Hi, so glad to be here! -- from Lor95

[Punarbhava]

Hi Lor.......

 

 

hope to post more later once the severe cog fog has lifted. I had constructed two posts the other day but the site's server went down so many times and thus, I lost both posts, along with a few other posts.

 

 

My computer sensitivities got so bad after that I became very sick and couldn't expose myself to the computer any longer (although I did tried a couple of times). I also was experiencing brain zaps from the cumulative effects of computer work. The wonderful dynamics of psyche drug WD.

 

 

My mind is in bad shape ATM but I will try to reconstruct my posts later today. I better get off-line now since, my CNS is feeling the effects from the monitor.

 

 

Punar

[Lor95]

Thank you my dear friends.

xxxxx

 

I have more to write later but just a suggestion for Pun....have you ever thought of (and I hope I'm not insulting your intelligence here) copying and pasting a quote or post you want to comment on to an MS Word doc and then working it as you want it, then copying it back into the reply box. That way you'll never lose a post.

It's what I do if I'm working on a particularly important or lengthy post - I've experienced the frustration of losing many, and when your cognition is challenged, it's not so easy to just start again.

 

xxxxxx

[Punarbhava]

Punar, thanking you for your thoughts just wouldn't be enough.

 

 

You're welcome Lor.

 

I have reinstated the 1mg xanax as, even though I really don't feel it has contributed to the deterioration (remember, at 15mg last time the symptoms were pretty much the same, increasing in severity over 3 months despite NOT using xanax).

 

Yes, I do remember this however, I believe you tapered more quickly the first time and/or didn't hold as long between drops before reaching the 15 mg point. No doubt the cumulative effect could have been playing out. And, I do understand that xanax was not in the picture at that point.

 

You mentioned in another post that THIS time, you became sicker more quickly and that you felt you were worse this time than last time. I wish to point out that THIS time around, you tapered much slower and thus, that in of itself should have produced more positive results, although I'm not saying that it still would have been easy at this stage. This time, you have utilized xanax, on a consistent basis, and thus, logic would alert someone into taking this factor into account.

 

However, with all that said, I won't repeat why this could be an influencing factor this time around, since, many of my previous posts, along with Rhi's posts indicate the various reasons why this could be.

 

BTW Lor, I wish to stress that the above paragraphs are not being presented in a challenging fashion but rather, I'm attempting to consider all relevant factors into the equation and thus, I don't wish for my typed thoughts to come across as aggressive in nature okay? Rather, I'm just being as analytical as possible, all in the spirit of concern (not wishing to miss anything that "may" be all or part of the equation). (lol)

 

I will now move onto the next subject that has come to mind: The Tolerance Factor. It is my understanding that most people, who are exposed to any drug, (long term) will develop a tolerance level to the drug, however, this does NOT mean that they will develop tolerance WD. There is a difference.

 

 

For example.........one may have been on a daily dose of say 100 mgs of any psyche drug. They begin to taper down and even by large drops but experience little problems (as what you incurred the first time you tapered).......feels like a piece of cake since, they have not incurred tolerance to the drug at these levels.

 

However, as one tapers to lower doses, things can become much more difficult and this is because one has now reached/discovered WHERE their tolerance level to the drug exists. So, in your case for example, your tolerance level to the drug is obviously at around 15 mgs. This is one reason why you likely have incurred much difficulty trying to get off the drug each time, within this dose range.

 

However, several attempts up-dosing, tapering again, reinstatments etc. etc. provoke bio-chemical confusion and this is when tolerance WD can develop for the first time. Now when this happens you are dealing with TWO scenarios playing out simultaneously. Your tolerance level at 15 mgs makes tapering more difficult in of itself however, once you've developed tolerance WD, tiny drops are going to be felt even more severely than if you were not in tolerance WD. In other words, YES these lower dosages would have been more difficult due to hitting your tolerance level but could have been more manageable/endurable and doable IF you hadn't developed tolerance WD.

 

 

If you were only dealing with your tolerance level to the drug, you'd be able to hold for long periods of time without incuring an increase in symptom severity. However, when coupled with the tolerance WD factor, you now can no longer hold for as long as you wish without incurring severe negative effects.

 

This next section is MY interpretation based on what I have observed, as well as my attempt to explain, in the simplest of ways, as to what happens when tolerance WD is severe.

 

Once one has developed tolerance WD (IF it is severe enough) the tolerance factor DOMINATES the equation and will continue to dominate unless it is somehow interrupted and interrupted in the right fashion (the proper tapering schedule and percentages) I was confused wondering WHY I could not make smaller drops. Why it would not keep the tolerance WD at bay etc. I kept thinking: "there has to be a reason for this!".

 

The simplest explanation is based on the my following thought: You know how the mind/brain cannot hold a positive thought and a negative thought simultaneously? Well I believe, or in fact, I know, in my case, my brain would NOT budge out of C/T state mode (due to severe levels of tolerance WD) by initiating a low percentage of a drop. The reason? Because it wasn't a large/great enough distraction for my brain.

 

In other words, I had to make a large enough drop to keep my brain BUSY, engaged actively enough in another activity in order to distract it from tolerance WD (screaming for more of the drug). As long as I could keep my brain busy enough up-regulating receptors (from the last drop) it could no longer fully focus on tolerance WD issue.

 

In my particular case 10 or 11 percent drops provided enough of a distraction. For other people 5 percent worked or even lower, depending upon the degree of tolerance WD that had developed. In other words, someone who was dealing with a lower level of tolerance WD could make smaller drops and could hold longer since their brain was not in as severe of a tolerance WD state and thus, a small percentage was enough of a distraction to keep the brain relatively satisified.

 

Now, in my case (as with others who experience severe enough tolerance WD) I also had to make drops closer together since, my brain appeared to up-regulate very quickly and as soon as those receptors (from the last drop) were partially up-regulated, my brain was no longer actively engaged/focused ENOUGH in a distracting activity and thus, it would quickly lapse back into severe C/T tolerance WD mode. In other words, my brain got bored and thus, reverted back into tolerance WD state.

 

So, the name of the game was to keep my brain moving FORWARD, at a regular pace , keeping it actively and regularly engaged in a distracting activity (up-regulating) so it could not focus as intensely on the existing severe tolerance WD state that it was in.

 

 

Again, this is MY explanation for things and I'm not saying I'm right here but it's the only explanation I can come up with and it does make sense to ME. Not saying others should by into my theory BTW. No one has explained it to me this way but I wish someone would have since, it would have given me something to mentally work with in the early phases of confusion, fear etc.

 

So, at this stage in your WD (xanax equation aside) you may have to make drops closer together and/or you may have to alter the percentage of your drops to keep the tolerance WD factor at bay as much as possible.

 

Please keep in mind that larger cuts do NOT eliminate tolerance WD symptoms. In fact, as you know, small drops can feel very profound when one is in tolerance WD and thus, if at all possible, it's best to keep the percentage of drops as low as possible and hold for as long as possible between drops.

 

One other thought, the up and down effect you seem to exhibit with each drop MAY indicate that you are not dropping a large enough percentage and thus, your brain may be waffling and confused between processing the last drop (up-regulating) and tolerance WD not being kept enough at bay.

 

With that said, it does appear that you are more able to utilize a lower percentage than I without lapsing into full C/T States. For example, 3 percent would never have kept my brain busy enough and thus, I would have been in 911 C/T states for a whole drop.

 

I must add the xanax factor here though since, this could be the cause of your drops being up and down in nature since, just about everyone, even the most extreme cases, exhibit a daily rhythm playing out. Symptoms most severe in the mornings and very slowly improving around 4 - 5 o'clock each day and feeling some relief (although not saying a person is feeling well by any means but can at least get out of bed at that point in the day to move around a bit) in the evenings.

 

This aligns will daily cortisol secretion cycles. Now IF you're not experiencing any degree of easement in the evenings then xanax is likely a factor here. In other words, if you become worse after 4 or 5 or 6 o'clock each day (once your morning dose of xanax has fully worn off) then I'd say xanax could playing a role in all this, at this stage of the game OR the percentage of your drops are not adequate enough.

 

Alto seems to know more about the intricacies of half-life factor than I do so keep in mind I'm relaying "generalities" in regard to xanax's half-life etc.

 

One other point, the lack of a pattern could also be the result of not dropping enough (percentage wise). IF you drop enough, you're brain will have adequate number of receptors to up-regulate and thus, you should notice the pattern or close to it, as I have described in earlier posts. This applies to a daily pattern (as described in above paragraph) as well as an overall pattern that should play out with each drop in dose (as I've describe in an earlier post).

 

However, this would be how things should play out WITHOUT any other drugs in the mix. Again, xanax could interrupt the daily pattern of events and/or make it much harder to observe as well as interrupt the sequence of events and patttern of how a drop plays out.

 

 

forgive me IF I've repeated any points here. To be clear: I'm not confused about what I have presented but rather, at this point, my brain is too tired to engage in further edits, so I will post "as it is"

 

Just wish I could present my thoughts in a more eloquent fashion however, WD has affected my cognitive abilities in way of being able to present my thoughts clearly in written form.

 

Lor I better post this ASAP. I'll try to proofread and edit once it has been posted but I'm afraid to lose all this in cyberspace.

 

Please excuse the abrupt exit.

 

Punar

[Altostrata]

Very sorry, everyone, for the site being so unstable. It's been moved to a new server, which should fix the problem.

[Punarbhava]

I tried to add this into my previous post but I was no longer allowed to edit so I have posted this additional info below:

 

 

 

I wish to add one other point regarding the "daily" cycle of how symptoms usually play out. While most people experience a degree of relief in symptoms (lower intensity) in the evening, some people will also experience an increase in intensity later in the evening (close to retiring).

 

This is what I experienced as well. So thought I'd better mention this. So, to recap: mornings produce most severe symptoms........gradually as the day progesses symptoms may slowly lessen in intensity. At around dinner time, between 4:00 - 6:00 symptoms should notice a greater degree of ease (although not implying that symptoms will disappear). Ex. I could not keep down food at all during the morning or daytime however, at around 6:00 I could manage to eat certain types of food, in small quantities (small snack). Later at 9:00 or 10:00 at night I could keep down my dinner and although it was not comfortable I felt grateful to be able to eat something and keep it down.

 

Very late in the evening, symptoms "could" become worse again. This not true for everyone though. Many people retain greater degree of ease all evening.......right through to bedtime.

 

 

Punar

[Punarbhava]

Very sorry, everyone, for the site being so unstable. It's been moved to a new server, which should fix the problem.

 

 

Oh Dear Alto..........not your fault so please don't feel bad. BTW, the new server seems to be operating MUCH better. I've remained signed in for a very long time now and I have NOT experienced one problem. Previous days, I couldn't even be in the site for 5 mintues without incurring problems. So, all seems so much better.

 

 

Thank you for posting about this and for working so quickly to correct this technical problem.

 

 

Punar

[Punarbhava]

Thank you my dear friends.

xxxxx

 

I have more to write later but just a suggestion for Pun....have you ever thought of (and I hope I'm not insulting your intelligence here) copying and pasting a quote or post you want to comment on to an MS Word doc and then working it as you want it, then copying it back into the reply box. That way you'll never lose a post.

It's what I do if I'm working on a particularly important or lengthy post - I've experienced the frustration of losing many, and when your cognition is challenged, it's not so easy to just start again.

 

xxxxxx

 

 

thank you Lor for the suggestion and you're not insulting me at all. I have indeed utilized this method for precautionary measures, however, everytime I went to copy and paste into SA I'd lose the whole post. I'd try to copy and paste again, and lose it once more etc. etc. because the site's server was broken. Site kept going into "not responding mode everytime I clicked on "post" icon.

 

While I had the bulk of it typed in my private email acc't (then copied and pasted it over) under "quotes from your text".

 

If I didn't respond to posts line by line, it would be less of a problem. (lol) But, as you can see from my long email, I had a lot of thoughts to relay and by the time I finished typing most of it in my email acc't I was on computer overload as it was but then I got even worse when I encountered repeated failures as mentioned above.

 

Anyway, I'm on overload right now and likely not explaining myself well (lol). In any case, your suggestion is not in vain. Others who read this thread (in present and future) will benefit from your recommendation.

 

Thank you for taking the time to relay this since, I agree, it is a good method to secure one's work/efforts.

 

 

Punar

[Punarbhava]

Forgot to include another point in the whole equation re: the drug metabolizing itself at lower levels.

 

 

 

Alto, do you think that this factor influences the rate at which one's receptors up-regulate? In other words, could one's receptors up-regulate at a faster rate at lower doses due to this factor?

 

Would this also mean that the half-life washes out quicker as well, hence producing more intense symptoms? I swear to God that I was upregulating very quickly towards the end and thus, I had to get off the drug since, it was causing more problems staying on the drug. And it did land up to be the case. The DAY I STOPPED the drug, I felt 50 percent better (although still very sick..........it just wasn't as violent).

 

I'm kind of on mental overload right now and thus, cannot fully process my thoughts on this ATM but I want to throw this out there before I forget.

 

 

Here's what occured in my situation although I'm not unique since, I've seen this occur in many people as well.

 

 

To explain: Earlier during my severe tolerance WD taper (when I was on 110 mgs) I was able to hold at a dose for approx. 30 days.

 

 

Then at around 80 mgs I could only hold for 21 days. At some point further down the holding time was 14 days and then once, I got down to lower doses it was 11 days.

 

 

I have no explanation for this other than what I have mentioned above. I have no idea IF this is correct but there must be some explanation for this change in holding pattern.

 

 

Note: please keep in mind that my drops were pretty much consistent re: 10 percent rate.

 

 

Punar

[Punarbhava]

question is..what options do I have now?

 

Lor, I reviewed the list of your drops (several times) and despite the up and down (inconsistent pattern) you appeared to have known WHEN to initiate your next drop. So, this is good news.

 

 

There definitely appears to be a point where symptoms do escalate in intensity AFTER HOLDING for a reasonable period of time. So, this aspect seems to be something that can be properly relied upon to assist you, in regard to knowing when to make another drop in dose.

 

 

Of course, this can only be relied upon when no other drugs are in the picture. Please for give me for repeating this point, yet again but I wish to cover my conscience in this whole process, not to mention, there will be other people reading this thread in the present and/or in the future and thus, I feel I must highlight this point repeatedly all along the way so there is no misinterpretations being made. When one is in bad WD state, one can easily forget critical points and thus, make an uninformed decision in haste and desperation. I just wish to minimize the chance of this happening to others, as well as yourself.

 

 

If I recall correctly, you did mention in one post that your use of xanax was intermittent during some phases but then became a more regular (daily) thing in recent drops. The intermittent use of xanax could explain fluctuations (up and down effect) experienced during some of your drops and/or as I mentioned, you just didn't drop the right percentage. I think I mentioned this in another post but I can't reread anything lengthy ATM so please forgive the repeat.

 

In any case and whatever the reason, you DID KNOW WHEN to make your next drop.

 

for some reason, and I don't have a clear answer to this but one's holding phase can change as one gets down lower in doses. BTW, this holding time could change dramatically and very quickly. For example, lower doses I was able to hold for 14 days but then, my NEXT drop tolerance WD hit me within 11 days of making a drop. I was terrified to make another drop because I thought "this is too soon!!!"

 

However, I held for another and another and another day and just got more violently sick and thus, I initiated a drop and it landed up being the right move. From that point forward I could no longer hold for 2 weeks.

 

Now, I need to be clear and remind that I'm not implying that this is the tapering schedule that is right for you or anyone else for that matter. It may be and yet, it may not be. I'm just sharing what occurred for ME. I do know many people though who could not hold longer than 14 days when they got down to lower doses.

 

Keep in mind that I'm presenting all this NOT factoring in any other drugs that are being simultaneously ingested.

 

Day 14, even more brutal, I won't elaborate, but trust me.

Day 15, today probably worse, we'll see how it goes.

 

 

 

Lor, you have several options at this time:

 

1) try to hold longer and see how things play out and if things keep getting worse then you may have to make another drop.

 

2) Make another drop now, utilizing the same percentage.

 

3) Make another drop either now or a bit later however utilizing a greater percentage eg. try 4 percent and see how that plays out.

 

4) Try a lower percentage IF you feel that may be enough to distract the tolerance factor. Unfortunately, there is no way for me to know what percentage will work for you. Have you tried anything below 3% or above this range in the past? If so, how did that work out for you? That may be some sort of guide for you to follow.

 

 

It appears, like last time at 15mg, steady deterioration at this dose, with no days of improvement.

 

 

I would feel more confident knowing what to advise if there were no other drugs in the mix. I have explained in a previous post re: the differences between last time and this time and the factors that may be involved etc.

 

With all that said, IF xanax was not in the picture, your current state could indicate that 3 percent may not be an adequate enough percentage, in the case of someone who is experiencing severe enough tolerance WD. I've explained the reasons for this in my last long post.

 

 

The only reason I am not bed-bound or running to ER is because of the xanax. Although even with it I am struggling to do anything but the most basic things, and even then god knows how I manage.

 

 

I understand what you're saying.

 

 

Honestly, I wish I could confidently offer a solid recommendation however, I can't due to the reasons I've mentioned above. The best I can do is offer possible options (listed above) and you will have to decide which approach you are willing to experiment with at this time.

 

Even when only one drug is in the mix, people must take a calculated risk never knowing how exactly how things will play out. That's the nightmare of these situations. Unlike classic WD tapers, these tolerance WD situations are very difficult, as you've come to know.

 

Lor, I truly wish I knew exactly what you should do next but I can only offer general guidelines, personal experience and possible explanations, along with anecdotal reports from others.

 

I pray you will be able to obtain a degree of clarity regarding how you may wish to proceed. I also pray that this next drop, based on whatever you decide, decreases the intensity of suffering.

 

 

Wishing You Peace, Clarity, Continued Healing and Full Recovery.

 

 

Punar

[Punarbhava]

hi Pun and Lor and ...

 

how less suffer with psychiatric meds:

not re-instate

not updose

when bad, do nothing, suffer and wait, better days will come

stay on the less dose possible

take the dose daily and regularly, at the same hour,

 

keep in mind you are on a poison which has burned a part of your receptors and after 15 years there are damages

it is not the drop the culprit, it is the 15 years taken

the solution is not in a drop, it is to be meds free to stop nerves alteration and begin the improvements

after my 13 years, i knew one thing : i will suffer from 13 years body deterioration ; and i suffer

 

Hi Stan.........

 

as always I agree with many of your points. I'm glad you posted since, you brought attention to a very important point that I have forgotten to mention re: "take the dose daily and regularly, at the same hour". This is so important! So, I thank you!

 

I agree that the "drop" is not the cause of the damage however, if I may share, I do believe (at least for some people in severe tolerance WD states) the "drop" is important. The percentage as well as the timing of the drop in order to minimize, as much as possible, the full manifestation of tolerance WD.

 

Please forgive me if I have misunderstood you in any way and please know I'm not challenging you but rather, sharing what I have experienced. I realize that not all tolerance WD situations are the same and thus, I do not believe that your method was wrong in your situation.

 

In regard to your other post describing your history. You tapered within 11 months which was a rapid taper n'est pas? No wonder you suffered. I understand though that you had legitimate reasons for having tapered in this fashion.

 

I sincerely hope you recover fully in the very near future Monsieur Stan! I know how difficult this has been for you.

 

 

May your recovery be swifter and more linear in nature from this point forward!

 

 

Punar

[Punarbhava]

Hi Lots,

 

It will be an interesting thing to see, you below 15mg and see how that makes you feel, as you have never in 15yrs been below 15mg,

I too agree with Stan and Pun, if you need the xanax then take it, and please we know your not going to abuse it, but some days are just bad,

WE KNOW, use the xanax, and i think, forgive me if anyone disagrees, but i do feel the only option you have now is to drop, even a small amount

might bring you some small relief, as looking at your history i dont think you are one that is going to improve between drops like many of us here can attest

too, me and stan and pun in particular.

 

Hang on in there huni, better days are coming your way, no matter how bad the bad days are, we know, we are all routing for ya xxxxx

 

Hello Dear Angie.......

 

please forgive me for responding to this post and please know that I'm not challenging you in any way. Rather, I just seek to clarify that Stan and I are not advocating the use of any benzo and/or any other psyche drug during WD.

 

Rather, Lor has been consistently utilizing xanax, for some time now and due to this fact, it could be detrimental for her to significantly reduce this medication, at this point in time since, she could further destabiilize her CNS, placing her in a worse state. So, this is why it was suggested that she remain on her current doses of xanax. I was not suggesting nor recommending that she take it occasionally or regularly to aid with AD WD symptoms.

 

So, I just wish to clarify this so others reading this post, in the future will not misinterpret anything during the course of reading this thread. I do not advocate the use of any psyche drugs during WD (not to mention other drugs and/or psychocative herbs) since, expsosure to such has the potential to complicate recovery not to mention, the risk of developing an additional addiction....which will then involve yet another tapering process along with post taper recovery.

 

I'm very concerned about being clear regarding this subject simply because I never, ever wish for anyone to unintentionally get themselves into a worse situation.

 

BTW, Angie, I do know that you were NOT accusing me of making such a statement. Rather, I believe you just missed a couple of points and understandably so since, there has been so much written in this thread and it's hard to keep up with it all, especially when one is reading so many other threads as well.

 

With all that said, you've written such a lovely supportive post to Lor and I'm sure she appreciates it greatly. Actually, I was very warmed by your post. You are always so supportive and encouraging to others, even amid your own suffering. You're a good soul Ms. Angie.

 

Again, I hope you can understand my reason behind my need to clarify and I hope I haven't offended you (in any way) in the process of doing so.

 

 

Sincerely Wish You Much More Healing and a Speedy Recovery!

 

 

Punar

[Altostrata]

....

Forgot to include another point in the whole equation re: the drug metabolizing itself at lower levels.

 

Alto, do you think that this factor influences the rate at which one's receptors up-regulate? In other words, could one's receptors up-regulate at a faster rate at lower doses due to this factor?

 

Would this also mean that the half-life washes out quicker as well, hence producing more intense symptoms?....

 

No, I don't think this affects upregulation, but faster metabolization gives the effect of a larger decrease. I guess one way to look at this is a shorter half-life, with more intense symptoms.

 

About the pattern of symptom severity you mentioned, my theory (observed in my own symptom pattern) is that the natural cortisol cycle, which peaks in the early morning, is exaggerated by the additional cortisol and hyper-alerting of withdrawal. So you get the worst symptoms in early morning, declining into late afternoon.

 

Then, as the nervous system winds down in the evening preparing for sleep, you get an additional jolt out of the alerting system, which wants to keep you at high alert. This wars with your natural sleep-related inhibitory mechanisms for a while, then lets you drop off, but wakes you throughout the night with more alerting.

 

A little melatonin at nightfall and My-B-Tabs with adenosine assist with the natural wind-down mechanism (which includes melatonin and adenosine) and can help overcome the alerting reaction sooner.

[Punarbhava]

....

Forgot to include another point in the whole equation re: the drug metabolizing itself at lower levels.

 

Alto, do you think that this factor influences the rate at which one's receptors up-regulate? In other words, could one's receptors up-regulate at a faster rate at lower doses due to this factor?

 

Would this also mean that the half-life washes out quicker as well, hence producing more intense symptoms?....

 

No, I don't think this affects upregulation, but faster metabolization gives the effect of a larger decrease. I guess one way to look at this is a shorter half-life, with more intense symptoms.

 

Thank you for responding to my questions Alto. What you have presented aligns with my current understanding however, I suppose I'm still stuck on the up-regulation factor.

 

Here's what I think (not saying I'm right BTW)......an AD with a longer half-life allows a smaller percentage of receptors to up-regulate before the next percentage of receptors go into the same mode. Because the drug is eliminated more gradually, the receptors can upregulate at a gradual rate rather than having to quickly do so.

 

When a AD has a short-half life, a greater percentage of receptors are forced to up-regulate but also within a more urgent setting. They have a shorter period of time in which to adjust to removal of the drug hence, they are forced to adapt more quickly.

 

There has been no easing into the up-regulatory process but rather, a sudden adaptation that must occur hence, the more intense WD symptoms. IF a drug washes out of one's system at a rapid rate, the up-regulation process is forced to occur more rapidly, not to mention more profoundly due to a greater percentage of receptors being affected.

 

Alto, forgive me, I know I'm repeating myself and I've tried to edit this section but my mind is now going in circles (lol). God, constructing one's thoughts, in written form, is such an extremely challenging endeavor during WD. (lol)

 

Also, based on my personal experience and observation (and I'm not saying I'm right here but rather speculating)...............I don't believe that the drug starts metabolizing itself faster, all of a sudden (at lower doses). Rather, I believe that this self-metabolization gradually occurs and increases, over the course of time. Consequently, one's taper gradually becomes more difficult as one tapers down to lower doses.

 

The gradual change may not be observed during each dose reduction however, a cumulative effect is occuring behind the scenes. In other words, when tapering from 80 mgs to 60.......I may not feel much differently at 70 mgs however, by the time I reach 60 mgs I'm starting to feel the effects of the small but cummulative percentages that have been banking up on each other all along the way...,,,,The half-life of my drug is now shorter at 60 mgs than at 70 mgs or 80 mgs.

 

In other words, (and speaking about classic WD here and not tolerance WD as well as factoring in that one is tapering at the same percentage during each drop) at 80 mgs. I felt drops more profoundly than at 110 mgs. At 60 mgs more intense than at 80 and so on (the drug metabolizing itself at a greater percentage at each stage). In other words, the half-life of my drug is becoming shorter and shorter throughout the tapering process. By the time one gets down to 20 or 15 mgs for example, the drug is metabolizing itself at a far greater percentage rate thus, decreasing the half-life even more significantly.

 

I don't even know if I'm wording things clearly enough due to mental and emotional exhaustion, so please forgive my lame efforts (lol).

 

In any case, as you brought forward re: half-life washing out at a more rapid rate (shorter half-life) which produces more intense symptoms, in Lor's case she actually is not experiencing a mere 3 percent drop in dose (at this stage of the game) but rather, a greater percentage. What that percentage is is unknown but the fact remains that her brain is now processing drops above 3%.

 

Correct?

 

About the pattern of symptom severity you mentioned, my theory (observed in my own symptom pattern) is that the natural cortisol cycle, which peaks in the early morning, is exaggerated by the additional cortisol and hyper-alerting of withdrawal. So you get the worst symptoms in early morning, declining into late afternoon.

 

Yes, that's my understanding based on the circadian cortisol rhythm. If I correctly recall, cortisol begins its secretion cycle at around 4:00 a.m. or 5:00 a.m. This is when many of us snap awake with extreme symptoms.

 

Then, as the nervous system winds down in the evening preparing for sleep, you get an additional jolt out of the alerting system, which wants to keep you at high alert. This wars with your natural sleep-related inhibitory mechanisms for a while, then lets you drop off, but wakes you throughout the night with more alerting.

 

Yes, this has been my understanding as well. However, I actually prefer the terms that you have utilized, as well as the articulations....since, they feel appropriate in regard to what actually occurs.

 

I have also read that insulin and blood sugar levels plays a role in this as well and vice versa. Cortisol dumps can occur during the night when our blood sugar levels drop. I know this was a huge problem for me throughout my taper as well as post-taper. I would snap awake with extreme hypoglycemic attacks. Anyway, won't go into the details.color]

 

A little melatonin at nightfall and My-B-Tabs with adenosine assist with the natural wind-down mechanism (which includes melatonin and adenosine) and can help overcome the alerting reaction sooner.

 

I've been so hyper-sensitive to so many things that I've refrained from ingesting anything other than Vit C and zinc. With that said, I do make a point of eating a solid snack and/or even a small meal before bedtime. Also try to include foods that provoke melatonin production.

 

With all that said, restoration of the natural sleep cycle, is a very non-linear, not to mention, a very long process in my case, although I know there are so many others who experience this protracted WD symptom.

 

 

Punar

[Punarbhava]

 

....

Forgot to include another point in the whole equation re: the drug metabolizing itself at lower levels.

 

Alto, do you think that this factor influences the rate at which one's receptors up-regulate? In other words, could one's receptors up-regulate at a faster rate at lower doses due to this factor?

 

Would this also mean that the half-life washes out quicker as well, hence producing more intense symptoms?....

 

No, I don't think this affects upregulation, but faster metabolization gives the effect of a larger decrease. I guess one way to look at this is a shorter half-life, with more intense symptoms.

 

Thank you for responding to my questions Alto. What you have presented aligns with my current understanding however, I suppose I'm still stuck on the up-regulation factor.

 

Here's what I think (not saying I'm right BTW)......an AD with a longer half-life allows a smaller percentage of receptors to up-regulate before the next percentage of receptors go into the same mode. Because the drug is eliminated more gradually, the receptors can upregulate at a gradual rate rather than having to quickly do so.

 

When a AD has a short-half life, a greater percentage of receptors are forced to up-regulate but also within a more urgent setting. They have a shorter period of time in which to adjust to removal of the drug hence, they are forced to adapt more quickly.

 

There has been no easing into the up-regulatory process but rather, a sudden adaptation that must occur hence, the more intense WD symptoms. IF a drug washes out of one's system at a rapid rate, the up-regulation process is forced to occur more rapidly, not to mention more profoundly due to a greater percentage of receptors being affected.

 

Alto, forgive me, I know I'm repeating myself and I've tried to edit this section but my mind is now going in circles (lol). God, constructing one's thoughts, in written form, is such an extremely challenging endeavor during WD. (lol)

 

Also, based on my personal experience and observation (and I'm not saying I'm right here but rather speculating)...............I don't believe that the drug starts metabolizing itself faster, all of a sudden (at lower doses and BTW, I'm not suggesting that you're implying this). Rather, I believe that this self-metabolization gradually occurs and increases, over the course of time. Consequently, one's taper gradually becomes more difficult as one tapers down to lower doses.

 

The gradual change may not be observed during each dose reduction however, a cumulative effect is occuring behind the scenes. In other words, when tapering from 80 mgs to 60.......I may not feel much differently at 70 mgs however, by the time I reach 60 mgs I'm starting to feel the effects of the small but cummulative percentages that have been banking up on each other all along the way...,,,,The half-life of my drug is now shorter at 60 mgs than at 70 mgs or 80 mgs.

 

In other words, (and speaking about classic WD here and not tolerance WD as well as factoring in that one is tapering at the same percentage during each drop) at 80 mgs. I felt drops more profoundly than at 110 mgs. At 60 mgs more intense than at 80 and so on (the drug metabolizing itself at a greater percentage at each stage). In other words, the half-life of my drug is becoming shorter and shorter throughout the tapering process. By the time one gets down to 20 or 15 mgs for example, the drug is metabolizing itself at a far greater percentage rate thus, decreasing the half-life even more significantly.

 

I don't even know if I'm wording things clearly enough due to mental and emotional exhaustion, so please forgive my lame efforts (lol).

 

In any case, as you brought forward re: half-life washing out at a more rapid rate (shorter half-life) which produces more intense symptoms, in Lor's case she actually is not experiencing a mere 3 percent drop in dose (at this stage of the game) but rather, a greater percentage. What that percentage is is unknown but the fact remains that her brain is now processing drops above 3%.

 

Correct?

 

About the pattern of symptom severity you mentioned, my theory (observed in my own symptom pattern) is that the natural cortisol cycle, which peaks in the early morning, is exaggerated by the additional cortisol and hyper-alerting of withdrawal. So you get the worst symptoms in early morning, declining into late afternoon.

 

Yes, that's my understanding based on the circadian cortisol rhythm. If I correctly recall, cortisol begins its secretion cycle at around 4:00 a.m. or 5:00 a.m. This is when many of us snap awake with extreme symptoms.

 

Then, as the nervous system winds down in the evening preparing for sleep, you get an additional jolt out of the alerting system, which wants to keep you at high alert. This wars with your natural sleep-related inhibitory mechanisms for a while, then lets you drop off, but wakes you throughout the night with more alerting.

 

Yes, this has been my understanding as well. However, I actually prefer the terms that you have utilized, as well as the articulations....since, they feel appropriate in regard to what actually occurs.

 

I have also read that insulin and blood sugar levels plays a role in this as well and vice versa. Cortisol dumps can occur during the night when our blood sugar levels drop. I know this was a huge problem for me throughout my taper as well as post-taper. I would snap awake with extreme hypoglycemic attacks. Anyway, won't go into the details.color]

 

A little melatonin at nightfall and My-B-Tabs with adenosine assist with the natural wind-down mechanism (which includes melatonin and adenosine) and can help overcome the alerting reaction sooner.

 

I've been so hyper-sensitive to so many things that I've refrained from ingesting anything other than Vit C and zinc. With that said, I do make a point of eating a solid snack and/or even a small meal before bedtime. Also try to include foods that provoke melatonin production.

 

With all that said, restoration of the natural sleep cycle, is a very non-linear, not to mention, very long process in my case, although I surely know I'm far from being the only one experiencing this protracted WD symptom.

 

Punar

 

[Lor95]

....

Forgot to include another point in the whole equation re: the drug metabolizing itself at lower levels.

 

Alto, do you think that this factor influences the rate at which one's receptors up-regulate? In other words, could one's receptors up-regulate at a faster rate at lower doses due to this factor?

 

Would this also mean that the half-life washes out quicker as well, hence producing more intense symptoms?....

 

No, I don't think this affects upregulation, but faster metabolization gives the effect of a larger decrease. I guess one way to look at this is a shorter half-life, with more intense symptoms.

 

About the pattern of symptom severity you mentioned, my theory (observed in my own symptom pattern) is that the natural cortisol cycle, which peaks in the early morning, is exaggerated by the additional cortisol and hyper-alerting of withdrawal. So you get the worst symptoms in early morning, declining into late afternoon.

 

Then, as the nervous system winds down in the evening preparing for sleep, you get an additional jolt out of the alerting system, which wants to keep you at high alert. This wars with your natural sleep-related inhibitory mechanisms for a while, then lets you drop off, but wakes you throughout the night with more alerting.

 

A little melatonin at nightfall and My-B-Tabs with adenosine assist with the natural wind-down mechanism (which includes melatonin and adenosine) and can help overcome the alerting reaction sooner.

 

Dear friends,

Just a note regarding this point.....I just want to mention that 15.5mg, for paxil, is still quite a high dose. The most widely recognised therapeutic dose is 20mg (well, it was when I started taking it, now it is accepted that 10mg is also sufficient for some people). In paxil's case, I would have thought that well below 10mg is when this issue comes into play?

 

I may be wrong - Pun, when you experienced having to drop more quickly, how far were you from the accepted "therapeutic dose"?

 

Lor

[Lor95]

Some further notes on how this drop is playing out.....

 

 

Days 15 to 18...

 

MARGINAL improvement. Feeling ok doesn't even come into it for the most part, but....

 

Have been able to sleep all the way to alarm without being interrupted by the streaming nonsensensical stupor and cortisol dumps that I experience from about 4am to rising (although 1 or 2 HORRIFIC nightmares).

 

Slight decrease in nausea, able to eat a little more although still supplementing heavily with Complan (probably the equivalent of Ensure in the States). I cannot afford to lose any more weight. Violent retching when brushing teeth in the morning SLIGHTLY better.

 

Mind is in a very strange, restless state (hard to describe and very disconcerting) but I am able to follow conversations although memory recall still very bad.

 

Evening xanax (at about 7pm), seems more effective than the daytime dose and I am able to be more "at peace" (well, as close as I get these days) although I completely lack motivation and the fatigue is extreme.

 

On the xanax point, I have paid close attention and do not see any pattern playing out in regards to interdose affects.

In general at the moment, it seems to help only marginally in the morning; symptom severity and type can go up and down in no particular fashion from a couple of hours after taking the dose to 6 or even 10 hours after. Go figure. It makes no sense at all.

 

 

For these reasons I am holding a little longer rather than dropping, to see what happens next.

[Punarbhava]

Dear friends,

Just a note regarding this point.....I just want to mention that 15.5mg, for paxil, is still quite a high dose. The most widely recognised therapeutic dose is 20mg (well, it was when I started taking it, now it is accepted that 10mg is also sufficient for some people). In paxil's case, I would have thought that well below 10mg is when this issue comes into play?

 

I may be wrong - Pun, when you experienced having to drop more quickly, how far were you from the accepted "therapeutic dose"?

 

Lor

 

Hi Lor.........

 

I had this in my files although I failed to copy the link but you can google info regarding Paxil.

 

 

"A wide range of interindividual variation is observed for the pharmacokinetic parameters. Following the single or multiple dose administration of paroxetine at doses of 20 to 50 mg, the mean elimination half-life value for healthy subjects appears to be about 24 hours, although a range of 3 to 65 hours has been reported. Both the rate of absorption and the terminal elimination half-life appear to be independent of dose. Steady-state plasma concentrations of paroxetine are generally achieved in 7 to 14 days. No correlation has been established between paroxetine plasma concentrations and therapeutic efficacy or the incidence of adverse reactions."

 

Please keep in mind that the above paragraph, describing individual response, is applicable to those who have NOT developed tolerance WD to the drug.

 

Things change once develops tolerance and the way things change depends upon the cause.

 

Here is a simple version of what happens when tolerance occurs:

 

http://en.wikipedia.org/wiki/Drug_tolerance

Drug tolerance

From Wikipedia, the free encyclopedia

Jump to: navigation, search

It has been suggested that Tachyphylaxis be merged into this article or section. (Discuss) Proposed since July 2011.

 

Physiological tolerance or drug tolerance is commonly encountered in pharmacology, when a subject's reaction to a drug (such as an opiate painkiller, benzodiazepine or other psychotropic drug) is reduced at a later time even though the dose or concentration at the effect site is the same[1].

 

This means that larger doses are required to achieve the same effect. Drug tolerance can involve both psychological drug tolerance and physiological factors.

 

Characteristics of drug tolerance: it is reversible, the rate depends on the particular drug, dosage and frequency of use, differential development occurs for different effects of the same drug. Physiological tolerance also occurs when an organism builds up a resistance to the effects of a substance after repeated exposure. This can occur with environmental substances, such as salt or pesticides.

 

Tachyphylaxis is a synonym for drug tolerance.

 

 

Mechanisms

There are two major mechanisms for tolerance:

 

Pharmacokinetic Tolerance- Also known as Dispositional tolerance: occurs because of a decreased quantity of the substance reaching the site it affects. This may be caused by an increase in induction of the enzymes required for degradation of the drug e.g CYP450 enzymes

 

Pharmacodynamic Tolerance - Also known as Reduced responsiveness: the response to the substance is decreased by cellular mechanisms. This may be caused by a down regulation of receptor numbers[2]

 

 

I have papers on the subject that are more detailed but this short Wiki article gives a general over-view.

[Punarbhava]

Hi Lor............

 

I will be leaving town tomorrow but I thought I'd share a few thoughts before leaving.

 

In regard to your current taper from Paxil, I believe you will have to experiment with the options I have presented in an earlier post, in order to discover which approach will work best for you, at this stage of game.

 

The bottom line is you will have to adjust your taper according to how your body is responding rather than according to our discussions regarding half-life and upregulation etc. You know what I mean?

 

In the end you may have to alter the percentages as well and modify the holding phases, in accordance to how things play out.

 

You seemed to have known, in the past, when to make your next drop and thus, you will have to trust that you will, once again, be able to determine the same.

 

In regard to xanax.........I think the best thing you can do for yourself is to thoroughly research the subject regarding it's half-life, inter-dose-WD, when, how and why this may occur, how to read the signs and what you can do if this occurs etc.

 

The absence of such information places one at a disadvantage in way of knowing how to assess one's current situation. As well, one may not see the relevancy of observations that may be presented by others and understandably so, if one is unaware of how these drugs separately work, not to mention how they may work in combination with each other.

 

BTW, please know that the above statement is not one of judgment but rather, a statement that applies to all of us (at one time or another) who have experienced difficulty getting off these drugs.

 

 

I would discuss the daily dosing of xanax and well as Paxil, in great detail, with Dr. Healy. I believe obtaining information from a medical professional will hold more validity, not to mention it is wise to be under medical supervision during this time by someone who appears to understand how these drugs work.

 

With that said, it would be prudent to research any information presented by him and/or by any of us.

 

One thing is for certain.............people have navigated through these journeys, have gotten off these drugs, recovered and went on to live full lives. ALWAYS remember this Lor! You can and will succeed in similar fashion.

 

Also remember that some people start to feel better once they get past a certain phase in WD. Try not to look too far ahead. Rather, take one drop at a time. This is what I had to do. Focus on this drop...........get through it and check it off your calendar as an accomplishment.

 

Some drops can be more difficult than others but don't allow them to prevent you from moving forward. Also remember that your next drop may be more endurable.

 

Each drop, no matter how it plays out, brings you one step closer to "0" mgs. That is the goal so keep tapering and never give up!

 

Much Beautiful Healing to You!

 

Punar

[Punarbhava]

Alto......

 

BTW, no need to respond to my question re: up-regulation. I should access info from my files regarding this subject rather than trying to explain when my mind is in mental overload mode. (lol)

 

 

Time will not permit me to access these files today but TBH, even on an okish day it can feel like an overwhelming mental endeavour, not to mention time consuming, coupled with prolonged exposure to the computer ..........all which render me into an state of exhaustion and CNS over-stimulation etc.

 

So, I'm in no shape to review any response you may represent at this time anyway (lol). Just wanted to save you the time and energy.

 

 

Punar

[Mixter]

How are you doing?

 

Great help you have got, I see.

 

I also deal with interval dose nausea and poop out.

 

I have got some help from 5-htp, I tried it because I was desperate.

 

It seems to work. It took away my depression, anxiety and agitation and my stomach works better.

 

I take between 300-500 mgs but initially I took around 10-25 mgs and added up, noticing reactions and adjusted to them.

 

I have Lyme, it cause low levels of serotonin but I am still on high dose Effexor, 123.5 mgs.

 

But I would not suggest you to try 5-htp, as it can be dangerous, - serotonin syndrome: need to try low doses and build up slowly.

 

But I know some who did on lower doses of Paxil, combination and it has helped.

 

The reason I did, because I was desperate for some kind of help... The longterm impact for me is not known.

[Lor95]

So good to hear from you Mixter!

I always appreciate updates from you.

 

Well, I was not improving or stabilising on 15.5mg so I managed to hold for 21 days and then decided on a small (just less than 5% drop) drop to 14.75mg.

 

It has been 4 days at this dose and I haven't really noticed any change.

 

I am sleeping through the night at this point in time, I wake up mildly better than previous weeks but I deteriorate as I get to work and it is pretty much just holding on through gritted teeth till hometime, where I might get a tiny bit of respite or I might not, no pattern really.

 

The effect of xanax does not seem to have a reliable pattern either. I take 0.5mg in the morning at about 8am, it seems to calm me for an hour or 2 (marginally) but symptoms can wax and wane throughout the day regardless.

 

The evening dose (at about 7 or 8pm) seems to help more.

 

Just for my records really.......

[Altostrata]

Lor, perhaps that smaller decrease is the key for you.

 

Remember, you can always decrease by an even smaller amount. The actual percentage doesn't matter, it's whether symptoms are tolerable that counts.

 

To answer a question above about "therapeutic" dosages -- those numbers are arbitrary. Dosage estimates arise from clinical trials, often with few people, and the drug companies decide on that basis what dosages to manufacture.

 

Many of these drugs, particularly SSRIs, are overpowered for our nervous systems. People often get "therapeutic" effects from very small doses, if their doctors are alert to individual variation.

 

So the concept of "therapeutic" dose has no real validity. It depends on the individual's reaction.

[Lor95]

Hi everyone,

 

Just want to check in (although I visit the site every day, I haven't written for a while). I'm still tapering, despite the fact that it is proving brutal with no definite patterns.

 

Seeing a lot of new names, which is nice....welcome to you all.

[Lor95]

I'm still here!!!!!!!!!!!!!!!

 

Just been reading lately and seen some really interesting and wise new people visiting (and some older names that are still an inspiration, I might add) - want to reconnect!!!!!!!

 

Alto, your site has really come along - what an amazing job you've done.

 

Lotty

[Altostrata]

Thanks, Lor. It's getting to be about all I can handle!

[Altostrata]

Lor, how are you doing?