StrangeAnimal: Deeply Concerned about Next Steps following Paxil Tolerance

[StrangeAnimal]

Agreed LexAnger, and I'm more than Gratefull to you and all all others who took the time to offer their stories and advice.

[LexAnger]

Indeed, this is the best site with the most knowledgable ppl willing to help!

 

I would suggest for you to hold on before a sound plan in place. I wish so much I could go back time and consult for critical decision when I made my quick own decision before. My situation and life can be so much better if I did.

[StrangeAnimal]

Hey guys, I promised an update so here it is...

 

I'm in a very bad spot at the moment. I felt it was important to stabilize before beginning my tapering so I upped the paxil from 30mg to 40mg. After 2 weeks (probably not long enough) I went back down to 30mg because I wasn't feeling any better and certain side effects reached an intolerable point. After a couple more weeks of desperate angst I finally caved and began a two week cross-taper to celexa. My doctor told me to reduce the paxil from 30 to 20 and add 10mg of celexa for the first week, and then 10mg of paxil and 20mg celexa for the second week, then remove the paxil and hold at 20 for now on the celexa. The first 5-6 days after my last paxil dose i felt reasonably well. Around the week mark, well, re-read the first sentence in this paragraph. I feel like I'm losing my mind (significant anxiety, depersonalization, insomnia, vivid dreams, virtigo. I probably would have checked myself into hospital if I didn't have ativan. Nevertheless, now I'm concerned about the 5 months I've been on ativan. Similar to brassmonkey I always felt fortunate that I was only ever on just one med, avoiding a cocktail conundrum. I always told myself I would never get myself into this situation (not knowing if the way I feel is withdrawal from one, start-up effect from the other, or perhaps benzo tolerance just to make things a little more fun and unclear for an ocd sufferrer who needs surety.

 

Anyway, I know I haven't given the celexa enough time yet (2 1/2 weeks today at 20 mg), but I'm not at all positive about where this is heading. In all seriousness, I would LOVE to have a panic attack right now to feel somewhat more real and grounded, plus, the relieved feeling of a panic attack subsiding is better than anything I've experienced in my zombie state the last little while.

 

For those of you who told me (NOT TO CROSS TAPER), please have a chuckle on my account, I wouldn't blame you at all.

 

Anyway, I just posted an update because I promised I would, and I always keep my promises.

 

I hope all of you are doing well.

 

Cheers

[StrangeAnimal]

******* PLEASE DISREGARD POSTING ABOVE, LOOKS SIMILAR BUT I SLIGHTLY REVISED AND COULDN'T REMOVE IT *******

 

Hey guys, I promised an update so here it is...

 

In short, I'm in a very bad spot right now. I felt it was important to stabilize before beginning my tapering so I upped the paxil from 30mg to 40mg. After 2 weeks (probably not long enough) I went back down to 30mg because I wasn't feeling any better and certain side effects reached an intolerable point. After a couple more weeks of desperate angst I finally caved and began a two week cross-taper to celexa. My doctor told me to reduce the paxil from 30 to 20 and add 10mg of celexa for the first week, and then 10mg of paxil and 20mg celexa for the second week, then remove the paxil and hold at 20 for now with the celexa. The first 5-6 days after my last paxil dose i felt reasonably well. Around the week mark, well, re-read the first sentence in this paragraph. I feel like I'm losing my mind (significant anxiety, depersonalization, insomnia, vivid dreams, virtigo. I probably would have checked myself into hospital if I didn't have ativan. Nevertheless, now I'm concerned about the 5 months I've been on ativan, I'm sure I was experiencing inter-dose withdrawal from the ativan before beginning the cross-taper. Similar to brassmonkey, I always felt fortunate that I was only ever on just one med, avoiding a cocktail conundrum. I always told myself I would never be in the situation I'm in now (not knowing if the way I feel is withdrawal from one, start-up effect from the other, or perhaps benzo tolerance just to make things a little more fun and unclear for an ocd sufferer who needs surety.

 

Anyway, I know I haven't given the celexa enough time yet (3 weeks tomorrow at 20 mg), but I'm not at all positive about where this is heading. In all seriousness, I would LOVE to have a panic attack right now to feel somewhat more real and grounded, plus, the relieved feeling of a panic attack subsiding is better than anything I've experienced in my zombie state the last little while.

 

For those of you who told me (NOT TO CROSS TAPER), please have a chuckle on my account, I wouldn't blame you at all.

 

Anyway, I have never felt worse in my life, I seriously don't know how much longer I can take of this. That's exactly what I'll be telling my Psych at my app't tomorrow, but my faith in him is now non-existent.

 

I'm desperate for opinions, should I wait out and try to stabilize on the celexa or switch back to paxil for stabilization? And if I switch back to paxil should I do another cross taper or just an immediate switch?

 

Any advice would be much appreciated.

 

Regards,

SA

[Altostrata]

Hello, StrangeAnimal, I merged your topics, please put all your updates in this one Intro topic.

 

One of the risks of switching to another antidepressant to go off the first is that the substitution does not work.

 

It makes sense that it took 5-6 days for your nervous system to recognize the absence of Paxil. If you have been getting progressively worse, it's likely you have Paxil withdrawal syndrome.

 

Will the Celexa ever "work" to mask Paxil withdrawal syndrome? My guess is since it hasn't so far, it's not going to.

 

Your choices are not pleasant: Risk the switch back to Paxil (I would try 20mg), switch to Prozac (another risk), or stick with the Celexa for a while. It's likely you will continue to need the benzo; chances are you will become dependent on that and have to taper off after you get the antidepressant sorted out.

 

The condition with "poop-out" is likely maximal downregulation of serotonin receptors. The reason upping the dosage works for a short time and then poops out again is that the poor serotonin receptors simply have no more downregulation left. Adding or switching to another SSRI often doesn't get any more downregulation out of them, either.

 

This is the destructive cycle of antidepressant use. Withdrawal syndrome is related to the downregulated receptors' delay in upregulating. While they attempt to correct, other neurohormonal and hormonal systems become dysregulated. This usually is expressed in autonomic nervous system dysfunction.

 

My guess is the difficulty you're having now is because of maximal downregulation from Paxil and Celexa had nothing left to work with.

 

I want to commend all the community members who have taken part in this topic for an exceptionally intelligent conversation.

[Meimeiquest]

I can promise you no chuckles...it's just hard to know what to do sometimes. My vote is with keeping things the same, but others might have a much more educated guess. There was once a member here with a diagnosis of Pure-O (that is not to say whether she has it or not) who had a real tough time with reinstatement. You might send her s PM and see if she responds....WatchingTV426. In the meantime, check out the Symptoms forum, especially the pinned topics. We hope for the best for you!

[Meimeiquest]

Alto wrote while I was typing, and she is the best you can get...ignore me

[StrangeAnimal]

Thanks Alto and Meimeiquest!

 

Alto, I completely understand the whole "this is not medical advice" parameters. However, I would love to know what you would do in my shoes.

 

Regards

[Altostrata]

I'm sorry, I really couldn't say.

[StrangeAnimal]

Well, your input and time is still appreciated Alto.

 

I understand that psychiatry is not an exact science. While accepting that nothing is guaranteed, I was just hoping to receive some sort of guidance that pointed me in a direction that was "most likely" in my long term best interest based on all the research and wisdom accumulated here.  

 

I feel more lost now than ever. I'm not going to sugarcoat anything at my app't tomorrow and if I'm admitted into hospital then so be it. I'm not sure how much longer I can live with this daily torment of fear, confusion and doubt about ever finding myself again. I'm trying to be strong but everywhere I look I only seem to find further guarantees of suffering and misery. In one respect, this site primarily supports the slow tapering and eventual cessation of all medication. Yet, there appears to be evidence that in some cases down-regulated receptors never recover following prolonged SSRI use. How can anyone be expected to muster the strength to endure this level of torment without at least a guarantee that things "will definitely get better". Perhaps I'm being selfish. Perhaps I'm just weaker than most. As someone with mental illness, I used to think that I was lucky to be born in this era, in which neurosis and psychosis were clearly distinguished from one another, and anxiety/depression were no longer treated by horrific means. Now, I feel that I (along with millions of others) may be victim to an era of psychiatric treatment that will one day be looked upon as no less horrific and even more criminal than generations prior.  

 

Many thanks to EVERYONE on this forum, your time and kind words are more appreciated than you'll ever know.

 

SA

[Meimeiquest]

Hi SA,

 

Just want to reach out and give you a virtual hug or whatever. I come from a relatively awful family background of mental and behavioral problems. I truly believed I was doing the responsible thing to tell doctors everything and do whatever they said. But there really is a better way, and there is every reason for hope. Many, many people have passed through this forum and into wellness...you just won't see their threads come up because they are busy out doing life.

 

I'm not done yet, but I have come off a lot of medication, and I'm still standing...and I've even made a lot of mistakes along the way. I have become a great believer in hyper-education...know everything you can about your drugs, your diagnosis, how the brain works, how psychiatry works, what underlying physical conditions could contribute to your symptoms. Read every pinned topic in every forum. When you're locked inside your head with symptoms, study, study, study.

 

Here are some web that have helped me: psycheducation.org (Dr. Phelps has a more traditional approach, but lots of great info and he even recommends this site!), Kelly Brogan MD, Nancy Mullan MD. More controversial, but the videos at Mensahmedical.com have profoundly impacted me. Beyondmeds.com is beyond amazing. I haven't read it, but Stuart Shipko MD offers an ebook on Amazon regarding the risks of taking and of going off meds.

 

Regarding hospitalization, have you identified your goals of treatment there? I had a friend who found inpatient treatment amazing in a unit that specialized in people with a history of trauma. My dad benefitted greatly from inpatient treatment that focused on his faith. But some people find it pretty traumatic. It is usually just for medication adjustment, or for safety.

 

Just my two cents, but again, really just want to offer support as you make some big decisions.

[LoveandLight]

Strange animal I so relate to what you wrote about finding yourself again..I'm also worried about that and I'm sorry your also worried about this while going through this x

[Altostrata]

It's unlikely hospitalization will resolve your withdrawal syndrome. Most likely, they'll mix up an arbitrary drug cocktail for you including an antipsychotic in the hopes of calming you down.

 

You will need to make a decision despite the unquantified risk of any of your options. The hospital will not be able to make a more informed guess than you can now.

 

Don't believe everything you read about downregulated receptors. We have many people here who have recovered even from states worse than yours. Withdrawal syndrome and recovery from it are largely unexplored territory.

[RubyTuesday]

To wrap this up, what clearly concerns me the most at the moment is the lack of clarity in mental health with regards to next steps

 

This is the understatement of the century. (quote above.)

Re: the 5 options: I would definitely go with micro-tapering and sticking with one drug and not adding any more to the mix. (and not tapering two at once. taper only one at a time.) But, it sounds like Ativan has already been added to the mix. Some advise withdrawing the activating drug first (Paxil) but since the time frame is so different I have also heard that withdrawing the last drug first is better. Ativan can sneak up on you even at the low doses and short times you mention (it did on me)

you may want to investigate Peter Breggin's method of tapering and then reinstating and then tapering: in Psychiatric Drug Withdrawal he gives some clear guidelines for deciding when to reinstate, I did this for part of my Seroquel withdrawal.

I also was encouraged by my original doctors to up and down dose myself with Prozac in correlation with my menstrual cycle. upon reflection I see that this damaged my brain further.

your "OCD" can greatly assist you in getting off the meds since you can think very carefully and precisely about all the aspects of the situation, and that is what is needed in order to determine the best next steps.

as angry as I am at the doctors who have callously led us into this situation by abusing their authority in this manner, I am even more grateful and amazed that the internet exists and forums such as this are an even more powerful tool for recovery.

blessings

[RubyTuesday]

so sorry you are going through this, believe me I have been there. when all else fails I remind myself that "this too shall pass" and "the only constant is change."

when I faced a similar decision I reinstated back to the original SSRI (Prozac) and off the "substitution". I felt that this made the subtle difference between Intolerable and Absolutely Intolerable.

Unfortunately there is never any way to know if a different decision might have been easier to tolerate. This is why the concept of "holding" is an important one. Or trying to figure out what is the best approximation of a "hold" that can be arranged in our present intolerable circumstance.

I wish you all the best, and don't be surprised if your doctor is not very helpful.

blessings

[StrangeAnimal]

Thanks for your replies Meimeiquest, LoveandLight, Alto and RubyTuesday, they are much appreciated!

 

I agree with you Alto, I don't truly believe that hospitalization is wise, I just feel so desperate at the moment. If, as you say, others have recovered from worse states than mine, then that is exactly the kind of encouragement that I need. 

 

I truly believe that I could handle almost any level of discomfort for a period of time, if I could only be guaranteed that I won't lose my sanity before the difficult period subsides. Unfortunately there are no guarantees for us, and I need to accept that fact while moving forward.

 

Thanks again!

 

SA 

[Prestorb]

Hi SA, I am sorry for how badly you are feeling right now. I had a similar experience trying to cross taper from Paxil (40 mg) to Zoloft early this year. After two weeks off the Paxil, I reinstated at 5 mg and then up to 10 mg, which is where I am currently. For me, reinstating Paxil was the key to reducing my symptoms. I was still on a low dose of the Zoloft initially, but tapered it off pretty quickly since I had taken it for such a short period. Everyone is different, but for me, this has stabilized my symptoms to a tolerable level. Hang in there!

[Meimeiquest]

What does "lose my sanity" mean to you? With my anxieties. I have to go through what I would do if XYZ happens. Which reminds me of my own insanity fear: That I will be so full of rage or suicidality that my husband will call 911 and they will give me an antipsychotic. But I am so sensitive to antipsychotics, a normal dose seriously might stop my breathing. Which reminds me I haven't had that talk with my new pdoc, need to do it at next appointment. He wouldn't do that, but what about on-call doc? Have explained the issues in detail to my husband. This is pretty unlikely since it hasn't happened in 54 years, but that's how I deal with those fears, just untangle them.

[Altostrata]

You are having an adverse drug reaction, not losing your sanity.

[StrangeAnimal]

Thanks Prestorb, Meimeiquest, and Alto. Well, had another appointment this morning and felt worse than I did prior. My Psych now reveals that it's not that he felt Paxil would no longer work for me, but he didn't want to increase it to 40mg for the first time in the 15 years I've been on it (I've never been on more than 30mg) because he knows I want to get off SSRI's one day and that increasing the Paxil would make it "Paxil" (the hardest one to come off of) that much harder. Well, unfortunately the two week cross taper and subsequent month in total on celexa has been a failure. And now I've got inter-dose Benzo withdrawal because this relapse has been so much longer than any prior. It was always pretty easy to come off short-term use of ativan once the paxil kicked in during past relapses. I can only imagine what it's going to be like this time. My Psych is against me returning to paxil but get this, "it is up to me" whether I should try upping the celexa from 20mg to 30mg at this time. Wow, thanks for the professional guidance doc! I'm so confused about what to do now, I'm leaning towards returning to paxil but I'm also somewhat desperate and don't like making arbitrary decisions in this state.

 

Any thoughts?

[Altostrata]

It's impossible to tell what will work. You need to make your decision and clearly and firmly communicate it to the psychiatrist.

 

Why did he switch you to Celexa rather than Prozac?

[StrangeAnimal]

Thanks for touching base Alto.

 

I believe he chose Celexa because it's newer and he felt it would be quicker acting.

 

Is there any particular reason why you feel prozac should have been considered first?

 

Thanks,

SA

[Meimeiquest]

I am guessing Alto was thinking that Prozac is, for at least some people, easier to taper because of its long half-life. And I believe it was the first drug to be studied for OCD, if your doctor is buying into that diagnosis. You can see the thread on the Prozac bridge....works for some, not for others.

 

So you have Prozac, Celexa, and Paxil as options. Possibly reinstate just a tad of Paxil (even if it doesn't feel like it, your brain is daily adjusting to its absence, so you possibly could get into real trouble if you reinstated a full dose) while on Celexa and if you stabilize, taper Celexa, then Paxil. I have no idea of dosage options, just the theory. Remember the four-day guideline, that's how long it generally takes for a change to register. I see those as your four choices,

 

So I have been tapering for three years, IMO, this is really the ultimate therapy, it puts you into so many positions to learn new skills. I'm guessing, if someone put an OCD label on you, that you like words like always, definitely, certainly. And now you have a decision to make where "definitely" "none" of those words apply. Free therapy . As long as one moves slowly, in tiny amounts, things normally don't get too messed up. And there are other ways to manage, with gentle exercise, dietary interventions, sleep hygiene. So just do a gut check, start a daily symptom diary so you can look back as you make new decisions, and join this risky, uncertain party! If you want to...but I'm pretty sure it's safer than just entrusting yourself to your physician.

[StrangeAnimal]

Meimeiquest, I really appreciate your input and inspiration, thank you!

 

I've been doing more research today (I've done enough the last couple months to publish a dozen scholarly articles) and it appears that Lexapro may be another option for me to stabilize with before I begin my slow taper. There's no question that frustrations stemming from the lack of clarity and direction for next steps following this first time failure of paxil to get me through a rough patch has left me very scarred and depressed. However, the fact is that my main mental health issues are anxiety based (OCD, panic attacks, etc.), not depression.

 

Today I came across a very detailed comparison of all the SSRI options, which looked at pretty much every variable I could ask for. Paxil and Luvox are considered the most sedating SSRI's. Notwithstanding the long term damage I'm now dealing with, perhaps that's why paxil worked for me over the years, sedative SSRI's are obviously more effective than activating SSRI's for those being treated for anxiety issues. In any case, Lexapro is listed alone as the best SSRI for anxiety because of it's "potent anxiolytic-like effects". It's a little strange to me that Lexapro is listed as the best for anxiety but not listed as the most sedative, I would have assumed that "sedative" and "anxiolytic" are simply two different ways of referring to similar properties. Apparently not, or it's not that simple?

 

Anyway, similar to Paxil's sedative properties, I'm wondering if Lexapro's anxiolytic properties will assist my weaning off ativan, which is my first priority. Multiple times throughout the years I would be prescribed ativan for daily use of 1-2mg during bad relapses for approximately 3-4 weeks until the paxil took effect. Not once did I have any difficulty stopping the ativan when the required paxil dose took effect. If Lexapro is the most effective SSRI for anxiety, perhaps it can at least somewhat assist with my inevitable withdrawal issues following 5 months and counting of daily ativan use between 1-2mg?

 

More options but more confusion

[LexAnger]

Just to share my experience since you are considering lexapro.

 

My own experience supports your finding that lexapro did help with my anxiety, it did not put me into depression either, so in terms of effectiveness of treating anxiety and impact on other psychlogical aspects, it did not produce much obvious bad effects to me. This is soley my case as you may alreayd learned that many others who took lexapro did get side effects in this area. Nevertheless, this drug created many many severe physical side effect and lots ppl found it is the most potent ssir and this in turn makes the withdrawal very difficult.

[Meimeiquest]

You will have a hard time finding someone here recommend a different SSRI. Your initial problem in this episode is probably too much serotonin exposure from prolonged SSRI use. See Alto's note above. If you didn't down-regulate you'd have serotonin syndrome. Basically, the drug train, for you, has probably left the station. Right now, you luckily haven't played around enough to start the bipolar diagnosis game (this is a very frequent occurrence here), where the meds and subsequent withdrawal difficulties are so increased.

 

Most researchers now believe the positive effect of SSRI's is not caused directly by the relative increase in serotonin in the synaptic space.

 

What might help most is to slowly re-allocate your Ativan into three daily doses. That dramatically helps some people by providing a more even blood level throughout the day. I personally couldn't do that without unacceptable drowsiness, but moving some helped a lot. I use inositol, a secondary messenger (it picks up the message from the (neuro)hormone in several systems, but it backfires for some). You would try a tiny amount for a few days to see if you can even tolerate it, then titrate up. GABA can also help. Almost everyone benefits from magnesium, nearly everyone (a slightly smaller percent) from fish oil. If you want to try some of those things, do one at a time, not all at once. And all the issues noted previously about choosing which drug platform to work off still apply.

[Altostrata]

Prozac is most commonly used for "bridging" off Paxil and other problematic antidepressants.

 

"Newer" means absolutely nothing among antidepressants. Lexapro is not more sedating than Celexa; it is a close relative of Celexa. Quite a few people find Lexapro to be more stimulating than Celexa. Since Celexa hasn't been any help, it's simply a gamble that Lexapro will do the trick -- which would be true of any other antidepressant.

 

Meimei has proposed perhaps the most cautious way to test whether a reinstatement of Paxil will help.

[StrangeAnimal]

Thanks for the input LexAnger, Meimeiquest and Alto! Boy, I really hope to return the favour for other sufferers on this board once I'm somewhat feeling like myself again.

 

Meimeiquest, the intial problem that started this episode was prolonged work stress caused by under-staffing and a micro manager. I was only on 10mg of paxil for the previous 2 years prior to this current relapse and doing fine. The reason I stayed on 10mg for so long was that my previous attempt at coming off was a little too fast and led to a bad relapse. I didn't want to try again until comfortable in my new job and living a healthy balanced lifestyle. Unfortunately that never happened with this job. I now believe that the reason paxil failed to stabilize me this time is that I continued to plow through at work while concurrently upping the dose to a therapeutic level, even while I could feel myself destabilizing. The causes of my past relapses were as simple as missing a couple doses (that's all it takes with paxil's short half life) and/or stressors that were quickly rectified, so I was always able to recover in a relatively stress free environment. Not so this time, by the time I pulled the plug on work and went on short-term disability I had already been on ativan for nearly 3 months, waiting in vain for the paxil to kick in. No wonder the paxil failed to kick in, I was still stressed to the max on a daily basis. I regret switching from paxil to celexa, by the time I was off work I now believe that the ativan was the main issue because of interdose withdrawal. I should have held at 30mg paxil (the most I've ever needed to get through a past relapse) and focused on tapering the ativan. And then start slowly tapering the paxil following the ativan.

 

Meimeiquest, unfortunately I've already spread out my ativan doses throughout the day. I take 0.5mg when I wake up, 0.5 in the afternoon, and 0.5 before going to bed. I truly believe that the ativan is my biggest problem at the moment, I experience inter-dose withdrawal only 3 hours after the previous dose. I can't take this emotional roller coaster any longer. I'm going to talk to my Psych next week about switching to the longer acting valium to begin an immediate taper. I already know that my Psych has never heard of the Ashton Manual so I'll have to educate him on it.

 

Alto, I really appreciate your input. The truth is, I would prefer to avoid gambling any further with additional drugs, I'm already disappointed that I'm on my second ssri, I was always somewhat comforted that I had only ever been on one, regardless of the length of time. At least I would know the source of any future problems. I'm just going to hold the celexa at the current 20mg, I don't have a clue how effective it has been because it has been overshadowed by the more powerful Benzo. Once off the Benzo I'll have a better idea whether I'm stable enough to begin slowly tapering the Celexa or whether I may need to cautiously test a reinstatement of paxil in the way Meimeiquest suggested.

 

Thanks again!

SA 

[Altostrata]

Did your symptom pattern change after you switched to Celexa or do you think it's all due to the Ativan?

[StrangeAnimal]

Hi Alto,

 

During the two week cross-taper from paxil to celexa I felt somewhat ok, and then I felt a little cautiously better for the first 5-6 days off paxil. By the one week mark off paxil (not surprisingly) I started to feel worse, and I obviously assumed that paxil withdrawal had finally arrived to the party. What's really frustrating at the moment is that I know I'm experiencing inter-dose Benzo withdrawal because I feel better after a 0.5mg dose and then my mood changes abruptly roughly 3 hours later. I'm not sure what to think about the ssri cross-taper. In one respect I still feel very anxious and "depressed" when I awake first thing in the morning (the longest span between Benzo doses) so one would think that the "anti-depressant" is not working. Nevertheless, I'm aware that depression is one of the main symptoms of Benzo withdrawal. No wonder I'm a nervous wreck, once you get into the cocktail conundrum it's just a complete guessing game.

 

SA   

[LoveandLight]

Yes I am sorry. I think being in the dark so much about what is going on is really hard and adds extra stress.

[Altostrata]

It could be that Paxil withdrawal syndrome has destabilized your nervous system and you are feeling the adverse effects of the benzo more because of that hypersensitization.

 

If I were you, I would not jump into another drug switch while suffering nervous system destabilization from an earlier drug switch. Switching from Ativan to Valium carries the same risk as switching from Paxil to another SSRI -- the substitution may not work.

 

If your symptoms have increased rather than decreased, it seems to me your switch to Celexa was not successful.

[StrangeAnimal]

Hi Alto,

 

In theory, would testing the reinstatement of Paxil at say 10mg while holding the celexa at 20 confirm that the switch to celexa failed if I end up feeling a little better within a week?

 

Thanks,

Chris

[Altostrata]

It would indicate you need Paxil to quell your withdrawal symptoms.

[StrangeAnimal]

Thanks Alto, have a good weekend.

 

SA

[Meimeiquest]

Flying by. If you are able to focus enough to read, I recommend reading Stuart Shipko MD's book Xanax Withdrawal before you make a firm decision about the benzos. I doubt Dr. Ashton would have the same recommendations about Valium if she were starting now, but she was an amazing pioneer.

 

I took tiny bits of benzo every two hours from 5 a.m. to 7 p.m., then a bigger dose at 9 p.m. for many, many months to get my levels where I needed them. It took a lot of trial and error, moving with little changes. But I was able to work (70% of full-time) the whole time. And now I'm down to 1/20th of my original dose.