Long-term consequences of a rapid 4-week benzo taper (effects on reward system)

[Hyperflux]

What are the overall consequences of a rapid 4-week benzo taper on your reward system, neurochemistry, personality, mental and physical health, etc?


My story: I was taking 1-2mg of etizolam for 12 weeks, once nightly for sleep purposes (equivalent to 10-20mg diazepam/Valium), as a stressed software engineering graduate student pursuing an accelerated 1-year program. Suddenly, my domestic benzologue vendor stopped carrying etizolam blotter so I carelessly and ignorantly graduated to the strongest, ultra potent RC hypnotic benzos they had for sleep (1mg flunitrazolam and 1mg clonazolam blotters respectively, both used once nightly, which is equivalent to a whopping 120mg diazepam/Valium). This continued for four weeks, until I realized an intervention was needed before it was too late, or until things progressively got out-of-hand which could have potentially ruined my life. The interdose and day-time withdrawal symptoms were absolutely unbearable - I was seriously contemplating suicide during those four weeks. This means that I was physically dependent on benzos for a total of sixteen weeks, with my latest equivalent tolerance being 120 mg diazepam/Valium.


My rapid taper protocol: I acquired diclazepam powder from a reputable source, prepared a 10 mg/mL solution with food grade propylene glycol (PG) using heat baths and excessive stirring, which was then verified by my local pharmacist to be homogeneous and well-mixed enough for accurate dosing. He really cares about my well-being and wants me to succeed in life, and understands that diclazepam is the ultimate benzo taper method despite being a Schedule IV Substance in Canada. He just wanted to help me to the best of his ability. As a funny aside: one of the top rated reviews for the food grade PG I bought said that it dissolved his diclazepam beautifully.

Important detail: my physician/GP is fully aware of my protocol to taper off successfully and fully condones it (as long as I see him every week so he can check up on me) as an alternative to going to a detox/rehab recovery center which does an ultra-rapid 8 day withdrawal and sends you home with a prescription. This often ends up making things worse in the end. I'm already two weeks into my taper but this is my 4-week taper calendar and dosages for each day. I'm starting at 12 mg diclazepam and ending at 0.1 mg. I'm tapering at a rapid rate of about 15% per day which goes against everything the Ashton Manual and the Canadian Guideline for Safe and Effective Benzodiazepine Tapering say. This also goes against common tapering practices suggested by various online forums/communities such as BenzoBuddies and subreddits like /r/benzorecovery. More slow-tapering guidelines are included here, some even slower than the Ashton Manual. You'll find the The British National Formulary, which is even slower than the Ashton Manual for tapering, and The Current Psychiatry?s Guidelines. Those resources advocate a slow 33-66 month taper based on their protocols and my calculations, which doesn't make much sense to me if I've only been on benzos for a total of 4 months. This would just create further dependency in my opinion, and I need to get off benzos as soon as possible because they are impairing my cognitive ability for my rigorous software engineering Master's program, and noticeably decreasing my performance and strength as an athlete, presumably due to the relaxing effects on the musculoskeletal system.


I will post an update after my taper is completed with the exact details of my protocol and what I took as an adjunct to help and cope with symptoms. I will include my nootropic/supplement/peptide/drug support stack and regimen that helped expedite recovery, minimise withdrawal symptoms/discomfort, and support/enhance daily functioning.


In terms of withdrawal symptoms I've experienced so far, they have been very mild and I'm almost done half my taper. I've been almost fully functional and carrying out my daily routine and responsibilities including going to the gym. The withdrawal symptoms are all present from this comprehensive, alphabetized list but relatively mild to my surprise and delight. I realize that there is a chance that some or all of these withdrawal symptoms may be protracted in nature as seen and explained in Tables 3 & 4 here, even after my taper is completed successfully. It could take months or years for full remission to occur, but this is not the norm since I've only been on for a relatively short amount of time. I expect the symptoms tend to fade away quickly, and peak cognition to come back over time.

The only symptom that's a bit difficult to deal with right now is dysphoria. Tapering ultra rapidly can make you go through excess dysphoria in a short period of time. It's difficult to reverse the "learning" and neurochemical adaptations that occurs from this process. This can potentially break your reward system and GABA/Glutamate/Benzodiazepene receptors. I have no idea regarding the magnitude or the length of how long this would possibly occur as it is merely conjecture and what I've read online from various resources. I don't know of any good literature on this and I'm not knowledgeable enough in this realm which is why I'm posting here.

Going forward, I should definitely avoid benzos due to kindling (sedative?hypnotic withdrawal). I would still like to use them very occasionally either for landing gear or recreationally but only sporadically (etizolam and clonazolam are the only ones I've enjoyed, never tried flualprazolam, and I have no interest in any other benzo/thienologues whether RC or pharma). I already know of sustainable sleep enhancing drugs (both in quality and architecture) that can be taken daily such as mirtazapine and trazodone.


Can anyone verify the validity of the above statement? Also, any insights, critiques, or advice is welcomed. Thank you and happy holidays!

 

[dopamimetic]

I'd instantly agree to that a glutamate - GABA imbalance can and will make one dysphoric*, probably in both directions but with too much glutamate (suspectedly) I felt and feel like being constantly under heavy pressure ... add some excess norepinephrine and you'll have a nice seizure (?) I know you can't 'feel' single transmitters like as you had a virtual status display in your brain but people keep saying they felt serotonin so I say I feel glutamate/GABA too..

*(or maybe manic, depends)

Curious about why tiagabine (GABA RI) supposedly doesn't share the same tolerance/withdrawal issues as usual BZDs have yet it is effective against anxiety (tested it myself). Etifoxine's another interesting one which raises levels of neurosteroids...

 

[Hyperflux]

I'd instantly agree to that a glutamate - GABA imbalance can and will make one dysphoric*, probably in both directions but with too much glutamate (suspectedly) I felt and feel like being constantly under heavy pressure ... add some excess norepinephrine and you'll have a nice seizure (?) I know you can't 'feel' single transmitters like as you had a virtual status display in your brain but people keep saying they felt serotonin so I say I feel glutamate/GABA too..

*(or maybe manic, depends)

Curious about why tiagabine (GABA RI) supposedly doesn't share the same tolerance/withdrawal issues as usual BZDs have yet it is effective against anxiety (tested it myself). Etifoxine's another interesting one which raises levels of neurosteroids...

I'm highly interested in trying Tiagabine for sleep enhancement, it's a GRI that greatly increases slow-wave sleep (Gabaxadol is another) but doesn't have the same issues as benzos. How was your experience with sleep quality and Tiagabine?

 

[Limpet_Chicken]

Gaboxadol is an orthosteric agonist at GABAaRs, is it not? I was unaware of it having GRI effects as a second modus operandi.

Pretty sure I recall side effects such as euphoria, hallucinations at high doses, people subjectively enjoying it, being the reason for it's being shitcanned in trials.

(what a fucked up, twisted world when that sort of viewpoint is allowed to not only survive, but dominate societies and nations, and to dictate what treatments are available to people. That would have been a first. Gaboxadol as a muscimol-like drug. Could have established a new GABAergic niche. Possibly with less tolerance compared to benzos, chlormethiazole, barbs (although I've never found any tolerance to chlormethiazole ever caused me any tolerance I could notice much), but folk say low tolerance to fly agaric. Don't think I've EVER heard of a physical withdrawal from muscimol..)

But damn...when a drug gets dumped in trials because it is found pleasant by some....what..does this mean the more unpleasant our remedies, the better, to avoid causing someone the disgusting indulgence, of euphoria, or else at the most innocent, the awful side effect they've been subjected to.

I for one, am not about to file a priority report to the NHS because some med caused an unforseen period of euphoria. It'd be one thing if a med is ditched for toxicity, or causing people to shit all over themselves projectile fashion, but to have a pleasant experience?

Regarding GRIs, just how safe are they? Because another not dissimilar looking overall, a GABA-transaminase inhibitor, vigabatrin, seems downright dangerous, noxious stuff, that you couldn't pay me to take, as it can blind users, and potentially as high as half of users develop visual-field defects and electrophysiological changes.

It is an irreversible GAT inhibitor though, and suicide inhibitors can often have a lot less safe of a profile in terms of designing enzyme inhibitors than reversible inhibitors.

 

[dopamimetic]

But damn...when a drug gets dumped in trials because it is found pleasant by some....what..does this mean the more unpleasant our remedies, the better, to avoid causing someone the disgusting indulgence, of euphoria, or else at the most innocent, the awful side effect they've been subjected

Yeah, exactly my opinion. Somehow the potential for organ failure in rare cases appears to be more tolerated in approval than that disgusting, impious possibility for .... EUPHORIA!!!!! OH MY GOD!! People might actually LIKE their meds, let's call the police asap...

How was your experience with sleep quality and Tiagabine?

Unfortunately I don't remember much, it was many years ago when I've stayed in France for several months, one of the only countries at least in the EU that have tiagabine... in higher dosages it got a bit weird as far as I remember, and rather interfered with sleep not unlike high dose pregabalin but below that threshold... well I slept fine and anxiety was gone (medium one-digit milligram range AFAIR).

 

[Limpet_Chicken]

Yeah, it's not really much more advanced than the days when we screamed 'WITCH! HERESY! BURN THE BASTARD!', only now govts realize there's no way in hell anyone would tolerate an ACTUAL burning at the stake. But still, handing down sentences worse than those given to child rapists, for dealing, etc....fucked up.

It's one thing to shitcan a med being trialled in humans if it's something like that Te Genero clusterfuck of a disaster (which IMO was conducted in a thoroughly negligent manner too, at that), and people's whole bodies and heads start swelling up, skin coming off after a massive cytokine storm. But god (may his holiness be praised jehova akhbar and all that bollocks) forbid anyone not have asceticism forced upon them, anything euphorigenic must be avoided, shunned as evil. Seriously, that is quite honestly, an outright offensive reason for shitcanning a trial med, that took time, effort, the butchering of animals, much suffering inflicted on animals by force, a whole lot of time and money both poured into development, licensing, to just GET it to the stage II and III trials.

Then oh, a few patients found some doses EUPHORIC...no way this can ever be prescribed to a patient in need, it might make their day more pleasant, or alleviate suffering!

Really, it'd not surprise me that much, if central govts could actually get away with it, if they'd actually mandate the practice of medicine to be aimed at causing, not relieving suffering.

So the CIA, NSA and MI6/MI5 could then sell us smack cut with fentanyls on the street and the addicts could be rounded up and used as fodder for a prison profit machine.


Yet we let shite like haloperidol on the market (unlike other already nasty ass D2 antagonist 'neuroleptic' drugs, it gets metabolized to a dopaminergic neurotoxin with effects similar to MPTP.), Drugs like vigabatrin, which can cause permanent blindness if you are unlucky, and if you are an average patient, still a 50-50 chance of some ocular toxicity.

Plenty meds with propensities towards causing stevens-johnson syndrome/lyell syndrome, literally flaying people alive, which aren't last-line meds used when there's no other option.

But euphoria? BURN THE HERETIC!!!

Reminds me of the lacosamide scandal not all that long back. A list of nasty side effects in potentiae, with just one side effect 'potential elevation of mood' being listed as positive. That was enough to get it thrown in schedule 5 in the US by those fascist smegma-insufflating subhuman DEAnus fuckwits. A challenge was launched, hoping to make it easier for epileptics not to face prejudice just because the med was scheduled, which doubtless will happen, knowing all too well what plenty doctors are like, even about such things as that. I'm not on lacosamide, nor am I actually dx as epileptic (due for a neurologist appt soon though actually), but the unarguable fact is, whether epilepsy, or of idiopathic origin, or some other non-epileptic, syndromic nature, I do, have seizures. I've shown the doctors videoclips of them in progress, taken because of the shit I kept copping because despite being on chlormethiazole, as maintainence med, and using the same for breakthrough, after EVENTUALLY persuading the docs to grant me 'rescue packs', essentially further quantities on an ad-hoc basis, as long as they feel like it and feel it isn't too often (which it invariably is, even if it's been 12 capsules, four bloody months ago...., it's ALWAYS too soon, too much, too often, no matter the time elapsed or quantity used.)

And that, was solely because I needed to be able to respond to breakthrough seizures. At first, I was left with nothing, at all, to the point I had to get out the vitamin B1, go walk quite some distance for my buggered knee, nerve damage and bilateral trochanteric fucking bursitis to go get some metabisulfite, cleave the stuff, CAREFULLY remove the pyrimidine fragment due to it's high-to-extreme toxicity (it's a convulsant poison, fucks up GABA biosynthesis by trashing vitamin B6-dependent processes), dry the intermediate alcohol once purified, tested, tested again and re-damn-well-tested, and chlorinate with SOCl2.

That was how bad it got. That, and a doctor actually telling me 'well you should just go have a seizure then', and that WHEN the rescue-pack 'permission' and setup had been instituted as 'a thing', with doctors bitching me out, arguing endlessly over semantics (specifically 'you aren't epileptic, because you do not have a diagnosis of epilepsy'

I had not once made the CLAIM to BE epileptic. Merely that seizures occurred, and of course, I do not as of yet, know their root cause. I simply know full damn well that they take place, that they happen in the first place, because it's bloody well me they are happening TO. The semantic dithering and bollockspeak, it was an excuse to try and deny me any rescue medication supply. Even with some halfass structure put in place, it's dependent on their whims, who and when I talk to. So is the size of the rescue pack. Some doctors do what they are meant to, sometimes, others cut it in half, no warning, no reason, just because they feel like it. And worse, that is likely to set a precedent, merely because some fucker did it once, means often as not, to other GPs that THEY ought to do the same thing. Just because some locum fucked me over, who's never seen me before in their damn lives. Hell never seen me at all in some cases, just a phone call.

And shit, chlormethiazole is...well it's definitely not 'might, just MIGHT, POSSIBLY possess a tiny, slight, vague word-of-mouth hint of it being, to some people, responsible for causing 'an undue elevation of mood'...it's an oldschool wallbanger downer, with a hell of a kick, and euphoric as hell if one wishes to use it thus.

The scheduling intent delayed epileptics getting lacosamide whilst officials dithered and bitched and shitspoke, smeared themselves in their own faecal matter, threw same at one another and what have you, as politicunts are wont to do if left unrestrained, out of reach of the lash and the shock-prod.

And unfortunately, the challenge to it's being scheduled, that in and of itself, caused more delays for people in need. Then the bastards went and scheduled it anyway.

IIRC it was a friend of mine with Rett's syndrome, she has seizures, not sure if it's directly due to Rett's, as she has a myoclonic epilepsy with some mitochondrial myopathy and a disruption of her electron transport chain, the myoclonic epilepsy, she explained as being highly similar to MERFF, along with also having some squirrely business akin to MELAS syndrome and a failure to produce sufficient ACTH.

Autistic activist, and she's quite the fiery girl, damn is she ever that. Absolutely LOATHES curebies, grabs 'em, munches on them alive, and spits out the still-screaming bodyparts just before they've time to quite finish dying. So they can end up in the dirt where they belong. That's her alright, real firecracker, and she knows it. Funny as hell sense of snark too. Damn smart, damn sexy, and damn PIISSSSED about the lacosamide scandal. Shit was she ever.

(her intellect, is most unusual, her expression of Rett's MECP2 protein mutation is chimaeric, and of incomplete penetrance, aided by skewed X-inactivation, given it's X-linked. Most Rett's girls (it kills males in-utero, save rare instances of XXY, XXYY, XXXY and similar aneuploidies providing an additional X chromosome enabling survival) are mentally retarded, often very severely, and physically crippled, never learning to speak, and never being ambulant. This particular lass, she's a most unusual medical collection of oddities, among them though, I'm glad to say, she is as fiercely intelligent as she is fiery. And a finer advocate for the autie community, we never have had IMO, someone I'm honoured to call a friend. Hell I'd have her babies any day. Absolute stunner too. And as for non-ambulant? coaches special ed kids as a gym coach. Real good egg, and one the most gorgeous ladies I've ever, ever set eyes on