Reached tolerance withdrawals or paradoxical?

[[an...]]

Hi everyone,

I could really use your advice and help. I was at the end of my taper at .25mg Valium when I took an antibiotic and was thrown into full withdrawal. Before this I was very stable with virtually now withdrawal symtoms. I held at .25mgs for about 30days with no change in disturbing new symptoms and then foolishly out of sure dispair and grief of my ruined taper, updosed .25mgs to .50mgs for two nights and then 1mg of valium on 3rd night hoping I could get to new dosage point, become more stable and taper off b/c at this point I have no longer been stable.

As soon as I did it, I regretted if and jumped back down the next night to .5mgs hoping that the updose could be treated as a one time. Since then for last few nights I have not felt well like there is something wrong with this .5mg dosage. I have been getting new symptoms of high anxiety, heavy feet, chest and head, knotts in stomach, increased surges, feeling like my body will be crushed that I am dying, increased tinnitus, burning and fatigue. I am wondering if I have reached some sort of tolerance or paradoxial affect with these symptoms due to the updose. I would appreciate any advice and knowledge you could share. I am really worried that now I have completely messed up....thanks so much.....

Angel

 

Edited June 22 by [an...]

[[Cr...]]

What antibiotic did you take? The good news is that unlike the other more potent benzos, .5 mg of Valium is still a very small dose. So don't stress too much about the updosing you did.

You said that after you updosed you regretted it. Was that because the higher dose immediately made your symptoms worse when it took effect, or did you mean you felt guilty for going backwards in your taper?

Generally a paradoxical reaction is when the medication causes you to feel worse right after taking, making the symptoms it was suppose to help even worse.

If you got even some mild relief from that updose it probably isn't a paradoxical situation. Your sensitive cns may have just been temporarily affected by the antibiotic use, enough so that doses of Valium as small as yours may not even be able to help.

My regular dose of Klonopin was .5 (10 Valium) before I stopped. When I had a bad reaction to alcohol even 1 mg (20 Valium) could barely calm my cns.

It may take some time to level back out. As long as the doses of Valium aren't making you feel worse right after taking them (they are probably just ineffectual and not helping) you are probably doing the right thing by holding at .5 mg right now for the time being.

[[an...]]

 @[Cr...] Hi Crono, thanks so much for your kind response.

I took amoxicillin. After I updosed, I felt my burning symptom seemed to get worse and thought it was a mistake. I don't feel right after I take the valium, everything seems to intensify or its like this most of the day and night. My tinnitus increases,the pressure in my chest and stomach increases. Sometimes I feel trouble breathing. Tight knotts in stomach. So scared, I don't know whats going on. Worried I have really messed things up? I have wondered if I should go back down to .25mg where I was the most stable? Look forward to hearing back you and your wonderful supportive advice.....

Edited June 22 by [an...]

[[an...]]

@[Cr...] Hi Crono, my symtoms seem to ramp up all day. I just took my Valium dose and it has little affect. Should I be worried? Do you think you could contact some buddies that might know more about tolerance and paradoxical withdrawal. I don't want to do any more damage to my NS. Your help and advice is greatly appreciated, thanks so much....

 

[[Pa...]]

Hi @[an...], I could be mistaken but I believe you're in active withdrawal because of the amoxicillin, I understand conventional wisdom concerning antibiotics says that only the fluoroquinolones produce the devastating effects of cold turkey like reactions but I've seen it happen to members who have taken other antibiotics.  I believe your .25 or even your .50 dose of Valium is ineffective to combat what the antibiotic has done to you so my suggestion is to taper off the Valium as quickly as possible and be benzo free.  Your dose is so low, (many members have jumped at this dose) its likely not producing any therapeutic effect so if you agree, its time to jump and be benzo free and begin your road to recovery.

If this is too much for you, if you can't do this then I feel the only solution is to slowly but greatly increase your Valium dose until you feel stable then start your taper again.

I know what I've proposed goes against what we typically suggest here but this is how I see it.  Other members are welcome to provide their take on your situation, I'm by no means an expert. 

[[an...]]

@[Pa...]Hi Pamster, nice the hear from you. Thanks for your kind response. In one of my other posts I should mention that I updosed (on advice from my Doc and a taper coach) b/c I had held at .25mgs in withdrawal for about 30 days with no improvement. So I updosed to .50mgs for two nights and then 1 mg updose third night. Upon updosing 1mg, I held for one night but it seemed to make the burning worse so I panicked and jumped back to .5mg where I have been holding.

It is since then that I gotten these new worrisom symtoms which rev during the day of heavy feet and head, pins and needles, extreme anxiety, knotted stomach, feeling of being crushed and last night pain in eyes, head and neck which do not improve with my .50mg Valium dose at night. Before I took the .50 doses with no problem. This is why I am wondering have I kindled myself or am I suffering from some sort of tolerance or paradoxical withdrawal. Burning is now also now much worse. Its like the dose has turned on me and I get worse or no improvement after I take it. I also thought of jumping back down to .25mgs where I was very stable. Any ideas on whats going on? I am terrified to take my dose tonight. I have also been trying to prepare to jump but I was so stable before the antibiotic and now I am such as mess....your thoughts as always greatly appreciated.....

angel

Edited June 23 by [an...]

[[st...]]

I agree with Crono, it does not sound paradoxical. I had a similar situation with valium after updose that did nothing good. What worked for me was to get back down to prior dose and then I tapered that to zero.

 

[[an...]]

@[st...], thanks for your response. I have been thinking of jumping back down to .25mg where I was stable since this dosage at .50mg is not working. I want to jump but so scared and feeling unstable....

[[no...]]

5 minutes ago, [[s...] said:

I agree with Crono, it does not sound paradoxical. I had a similar situation with valium after updose that did nothing good. What worked for me was to get back down to prior dose and then I tapered that to zero.

so was it actually getting off the drug completely that helped you? I’m also taping off Valium. I’m not sure now whether the side effects from the drug or the  taper its  self I

 I have seen other people say the same the symptoms that they were suffering to the taper and putting down to withdrawal symptoms disappeared very soon or practically immediately after stopping the drug completely. 

[[st...]]

My body didn't like ANY abrupt fluctuations, up or down. So after updose didn't work, I reduced to prior dose by decreasing gradually daily at a rate of about 0.25 per week (my total updose was about 0.5 V so it took 2 weeks) and then I tapered the remaining dose more gradually. My last 0.25 took about 2 weeks to taper.

Yes my body healed completely after being off, but I think going off gradually helped that healing happen quicker.

Edited June 23 by [st...]

[[an...]]

@[st...] @[no...], thanks so much. I have to agree with staystill. When I was tapering I had to keep moving downward .25mg about every 3 wks, if I stayed to long on a dosage I started to get symptoms but if I keep going, things went well with virtually no symptoms...

Edited June 23 by [an...]

[[Pa...]]

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

@[Pa...]Hi Pamster, nice the hear from you. Thanks for your kind response. In one of my other posts I should mention that I updosed (on advice from my Doc and a taper coach) b/c I had held at .25mgs in withdrawal for about 30 days with no improvement. So I updosed to .50mgs for two nights and then 1 mg updose third night. Upon updosing 1mg, I held for one night but it seemed to make the burning worse so I panicked and jumped back to .5mg where I have been holding.

It is since then that I gotten these new worrisom symtoms which rev during the day of heavy feet and head, pins and needles, extreme anxiety, knotted stomach, feeling of being crushed and last night pain in eyes, head and neck which do not improve with my .50mg Valium dose at night. Before I took the .50 doses with no problem. This is why I am wondering have I kindled myself or am I suffering from some sort of tolerance or paradoxical withdrawal. Burning is now also now much worse. Its like the dose has turned on me and I get worse or no improvement after I take it. I also thought of jumping back down to .25mgs where I was very stable. Any ideas on whats going on? I am terrified to take my dose tonight. I have also been trying to prepare to jump but I was so stable before the antibiotic and now I am such as mess....your thoughts as always greatly appreciated.....

angel

It sounds as if other members agree that going up in dose isn't the answer, this is my feeling as well.  I stand by my suggestion to prepare to come off the Valium completely.  I don't believe .25 mgs is giving you any therapeutic benefit and is only prolonging your time on the drug.  Jumping and starting on the road to recovery seems like your best option.  Yes, you're likely to deal with these same symptoms and perhaps more but this is what most have to face when they jump.  

May I ask who your taper coach is?

[[an...]]

@[Pa...]Thanks so much for all your support. Her name is Nicole Lamberson, she is quite know in the Benzo Communtiy. She suggested since I was so stuck to go up small increments until I found a stable dosage holding every 3 - 5 days and then stay at that dosage for a while until I was ready to taper again. She would not have told me not to hold at the 1mg for one night and jump back down to previous dose. That was my bad move.

[[Cr...]]

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

I don't believe .25 mgs is giving you any therapeutic benefit and is only prolonging your time on the drug. 

@[an...]

I agree with this sentiment. At .25mg it is not enough to get any positive benefits but probably still be enough to contribute to the negative symptoms.

A silver lining in your situation is at least this antibiotic reaction happened while you were on a very low dose where most people would be capable of stopping anyway. Many people jump before even reaching .25 mg. If you want to go lower, then a rapid taper, like Pamster said, may be your best bet.

Things might be rough for awhile from the Amox reaction, but there is a chance you may see some improvements in other symptoms after you come off of Valium.

[[Ro...]]

10 hours ago, [[a...] said:

@[Pa...]Thanks so much for all your support. Her name is Nicole Lamberson, she is quite know in the Benzo Communtiy. She suggested since I was so stuck to go up small increments until I found a stable dosage holding every 3 - 5 days and then stay at that dosage for a while until I was ready to taper again. She would not have told me not to hold at the 1mg for one night and jump back down to previous dose. That was my bad move.

She is clearly paradoxical. She also appears to have had a reaction to the AB. She needs to go back down to 0.25 and ride out the AB reaction. And while dropping, if that actually feels better immediately, there was also a reaction to the benzo which got worse because it's dose-dependent. Going to 0.25 will stop that too. Or at least ease it to a minimal degree. Most of the people online are having unrecognized PRs. A PR IS what toxicity IS. 

Angel, you might want to make this drop in two steps since you have had a likely reaction to the AB, so go to 37.5 and see how that feels. If that's not worse, go back to 0.25 and wait to heal from the AB reaction. Once you heal from that, continue tapering. 

If anything has changed, it's due to gene expression shifts. It changes the dose amounts where reactions happen. Especially if you reinstate or increase doses. That is not very often a good idea. 

It sounds like you had a reaction to the AB, and then possibly (maybe not, too, not sure) the valium too, upon updose. If you felt better reducing the entire time on the benzo to 0.25, it's because you were relieving a PR. PRs are not conventional withdrawals, they are toxicity, and toxicity is a direct poisoning. 




My advice. All the best. 

Robb

Edited June 24 by [Ro...]

[[Co...]]

I cannot locate the passage (it might be from a video of conference speech), but Prof. Ashton cautioned against unnecessarily long, drawn-out tapers. Particularly the end stages, where the dose is pharmacologically insignificant, with no therapeutic effects.

A few things to consider:

1. Ashton had hundreds of patients successfully taper off benzodiazepines, and usually from diazepam (Valium)
2. The smallest available diazepam pill (2mg) is much less potent than the smallest dose pill of most other benzodiazepines.
3. Diazepam has a much longer half-life than most benzodiazepines. This means that your last dose does not result in a sudden drop (to zero) in blood levels (it occurs over a week or more).

I am not saying there is no utility in making even smaller reductions from 0.5mg for some people, but it is unusual. And there is no apparent utility in remaining at 0.5mg diazepam for an extended or indefinite period. (And surely not if the intention is to quit.)

[[ba...]]

Many AB's destabilize us. I believe your distress has been caused by the amox. I have had several needed medications through my taper, including a recent one, oxycodone, which I had an adverse reaction to, and have been struggling ever since. Every antibiotic destabilized me badly, and for several weeks. Now the oxy has done the same thing.

Sometimes I think the destabilization caused by another med can't really be corrected by the benzo. Updosing just a bit has been my go to when it's really bad, but that has questionable benefit.

Updosing usually doesnt work when it's not the benzo that is the problem. However, I understand the agony of your situation, and why you updosed.

You were not bad, this experience sucks, and you were trying to get relief. Dont be hard on yourself.

I think tried and true is the go to when this happens. Resume your taper from here in small increments to get back to your .25, and if that does not work, consider jumping. If the medication is not working, and you are so low, jumping could be the best course of action.

However, i would give tapering another shot before doing that.

xx

 

 

 

[[Ch...]]

14 hours ago, [[C...] said:

I cannot locate the passage (it might be from a video of conference speech), but Prof. Ashton cautioned against unnecessarily long, drawn-out tapers. Particularly the end stages, where the dose is pharmacologically insignificant, with no therapeutic effects.

A few things to consider:

1. Ashton had hundreds of patients successfully taper off benzodiazepines, and usually from diazepam (Valium)
2. The smallest available diazepam pill (2mg) is much less potent than the smallest dose smallest dose pill of most other benzodiazepines.
3. Diazepam has a much longer half-life than most benzodiazepines. This means that your last dose does not result in a sudden drop (to zero) in blood levels (it occurs over a week or more).

I am not saying there is no utility in making even smaller reductions from 0.5mg for some people, but it is unusual. And there is no apparent utility in remaining at 0.5mg diazepam for an extended or indefinite period. (And surely not if the intention is to quit.)

It's in the Ashton Manual, p.35 (emphasis added)

 

14 hours ago, [[C...] said:

I cannot locate the passage (it might be from a video of conference speech), but Prof. Ashton cautioned against unnecessarily long, drawn-out tapers. Particularly the end stages, where the dose is pharmacologically insignificant, with no therapeutic effects.

A few things to consider:

1. Ashton had hundreds of patients successfully taper off benzodiazepines, and usually from diazepam (Valium)
2. The smallest available diazepam pill (2mg) is much less potent than the smallest dose smallest dose pill of most other benzodiazepines.
3. Diazepam has a much longer half-life than most benzodiazepines. This means that your last dose does not result in a sudden drop (to zero) in blood levels (it occurs over a week or more).

I am not saying there is no utility in making even smaller reductions from 0.5mg for some people, but it is unusual. And there is no apparent utility in remaining at 0.5mg diazepam for an extended or indefinite period. (And surely not if the intention is to quit.)

@[an...]

The Ashton Manual, p. 35 (emphasis added):

"Getting off the last tablet: Stopping the last few milligrams is often viewed as
particularly difficult. This is mainly due to fear of how you will cope without any drug at
all. In fact, the final parting is surprisingly easy. People are usually delighted by the new
sense of freedom gained. 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 reach0.5mg daily; full recovery cannot begin until you have got off your tablets completely."

I find it bewildering that Nicole Lamberson allegedly told you to updose from .25mg of Valium? Is that correct????

[[Co...]]

7 hours ago, [[C...] said:

The Ashton Manual, p. 35 (emphasis added):

"Getting off the last tablet: Stopping the last few milligrams is often viewed as
particularly difficult. This is mainly due to fear of how you will cope without any drug at
all. In fact, the final parting is surprisingly easy. People are usually delighted by the new
sense of freedom gained. 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 reach0.5mg daily; full recovery cannot begin until you have got off your tablets completely."

Thank you @[Ch...]. I thought it was from somewhere other than the Manual. Frankly, it has been many years since I've read through it - I probably should go through it again and refresh my memory.

[[Sc...]]

I had this happen to me as well with an antibiotic. It made my sxs bad, intolerable even. I thought taking more Valium would help, but I was on 1mg and jumped.

In some way, taking Valium was making me feel worse, my Dr. suggested I stop taking it (since I've been down to 1mg for a bit)and see how I feel. It worked and I am feeling better each day.

Antibiotics can be rough, but once they were out of my system I felt better mentally. 

I hope this helps and that  you feel better soon and find relief