Question on Xanax Taper

[[Cy...]]

Is it possible to do a micro water taper from 3mg of Xanax? Or are micro water tapers only for those on much lower doses near the end of their tapers? I just don’t feel like I can dry cut and hold….I’m overly sensitive to the effects of this drug after 37 years on it, and can’t imagine feeling any sicker than I already do, 24/7.  It is the only medication I take.

I haven’t been able to leave my house in over 4 years now.

[[Pa...]]

Hi @[Cy...], you can liquid micro taper from a high dose of Xanax but what works better is to use a combination of your tablets plus liquid.  Also, while we think of micro tapering as reducing every day, many have found that the reductions can stack up over time with symptoms becoming more intense if you're not allowing time between reductions for your symptoms to settle.  So, while we think of micro tapering as reducing a small amount each day, members have found they still need to pay attention to their symptoms and let their body decide when to reduce again. 

 

Are you interested in working on a plan?

[[Cy...]]

Hi, @[Pa...], thank you so much for answering my question!  Yes, I’m very interested in working on a taper plan. I wouldn’t even know how to go about devising a plan with my tablets plus liquid!

 I currently have to dose at .5mg every 4 hours around the clock (which is 6 times every 24 hours).  I’m apparently not in complete tolerance, as taking my next scheduled dose takes the worst of the withdrawals away, but not enough to keep me from feeling quite ill 24/7.  It’s not just physical anymore, it’s affecting me mentally, now, too.

A few years ago, before I knew what I do now, I tried to taper on my own and ended up having a seizure. My family practitioner is not benzo wise, and I have been unable to find one who will work with me anywhere near where I live. I need to be proactive more than ever now, as I’m pretty sure he’s going to want to deprescribe me any day now, due to my age. I bought a copy of the Ashton Manual for him, and also the Maudsley Deprescribing Guidelines, but after 21 years under his care, I’m quite sure he will have no interest in either if I offer them. Perhaps having a doable taper schedule to hand to him as well, might make him more amendable to helping me, and not yanking me off too quickly? I don’t know, but at this point I still don’t have a Plan B. 😞

[[Pa...]]

I'm glad you mentioned you've had a seizure, many of our members worry about this but they're uncommon unless, you've had them in the past.  This is important information because seizures can cause changes in the brain that make it easier to have more. 

Kudo's for being so proactive by purchasing guides to help you taper off of the Xanax, unfortunately many doctors are resistant to learning how to safely taper their patients off of these medications.  Many of our members live in fear of being cut off by their doctors or they're forced into rapid tapers that leave them non-functional. 

I'm sorry to hear you have to dose so often, I'm sure it interferes with your sleep but the short half life pretty much guarantees interdose withdrawal.  Have you considered switching to a longer acting benzodiazepine like Valium or Klonopin, its not easy to cross over but it can help with the interdose.  Of course, if your doctor is unwilling, that's that.

I know I mentioned you're going to need to go very slowly so I'm also worried your doctor will try to run your taper, if you show him what we have planned, do you think he'll try to change it?  I'm thinking to begin with only a little under a 5% reduction just to see how you handle it.  Tapers need to be monitored and adjusted with careful attention paid to symptom severity to use as a guide to determine the next reduction.  Do you remember how much you reduced when you had the seizure?

 

 

[[Cy...]]

@[Pa...] Yes, I distinctly remember halving one of my .5 mg doses, so .25mg. Such tiny pills, I had no idea what I thought was such a small decrease could backfire so badly!

I very much like the idea of transitioning to Valium, and tapering from that! Or at least attempting to, as I have read that it’s not tolerated by everyone. I was hoping that with the much longer half-life, I might actually get a chance to stabilize a bit from these interdose withdrawals every 3-4 hours. 
In looking for a benzo wise provider to work with me on a taper, not only have I not been able to find anyone, it now seems that prescribing Valium for seniors is very much on the hit list! Even my insurance has extremely strict prescribing guidelines that only affect patients 65 and over! I’m fine paying cash, but my heart sank when I saw the changes that went into effect with their formulary last January. I definitely am not interested in transitioning to Klonopin though.

Back to Valium, I also agree with the small decrease you are proposing, and seeing how I handle that, once I’ve been properly transitioned over, of course. I’m aware what many authorities (including Dr.Ashton) have to say about the equivalencies between benzos, and I would certainly expect pushback from my doctor at 60mg of Valium being equal to 3mg of Xanax. If he, or anyone else only agrees to 10mg vs 20mg, I feel like I’ll be in a bad place right out of the starting gate! This fear literally keeps me awake most nights. I very much want to be in charge of my own taper!

At 67, who knows how much time I have left on this Earth? More than half of my life has been stolen by this drug, and I don’t want to be even sicker for many years to come. Who would want to spend their last years suffering so? I’m certainly not living anymore, I’m merely existing, and it isn’t worth it. I could  and should be having a wonderful life! The damages from this benzo notwithstanding, I’m healthy in every other aspect. Not on a single medication for anything. Not overweight, joints in good shape, healthy heart, etc.

I really, really appreciate your help!

[[Pa...]]

Hi @[Cy...],

When we have members join who are in their 80's wanting to taper off of these medications, we'll typically caution them about quality of life in their later years and how the chances of them seeing recovery after a lifetime of benzodiazepines is questionable but at 67 and in otherwise good health, I believe you have a good shot.  You deserve more from this time in life than simply existing, and I believe you can achieve good quality of life. 

I'm glad you remember what precipitated your seizure, we'll do our best to avoid that in the future.  Its good to hear you're interested in crossing over to Valium, many of our members who have successfully crossed over say its a welcome relief from the short acting medications.  Many have had good luck with nurse practitioners when it comes to prescribing, they seem to be a little more understanding, but if they're going to have to fight insurance companies, that complicates things.  As for tolerating the Valium, I'm told the depression and sedation aspects of it settle down once you acclimate to it.

Professor Ashtons equivalencies are on the high side, but this is what she saw in her clinics as her patients best hope but many members have been able to do just fine on less, I sure hope you can find someone to help you. Benzodiazepine Equivalents Conversion Calculator - ClinCalc.com

How shall we work this, will you let us know if you can find a provider to prescribe the Valium, or would you like to begin your taper from the Xanax?

 

 

[[Cy...]]

Hi @[Pa...]!  Thank you so much for the shot of positivity that I might not be too old to  still regain my quality of life! I appreciate hearing that more than you can know. ❤️

I’ve been searching for a benzo wise provider for years now with no luck. I’m only getting sicker with each passing week. I guess the best plan is to start with a very slow taper from Xanax while I continue to look for someone to prescribe me Valium? It’s a scary thought because my brain seems to be so incredibly sensitized to the Xanax after 37 years. I’ve only ever had two increases in my dosage over all of these years. The last increase was back in 2008! My script is written for 4mg each day, but I have forced myself to stay at 3mg. I know I probably could feel better by increasing to 4mg, but then it will only prolong my taper, plus it would only be a matter of time before I hit tolerance again.

This brings us back full circle to my original question, if I could even do a liquid micro taper from 3mg of Xanax? I’m probably grasping at straws, but just hoping to find a way that would be more gentle on me than a dry cut and hold would be. 

 

[[Pa...]]

@[...], I didn't taper so what you're getting with me is what I've observed here, its not from personal experience.  I'm concerned with your expectations about micro-tapering.  What some members have found is a daily reduction can lead to a phenomenon they describe as their symptoms stacking up, they've noticed reducing daily doesn't allow for the body to stabilize between reductions so sometimes they get hit with severe symptoms.  They work around this by holding every so often but this requires tight monitoring of symptoms because you don't want to let these symptoms get too severe before taking steps to mute them.  So, micro-tapering is still somewhat a cut and hold and all tapers need to be monitored and adjusted from time to time.

Are you familiar with the mechanics of liquid tapering, have you watched any video's? Its not a solution because of poor solubility so its considered a suspension that will need to be agitated before consumption to include rinsing the receptacle and drinking the rinse water.  

 

[[Cy...]]

4 hours ago, [[P...] said:

@[...], I didn't taper so what you're getting with me is what I've observed here, its not from personal experience.  I'm concerned with your expectations about micro-tapering.  What some members have found is a daily reduction can lead to a phenomenon they describe as their symptoms stacking up, they've noticed reducing daily doesn't allow for the body to stabilize between reductions so sometimes they get hit with severe symptoms.  They work around this by holding every so often but this requires tight monitoring of symptoms because you don't want to let these symptoms get too severe before taking steps to mute them.  So, micro-tapering is still somewhat a cut and hold and all tapers need to be monitored and adjusted from time to time.

Are you familiar with the mechanics of liquid tapering, have you watched any video's? Its not a solution because of poor solubility so its considered a suspension that will need to be agitated before consumption to include rinsing the receptacle and drinking the rinse water.  

[[Cy...]]

@[Pa...] I’ve been reading and watching YouTube videos for a couple of years now, on all things benzo withdrawal and tapering related. I thought I had an understanding of it, but I’m starting to see I haven’t fully grasped it. I know the tools I need, and about shaking the Xanax quite a lot since it doesn’t mix all that well in water. I also read to be sure to re-fill the jar you just drank from with fresh water, and to swirl that around to get any residue left on the sides, and then drink that water, too.

So, what would you guys suggest I do to begin my taper? I guess that probably means buying a scale, weighing and cutting the pills? If that’s what I need to do, then I will. I do know I’m going to struggle with the math involved with either method, at least at first. Math has never been my strong suit, and especially not with a benzo brain! 😞  

I can follow good instructions though…..so there’s that, I guess. lol

 

 

[[vo...]]

Hi @[Cy...] I read some of your comments here. I came off of xanax too, 6mg a day after several decades of use, so I understand what you're going through. Unfortunately, I hadn't discovered this group yet and I was ignorant of the dangers so I tapered in 2 weeks. It caused me to have multiple withdrawal symptoms, many of which I still have 13 mos. later. but a few have subsided! It's a bit more complex than that. Anyway, I wanted to tell you that I'm 67 too! almost 68. @[Pa...] and others will give you good taper advice here. If I had known about tapering over time, I would have gotten myself down from 6mg to 3mg with larger cuts and then beginning at 3mg doing micro cuts like you are talking about. That's smart of you to do.

Currently I'm tapering off of ambien, because again, the lack of insight I had on all of this. I didn't realize it would affect the same GABA receptors when I went on it for insomnia, nor did I realize at the time that I was in acute withdrawal. I'm letting my symptoms tell me how much to cut. I see you mentioned valium. I don't know the in's and out's of adding in another benzo to come off of xanax but I really hope you don't have to go that route. I wish you well on your journey here!

[[Pa...]]

Hey @[Cy...], I should have known you'd prepared by watching video's, you're remarkably informed about all aspects of this process. 

I didn't mean to suggest that using liquid titration wasn't a good idea, just informing you of the limitations we face.  Because this process forces us to become kitchen chemists, we try to  do our best but it would be so much better if the pharmaceutical companies made it as easy to get off the drug as it is to get on.  There are tapering strips in Europe and liquid formulations available for some benzodiazepines but unfortunately Xanax isn't one of them.  I do see a concentrated offering for alprazolam on this list, but I'm not sure if its available.  Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations (fda.gov)

So, liquid or dry with scale, what's your preference until we can get you crossed over to Valium?  And don't worry about the math, we have some really smart people here who can help you with that, its not me b the way. 

[[Cy...]]

@[Pa...] Dry with scale I guess is my only option right now, until I can find a benzo wise provider to take over prescribing. Thus far, my long time FCP is still refilling my prescription. I don’t know for how much longer though. I certainly can’t approach him and ask for him to start prescribing me compounded Xanax liquid so that I can taper off! Knowing him as I do, he will either cold turkey me, or do a rushed taper. I won’t risk that!

Does that mean that someone else here will actually work up a taper schedule for me? That would be awesome, if so!

To summarize: 3mg Xanax/alprazolam. Dosing at  .5mg every 4 hours around the clock, due to tolerance withdrawals, after 37 years of use.

Thank you for your time! 😊

[[Cy...]]

16 hours ago, [[v...] said:

Hi @[Cy...] I read some of your comments here. I came off of xanax too, 6mg a day after several decades of use, so I understand what you're going through. Unfortunately, I hadn't discovered this group yet and I was ignorant of the dangers so I tapered in 2 weeks. It caused me to have multiple withdrawal symptoms, many of which I still have 13 mos. later. but a few have subsided! It's a bit more complex than that. Anyway, I wanted to tell you that I'm 67 too! almost 68. @[Pa...] and others will give you good taper advice here. If I had known about tapering over time, I would have gotten myself down from 6mg to 3mg with larger cuts and then beginning at 3mg doing micro cuts like you are talking about. That's smart of you to do.

Currently I'm tapering off of ambien, because again, the lack of insight I had on all of this. I didn't realize it would affect the same GABA receptors when I went on it for insomnia, nor did I realize at the time that I was in acute withdrawal. I'm letting my symptoms tell me how much to cut. I see you mentioned valium. I don't know the in's and out's of adding in another benzo to come off of xanax but I really hope you don't have to go that route. I wish you well on your journey here!

I can’t even begin to imagine the hell you must have gone through tapering that high of a dose in only two weeks time! 😳 Wow!

It’s interesting about the Ambien…..I was prescribed it after a bad auto accident in 1998. I took it every night until 2008 (10 years), and then decided one day I didn’t want to take it anymore. No doctor ever told me it needed to be tapered. So I obviously did a cold turkey, and had no withdrawal symptoms whatsoever! I started taking Benadryl instead each night for sleep, and did that for another 10 years before I feared getting dementia from it, and just stopped that as well. I might add that my husband also stopped taking his Ambien during this same time period, and he had zero withdrawal symptoms either, and he’s never taken a benzo before. It’s interesting how different our bodies all react with these drugs!

I wouldn’t be taking two benzos to taper off the  Xanax. I would be transitioning from Xanax (very short half life) over to Valium (extra long half life), and then doing my taper from the Valium. I wouldn’t have to dose 6 times a day around the clock, and it might stop these interdose withdrawals I have. Lots of people do it, and say it makes tapering much more comfortable, and allows them to be more functional during their tapers.

I wish you well on your journey, too! I wish I was as far along as you are right now….congratulations on that!

[[vo...]]

31 minutes ago, [[C...] said:

I can’t even begin to imagine the hell you must have gone through tapering that high of a dose in only two weeks time! 😳 Wow!

It’s interesting about the Ambien…..I was prescribed it after a bad auto accident in 1998. I took it every night until 2008 (10 years), and then decided one day I didn’t want to take it anymore. No doctor ever told me it needed to be tapered. So I obviously did a cold turkey, and had no withdrawal symptoms whatsoever! I started taking Benadryl instead each night for sleep, and did that for another 10 years before I feared getting dementia from it, and just stopped that as well. I might add that my husband also stopped taking his Ambien during this same time period, and he had zero withdrawal symptoms either, and he’s never taken a benzo before. It’s interesting how different our bodies all react with these drugs!

I wouldn’t be taking two benzos to taper off the  Xanax. I would be transitioning from Xanax (very short half life) over to Valium (extra long half life), and then doing my taper from the Valium. I wouldn’t have to dose 6 times a day around the clock, and it might stop these interdose withdrawals I have. Lots of people do it, and say it makes tapering much more comfortable, and allows them to be more functional during their tapers.

I wish you well on your journey, too! I wish I was as far along as you are right now….congratulations on that!

@[Cy...] Congratulations on your journey too! Under normal circumstances, I wouldn't have to taper off the ambien, but because I'm in withdrawal from xanax, I don't want to make my GABA receptors go crazy. 

[[Pa...]]

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

@[Pa...] Dry with scale I guess is my only option right now, until I can find a benzo wise provider to take over prescribing. Thus far, my long time FCP is still refilling my prescription. I don’t know for how much longer though. I certainly can’t approach him and ask for him to start prescribing me compounded Xanax liquid so that I can taper off! Knowing him as I do, he will either cold turkey me, or do a rushed taper. I won’t risk that!

Does that mean that someone else here will actually work up a taper schedule for me? That would be awesome, if so!

To summarize: 3mg Xanax/alprazolam. Dosing at  .5mg every 4 hours around the clock, due to tolerance withdrawals, after 37 years of use.

Thank you for your time! 😊

Good plan not to tempt fate with your prescriber, we’ve seen too many face this exact scenario!  

We don’t actually make up tapers but our founder is working on something I hope we’ll be able to use in the not too distant future.  However, I’ve seen members work them up for other members.  Personally, I’m more in favor of planning the first couple of reductions, then assessing how its going in order to make adjustments.  The thing is, tapers have to be flexible, life happens and even if symptoms are manageable, there can be family events, employment challenges, trips and other events that could mean a change in the taper.  We have to be able to live our lives while we rid ourselves of the drug. 

I assume you’ll need to order the scale, most of our members use a fairly inexpensive one they order from Amazon for about $30 US, they aren’t very accurate but using care, they can do the job.  

I may ask another member to drop by, I’ve noticed they’re very helpful when it comes to using a scale. 

[[Cy...]]

4 hours ago, [[v...] said:

@[Cy...] Congratulations on your journey too! Under normal circumstances, I wouldn't have to taper off the ambien, but because I'm in withdrawal from xanax, I don't want to make my GABA receptors go crazy. 

Totally understandable! If it were now, and not “back then” when I didn’t know better, I would choose to do exactly like you are!

[[Cy...]]

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

Good plan not to tempt fate with your prescriber, we’ve seen too many face this exact scenario!  

We don’t actually make up tapers but our founder is working on something I hope we’ll be able to use in the not too distant future.  However, I’ve seen members work them up for other members.  Personally, I’m more in favor of planning the first couple of reductions, then assessing how its going in order to make adjustments.  The thing is, tapers have to be flexible, life happens and even if symptoms are manageable, there can be family events, employment challenges, trips and other events that could mean a change in the taper.  We have to be able to live our lives while we rid ourselves of the drug. 

I assume you’ll need to order the scale, most of our members use a fairly inexpensive one they order from Amazon for about $30 US, they aren’t very accurate but using care, they can do the job.  

I may ask another member to drop by, I’ve noticed they’re very helpful when it comes to using a scale. 

@[Pa...]  The scale isn’t going to be very helpful if I can’t even wrap my mind around how to even begin this taper. I mean, figuring out exactly how much to even cut? And which one of my 6 doses do I even start with?

I think I might have misunderstood what posting under this topic was all about. It sounds like it might be better suited to someone already tapering who needs help. Not someone like me, who hasn’t even started yet. 
I do thank you though, and I’m sorry if I wasted your time.

[[Pa...]]

@[Cy...], we/I can help you plan your first reductions and help you with the mechanics of how to use the scale but if you’re feeling overwhelmed, I understand.  Feel free to start a thread Here if you need more time to consider your options or have questions for the wider community.  And you haven’t wanted my time, I’ve truly enjoyed our exchange.