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Tapering Xanax, diazepam necessary?

AIWL

Greenlighter
Joined
Mar 9, 2016
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2
I have found myself in the unfortunate position of taking alprazolam every night for sleep for the past 2.5 years. This was doctor prescribed, all though the messages got crossed and I was only supposed to take it sometimes, not every night. Now, I'm not happy about it, especially when a year in I asked that doctor about the effects of alprazolam and risks of both addiction and poor sleep architecture and he said not to worry, but about 6 months later his office was concerned because I was taking it every night and that was news to them even though they had taken over the prescription and were filling it for a year and a half. After some arguing and pointing to the time when they told me to take it, they tacitly agreed it was "okay" but I feel like I'm treated like a drug addict every time I see them. So I'm just ready to be done. My sleep is under control, I don't think I need it anymore- (I have other meds and I have improved sleep hygiene). But I read and here it's probably not safe to stop cold.

Or is it?

And that's why I'm asking. I've been reading up on alprazolam tapering, and specifically the difficulty of such. The recommendation is switching from a short acting to a long acting benzodiazepine. But everything I've read also talked about people that are taking Xanax multiple times a day, and who have cravings. I have no cravings. Even when I forget (in fairness, this isn't often). I do on rare occasions take it during the day for anxiety, but that is at most, a couple times a month and frequently not at all.

I have a wonderful psychiatrist and she seemed on the fence on how to taper since at that point I was already on what she considered a low dose for tapering. I was taking 1mg alprazolam at bedtime, but dropped it to a half (.5 mg) at bedtime when the prescribing doc was dragging his feet over refilling it. That was 3 or 4 months ago. I didn't notice a difference. At all. But I've also heard that it's easier to taper down the big doses, and when you get to the lower dose end of the taper that it becomes problematic.

The psychiatrist decided that we should do the diazepam switch and taper. And here I am, looking at these pills, wondering if I'm not just asking for trouble. I also don't want to be groggy all day. If I'm not having interdose withdrawals on the aprazolam, and am taking it once a day. Is there the same risk of seizures and other WD effects? Can I just taper xanax down a little more and be done with it? Or is that an irrelevant factor?
 
Hi AIWL - yes, definately taper as you've been on it for over two years. I feel your doctor is also correct I switching you to diazapam, as it is a longer acting benzo (stays in your system longer than Xanax). If you find that you are drowsy during the day you can modify when you take it. I really would not recommend quitting cold turkey as you have been on them for a while and do have a seizure risk at this point. Also quitting cold turkey will make the withdrawal and protracted withdrawal worse and for a longer duration. If there are questions about dosage and timeline for withdrawal I would recommend looking into the Ashton's manual for benzo tapering. You can google it as its available online.

As for not being informed that they shouldn't be taken daily long term, I feel you. I had a 10 year run with Xanax and was not told by my doctors throughout the years how addictive and dangerous they are for long term use. Feel free to pm me if you have questions or find you are having difficulties during your withdrawal. Good luck!
 
4 mg for 7 days, 2 mg for 7 days, 1 mg etc, 0.5mg, etc, with the option of taking each level longer if I am having WD effects by the time that dose ends.

I started it shortly after posting, having a fuck it moment. By the end of the second day I had more anxiety than I was expecting. Not intolerable, just something I noticed. It could have been a coincidence, but it felt unusual.
 
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