jazee
Newbie
Reged: 09/16/04
Posts: 47
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I'm curious what people here think are the typical dosing patterns required to experience signficant withdrawl symptoms if suddenly you stopped taking (cold turkey).
It seems there would be four contributing factors:
1. Length of use
2. Amount of each dosage
3. Frequency of dosage
4. Consistency of dosage frequency
2 and 3 could be combined to call it total daily dose I guess.
It is obvious that withdrawl symptoms will occur if both #1 and/or #2 are fairly high - you've been taking it for a long time, or you've been taking high dosages for a short time. If both, watch out!
I'm trying to gain insight into what has the most effect on creating potential withdrawl systems. So let me form it as a poll. I'll describe some different situations and let everyone rank the potential withdrawl symptoms (none, mild, moderate, severe) if one were to stop cold turkey or at least dramatically reduce their dosage to like 25% normal.
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Listvoer
Board Addict
Reged: 01/14/04
Posts: 384
Loc: New America
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"High dose (2mg Xanax, 4mg Ativan, 1mg Klonopin/Rivotril)"
That's considered "high dose'? If that's the case then I know far too many docs prescribing mega-doses. I've been prescribed 2mg xanax 3 times daily in years gone by, and generally I take either 4mg clonazepam (klonipin/rivotril), 2-4mg alprazolam, or 40-60 mg diazepam daily, with permission from the doc, for many years. I would certainly never recommend anyone take that much and quit too quickly or cold turkey, but if a proper taper schedule is followed ht can be pretty painless to come off such doses. I've known some people to be prescribed up to 10mg xanax daily because their tolerance had slowly, under doc supervision, grown to that level. Is there such a thing as a benzo-holiday That'd probably be like a week on looney island.
L
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Due to PM spam I rarely check mine so if you send me one, make sure to let me know...
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swtangel
Member
Reged: 07/09/04
Posts: 137
Loc: Delaware
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If you are on any dose other than maybe a baby dose (the smallest amount you can take) and for a very short time. You would not be able to go on a benzo holiday at least not without your doctors guidence. If you quit benzos cold turkey you will go into w/d the next day, and run into risk of having a siezure. There are medications that you can take that will counter act the effects of the benzos and the w/d.
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InvaderCAL
Member
Reged: 08/25/04
Posts: 197
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It stands to reason that the withdrawl effects would coincide directly with the amount of the drug you had floating around in your system at the time you stop. Since that amount is what the body is used to.
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jazee
Newbie
Reged: 09/16/04
Posts: 47
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I think you a valid point about what is really called a "high" dose. The problem is I'm a newbie still trying to find the drug a dose regimen that works best for me. So I'm going by a lot of the literature out there as far as starting and maximum doses. The "high" doses I specified are roughly near the max recommended dosages either single dose or multiple per day.
So does this mean what the other poster called 'baby' doses would be about equivalent to what I'm calling 'low' doses in my poll.
I just don't see how someone could have significant withdrawl if say they took 'high' doses once a day every other day for 3 days. These drugs don't accumulate in your body like the fat soluble Valium does. So it seems the withdrawl would have to be based on the last highest amount of the drug in your system.
There has to be something else operating here, like your brain's reaction to the drug takes longer to quit than the drugs presence in your blood.
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Listvoer
Board Addict
Reged: 01/14/04
Posts: 384
Loc: New America
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Quote:
If you are on any dose other than maybe a baby dose (the smallest amount you can take) and for a very short time. You would not be able to go on a benzo holiday at least not without your doctors guidence. If you quit benzos cold turkey you will go into w/d the next day, and run into risk of having a siezure. There are medications that you can take that will counter act the effects of the benzos and the w/d.
 I certainly wasn't advocating a benzo-holiday.... I guess I should have made that more clear. I was actually just whining a little that it'd be wonderful if we COULD take a benzo holiday occasionally w/o risking life & limb (and sanity!). Right now my tolerance is crazy... crazy enough anyway that I don't feel "good" when I take benzos in any safe amount except that I now call feeling normal as "good", but I sure do feel bad pretty quickly if I skip more than 1 dose. Other than on a few non-planned occasions, i've not been off benzos for more than about a month-straight in over a decade. I've been on at least 10 different benzos over the years so i've seen good and bad from all of them on so many different angles, but when the rubber hits the road so to speak, and you take that final dose after tapering, it still stinks. At least, it always has for me...
L
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Due to PM spam I rarely check mine so if you send me one, make sure to let me know...
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jazee
Newbie
Reged: 09/16/04
Posts: 47
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Well that makes sense. I'm experimenting with Ativan dosages preparing for infrequent use for business air travel. I purchased some from an International Online Pharmacy to try out. Little pink pills in foil packet, 1mg lorazepam.
I too 2mg a was expecting to feel all relaxed and 'jello like'. I felt a very mild relaxing effect. Not an effect I would expect would really offset severe flying anxiety. I don't have panic attacks and run back up the walkway when trying to board, but I do start to sweat a little.
So I'm reading the dosage recommendations and 2mg 3 times a day is like suppose to be the max recommened dosay or 10mg total per day (which is actually 3.3mg 3 times a day - gee that makes sense).
I'm a 185 lb male. Was I just expecting too much from 2mg dose of lorazepam because I'm not sure this will get me through the flight without still having significant anxiety.
I read somewhere else that the dosage prior to an operation is 50mcg/kg which works out to 4mg which by the way was also the max recommended dose for pre-op.
I think I'm answering my own question here and obviously I just need to find what works right for me but I want to make sure people aren't saying, 2mg of Ativan should be PLENTY, you must have bogus tablets.
Also, one day I took 2mg. The next day I took 2 2mg doses about 3 hours apart. Again, only a very mild relaxed feeling. I did not experience any kind of withdrawl except for a very very mild tension headache which I get quite often. I didn't take any for the next two days and feel quite fine. So it goes back to my question of why it takes so long to taper off when you've been taking these drugs for a long time, when you can take significant doses over very short periods (2-3 days) and really not feel much withdrawal at all? The average half life is like 10 hours so you could say like 90% of the drug is out of your system in 4 days or so.
AHH, I see now, if you are taking it 3 times a day for more than 4 days straight, you could have quite an accumulation. So the withdrawls would be from having so much accumulated, but then why doesn't the taper process only take 4 days rather than weeks? My guess is that there is a significant psycholigical component to the withdrawl in addition to the physilogical withdrawl from the drug leaving your system. This makes sense and exlpains why one could take a couple good size doses two days in a row, then take none and not really feel any withdrawl.
Can anyone confirm on if my perceived effect of this drug is about on par with what others have experienced and if my hypothesis regarding being able to safely take significant amounts for short periods (1-3 days) and then not take it at all, without experiencing serious withdrawl? (There will be times I will need to do 4 flights in a day for maybe 1 or 2 days in a week and then not take it at all for a week. I really don't want to be taking this stuff in low doses constantly to avoid withdrawls - it's sounds like I don't need to do that.)
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jazee
Newbie
Reged: 09/16/04
Posts: 47
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I went back and re-read the dosage recommendations at rxlist.com:
The usual range is 2 to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the daily dosage may vary from 1 to 10 mg/day.
For anxiety, most patients require an initial dose of 2 to 3 mg/day given b.i.d. or t.i.d.
For insomnia due to anxiety or transient situational stress, a single daily dose of 2 to 4 mg may be given, usually at bedtime.
---
So in other words, I was right, I need 3mg. The question is, will 3mg twice a day for 1 or 2 days require a followup low dosage of 1mg once or twice a day inbetween days that I travel in order to avoid withdrawl symptoms. I don't think so, but I guess I'll find out.
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Listvoer
Board Addict
Reged: 01/14/04
Posts: 384
Loc: New America
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Sounds like you have many questions, so i don't think i'd start taking this family of meds before having more knowledge of what you may be in for. For starters, here's a few links that should answer a lot of your questions.
http://www.benzo.org.uk/index.htm -- there is a LOT of info on this site. If you click on 'Prof Ashton' in the left menu column you will be taken to a page containing a whole lot of scientific data & studies.
http://www.geocities.com/benzobusters/
http://www.benzoliberty.com/
There are 2 more good benzo-info pages. Most of the pages are anti-benzo, be forewarned, but there is a plethora of good reading info on there. If I knew then what I know now, I never would have started down the yellow-v road....
L
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Due to PM spam I rarely check mine so if you send me one, make sure to let me know...
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jazee
Newbie
Reged: 09/16/04
Posts: 47
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Thanks for the links. I'm already pretty well read on the subject. I might note on the first site you listed, it pretty much answered my question about withdrawl probability:
How Quickly Can I Become to Benzodiazepine?
"in as little as 14 days of regular use at therapeutic dose levels. Your probability of forming some degree of dependency is significant, probably at least 50%, by the time you have been using them daily for 6 months."
I'm obviously not at risk taking therapeutic doses maybe 1-4 days a week, and usually only once a day when the recommended dosage is 3 times a day.
I'm still dissapointed with the effects of the Ativan. I just flew and tried a 3.5mg dose (equiv to 1.75mg Xanax) and I felt a mild relaxed feeling which was barely enough to cope with my anxiety. The onset was slow (about an hour) and I really never had a super relaxed, care-free feeling like I would expect from that high a does. I'm using a generic brand from an IOP. Could I have a diluted batch of pills or am I just expecting too much of a pronounced effect from these Benzos?
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zippy66
Enthusiast
Reged: 09/17/04
Posts: 213
Loc: The Spine
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Man,
Don't depend on ativan for Panic attacks, just general anxiety. For panic attacks you need xanax or valium (and live with the grogginess after). Apparently there are some sublingual versions of benzos that help too, but I'm not so familiar with those. Or you could pack a hypodermic of .... just kidding. Xanax next time and val backup!
Zip
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blissmiss
Member
Reged: 08/10/04
Posts: 124
Loc: Connecticut, via Illinois, Mis...
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At the Institute I used to work for, we only gave Ativan to help aggressive, and/or really, really outta control folks that, to help calm them down.
For panic, nerves, or just plain anxiety attacks, it was always Valium, or Xanax
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Do you not see how necessary a world of pains and troubles is to school an intelligence and make it a soul?
John Keats 1795-1821, British Poet
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rockystuart
Enthusiast
Reged: 03/11/04
Posts: 206
Loc: San Fran Bay Area, Calif
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Ativan is recomended by the AMA and PDR for "generalized anxiety disorder". xanaxis ONLY recommened by AMA and PDR for PANIC attacks is .
They will try buspar and zoloft for anxiety attacks; and it works in cases where there is not an organic cause - but sweet tea or bourbon would have cured those cases also.
Organic sourced PANIC disorders are rare and are usually acompanied by depersonalization and/or de-realization - I know - I set myself on fire once during one. But boy the world became very real very quik - they say I should take the pills instead.
I woner why so many people have PANIC on this board - XANAX is a hot topic and it's a 1 in 5,000 shot to have it(i.e. organic sourced panic)
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rockystuart
Enthusiast
Reged: 03/11/04
Posts: 206
Loc: San Fran Bay Area, Calif
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Wait a minute I didn't relly set myself on fire or cut myself during panic attacks - that was my other brother darrell.
and one advantage of schitzoaffective disorder is that we all know each others names!
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jazee
Newbie
Reged: 09/16/04
Posts: 47
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So what are the typical dosages most people on this board are taking of Xanax, Ativan, or Klonopin. I've run across enough messages it seems it isn't uncommon for someone to be taking 2mg of Xanax 3 times a day or 1mg of Klonopin twice a day? Are these about average, below average, above average?
I can see major withdrawl problems with Xanax at those levels or above.
It sounds to me like the Xanax is going to work better for the occasional plane flight than Ativan, but I've heard kudos for both in that application. I've only tried Ativan though and even at 3mg the effect is very mild. I guess I'll see how Xanax compares.
How does the feeling of using Klonopin compare to Ativan and Xanax?
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Listvoer
Board Addict
Reged: 01/14/04
Posts: 384
Loc: New America
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As of late, I normally take 2mg of xanax with breakfast and possibly 10mg of valium (the valium really helps with muscle spasms, an it seems to make the xanax stick around longer). By lunchtime the xanax has usually worn off so I take another 2mg, and sometime between dinner and bedtime i'll take another 2mg. At bedtime I take another 20mg of valium and all is well. I know it's crazy dosing but i've been prescribed benzos for 15ish years and this is what works for me. I don't keep this schedule all the time though, as I tend to swap between klonipin and xanax depending on which is cheaper, as they both have about the same effect on me. I fully realize that if/when I decide to taper from these it'll take a year, but right now I have no plans for that as it is working quite well for my mixed bag of medical problems. At this point, after 15 years, it is quite rare for any benzo to be 'felt' by me, other than they keep me at a nice even keel. The idea of me abusing them for any euphoric effect became laughable over a decade ago so that's certainly not why I take them. You know you have a tolerance when 10 mg of xanax doesn't even produce a yawn, or 100mg of valium is mildly relaxing.
Take it from one who is 'there' and has been there and back many times - try to keep your doses as low as possible or you WILL regret it sooner or later.
L
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Due to PM spam I rarely check mine so if you send me one, make sure to let me know...
Edited by Listvoer (09/27/04 05:39 PM)
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blissmiss
Member
Reged: 08/10/04
Posts: 124
Loc: Connecticut, via Illinois, Mis...
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Quote:
Wait a minute I didn't relly set myself on fire or cut myself during panic attacks - that was my other brother darrell.
and one advantage of schitzoaffective disorder is that we all know each others names!
I think you are a being a little unkind to those who suffer from this disorder. If you would like more information, or to learn a little about what this disease is actually like, I hope you will read the following. (The spelling you used was mildy offensive, for those who suffer from it.)
http://www.schizoaffective.org/
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Do you not see how necessary a world of pains and troubles is to school an intelligence and make it a soul?
John Keats 1795-1821, British Poet
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