Is tapering always worse than post taper? So confused with all of this...

[[os...]]

Hi all,

 

I am stable at 3.8mg equiv of Valium right now, i have been holding for 9 days and i feel better able to write a question.

 

I have been tapering from 12mgs Valium for 9 months, it has been mostly doable but i have had symptoms, d/p, d/r, fatigue, agoraphobia (brief but still have not been out in months)... many of these are much better now but i am aware that i am not well...

 

My question is this... is tapering always harder than acute withdrawal?

 

Can symptoms dramatically worsen after zero?

 

Some say slow is the way to go and even Ashton states that many can lose symptoms whilst tapering, yet i read earlier of a BB that tapered for 2.5 years and still is not healed years out... this really worries me as that person did not stipulate what symptoms remained.

 

I often wonder if i take a year more to taper my last mgs whether i really am prolonging this?

 

NOTHING makes any sense in this at all...

 

I´ll explain what i am fearing... What i fear is that symptoms could be so much worse post taper and i read many posts where people say they are better but i don´t get a vague clue as to what to expect post taper... some seem to be OK by zero if they go slow enough (which is what i am doing), others say that healing does not happen until we are off.

 

I am sure healing happens... i am better than i was months ago but obviously i am not "well" as i am still tapering...

 

I have had few physical symptoms, yet i have had bad anxiety if i have vaguely gone too fast... and that fries my CNS and i simply cannot see that being a good thing at all... yet some swear that tapering so slowly is prolonging this.

 

WHAT TO BELIEVE???

 

Do people suffer endless months of high anxiety and fear and so on even after a sensible taper???

 

I am not talking regular anxiety here... i am talking severe anxiety... or does that only last a few months post taper???

 

I guess the answers will vary seeing as many jump at different levels and without meaning to cause upset, many may have pre-existing anxiety anyway???

The thing i am asking is hard to explain, i just want to know the difference between tapering and post taper in the acute phase... or does everything really kick off after the final dose, even when tapered down really carefully???

 

One example, could super high anxiety with startle response to sound actually be WORSE post zero for many months/years or does this settle pretty quickly???

 

I cannot see these extreme symptoms lasting for many months... i am talking about the severe anxiety and fear mainly... or can it???

 

Can anyone help? I cannot really see a pattern in any of this... and when people are free they can exclaim they feel GREAT but then say they still have sxs lingering but often don´t say what!!! Aaaargh... i wish those that got free could be more specific...

 

I often even wonder if i CT´d i probably would not be much worse off especially if my symptoms are really bad... i mean high anxiety and diarrhea and being scared of your own cat is bad enough... these fears and paranoias and high anxieties can only get so bad surely?

 

Am i prolonging this or should i cut myself out sooner? Or will i just be looking at a far longer acute stage?

 

Oscar

[[os...]]

This is the one thing that makes me feel like i am losing the plot in all of this... Ashton does not seem to say to what degree symptoms are during and post taper... not that i have read anyways...

 

I know we all vary and many CT, jump at higher doses etc and some rapid taper and some go real slow but i still cannot wrap my head around any of this... i mean, if Ashton says that real healing cannot happen until we are off WHAT DOES SHE MEAN BY "REAL" HEALING???

 

I get that we have to be drug free in order to heal but what about the severe symptoms? When do these start to abate generally???

 

Oscar

[[we...]]

Oscar,

the people who do a slow taper seem to do much better than those who cold Turkey. 

 

http://www.benzosupport.org/recovery_times.htm

 

[[os...]]

 

Imagine having a year of very high anxiety and startle response, diarrhea etc after tapering for 2 years!!! I HOPE NOT!!!!

 

Sometimes i cannot help but wonder what i am doing after 20 years on this drug, i hate the thought of being ill for the rest of my taper and a year or two more after sounds just unfathomable, if i am gonna suffer i often feel i may as well jump BUT i think that i may at least have a shot at a shorter acute stage...

 

Anyway, i just found this... after 20 years of being on this drug i hope i don´t regret this whole recovery business... if i am going to be in hell for years i often wonder what the point is... sorry, i hate to be so negative but most on here have not been on for decades like i have.

 

:'(

 

Oscar

 

I found this...

 

_______________________

 

 

Question: What is the definition of Acute Withdrawal Symptoms from “The Ashton Manual”?

 

 

“The Ashton Manual” by Heather Ashton, 2002

 

Acute withdrawal symptoms. "The most prominent effect of benzodiazepines is an anti-anxiety effect - that is why they were developed as tranquilizers. As a consequence, nearly all the acute symptoms of withdrawal are those of anxiety. They have been described in anxiety states in people who have never touched a benzodiazepine and were recognized as psychological and physical symptoms of anxiety long before benzodiazepines were discovered. However, certain symptom clusters are particularly characteristic of benzodiazepine withdrawal. These include hypersensitivity to sensory stimuli (sound (Noise), light, tough, taste and smell) and perceptual distortions (for example sensations of the floor undulating, feeling of motion, impressions of walls or floors tilting, sensation of walking on cotton wool). There also appears to be a higher incidence than usually seen in anxiety states of depersonalization, feelings of unreality, and tingling and numbness. Visual hallucinations, distortion of the body image (“my head feels like a football/balloon”), feelings of insects crawling on the skin, muscle twitching and weight loss are not uncommon in benzodiazepine withdrawal but unusual in anxiety states.”

 

 

 

I saw you were looking for a reference regarding Acute Withdrawal Phase. I put some information together that I thought might be helpful.

 

 

Protracted Withdrawal From Benzodiazepines:

The Post-Withdrawal Syndrome

 

School of Neurosciences

Division of Psychiatry

The Royal Victoria Infirmary

Queen Victoria Road

Newcastle upon Tyne NE1 4LP

Professor C Heather Ashton, DM, FRCP

First published in:

Psychiatric Annals 25:3/March 1995, pp174-179

 

ACUTE WITHDRAWAL PHASE

The acute "pharmacological" benzodiazepine withdrawal syndrome is classically described as lasting 5 to 28 days, with a peak in severity around 2 weeks post-withdrawal, after which most symptoms return to pre-withdrawal levels.6-12

 

However, the duration of this acute phase has probably been underestimated. First, most clinical studies terminate 4 to 8 weeks after withdrawal, and the progress of remaining symptoms is not monitored. Second, most reports do not include the later experience of dropouts, although the reason for dropout is often the continuation of symptoms. Indeed, persistence of high anxiety levels beyond 28 days post-withdrawal is usually interpreted not as a withdrawal effect, but as re-emergence of an underlying anxiety state previously controlled by the benzodiazepine12,13 and often results in reinstatement of benzodiazepine treatment. Third, it has been assumed that return to pre-withdrawal symptom levels in those who complete withdrawal represents the end of the withdrawal syndrome.

 

Some clinical reports do not support these assumptions. Observations of patients followed up for longer periods suggest that, at least in some individuals, typical benzodiazepine withdrawal symptoms, including paraesthesiae, sensory hypersensitivity, muscle spasms, and tinnitus as well as less specific symptoms such as anxiety, insomnia, and depression, can take 6 to 12 months to subside completely.14-21 A further problem is the interpretation of "baseline" symptoms. Patients presenting for withdrawal often have many "typical" benzodiazepine withdrawal symptoms, as well as high levels of anxiety, even while still taking the drugs.4,15 Although these symptoms may return to pre-withdrawal levels in a matter of weeks following an acute withdrawal peak, follow-up observations show that such symptoms may continue to improve over subsequent months. Even without specific treatment, they may decline to levels well below "baseline," sometimes enabling patients to resume their normal lives after years of incapacity.4,18,20 In a few patients, somatic symptoms persist for years in the absence of psychopathological signs of anxiety or hysteria, suggesting a pharmacological causation.3,4,20

[[Fl...]]

Oscar, I don't know if you saw this interchange between Laura and I.  I'm going to post it in it's entirety. Laura is concise and honest about her symptoms and experience. I hope you find it revealing and comforting.

 

 

**************************

 

 

 

Quote

Oh my gosh, Laura, has it been a month?  That's amazing!  Congratulations, girl. This makes me so happy.

 

Of course I'm not liking the symptoms youre having.  From here, it seems like you're having migraines, bladder issues and panic that wasn't there during the last of your taper.  You say it's manageable but I know how tough you are.  Do you have really good moments, too?  Is anything actually better than your taper? And the big question, looking back on your taper, would you do anything differently than you did?

 

I'm asking for my own sake, as well as caring deeply about you.  My Pdoc just refilled the liquid Valium for 500 ml, even though I only asked for 200. I had put the last one in the refrigerator and I'm going to take it back to the pharmacy for disposal, since it probably degraded.

 

Anyway, I have enough to do the taper however I want to. As always, I value your advice, Laura. I have about 70 2 mg tablets, as well.  I won't need all of them either. Starting tonight, if I stay out of the ER, I'm going to reduce by .01. Morning dose 1 mg, evening .99. LOL. I'll bump it up a little after I get over whatever I have. I had gotten to 1.9 by doing it that way every day before I got sick and then went back to 2 just for convenience.

 

Please, don't strain yourself to answer, OK? I have plenty of time. But you are still my taper coach, girlie!!! 

 

And thanks for your wisdom and insight on my blog. If I start throwing up, I will go to the ER and I won't leave without some kind of diagnostic scan.  I'm not going to say I hurt really bad, because I don't want them to do surgery of an exploratory nature.  And I don't really have a lot of pain. It's the weirdest thing. High white count, no fever, throwing up for no reason.

 

Well, look how I've managed to turn a congratulatory message to you around and make it all about me!!  I am SO happy for you, dear one. You know that, right?  Your victory feels like my victory!

Much love,

Flippie

 

 

 

Hey my sweet friend 

I'll reply here because it will be easier for you to find it, OK?

 

Thanks for the congratulations, Yep I can't believe that a month has passed, WOW  

 

I don't like either the symptoms I'm having but this is part of the recovery and a sign that my brain is trying very hard to regulate the GABA again. It's very uncomfortable as you know when we are being hit with w/d sxs but as soon as they go I feel better.

I have had more migraines after I jumped off than during the last months of the taper but they don't last all day as before. During pre taper and at least 4 months into the taper I lived with migraines all day. I'd woke up in the middle of the night with one wanting to chop my head off and I'd cry during the day because of the pain. That doesn't happen now. I have one migraine for a short time, maybe a couple of hours max, it goes away and it comes back later or next day but not so strong as before.  I have had also a few days migraine free.

 

All the other w/d sxs I have had after I jumped off are the same I had during the taper at one moment or another. The only difference is that they are milder, much milder actually. The thing is that my mind wants make me believe that they are sooooo bad. You know how our mind can play us into believe things that aren't real. One thing that bothers me is fear. When I have that ugly sx my mind start asking ridiculous questions and saying that those w/d sxs won't ever go away. Once I make myself clear that that is only another w/d sx then I calm down and feel better.

 

I seem to be having less tolerance with stress now but I have to recognize that I have been under lots of stress lately. I really think that a year ago it would have been impossible to deal with the things I'm dealing now. A year ago just waking up and going to work was very painful, some days just going to the couch or bathroom was a hard task. Now I'm thinking in moving back to my country with all the work that means. I have dealt with so many paperwork and I needed my mind clear for that. I have done it well and not wonder I feel mentally tired after that. But I see all that as progress. I feel more adrenaline now but if I do something psychical it goes away soon.

 

The thing is Flip that I really thought that after doing the slow taper and finishing I'd just feel amazingly right away. How that didn't happen I felt discouraged and started thinking how tired I really am from all the w/d. It has been over 2 years now since this nightmare started and I'm ready to live again but I realize that I have to give myself more time. I have to be patient because I need more time to function the way I want to do it. I'm convinced now that doing a slow taper allow us to function better in the meantime and we can start healing before jumping off. BUT that doesn't mean that right after the taper we'll feel totally healed. The receptor will need more time after being drug free to  regulate and start producing its own gaba again and that takes time. I'm just understanding that part now and that is why I  crashed when the sxs started to pop up. Now w/d sxs don't follow any rule as before. During the taper I'd know what to expect each week, now I can't expect anything because it doesn't follow a pattern. They just pop up at any moment without any advice. It's like at any moment a chemical reaction occurs and you can feel the impact but all this is part of the recovery. 

 

I have good moments too. When I have a hit, doesn't last all day, I have a few normal hours in the meantime. I can't say those moments are windows where I feel symptomless but they are the same as the last months during the taper when I felt strong and full of hope. 

 

One thing that is better is the sleeping. Except last night that it took me 1 hour to fall asleep I have fallen asleep fast since the last dose. Sleep has been solid and not many vivid dreams or waking up a lot during the night as before. I have been walking everyday also for 3 weeks now and the balance is better now. My concentration seem to be better too and even when I still having cog fog isn't so thick was before. So yes Flip I think that I'm healing and improving, little by little but overall I think I'm doing better. At least I know that I'm doing so much better than a year ago. Looking at the changes day by day it may not be a good idea but looking at the big picture I can see I'm doing better. 

 

The only thing I'd change about my taper it would be the start. I'm sure that if the start would have been smoother the first 6 months wouldn't have been so bad. The last months of the taper were very good for me and the w/d were milder so I wouldn't change anything about that.

 

I think is great idea that you do the micro taper. Even when I don't have personal experience with it for what I have read is a very good method for people that have problems with the cut and hold. I see that Stabler is doing much better with it now. So yes I think you have to try it and see if it works well for you. If not maybe you can try a combination of the 2 methods. I mean micro cuts every couple of days instead of daily. These last 2 mg have been so hard for you Flip, that didn't happen to me. I think in my case valium was making me feel so sick that only when I reached a very small dose I started to feel better. I'm so glad you have more than enough valium to finish with your taper. That will give you peace of mind knowing that you don't need to ask for more valium or that you won't run out of it at any moment. You have had  a couple of health issues too during the last months, first with the BP med now with this infection and that of course doesn't help the taper in any way. The simple fact of having an infection is more than enough for any one to feel like crap much more when you are dealing with a benzo w/d in top of everything.

 

I really hope the health issues can be fixed soon so you can only concentrate on the taper and this way you'll know  what is w/d and what isn't.  It really hurt my heart knowing that you are so close to be free but have all these other things to deal with it that are complicating the w/d.

 

I hope to hear soon that you are feeling better. Sending many hugs your way my friend.

 

Love ya girl, you and the friends I have found during this journey are the best part of benzo w/d. 

Laura

 

[[os...]]

Thanks Flip, i just think my main issue is not so much my method of getting off, my worry is that as i am such a long term user, that my acute withdrawals may be really bad no matter what... i know this is projecting negative but after 20 years use this is a real worry... i can handle some anxiety but when i have over tapered recently my sxs have been really awful... so all i can do i go super slow and hope and pray that by zero my jump is not as awful as i think it might be... i can handle sxs but not the kind that are crazily extreme... but then again i guess i´d even get through that... i guess there is no point in worrying about it now... but at times i really wonder if i have been on this med too many years to get off without years of suffering afterwards, i think anyone on for 20 years would often question this... yet i am in this now, so there is no turning back...

 

Oscar

[[ve...]]

Hi Oscar.

The only time I had "crazy extreme" s/x was after my c/t.  That being said, I had some relatively strong side effects after each cut I made from 6 to 2mg.  I don't think the side effects were quite so strong once I held for three weeks once I got down to 2mg.  Of course you are titrating very slowly so probably no comparison.

 

I went really slow from 2mg which helped.  Yet, after my taper, I did make a mistake and have some alcohol in the first month off and that coupled with some very stressful things going on at the time regarding my sick father, resulted in my getting Shingles.  I think it was a perfect storm, not likely to happen to you or anyone else.

 

Even with the Shingles, after a few weeks, nothing I experienced was as strong as that first few months tapering fairly rapidly down to 2mg and no comparison to the c/t.  If you continue to go slowly and hold here and there for a couple weeks, I don't believe you are going to have any major shocks.  Remember that you can also work yourself up with worries and hypochondria.  As I posted somewhere before, maybe in a PM, "overanalysis is paralysis" so just try to take one day at a time and not get too worked up about the "what ifs".

 

Take care,

 

Vertigo

[Guest [Da...]]

Hi Oscar:

 

Today, I seem to be pessimistic. I, too, sometimes wonder and get baffled. My mind in simplistic logic mode wants to think that as I taper lower and finally get off benzos, I should be fine shortly thereafter because I did it slowly. The scant research available says otherwise. I still don't fully understand why being on a really low benzo dose it so hard, but I will when I get there.

 

My GP says it like it is...no sugar coating...he was the one that told me from the start that the lower the benzo dose in tapering, the higher the chances for increased w/d s/x. Everyone is different though as we have seen on BB. I don't want to bring you down. I believe we have to remain positive throughout this long, long, long benzo w/d journey (there is no short way afterall) and afterwards. Being negative will obviously cause us to have increased psychological w/d s/x because benzo brain plays a lot of tricks on you.

 

I was put on benzos for anxiety issues (13 years ago), so I figure I am going to get that s/x increased because I am already prone to anxiety. But, I don't know and I hope not.

 

Also, from different pharmacists, I ask questions whether they believe in benzo w/d s/x and tapering. Some are clueless others point out that length of time I was on Clonazepam and that w/d s/x may be harsher on me but tell me to hang in there and I'm doing great. Positive reinforcement sure helps. The pharmacists are not experts by all means. That is the thing...NOBODY knows or can predict how things will be played out for us on an individual basis. So I just keep plugging away. Mostly, I am positive.

 

I wish we could just have a definitive...YES, you are going to be fine and once you are off, you will be functioning absolutely well and you will feel great.  Well, it sure doesn't seem to be the case for some of the people on BB who are off benzos and are still struggling.

 

There is just not enough scientific (hard evidence) research from many sources on benzo w/d out there. Sure we are all different with our w/d s/x, but we all have the same struggling when tapering off benzos.

 

I try to stay positive, but sometimes it is very hard. You caught me in one of those negative moments.

 

Danni

[[os...]]

Vertigo, thanks, i know i go on and on but i am feeling pretty well and thought i would post whilst i am able to think somewhat clearly.

 

Danni, i feel for you in this... it is true that there seems to be so many variables in this... i can only say that i have steadily improved the lower i got as i tapered, much of the time i was unaware i was tapering (probably from 7mg to 4mg was really not bad at all apart from fatigue) but at 4mg things changed, i think i would advise anyone tapering to start going much slower around 6mg as like Vertigo said... the lower numbers just need to be tapered very slowly.

 

I think i just need to go real slow to each half mg and reevaluate... i have heard from a few that things improve at 3mg/2.5mg and 2mg but that the last mg can be hard... in a way it is good to know, even micro-tapering... for those that are unfamiliar with this process, to have some heads up that the lower numbers can be problematic helps as i sure did not know quite how things would change, that said, some maybe able to get lower or even cut .5mg in the last 2mgs... (Yikes, not for me thank you).

 

Slooooowly and i have decided that if things get rocky again i will hold and ride it out, no alternative but i am going to just make sure that i am really well set up for the last mg and couple of months post taper... including ear plugs if that is going to be a bad sx... but i am hoping that by crawling down these last mgs i can minimize this as much as possible... i over tapered, did not hold for long enough and over tapered again... and i made myself quite ill... if i could do this all over again i would have gone a little slower in these past months...  as when things get rocky it can just make one feel worse... so go slow and know you will feel better overall but if you hit a rocky patch it is simply because you have overdone the reductions... logic says that tapering down to zero increases chances of a smoother landing... but whatever, people survive CT´s and heal but i often question if spending months on these last mgs is worth it... it does NOT help when others post that it made no difference... i am dubious about such statements if i am honest... the severity of symptoms must be eased i am sure.

 

Oscar