I just can't keep away from alcohol!

[behindblueeyes]

I suffer from depression and anxiety. I'm on 2mg of klonopin daily and 45mg mirtazapine (antidepressant). I really feel like the antidepressant is starting to help since the dose was raised, but I have a huge problem: I have an alcohol problem. The antidepressant has actually decreased my cravings a little... I don't binge every night anymore (just my nights off work), but the cravings are still there. And I know this is contributing to my depression/anxiety.

The other issue is, I've been taking klonopin daily for nearly a year. I'm tolerant to it, and can even feel it start to wear off after 3-4 hours. I sometimes feel like I take it to avoid withdrawal. I know my dr. is soon gonna want to wean me off of it, and I'm really scared because I know once I'm tapering I can't abuse alcohol as it will screw with the taper. But can I drink socially?

Any advice?

 

[laCster]

you kind of fucked yourself by drinking heavily on klonopin. clonazepam has a 18-50hr halflife and will build up in your system after a month of taking it daily. so even if you are taking the klonopin in the morning and drinking at night, the alcohol was still interacting with the kpin. combining the kpin with alcohol is not like combining other drugs as benzos and alcohol synergize and exponentially increase each others' effects (i.e. 1+1=3).

you need to be sober from alcohol before you do the taper as the alcohol abuse will fuck up your taper. i think you know that you cant drink but dont have enough selfcontrol to stay away from alcohol. tapering from kpin or any benzo is hard enough alone man. only you can stop yourself from drinking, others cannot control you. the desire to be sober has to come from within, and successfully stopping and staying sober requires hard work. good luck, you will need it...

 

[behindblueeyes]

you kind of fucked yourself by drinking heavily on klonopin. clonazepam has a 18-50hr halflife and will build up in your system after a month of taking it daily. so even if you are taking the klonopin in the morning and drinking at night, the alcohol was still interacting with the kpin. combining the kpin with alcohol is not like combining other drugs as benzos and alcohol synergize and exponentially increase each others' effects (i.e. 1+1=3).

you need to be sober from alcohol before you do the taper as the alcohol abuse will fuck up your taper. i think you know that you cant drink but dont have enough selfcontrol to stay away from alcohol. tapering from kpin or any benzo is hard enough alone man. only you can stop yourself from drinking, others cannot control you. the desire to be sober has to come from within, and successfully stopping and staying sober requires hard work. good luck, you will need it...

Yes I do lack self-control, but I'm getting better at it. And yes, I also know I screwed myself by drinking heavily on kpins. Luckily though, with the kpins I can stop the alcohol without having to go to a hospital. I'm preparing for the benzo taper by slowing my alcohol intake... drinking 2-3 nights a week instead of almost every night. And soon be sober altogether. I know I'll have to be. I've heard of medicines that reduce cravings for alcohol and also ones that make you sick when you drink. I'm leery about asking my doctor for those though..

 

[deficiT]

You're headed in the right direction. I wouldn't rely on medication to stop your cravings I think you can handle it yourself. Taper off the booze, and then get off the klonopin. If I were you I wouldn't drink at all until you're fully off the benzo, which could take some time. And even then if you're a problem drinker, I wouldn't risk it. So prepare to be unpleasantly sober for awhile. You're in the driver seat though.

 

[behindblueeyes]

Do you think it would be wise to ask for something to help anxiety during the taper... like lyrica, gabapentin, anti-seizure meds? I don't know if my doc would go for that.... but I have a feeling it's gonna be a longggg time for my GABA to get back to normal.

 

[AlphaMethylPhenyl]

I think the first thing to do is stop drinking - even if you must raise your dosage(s). Then go from there.

Best time to start is now.

 

[pasha]

Do you think it would be wise to ask for something to help anxiety during the taper... like lyrica, gabapentin, anti-seizure meds? I don't know if my doc would go for that.... but I have a feeling it's gonna be a longggg time for my GABA to get back to normal.

Medications such as pregabalin, and gabapentin, are extremely effective at treating any form of gabaergic withdrawal, which in your case would be clonazepam and alcohol.

IMO, they wipe out most of the symptoms of benzodiazepine and GHB (similar to alcohol) withdrawal/cravings. I can cycle between GHB, clonazepam, and pregabalin without feeling a single thing.

They do have withdrawal symptoms of their own sometimes though, so don't use them for longer than you have to.

Your doctor shouldn't have a problem with it, most of them are well aware that pregabalin/gabapentin halt the withdrawal symptoms of gabaergic drugs.

 

[behindblueeyes]

I think the first thing to do is stop drinking - even if you must raise your dosage(s). Then go from there.

Best time to start is now.

I agree. Tonight is gonna be hard bc I have off work tom :/ but so far I'm making progress.... normally by now I'd have like 6 beers in me but it's almost 6pm and haven't had a drink.

Medications such as pregabalin, and gabapentin, are extremely effective at treating any form of gabaergic withdrawal, which in your case would be clonazepam and alcohol.

IMO, they wipe out most of the symptoms of benzodiazepine and GHB (similar to alcohol) withdrawal/cravings. I can cycle between GHB, clonazepam, and pregabalin without feeling a single thing.

They do have withdrawal symptoms of their own sometimes though, so don't use them for longer than you have to.

Your doctor shouldn't have a problem with it, most of them are well aware that pregabalin/gabapentin halt the withdrawal symptoms of gabaergic drugs.

I'll ask about those... what about Lamictal (sp?)? I heard it's an anticonvulsant and mood stabilizer, and I'll probably need a mood stabilizer at that time too as I'll be all over the place emotionally. Esp. not used to being sober or having a crutch.

 

[AlphaMethylPhenyl]

Its better to taper off with something such as lamictal, lithium, or depakote given their vast disparity with regards to addiction when compared to benzodiazepines or gabapentin/pregabalin. These aforementioned three also treat bi-polar depression (lamictal is probably the best for the depression side, lithium as an intermediate, and depakote for mania).

 

[pasha]

All active medications significantly reduced observer-rated and self-rated withdrawal severity, dysphoric mood, and supplementary diazepam administration compared with placebo.

Source:http://www.ncbi.nlm.nih.gov/pubmed/17374039

You're right HCM, there is efficacy for other anti-glutaminergics in alcohol withdrawal, but nothing has really shown as much promise as gabapentin/pregabalin. I also don't think drugs like lamotrigine are in the practical phase for treating alcohol withdrawal yet as far as I know.

Gabapentin was well tolerated and effectively diminished the symptoms of alcohol withdrawal in our population especially at the higher target dose (1200mg) used in this study. Gabapentin reduced the probability of drinking during alcohol withdrawal and in the immediate post-withdrawal week as compared to lorazepam.

Source:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769515/

The efficacy of pregabalin was superior to that of tiapride, used largely in research trials and, for some measures, to that of the 'gold standard', lorazepam. Accordingly, pregabalin may be considered as a potentially useful new drug for treatment of AWS, deserving further investigation.

Source:http://www.ncbi.nlm.nih.gov/pubmed/20078487

I'll ask about those... what about Lamictal (sp?)? I heard it's an anticonvulsant and mood stabilizer, and I'll probably need a mood stabilizer at that time too as I'll be all over the place emotionally. Esp. not used to being sober or having a crutch.

It's hit or miss for a lot of people as a mood stabilizer, some say it's a godsend, others don't know what it's doing.

 

[AlphaMethylPhenyl]

Oh certainly gabapentin will treat alcohol withdrawal.

I think its fairly-well established, but I would go for depakote + an antidepressant (personal, non-medical opinion) before using lamictal
http://onlinelibrary.wiley.com/doi/...sCustomisedMessage=&userIsAuthenticated=false
http://www.sciencedirect.com/science/article/pii/S0028390807002924

On depakote, but interestingly finding carbamazepine superior to that and gabapentin:
http://www.sciencedirect.com/science/article/pii/S027858460700351X

 

[pasha]

Another option I forgot to mention is baclofen, if you're interested in that, it can be a miracle for alcohol withdrawal plus cravings. But I would stick to the anti-convulsants to kill two birds (benzodiazepines, alcohol) in one stone.

 

[Morphling]

I was going to mention baclofen.

You have to be careful with depakote if you continue to drink, both due to interactions and possible liver damage.

 

[behindblueeyes]

Depakote? My ex was on that for mania in bipolar.... I guess I could ask about that.... gotta look up baclofen.... i'll know for sure when my doc decides to get me off the kpins

 

[Chris84]

Dunno if your doctor has told you this already or not, but mirtazapine shouldn't be mixed with alcohol as it stops it working properly, which is probably why you need such a high dose of it to feel the effects. I don't drink and I'm on 15mg of mirtazapine daily, I think that stuff saved my life, as I was seriously depressed, nearly to the point of being suicidal before I started taking it, the only bad side is it makes me put on weight. Be careful when you stop drinking though as if you've become dependent on it then the withdrawals you can get can be life threatening, as you could have seizures.

 

[laCster]

Whatever you do, DO NOT get on antibuse. I knew someone that almost died from drinking on that shit

I agree with chrom, lyricA and gabapentin are essential to get off benzos and alcohol IMHO/IME . They literally remove all symptoms for opiate withdrawal and work just as well, if not better, for relieving benzo physical and psychological withdrawal symptoms

 

[Chris84]

I agree with chrom, lyricA and gabapentin are essential to get off benzos and alcohol IMHO/IME . They literally remove all symptoms for opiate withdrawal and work just as well, if not better, for relieving physical and psychological withdrawal symptoms

Yes forgot to mention that, pregabalin is very helpful when coming off anything GABA related like alcohol or benzos and would be essential when getting clean if you're dependent on alcohol.

 

[Derschieber]

omg !! What's with the meds obsession....take this, try that, cycle between these two, get off this, get on that...insanity much? This obsession with finding answers in pills is just embarrassing...If it's a problem, don't stuff around and book yourself into rehab...stop drinking for sure, and stop this other crap as well. Don't be looking to drugs. Get off drugs. All of it. You think you can somehow avoid hardship and pain. You can not do it. No one can.

It's especially hard, because alcohol and pills reduce us to emotional jelly-fish...I know what they do...we all know. It's pathetic really. Yea it's hard, when you've got no emotional muscle. But there is no other way. You have to start using those withered muscles...the ones you neglect for years already. They DO get stronger. NO meds will compensate. Stop this childish blabber about finding solutions in pills already. All of you.

The work is difficult and very uncomfortable. Nothing will get you out of this. No one gets out of this. No you, not me...There is not any way...it will not kill you. In fact on a scale of things, it's not even hard. Try rehabilitating from having your legs crushed in an auto-wreck (for example). When you decide you want to what...Grow up? yea...that's really it, isn't it...when you decide it's time to continue growing as a person, instead of stalling with drugs, you will simply do the work, like so many others are doing...don't be telling yourself what you need to do is sooo hard...it's not. You're just weak, in exactly the places where you need to become stronger. And you will. Just as soon as you stop obsessing with finding solutions in those idiotic pills & alcohol...

I get the impression that you're not far down the road of alcoholism anyhow...you'll get through this just as soon as you stop cringing away from a little hardship.

Don't finish up resigning to a life-time obsessing over pills and medications. Do not accept this lame crap !!
Hanging out or seeking advice from pill-heads is a really bad idea. I recommend you book yourself in. You'll come away feeling like a million bucks...you know...without medicating side-effects from pills to get over drink whilst tapering of these tablets until switching over to those...bloody hell... time to grow up and be free...
You can do this. It's no big deal at all.

 

[Toz]

Medications such as pregabalin, and gabapentin, are extremely effective at treating any form of gabaergic withdrawal, which in your case would be clonazepam and alcohol.

IMO, they wipe out most of the symptoms of benzodiazepine and GHB (similar to alcohol) withdrawal/cravings. I can cycle between GHB, clonazepam, and pregabalin without feeling a single thing.

They do have withdrawal symptoms of their own sometimes though, so don't use them for longer than you have to.

Your doctor shouldn't have a problem with it, most of them are well aware that pregabalin/gabapentin halt the withdrawal symptoms of gabaergic drugs.

I disagree, taking gabapentin never did anything for me in benzo withdrawal, all it ever did was give me an even worse withdrawal than the benzos afterwards...

Taper the benzo slowly and DO NOT use other drugs to mitigate the symptoms. If you can't handle it then taper even slower. I've been through so many withdrawals so many times I've learnt the hard way that using one drug to get off another is a really shitty idea. You might easily end up even worse than you were before with 2 addictions instead of one.

 

[Morphling]

^^ I can accept your hard, tough love stance for what it is but...

Precipitated benzo withdrawal can cause brain damage.

Statistically speaking, cold turkey w/d is a poor solution, as a huge percentage of people relapse far more rapidly with this method than any other.

You make it sound like medications are the devil, wherein by most standards, they are there to HELP people, not get them addicted. Chemical solutions, aren't they, but air and food are made of chemicals too.