Who has Updosed and what has been the result?

[[Sh...]]

Hi I have been at .35mg of ativan for over 3 months after coming down from .8mg to .35mg in a sauna rehab center in 2 months. I have had no stability what so ever at this dose and was not very stable at .8mg when i did the detox, though there were a couple of weeks where I was good at the center around .7mg-.5mg range. However since being back it has been so intense with minimal relief and I wonder if I went back up to say 1mg, would i get stabilized and then start again alot slower? What have been others experience.

 

Thank you so much for your advice and support.

 

Sean

[[Bi...]]

I did, and the result was destabilization of taper. I had to cut faster because of Paradox. reactions.

 

Here is some info about updosing:

 

 

Reinstatement, updosing

A dilemma faced by some people in the process of benzodiazepine withdrawal, or after withdrawal, is what to do if they have intolerable symptoms which do not lessen after many weeks. If they are still taking benzodiazepines, should they increase the dose? If they have already withdrawn, should they reinstate benzodiazepines and start the withdrawal process again? This is a difficult situation which, like all benzodiazepine problems, depends to some degree on the circumstances and the individual, and there are no hard and fast rules.

 

Reinstatement after withdrawal? Many benzodiazepine users who find themselves in this position have withdrawn too quickly; some have undergone 'cold turkey'. They think that if they go back on benzodiazepines and start over again on a slower schedule they will be more successful. Unfortunately, things are not so simple. For reasons that are not clear, (but perhaps because the original experience of withdrawal has already sensitised the nervous system and heightened the level of anxiety) the original benzodiazepine dose often does not work the second time round. Some may find that only a higher dose partially alleviates their symptoms, and then they still have to go through a long withdrawal process again, which again may not be symptom-free.

 

Updosing during withdrawal? Some people hit a "sticky patch" during the course of benzodiazepine withdrawal. In many cases, staying on the same dose for a longer period (not more than a few weeks) before resuming the withdrawal schedule allows them to overcome this obstacle. However, increasing the dose until a longed-for plateau of 'stability' arrives is not a good strategy. The truth is that one never 'stabilises' on a given dose of benzodiazepine. The dose may be stable but withdrawal symptoms are not. It is better to grit one's teeth and continue the withdrawal. True recovery cannot really start until the drug is out of the system.

 

Pharmacologically, neither reinstating nor updosing is really rational. If withdrawal symptoms are still present, it means that the GABA/benzodiazepine receptors have not fully recovered (see above). Further benzodiazepines cause further down-regulation, strengthen the dependence, prolong withdrawal, delay recovery and may lead to protracted symptoms. In general, the longer the person remains on benzodiazepines the more difficult it is to withdraw. On the whole, anyone who remained benzodiazepine-free, or has remained on the same dose, for a number of weeks or months would be ill-advised to start again or to increase dosage. It would be better to devote the brain to solving individual symptoms and to finding sources of advice and support. Advice about how to deal with individual symptoms is given in the Manual (Chapter 3).

 

I actually got this post from Beeper.

 

Billy.

[[Me...]]

i did.....the results were awful, i felt even worse 'if you can imagin' when i updosed than being on the lower dose.

 

i would suggest to just continue to hold.  i know its tough, and you'll never really stabalize, but you'll eventually feel strong enough to make another cut

 

all the best

[[Sh...]]

Thanks so much both of you! What were the symptoms you had when you updosed? I went up from .3mg after 2 1/2 months to .35mg just so I could have it broken down throughout the day and I think you are right i feel worse.

[[bl...]]

I agree with Billy F and Metheral it was the worst thing I have ever done and the whole taper has been very difficult as a result.

 

Try to avoid doing it is my advice.

 

B

[[sw...]]

Hey there,

 

For starters, congratulations on making it all the way down to .35mg!!!  I know that that was some hard work to accomplish!

 

As for what to do from here, while I chose to never updose no matter how rough things got, this is a very legitimate question and it comes up here about every other week or so.  What the results seem to be is that it seems that the majority who updose get no relief from it but yet still have to go through absolutely all of the pain of cutting their dose coming back down again.

 

HOWEVER, that said, there are a subset of people who sometimes benefit from updosing, but under specific circumstances.  Those are people who either cut their dose and realize within a week (ie, before their body has really stabilized at the lower dose) that that was *way* too big a cut and go back up a bit (*never* more than the last dose they were stable at, and frequently a little lower).  The other situation is if someone becomes benzo wise within a few weeks of a cold turkey that they are really suffering from they can reinstated and taper down, instead.

 

That said, while those are the only sets of circumstances that I have ever seen people report benefits from updosing, it really needs to be emphasized that there are many people in those very circumstances who never benefit from the increased dose and suffer very horribly while coming back down, and in some cases suffer far more the second time around.

 

My best advice to you would just be to hang out where you are.  I'm actually very impressed that you were at what sounds like a benzo-wise facility that took your dose down at a relatively reasonable pace.  The absolutely longest it took me to stabilize after a bad cut was 2.5 months.  Sometimes it does take a while, but just about everyone stabilizes when they stay at the same dose long enough.

 

As for what to do once you stabilize, I would suggest (if you don't have it already) getting a liquid solution of your medicine from a compounding pharmacy so that when you do resume cutting your dose you can do it in very small and gentle cuts.

 

Best wishes.

 

[[os...]]

Miniscule dose "correction" here... i am titrating so that would not class as an updose... (it was just a couple of mls in my liquid), i´d say updosing in general is not a good idea, if you have to go that route make it a small updose and stabilize properly, then change your method of getting off, maybe by titrating daily but stick it out if you can, holding should be sufficient in itself but proceed slowly.

 

Oscar

[[jo...]]

I haven't read this thread cos I am scard to.

 

I updosed twice and regretted it bitterly.

 

Dont do it.

 

Give yourself time to stabilize before making a really sensible small cut.

 

Hope that helps.

[[Sh...]]

Thanks so much all of you. Sweet g thanks for the words of encouragement. It is scary to think you don't have updosing in your back pocket and I am not stabilizing after 3 months. Some say to keep going down regardless and you give very caring advice about staying still, it is tough to make all these decisions when I am feeling so out of it and driven by fear and need to feel relief.

I will keep positive though like all of you seem to and really appreciate the reassurance.

 

Sean

[[os...]]

If you can titrate, go with that and make tiny cuts to pull you out of this rut slowly.

 

Oscar

[[sw...]]

So you have been at your current dose for three months?  Do you feel any better now than you did three months ago?

[[Sh...]]

Ya, I have been at my current dose for 3 months and don't feel any better.

[[sw...]]

I'm sorry to hear that.  Have you read the Ashton Manual?  There is a section in there that refers to people who don't stabilize (some at specific doses, others throughout the whole process).  The advice in there is if you are not able to stabilize to ultimately start cutting again in small gentle reductions, because the only way you will ultimately find relief is when you are finally off the drug and the healing process can begin in earnest (though, hopefully you will not need to wait that long!).

 

Best wishes.

 

[[Sh...]]

Thanks Sweet G, that is what I am thinking as well.