Benzos Benzo C/T with mirtazapine and DXM (Delsym specifically)

[MagickalKat777]

It seems like the mirtazapine would counteract the adrenal response of the benzo withdrawal and the adrenal activation of DXM.

I'm sick of this cycle. I was down to 2.5mg of Valium a day and an idiot psychiatrist forced me onto Tegretol even after I suggested that Trileptal would be a much better option for a myriad of reasons besides the fact that it doesn't induce elimination of benzodiazepines. I took it for three days... I went into full blown withdrawal. Right back where I fucking started. 20mg a day in two doses every 12 hours. Tapering is hell. I've been considering switching to alprazolam because it doesn't have the active metabolites that stick around and draw things out for months but alprazolam gains a rapid tolerance with me while 20mg of diazepam, even with my... Rather high amount of alcohol consumption when I drink (I just drank 750mL tonight)... My tolerance to the diazepam doesn't change other than the two to three days (if I've been on a bender) that I feel like I'm numb and can't breathe... But I've noticed that mirtazapine not only eliminates that completely, 7.5mg knocks me out between 12 and 18 hours.

I know I have a low dose of diazepam and I can honestly say that said low dose has prevented me from ever having one of those horrendous alprazolam or clonazepam rebounds but I want off of it. Gabapentin and I have a love hate relationship....... Mostly hate. Even 100mg I get knocked out one night, the next night it does zero so that's obviously a bad path. diazepam is the only drug besides mirtazapine and trazodone and dextromethorphan that I never gain a tolerance to (although in the case of DXM I used it too much and now taking enough to get me high results in fucked up vision, vertigo, plus all the negatives like tachycardia, nausea, etc).

On paper, mirtazapine and DXM look like the perfect therapy - trazodone..... Well because of mCPP it doesn't look as nice. Then there's also the cigarettes I picked up again which I already know DXM blocks but I need something to temper my adrenals either way and mirtazapine seems like it fits the bill.

Make no mistake, I have 4 months worth of scripts for my meds plus Gabapentin from my legit doc... I'm just sick of how much diazepam affects me. I take it and I'll be playing a video game and suddenly feel like going to bed - and when I do I won't wake up until the alarm goes off. I forget everything I did the day before until about a week later, when I finally do dream it's this horrible tangle of one nightmare after another because REM rebounds... And I just hate the fact that I'm stuck on a medication. I'm at the point that if C/T kills me, so be it, because this isn't a life it's hell. The fucked up thing is I ended up getting hooked because I had surgery and they pulled me off the morphine, discovered that hydrocodone gave me panic attacks... So instead of giving me morphine pills (I have the same panic reaction to any thebaine derivative, even oxycodone), they gave me vicodin 5 times a day with half a milligram of Xanax... For 6 weeks. Dropped the hydro (7.5x5 a day) no problem but the Xanax? I stopped everything when I went back to work and had to use the restroom... I had to crawl out on my hands and knees talking to family on the phone to get through it, called my doctor and he told me I had to keep taking the Xanax. We got the 1.25mg a day down to 0.5mg a day instantly... Within 3 months it was 1mg. Withing 6 it was 4mg. At the end of 12 it was 8mg between IR and XR (yes I know my doctor was a fool). Anyway. What do I do? I'm going on the DXM either way because I'm smoking cigarette butts right now so I need to figure out how to balance out that adrenal uptick from the DXM anyway but what about for my benzos? Might as well kill two birds with one stone.

I want it to be known I know the risks of benzo withdrawal. Clonazepam and diazepam both almost killed me. The thing is this time I'm at home and I have plenty of meds and it was forced inpatient the other times. It takes 30 minutes to kill withdrawal if I dust the pill and wash it down. My phone has a handy dandy heart rate sensor so I can see whenever I'm in the danger zone. Even if I have to wait until I'm pushing 150 before I take a couple milligrams it might be a lot more effective and efficient (it took me 16 months to get down to 2.5mg) than a proper taper.

 

[Keif' Richards]

Hey man, I'm sincerely sorry that you're going through benzodiazepine withdrawal like this. Admittedly, I've never been through a benzo detox per se but I have had to go CT off of high-volume habits of alcohol and from what I've read and heard, they're pretty similar processes.

My first question, and please forgive me if this was somewhere included in your OP and I missed it, why not just go to inpatient and be done with it? Not only will you be in safe hands that virtually guarantee your wellbeing, but I've found that when I was inpatient for alcohol detox, just the fact that I was in said safe hands was enough to quell my raging anxiety somewhat. I'm sure you know what the "fear" is like so I don't need to explain it, but being in the right place really helped me to calm down about my condition.

Secondly, you mentioned that you have four months of scripts available, including gabapentin (Neurontin), what is your previous experience with gabapentin, as for me, it helps tremendously with various different symptoms of both sedative/hypnotic and opioid withdrawal. In my limited knowledge, I don't believe that drugs in gabapentin's family (pregabalin, phenibut, baclofen etc.) are contraindicated in your current situation. Perhaps try some high(er) doses of gabapentin and see if it brings your any relief. I tend to go as high as 4 grams and up when I am seriously hurting, but you may be different. If you do choose this drug as an aid, be sure to consume some high-fat foods (spoonfuls of peanut butter work great) prior to ingestion and stagger your dosing. The lipid content of your stomach can impact absorbtion rather severely. This could account for its varying level of efficacy in your experience.

Thirdly, why not just give your benzo taper another honest try? If diazepam is knocking you out and blacking you out, perhaps you're taking too high of a dose? I also think that you're doctor is really fucking you over and if you are truly honest about breaking free from your benzo hell, you could perhaps try seeing a more responsible doctor who will actually help you. Withdrawing C/T or too quickly from sedative/hypnotics is not the way to go. Even if it doesn't kill you, it's bad for your health as I'm sure you're you know.

As far as the dextromethorphan is concerned, I would avoid it. DXM along with OTC antihistamine sleep aid has always just exacerbated my problems during withdrawal. I've never received anything that I would consider a benefit from either while sick. You, however, may be different. Good luck man, I hope this helped you out a little.

 

[OntarioGuy]

What helped me to taper was Lyrica (Pregabalin) also gabapentin is great imo. I used large doses of lyrica to get down to 2 mgs of diazepam once a day (my current dose) from 30-60 mgs of alprazolam/clonazepam per day.

Using Lyrica I straight up switched from high dose xanax/rivotril to 30 mgs of diazepam once daily.That was in March. Tapered 1 mg every 2 weeks to now, and like I said am down to 2 mgs of diazepam.

I seriously recommend pregabalin and Gabapentin to assist tapering, and they can even help drastically in a cold turkey situation.

 

[bdomihizayka]

Thanks for my message man.

So you say you are stabilized on the valium at 20mg? That's pretty wild given your tolerance for xanax and klonopin.

So I am not completely following you- are you trying to do a rapid/ cold turkey detox?

Tapering is hell.... but cold turkey is dangerous, and also there is literature out there that too big of a cold turkey detox and it can make permanent changes in one's brain and leave you feeling permanently funky.

How long have you been on benzos?

 

[JM357]

Have you tried increasing the dose of gabapentin short term? I don't take my gabapentin every day as I don't want physical dependence, but when I take it two days in a row my tolerance goes up fast but doesn't go up as quickly after that. I get the 300mg pills and at first a couple (usually 1 every 30-60 minutes till I feel better- I've heard the body can't really utilize much at once) work then it might end up being 3-4 the next day. I have taken it as long as a week and haven't had noticeable withdrawals.

 

[MagickalKat777]

Hey man, I'm sincerely sorry that you're going through benzodiazepine withdrawal like this. Admittedly, I've never been through a benzo detox per se but I have had to go CT off of high-volume habits of alcohol and from what I've read and heard, they're pretty similar processes.

My first question, and please forgive me if this was somewhere included in your OP and I missed it, why not just go to inpatient and be done with it? Not only will you be in safe hands that virtually guarantee your wellbeing, but I've found that when I was inpatient for alcohol detox, just the fact that I was in said safe hands was enough to quell my raging anxiety somewhat. I'm sure you know what the "fear" is like so I don't need to explain it, but being in the right place really helped me to calm down about my condition.

Secondly, you mentioned that you have four months of scripts available, including gabapentin (Neurontin), what is your previous experience with gabapentin, as for me, it helps tremendously with various different symptoms of both sedative/hypnotic and opioid withdrawal. In my limited knowledge, I don't believe that drugs in gabapentin's family (pregabalin, phenibut, baclofen etc.) are contraindicated in your current situation. Perhaps try some high(er) doses of gabapentin and see if it brings your any relief. I tend to go as high as 4 grams and up when I am seriously hurting, but you may be different. If you do choose this drug as an aid, be sure to consume some high-fat foods (spoonfuls of peanut butter work great) prior to ingestion and stagger your dosing. The lipid content of your stomach can impact absorbtion rather severely. This could account for its varying level of efficacy in your experience.

Thirdly, why not just give your benzo taper another honest try? If diazepam is knocking you out and blacking you out, perhaps you're taking too high of a dose? I also think that you're doctor is really fucking you over and if you are truly honest about breaking free from your benzo hell, you could perhaps try seeing a more responsible doctor who will actually help you. Withdrawing C/T or too quickly from sedative/hypnotics is not the way to go. Even if it doesn't kill you, it's bad for your health as I'm sure you're you know.

As far as the dextromethorphan is concerned, I would avoid it. DXM along with OTC antihistamine sleep aid has always just exacerbated my problems during withdrawal. I've never received anything that I would consider a benefit from either while sick. You, however, may be different. Good luck man, I hope this helped you out a little.

What helped me to taper was Lyrica (Pregabalin) also gabapentin is great imo. I used large doses of lyrica to get down to 2 mgs of diazepam once a day (my current dose) from 30-60 mgs of alprazolam/clonazepam per day.

Using Lyrica I straight up switched from high dose xanax/rivotril to 30 mgs of diazepam once daily.That was in March. Tapered 1 mg every 2 weeks to now, and like I said am down to 2 mgs of diazepam.

I seriously recommend pregabalin and Gabapentin to assist tapering, and they can even help drastically in a cold turkey situation.

Okay I'm doing this from my phone which isn't ideal so I neglected to mention that I've been in "safe" hands and they almost killed me three times - twice on Klonopin and one time on Valium. I don't trust those idiots any further than I can throw them (and since I don't work out like bdom I couldn't even get most of them over my shoulder...). That rapid taper shit is just as bad as a proper taper.

Thanks for my message man.

So you say you are stabilized on the valium at 20mg? That's pretty wild given your tolerance for xanax and klonopin.

So I am not completely following you- are you trying to do a rapid/ cold turkey detox?

Tapering is hell.... but cold turkey is dangerous, and also there is literature out there that too big of a cold turkey detox and it can make permanent changes in one's brain and leave you feeling permanently funky.

How long have you been on benzos?

I know that 20mg is insanely low given my tolerance for all other gabaergic meds. The problem is that I feel the removal after about 12 hours (probably the oxazepam) then I stabilize around day 3 until the 10th day when the diazepam actually starts being cleared out along with nordiazepam.

Have you tried increasing the dose of gabapentin short term? I don't take my gabapentin every day as I don't want physical dependence, but when I take it two days in a row my tolerance goes up fast but doesn't go up as quickly after that. I get the 300mg pills and at first a couple (usually 1 every 30-60 minutes till I feel better- I've heard the body can't really utilize much at once) work then it might end up being 3-4 the next day. I have taken it as long as a week and haven't had noticeable withdrawals.

Gabapentin gives me weird pains in my body and makes me piss a lot, even at 100mg and being on Medicare... Lyrica would be an expensive option and besides I tried it before when my doctor gave me free samples and it literally took 900mg to get where I felt calm. Even if UHC agreed to pay, they won't exceed 450mg a day except under extreme circumstances.

Maybe my problem is that I'm treading lightly with Gabapentin instead of diving right in? I mean... I tend to be very sensitive to most drugs (give me 10mg of Zyprexa Zydis and I'm tripping my ass off while my heart pounds away and give me Geodon and I gain a daily tolerance - one psych ward I was at (the closest to killing me from Klonopin withdrawal and the only reason I'm here today is because they kicked me out for not going to group, much less eating, and in the OD attempt I made (and succeeded - I have the 12k ambulance and the memories of this big dude grinding on the center of my chest plus medical documents that I was dead at the scene), they thought they got all my pills but I tricked the nurse into giving me my bag when I was waiting for the taxi. Dumbasses missed the couple 5mg of diazepam yet took everything else. It took 20mg when I got back to my father's house before my pulse finally went down from "way too fast to count" to 77.

I was on a taper for 16 months. Barely functioning. I got down from 20mg to 2.5mg and then my psychiatrist forced me on carbamazepine. Even though I explained the benefits of oxcarbazepine, including the fact it wouldn't flush my benzos. 3rd day on it was like that 10 day marker I seem to have for both clonazepam and diazepam (with clonazepam being the worst of the two without additional medication intervention). My last try with a facility........ They did the rapid taper protocol, put me on 1500mg (yes, 1500mg) of Depakote, kept me for 9 days, ran blood tests and surprise surprise my 180 pound body was not happy with the Depakote level so they skipped my last dose at the hospital and sent me home. Well I was supposed to have been on another dose 8 hours later, they just split it to 1000mg a day. My roommate was too busy with his stupid vacuum shit to pick up my prescription and I went into withdrawal the next day. He picked it up the next day but obviously in withdrawal you don't have any tolerance for fuck all and every drug introduced (or reintroduced in my case) will mess you up.

You want to know how bad it got before I went to the ER? Pitch black room watching King Of The Hill, I could not only see the TV but everything else in the room. My pupils were more blown than any amount of any drug could ever blow them - pitch black. The light from the TV was as bright as an incandescent with a pink throw over it. The really scary part is that I remember every single second of every single withdrawal visually. I can't remember yesterday but if I had any talent I could paint exactly what I was seeing. Benzos are bad mmkay? I'd rather be shot in the head than live like this.

 

[Memantine]

You shouldn't combine DXM and mirtazapine. α2 receptor antagonists increase DXM's neurotoxicity.