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Irreversable brain changes after long term use of benzo's

Nimshie29

Bluelighter
Joined
Jul 27, 2011
Messages
33
Location
Darwin
Hi People,
Two pain specialists and one psychiatrist have told me that I may not be able to entirely come off benzo's after using them for 11 years (as prescribed).
The pain specialist said this was due to permanent changes to GABA receptors which can leave the patient in a permanent state of high anxiety without small doses of benzos.
I have currently tapered from 30mg diazepam / day to 9mg / day over 7 months and would like to come off completely.
Any comments or experiences please?
Nimshie29
 
Many people have come off high-dose/long-term benzo use without significant protracted withdrawal symptoms. I think if you follow an EXTREMELY slow taper plan, perhaps taking place over a year or more, you could successfully be benzo-free without severe PAWS.

There has also been some success using flumazenil (a benzo antagonist) AFTER you have tapered off of benzos. It is hypothesized to "reset" your GABAa receptors, allowing them to function normally (or more normal) in the absence of benzos.

Flumazenil in treatment of protracted benzo withdrawals: http://www.springerlink.com/content/2vpf562teffglej5/fulltext.pdf?MUD=MP

Here is a nice paper explaining the neuroadaptation associated with long-term Benzo dependence:

It can be accessed free at PubMed http://www.ncbi.nlm.nih.gov/pubmed/22536226
 
Have input;lack time....

- What prompted the need for drug discontinuation after 11 years?

- Investigate merits of high dose Gabapentin

- Flurazepam, a partial agonist of sorts, could be useful in patients who have been on BZDs for many years
 
How has your taper been so far? How do you feel at the dose you are on? I have read a lot of hellish stories about bzd withdrawal, but it seems given enough time, everyone eventually gets back to normal. The brain is an amazing organ, but it does seem the GABA system is very slow to heal. Mixed reports on gabapentin or lyrica. Some people seem to find helpful, some people seem to find it exacerbates difficulties.
 
Hi People,
Two pain specialists and one psychiatrist have told me that I may not be able to entirely come off benzo's after using them for 11 years (as prescribed).
The pain specialist said this was due to permanent changes to GABA receptors which can leave the patient in a permanent state of high anxiety without small doses of benzos.
I have currently tapered from 30mg diazepam / day to 9mg / day over 7 months and would like to come off completely.
Any comments or experiences please?
Nimshie29

I'm new to this forum and freaking out after reading this post. I've been going through protracted withdrawals and I'm at the 2 year mark. Posts say that, in time, I will be back to normal, but now you have a couple doctors saying something that is different. I was on Klonopin for about 8 months after coming off off Oxy. My symptoms are much reduced yet I do still experience some anxiety and depression. I never had these symptoms before stupidly taking opiates.

I appreciate any advise, reassurance that you can provide.
 
Hi People,
Two pain specialists and one psychiatrist have told me that I may not be able to entirely come off benzo's after using them for 11 years (as prescribed).
The pain specialist said this was due to permanent changes to GABA receptors which can leave the patient in a permanent state of high anxiety without small doses of benzos.
I have currently tapered from 30mg diazepam / day to 9mg / day over 7 months and would like to come off completely.
Any comments or experiences please?
Nimshie29

Going from 30mg to 9mg in 7 months seems like a fairly aggressive titration, especially for someone with 11 years of use. If the tapper so far hasn't been too hard to manage for you; I would think you are well on your way to getting off completely.

I don't think there is any proof that benzos cause permanent structural damage. Even if benzodiazapines cause long lasting functional changes, that doesn't mean that you are guaranteed to suffer from PAWS once you are off of them.
 
I've taken clonazepam on and off for years. I force myself off it about once a year to keep things balanced, not fun but I'm usually baseline within a week or so. However, I should note that at baseline, my GABA levels are off. This is because I am a recovering alchoholic though. I take the clonazepam to help with the twitching, ticks, etc. I have been sober for quite some time, but after 17yrs of HEAVY drinking the damage was done. So I guess what I'm saying is that I can see how you could potentially cause long-term issues, but I think you would have to be abusing them badly and for years and years. I just don't think you should worry about theraputic doses if they are providing a needed/desired effect.
 
Hi benzonomore,
8 months on Klonopin, in my experience, would not have done much damage at prescribed doses. I came off them after 18 months and returned to my previous mental state in a couple of weeks. I do not know about any long term changes using opiates.
Enjoy,
Nimshie29
 
Hi Mesmer,
I thought I had replied before but cant find it now. Taper has been tolerable with some periods of high anxiety helped by pregablin (Lyrica). What else can I do but continue and seee what happens?
Enjoy,
Nimshie29
 
Hey man I'm not a specialist in any way but I felt that I should drop I comment on your thread

I've been addicted to booze (bender/rough times 4yrs) along with xanax/klonopin/valium use, AND gabapentin use... So my gaba receptors were toast, and I've been in a state of high anxiety for a long time. I saw a doctor who legitimately cares about his patients, and was honest with him. I take Vitamin B12 + Folic acid along with Lithium Orotate (the mineral, not the prescription drug lol)... and it's helped me out a ton... and the best part is that there are no withdrawals ! :)
 
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There has also been some success using flumazenil (a benzo antagonist) AFTER you have tapered off of benzos. It is hypothesized to "reset" your GABAa receptors, allowing them to function normally (or more normal) in the absence of benzos.

Flumazenil in treatment of protracted benzo withdrawals: http://www.springerlink.com/content/2vpf562teffglej5/fulltext.pdf?MUD=MP
Must read more into this. I wonder if it would work on those of us already with PAWS, and have had them for quite some time, continuing to relapse on BZDs.

Have input;lack time....

- What prompted the need for drug discontinuation after 11 years?

- Investigate merits of high dose Gabapentin

- Flurazepam, a partial agonist of sorts, could be useful in patients who have been on BZDs for many years

thx
 
I don't think this is impossible but I'm far from being a pain specialist (not counting the fact I know how to manage it...) or a psychiatrist (and that's fine because they all move in this field as if through a fog). I have taken benzodiazepines *daily* and *not as prescribed* since I was 14, now I'm 22. Considering there's quite a big spectrum in dosing as the tolerance rises it would mean I have completely no choice of getting off what I take now, that is clonazepam. Well, I cut my dose by 50% during the last months and I hadn't touched the dose earlier for a long time, I mean tapering down, but I had taken more than I should be stable at.

There were times I could swallow the whole leaf of this shit (30 pills x 2mg) and function normally like I didn't feel its effects really on my concentration that much, I could almost drive a car if I only weren't aware I had taken that much of clonazepam. I've lowered my dose to 2.5mg today from 3mg.

I had to get a script from a different psychiatrist last time because mine was on holidays and just like most psychiatrists here now he thinks I should definitely taper off and prescribed me a lower dose, well, shouldn't really do that and I wouldn't be fine with it if I hadn't actually worked my way down from some time, not telling the shrink. I hardly believe there are some treatments here with substituting long-term use of benzodiazepines with flurazepam as it's not even marketed here and I doubt flumazenil is used for anything but benzodiazepine overdose.
 
Hey man I'm not a specialist in any way but I felt that I should drop I comment on your thread

I've been addicted to booze (bender/rough times 4yrs) along with xanax/klonopin/valium use, AND gabapentin use...

If you have really bad benzo/booz w/d I reccomend Acamprosate or another strong NMDA Antagonist such as mementine to start things off.
 
I hardly believe there are some treatments here with substituting long-term use of benzodiazepines with flurazepam as it's not even marketed here and I doubt flumazenil is used for anything but benzodiazepine overdose.

Nonetheless, both compounds have been used in the context of BZD withdrawal syndromes, however make sure you understand the context in which flumazenil was mentioned (ie, not during the active withdrawal process). Flurazepam is of interest in certain cases due to some unique pharmacological properties, as well as some pharmacokinetic advantages. Yet, it is unlikely to precipitate withdrawal symptoms as would buprenorphine in a patient dependent on morphine.

Gabapentin in high doses can sometimes be helpful particularly during the acute withdrawal, and there is even some limited data to support its utility in capacity. While the following is an anecdotal account, it may of some interest:

When I experienced BZD for my second time, I found high doses of pregabalin (600-900mg) to be quite effective in providing transient yet profound relief of most symptoms during the moderate-acute phase. While this relief was short-lived due to pharmacokinetic limitations, it provided a valuable 'breath' from the anxiety/panic states. When such symptoms are allow to fully develop (as they had during my first BZD withdrawal experience), they are more likely to reach an intensity sufficient to induce post-traumatic disorders, PAWS, etc.
 
I haven't seen anything that states permanent changes from long term benzo use, but i do know that if you are prone to protracted withrawal, it can take ~8-24 months to regain some sort of normality. there are plenty of people who used benzos for ~2-3 months and suffered 6-12 months of withdrawal. The bottom line is your genetic predisposition to the withdrawal b/c there are a ton of people who can take them for 10 years and have 2 weeks of discomfort.

My prescription benzo withdrawal
After 2 random panic attacks, i was prescribed xanax by a dr and took it as prescribed for ~3.5 yrs, up to 3mg and slowly tapered to .25mg where i started having very high anxiety/dp/dr/stomach bloating/throat tightness/acid reflux/insane fatigue/and more...

I'm ~8.75 months off now and these are the things that improved; memory came back, personality came back, no problem falling asleep or staying asleep. I still have the fog vision(dp/dr) and vertigo/anxiety when i try to drive for any distance, also a heightened baseline of anxiety. these symptoms go away sometimes but they come back, so i can be back to normal for a day but then be shot for 2 weeks straight. It's very back and forth.
 
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