Benzos 1 Month of varied moderate Benzo use; withdrawal/taper advice needed!

[PontiffTheGreat]

I didnt even think about withdrawal. I havent been using the benzos i've had available therapeutically. Ive been using lorazepam, bromazepam and alprazolam. I'll use "Xanax equivalent" to describe my use though. A couple nights (maybe 5 or so) I used up to 3-3.5mg. But the average is probably around 0.75mg per night. Some nights I didnt use any, some nights I used small amounts of alpazolam (like .25-.5mg xanax) or lorazepam (like 1-2mg) with opiates. Which I am around day 4/5 of very mild Withdrawal of (Mild codeine/Tram use ~ 500mg currently clean). Given the aforementioned and the possibility of a benzp withdrawal/rebound i've been taking 2.5mg lorazepam nightly (last few days), i'm not feeling amazing but not horrific either. Should I CT? I was thinking a quick-taper would be in order; say drop to 1.25mg lorazepam tonight (maybe + 0.25mg xanax or 1.5mg bromazepam) for a couple days then jump off and use 0.25 xanax as needed until clear). Around mid-year I did a similar thing and just jumped off without a taper.

Thoughts/advice/input?

Meds I have available;

-Hydroxyzine 25mg (taking 50mg nightly atm, going to up it to 100mg with drop in benzo)

-Quetiapine 200mg (taken nightly as part of treatment) which I can up.

-small amount of diphenhydramine and doxylamine.

-Bromazepam 6mg bars & 0.5mg Xanax tabs.

-only 7.5mg of lorazepam left.

I can use/vary any of the above.

I have a long international flight in under 3 weeks

 

[Slow_Mobius]

I wouldn't CT. You dosage of tramadol is already above the recommended maximum, and that will enhance the seizure risk associated with benzo WD.

Why can't you just bring your meds with you for your flight? Do you not have a prescription?

 

[Scrofula]

What has your use been in like the last week? It's hard to tell exactly. You have low nightly use, with occasional binges?

OK, 2.5mg lorazepam each night. That's a regular daily dose for a lot of people. At that level, you could just cut it in half till it's gone. You could probably cold turkey if you don't have any symptoms right now.

Oh, tramadol is a complication, since it lowers seizure threshold, just like benzo withdrawal. And I can't tell if you're still on your "mild" maximum dose of 500mg.

You don't want tramadol in your system if you're worried about benzo withdrawals, whether you feel anything or not.

So, to quit benzos you need to quit tramadol. You can probably wean off both together. But you're taking a lot of tramadol now (or were), so I wouldn't want to taper off benzos without at least cutting back a bit. I mean, it's impossible to predict what the risk is, just know the seizure risk is "high" for acute heavy benzo withdrawal and "moderate" for high tram doses (all relative), and seizure risk usually multiplies, it doesn't sum.

Otherwise your benzo use sounds low, like there'd be no compolications, and you have plenty of other meds to knock you out if you need.

Good luck

EDIT: dammit why don't I hit refresh on these things.

 

[Freek123]

Hi Pontiff, if i may give you some advise then firstly stop taking different benzo's together, because on that way its impossible to determine if and if so how high your tolerance may be, but a month is usually not enough to get dependent what you can expect though are rebound symptoms so this means that the reasons for which you started using the benzos will come back with a vengeance this does not mean there is already dependence going.

Now the first thing you should do imo is to take the benzo you still have the most from preferably a long acting one so let me see if you have a longer acting one hmm no not really it are all medium halflifetime benzos still its possible in a matter of days to use only one benzo type that one you could taper in the course of two weeks and if possible not longer, because the longer you take the benzo no matter the tapering makes the risk of dependency only higher.

You can use the hydroxizine and the quetiapine as sleeping aids if needed "they" say that you cannot get dependent from say quetiapine depending whom you ask though, but i happen to use quetiapine for quite sometime already and without it my sleep is disturbed including more smaller issues and "they" call that anti psychotic discontinuation syndrome, which are just confusing words, because its dependency not apds.

You dont mention how many of the named benzos you still have left aside from the lorazepam at 7,5mg so i cannot give you a taper scheme, however like i said above one month into benzo's basically wont cause dependency and from the benzos you have so i consider bromazepam as the one to use in trade of the other benzo's when this is done in some days then include the days you needed to take one benzo type only say 3-4 days then from there in ten days tapering the benzo down and only if really needed you take the lowest amount possible from one of your other benzos and that is the best advise i can come up with at this point.

You know there exists a substance who would wipe possible benzo issues under the doormat this substance is called lyrica with pregebalin as substance name well if you cant lay your hands on that one then gabapentin in a roughly three times higher dose does roughly the same so in other words with one of these two substances you wont need your benzo's anymore so lets call that the fast cure so that you need nothing anymore when your international flight comes up.

For the rest dont think too fast that after a month not even very high benzo use that without them badness will be yours, but i doubt if its more then being plagued by insomnia only for reasons like that you have the seroquel and/or the hydroxizine.

Good luck my friend and if more questions arise just shoot one problem though i dont post here for long yet no matter my earlier membership and i can never find postings back in which i said something, but i guess i will figure that out when more time passes.
Best regards, Freek. ps i am about to hit send if only i wont see a too long reply back its just that i like to be clear and with english not being my native language my replies can be lengthy.

 

[PontiffTheGreat]

I wouldn't CT. You dosage of tramadol is already above the recommended maximum, and that will enhance the seizure risk associated with benzo WD.

Why can't you just bring your meds with you for your flight? Do you not have a prescription?

I'm off the tram (total was only used a half dozen or so times), day 4/5 (I did a quick taper so depends on opinion) off the opiates. I dropped the lorazepam to 1.25mg and added 1.5mg bromaz so = 1.25 alpraz equiv down to 0.8 or so and got around 8/9 hours sleep.

If my understanding is correct tramadol lowers the seizure threshold when consumed, so wouldnt its rebound effect be to INCREASE the seizure threshold?

 

[Lorne???]

^No, that is not how it works. At best seizure threshold at baseline.

Your posts are confusing, please list actual doses, not "xanax equivalent", as it is more complex than that

Alrazolam will have the fastest and probably hardest wd, lorazepam has a longer duration, would advise using your, 7.5mg(?) with caution, xanax should be to supplement the taper, not finish, IMO

And 200mg seroquel is a lot, especially w/ 100mg hydroxyine; Personally, would cut it in half, to 100mg seroquel, and maybe just take 25mg hydroxyine for a night, then 75 the next night? Best of luck anyway

 

[ikarma]

I've found you can get off alp pretty fast but have to have self control. Quit till you can't stand it then take half normal dose. Next dose lower. You should be able to minimize the WD. I was in hard core withdrawal after 3 weeks. 2 Ativan cured it.

Also diphenhydramine made me go further into psychosis.

 

[Subolyrica etc]

Hallo everyone,
I'm new to this forum and I would like to ask some advices, if anyone can.
My problem is benzodiazepines, suboxone and now my TRULY crazy doctor prescribed me Lyrica... I have many questions and I would be extremely glad if someone can "show me the way" to be at a right thread for the problems I have mentioned.
Thank you very much, every answer is welcome and I would be very grateful to anyone who answers me

 

[Trabbamab]

I think most of the above posters have covered things pretty well. I am just wondering something: Does tramadol lower seizure threshold in WD as well? I know heavy doses of it do. I would find that interesting that both its effects and WD lower seizure threshold. And horrible. Man, that would really lower my already pretty low opinion of this drug.

 

[Scrofula]

Hallo everyone,
I'm new to this forum and I would like to ask some advices, if anyone can.
My problem is benzodiazepines, suboxone and now my TRULY crazy doctor prescribed me Lyrica... I have many questions and I would be extremely glad if someone can "show me the way" to be at a right thread for the problems I have mentioned.
Thank you very much, every answer is welcome and I would be very grateful to anyone who answers me

If you can narrow things down to a specific question or two, I will create a thread for you in the vaguely right spot.

 

[Scrofula]

I think most of the above posters have covered things pretty well. I am just wondering something: Does tramadol lower seizure threshold in WD as well? I know heavy doses of it do. I would find that interesting that both its effects and WD lower seizure threshold. And horrible. Man, that would really lower my already pretty low opinion of this drug.

Tramadol lowers seizure threshold on its own; withdrawal from some drug classes can also lower threshold. The two together can be worse than their sum. Like, the risks multiply.

Seizure risk isn't usually "linear" either. So if 200mg gives you x amount of risk, 400mg gives you more than 2x the risk.

Does withdrawal from tramadol by itself lower the seizure threshold? IDK.

Most drugs have a rebound, opposite effect in withdrawal. Does tramadol raise the threshold in rebound, and cancel things out? IDK.

I wouldn't think so, but I don't think anyone knows for sure what the source of the seizure risk is. So you can't predict how it will behave in withdrawal. It's one of the meds that should only be adjusted by itself, with some washout (really, you should do that for every med, but this one has more risk).

 

[Jebcity]

1 month of use and you really shouldn't have anything to worry about. There is a lot of melodrama about benzo withdrawal. It certainly can be bad for long time use in higher doses but for a month of use, not even every day, you shouldn't worry. Something similar happened to me, I used on and off for sleep for about 6 months, slowly escalating to 2mg of klonopin a night for 2 months straight. After reading about withdrawals online I really got spooked, but stopping wasn't a huge issue. Honestly most of it was probably in my head. I definitely had some rebound anxiety and still have trouble sleeping, but fear of the withdrawals was the worst part. After a week I was so spooked I went to the doctor and he told me that I had nothing to worry about. The seizure threshold is like 24-48 hours and I should expect some rebound anxiety for 10-14 days. Don't sweat it, just relax and if you get really bad anxiety take a small does, you'll start to need it less and less. Benzos are a band aid, they only mask, not solve, underlying issues. Let me know if you have any questions, I'd be glad to answer.