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Benzos Alprazolam - considering the future

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Greenlighter
Joined
May 8, 2014
Messages
19
Greetings bluelighters. This post is long but I wanted to be thorough but you can skip to the bolded and underlined piece at the bottom if you don't want to read my whole history related to the matter at hand.


Background: I am someone who experiences moderate depression and severe anxiety and been getting treatment for the first time in my life for a little less than a year now. I "self-medicated" through my teenage years and early twenties variously with cigarettes, alcohol, opiates, stimulants, marijuana, synthetics, and am most recently quitting a DXM habit that was very heavy last November and December, and a few "relapses" this spring but I am determined to leave DXM behind me for the sake of my health.


I've been through the antidepressants bupropion and desvenlafaxine last year, I've also tried buspirone for anxiety which was useless for me and quetiapine for my insomnia which was useful but my insurance refused to cover. Presently I take sertraline (100 mg), trazodone (150 mg) and alprazolam (4 mg) every day for sleep. My depression is about 50% under control, my insomnia about 70%, my anxiety about 80% - which I am incredible grateful for but have my alprazolam to thank.


I take folic acid every morning with my antidepressant (because I can't afford Deplin, the new active metabolite of folic acid I think would work quite well for me but I get by with the normal vitamin) and Valerian root sporadically, sometimes at sleep and sometimes in lower doses at daytime. My trazodone is for sleep but sometimes I take 50mg or 100mg during daytime to get an extra anxiolytic boost. I'm not currently using any substances beyond drinking and smoking cigarettes both socially and on a less than once a week basis. I've binged on alprazolam recreationally only twice, once with alcohol, without any problems but I don't intend to do that anymore because my prescription hugely improves my life and I don't want to risk making it useless for a short high.


Questions: So I've been on 4mg alprazolam daily since February. I didn't build up to it save for three days on lorazepam (which my GP gave me, not my psychiatrist) at 4mg which was what it took to pacify my panic attack (why I went to my GP, because I needed immediate help) and the same dose (spread out the day) to calm my dysphoric feelings in the days after. My psychiatrist put me on 4mg a day and from the first time I swallowed a bar I immediately felt clear headed and normal.


I've built some tolerance. I've spent maybe 10 or so random days since February taking only 2mg in a day out of not feeling the need to take my second dose and five days off completely on days that weren't consequential (where I could lay around on my bed watching Netflix all day and interact with no one). One day was in February, one in March. Three weeks ago I took three consecutive days off after the last "binge." Given that I had extras in the first place and can refill one day early, I only really would have had to spend two days taking 2mg instead of four. But I took the full break because I was afraid of myself with how I had total amnesia and ended up going through 14mg in the course of 24 hours (which I incorrectly "remembered" to only be 10). I was concerned I'd just massively upped my tolerance.


So I committed to the three day break. I took preventative measures of smoking about five cigarettes every day and taking 300mg of Trazodone each day, half right when waking up and half at night. Beyond slightly less sleep, nightmares (probably from too much Trazodone), and somewhat dysphoric feelings, I experienced no real withdrawal.


Oh, and not sure if this is consequential but I take about half my alprazolam orally and half sublingually, most of the time sublingually when there is food in my stomach and I don't want to wait to digest to take my dose. I'm relieved to see that being off alprazolam for 72 hours didn't put me in the living hell I read about others going through but still want to tread carefully.


My psychiatrist says I don't have to taper when I'm ready and she would keep renewing my refills as long as I still want it, and I do.
9 days from now I'm travelling (I refill in two days and I'll be back before I'll need the next) and I was considering seeing if I could spend my holiday taking 2mg or 1mg every day save for the actual days flying where I'll take my full dose for the sake of sleep.


I want my holiday to be as pleasant as possible and if turns out I am bothered by the draw down I will go back to my normal daily dose. But I am going to be with my girlfriend in Germany (where she lives) and I love the country and I already met all her friends the first time I went there to see her at end of 2012 and whenever we're together in person I feel very at ease and not depressed or anxious, so I think it's an ideal time to try.

What would be better though, for the sake of bringing tolerance down? Random days off alprazolam completely, or a full 12 days taking less than 4mg? I also would like to mention that I'm not going to be smoking cigarettes and I plan to use my Trazodone only for sleep, so I am not sure I will cope as well with the alprazolam reduction as I did during my three day break - but I won't be completely off it either. And I haven't had a day off my full dose since my break. Should I even try this at all? If so, what's the best way to go about it? If my tolerance builds and builds anyway over the next months, would switching to 4mg of Klonopin be an "upgrade"? And is it viable to be a "benzo lifer" since I do have a legitimate, severe case of generalized anxiety and non-agorophobic panic disorder?
 
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