I'm New. Is it too late to change my mind about cold turkey withdrawal?

[[Ki...]]

Hi new friends ♥

I am writing for my 63 year old husband, who is too sick to get up. I wish we would have found Benzo Buddies before he started cold turkey withdrawal, 3 weeks ago, from 40 years of Lorazepam!!!  He went cold turkey off of Heavy doses of opiods a couple of years ago, (Morphine and Oxy), which was foolish,  after being on it for more than a year after failed back surgery, and we thought that was really bad (severe vomiting, diarrhea etc for 12 days)... but then it went away and he felt better than ever.  This Benzo withdrawal seems to have no end in sight. Here are some of his symptoms: insomnia, non-stop headache, ringing in the ears, too dizzy to want to get up, crawling skin, tingling extremities, nausea, diarrhea, leg muscle cramping, etc.  When he was 2 weeks into the withdrawal I found Benzo Buddies.  We asked one of his doctors and his pharmacist if they thought he should start back on a smaller dose and then taper off slowly?  They both said: "Welllllll, after 2 weeks, the worst of it is past, and if you start back on Lorazepam now, that is just longer the withdrawal process will be."  They were wrong about that, weren't they? Week number 3 has been not one bit easier, and his headache today is almost unbearable.  We don't know what to do now.  We don't want him to loose any headway, if that makes sense??  Is it totally stupid to keep up the cold turkey?

 

He has been on 4 mg of Lorazepam, 2 to 3 times a day(or sometimes more if he felt like he was going to have a panic attack) for most of the past 40 years; started after having 1/2 of his stomach removed due to life-threatening ulcers started from years of childhood abuse.  He has been on every anti-depressant, and is currently on Prozac and Abilify, and Trazadone at bedtime.  He started to lose himself in it more and more, and lost the drive to stay in touch with family or want to leave the house. We are hoping that life after Benzos with give him his life back, and he can be a successful executive again, instead of stuck at home.

 

Thank you soooooo much in advance!

 

His adoring wife

[[ma...]]

Hello Kingair

Welcome to benzobuddies 3 weeks is not too late to reinstate, its dangerous to c/t these drugs after years of use

he needs to get back on a stable dose and then do a slow taper

 

please get back to us

 

Magrita

[[fi...]]

I agree with Margrita.  I have done several c/t's before I found BenzoBuddies and had to reinstate.  I am now on a very slow taper that my body can handle.  The tapering process shouldn't be unbearable where a person can't function at all.  Seizures, of course, are the biggest concern with doing a c/t off of a benzo.

 

At any rate, I hope he gets stable soon and then he and his doctor can devise a slow taper plan.

 

Sincerely,

 

fg

[Guest [vi...]]

i agree with magrita. c/t recovery from 40 years of use will ruin him and is not at all advisable. it might take him more than a year (in the current state) to notice improvement. please reinstate and my advice would be to not stop the prozac and other antidepressant till he has successfully tapered from his benzo. stopping opiods earlier was the right decision. if he reinstates and slowly tapers down, he will be the executive he was very soon (even during the taper).

[[Ki...]]

Thank you for your replies. So, we talked it over, and he would like to reinstate and do a direct taper.  His daily dose was 8 mg of Lorazepam a day (two 4 mg pills at bedtime) and sometimes he took two more 4 mg pills during the day, making a total of 16 mg.

 

I understand the general directions of tapering off by 10%, but since he has been cold turkey off of it for 3 weeks, where should he start his taper now? Does he start 10% off of the 8 mg dose, or 10% off of the 16 mg dose....or 10% off what dose....can it be 10% off less than the 8 mg dose??  Does it help at all that he was off everything for 3 weeks....where does he start back without losing ground, if that makes sense? It seems that in the Benzo withdrawal world, 3 weeks off is not much, right? The pharmacist said he was completely out of danger after 3 days of withdrawal....but that is why we are Here, asking our New Benzo Buddies instead   He just lost his Cobra insurance last month, so he is really trying to stay out of trouble until he can get well and get another job and insurance!

 

Thank you so much~~~~~~~"Mrs. Kingair" ♥

[Guest [vi...]]

very good questions kingair. in time more knowledgeable posters will chime in. however, i think you should first make sure he stabilizes at 8 mg. it might take a few days for him to stabilize too for the blood concentration goes up slowly in the body. if he does not stabilize at 8 mg after a week or so then i am afraid you might have to take medical help and doctors might increase the prozac dose (which he can get off of after his taper is finished).  warning: starting/increasing an antidepressant in benzo withdrawal should be very closely monitored for the first 3/4 weeks are sheer torture. this is all my persona opinion. there are good chances he will stabilize at 8 mg alone with his current level of prozac.

[[Ki...]]

Thanks Vineet.  So, that is 8 mg spread throughout the day, right? Thanks............

[Guest [vi...]]

just reread your posts kingair. your husband was on 8 mg at night and 8 mg during the day (sometimes) of lorazepam. i'd say reinstate the nightly 8 mg dose and see for a day if he notices partial improvement. if there is improvement, you can restore 4 mg during the day (but now it should be daily and not occasionally).

 

also, wait for a few more knowledgeable people to chime in. i say this because some folks might suggest he cross over to valium at this stage because it has a  longer half life and your husband might not need the daytime lorazepam then. i know this is getting complicated.

 

but let me reiterate: i think the nightly dose of 8 mg you should start immediately. he should experience significant relief with it. you should take up things from there (stuff like cross over etc. and adding daytime dose of either lorazepam or valium).

 

edit. apologies if my post sounds prescriptive. magrita is right in the post below.

 

[[ma...]]

Hi Kingair

 

He needs to reinstate at a dose he feels comfortable with and wait till he stabilises before slowly tapering

 

Would you like to read Prof Heather Ashtons Manual  http://www.benzo.org.uk/manual/

 

Please keep us posted

 

((hugs))

 

Magrita

[[Ho...]]

If it were me, I'd go back to the exact dose that I stopped cold turkey and stay on this dose until I stabilized, then figure out a taper plan from there.

 

Tapering isn't the main concern at the moment. Getting your husband stabilized is most important. Even at his prior dose, it will take time for him to stabilize. It could be several weeks, perhaps longer.

 

You might want to visit our General Taper Plans Board for more insight and to learn more about tapering.

[[Re...]]

HI!

 

I agree with Hope. Reinstatement at the dose and the times he was taking them and giving him a few weeks to stabilize would be most appropriate. How often was he taking the 4 mg in the afternoon? Lorazepam has a short half life( it is metabolized more quickly than other benzo). The ashton manual will be of great assistance. If he was taking the Lorazepam twice a day , I would have him reinstate that and if he does not feel stable on that , add a midday dose until he feels that some of his withdrawal symptoms have lifted and life is tolerable again. I would not make any adjustment to his other medications as that complicates things and it will be difficult to differentiate which medication is giving him symptoms. I hope he has a Dr that will be willing to work with him taper the mediation. He will likely start with a driect taper until is doage is lower and then can crossover to valium if necessary ( it has a longer halflife and for some is a more tolerable taper). You can look at the tapering sections for help with this.

 

Take good care. The support network here is tremendous and his symptoms are classic in withdrawal.

 

Recover

[[fi...]]

For what it's worth, I had a 5-day hospital detox from Klonopin some time back and it was terrible.  I absolutely had to reinstate and I reinstated at the same dose I was on.  I am working with a doctor (benzo-wise pdoc) who has developed a slow taper plan for me.  I had to get stable first and then be concerned about the taper.

 

Does he have a good doctor to work with, by the way?

 

Sincerely,

 

fg

[[...]]

If it were my husband,  I would follow Hope's advice.  If he is oversedated on the dose he was on when he stopped, then you will know his tolerance has dropped a bit and act accordingly.  He MUST let his physician know what you are doing.  Please don't blindly accept advice as gospel.  We are all different.

 

  May I ask why he decided to go cold turkey?  Was it because, as you stated he was becoming agoraphobic and house bound, or did the doctors cut him off?  The symptoms he was having certainly sound like issues with the benzo, the ad's or the combination.  Classic symptoms actually.

 

It will be important for him to stabilize and then see his doctor asap to work on a tapering schedule.  You have access to Ashton's manual?  Take a copy to his doctor and make sure the doctor and the pharmacist understand that after 40 years of benzo use, it is going to take much longer than 2 weeks to get off this drug, in a SAFE and HUMANE way.  If this doctor does not agree, you will have to find a physician who knows about this.  Good luck and please take the well intentioned advice, including mine with a grain of salt and much consideration.  Take care.....

Skyy

[[Ki...]]

Dear new friends,

Thanks to everyone for chiming in yesterday. We made a good, safe plan based on your input.  But unfortunately, he made some poor choices for himself while I was at work, and evidently once he started back on Lorazepam, his old behaviors of "coping with chemicals" kicked in, and he took wayyyy too much Lorazepam to numb his anguish, and wanted to know where all the pills went that were in his bottle when I got home last night. He seemed "drunk" from the pills, and hostile and angry with me about everything (he is the sweetest man on earth when he is not on mind-altering chemicals).  It made me so sad and discouraged.......here we go again.  It is hard to watch someone you love do things to hurt themselves, and our relationship takes a hit when that happens over and over. I am just glad that he didn't drive like that. We will try to get him stabilized, and do a controlled slow taper, now that we know more about Benzo withdrawal.  I had been pouring over Dr. Ashton's manual that I found on the link from Benzo Buddies last week before I set up this profile.  It was so insightful, I had no idea that Benzo's were so insidious. I knew that Lorazepam was his "drug of choice" to numb his pain, and escape from the world and alienate himself from his family , but I didn't know how hard it would be to get it out of his system, unlike pain pills that he also had abused. 

 

I have to go to work now, but will pray for courage and for things to get better.  I usually keep these trials a secret, but I have the feeling that there are plenty of folks here that will understand. Funny......I just realized how lonely it has been to keep all these things to myself, and put on my happy face and go to work and pretend that nothing is wrong.....

 

Thanks for listening.  XXOO Kingair

(p.s. "Kingair" was his favorite airplane that he used to fly before his life spun out of control and he lost everything.)

[Guest [vi...]]

kingair, you are nothing short of an amazing wife! love you!

 

it is very positive that he is responding after resuming lorazepam! this is a sure sign of quick stability. unfortunately overdosing is not good as you already know. you have to swiftly tackle this in your own way. but it's good that he is responding to the reinstatement!

 

 

[[Ki...]]

Bless you Vineet!  You made me cry.  I didn't realize how much I needed positive reinforcement in that way. I prayed this morning for help for my husband, but didn't realize I would be the recipient. 

Thanks you little sweetie pie ♥

[Guest [vi...]]

thanks kingair and you are quite welcome. i meant every single word of what i said.

 

take heart. slow taper is the way to go to get off these benzos while still being functional. your immediate goal is to have him stabilized. then he too must join this forum and make a resolve to taper with the help of the peer support available here. he's lucky he has an amazing wife like you!

[Guest [vi...]]

kingair,

 

Here is what Prof. Ashton has to say about updosing (while tapering) and reinstating (after finishing):

 

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)."

 

-----------------------------------------------------------------------------------------------------------------------------------------------------------------

 

don't feel let down by prof. ashton's comments. every person is different. just hope that your husband stabilizes during this reinstatement. but you have to plan for contingencies too. in my personal experience, when my doc. made me c/t from my benzo, he reinstated the benzo. after 2 weeks and started an ssri (antidepressant). i stabilized. i do not know if i would have stabilized by the reinstatement alone. probably the ssri helped me (for the doc. had actually reinstated a lower dose -- 65% of my earlier benzo intake! but i experienced total resolution after the antidepressant start up period of roughly 2 weeks). prepare yourself for the possibility that doctors might increase his antidepressant if he shows only partial recovery after a few weeks of reinstatement. it is utmost important for him to stabilize at this moment. then again, since he is already on prozac, that might vastly increase his chances of experiencing a successful reinstatement from the the benzo. (without any antidepressant increase!).  hope for the best kingair but prepare for the worst.

 

also read this one man's story about how ssri's helped him quit benzos (it's only ONE man's story but i am highlighting it because your husband is already on a ssri): http://ashtonbenzomanual.com/

 

be careful of his self over-medication twitch. THAT can be fatal. also read skyy's posts in this thread. she is spot on (in PURELY my personal opinion).

 

don't get overwhelmed by the surfeit of information here (or in this thread). we are all groping in the dark  but at least we have valuable experiences to share (that docs., sometimes have no clue about). you've been doing a great job so far and you will do only better!

 

keep posting developments. we are tuned in.

 

lots of love and hugs,

 

vineet

[[...]]

Dear new friends,

Thanks to everyone for chiming in yesterday. We made a good, safe plan based on your input.  But unfortunately, he made some poor choices for himself while I was at work, and evidently once he started back on Lorazepam, his old behaviors of "coping with chemicals" kicked in, and he took wayyyy too much Lorazepam to numb his anguish, and wanted to know where all the pills went that were in his bottle when I got home last night. He seemed "drunk" from the pills, and hostile and angry with me about everything (he is the sweetest man on earth when he is not on mind-altering chemicals).  It made me so sad and discouraged.......here we go again.  It is hard to watch someone you love do things to hurt themselves, and our relationship takes a hit when that happens over and over. I am just glad that he didn't drive like that. We will try to get him stabilized, and do a controlled slow taper, now that we know more about Benzo withdrawal.  I had been pouring over Dr. Ashton's manual that I found on the link from Benzo Buddies last week before I set up this profile.  It was so insightful, I had no idea that Benzo's were so insidious. I knew that Lorazepam was his "drug of choice" to numb his pain, and escape from the world and alienate himself from his family , but I didn't know how hard it would be to get it out of his system, unlike pain pills that he also had abused. 

 

I have to go to work now, but will pray for courage and for things to get better.  I usually keep these trials a secret, but I have the feeling that there are plenty of folks here that will understand. Funny......I just realized how lonely it has been to keep all these things to myself, and put on my happy face and go to work and pretend that nothing is wrong.....

 

Thanks for listening.  XXOO Kingair

(p.s. "Kingair" was his favorite airplane that he used to fly before his life spun out of control and he lost everything.)

 

This is why I mentioned his tolerance may have dropped after being off for awhile.  Can you please contact his doctor about what is going on?  Overdosing as you know can be fatal.  Skyy

[[bl...]]

I would partially reinstate at a lower dose which still relieved my symptoms. That might involve some trial and error. Then I would taper. Best of luck!

[[...]]

Goodness, I really hope this man is OK.....

[[Ki...]]

Hi Skyy, He is ok, thank you.  I was pretty upset with him on Wednesday night when he had taken ten 2 mg pills of Lorazepam that day after being cold turkey for 3 weeks and was acting so weird. He admits that he just screwed up.  He was acting normal again when I got home last night from work, and he is ok again tonight.  We are experimenting with his reinstatement dose.  We are cutting four, 2 mg pills in half and spreading them throughout the day.  His symptoms have eased up a bit, and he has been able to sleep finally, which was such a relief in and of itself. I had actually been mistaken when I wrote my original post, his pills were 2 mg and not 4 mg, so we have him reinstated back on his full dose right now, but spreading them throughout the day.  I guess we will get him stable on this, and then start a more humane taper, now that we know better.  He feels like he wasted the 3 weeks of cold turkey, but he was feeling so desperate and didn't know how much longer he could take it.  I work at the front desk in a busy Urology clinic with 6 doctors.  I am pretty savvy about all the urology meds, but didn't know much about benzos I guess.

 

I was so exhausted and discouraged myself from being his caregiver, but I am better now too, and thankful for the weekend so I can get some rest.  I am 57 and feel too old to be working full time, and then come home to a sick husband and feel like it is my second job, as much as I love him. We are in huge medical debt after he had two hip surgeries, and blood transfusions and severe anemia and iron transfusions, and has been out of work for 2 years.....but this too shall pass, right?  We can do it.  And the sooner he gets off all of these crummy meds, the sooner he can get his brain back.  Reminds me of my favorite movie, The Wizard of Oz....."if I only had a braaaaiiinnnn"!!!   

[[...]]

You are a good wife and he is very lucky to have you.  You certainly can have him stabilize (if he can) on the old dose and begin to taper from there as Hope suggested. Once you both agree he is stable that is..

 

I hate to ask this, but can you trust him to appropriately space out the meds when you are at work?  It has got to be so hard to feel "responsible" for another persons med intake.  Hopefully he is fully committed and engaged in this process.  That will be the only way this can work.

You will find a ton of moral support here and so will he.  There are many many, men and women who have been exactly where he is at, and are doing well.  I hope you are able to find some time for yourself, burnout is not what you need!

Hugs, Skyy