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Taking multiple psych drugs? Which drug to taper first?


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#1 Altostrata

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Posted 04 May 2012 - 10:34 AM

ADMIN NOTE This topic is a general discussion about how to decide which drug to taper first. For case-by-case consideration of what YOU should do, please put your questions in an Introductions topic.
 
Do not put those questions in this topic, because detailed discussion of YOUR particular circumstances will take it off track and make this topic difficult for others to follow. The moderators will move any questions about YOUR particular case to the Introductions forum. Thank you.
 

 

Polypharmacy complicates tapering. Which drug to taper first?

Consider discussing the following considerations with your doctor.

 

You are having adverse effects from one or more of the drugs

  • Put ALL the drugs you take in the Drug Interactions Checker at http://www.drugs.com...teractions.html.
  • Sometimes it's clear one drug is causing problems. You might consider tapering that drug first.

Any drug causing a serious life-threatening adverse effect should be discontinued as soon as possible. Talk to your doctor about this immediately.

 

"Accelerators" and "brakes"
If no one drug is clearly causing an adverse effect, "discontinue the more activating drugs first," I have been advised by a doctor who studies withdrawal syndromes and iatrogenic damage.

 

Antidepressants and ADHD drugs (most are amphetamine analogs) tend to be activating drugs, causing jitteriness, anxiety, or sleeplessness.

 

Benzodiazepines, the "Z" drugs for sleep, anticonvulsants (such as lamotrigine), Lyrica, gabapentin (Neurontin), and antipsychotics tend to be regulating or sedating drugs, causing drowsiness, sluggishness, or dopiness.

 

The two types of drugs can be thought of as "accelerators" and "brakes."

 

Many people have a sedating drug -- a brake -- added to an activating drug -- an accelerator -- to treat drug-induced anxiety or sleep problems.

 

In those cases, unless you are having clear adverse reactions from a particular drug, taper the antidepressant or stimulant first. Otherwise, you will experience activation from the other drug as you decrease the "brake."

 

"Brakes" may temper withdrawal symptoms

The most common and significant antidepressant withdrawal symptoms are nervous system activations (indicating a too-fast taper): hyper-alerting, sleeplessness, abnormal anxiety, agitation, etc.

Withdrawal sleeplessness is a symptom you want to avoid. It makes tapering much harder and post-withdrawal syndrome more difficult to recover from.

If you reduce the accelerator while taking a sedating drug, the sedating drug may help alleviate the activation of withdrawal. You may plan to taper the sedating drug later.

BUT -- Don't add a "brake" to your cocktail to prepare for withdrawal
Do not increase your risk of neurological damage by increasing your polypharmacy. Adding drugs may conflict with a drug you're already taking.

The sedating drugs also will need tapering, and can incur a withdrawal syndrome of their own.

THE PROPER WAY TO MINIMIZE WITHDRAWAL EFFECTS IS TO TAPER AT A SLOW ENOUGH RATE FOR YOUR NERVOUS SYSTEM.

Benzos are addicting! Why not quit the benzo first?
Yes, benzos are defined as truly addicting drugs. But when it comes to withdrawal, the physical dependency incurred by other psychiatric drugs makes the concept of "addiction" moot.

Psychiatric drugs that are technically non-addicting can be just as hard to go off, and some cause much more physical damage than benzos.

I am not minimizing at all the difficulty of a benzo taper or the seriousness of benzo dependency. We are in the disgusting situation of always having to evaluate the least bad choice. I know many people are anxious to get off benzos once they find they're addicted, but even though ADs are not technically addictive, severe antidepressant withdrawal syndrome is just as bad.

When you are taking an antidepressant and a benzo, if you are not having significant adverse effects from the benzo, consider tapering the antidepressant first for these reasons:

  • Antidepressants are activating while benzos are sedating. The action of the benzo can soften the suffering from antidepressant withdrawal symptoms.
  • Conversely, a concurrent antidepressant will not reduce withdrawal symptoms during a benzo taper. With all due respect, Prof. Heather Ashton's suggestion antidepressants might help is misguided, see http://survivinganti...dpost__p__14205

    In Dr. Stuart Shipko's e-book Xanax Withdrawal (2012), he addresses the Ashton Manual's apparent recommendation of antidepressants to counter benzo-withdrawal depression, see http://survivinganti...dpost__p__28759
  • Often, benzos are prescribed to cover up adverse effects, such as anxiety, insomnia, and akathisia, from an antidepressant. When you remove the benzo, the antidepressant's adverse effects come to the forefront. You then may be in such distress, it is difficult to taper the antidepressant slowly enough to forestall severe withdrawal symptoms.
  • Benzo withdrawal before antidepressant withdrawal increases the risk of a difficult antidepressant withdrawal.

    Going into an antidepressant taper with GABA downregulated by prior benzo withdrawal is a very perilous strategy. Your nervous system will need GABA to deal with antidepressant withdrawal symptoms.

    You may more easily control an antidepressant taper. Fast recovery from antidepressant withdrawal will enable you to tackle your benzo taper.

    The people who have the worst withdrawal syndrome are those suffering from both benzo withdrawal and antidepressant withdrawal, because two systems -- serotonin and GABA -- that might help them recover are not functioning due to downregulation.
  • If you have already done the hard work of getting off a benzo and then suffer severe withdrawal syndrome from the antidepressant, you are faced with the decision of whether or not to get on the benzo merry-go-round again.

    Many doctors treat antidepressant withdrawal symptoms with benzos, although that brings in a whole other set of problems, which you know well. Still, many people can't get through withdrawal without an occasional benzo dose. Consider using benzos very, very sparingly.

And then there are antipsychotics...
To make this a little more confusing, if you are taking an antipsychotic, e.g. Seroquel or Risperdal, you may wish to discontinue that first, because of serious adverse health effects from antipsychotics, such as diabetes.

However, if you're taking an antipsychotic to counter an adverse effect of an antidepressant, such as sleeplessness or agitation, you may want to discontinue the antidepressant first.

Conceivably, one might systematically lower the antidepressant part way, then lower the antipsychotic. If sleep doesn't break up, continue to get off the antipsychotic. If it breaks up, stop lowering the antipsychotic, stabilize, and lower the antidepressant, managing the tapers in a way that preserves sleep.

Before tapering, be sure to discuss the above with your knowledgeable medical caregiver.


Edited by Altostrata, 27 June 2015 - 04:34 PM.
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#2 Nikki

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Posted 04 May 2012 - 01:52 PM

I know people who are on cocktails of meds, and not feeling any better. From the knowledge I gained here I really see how dangerous these cocktails are. These doctors will take a patient off of one & immediately start another. When the patient complains they aren't responding the doctor's never really seem to realize that the poor patient is in WD from the pill they just took them off. I can also see how, over time, there really is a sensitivity which develops, rendering the meds ineffective... Alto this site will be up for years with people being prescribed these cocktails.... Hugs

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at Pharmacies GSK halted deliveries

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Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine


#3 alexjuice

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Posted 04 May 2012 - 07:44 PM

I endorse. It's sometimes said that benzo folks recommend benzo taper first without disturbing other meds, while AD folks promote the converse. But, from my personal experience, it's not a you say tomAto, I say tomato. If there is rationale behind the "taper the benzo first" course, I don't know the basis for it. If I could do it again, I'd taper slower and delay the benzo. Alex

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#4 alexjuice

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Posted 04 May 2012 - 08:26 PM

I'd add one thing. IMO, id advise an exception to the taper inversely to the level of stimulation. Atypical antipsychotics are sedating but I would taper an atypical first because of the risk profile. The atypicals are especially, from my experience, observation and correspondence with clinicians, nasty.

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#5 Skyler

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Posted 05 May 2012 - 05:17 AM

Hi Alto, this is great, but given anecdotal reports, I'm wondering where in this pecking order anti-convulsants fall. They can take the edge off benzo withdrawal, so can have a legitimate role when prescribed judiciously and in low doses? There is art in knowing how to withdraw when drug cocktails are prescribed. Thanks.. you are Aces as usual.~S

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.

 

Requip - 3/16 ZERO  Total time on 25 years.

 

Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.

 

Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin

 

 


#6 Altostrata

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Posted 05 May 2012 - 11:42 AM

Excellent point, Schuyler. The anticonvulsants are on the sedating side. If they can help benzo withdrawal symptoms, they should be tapered last -- if they are not causing adverse effects. alex, you have a good point too. One doesn't want to stay on an antipsychotic any longer than necessary. But they tend to be sedating, if not stupefying. If you're taking Seroquel to sleep, for example, you'll want to lower the antidepressant first. It's all a big tangle. I sure wish doctors would deal with this.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#7 alexjuice

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Posted 05 May 2012 - 03:40 PM

Agreed. A dose of seroquel directed at 'psychosis' (600-1200+mg) poses entirely different risk than one directed at sleep disturbance (50mg, maybe 100). It *is* a tangle, in so many ways. It's such a tangle these protocols and parameters are not standardized in the profession. It is an embarrassment (yet again) to psychiatry and pharma-psych that we, the patient aftermath, must use our time, effort, resources to define algos for de-Drugging and managing withdrawal risk. I feel doubtly insulted, like I've been shot and tossed into a big room with hordes of other gunshot victims and we're all just supposed to put our heads together and decide how best to remove the bullet, treat the wound and prevent further injury. It's a massive injustice. Everyday, though, someone (like me in 04) goes back on meds or back on meds plus more meds because an ill-informed attempt at discontinuation and subsequent w/d is misinterpreted as confirmation of psychiatric illness or even revealing new and additional diagnoses. At least this site is rising in search and other cracks are forming in the dam. Hoping for fewer me's in the future. Also, nobody, especially someone under 25 should be on the lg doses of the antipsychotics. I watch people in meetings and think of my own life. I got two emails in a short span from the NAMI-affiliated clubhouse here in town. Two needlessly overmedicated people, friends of mine from there, are dead. One girl committed suicide about 6 weeks ago. The second email came last week, another man took his life. It just pisses me off. Alex

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#8 Skyler

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Posted 06 May 2012 - 12:49 PM

Antidepressants and ADD drugs (methamphetamine analogs) are activating drugs. Benzodiazepines, the "Z" drugs for sleep, anticonvulsants, Lyrica, gabapentin (Neurontin), etc. are sedating drugs.


How long can after discontinuation may lamactil still help after a person stops taking an ADs? For example, a 2 months out, 4, 10? Do benzos have the same sort of window for post discontinuation use? I'm reading about someone now who is suffering after 18 months off. Why Lamactil as opposed to Lyrica, neurontin etc., do the latter work as well? Do the type of symptoms someone is exhibiting have any bearing on whether one of the anti-convulsants are prescribed?

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.

 

Requip - 3/16 ZERO  Total time on 25 years.

 

Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.

 

Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin

 

 


#9 Altostrata

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Posted 06 May 2012 - 01:09 PM

Any of the anticonvulsants, including benzos, may help reduce prolonged withdrawal symptoms, but each drug carries its own risks, including triggering hyper-reactivity and paradoxical reactions. They are helpful because they reduce nervous system activity, in different ways. For example, benzos ramp up the GABA system, the body's natural regulatory (dampening) mechanism. However, they might do this too strongly, causing the body's alerting system set up an alarm, and they tend to weaken the native regulatory system, causing dependency.

 

Lamictal (lamotrigine) is unique in that it targets glutamatergic transmission in the alerting system, dampening that type of alerting. It does not downregulate GABA receptors.

 

Lyrica and Neurontin affect the GABA system in a different way than benzos.

 

While doctors may throw anticonvulsants at withdrawal symptoms, mostly going after the anxiety, so few doctors know anything about withdrawal syndrome, not much is known about what drugs are appropriate for what kind of withdrawal syndrome, or how to dose them.

 

From my observation, there definitely do seem to be a few types of withdrawal syndrome. The most common is based on hyper-alerting. Another is more like fibromyalgia and hyper-sensitivities. A third seems to trigger possibly pre-existing borderline auto-immune conditions.


Edited by Petu, 16 January 2014 - 03:19 AM.
fixed text

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#10 Rhiannon

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Posted 07 May 2012 - 11:06 AM

I'd add one thing. IMO, id advise an exception to the taper inversely to the level of stimulation.

Atypical antipsychotics are sedating but I would taper an atypical first because of the risk profile. The atypicals are especially, from my experience, observation and correspondence with clinicians, nasty.

Yep I would have to agree with this. ADs are actually more toxic than benzos, another reason to taper the AD first, but the antipsychotics are extremely toxic and cause high risk for other health complications which may not be easily reversible. I would be inclined to say, taper the most dangerous drug first.

Also want to add that there are exceptions to every rule, and there may be times when a person needs to taper their benzo first due to other issues they're having (such as paradoxical reaction to the benzo, health complications caused by the benzo, or work issues where excess sedation or problems with memory are a big problem).

However, I concur that in the absence of complicating factors, tapering the AD first makes the most sense.

Another possibility is to taper the AD to a lower dose, then taper the benzo for a while to a lower dose, then return to the AD taper. There would need to be breaks between the tapers to allow for healing and adaptation; this wouldn't be a fast process. But it might be an alternative for someone who needs to get off the benzo due to other factors.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

Now:                43                    0.625                 0.0775            1.3

 

I'm not a doctor. Any advice I give is just my civilian opinion.


#11 Rhiannon

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Posted 07 May 2012 - 11:16 AM

Want to add something else: If you've been on a benzo for a while, its sedating effects aren't really going to help you with AD withdrawal. The sedating effect of a benzo goes away as tolerance develops, which happens pretty quickly (in a matter of four to eight weeks). After that the only thing the benzo is really doing is preventing withdrawal symptoms. This isn't the case if you just take the benzo intermittently. If you take it intermittently enough that you don't develop tolerance, then you will get sedative effects from it. I still concur that it's best to taper the AD first, though, because ADs don't seem to stop being activating over time, and if you're tapering a benzo the last thing you need is to be taking a drug that's stimulating.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

Now:                43                    0.625                 0.0775            1.3

 

I'm not a doctor. Any advice I give is just my civilian opinion.


#12 Annie3

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Posted 07 May 2012 - 03:03 PM

Great topic. I have been following a benzo site and they say to taper the Benzo first, but this makes sense to taper the AD first. I think the reasoning behind tapering the benzo first is because the AD might help with the anxiety and depression brought on by benzo withdrawal, but the benzos can help with the anxiety and insomnia in AD w/d. In my case I started taking benzos everyday because of AD withdrawal until tolerance started and i upped the dose and then it went paradoxal on certain high doses. I have to admit after reading horror stories on benzo withdrawal it scares me to stay on them longer, but in the end it may be better.

1998-2013 Various antidepressants switches and CTs.

Benzo addiction unknowingly trying to cover withdrawals in 2011

January 2012,, 25 mg Zoloft , March 2012, Remeron 7.5 to sleep and 1 mg Clonazepam.

Tapered Clonazepam from April to June 2012 from 1 mg to .25 mg (stuck)

September to October 2012 tapered Remeron 7.5 mg to 5 mg. December upped to .75 mg Clonazepam due to mothers passing of cancer.

February 2013 to December 2013 tapered off 25 mg Zoloft

January 2014 to March 2014 tapered off 5 mg Remeron Doing not to bad, not perfect but okay. Here is where I screw up May 2014 to October 2014 tapered Clonazepam from .75 mg to .25 mg. Rapidly worsening every week. January 2015 updosed Clonazepam to .5 mg. Big Mistake - Holding

Currently .25 mg  Clonazepam 11 pm at night (give or take an hour)  and .25 mg 9 am in the morning (give or take an hour)

Hope this isn't to confusing.


#13 Altostrata

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Posted 07 May 2012 - 05:42 PM

the AD might help with the anxiety and depression brought on by benzo withdrawal

I know the benzo sites are saying this, but it is untrue.

It probably comes from Ashton, who didn't understand antidepressant withdrawal at all. She might have thought AD withdrawal is like relapse. Anxiety and depression are only one facet of AD withdrawal syndrome, as so many of us have found out. The surges of hyperalerting and sleeplessness are probably the most destructive AD withdrawal symptoms.

Even if you don't feel the sedative effects of a benzo you've been taking, it is dampening some reactions in your body, which can come in handy during AD withdrawal.

If the benzo has gone paradoxical, its dosage must be reduced. A paradoxical response to benzos is as bad as hyperalerting from antidepressant withdrawal. The alerting system is something you do not want to go haywire.

In case anyone has misinterpreted the first post, I want to emphasize it is only about polypharmacy, where you've already been taking several drugs for a while and you may be physically dependent on all of them.

While some people find they need an occasional benzo to get through antidepressant withdrawal, I am not advocating ADDING any kind of sedating-type drug to your drug regimen in order to make antidepressant withdrawal easier. This won't work; you'll just end up dependent on all of them and multiplying your withdrawal problems.

IF YOU ARE IN THE MIDDLE OF TAPERING do NOT count on adding a drug to make withdrawal symptoms more tolerable. If you are already having withdrawal symptoms, the addition of any other neuroactive drugs could make it worse.

 

If possible, deal with withdrawal symptoms during a taper by slowing the taper or updosing slightly.

You have much more control over a slow taper than you would have depending on a benzo to control your symptoms.


Edited by Altostrata, 06 February 2015 - 01:28 PM.
clarification

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#14 alexjuice

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Posted 07 May 2012 - 06:03 PM

Want to add something else: If you've been on a benzo for a while, its sedating effects aren't really going to help you with AD withdrawal. The sedating effect of a benzo goes away as tolerance develops, which happens pretty quickly (in a matter of four to eight weeks). After that the only thing the benzo is really doing is preventing withdrawal symptoms.

Hey Rhi,
This bit is confusing to me. You mean continuining on a benzo prevents symptoms that would occur if the benzo itself is removed/reduced? That after a few weeks the benzo wouldn't ameliorate AD withdrawal symptoms? Reading you right?

Alex

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#15 Barbarannamated

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Posted 07 May 2012 - 06:14 PM

Sedating vs anxiolytic effects, possibly? I've been taking Klonopin 1mg qhs for bruxism since 1995ish and it still seems to help. When i miss it or use generic, i wake with terrible facial pain/headache.
Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

#16 alexjuice

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Posted 07 May 2012 - 06:18 PM

ADs are actually more toxic than benzos, another reason to taper the AD first, but the antipsychotics are extremely toxic and cause high risk for other health complications which may not be easily reversible. I would be inclined to say, taper the most dangerous drug first.

Last March when I first lost my lunch and things got really bad, I spoke with a Whitaker-friendly doctor, from Advocates in Framingham, MA and the faculty at Harvard med school.

He didn't understand protracted withdrawal at that time, however he felt taking the psych drugs presented horrific risks. When I told him I was off Effexor and Riperdal but not yet off the benzos, he told me that I'd wisely "gotten off the most dangerous ones" and he further advised to return to the benzo dose before my collapse and recommended I jut sit tight for another 1-2 years.

At the time, I was surprised how little he understood withdrawal. I'd been off Effexor and Risperdal for 12 months and he felt that, in spite of my poor health, I'd jumped that hurdle already.

So to your point, this doctor agreed. he categorized both ADs and atypicals as worse than benzos from a health consequence/risk perspective, independent of withdrawal.

I felt, nd continue to feel, that high therapeutic dose of ny atypical antipsychotic presents the worst health risk, disproportionately greater thaattune syndromes they mean to """treat"""". I think we all agree that the widespread writing of antipsychotics, prescribed so often to the downtrodden and young, is an abominable tragedy.

Alex

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#17 Skyler

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Posted 08 May 2012 - 05:18 AM

ADs are actually more toxic than benzos, another reason to taper the AD first, but the antipsychotics are extremely toxic and cause high risk for other health complications which may not be easily reversible. I would be inclined to say, taper the most dangerous drug first.


I did not know this before coming to this site, but the side effect profile from ADs is worse than benzos. The benzo forum I was on inadvertently supported the idea that benzos are the devil reincarnate.. that every ill stems from side effects.. this would lead to the faulty notion that one type of withdrawal is worse than another. When you are in withdrawal, all are horrible.

Want to add something else: If you've been on a benzo for a while, its sedating effects aren't really going to help you with AD withdrawal. The sedating effect of a benzo goes away as tolerance develops, which happens pretty quickly (in a matter of four to eight weeks). After that the only thing the benzo is really doing is preventing withdrawal symptoms.


I'm confused here.. I agree with what Rhi is saying, but Alto, are you referring to something else here, that there are non sedating effects from benzos that may cover some AD side effects? To put it another way, the action of benzos on neuroreceptors mitigate some of the withdrawal effects from GABA? So the clinical effects of benzos are not the reason you say this?

Do NOT add Lamictal. Do NOT add Seroquel. Do NOT add Topamax. Do NOT add Lyrica. Do NOT add Neurontin. If you are already having withdrawal symptoms, the addition of any other neuroactive drugs could make it worse.


I thought that in some very difficult instances anticonvulsants may help withdrawal and this was why you were put on this?

Also, I'm still unclear as to whether there is any rule of thumb about reinstatement for ADs, e.g if someone is off ADs for 2 months, after ct or too quick a withdrawal, they could reinstate ADs at a judicious dose. But if someone has been off for 6 months, it might be too late for reinstatement to help?

Alex, antipsychotics, aka the major tranquilizers make me cringe. I've seen their devastation in my family, they are truly and awsomely bad. Adjectives are insufficient. Carnage.

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.

 

Requip - 3/16 ZERO  Total time on 25 years.

 

Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.

 

Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin

 

 


#18 Altostrata

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Posted 08 May 2012 - 10:07 AM

Schuyler, thanks for asking for clarification. I've edited my post above to say:

IF YOU ARE IN THE MIDDLE OF TAPERING Do NOT add Lamictal. Do NOT add Seroquel. Do NOT add Topamax. Do NOT add Lyrica. Do NOT add Neurontin. If you are already having withdrawal symptoms, the addition of any other neuroactive drugs could make it worse.

You have much more control over a slow taper than you would have depending on a benzo to control your symptoms.


If you have prolonged withdrawal symptoms after you finish your tapering, you'll have to be very, very careful adding any of the sedating drugs, including benzos, to deal with your symptoms. So few doctors understand how to do this, I cannot recommend it as something to do as a matter of course. If you try a very low dose of lamotrigine, for example, you'll be experimenting on your own.


Let me explain further:

I'm not saying benzo withdrawal is going to be easier than antidepressant withdrawal. The withdrawal symptoms are very similar. What I'm saying is don't further destabilize the GABA system with benzo withdrawal before antidepressant withdrawal, or you'll have double trouble.

The GABA system and the serotonin system help keep the nervous system in balance. They both help regulate the alerting system. Benzos produce similar withdrawal symptoms because when the GABA system is knocked out from being downregulated by the drug, the alerting system takes over in this situation, too.

(I've had my problems with benzos, too. In my case, I had severe AD withdrawal and tiny doses of the benzos went paradoxical fairly quickly. It was horrible and just about destroyed my nervous system.)

Bringing in antidepressant withdrawal symptoms in the context of GABA destabilization is the worst scenario. Both GABA and serotonin is downregulated. There are no brakes at all on the alerting system.

Even if someone has reached tolerance on the benzo, the GABA system is still stable. It is still working to suppress some activities in the nervous system, even if the person can't feel it. If the person is suffering adverse effects from the benzo at this point, I agree the benzo should be very carefully eliminated.

In my opinion (and that of an informed doctor), carefully reducing the more activating drugs first, minimizing nervous system dysregulation in that process, is preferable to reducing the activating drugs in the context of GABA downregulation, which is what you'd have if you reduce the benzo first.

It's true benzos are technically addicting, which makes being dependent on them scary and stigmatizing, and antidepressants are technically not addicting, a definition engineered by pharma that has been a big selling point for them. But the difference between benzo dependency and antidepressant dependency is largely semantic. In the body, one dependency is not worse than the other.

These are all terrible choices! I'm very angry that medicine forces us to make them on our own.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#19 Rhiannon

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Posted 08 May 2012 - 10:45 AM


Want to add something else: If you've been on a benzo for a while, its sedating effects aren't really going to help you with AD withdrawal. The sedating effect of a benzo goes away as tolerance develops, which happens pretty quickly (in a matter of four to eight weeks). After that the only thing the benzo is really doing is preventing withdrawal symptoms.

Hey Rhi,
This bit is confusing to me. You mean continuining on a benzo prevents symptoms that would occur if the benzo itself is removed/reduced? That after a few weeks the benzo wouldn't ameliorate AD withdrawal symptoms? Reading you right?

Alex


This is my understanding based on what I've read. When we take benzos regularly, the body fairly quickly alters its GABA system (and other benzo receptors presumably, because they don't just act on GABA) to adapt to the benzo in the body.

When people in studies are given benzos for anxiety, at first they experience a reduction in anxiety compared to placebo, but after a few weeks the anxiety actually begins to increase relative to placebo. At the end of the study they don't seem to be getting any actual effect from the benzos any more, as far as the anxiety is concerned, relative to placebo. Once taken off the benzo at the end of the study the anxiety skyrockets to a level higher than it was before the study began.

Now, admittedly this is not nearly enough information to say "benzos do nothing at all once you develop tolerance to them, which happens in a few weeks time". I don't actually know what they're doing in all the body systems they affect. There are apparently benzo receptors in every cell in the body (in the mitochondria) and all kinds of GABA involvement in regulating pretty much everything. And that's just the limited amount that I actually know about.

What I think I can say with some confidence, though, is that the thing they do MOST is prevent the train wreck that would happen if they were suddenly removed.

Agree 100% that the last thing you need when you're trying to taper an AD is an already-wrecked GABA system from benzo withdrawal. Unless there are other complicating factors, tapering the AD first makes more sense to me than tapering the benzo first.

I disagree with Ashton on this and a few other points. She has a great deal of experience working with benzo withdrawal and her work is immensely important. But she did most of her work in the 80's and 90's before our current understanding of neuroplasticity. I get the impression she doesn't know much about ADs and what they really do to us. She's retired now--I think she's in her 80s or so--and I suspect that if she were more actively involved in current research she would not endorse ADs at all. I could be wrong. But she's human and I don't think she's infallible.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

Now:                43                    0.625                 0.0775            1.3

 

I'm not a doctor. Any advice I give is just my civilian opinion.


#20 Skyler

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Posted 08 May 2012 - 11:19 AM

Do NOT add Lamictal. Do NOT add Seroquel. Do NOT add Topamax. Do NOT add Lyrica. Do NOT add Neurontin. [color="#8B0000"][b]If you are already having withdrawal symptoms, the addition of any other neuroactive drugs could make it worse.

Much better.. what a turn of phrase can do. Thanks

So few doctors understand how to do this, I cannot recommend it as something to do as a matter of course. If you try a very low dose of lamotrigine, for example, you'll be experimenting on your own.

I wondered if this was the reason. The art of tapering is Neanderthal.

(I've had my problems with benzos, too. In my case, I had severe AD withdrawal and tiny doses of the benzos went paradoxical fairly quickly. It was horrible and just about destroyed my nervous system.)

Sorry to hear that. Short of anti-psychotics, you got slammed with about everything in the cupboard.

It's true benzos are technically addicting, which makes being dependent on them scary and stigmatizing, and antidepressants are technically not addicting, a definition engineered by pharma that has been a big selling point for them. [b]But the difference between benzo dependency and antidepressant dependency is largely semantic. In the body, one dependency is not worse than the other.

I think the only difference here is that one can get stuck on benzos faster.. but stuck is stuck, and it does not take all that long to get hooked on antidepressants either. Maybe a couple of months as opposed to a couple of weeks. Of course, to confuse, the hook time varies according to age, drug history, genes, etc.

The only question I still have is about the window for reinstatement for ADs. How long would a person need to be off before the clinical efficacy of reinstatement is not worth the risk? Given each situation is different..

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.

 

Requip - 3/16 ZERO  Total time on 25 years.

 

Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.

 

Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin

 

 


#21 Altostrata

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Posted 08 May 2012 - 03:27 PM

I think the only difference here is that one can get stuck on benzos faster.. but stuck is stuck, and it does not take all that long to get hooked on antidepressants either. Maybe a couple of months as opposed to a couple of weeks. Of course, to confuse, the hook time varies according to age, drug history, genes, etc.

That's hard to say. There are people who react so strongly to a serotonergic, within a few doses their nervous systems are dependent -- and they are suffering severe adverse effects. These people have withdrawal syndrome-like nervous system dysfunction when they quit, which may be after only a few days.

I believe the literature says antidepressant withdrawal symptoms are a risk after taking a medication for 60 days.

The only question I still have is about the window for reinstatement for ADs. How long would a person need to be off before the clinical efficacy of reinstatement is not worth the risk? Given each situation is different..

Unfortunately, this is unpredictable. Certainly reinstatement is more likely to work when it's done as soon as possible, within a few weeks or perhaps months. However, some people find reinstatement works after a much longer time while others find it doesn't work at all, or makes symptoms worse.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#22 Annie3

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Posted 08 May 2012 - 07:35 PM

Schuyler, thanks for asking for clarification. I've edited my post above to say:


IF YOU ARE IN THE MIDDLE OF TAPERING Do NOT add Lamictal. Do NOT add Seroquel. Do NOT add Topamax. Do NOT add Lyrica. Do NOT add Neurontin. If you are already having withdrawal symptoms, the addition of any other neuroactive drugs could make it worse.

You have much more control over a slow taper than you would have depending on a benzo to control your symptoms.


If you have prolonged withdrawal symptoms after you finish your tapering, you'll have to be very, very careful adding any of the sedating drugs, including benzos, to deal with your symptoms. So few doctors understand how to do this, I cannot recommend it as something to do as a matter of course. If you try a very low dose of lamotrigine, for example, you'll be experimenting on your own.


Let me explain further:

I'm not saying benzo withdrawal is going to be easier than antidepressant withdrawal. The withdrawal symptoms are very similar. What I'm saying is don't further destabilize the GABA system with benzo withdrawal before antidepressant withdrawal, or you'll have double trouble.

The GABA system and the serotonin system help keep the nervous system in balance. They both help regulate the alerting system. Benzos produce similar withdrawal symptoms because when the GABA system is knocked out from being downregulated by the drug, the alerting system takes over in this situation, too.

(I've had my problems with benzos, too. In my case, I had severe AD withdrawal and tiny doses of the benzos went paradoxical fairly quickly. It was horrible and just about destroyed my nervous system.)

Bringing in antidepressant withdrawal symptoms in the context of GABA destabilization is the worst scenario. Both GABA and serotonin is downregulated. There are no brakes at all on the alerting system.

Even if someone has reached tolerance on the benzo, the GABA system is still stable. It is still working to suppress some activities in the nervous system, even if the person can't feel it. If the person is suffering adverse effects from the benzo at this point, I agree the benzo should be very carefully eliminated.

In my opinion (and that of an informed doctor), carefully reducing the more activating drugs first, minimizing nervous system dysregulation in that process, is preferable to reducing the activating drugs in the context of GABA downregulation, which is what you'd have if you reduce the benzo first.

It's true benzos are technically addicting, which makes being dependent on them scary and stigmatizing, and antidepressants are technically not addicting, a definition engineered by pharma that has been a big selling point for them. But the difference between benzo dependency and antidepressant dependency is largely semantic. In the body, one dependency is not worse than the other.

These are all terrible choices! I'm very angry that medicine forces us to make them on our own.

I am in a bit of a dilemma. I think I am in prolonged withdrawal, just realizing this now even though I am on 25 mg Zoloft. I am also going through benzo withdrawal. I knew nothing about any kind of withdrawal problems or dependence last summer when this all started. If I could only turn back time....sigh..... I decided to halt my benzo taper for awhile until I figure out what to do next. I am unsure if i should stabilize on the benzo....if I can for a few months and then taper Zoloft .......or if I should continue tapering the benzo. I am scared of tolerance withdrawal since I think I was already in it when I started to taper. I don't know if I will stabilize on the Zoloft either......feeling rather crazy right now. Any suggestions? I know this is my own issue to decide, but I am so confused right now and could use some advice and support. My last doc told me to just quit the Zoloft ct as I was on such a low dose. I know that doesn't work. Thank you everyone.

1998-2013 Various antidepressants switches and CTs.

Benzo addiction unknowingly trying to cover withdrawals in 2011

January 2012,, 25 mg Zoloft , March 2012, Remeron 7.5 to sleep and 1 mg Clonazepam.

Tapered Clonazepam from April to June 2012 from 1 mg to .25 mg (stuck)

September to October 2012 tapered Remeron 7.5 mg to 5 mg. December upped to .75 mg Clonazepam due to mothers passing of cancer.

February 2013 to December 2013 tapered off 25 mg Zoloft

January 2014 to March 2014 tapered off 5 mg Remeron Doing not to bad, not perfect but okay. Here is where I screw up May 2014 to October 2014 tapered Clonazepam from .75 mg to .25 mg. Rapidly worsening every week. January 2015 updosed Clonazepam to .5 mg. Big Mistake - Holding

Currently .25 mg  Clonazepam 11 pm at night (give or take an hour)  and .25 mg 9 am in the morning (give or take an hour)

Hope this isn't to confusing.


#23 Altostrata

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Posted 09 May 2012 - 04:45 PM

Annie, as I've posted in your topic several times: In my opinion, stop tapering the benzo and the Zoloft. Stabilize, then taper Zoloft. Taper the benzo later. Some of us doubt there is such a thing as benzo tolerance withdrawal. See the discussion starting here http://survivinganti...dpost__p__19152
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#24 Skyler

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Posted 09 May 2012 - 11:48 PM

Annie, as I've posted in your topic several times: In my opinion, stop tapering the benzo and the Zoloft. Stabilize, then taper Zoloft. Taper the benzo later.

Some of us doubt there is such a thing as benzo tolerance withdrawal. See the discussion starting here http://survivinganti...dpost__p__19152


Hi Annie.. the link goes thru to my thread. I was on the bitter end of a 2 year taper off clonopin/diazepam structured for me on one of the major benzo forums. The issue of tolerance withdrawal is discussed from every conceivable angle.. I've been holding at 1 mg of diazepam since 4/16, and will be doing so for the foresesable future. I came to agree with Alto and Rhi, and believe that what is taken for tolerance withdrawal is actually lag time catching up.

Ohhh, I surely was something of a crumdugeon. Talk about killing the messanger. :o Alto can have the patience of Job!

~S

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.

 

Requip - 3/16 ZERO  Total time on 25 years.

 

Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.

 

Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin

 

 


#25 alexjuice

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Posted 13 May 2012 - 06:20 PM



Want to add something else: If you've been on a benzo for a while, its sedating effects aren't really going to help you with AD withdrawal. The sedating effect of a benzo goes away as tolerance develops, which happens pretty quickly (in a matter of four to eight weeks). After that the only thing the benzo is really doing is preventing withdrawal symptoms.

Hey Rhi,
This bit is confusing to me. You mean continuining on a benzo prevents symptoms that would occur if the benzo itself is removed/reduced? That after a few weeks the benzo wouldn't ameliorate AD withdrawal symptoms? Reading you right?

Alex


This is my understanding based on what I've read. When we take benzos regularly, the body fairly quickly alters its GABA system (and other benzo receptors presumably, because they don't just act on GABA) to adapt to the benzo in the body.

Interesting. In November 2007 I completed a 10 day detox to stop taking benzos. I still took many other psych Rx. In November 2009, I decided to cut them all. Come May 2010 I reinstated a benzo to deal with anxiety, insomnia, hypersensitivity, etc. that began simultaneous to my d/c of Effexor and Risperdal, a connection unnoticed by my then-treating shrink. Almost immediately, I found a large degree of relief from the w/d symptoms with only the hypersensitivity remaining. By October of that year, I had lost much of my extra Drug weight and was waking daily at 7 am following 8 hrs of sleep. I interviewed for a job and was volunteering three days weekly, generally believing the worst wa well behind.

At this time, I suffered a substantial setback due to a hypersensitive reaction to lecithin. Since then it seems major setbacks derived from hypersensitive overreaction or were benzo related.

Since I experienced no hypersensitivity during the 2 years I didnt take benzos, I've never associated them with the benzos, though i know others experince this problem in bzd withdrawal.I have assumed the benzos have blunted ongoing Effexor w/d symptoms, that I'd experience a return of Effexor related anxiety and insomnia minus the benzos and that the hypersensitivity represents AD w/d slipping through the dampening effect provided by the anxiolytics.

I also sometimes wonder if I ever got over the withdrawal syndrome triggered by my BZD d/c. In 2008 and 2009 I still drank alcohol to excess now and then. It's very tricky for me to know exactly what is causing what after Ive been messed about with the number and diversity of neuro-disruptive agents as I have, I think.

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#26 Barbarannamated

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Posted 13 May 2012 - 06:41 PM

Alex, I've wondered same about myself, especially after the simultaneous CT off of Klonopin (cross to diazepam, i think) and opiate in university detox facility because "they interfere with effectiveness of SS/NRIs". What a load of BS! My pain level and anxiety skyrocketed after that nightmare.
Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

#27 Rhiannon

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Posted 14 May 2012 - 09:30 AM

Well, I have to say that seeing it this way (that after the first couple of weeks the benzo isn't really doing anything much, just preventing benzo withdrawal symptoms) fits with my own experience in tweaking and tapering my multiple meds. Unfortunately, the side effects (stupefying, amnestic, hormonal, etc.) don't seem to go away just because the GABA system has adjusted to the presence of the benzo. I doubt that staying on a benzo during AD withdrawal would really help with the effects of withdrawal from an AD. That is, not in a sedative way. I think the sedative effects of a benzo, once tolerance is reached (after a few weeks of daily use, that is) are primarily relative--that is, sedating the stimulation that happens when the previous dose wears off. But I suspect that being on an AD could complicate the effects of withdrawal from a benzo. And for sure, if you're tapering an AD, the last thing you need is to be suffering through benzo withdrawal or recovery from benzo withdrawal. So if you're choosing which to taper first, an AD or a benzo, I think tapering the AD first does make sense. The only piece of the argument for that which I question is the idea that staying on the benzo is somehow going to sedate or help with the AD withdrawal effects. I don't really think that's a big contributor. (That's with daily regular use of the benzo. Intermittent use is different, if tolerance doesn't develop.) (Nor do I think staying on an AD is going to help with benzo withdrawal effects. Except in the same sense, that trying to QUIT an AD that your body is adapted to, if you're in benzo withdrawal, will definitely make things worse.)

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

Now:                43                    0.625                 0.0775            1.3

 

I'm not a doctor. Any advice I give is just my civilian opinion.


#28 Altostrata

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Posted 14 May 2012 - 11:21 AM

I will concede, Rhi, that if you've reached tolerance with the benzo and do not feel its sedating effects, it may not help with AD withdrawal symptoms. I don't know the answer to that. But -- let's say you're at this point and sleeping regularly. Stopping or decreasing the benzo may very well destabilize your sleep. This is highly undesirable if you want to go off an AD, because it may further wreck your sleep and then you'll be extremely miserable.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#29 alexjuice

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Posted 14 May 2012 - 01:09 PM

Again, interesting responses. In case it isn't clear (which it probably is not) I'm prodding here because I am preparing to start reducing the benzos. I have been hesitant, partly b/c i feared a return of some of my primary AD w/d symptoms which may not constitute a potent threat. But was a fear I wanted to explore to aid my comfort level. I am also concerned about the timing. I've been waiting to taper the benzos until I settled on more of a symptom plateau, lately been peaks and valleys. But at some point the waiting probably costs more than just starting the taper. There will probably not come a perfectly rosy time to begin it. Larger context, I hope it didn't come across as though I advocate benzos to alleviate AD or any other withdrawal syndrome. IMO, that'd make a perfectly terrible idea. Alex

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman


#30 Skyler

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Posted 14 May 2012 - 04:19 PM

Larger context, I hope it didn't come across as though I advocate benzos to alleviate AD or any other withdrawal syndrome. IMO, that'd make a perfectly terrible idea.

Alex


Hi Alex, I think any sedating benzo effect that might take the edge off AD withdrawal would be very short lived, and the use would not be justified given one can get addicted to benzos in a month or sometimes less.

Alto..thanks for sticking with us on the benzos so we got it cleared up.~S

As always, LISTEN TO YOUR BODY! A proud supporter of the 10% (or slower) rule.

 

Requip - 3/16 ZERO  Total time on 25 years.

 

Lyrica: 8/15 ZERO Total time on 7 or 8 yrs.

BENZO FREE 10/13 (started tapering 7/10)  Total time on 25 years.

 

Read my intro thread here, and check the about me section.  "No matter how cynical you get, it's almost impossible to keep up." Lily Tomlin

 

 


#31 Rhiannon

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Posted 16 May 2012 - 12:13 PM

I will concede, Rhi, that if you've reached tolerance with the benzo and do not feel its sedating effects, it may not help with AD withdrawal symptoms. I don't know the answer to that. But -- let's say you're at this point and sleeping regularly. Stopping or decreasing the benzo may very well destabilize your sleep.

This is highly undesirable if you want to go off an AD, because it may further wreck your sleep and then you'll be extremely miserable.

Yep absolutely. If you stop taking the benzo it will definitely screw up any homeostasis you may have managed to achieve. I do think it makes sense to taper the AD first if there are no other complicating circumstances.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

Now:                43                    0.625                 0.0775            1.3

 

I'm not a doctor. Any advice I give is just my civilian opinion.


#32 Rhiannon

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Posted 16 May 2012 - 12:15 PM

Again, interesting responses.

In case it isn't clear (which it probably is not) I'm prodding here because I am preparing to start reducing the benzos. I have been hesitant, partly b/c i feared a return of some of my primary AD w/d symptoms which may not constitute a potent threat. But was a fear I wanted to explore to aid my comfort level.

I am also concerned about the timing. I've been waiting to taper the benzos until I settled on more of a symptom plateau, lately been peaks and valleys. But at some point the waiting probably costs more than just starting the taper. There will probably not come a perfectly rosy time to begin it.

Larger context, I hope it didn't come across as though I advocate benzos to alleviate AD or any other withdrawal syndrome. IMO, that'd make a perfectly terrible idea.

Alex

I thought maybe you were thinking about starting down on the benzos.

Just be very careful, okay? teeeeny baby steps, long holds, especially at first.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

Now:                43                    0.625                 0.0775            1.3

 

I'm not a doctor. Any advice I give is just my civilian opinion.


#33 Altostrata

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Posted 20 May 2012 - 08:56 AM

I'm really worried about how this information is being misinterpreted.

It seems people are peeking in from the Internet on smartphones, failing to read the whole topic or even the entire first post, and thinking they can add Lamictal or something to their tapers to compensate for withdrawal symptoms.

DON'T DO THIS!!!!!! Don't count on being able to take a pill to fix whatever is wrong with you.

Anything you add may conflict with something you're already taking.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#34 Altostrata

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Posted 04 August 2012 - 12:50 PM

In post #1, added link to additional comment on Ashton and antidepressants from Stuart Shipko.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#35 Altostrata

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Posted 21 September 2012 - 06:43 PM

Talked to Stuart Shipko about discontinuing multiple drugs, he said he usually leaves the benzo for last, for all the above reasons.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#36 Nikki

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Posted 07 February 2013 - 05:30 PM

Alto when I first met you it was a number of years back. Could have been 2006 on another site. 99% of the members on that site were tapering one drug. At the most (2). The two biggest culprits were Paxil and Effexor. Zoloft was there too. Fast forward....so many people are on several drugs. What on earth happened? Is it largely due to people having WD from one drug a doctor dismissing WD as a return to symptoms and adding more and more drugs?????? I can't get over this poly drugging mumbo-jumbo :rolleyes: Alot of people have been hurt by so many drugs being introduced into their systems. Hugs

Intro: http://survivinganti...ndown-with-ads/

 

Paxil 1997-2004

Crossed over to Lexapro Paxil not available

at Pharmacies GSK halted deliveries

Lexapro 40mgs

Lexapro taper (2years)

Imipramine

Imipramine and Celexa

Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine