Benzo witdrawal questions / paradoxical reaction to pregabalin

[Cyanoide]

I just went through my 3rd benzo detox. It was by far the most horrible of them all the most miserable experience in my life.

This time I sought help myself as I was taking 8-12 mg clonazepam/day, a dose which would be very complicated, and dangerous, to attempt to quit on my own. I tapered down to 4.5 mg clonazepam before going to rehab. In rehab I was switched to 30 mg diazepam (I and the nurses had no idea why the doctor thought it was a smart idea) and was getting twitches and psychotic spells so the dose was upped to 60 mg diazepam/day. It took 2.5 months to taper to zero from that dose and it went quite well in the beginning but the last part of the taper was horrible. 15 mg -> 10 mg -> 5 mg, those dose reductions resulted in heavy WD symptoms. Going from 5 mg to zero was the hardest part and should have been done differently.

Anyway, I was without diazepam for 12 days and I have continuously suffered from WD symptoms. I should have been out of danger after that period. But because I felt so miserable I decided to try pregabalin (Lyrica), since I had a prescription for it and it has previously helped immensely during withdrawal.

This time, pregabalin did something very nasty. I cannot find any other explanation for what happened other than a strange and paradoxical reaction to pregabalin. Yesterday after taking 600 mg Lyrica (2x300 mg) for the second day (and got quite high on Lyrica to be honest) I started getting twitches and jerking in my muscles (especially the neck). Then I got a reaction I never had before; I lost all contact to reality, started twitching heavily and finally had some kind of "mini seizure" as I was thrown out of my chair without any control of my body. I couldn't believe that the pregablin could do this, as it as anticonvulsant and has helped my previously. But today, almost exactly same reaction occurred after taking 300 mg Lyrica. Since I'm at work now, I had no option but to take some diazepam I had to stop this as my muscles started twitching heavily. But I took only a tiny amount, approx 2.5-3 mg diazepam. This reduced the reaction although I still have occasional twitches in my body. It seems I'm having paradoxical reactions to pregabalin. Previously I have used pregabalin for many years before without any problems. I do have other meds prescribed to combat WD, e.g. Valproate (2 x 500 mg) and it may be the case that pregabalin and with Valproate could have some interaction, I really don't know.

I do think that the taper was done far too quickly in the end and with too big dose reductions, resulting in unnecessary suffering. That's why I've been thinking about reinstating diazepam and doing a slower taper with smaller dose reductions as I still have a few 10 mg pills left; e.g. 2.5 mg x 7 days and then 1 mg x 7 days. Another option would be 3 mg x 5 days, 2 mg x 5 days, 1 mg x 5 days. I can attempt this without medial supervision because the doses are so small.

Do you think this one tiny dose of diazepam (smaller than any dose I was given in rehab) will ruin my recovery from benzos? If so, do you think it's a better idea to reinstate diazepam to taper it more slowly as in the exampes I gave? And, finally, what on earth could be the reason for this strange reaction to Lyrica (seems to lower my seizure threshold)?

 

[Coolwhip]

I have heard of Gabapentin causing seizures in extremely high doses, I know, it's counter-intuitive. And 600mg of pregabalin is a very high dose. Perhaps the high dose coupled with you just recently WDing from benzo's is what caused it.

I don't think that one doe will ruin your recovery, but if my quality of life were suffering, which it must be if you are resulting to high dose pregabalin and valproate. then I would employ the last of your diazepam as so. But be careful you don't reignite any addictive behaviors.

 

[Cyanoide]

That's what I thought too. When I have abused pregabalin in the past in extreme doses (1000+ mg) I have got musle twitching and tremors. But I've also been prescribed 600 mg/day pregabalin for GAD. So 600 mg is a therapeutic dose although the maximum dose prescribed. Unfortunately I had to take another 3 mg diazepam so approx 6 mg altogether. I don't know what it means for my recovery. It's a backlash but still a quite small dose.

 

[Keif' Richards]

Well, although the class of drugs known as Gabapentinoids, of which Pregabalin (Lyrica) is included, were originally thought to exert their action by acting in the same or similar way as Benzodiazepines and/or Alcohol, it's actually now understood that they exert their effect by effecting Calcium Channels in the body, but there is no need to get into the specifics at this time for your concerns. I would not definitively refer to this reaction as paradoxical for this reason. Essentially, as you already know, you have gone through what was probably a far too rapid Benzodiazepine detox and I would attribute 90% of what you experienced to your wihdrawal, as opposed to the primary effects of the Pregabalin (Lyrica).

There is a pretty fine line between conceding to your Benzodiazepine cravings and avoiding potential harm to yourself. With that being said, I really don't think that there could be anything wrong with taking some Diazepam (Valium) at this time. However, I don't think you will ultimately succeed with this if you don't contact a prescriber of some kind to help you. It's possible that you can do it, but even if you succeed, withdrawal from Benzodiazepines too rapidly can still cause permanent neurological damage, whether minor or major.

 

[Cyanoide]

I decided to reinstate diazepam but at a very low dose of 2.5 mg, and will up it to 5 mg if needed and then taper from that. Quitting from only 3 days on 5 mg diazepam to zero in detox was what really caused horrendous withdrawal symptoms. In this case I simply disagree with how the tapering was done in detox and I'll do it over again more slowly on my own.

For sleep I'm prescribed hydroxyzine (Atarax), mirtazapine, olanzapine and melatonin. I sleep surprisingly well on that combination. And, as I already wrote, I'm prescribed valproate to prevent seizures and pregabalin but I have to be careful with pregabalin, maybe 2 x 150 mg / day now.