Fish77: Valium Taper with Polydrug - What should I do?

[Fish77]

Hi:

 

I'm currently in the middle of a Valium taper (10 years of Xanax ER crossed over to Valium for taper) right now but taking my psychotropic drugs.  The taper is going very well so far.  I was wondering whether it makes sense to hold the Valium taper and withdraw from any of the other drugs first.  The reason I’m tapering from Benzos is that I’m suffering severe cognitive symptoms, especially anterograde amnesia, forgetting words, and speaking slowly.  My current drugs are as follows:

Benzo Withdrawal
9/30/2019 - Xanax ER 1.5mg
10/1/2019 - Direct Crossover to Valium 20mg
10/13/2019 - Valium 17.5mg
10/20/2019 (anticipated) - Valium 15mg

Other Medications
Pregabalin (Lyrica) 300mg 
Viibryd (SSRI) 40mg
Lithium 600mg
Cardizem (For sinus tachycardia) 180mg
Synthroid (hypothyroidism) 25mcg

 

Thanks for your help!

[Sassenach]

Hello     Fish   and welcome to SA.

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

I am sorry you are having such a rough time but you are now in the right place.

 

Thank you for your drug information.

My first impression is that you seem to tapering somewhat faster than recommended on this site.

However my knowledge of Benzos is small so I will send a report to those who do deal with them for their advice.

 

Sassenach

[Altostrata]

Welcome, Fish.

 

What are pregabalin, Viibryd, and lithium supposed to treat?

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results or a link to them in this topic.

[Fish77]

18 minutes ago, Altostrata said:

Welcome, Fish.

 

What are pregabalin, Viibryd, and lithium supposed to treat?

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results or a link to them in this topic.

 

Hi Altostrata:

 

Pregabalin is also known as Lyrica, a more modern version of Gabapentin.  It is used purely off label to treat anxiety.

Viibryd is an SSRI that is also a 5HT-1A receptor activator.  It is used to treat Major Depressive Disorder.

Lithium is a mood stabilizer.

 

Here is a link to the Drug Interaction Checker:

 

https://www.drugs.com/interactions-check.php?drug_list=3296-15039,862-441,1477-16548,1937-0,1463-869,890-461

 

Looking at all the interactions, I feel pretty fortunate that I'm still relatively functional.

 

Thanks!

 

[Fish77]

58 minutes ago, Sassenach said:

Hello     Fish   and welcome to SA.

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

I am sorry you are having such a rough time but you are now in the right place.

 

Thank you for your drug information.

My first impression is that you seem to tapering somewhat faster than recommended on this site.

However my knowledge of Benzos is small so I will send a report to those who do deal with them for their advice.

 

Sassenach

 

HI Sassenach and thanks for the welcome!  I know I'm doing the benzo taper a bit quicker than the Ashton Manual, but I'm planning to slow down when I get to 10mg valium, and will also slow down if I get bad side effects.

 

Overall, I'm doing okay considering the amount of psychotropic drugs that I'm on.  But I plan to get off of all them, hopefully by the end of 2020.  I have spent my entire life on psychotropic drugs since the age of 8 and its time to see what life is like without them.

 

-Fish77

[Altostrata]

There could be several factors responsible for the adverse effects you feel, diazepam is only one of them.

 

Since you've been on psychiatric drugs since you were a child, have you had a lot of drug changes? Have you ever experienced withdrawal syndrome?

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

 

[Fish77]

5 minutes ago, Altostrata said:

There could be several factors responsible for the adverse effects you feel, diazepam is only one of them.

 

Since you've been on psychiatric drugs since you were a child, have you had a lot of drug changes? Have you ever experienced withdrawal syndrome?

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

 

 

 

I've probably been on every SSRI that ever hit the market over the years other than Effexor (not joking).  Had a bad reaction to Prozac and had to be taken off (family member found me having a conversation with a wall).  The only one that gave me nasty withdrawal symptoms was Paxil.  Every time I switched, I did it cold turkey.  I've found every SSRI to pretty much be useless, but I'm still on Viibryd due to inertia more than anything else.

 

Will work on doing my profile.  It may take some time because I have to research my own extensive psychiatric drug history.

[Altostrata]

Just the last several years will be enough.

 

It's good your diazepam taper is going well, but it's possible that when one has a history of going on and off psychiatric drugs and adverse reactions, including withdrawal syndrome, your nervous system might be more sensitive to drug changes. I would not assume that going off any other drugs may be done rapidly.

 

Ordinarily, we recommend people taper the benzo last, as it can address withdrawal symptoms, such as sleeplessness, from tapering the other drugs. It's possible your mental fog is due to the pregabalin and lithium as well. Your cocktail is a nasty one, have you been getting regular tests for kidney and liver function? That's required for lithium.

 

What times of day do you take your drugs, and their dosages?

[Fish77]

2 hours ago, Altostrata said:

Just the last several years will be enough.

 

It's good your diazepam taper is going well, but it's possible that when one has a history of going on and off psychiatric drugs and adverse reactions, including withdrawal syndrome, your nervous system might be more sensitive to drug changes. I would not assume that going off any other drugs may be done rapidly.

 

Ordinarily, we recommend people taper the benzo last, as it can address withdrawal symptoms, such as sleeplessness, from tapering the other drugs. It's possible your mental fog is due to the pregabalin and lithium as well. Your cocktail is a nasty one, have you been getting regular tests for kidney and liver function? That's required for lithium.

 

What times of day do you take your drugs, and their dosages?

I got one test a month after starting Lithium for kidney function and it was normal.  Lithium did induce severe hypothyroidism unfortunately, which is being treated with synthroid (going back to Endocrinologist to increase dose next week).  I’ve been on lithium for 6 months or so.

 

My morning drugs and dosages are:

Valium 7.5mg

Viibryd 40mg

Pregabalin 150mg

Diltiazem 180mg

Synthroid 25mcg

 

Evening:

Valium 7.5mg

Lithium ER 600mg

Pregabalin 150mg

 

My cognitive issues began before stating Lithium or Pregabalin, and coincided with a significant increase in my 10-year Xanax dose about 8 months ago due to an extreme anxiety episode.

 

At this point I’m becoming a bit leery of stopping my benzo taper since I’m in the middle of it and it’s going better than I could have hoped so far.  I’ve probably withdrawn (cold turkey) from more than a dozen different SSRIs in my life and only had one difficult withdrawal (Paxil).  In the past 6 months I also cold turkey withdrew from Seroquel, Trazadone and Mirtazapine without any withdrawal problems.

 

No idea what to expect from Lithium or Pregabalin, but I plan to slow taper them.  I’ll also taper Viibryd because I’m now more aware of potential withdrawal issues.

 

 

[Altostrata]

Since lithium has had such a drastically bad effect on your health, why did you not reduce it?

 

You've only been tapering diazepam since the end of September? Have you noticed any changes in your symptom pattern since then?

[Fish77]

14 minutes ago, Altostrata said:

Since lithium has had such a drastically bad effect on your health, why did you not reduce it?

 

You've only been tapering diazepam since the end of September? Have you noticed any changes in your symptom pattern since then?

More of inertia/depression than anything else as for my reason for not stopping Lithium.  It also made me feel better for a while, but that may have been psychosomatic.  I’d be willing to cut that out during the benzo taper.  I have no attachment whatsoever to any of these drugs.

 

Actually feeling somewhat better as my benzo taper continues.  Better than I have in many months.  Almost like a paradoxical withdrawal effect. We’ll see if that continues as my taper goes further down.

 

Appreciate your concern and help.

[Shep]

On 10/19/2019 at 2:32 PM, Fish77 said:

Benzo Withdrawal
9/30/2019 - Xanax ER 1.5mg
10/1/2019 - Direct Crossover to Valium 20mg
10/13/2019 - Valium 17.5mg
10/20/2019 (anticipated) - Valium 15mg

 

Hi, Fish. 

 

I copied this from your earlier post because I'm concerned that your crossover was to a lower dose than we recommend. We go by this equivalency chart that's been used for years on various benzos forums - Benzo Equivalency Chart.

 

Xanax is 20 times as potent as Valium, so going from 1.5 mg Xanax should have been to 30 mg of Valium. 

 

11 hours ago, Fish77 said:

Actually feeling somewhat better as my benzo taper continues.  Better than I have in many months.  Almost like a paradoxical withdrawal effect. We’ll see if that continues as my taper goes further down.

 

It's good you're feeling better with the crossover and the decrease but as you point it, it's "almost like a paradoxical withdrawal effect." 

 

Some people experience episodes of hypo-mania with sudden benzo decreases where they do feel better for awhile. This can cause people to continue tapering until the hypo-mania ends in a crash (feelings of fatigue, depression, etc). 

 

I don't know if this will happen to you, but it is a concern. Would you be willing to hold for a couple of weeks and see how your mind/body reacts to all of these recent changes? 

 

It will be helpful to know more about your benzo history, as well as the history of your other drugs.  Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

 

[Fish77]

2 hours ago, Shep said:

 

Hi, Fish. 

 

I copied this from your earlier post because I'm concerned that your crossover was to a lower dose than we recommend. We go by this equivalency chart that's been used for years on various benzos forums - Benzo Equivalency Chart.

 

Xanax is 20 times as potent as Valium, so going from 1.5 mg Xanax should have been to 30 mg of Valium. 

 

 

It's good you're feeling better with the crossover and the decrease but as you point it, it's "almost like a paradoxical withdrawal effect." 

 

Some people experience episodes of hypo-mania with sudden benzo decreases where they do feel better for awhile. This can cause people to continue tapering until the hypo-mania ends in a crash (feelings of fatigue, depression, etc). 

 

I don't know if this will happen to you, but it is a concern. Would you be willing to hold for a couple of weeks and see how your mind/body reacts to all of these recent changes? 

 

It will be helpful to know more about your benzo history, as well as the history of your other drugs.  Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

 

 

Shep:

 

Thanks for your insight.  I'd be willing to hold for an extra week at 15mg to see how it goes.  When I spoke with my psychiatrist about the crossover/taper, we discussed the range of equivalencies that appear in published medical literature, which ranges from 10x-20x as potent (15-30mg valium equivalency).  She asked me to start at 20 mg, but prescribed me enough pills to go up to 30 mg if I didn't feel well because she trusted me not to abuse the extra pills (which, of course, I didn't and wont).  I didn't feel any withdrawal symptoms when I crossed over to 20mg, so I didnt even think about taking the extra pills and starting my crossover at 30mg.   

 

Part of the paradoxical effect may just be that I moved to a new city closer to friends and family and started medical leave around the same time as starting the taper.  That being said, as I mentioned before, I'm willing to hold 15mg for an extra week.

 

Inalso updated my signature to the best of my ability with only 12 line available.

 

Thank you1

[Shep]

22 hours ago, Fish77 said:

Thanks for your insight.  I'd be willing to hold for an extra week at 15mg to see how it goes.  When I spoke with my psychiatrist about the crossover/taper, we discussed the range of equivalencies that appear in published medical literature, which ranges from 10x-20x as potent (15-30mg valium equivalency).  She asked me to start at 20 mg, but prescribed me enough pills to go up to 30 mg if I didn't feel well because she trusted me not to abuse the extra pills (which, of course, I didn't and wont).  I didn't feel any withdrawal symptoms when I crossed over to 20mg, so I didnt even think about taking the extra pills and starting my crossover at 30mg.   

 

It sounds like you have a doctor that will really work with you. This is very good to read. 

 

22 hours ago, Fish77 said:

Part of the paradoxical effect may just be that I moved to a new city closer to friends and family and started medical leave around the same time as starting the taper.  That being said, as I mentioned before, I'm willing to hold 15mg for an extra week.

 

Sounds like these were some good changes for you. 

 

Yes, a hold may be very helpful. With Valium's half-life of up to 200 hours, many people don't even feel the reduction until a week after the cut. This can lead people to continue making reductions until withdrawal catches up to them. So periodic holds can be very helpful in providing feedback on how your nervous system is tolerating the reductions. 

 

[Fish77]

On 10/23/2019 at 8:45 AM, Shep said:

 

It sounds like you have a doctor that will really work with you. This is very good to read. 

 

 

Sounds like these were some good changes for you. 

 

Yes, a hold may be very helpful. With Valium's half-life of up to 200 hours, many people don't even feel the reduction until a week after the cut. This can lead people to continue making reductions until withdrawal catches up to them. So periodic holds can be very helpful in providing feedback on how your nervous system is tolerating the reductions. 

 

Shep:

 

Thank you for your sage advice.  I ended up developing some pretty extreme fatigue/somnolence (falling asleep on the train/subway and missing my stops, being unable to drive, etc.) over the past few days along with a near total loss in appetite. 
 

An extra week hold is definitely called for right now to stabilize before continuing the reductions.  Even my psychiatrist agrees!

[Shep]

9 hours ago, Fish77 said:

I ended up developing some pretty extreme fatigue/somnolence (falling asleep on the train/subway and missing my stops, being unable to drive, etc.) over the past few days along with a near total loss in appetite. 
 

An extra week hold is definitely called for right now to stabilize before continuing the reductions.  Even my psychiatrist agrees!

 

Fish, what you're describing are fairly severe symptoms. I would hold longer than a week. Please note that symptoms that arise from going too fast don't always resolve by updosing or slowing down your taper. 

 

I don't want to alarm you, but what you're describing are symptoms of a potential nervous system crash. If you don't want to updose, I would at least hold for several weeks until these symptoms resolve. Here is a guide to go by to know when it's safe to taper again - it's called being in Withdrawal Normal: 

 

Withdrawal Normal

 

Updosing may help resolve these severe symptoms. The rule with benzos is updoses work best within 2 - 4 weeks of your last decrease. So don't go too long without making the decision that an increase may help if these symptoms continue. 

[Fish77]

8 hours ago, Shep said:

 

Fish, what you're describing are fairly severe symptoms. I would hold longer than a week. Please note that symptoms that arise from going too fast don't always resolve by updosing or slowing down your taper. 

 

I don't want to alarm you, but what you're describing are symptoms of a potential nervous system crash. If you don't want to updose, I would at least hold for several weeks until these symptoms resolve. Here is a guide to go by to know when it's safe to taper again - it's called being in Withdrawal Normal: 

 

Withdrawal Normal

 

Updosing may help resolve these severe symptoms. The rule with benzos is updoses work best within 2 - 4 weeks of your last decrease. So don't go too long without making the decision that an increase may help if these symptoms continue. 

 

Shep:

 

I actually felt much better starting this morning and felt better all day today. I'd say back to well within "withdrawal normal" as described in your link. I think the weekly cuts just finally caught up to me for a few days.  Will hold for at least another week.

[Shep]

7 hours ago, Fish77 said:

 

Shep:

 

I actually felt much better starting this morning and felt better all day today. I'd say back to well within "withdrawal normal" as described in your link. I think the weekly cuts just finally caught up to me for a few days.  Will hold for at least another week.

 

Very glad to read this, Fish. Yes, holding a bit longer will definitely help. 

[Fish77]

On 10/27/2019 at 9:22 AM, Shep said:

 

Very glad to read this, Fish. Yes, holding a bit longer will definitely help. 

 

I held the extra week and just tapered to 12.5mg.  We'll see how it goes.  

 

On a side note, even though the Valium pills are clearly scored, they do not break cleanly and sometimes can crumble (this goes for the 10mg, 5mg, and 2mg).  A razor blade is needed to accurately halve or quarter these pills.  Maybe just a poor generic  pharmaceutical manufacturer (or a poor batch), but hoping this might help someone on a Valium taper.

[Shep]

On 11/1/2019 at 10:47 AM, Fish77 said:

On a side note, even though the Valium pills are clearly scored, they do not break cleanly and sometimes can crumble (this goes for the 10mg, 5mg, and 2mg).  A razor blade is needed to accurately halve or quarter these pills.  Maybe just a poor generic  pharmaceutical manufacturer (or a poor batch), but hoping this might help someone on a Valium taper.

 

You may want to weigh your pill instead of using a razor blade. This would be more accurate. Please see:

 

Using a digital scale to measure doses

 

A scale that many members recommend is this one:

 

Gemini 20 Scale

 

You can find this scale for sale online (Ebay, Amazon, etc).

[Fish77]

On 11/3/2019 at 6:39 AM, Shep said:

 

You may want to weigh your pill instead of using a razor blade. This would be more accurate. Please see:

 

Using a digital scale to measure doses

 

A scale that many members recommend is this one:

 

Gemini 20 Scale

 

You can find this scale for sale online (Ebay, Amazon, etc).

Shep:  thanks for the scale idea!

 

On another note, I was wondering why the Ashton Manual recommends completely eliminating certain Valium doses (like the morning and mid-day dose) in favor of maintaining a high evening dose rather than evenly splitting the reductions between morning  and evening.

Currently the manual looks something like this for me:  morning 0mg, mid-day 0mg, Evening 10mg (reduce further from evening dose).

Wouldn’t it be better both to help those with daytime anxiety and help maintain appropriate Valium blood levels throughout the day to have it look something more like this:  morning 5mg, mid-day 0mg, evening 5mg?

Dose reductions could then be alternated between the morning and evening doses every 2 weeks or as appropriate.

Hopefully this makes sense.

[Shep]

15 hours ago, Fish77 said:

On another note, I was wondering why the Ashton Manual recommends completely eliminating certain Valium doses (like the morning and mid-day dose) in favor of maintaining a high evening dose rather than evenly splitting the reductions between morning  and evening.

 

While we recognize Dr. Ashton's work and what she gave to the withdrawal communities, we don't adhere to the Ashton Manual here. If you're interested in discussions about this, we have this thread over in the benzo forum - Ashton and beyond in benzo tapering.

 

I would suspect that keeping the evening dose higher would be to help with sleep, and that may have been Dr. Ashton's reasonings. Since Valium has a half-life of up to 200 hours, it's a drug that can taken once a day. For people who find Valium overly sedating during the day, taking it only at night is best.

 

However, others benefit from having a dose during the day. So you'll have to do what's right for you based on your own symptoms. I would go by your own symptoms more than by the Ashton Manual. 

 

Since you're also taking Viibryd, which can be stimulating for many people, once you get down low enough on the Valium, you may want to hold and think about tapering the antidepressant next. Just a thought, as preserving sleep is key. This thread explains more:

 

Taking multiple psych drugs? Which drug to taper first?

 

Keeping a small dose of Valium at night for sleep may be helpful. If you find that to be true, you could hold the Valium steady and reduce another one of your drugs. But again, I would go by your symptoms. 

[Fish77]

2 hours ago, Shep said:

 

While we recognize Dr. Ashton's work and what she gave to the withdrawal communities, we don't adhere to the Ashton Manual here. If you're interested in discussions about this, we have this thread over in the benzo forum - Ashton and beyond in benzo tapering.

 

I would suspect that keeping the evening dose higher would be to help with sleep, and that may have been Dr. Ashton's reasonings. Since Valium has a half-life of up to 200 hours, it's a drug that can taken once a day. For people who find Valium overly sedating during the day, taking it only at night is best.

 

However, others benefit from having a dose during the day. So you'll have to do what's right for you based on your own symptoms. I would go by your own symptoms more than by the Ashton Manual. 

 

Since you're also taking Viibryd, which can be stimulating for many people, once you get down low enough on the Valium, you may want to hold and think about tapering the antidepressant next. Just a thought, as preserving sleep is key. This thread explains more:

 

Taking multiple psych drugs? Which drug to taper first?

 

Keeping a small dose of Valium at night for sleep may be helpful. If you find that to be true, you could hold the Valium steady and reduce another one of your drugs. But again, I would go by your symptoms. 

 

Shep:

 

Thanks for your insightful response.  I didn't realize the Ashton Manual was not adhered to here (I honestly thought it was the only published method for slow-moderate taper).

 

I talked with my Psychiatrist and she is reluctant to have me hold on the Valium WD and start the Viibryd WD.  Her reasoning is that I've made so much progress on the Valium wd already, she is concerned that it could derail or cause a backslide for the benzo withdrawal.  That may not be correct reasoning, but she has worked with me for years and has given me every bit of help I could ever ask for on my benzo wd journey so far (crossing me over to Valium, prescribing pills of all sizes to let me go as slow or fast as I need to, calling to check in, etc.).  So I wont push her further on this at this time.

 

I've thus far been very fortunate with regard to my withdrawal symptoms.  Had about two days of really wacky nervous system deregulation where I was practically narcoleptic and have had some headaches, muscle pains, tremors, etc., but I understand the worst is yet to come.  If my symptoms get out of control, I'm sure my Psychiatrist will work with me.  But for now, she's asked me to stay the course and try to see this benzo withdrawal through to the end.

 

My plan after Valium withdrawal is to go off Viibryd, then Lithium, then Pregabalin.  The other drugs will remain as they are not psychiatric.

 

[Shep]

20 hours ago, Fish77 said:

My plan after Valium withdrawal is to go off Viibryd, then Lithium, then Pregabalin.  The other drugs will remain as they are not psychiatric.

 

Removing the Viibryd next sounds like a good plan, Fish. The lithium and pregabalin may give you enough sedation to help with sleep, especially as the stimulating antidepressant is removed.

 

And since you mentioned lithium causing hypothyroidism, you may not need the thyroid drug after you come off these drugs. You may want to have a read of the thyroid thread on SA, as many members have had the same experience of developing thyroid issues due to psych drugs. 

 

Thyroid symptoms: hypothyroid, Hashimoto's

 

 

20 hours ago, Fish77 said:

Had about two days of really wacky nervous system deregulation where I was practically narcoleptic and have had some headaches, muscle pains, tremors, etc., but I understand the worst is yet to come.

 

I don't think the worst is yet to come if you adhere to a slow and careful taper. From what you posted earlier in your thread, you were likely tapering too fast and these reductions caught up to you. So slowing down and doing plenty of holds will help with this. 

 

Your symptoms will guide you through this. 

 

You may want to check out the non-drug coping section and see if anything interests you that may help with your symptoms. 

 

Non-drug techniques to cope with emotional symptoms

 

Non-drug techniques for dealing with body pain

 

Benzos are muscle relaxers, so withdrawal from them can cause muscle pain. Stretching and yoga can be very helpful for this. The Beyond Meds site is written by someone who came off a large cocktail of psych drugs and she compiled some very useful articles and videos. 

 

Beyond Meds - Yoga archives

 

 

20 hours ago, Fish77 said:

 I didn't realize the Ashton Manual was not adhered to here (I honestly thought it was the only published method for slow-moderate taper).

 

The Ashton Manual is from the 80s. A lot of what doctors need to know about tapering doesn't even come from other doctors - it comes from what we're compiling online here  and on other sites. This site has already been used in the scientific literature and in developing tapering strips, as Alto mentions here: 

 

SurvivingAntidepressants.org mentions and honors

 

And web forums are being cited in psychiatry's own online sites: 

 

Psychiatric Times: Online Communities for Drug Withdrawal: What Can We Learn?

 

Dr. Ashton did important work, but she was just the beginning. We've come a long way since then. 

[Fish77]

On 11/8/2019 at 7:21 AM, Shep said:

 

Removing the Viibryd next sounds like a good plan, Fish. The lithium and pregabalin may give you enough sedation to help with sleep, especially as the stimulating antidepressant is removed.

 

And since you mentioned lithium causing hypothyroidism, you may not need the thyroid drug after you come off these drugs. You may want to have a read of the thyroid thread on SA, as many members have had the same experience of developing thyroid issues due to psych drugs. 

 

Thyroid symptoms: hypothyroid, Hashimoto's

 

 

 

I don't think the worst is yet to come if you adhere to a slow and careful taper. From what you posted earlier in your thread, you were likely tapering too fast and these reductions caught up to you. So slowing down and doing plenty of holds will help with this. 

 

Your symptoms will guide you through this. 

 

You may want to check out the non-drug coping section and see if anything interests you that may help with your symptoms. 

 

Non-drug techniques to cope with emotional symptoms

 

Non-drug techniques for dealing with body pain

 

Benzos are muscle relaxers, so withdrawal from them can cause muscle pain. Stretching and yoga can be very helpful for this. The Beyond Meds site is written by someone who came off a large cocktail of psych drugs and she compiled some very useful articles and videos. 

 

Beyond Meds - Yoga archives

 

 

 

The Ashton Manual is from the 80s. A lot of what doctors need to know about tapering doesn't even come from other doctors - it comes from what we're compiling online here  and on other sites. This site has already been used in the scientific literature and in developing tapering strips, as Alto mentions here: 

 

SurvivingAntidepressants.org mentions and honors

 

And web forums are being cited in psychiatry's own online sites: 

 

Psychiatric Times: Online Communities for Drug Withdrawal: What Can We Learn?

 

Dr. Ashton did important work, but she was just the beginning. We've come a long way since then. 

The stretches have been helpful (I’m too heavy for most yoga), as has meditation, CBT, spending time with family and friends, and taking medical leave from work to reduce stress.

 

I’m now down to 8mg Valium per day and have been relatively asymptomatic compared to the horror stories that I’ve read on here and BenzoBuddies.    Definitely in withdrawal normal.  Here’s hoping it stays that way and I remain fortunate.  I also wonder if the fact that I’m on 2 different calcium channel blockers/medicines is helping in any way.

 

I’ll be moving forward based on my symptoms.  Also looking forward to ending lithium, getting my thyroid function back, and getting off Synthroid.

[Shep]

Excellent update, Fish. Sounds like you're doing everything right. 

[Fish77]

On 11/15/2019 at 9:09 AM, Shep said:

Excellent update, Fish. Sounds like you're doing everything right. 

Thought I’d return for an update.  
 

I’m now down to 3mg.   It’s been a difficult journey.  I had particularly tough mental symptoms at around 5mg (stayed in the apartment for 5 straight days, extreme anxiety, depression and paranoia), but they resolved with an extra week hold.

 

As for physical symptoms, my muscles have been extremely sore throughout and I’ve had a lot of headaches and overall fatigue and exhaustion.

 

I can see the end of this journey in the near distance.  It is close and I’m motivated to see it through.

[Shep]

On 11/14/2019 at 12:21 PM, Fish77 said:

I’m now down to 8mg Valium per day and have been relatively asymptomatic compared to the horror stories that I’ve read on here and BenzoBuddies.  

 

14 hours ago, Fish77 said:

I’m now down to 3mg.   It’s been a difficult journey.  I had particularly tough mental symptoms at around 5mg (stayed in the apartment for 5 straight days, extreme anxiety, depression and paranoia), but they resolved with an extra week hold.

 

Fish, please stop tapering and hold. 

 

You've gone from 8 mg down to 3 mg - a 62.5% reduction - in 44 days, which is way too fast. Please see:

 

Why taper by 10% of my dosage?

 

On 8/5/2011 at 4:43 PM, Altostrata said:

In a nutshell, the 10% taper method recommends a 10% dosage reduction every 4 weeks, with the 10% calculated on the last dosage. The amount of decrease is proportionate to the last dosage (not the original prescription) and keeps getting smaller.

 

Because of Valium's long half-life, you may not feel a reduction for a week or longer. It's good you felt better after a week's hold and the symptoms resolved, but I really wouldn't push your luck, especially with a long history of polydrug use. 

 

If you go too fast and you crash your nervous system, the symptoms won't resolve for a long time and updosing may or may not work.

 

Since you have other drugs to taper, it's important to nurture your nervous system for the entire journey of coming off these drugs. 

 

[Fish77]

2 hours ago, Shep said:

 

 

Fish, please stop tapering and hold. 

 

You've gone from 8 mg down to 3 mg - a 62.5% reduction - in 44 days, which is way too fast. Please see:

 

Why taper by 10% of my dosage?

 

 

Because of Valium's long half-life, you may not feel a reduction for a week or longer. It's good you felt better after a week's hold and the symptoms resolved, but I really wouldn't push your luck, especially with a long history of polydrug use. 

 

If you go too fast and you crash your nervous system, the symptoms won't resolve for a long time and updosing may or may not work.

 

Since you have other drugs to taper, it's important to nurture your nervous system for the entire journey of coming off these drugs. 

 

I’m about to go on vacation, so I’ll be holding at 3mg until 1/13/2020.  That’ll be my longest hold this entire journey (12/24-1/13) and hopefully will be enough to adjust.