Have you changed from the cut and hold method to microtapering?

[[Wi...]]

See this is where I get into trouble...

 

I was at 3 mg and was cutting .15 a week, so about 10 -15 % down to 2 mg.  And to be candid, it kickd my a**.  I'm prepared to deal with some discomfort and perhaps I'm one of those, like Ashtons people that Colin mentioned that were more difficult than most.  I would give my right arm if i could taper more quickly, but at the moment that simply isn't possible.  I wanted to follow Hope's example, thinking that what could 2 measly mg do after having come from so high.  Turns out for her it worked out, although I'm sure she has some s/x.  For me it hasn't.  I don't know where I'll jump and no matter where I jump from, it's going to be  higher than any other cut, but while I have great respect for Colin and Hope, in my case things are going very differently then is described here.

 

I DO notice the cuts and intensly,  but perhaps I'm an anomily.

 

WWWI 

[[Ho...]]

 

Everything Colin has posted should be filed under 'your mileage my vary". Ultimately, you should do what's right for you.  There are those who couldn't make the jump or cuts I did. It's so frustratingly individual, I know.

 

 

I am having symptoms but they aren't any worse than the symptoms I had while tapering. I am suffering from insomnia, tremors, dizziness..etc. These are symptoms I can live with. They are not crippling me. There are those who may want to taper more slowly because they feel safer doing so. If that's how they feel, then that's what they should do. Colin is pointing out that pharmacologically speaking, tiny cuts at very small dosages doesn't make sense but there is a big psychological factor at play here as well.

 

I don't know why one cut is easier for one, and harder for the other but it seems it is. It's not fair and it's hard to watch others jump when you're still struggling. I get that. 

 

[[Wi...]]

Hope,

 

While there may be no pharmacological reason and perhaps there is a psychological aspect, what impacts me is the physical aspect.  Increasing my cuts now is no different than when I increased my cuts at pretty much any point in the taper.  Under 5 mg I've also begun to experience intermittent tinnitus and the faster I go, the more constant that becomes.  And while I could see that it's possible to psych oneself out and have it manifest in higher anxiety or other symptoms which are unclear how much is physical and how much is psychological, I am not clear on how I could psych myself into different degrees of tinnitus.

 

As I've mentioned before, while I am envious, I truly am happy that you were able to jump and that the s/x aren't crippling to you. 

 

WWWI

[[Ho...]]

Hope,

 

While there may be no pharmacological reason and perhaps there is a psychological aspect, what impacts me is the physical aspect.  Increasing my cuts now is no different than when I increased my cuts at pretty much any point in the taper.  Under 5 mg I've also begun to experience intermittent tinnitus and the faster I go, the more constant that becomes.  And while I could see that it's possible to psych oneself out and have it manifest in higher anxiety or other symptoms which are unclear how much is physical and how much is psychological, I am not clear on how I could psych myself into different degrees of tinnitus.

 

As I've mentioned before, while I am envious, I truly am happy that you were able to jump and that the s/x aren't crippling to you. 

 

WWWI

 

I didn't have as much time to type what I wanted really should have WWWI. I didn't mean to imply your symptoms weren't real. I know they are. My statement was more general in nature. I should have made that clear. I know there are some who have a hard time even on the lower dosages. I don't know why that is as there appears to be no pharmacological explanation for it but then so much of this often seems to me to defy explanation. From why doctors don't get this, to why some end up completely incapacitated while others don't. Why do some members start having terrible symptoms 2 months out? It's well beyond my understanding.  The questions go on and on for me.

 

I don't doubt members are having problems at these low doses. This is why I stated that, in my opinion, these are general guidelines and everyone should do what is right for themselves.

 

I'm sorry I wasn't more clear. I should have left this until I had more time.

[[rh...]]

Hope,

 

While there may be no pharmacological reason and perhaps there is a psychological aspect, what impacts me is the physical aspect.  Increasing my cuts now is no different than when I increased my cuts at pretty much any point in the taper.  Under 5 mg I've also begun to experience intermittent tinnitus and the faster I go, the more constant that becomes.  And while I could see that it's possible to psych oneself out and have it manifest in higher anxiety or other symptoms which are unclear how much is physical and how much is psychological, I am not clear on how I could psych myself into different degrees of tinnitus.

 

As I've mentioned before, while I am envious, I truly am happy that you were able to jump and that the s/x aren't crippling to you. 

 

WWWI

 

I understand where you're coming from WWWI. I'm having to make very small cuts, and I'm going to keep sipping and chipping until I'm benzo free.

 

I've got the screaming tinnitus most of the time, maybe one day a week I'll get a break. For me, there's no rhyme or reason .

Right now I'm taking this moment by moment, taking solice that the numbers are decreasing and not increasing.

 

I too am happy and envious of those that can taper faster and jump, but I don't want to fall into the category of reinstatement because of a rushed taper. Just saying that some do reinstate.

 

Sending my love,

RG

[[jo...]]

Hi dd58

 

Maybe you're in a similar situation to me.

I ws using cuts of 0.018 and that got too much, so I have chosen to hold while I decide what to do next and to give myself time to re-stabilize.

I plan on continuing my daily titration but will start with cuts of 0.012 and take it from there.

 

I also feel pretty unimpressed that I am on 2.4mg even though, in reality, we have both climbed a mountain to get down to these low doses.

 

Lithium is an inhibitor of the CYP 450 enzymes that we use to metabolise benzos.

Tapering lithium will reduce some of that inhibition, and that could have brought on some withdrawal from benzo, as benzo is now leaving your system quicker than it was before you started tapering lithium.

 

I'm not going back on cut and hold, because it didn't work for me personally. I found myself worrying about symptoms after each cut, to the extent that the stress slowed my taper. With daily titration, I feel I have a bit more control, in that I can correct things quickly, if symptoms show.

[[Wi...]]

Hope,

 

I think if I hadn't just hadn't spent most of Sunday wrestling with this on here and the weeks prior trying desperately to come to terms with the fact that I have to slow this down to even more of a crawl then it already is, I wouldn't have been over sensitive about this.  I really hear what you are saying and it is my greatest want that someday they can and will figure this out for those who come after us because for any of us that end up here, the price we pay is attrocious. 

 

RG

 

When you say "Right now I'm taking this moment by moment, taking solice that the numbers are decreasing and not increasing." I'm SO right there with you.

 

And when you said "but I don't want to fall into the category of reinstatement because of a rushed taper" That's it exactly.  I know myself and I couldn't do this again, I would not survive.

 

 

WWWI

[[pu...]]

 

You are correct in your percentages. However, neither percentages nor discrete amounts in a taper plan or formula are inherently correct or wrong. It is just that thinking about percentages at higher doses is better way of describing a sensible taper plan. At lower doses, a more linear taper, reducing dose by discrete amounts makes more sense.

 

Two things I'd like you consider. First, even if you cut from a dose of 0.00002mg Valium to 0.00001mg Valium, this would still represent a cut of 50%. Do you think these kind of doses or cuts would be even perceptible? Second, when we are at a low dose, more of our normal GABA functioning is in place. So, our low dose of benzodiazepine has a minimal effect. Cutting a dose in half that has minimal effect will result in a minimal withdrawal reaction, as it forms only a very small part of our overall GABA functioning.

 

At higher doses, where most of GABA functioning is taken over by the benzodiazepine, it makes more sense to think of reductions in terms of percentages. Although Ashton did not use percentages in her benzodiazepine withdrawal schedules, if look at her tables, they do indeed tend to follow a pattern of relative percentage reductions at higher doses and a linear taper towards the end.

 

Colin!  Thank you for this.  I just posted yesterday about examples where Ashton does cuts up to 50%.  I was confused about the meaning of it.  What you've said is certainly one way she could be deciding on the amount. (personally I wish she would explain the examples more.)

 

I've been horribly worried about all these cutting decisions, and your post gives a somewhat different way to think about lower doses...... Possibly going faster as the dose reduces.

 

Would you care to make any guesses about my case?

Taking 5 mg Valium for aprox 4 months

Reduced by 25% about 9 days ago (the date is in my signature, it was Saturday a week ago).  That was before I knew the 5-10% guideline. 

I'm not sure how to describe the result.  I would say more anxiety, maybe a bit less sleep. But both have been problems anyway, so I'm not so sure what's due to the dose change, what's due to my massive new worries about benzo issue, and what is random...... I did feel that today my anxiety "eased up" just a bit.  hopefully tomorrow will continue that......

So now I'm taking 3.75 mg (aprox, inexact cutting)

I just got an Rx for 2 mg pills which I have not yet filled.

 

I'm thinking when I get the 2 mg pills that just as a practicality I can't really take 3.75 mg Valium using 2 mg pills (that would require taking 1 and 7/8 pills).  So, seems a cut to 1 and 3/4 pills (3.50 mg Valium) would make sense.  That's a cut of .25 which is between 5 and 10 %.  Then I could continue with the 2 mg pills.

 

Then I think: since I handled a cut of 1.25 mg, a cut of .75 mg (to 1 and 1/2 pills) should be reasonable.....  But that is 20%, clearly way over the guideline.

 

I guess this is everyone's struggle - wanting to have tolerable symptom level, but also wanting to get to the lower range sooner, in order to, as you say, have GABA system be able to mostly work, and recover more.

 

I think part of my question is to ask whether the lower dose / discrete progressive cut amount idea applies based on the actual dose or is more about relative dose.  That is, since I started at 5 mg not 40 mg, does that mean it somewhat faster schedule makes sense or not.  If we think what matters is purely my starting point then 20% is too much.  If we think the actual amount of Valium in my system is a factor, then perhaps 20% of 3.75 mg is not so extreme.

 

Another question would be "what's a low dose"?  Maybe the discrete thinking applies to me now, and maybe not.

 

In any case, Colin, you seem to have a lot of thoughts about these kinds of issues, so I would welcome your thoughts on this.

 

In the end I may decide based more on how I feel (anxiety etc) and what activities and tasks I need to manage (e.g. I have a dental appointment next week.). I may make another cut at the end of this week, or I may not.

 

This whole process is new to me and wildly anxiety provoking to say the least!

 

Thanks again for your comments which I quoted above.

 

[[os...]]

It is the same with me as it is for WWWI´s, there is just NO WAY i could get away with making bigger cuts.

 

For me a big cut would be like signing up for a huge panic attack, followed by a week or more of severe morning adrenaline and LOTS of fear...

 

No thank you, been there, done that.

 

What i see so many times is that those that taper faster via the cut and hold method create many back log "waves" that often continue post taper... show me ANYONE on the site that was withdrawal free after a couple of months using Ashton, or even close to it.

 

At least with tiny daily cuts, one can take time out and recharge... some larger cuts seem to put some in a bad place and that can often be hard to get out of...

 

If i cut bigger, every cut would shock my nervous system and create a lasting trauma, the last big cut i took left me in a state for months and it was not even a big cut.

 

Lord knows what a bigger cut would do, i don´t even want to go there.

 

From what i have seen on here, any taper lasting less than a year has not been an easy recovery post taper.

 

ALL the years of suffering on here are a result of CT, rapid tapers and high jumps... why do it?

 

Oscar

[[...]]

Morning all.  Had my beauty sleep  it is 5.

 

Wow what a great discussion between us all so far no doubt there will be more replies, well from what I have read so far it is obvious none of us are cutting our dose at the same time or the same amount. I would guess we have tried different amounts that are suitable for our selves.

 

This may be because we are all built differently and of different sexes, this is going off the topic but when we had our two cats who are brothers they needed tablets, they were weighed and were given the appropriate dosage they needed.

 

We humans on the other hand are given a starting dose of the same no matter what size or sex that we are and I do not agree with this never have done, but then the argument comes to what size tablets can one give us, wished they had not but there is no going back what is done is done.

 

I may have already stated that I have c/t badly and I mean badly I was a walking skeleton and was just under 7 stone or 98lbs and at 5ft 8 ins not a pretty sight. unfortunately those that thought they knew it all would not accept this and treated me for depression yes we all know what c/t sxs are, but they obviously did not believe in it.

 

So here I am now doing a slow but painful taper, not painful as in pain as I may be lucky at the fact that my w/d sxs have been really bad palpitations , trembles and bad headaches, the depression side of things have somewhat lifted, but still lurking  is that because I am now lower in my dose and there fore the V is obviously decreasing and it is what is going on inside of me. Or is it what is going on inside my head can't spell psych what ever, it was not until last night that I counted to see how long it has taken to drop 1 mg and went to bed thinking this is going to take forever.

 

What a  I am I have just checked it was actually 62 days and not 94 days don't ask how I got mixed up blame Mr V. there again my maths is no good and to think I was hubby's book keeper but that was before benzo.

 

I feel like a lot of us do that we can only tolerate what we can cut by our gut feeling, I am cutting mainly .02 mg daily but have held or just cut .01 mg I personally have not up dosed but that is me.

 

I am also taking Remeron 10.5 mg and the Lithium this may make a difference to my w/d sxs can anyone actually say, there is one thing that I found which I may be wrong is that Valium can interact with lithium, yet I am taking both. When I was given all 3 of my meds in hospital  I was put on  Nitrazepam 10 mg sleeping tablet, Remeron 15 mg then increased to 30 mg for 2 weeks the Lithium was not added until weeks later as the depression was still there, is this the depression because I had c/t oh I forgot there is no such thing as c/t w/d sxs it is all in this stupid head of mine.

 

Well I think no I know I have said enough so as from tonight as I take all mine at night reluctantly take them believe you me I have cried thinking what the heck are you doing, it is like having to take a fix sorry if I offend anyone but I did not choose to take these, I had no sleep the times I wished I had never gone to my local hospital because I was climbing the walls because I had not slept.

 

To then be taken straight to the psychiatric hospital to be sectioned this was back in November 09 when this all started but this last 4 month stint last year has been the worse thing that has happened in my life, unless you have been there you have no idea .

 

DD

 

 

 

 

[[Co...]]

Well, Collin,

 

I took a look at the patent link that you posted. Thank you for doing that.

 

I do think that if it is suggested that someone taper .01 mgs of V per day, it's still a suggestion which that person may or may not follow. It also may or may not be comfortable for that person and they are free to "not" follow that suggestion.

 

Hi Intend to be off,

 

I think if a method is formalised, we need to be very careful in what we might 'suggest'. BenzoMicroTaper is presented as being somehow optimal. I would suggest that members taper off at any rate that works for them, but why plant the thought that they might taper off at a rate that it is almost certainly very much slower than is necessary? 7 years to taper off 20mg Valium is not a sensible 'suggestion'.

 

They can "up" their cut, lower their cut, or do some other method altogether. To me, it's about freedom of choice here on these methods. And that's really it. I appreciate your dedication to explanation and looking in all this.

 

Pill-splitting, substitution with Valium, and titration all have their places. The only reason I would prioritise one method over another is based upon simplicity and practicality. Pill-splitting is simple, and requires no new prescription (though, you would usually require a supply of the lowest dose pill available for that particular benzo). Substitution with Valium is already very well described in Ashton's Manual, but will require a new prescription. Titration certainly has its uses, especially for shorter acting benzodiazepines, but might be considered a chore (it ties down people to the kitchen). Individual preferences and requirements will dictate which method is best in a particular situation.

[[Co...]]

Colin:  Thanks for another great post. I never knew exactly what Hill's method was.

 

Thank you. I never knew either - I'm not sure I still fully understand. There seems to be nothing novel in the method, except for (maybe)* the idea of drinking 1-3 ounces of grapefruit juice in the event of an unspecified dosing error. As I write in my main post to this thread, this is a terrible suggestion.

 

* I think I've come across this idea before. If so, even this patent particular would fall foul of prior art objections.

 

Vribble:  With regards to multiple daily dosing of Valium, unfortunately it is a little more complicated than basic half life. In pharmacology we have a term called duration of action which is defined as the length of time a given drug is clinically effective. Duration of action time for Valium is commonly 6-12 hours for most individuals but can range up to 24 hours. The exact time frame is dicey as it depends on several factors such as the drug action reversibility, the slope of the concentration-response curve, serum half and other variables. Also, Valium is distributed in what is known as a two compartment model wherein there is an initial rapid drop off in serum concentration and then a slower decline as the drug accumulates in tissues. Various studies have shown peak performance decline for the iv, im and oral routes as in the neighborhood of 15minutes-1hour  up to 2 hours and lasting as long as 3-4 hours. Also, Valium also undergoes biphasic metabolism which means it is metabolized rapidly at first and then slower later. From my reading the effects of Valium are said to correlate poorly with an individual's serum level. I know that Ashton pushes the idea of half life quite a bit in her manual, but I suspect this is to simplify things for lay people. She also has you dosing Valium multiple times per day earlier in your taper so I'm sure she knows all about duration of action as this is a basic pharmacological concept. There certainly are a lot of people on BB who will attest to interdose withdrawal symptoms with once a day Valium dosing.

 

http://www.inchem.org/documents/pims/pharm/pim181.htm#SectionTitle:6.3%20%20Biological%20half-life%20by%20route%20of%20exposure

http://www.ncbi.nlm.nih.gov/pubmed/7352385

http://www.ncbi.nlm.nih.gov/pubmed/7352385

http://www.nhtsa.gov/people/injury/research/job185drugs/diazepam.htm

http://www.mentalhealth.com/drug/p30-v01.html

 

Interesting stuff, Bart. I'll try to read those referenced pages later.

[[...]]

Hi Colin

 

Last night I added up how long it has taken me to taper 1 mg of Valium and that is doing a daily cut of .02 mg mostly with .01 mg and some days of holding and it took me 62 days. At this rate is it deemed as to taking to long. Because as no doubt many others may also would like to know. When I spoke to hubby about doing a cut and hold for 1-2 weeks and dropping 1 mg, his reply was are you mad, you know hat happened when you stopped your tablets. Mind you I did stop 10 mg of Nitrazepam, so a lot more than 1 mg.

 

 

Thank you

DD

[[Co...]]

Please correct me if I am wrong as this is the first time I have done a proper taper previously I had foolishly c/t before, are you saying that it is possible to go from 2 mg down to 1 mg, because I know when I was in hospital they were giving me 5mg of V for 2 weeks then suddenly I was given 2 mg for 2 days and they stopped it and I had w.d sxs.

 

Yes, it is perfectly possible to cut from 2mg to 1mg Valium - this is what most people do when following Ashton's schedules. Many members at BB prefer to make 0.5mg cuts at low doses of Valium - this would seem reasonable. Of course, the might make more frequent cuts if the size of their cut is halved. I just question the validity (for the vast majority of people) of titrating Valium (unless they do not have access to 2mg tablets).

 

There is big difference between a 2mg to 1mg cut compared with 5mg to 2mg and then to zero after a couple of days.

 

So surely going from 2 mg down to 1 mg is not an easy way to taper off, some may be able to do this I very much doubt that I can do it.

 

You might make 0.5mg cuts, or, of course you can titrate. I am not saying don't titrate. If you feel you need to this, then do it. It will do you no harm, and if you feel a benefit, do it. I only suggest that if members are making very small cuts, they strongly consider increasing the frequency of those cuts (to add up to a reasonable overall taper rate). From what I have read about your situation, it seems that you already make frequent small cuts.

[[Co...]]

See this is where I get into trouble...

 

I was at 3 mg and was cutting .15 a week, so about 10 -15 % down to 2 mg.  And to be candid, it kickd my a**.  I'm prepared to deal with some discomfort and perhaps I'm one of those, like Ashtons people that Colin mentioned that were more difficult than most.  I would give my right arm if i could taper more quickly, but at the moment that simply isn't possible.  I wanted to follow Hope's example, thinking that what could 2 measly mg do after having come from so high.  Turns out for her it worked out, although I'm sure she has some s/x.  For me it hasn't.  I don't know where I'll jump and no matter where I jump from, it's going to be  higher than any other cut, but while I have great respect for Colin and Hope, in my case things are going very differently then is described here.

 

I DO notice the cuts and intensly,  but perhaps I'm an anomily.

 

WWWI

 

Hi WWWI,

 

That's a slow taper, but it is not crazily slow. If you feel you need to taper off your final few milligrams over some months, then do that. If the goal is to be benzo-free, then within reasonable bounds, it matters little how long the taper lasts.

 

0.15mg cut from 3mg is actually a 5% cut. At low doses of Valium, that is a small cut, but as I said, not altogether unreasonable in particular circumstances and for some people. If the end part of your taper takes some extra weeks than what is suggested by Ashton, this is not a big deal.

 

My aim with these posts is to help some people from following taper plans that are totally unnecessarily long (plans that last years from relatively low doses).

[[...]]

Hi Colin

 

I hope you have read the above about how long it has taken to taper my 1 mg over 62 days and I am having w/d sxs doing the cuts that I am doing, what I would be like going from 2 mg to 1 mg I dread to think, or is Ashton saying just get on with it and grit your teeth.

 

DD

[[Co...]]

 

You are correct in your percentages. However, neither percentages nor discrete amounts in a taper plan or formula are inherently correct or wrong. It is just that thinking about percentages at higher doses is better way of describing a sensible taper plan. At lower doses, a more linear taper, reducing dose by discrete amounts makes more sense.

 

Two things I'd like you consider. First, even if you cut from a dose of 0.00002mg Valium to 0.00001mg Valium, this would still represent a cut of 50%. Do you think these kind of doses or cuts would be even perceptible? Second, when we are at a low dose, more of our normal GABA functioning is in place. So, our low dose of benzodiazepine has a minimal effect. Cutting a dose in half that has minimal effect will result in a minimal withdrawal reaction, as it forms only a very small part of our overall GABA functioning.

 

At higher doses, where most of GABA functioning is taken over by the benzodiazepine, it makes more sense to think of reductions in terms of percentages. Although Ashton did not use percentages in her benzodiazepine withdrawal schedules, if look at her tables, they do indeed tend to follow a pattern of relative percentage reductions at higher doses and a linear taper towards the end.

 

Colin!  Thank you for this.  I just posted yesterday about examples where Ashton does cuts up to 50%.  I was confused about the meaning of it.  What you've said is certainly one way she could be deciding on the amount. (personally I wish she would explain the examples more.)

 

I've been horribly worried about all these cutting decisions, and your post gives a somewhat different way to think about lower doses...... Possibly going faster as the dose reduces.

 

Hello Purple,

 

Only 'faster' in terms of percentages. Usually, the absolute size of cuts (in terms of milligrams) decreases as the taper progresses (or the period between cuts is increased), but the size of cuts are longer reduced towards the end of the taper.

 

Would you care to make any guesses about my case?

Taking 5 mg Valium for aprox 4 months

Reduced by 25% about 9 days ago (the date is in my signature, it was Saturday a week ago).  That was before I knew the 5-10% guideline. 

I'm not sure how to describe the result.  I would say more anxiety, maybe a bit less sleep. But both have been problems anyway, so I'm not so sure what's due to the dose change, what's due to my massive new worries about benzo issue, and what is random...... I did feel that today my anxiety "eased up" just a bit.  hopefully tomorrow will continue that......

So now I'm taking 3.75 mg (aprox, inexact cutting)

I just got an Rx for 2 mg pills which I have not yet filled.

 

I think it would be sensible to fill the prescription for the 2mg pills. Don't worry about the cut from 5mg to 3.75mg. Ashton's protocols suggest a cut from 5mg to 4mg, so your situation is not much different. However, going forward, you might find you need those 2mg pills so that you can make smaller cuts.

 

Since you have been on Valium for a relatively short time (I assume there was no other recent bezodiazepine use), I would caution you over following an overly cautious taper plan. Benzodiazepine dependency can occur in as little as a few weeks, but this is unusual. The likelihood is that you dependency is relatively low. In you shoes, in the first instance, I think I would aim to to cut by 1mg per week, but of course if you are overly symptomatic, you would adjust your taper plan to suit. (so, down to 3mg, 2mg, 1mg, and then off).

 

I'm thinking when I get the 2 mg pills that just as a practicality I can't really take 3.75 mg Valium using 2 mg pills (that would require taking 1 and 7/8 pills).  So, seems a cut to 1 and 3/4 pills (3.50 mg Valium) would make sense.  That's a cut of .25 which is between 5 and 10 %.  Then I could continue with the 2 mg pills.

 

You could tale 3.5mg, and make 0.5mg cuts from there. Again, though, just keep an eye on the overall taper rate - there is no point in drawing out this for longer than necessary. After all, dependency develops over time, even when you are tapering.

 

Then I think: since I handled a cut of 1.25 mg, a cut of .75 mg (to 1 and 1/2 pills) should be reasonable.....  But that is 20%, clearly way over the guideline.

 

It is not very useful to think of percentages at low does. Keep the cuts smallish, but aim to get off over some weeks rather than months.

 

I guess this is everyone's struggle - wanting to have tolerable symptom level, but also wanting to get to the lower range sooner, in order to, as you say, have GABA system be able to mostly work, and recover more.

 

Yes, it is a balancing act. Adjust your taper according to how you react.

 

I think part of my question is to ask whether the lower dose / discrete progressive cut amount idea applies based on the actual dose or is more about relative dose.  That is, since I started at 5 mg not 40 mg, does that mean it somewhat faster schedule makes sense or not.  If we think what matters is purely my starting point then 20% is too much.  If we think the actual amount of Valium in my system is a factor, then perhaps 20% of 3.75 mg is not so extreme.

 

Cutting by 'discrete' amounts from a low dose is more sensible, irrespective of the dose at the start of the taper.

 

Another question would be "what's a low dose"?  Maybe the discrete thinking applies to me now, and maybe not.

 

When I used to draw up titration plans for people, I'd switch to a linear (discrete cuts) at about two pills, or one pill for a very slow taper (assuming they were using the lowest dose pill available for their particular benzodiazepine). A linear taper for Valium easily might be started at a higher dose. This is the case with Ashton's schedules.

 

In any case, Colin, you seem to have a lot of thoughts about these kinds of issues, so I would welcome your thoughts on this.

 

I'm happy to oblige, but your mileage might vary.

 

In the end I may decide based more on how I feel (anxiety etc) and what activities and tasks I need to manage (e.g. I have a dental appointment next week.). I may make another cut at the end of this week, or I may not.

 

All reasonable considerations.

 

This whole process is new to me and wildly anxiety provoking to say the least!

 

Thanks again for your comments which I quoted above.

 

Unless you already have experience that informs you otherwise, your expectation should be that you can taper off with relatively few problems.

 

Good luck.

[[Co...]]

It is the same with me as it is for WWWI´s, there is just NO WAY i could get away with making bigger cuts.

 

For me a big cut would be like signing up for a huge panic attack, followed by a week or more of severe morning adrenaline and LOTS of fear...

 

No thank you, been there, done that.

 

What i see so many times is that those that taper faster via the cut and hold method create many back log "waves" that often continue post taper... show me ANYONE on the site that was withdrawal free after a couple of months using Ashton, or even close to it.

 

At least with tiny daily cuts, one can take time out and recharge... some larger cuts seem to put some in a bad place and that can often be hard to get out of...

 

If i cut bigger, every cut would shock my nervous system and create a lasting trauma, the last big cut i took left me in a state for months and it was not even a big cut.

 

Lord knows what a bigger cut would do, i don´t even want to go there.

 

From what i have seen on here, any taper lasting less than a year has not been an easy recovery post taper.

 

ALL the years of suffering on here are a result of CT, rapid tapers and high jumps... why do it?

 

Oscar

 

Oscar,

 

If this slow taper plan works for you, good for you. I just wish to curtail the expectation by members that they need or should taper off very slowly (many months or years to quit a small dose of Valium). There should be no expectation of this. Most people can taper off as per Ashton or faster (though not necessarily by a typical member of our self-selecting group).

[[Co...]]

Hi Colin

 

Last night I added up how long it has taken me to taper 1 mg of Valium and that is doing a daily cut of .02 mg mostly with .01 mg and some days of holding and it took me 62 days. At this rate is it deemed as to taking to long. Because as no doubt many others may also would like to know. When I spoke to hubby about doing a cut and hold for 1-2 weeks and dropping 1 mg, his reply was are you mad, you know hat happened when you stopped your tablets. Mind you I did stop 10 mg of Nitrazepam, so a lot more than 1 mg.

 

 

Thank you

DD

 

I would not tell you that it is taking you 'too long'. I am just trying to prevent seeds being planted that suggest that tapering off at incredibly slow rates is somehow optimal. The optimal rate of withdrawal is the fastest one that can be reasonably achieved without causing intolerable withdrawal symptoms. There will be great variability in this, but most people can taper off as per Ashton's protocols or faster. If you need to take it more slowly, so be it.

[[...]]

Thanks Colin

 

One final question if I may as I know you are busy, if and it is a if I choose to taper quicker than I am doing.

 

1. Now that I am at 2 mg as of last night. how long do I hold before I cut to 1 mg and then what happens when I get to 1 mg is that is that it no more I guess, and this could be done in a space of a month that is if I was to hold for 2 weeks before cutting.

 

2. alternative cut more daily instead of cutting .02 increase that up to say .05 mg, I am getting hit now with the doses that I am doing at present, surely dropping more either way is going to cause me worse w/d sxs.

 

DD

[Guest [...]]

Thanks for all these explanations, Colin. I have just read through this whole thread. Your opinions have validated many of my thoughts about the illogical nature of, dare I say it, 'microtapering'. You have covered all the things that bothered me like exact measurement, interaction with other foods, time of taking doses etc.

 

You are so knowledgeable and sensible about all this. I am so glad I happened upon the thread as I am just about to embark on a second taper - this time directly from 1mg Xanax. I previously crossed from 4-5mg Xanax over to Valium and spent a difficult year getting down to 1mg and chucking it in because I was exhausted and sick of being sick.

 

I see that you withdrew from 4.5mg Clonazepam in 6 months all those years ago. How were you straight after? Did it take a long time to get back to 'normal'?

 

I realise you have probably written about this elsewhere. I am just curious.

 

Xana

[[Co...]]

Thanks Colin

 

One final question if I may as I know you are busy, if and it is a if I choose to taper quicker than I am doing.

 

1. Now that I am at 2 mg as of last night. how long do I hold before I cut to 1 mg and then what happens when I get to 1 mg is that is that it no more I guess, and this could be done in a space of a month that is if I was to hold for 2 weeks before cutting.

 

You would cut when you feel ready - I cant be more specific than this. You might cut by 0.5mg instead. Or you might even titrate as you have been doing. If you titrate, just keep an eye on the overall taper rate.

 

2. alternative cut more daily instead of cutting .02 increase that up to say .05 mg, I am getting hit now with the doses that I am doing at present, surely dropping more either way is going to cause me worse w/d sxs.

 

This is probably with experimenting with. There is no pharmacologic reason for you to expect to  have to taper 1mg over a couple of months. However, there are psychological reasons why you might benefit from this. Feeling 'comfortable' with what you are doing is important too. Please understand, I am not telling anyone what they 'should' do.

[[Co...]]

I realise you have probably written about this elsewhere. I am just curious.

 

Xana

 

Check out the link in my signature line. It is terribly out of date - I am a lot better now.

[[Ho...]]

Thanks Colin

 

One final question if I may as I know you are busy, if and it is a if I choose to taper quicker than I am doing.

 

1. Now that I am at 2 mg as of last night. how long do I hold before I cut to 1 mg and then what happens when I get to 1 mg is that is that it no more I guess, and this could be done in a space of a month that is if I was to hold for 2 weeks before cutting.

 

You would cut when you feel ready - I cant be more specific than this. You might cut by 0.5mg instead. Or you might even titrate as you have been doing. If you titrate, just keep an eye on the overall taper rate.

 

2. alternative cut more daily instead of cutting .02 increase that up to say .05 mg, I am getting hit now with the doses that I am doing at present, surely dropping more either way is going to cause me worse w/d sxs.

 

This is probably with experimenting with. There is no pharmacologic reason for you to expect to  have to taper 1mg over a couple of months. However, there are psychological reasons why you might benefit from this. Feeling 'comfortable' with what you are doing is important too. Please understand, I am telling anyone what the 'should' do.

 

I think Colin meant: Please understand, I am not telling anyone what they 'should' do.

[[...]]

Thanks Hope

 

I did realise what Colin was saying

 

Thanks Colin.

 

DD