciated. 

[[...]]

@[Ni...], hello to you and welcome to BenzoBuddies! Guess you've found the right place to be advised and supported.

I can imagine what you're going through right now since I was there too. Feel for you with all my soul! Sorry i'm not much of an expert at tapering, although somehow managed my own to the end. I'm sure other members will look in and give you their piece of advice. 

As for me, you seem to be doing the tapering too fast. Could you tell how long you have been taking xanax; if there is any other medication you're taking to cover the symptoms; what the reason was for you taking benzo. Think it's important and can give us a better idea of your circumstances.

Anyway, Good Luck to you!)

[[Ni...]]

I was on it for 2 years and stopped and then started 5 months later started again. that was April of 2023. I started tapering in Aug of 2023. Just to add, it seems like i feel worse after i take my first dose of the day which is usually 8am. 

[[Em...]]

Hi Nick,

It seems like we have tapered on a very similar rate... but I was on 2mg and am now on 0.75 over nearly 8 months. So you are at lower dose and these drugs bind to more receptors at lower doses. Meaning that towards the end you have to take it much slower than early on.

Just wanted to tell you that I am now holding. It has just gotten tiny bit better but Ive held for like 4 weeks now.

I dont know if you should updose, crossover to longer acting benzo, space out your dose or simply hold longer... I will let others more experienced people advice you on that. Have you not gotten any better by holding at all? Are you the same or worse?

I feel so bad for you. I have every symptom you describe. Its insane, I really get it.

Stay strong. You've come a long way! And you have gone fast.

Hope someone advices you what's the best thing to do.

[[...]]

32 minutes ago, [[N...] said:

I was on it for 2 years and stopped and then started 5 months later started again. that was April of 2023. I started tapering in Aug of 2023. Just to add, it seems like i feel worse after i take my first dose of the day which is usually 8am. 

Did you go cold turkey first time you jumped off xanax? Why did you reinstate it? Too severe symptoms, right? Was the first withdrawal the same tough on you for the whole 5 months? Did you manage to stabilise prior to the current tapering? Have you ever felt you hit tolerance?

Not sure what means your feeling worse after taking the first dose of a day. Has it been always the case?  Sorry for so many questions. Just trying to figure out where you're standing atm.

 

[[...]]

35 minutes ago, [[E...] said:

...So you are at lower dose and these drugs bind to more receptors at lower doses. Meaning that towards the end you have to take it much slower than early on.

@[Em...], that's interesting. I mean benzo binding to more receptors at lower doses. I'd really like to read about it. Could you tell, pls, where can i find the information?

Do hope you'll stabilise soon and go on with the tapering successfully and then - benzo free!)

[[Ni...]]

I tapered for 2 months the first time. Slight withdrawal but nothing major. I had a bad situation at work and took one and that started me on the path again. When I wake up I feel pretty good then i take my first dose because i know i need to and after i take it the horrible feeling start. This time has been horrible. Literally feel like im going to die at any minute all day. 

[[Ma...]]

I would not updose or switch to Valium at this point.  Your taper from 1.5 of Xanax over 9 months is somewhat fast, but I would not call it rapid.  If you have held for 6 weeks and are getting no better, you might consider a SMALL cut and see how things go.  I know that seems backwards, but sometimes when people get to these low doses, it actually helps.  Also, if you are struggling right AFTER you take your first dose, I’d consider eliminating that dose.  Eventually you need to stop all theee doses so that seems the most logical one to drop.  

[[Ni...]]

Emilia, I do know about the higher percentage binding at lower doses. These symptoms now have just got so intense.

[[Ni...]]

Matt, my doses were .06 three times a day. 8am 12pm and 4pm. I cut the 12pm dose in half so its now .03mg and the other two doses are .06. I don't think 10 months has been fast. I couldnt do the water taper so i have been doing dry cuts the entire time. Basically cutting each dose (1of 3)  in half every 2 to 4 weeks. 

[[Ma...]]

No, I agree it’s not fast.  It’s only a little faster than my taper and I’ve been on these drugs for almost a decade.   I struggled with a water taper too.  I did hold for 2 months on Clonazepam and stabilized; I would say it took me 3-4 weeks to feel ok, and then I held for another month because I was overseas.  Can’t say you won’t eventually stabilize, but I know it gets harder at these lower doses.  You don’t want to updose after coming this far.  If it were me and it had been 6 weeks, I’d probably try to cut out the dose that’s giving me problems and make a small cut, but again that’s just me.  I wouldn’t hold too much longer regardless of what you do if your symptoms are unbearable.  

[[Em...]]

[[Em...]]

22 minutes ago, [[N...] said:

Emilia, I do know about the higher percentage binding at lower doses. These symptoms now have just got so intense.

I am so sorry 💔

The only thing that has helped me is fish oil. Thats the only thing I have man.... My heart really goes out to you.

Stay strong. Dont make any decisions in panic. I believe we know from our own instinct what is best most of the time.

Remember how far you've come.

All the best of luck to you.

[[...]]

15 minutes ago, [[E...] said:

Thank you so much 🥰

This is from Marks Horowitz book. It just came in my mail few days ago. Deprescriping Guidelines.

Theres this graph from chimpanzes that shows for example that going from 2mg to 1mg of Xanax is going down about 17% of GABAa occupancy, while going from 1mg to zero is going down 45% GABAa occupancy. So like almost 3 times more but still the same dose reduction.

This is really mindblowing and I am in shock that doctors are mostly unaware of this. You can find interview with dr. Horowitz on youtube where he explains this. Type in Mark Horowitz on benzos.

Thank YOU so much Really interesting and mind-blowing! Going to read about it)

[[Br...]]

Hi @[Ni...] and welcome to BenzoBuddies!

I'm so sorry you're going through a rough time like this.  It's really miserable but you will get through it.

 

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

it seems like i feel worse after i take my first dose of the day which is usually 8am. 

 

This makes me think you may be experiencing morning cortisol surges - a common symptom of  benzo withdrawal.  Some people report waking with a surge of anxiety first thing in the morning that levels of as the day goes on.  The thinking is that the normal function of cortisol is to wake us up but since our systems are hypersensitive during withdrawal the normal morning rise in cortisol is felt as a surge in panic, anxiety and dread. Another theory is that this surge is affected by a drop in blood sugar and so some people find it helpful to start off the day with a snack high protein with high protein and complex carbohydrates they keep by the bed and eat first thing. 

2 hours ago, [[N...] said:

Matt, my doses were .06 three times a day. 8am 12pm and 4pm. I cut the 12pm dose in half so its now .03mg and the other two doses are .06. I don't think 10 months has been fast. I couldnt do the water taper so i have been doing dry cuts the entire time. Basically cutting each dose (1of 3)  in half every 2 to 4 weeks. 

A few comments on this-

We generally advise members to keep their doses consistent throughout the day so that each dose is the same.  And when cuts are made, the same reduction is made in each dose. The brain craves consistency and this can be particularly critical when you're tapering a benzo with a short half life like Xanax.  

I note that you are taking 3 doses a day.  Some members find it helpful to take Xanax in 4 doses a day

We typically suggest tapering with cuts of no more than 5-10% of your most recent dose (not the initial dose).  Here's a link that goes into the rationale for tapering this way as opposed to making uniform reductions based on the initial dose. The best taper is one that is based on your symptoms.  If your symptoms become more difficult and affect your ability to function then you need to slow down, hold longer and/or make smaller cuts.  It's very important to remain flexible. I agree with all of the comments that the taper often gets harder as you get down to lower doses and this often means you need to slow down in this way. 

This is a hard road to travel but with time and a careful, flexible taper it will get better.

 

 

 

 

 

[[Ma...]]

11 hours ago, [[B...] said:

We generally advise members to keep their doses consistent throughout the day so that each dose is the same

 The Ashton manual drops doses gradually, not all at the end of the taper (granted that is with Valium which has a longer half life).  Regardless, OP is struggling with one of his doses and is at a very low level in all 3 doses.  Eventually all 3 need to be discontinued so dropping the dose that is causing problems, at this stage, is a reasonable strategy.