It looks like I am hopeless now - an invisible wall of 2.05 mg of V.

[[JC...]]

It looks like I have an invisible wall in front of me -  2.05 mg.

 

I was at 2.055 mg and try to cut to 2.0525mg - yes a 0.0025mg cut, no sleep immediately. 

 

Going to see my psychiatrist today, likely will ask me to do c/t.

 

It does not look like there is anyone and anything that could help me. I think this is the end.

 

 

[[ve...]]

Hi JC20.  I tapered off 7mg valium over 9 months.  I can tell you that when I hit 2mg, I hit a big wall and had to hold for 3 weeks to stabilize.  Also, I know of folks who hit walls at higher doses, usually between 3 and 5mg.  It's part of the process. The Ashton Manual is a guideline for tapering.  For many, .5 cuts are too much, particularly as you get lower and lower in dose where the % of cut gets higher.  I tapered .25mg every 10 days until I reached 2mg.  From there, I made much smaller cuts using a combination of liquid valium and tablets.  When I got to 1mg, I used liquid only which you can get from a compounding pharmacy if your psychiatrist will agree to prescribe the liquid. I see no reason why he/she wouldn't allow it.  Some folks just need to do two things to get through their valium tapers:

 

1)hold for longer periods between cuts (2-3 weeks)

2)reduce the size of cuts to .25mg or less

 

You'll get there.  Please don't do a c/t from here.  My neurologist told me that he tapers his patients who have ear problems flying from 2.5mg  valium all the way down.  Doing a c/t now would only reverse all the progress you've made thus far!

 

Hang in there,

 

Vertigo

[[sp...]]

I'm not saying "this is all in your head", but from your post, it seems like there's a big psychological component for a couple reasons:

#1) 0.0025 mg of valium is not a physiologically meaningful amount. It's not something that can be detected on any known toxicology test.

#2) the long half life of valium means that the significant effects of a dose cut take a day to several days to materialize

 

in the fictional book Zero History by William Gibson, one of the characters, Milgrim, is withdrawn from benzos over a long period by an extremely expensive Russian clinic who formulate his pills for him and refuse to tell him what's actually in them, or what the dose is. At a certain point in the book, Milgrim goes into a panic when he realizes that he is out of his pills, and begs his handlers to give him more. At that time they tell him "oh, don't worry about it, you've been on placebo pills for a long time now. We haven't given you any actual benzos in months at this point".

 

Yes, it's a fictional book, but the point is valid. The good part about being in charge of your own taper is that you can feel your way through it at your own rate, but the downside is that you are acutely aware of when you have made dose reductions, and start monitoring for symptoms. Among the normal population who have never taken benzos, one of the biggest reasons people suffer insomnia is from anxiety about sleeping or anxiety about when they need to wake up. So, even for people without benzo problems, being worried about not being able to sleep creates a self-fulfilling prophecy, and other conditions with a heavy psychological component (HPPD, tinnitus, etc) work in a similar way.

 

I will try to dig up a paper I saw referenced recently that was specifically evaluating the psychological impact of the placebo effect as it relates to diazepam. The researchers used a pool of people suffering from anxiety, and gave them diazepam. However, they only told one part of the group that they had been given valium, and they told the other half of the group that they had been given a placebo (even though they had, in fact, been given diazepam). The group who knew they had received valium showed a much more significant decrease in anxiety, even though both groups had been given the same dose of the same drug.

 

Please do not read this as "it's all in your head", as that statement carries a lot of weight with it, and that is not at all what I am saying. The placebo effect is a very real thing, which is still not well understood by modern science.

 

Note that in Ashton's study where she refers to "walls", she is talking about much more significant dose reductions. The idea of reducing valium by 0.0025mg at a time is not something Ashton even considered, because titration did not exist at that point and she was working with 2mg diazepam tablets. If you look at the actual Ashton literature, it calls for reducing 1mg or 0.5mg at a time, all the way down to 0mg. This is almost certainly contributed to the "walls" she observed: a dose reduction from 2mg to 1.5mg is a 25% reduction, a cut from 1.5mg to 1mg is a 33% reduction, and a cut from 1mg to 0.5mg is a 50% reduction. Note that this was the smallest step-down that she used in her research, and she was able to withdraw virtually all her patients at that rate. While she did see protracted withdrawal symptoms in some cases, it's definitely the minority.

 

Stepping off from 2mg valium, while it's not a good idea, is also not at all equivilent to a cold turkey if the entire up to that point was done in a slow and proper fashion. In the Ashton literature, "cold turkey" literally refers to cessation of benzos directly from whatever the theraptic/tolerant dose was (for example, taking 20mg of valium for two years and then just stopping). Tapering from 20mg to 2mg over the space of a year and then stepping off the last 2mg is not a cold turkey, it is a normal taper with a too-large cut at the end. It is likely that it would be more traumatic to do that than to finish off tapering the last 2mg, but it is not comparable to a cold-turkey. Going from 20mg of valium to 0 in one day is medically dangerous because it can cause seizures (or, in extreme cases, death). Going from 2mg of valium to 0 in one day is not medically dangerous in any literature I've ever seen anyplace.

[[JC...]]

I have been holding at 2.06 mg for 3 weeks. I know 0.0025 mg is so tiny tiny. That is why I think there is something not quite right there.

 

Problem is the healing part; it does not look like I am healing at this point at all.

[[ve...]]

Hi Spengler.  Interesting post.  I think JC20 is talking about 2mg of valium, not 0.0025.  Also, as I posted earlier, Prof Ashton was a pioneer and did the best she could given the times.  However, 1mg and even .5 cuts for some are simply too much for whatever the reason.  Many folks do better with smaller cuts and a little longer taper.  I found .5 cuts from 6mg were much harder in terms of withdrawal symptoms than the .25 cuts.  And I know others who not only felt the same but still persisted with .5 cuts, a few who ended up with very intense symtpoms and at least one or two I recall, ended up protracted.  Not trying to scare anyone.  To be sure, there are some who can tolerate .5 cuts all the way down.  However, there are quite a few who start to notice greater intensity of symptoms with those larger cuts, often from 4 or 5mg and not surprisingly at 2mg. 

 

As I posted earlier, Spengler, my neurologist confirmed that 2mg of valium is a large enough dose which should not be cold turkeyed.  So with respect, although you have "not seen anywhere on the internet that it is medically dangerous to cold turkey 2mg of valium", my otoneurologist who sees hundreds of patients a year advised that it is recommended to taper 2mg of valium.

 

I guess it's a matter of semantics as to whether one calls it a "cold turkey" off a smaller dose or a "large cut at the end".  Whatever one calls it, cutting 2mg of valium can result in severe withdrawal symptoms, from vertigo to tinnitus to possibly seizures, though maybe the last one is not as likely, it is possible. So I reiterate my suggestion to JC20 to taper down the remaining 2mg but first to hold here for at least three weeks.

 

Vertigo

[[ve...]]

I have been holding at 2.06 mg for 3 weeks. I know 0.0025 mg is so tiny tiny. That is why I think there is something not quite right there.

Problem is the healing part; it does not look like I am healing at this point at all.

 

Hi JC20.  It is not reasonable to expect that you will feel like you are healing at this juncture of your taper!  The last few milligrams of a valium taper and whatever the equivalent in klonopin or ativan can be the most difficult to cope with.  Also, you can expect at least 30 days of withdrawal symptoms after your taper is finished,  since the valium does take weeks to process out of your bloodstream (your psychiatrist can confirm this).  Sorry if this is bad news, but I believe it is important to have a realistic perspective on expected healing and withdrawal symptoms as you get to the end of your taper.  You still have a couple months to go and probably some months after that to feel completely healed.

 

Vertigo

[[sp...]]

Vertigo,

 

I don't disagree with anything you said. From the context of the post, it looked to me like the poster was doing a milk titration, and cutting from 2.05 to 2.025. If they were actually talking about 2.5 -> 2.25, I retract my statement that it is not a dose cut which would be physiologically meaningful.

 

As I posted earlier, Spengler, my neurologist confirmed that 2mg of valium is a large enough dose which should not be cold turkeyed.  So with respect, although you have "not seen anywhere on the internet that it is medically dangerous to cold turkey 2mg of valium", my otoneurologist who sees hundreds of patients a year advised that it is recommended to taper 2mg of valium.

 

I'm not disagreeing with this, obviously a taper from 2mg is better than stepping off 2mg, and I agree that whether or not you call that a "cold turkey" is a question of semantics. My point was only that it would not be medically dangerous in the physical sense to just stop taking 2mg, in terms of affecting seizure thresholds, etc. I definitely agree that it would be likely to be unpleasant; I fully expect to spend a couple months tapering off my last 2mg when I get there.

[[ve...]]

Hi Spengler.  No worries. I don't mind if people disagree here, if done civily.  I understand your point as well.  I hope you have a safe taper the rest of the way. By the way, if you or JC20 would like to look at my old blog "4mg and chipping away", you can find it on page 17 of the buddy blog section of forum.  I decided to close it in June of last year when I declared myself healed at about 90%. There were quite a few folks on there tapering valium below 4mg.  Check it out if you or anyone tapering valium in the low milligrams might be interested.

 

Best,

 

Vertigo

[[JC...]]

It is really 0.0025 mg. I know it sounds so tiny but it is what it is. I have a sense that while I am holding on 2.06 mg - I have developed tolerance on the drug.

 

Or I think my underlining problem is not resolved. I was a good sleeper and 1 vacation (I have been the same place many many time) come back with a mood change and insomnia.

 

I feel my condition has improved but it looks like there is an invisible wall in front of me.

 

I have lower my dose to 2.05 mg last night; I hope I could see some improvement later on.

[[JC...]]

vertigo,

 

Do you see any turnaround once you go lower? I have a feel that I need to signal my body (perhaps a drop of 0.05 mg will do) that the Benzo is going down; so don't ask for more (as I think I have developed a tolerance).

 

Regards

 

 

JC