How Long After Benzo Withdrawal Can You Take Benzos Again
It'southward been a year since I took my last dose of a benzodiazepine. I had shared publicly about my journey off benzodiazepines during my taper (see hither and here ), and since many have asked me lately how I'one thousand doing, it's fourth dimension for an update. In this article, I'll be discussing my benzodiazepine journey then far and answering some of the mutual questions I receive from the benzodiazepine-harmed community.
Please understand that everyone has a different journeying coming off benzodiazepines. The post-obit is simply my own experience and is not meant to be taken as medical advice. However, I hope that many people tin can benefit from my story and what I've learned forth the way.
Ancestry:
In Baronial 2015, I was prescribed Xanax for insomnia acquired by the intense pain of dry eye syndrome. Within a few weeks of taking a " low dose " of Xanax (0.25 mg nightly), I adult a tremor and severe anxiety. In hindsight, these symptoms were a event of interdose withdrawal and tolerance . At the time, this was not readily credible to me or my doctors. I at present understand that this lack of insight stemmed from how little training doctors receive related to the adverse furnishings of benzodiazepines. I spent ii fruitless months undergoing evaluation by multiple medical specialists in an attempt to explain my symptoms. Benzodiazepine dependence/interdose withdrawal were not once considered in the differential diagnosis. Meanwhile, I became progressively more sick.
Benzodiazepine dependence/interdose withdrawal were not once considered in the differential diagnosis.
I was encouraged by my doctors to add a dose of Xanax in the daytime hours to alleviate my increasing anxiety. I was prescribed 0.five mg up to iii times daily as needed, and I never exceeded this prescribed dose. When my medical tests came back normal, I turned to the cyberspace in search of aid. I entered "Xanax" into the Google search bar, and subsequently sifting through a bunch of drug detox and addiction heart websites (none of which seemed to apply to me), I found BenzoBuddies , a support forum for patients withdrawing from benzodiazepines. After reading diverse threads, I was shocked to find that my symptoms were consistent with benzodiazepine dependence.
I now knew that the only way to go my life back was to detect a style to get off Xanax. I tried to taper on my own, only it was impossible—the withdrawal symptoms were merely too severe. On BenzoBuddies, I plant the Ashton Manual , a guide for benzodiazepine tapering and withdrawal written by a md, Heather Ashton, who had extensive clinical experience with this issue. Ashton recommended switching from the curt-acting Xanax to Valium, as its longer half-life eases symptoms of interdose withdrawal and facilitates tapering.
Despite the fact that I'1000 a doctor myself, when I went back to my providers with this information, I was dismissed outright.
Despite the fact that I'yard a physician myself, when I went dorsum to my providers with this information, I was dismissed outright. Ane told me (wrongly) that I didn't need to taper off Xanax at all and could just stop taking it, since I'd been on it only a few weeks. Another unsaid that I was an addict, which was untrue. Please note that physical dependence and addiction are not synonymous, and appropriate utilise of this linguistic communication matters .
Past this time, I was very sick and knew I was in deep trouble if I didn't receive help soon. After a month-long search, I found a local psychiatrist who believed me. Over a flow of six weeks, he helped me "cross over" from Xanax to Valium. I eventually stabilized on xv mg of Valium, and my symptoms of interdose withdrawal were relieved.
The Taper:
When I started my Valium taper on December 27, 2015, I had no idea that it would exist a multi-year procedure. My psychiatrist and I decided to start the taper using the schedule in the Ashton Transmission, which recommends a traditional "cut and hold" method. My outset "cut" (dosage reduction) was 1 mg. This sent me into a tailspin of intolerable symptoms, the worst being tachycardia, chemical terror, and severe nausea. It was readily apparent that the schedule in the manual was simply too fast for my body.
After waiting a month to stabilize from that first reduction, I continued my taper using smaller dosage reductions (0.5 mg), which were better tolerated. I reduced my Valium dose every two weeks as recommended in the manual, simply rapidly realized that my trunk needed up to three to four weeks to fully stabilize betwixt reductions.
The first half of my taper, from 15 mg to 7.five mg, took roughly a year (including my diagnosis of breast cancer in Apr 2016, which necessitated a total of six months of property my dose for 2 separate surgeries). The 2d half of my taper, from seven.5 mg to 0 mg, took ii years and almost 3 months to consummate. This is consistent with psychopharmacologist Malcolm Lader's observations that the "early stages of withdrawal are easier to tolerate than the afterwards and final stages." This is likely because, as a taper progresses, any given dose reduction constitutes a larger percentage of the full dose. I found that while using the "cut and agree" method I could make reductions of upwards to 7% of the total dose. Anything exceeding that per centum was catastrophic for me. (Please note that this corporeality of reduction was what worked best for my body, and that some individuals must taper fifty-fifty more slowly, while some tin can become faster.)
Effectually this halfway mark, I could no longer handle the intensity of symptoms acquired by larger dosage reductions. I knew of "microtapering" from BenzoBuddies, but had always constitute this method intimidating. Notwithstanding, I knew that the current plan was no longer working, then I began to research microtaper methods . After reading that some people have difficulty transitioning from solid to liquid formulations, and because I had access to a lab grade scale, I decided that the "dry" or calibration method would be my best pick. I knew that I was sensitive to medication changes, and that liquid would introduce a new variable into the equation, potentially destabilizing me further. (Please annotation that I know many people who accept been successful with liquid microtaper methods, and that this was simply the choice I made in my own journey.)
Dry microtapering entailed a learning curve, required some math, and was more time consuming than splitting pills, but I picked it upwards pretty chop-chop. It smoothed out my tapering experience overall, as I was no longer hit with the total intensity of symptoms that result from the "cutting and hold" method. I've seen microtapering described as going down a slide versus taking the stairs, and that's a fair comparison. It wasn't perfect. My slide had quite a few bumps, when symptoms would pile upwards equally micro-cuts compounded upon themselves. When this happened, I'd slow downward the charge per unit of reduction or even hold my dose for a couple of weeks if things were actually bad. After much trial and error, I found that reducing my Valium past 0.25 mg to 0.3 mg a month was a comfortable schedule for me.
Despite my tiresome taper, it was, overall, a nightmare from get-go to cease.
Despite my slow taper, it was, overall, a nightmare from commencement to finish. Some people tend to improve as they taper lower, only that wasn't true for me (although some individual symptoms like nausea and blunted personality improved equally my taper progressed). Information technology was obvious that I needed to continue making dosage reductions in lodge to get off the drug, so I tapered as fast every bit I was able while trying to maintain some level of function in my daily life. Although holding my dose periodically helped me achieve a degree of stability, I never once felt well during my taper. My "good" days would be considered really bad by normal standards. I would never be symptom free or feel even remotely skilful until I was off Valium.
I suffered seventy-nine different symptoms , these existence the ones I bothered to document on my Twitter account . I won't rehash them here, but they may be worth a read for those who need validation of their ain feel. Suffice to say, I was seriously ill to the signal that my family unit thought I might die. My entire life was upended and, especially in the latter part of my taper, I spent a lot of fourth dimension bedbound and isolated in my room. I was so severely disabled by the terminate of my taper that it became hard to tend to my basic needs like showering, dressing, and cooking.
Information technology was a relentless, 24/7 torture that defies description.
The worst part of benzodiazepine withdrawal wasn't the intensity and severity of symptoms, information technology was the fact that the symptoms went on for years. Information technology was a relentless, 24/vii torture that defies description. Every day I wanted to die to escape the torture, but I kept going, property onto hope that one 24-hour interval I'd exist well again. It got to the point where I didn't intendance if I died: if I made it, fine, and if non, well at to the lowest degree I was done suffering. I suppose this was my version of radical acceptance. With this attitude, I became an impartial observer to the fiery inferno occurring in my body, ignoring symptoms that would ship normal people straight to the emergency room. It'southward a strange state of affairs to be trapped in a body with every system imploding and feel no sense of alarm, just this is what was required for me to survive.
Cease taper and jump:
Below a dose of 2 mg daily, I could feel Valium losing its hold on my body. In fact, under 1 mg, it felt as if I were no longer taking the drug at all, both physically and psychologically. Old and familiar symptoms hit me similar a freight railroad train, only now with greater intensity. Symptoms cycled rapidly, and how I was feeling changed on an hour-to-hr, even minute-to-minute basis. At this indicate in my taper, holding my dose gave me no benefit, and then I pushed forwards with daily micro-reductions.
When I looked in the mirror, I didn't recognize myself.
Subsequently almost 4 years on benzodiazepines, my body was a wreck. I was besides silly and tachycardic to stand for more than a few minutes. My muscles were and then spasmed that walking felt similar I was trying to move stone. I was so weak that I struggled to transfer wet laundry from the washer to the dryer. I craved carbohydrates, and since nutrient was the only thing that fabricated me feel remotely amend, even for a few minutes, I had gained l pounds over the course of my taper. I had developed metabolic syndrome and several nutritional deficiencies. When I looked in the mirror, I didn't recognize myself. Seeing the damage that benzodiazepines had done to me was terrifying.
Three years, two months, and twenty days after my taper started, I "jumped" off Valium at a dose of 0.175 mg. There's no magic to this numerical value. As I tapered lower, the pill chunk I was filing and weighing became miniscule, and I could no longer handle information technology from a dexterity standpoint. At that point, I decided I was done.
Three years, two months, and twenty days after my taper started, I "jumped" off Valium at a dose of 0.175 mg.
Ask anyone what Valium dose to "spring" from, and you'll become a different answer every time. The Ashton Manual recommends 0.five mg, while some in the benzo-harmed community say to taper all the mode to zero, or anywhere in between. Looking back at my own journey, I remember that it is best to taper equally low as possible, since you are trying to ease the landing, but in my opinion it's not necessary to drag it out by tapering to zilch.
Many people are humble (to put it lightly) well-nigh finishing their benzodiazepine taper, and I was too. But in the end, it wasn't earth-shattering or catastrophic. Stopping Valium at 0.175 mg felt like any other "cut" I'd done during my taper. I had an uptick of symptoms a few days after I jumped, so over again about 3 to four weeks off. It was more of the same pain that I had dealt with during my taper, so I was more than prepared for how to cope. The second month off was more than intense than the first, as I presume this is when Valium completely exited my body.
Many enquire me if in that location's anything I would accept washed differently in my taper. With the benefit of hindsight, I would probably start microtapering before or even at the outset of my taper, but because it smoothed out the symptoms. Merely I don't remember this would have changed my long-term result. Overall, I did my best with the challenges this feel threw at me, and I take no regrets about any of the decisions I made during my taper. No matter what method a person chooses for their taper, I cannot emphasize enough that following Ashton'southward basic principle of a patient-led, symptom-based approach is the best style to come off benzodiazepines, no matter how long it takes.
The Aftermath:
It was a relief to no longer exist required to take the drug that had been poisoning my body. The constant threat of losing my Valium prescription and going into severe withdrawal was now in the past. A twelvemonth later, I rarely think of Valium, and when I practise, I think, "Wow, I actually accept no interest in taking that at all!" I but take no need for a benzodiazepine, and it is no longer a part of my life.
I think ane of the biggest shocks for people tapering benzodiazepines is that the journey is not over when the taper is consummate. The brain and body still have quite a fleck of healing left to do, and in my own experience, substantial healing took place but after I was completely off Valium.
I accept spent this year recovering and picking up the pieces of my life. With my new primary care dr., I worked on modifying my diet and correcting my aberrant labs. For the first few months, I followed a ketogenic diet. Although I am no longer following a strict keto regimen, I even so maintain a diet low in sugar, grains, and processed foods. So far I've lost 35 pounds, I no longer take metabolic syndrome, and my lipid contour is trending toward normal. I too started physical therapy a month afterward my taper ended to help with my profound weakness and deconditioning. My functional status was so poor at the first that, besides the standard parameters, my physical therapist used my ability to do laundry and cook equally barometers of my recovery.
My functional status was so poor at the showtime that, besides the standard parameters, my concrete therapist used my ability to do laundry and cook equally barometers of my recovery.
Subsequently ii months off Valium, I began to see slow improvements in my overall health and role. The overall trajectory of my affliction is continued recovery, merely it has non been a linear process. I suffered the blueprint of "waves" (increased symptoms) and "windows" (periods of relative stability) typical of post-acute withdrawal syndrome.
Coming off benzodiazepines felt similar waking up from the dead, or as if I were Rip van Winkle and had been comatose for years. The first time I went into a grocery shop that I had frequented earlier my disease, I had a surreal deja vu feeling. Suddenly I was seeing everything with fresh eyes, but besides tinged with memories of the past. Colors became more vivid. One day while waiting for my daughter'due south school day to end, I was struck by the beauty of the garden in front of her school building. I had "seen" information technology several days a week for the past iii years but had been besides sick to comprehend it. I began to notice details of the things around me, similar the clothing people wear. Let's merely say I institute out that my entire wardrobe needed an update!
As I recovered, I began to resume my old activities, but I struggled with cognitive and physical limitations. When I was able to melt once again, at first information technology was hard for me to consummate a recipe without a glitch or a full-blown disaster. I kept leaving the flour out of the batter while baking, and this became a running family joke. (Pro tip: Peach cobbler without flour makes a great topping for vanilla ice cream.)
Effectually iv months off Valium, my motivation to complete tasks exceeded my physical abilities. Afterward years of missing out on life, I wanted to take on every project and travel to all the places on my bucket list, simply fatigue quickly landed me dorsum in bed. Managing my daily schedule was a challenge. I now had more than things on my plate than during my taper, but cognitive impairment fabricated it difficult to remember what I was supposed to be doing, and I would ofttimes forget appointments.
Meanwhile, I began to look more similar the old me. Acquaintances from my girl's school, who had only known the "benzo sick" me, would do double takes and tell me how practiced I looked. One even asked me for the secrets of my amazing transformation. But there was no great mystery. I'd been poisoned, and at present that the poison was removed, my body was getting back to its normal state.
I'd been poisoned, and at present that the toxicant was removed, my body was getting back to its normal state.
In some means, being off Valium was frustrating. I was still sick, but in that location was aught I could do likewise support my trunk and wait. I could no longer micromanage my taper to moderate symptoms or expect forward to the goal of being off benzodiazepines, and this sometimes felt anticlimactic.
I have noticed that benzodiazepine back up groups take a wealth of data to back up those who are tapering, just tips for managing the post-withdrawal period are scanty at best. For this reason, I'1000 sharing a list of things that helped me cope during this challenging menstruation. I however employ them at a year off:
- I understand that healing is a boring process, so I do my best to exist patient with myself. I consider myself a work in progress.
- I practise tasks that require relatively more encephalon ability (such as writing) in the morn, before fatigue sets in.
- I use a planner to write down "to do" lists and appointments.
- I set boundaries around things that drain my energy or are triggering. For instance, I limit phone calls and social media. I besides try to accomplish work and tasks on the weekdays so I have the weekends to recharge.
- I footstep myself with activities, and I requite myself permission to rest.
- I remove whatever unnecessary stress. If I can accept something off my plate, I do!
- I showtime small with projects. Later on four years of sickness, my house was a disaster and was completely overwhelming to my damaged brain. I couldn't tackle the projection all at once, and so I committed myself to getting rid of one particular a solar day. My house is looking better a yr subsequently!
- Bad mornings still happen, but I've establish that getting upward and moving forrad with my twenty-four hours distracts me from my symptoms, and soon I'yard feeling meliorate.
A give-and-take on other medications, supplements, and what helped:
People oftentimes want to know what they tin take to feel improve during the taper process. Unfortunately, there is no one-size-fits-all medication and/or supplement regimen that helps with benzodiazepine withdrawal. Taking every bit lilliputian as possible in the fashion of extraneous substances during a taper is probably best in the interest of lowering the take chances of agin effects and drug interactions. It'south well known that polydrugging can create some serious problems.
With that being said, I wasn't averse to taking medication to ease specific symptoms during my taper when admittedly needed. For instance, I adult severe acid reflux hurting as a side event of Xanax. Information technology was refractory to antacids and H2 blockers, so I ended upward on the proton-pump inhibitor (PPI) pantoprazole for the duration of my taper, and this profoundly improved my quality of life in regard to my acid reflux. I did a fair amount of research earlier I started a PPI and found that they have the potential to increase Valium levels. I specifically chose pantoprazole because information technology has the to the lowest degree potential for interactions out of all the PPIs.
I also took propranolol, a beta blocker, as needed to ease the tachycardia and heart pounding acquired by benzodiazepine withdrawal. In the terminal third of my taper, I used it on a daily basis to alleviate my cardiac symptoms. Several months subsequently my Valium taper was complete, I was able to taper successfully off both propranolol and pantoprazole. Thankfully, it was much easier than tapering off Valium.
My experience with other medication wasn't all practiced. I struggled with insomnia, particularly at the beginning of my taper, so my psychiatrist prescribed Remeron. It helped me slumber, only one dose made me feel like a zombie for the side by side 2 days. My family also told me it made me angry and irritable. Later the Remeron wore off, I decided I'd rather just deal with the indisposition than the awful side effects of another drug.
As far as supplements were concerned, I tried a few during my taper to treat specific symptoms or correct nutritional deficiencies. I was very cautious, as I knew calculation supplements had the potential to make things worse. I used Natural Calm powder (magnesium citrate) during the first half of my taper to help salvage severe constipation, another benzodiazepine side effect. Magnesium utilize is controversial in the setting of benzodiazepine withdrawal, but for me, information technology did the trick, and I had no trouble stopping it. I besides tried melatonin for slumber, and while at that place were no ill effects, information technology didn't really help either.
I had lab piece of work done during my taper that confirmed low serum levels of iron, vitamin D, and vitamin B12. Pantoprazole had its negative side—it interfered with my absorption of iron and vitamin B12 and was at least partially responsible for these deficiencies. My primary physician recommended supplements to correct the deficiencies. The but consequence I had with the supplements was an incident of akathisia afterward starting a full-dose poly peptide powder containing a high dose of vitamin B12. Afterwards stopping it for a week, then titrating information technology upward slowly (adding in 1 teaspoon of powder every week until I reached the desired dose), I was able to tolerate it. The moral of the story is that if you lot're trying a new supplement, you should get-go depression and get slow.
Unfortunately, as I learned, there'southward no magic bullet for benzodiazepine withdrawal syndrome.
Unfortunately, as I learned, there'southward no magic bullet for benzodiazepine withdrawal syndrome. Finding something that helps is ofttimes a procedure of trial and error. Whatsoever medication or supplement has the potential to make things better or worse, and often the take a chance of making things worse is reason to steer clear of experimentation. In the latter one-half of my Valium taper, I was less willing to try new medications and supplements as I had learned that what helped virtually was just tapering off the drug and the passage of time.
Where am I now?
At ane year off benzodiazepines, I'grand non 100% back to my former self. With that being said, I'm way better than I was at the end of my taper. The good news is that the relentless torture is over. My thinking is clearer, and my free energy levels and overall strength and daily function are standing to ameliorate. The bad news is that I all the same accept symptoms, the nearly bothersome of which include inner tremor (buzzing similar I'm plugged into an electrical socket), fatigue, intermittent heart pounding, and muscle pain/spasms. Mornings are nevertheless difficult—I wake with heightened anxiety and heart pounding, but this at present lasts only a few hours, and the intensity has eased quite a bit compared to my taper days.
At 1 yr off benzodiazepines, I'g not 100% back to my quondam cocky.
Many people ask me to limited my healing in terms of a percentage, merely it'southward hard to assign an verbal numerical value. It'south more than useful for me to speak in terms of my electric current level of function. Although I need to lie down to residual during the afternoons, I'thousand no longer crippled equally I was last year. Showering, cooking, doing laundry, and walking are no longer a big deal. But I still have physical limitations, and if I'm non careful, my exuberance about getting back to life causes me to "crash" and end up in bed for a few days. However, this is happening less as time goes on.
Several months ago, I transitioned from physical therapy to exercising with a personal trainer at a local cancer center (I qualify for this program due to my history of breast cancer). I'm finally strong enough to join a group exercise class with other cancer patients, some of whom are actively in chemotherapy and are in better shape than me. While this may sound pathetic, please proceed in heed that benzodiazepines made me sick for years, and that only a year ago I was bedridden. I've come a long way.
The month of March 2020 has been the biggest test of my health and so far. I took a trip to Disneyland over spring break, just earlier my one-year anniversary off benzodiazepines, which was March 15. I was able to handle air travel and three busy days in the park, non at full speed, perhaps, but I still accomplished a slap-up deal. I arrived back from Disneyland only to be isolated in my home with my husband and 9-year-quondam daughter because of the COVID-19 pandemic. During this fourth dimension I've been preparing three meals a mean solar day, homeschooling my daughter, and also tackling one domicile projection afterward another to keep myself distracted. Despite the extreme stress of the situation, I'thou able to cope. This would accept been incommunicable last year.
Despite my improvements, I still take bad days, and I get frustrated that my mind and torso aren't the aforementioned. Lately I've asked myself, "What if this is best I ever become? Could I live this mode the rest of my life?" The answer is yes! I still have symptoms and limitations, but I am living my life. I am able to experience joy once more, and my life is fulfilling. There was a period of years where I wanted to die every 24-hour interval, and I'm then glad I didn't requite in to that desire.
Subsequently years of tapering and living with benzodiazepine-induced hell, it is apparent that what I am experiencing is not just withdrawal. My current symptoms are due to neurological damage from the drug, and that takes a long time to heal.
Afterwards years of tapering and living with benzodiazepine-induced hell, it is credible that what I am experiencing is not merely withdrawal. My current symptoms are due to neurological damage from the drug, and that takes a long time to heal. I practice believe some healing occurs during the taper itself, just given my own remarkable recovery in the by yr, it was obvious I needed to be off the drug before I could brand substantial improvements. For me, true healing could merely start in one case I was off the benzodiazepine. My health has improved immensely in the last year, and I expect to proceed with the current trajectory of healing. I don't know how long information technology will take, or whether I'll always be completely symptom gratuitous. I'grand merely taking information technology one mean solar day at a fourth dimension and continuing to call up positively about the future. I think the biggest testament to my recovery is that recently I've started unconsciously speaking about my benzo ordeal in the past tense.
Then what now?
I'd like to thank everyone who helped me get through the most trying time in my life—my family unit, my friend Ernie who mentored me through my taper, my friends and colleagues at Benzodiazepine Information Coalition, and the psychiatrist who supervised my taper.
This ordeal has given me a new perspective. Overall I've become a person who is more than understanding and forgiving. The things I worried about in the past seem pretty stupid. Money and possessions now have less worth, and relationships with friends and family are my priority.
Every bit I have become more active in my daily life, I accept less time to be active in the benzodiazepine support groups, but my heart will always lie in advocacy. I plan to continue my directorship at Benzodiazepine Information Coalition, focusing on my writing and spreading awareness near the benzodiazepine trouble.
While I'll always be a cardiologist, I don't have plans to return to practice in the immediate future. My current priorities include focusing on my health and regaining lost time with my family. If I practise become dorsum into practise, though, I can promise one thing: I'll never miss a diagnosis of benzodiazepine dependence, withdrawal, and/or injury!
Source: https://www.benzoinfo.com/2020/04/20/one-year-off-benzodiazepines-a-doctors-journey/
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