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Tapering After 8 Weeks


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#61 fishinghat

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Posted 23 October 2023 - 02:16 PM

"10 days ago Doc changed my DULOXETINE 20mg to 30mg.  Is 10 days still early days (too soon) to see the FULL benefit of 10mg increase dose change?"

 

No, it should take only 3 - 5 days to see the effect.

 

A drop from 7mg to 3mg 9 days ago.on Diazepam may cause anxiety that can last 1 to 1/2 years. That kind of drop usually takes a year or more, in my opinion.

 

"You know with the Diazepam withdraws it's probably making it that wee bit harder to appreciate any benefit right now from the Duloxetine"

 

Very true.

 

"It's beginning to dawn on me that I should stop this cursed Dizzypam for good......they are undoubtable great for that short period when you need the extra help but it's not so easy to always find the discipline to get off them"

 

I once did a study on the FDA approval for many of the various benzos including Diazepam.  Without exception they always took the position that they should not be used more than 4 weeks due to several factors...addictiveness, severe withdrawal and a possible link to dementia with long term use. Most of the manufacturers also take that position. See post below for additional information. 


#62 looneytune

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Posted 23 October 2023 - 02:24 PM

Ta Bro :)


#63 fishinghat

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Posted 23 October 2023 - 02:29 PM

Benzo Notes (Page 1)
Usage data
 
In 2008, approximately 5.2% of US adults aged 18 to 80 years used benzodiazepines. The percentage who used benzodiazepines increased with age from 2.6% (18-35 years) to 5.4% (36-50 years) to 7.4% (51-64 years) to 8.7% (65-80 years). Benzodiazepine use was nearly twice as prevalent in women as men. The proportion of benzodiazepine use that was long term (> 120 days) increased with age from 14.7% (18-35 years) to 31.4% (65-80 years), while the proportion that received a benzodiazepine prescription from a psychiatrist decreased with age from 15.0% (18-35 years) to 5.7% (65-80 years). In all age groups, roughly one-quarter of individuals receiving benzodiazepine involved long-acting benzodiazepine use.
 
Estimates of the number of benzodiazepine-dependent persons in Germany range from 128 000 to 1.6 million.
 
Use benzodiazepines for only 4 weeks or less to minimize risk of addiction.
 
Dependency problems with benzodiazepines have been a familiar phenomenon for
about 40 years for this reason, pharmaceutical companies and the German Federal Institute for Drugs and Medical Devices (BfArM) have restricted the standard period of use to 2–4 weeks since the 1980s. According to the current law on prescriptions of medical drugs, hypnotics and tranquillizers can be prescribed for period can be extended if sound reasons exist.
 
Within weeks of chronic use, tolerance to the pharmacological effects can develop and withdrawal becomes apparent once the drug is no longer available, which are both conditions indicative of benzodiazepine dependence.
Withdrawal symptoms are observed following discontinuation or abrupt reduction of BDZs dosage, even after a relatively short treatment period (three to four weeks). Such physiological symptoms are the main signs of physical dependence. The most frequent are insomnia, gastric problems, tremors, agitation, fearfulness and muscle spasms. Less frequently observed are irritability, sweating, depersonalisation, hypersensitivity to stimuli, depression, suicidal behaviour, psychosis, seizures and delirium tremens. Over-rapid withdrawal from BDZs also increases the severity of the symptoms. Slow and gradual reduction of dosage customised to the individual accompanied by psychological support are the most effective way of managing withdrawal. Complete withdrawal can require four weeks to several years.
 
National Health Committee. Guidelines for assessing and treating anxiety disorders. Wellington (New Zealand): National Health Committee; 1998.
Recommend restricting their use to no more than 3–4 weeks
 
Recommend restricting their use to no more than 3–4 weeks
 
Review of research listing proper use of benzos.
In general, compounds with higher potency and a shorter half-life are associated with a greater likelihood of developing withdrawal syndromes and dependence.
A significant risk of dependence is recognized in some patients receiving treatment for longer than one month, and health professionals should be aware of this when considering the relative treatment benefits and risks.

#64 fishinghat

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Posted 23 October 2023 - 02:32 PM

Page 2

 

Benzodiazepine dependence could be prevented by adherence to recommendations for short-term prescribing (2-4 weeks only when possible).
 
Clinical Guideline 22 (amended). Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care" (PDF). National Institute for Health and Clinical Excellence. 2007. pp. 23–25. Retrieved 2009-08-08.
According to National Institute for Health and Clinical Excellence (NICE), benzodiazepines can be used in the immediate management of GAD, if necessary. However, they should not usually be given for longer than 2–4 weeks. The only medications NICE recommends for the longer term management of GAD are antidepressants.
 
McIntosh A, Cohen A, Turnbull N, et al. (2004). "Clinical guidelines and evidence review for panic disorder and generalised anxiety disorder" (PDF). National Collaborating Centre for Primary Care. Retrieved 2009-06-16.
Barbui C, Cipriani A (2009). "Proposal for the inclusion in the WHO Model List of Essential Medicines of a selective serotonin-reuptake inhibitor for Generalised Anxiety Disorder" (PDF). WHO Collaborating Centre for Research and Training in Mental Health. Retrieved 2009-06-23.
Based on the findings of placebo-controlled studies, they do not recommend use of benzodiazepines beyond two to four weeks, as tolerance and physical dependence develop rapidly, with withdrawal symptoms including rebound anxiety occurring after six weeks or more of use.
 
Benzodiazepines are generally highly effective when first given, but they should generally be given only for strict indications and for a limited time. If these drugs still need to be given beyond the short term, timely referral to a specialist is indicated, and possibly also contact with the addiction aid system.
 
Royal College of Psychiatrists
How long should I take a benzodiazepine for?
Up to 4 weeks - no longer. This should really be just to give other (often psychological) treatments a chance to work.
 
Limited effectiveness/Long-term use and Addiction
The Canadian Psychiatric Association (CPA) recommends benzodiazepines alprazolam, bromazepam, lorazepam, and diazepam only as a second-line choice, if the treatment with two different antidepressants was unsuccessful. Although they are second-line agents, benzodiazepines can be used for a limited time to relieve severe anxiety and agitation. CPA guidelines note that after 4–6 weeks the effect of benzodiazepines may decrease to the level of placebo, and that benzodiazepines are less effective than antidepressants in alleviating ruminative worry, the core symptom of GAD. However, in some cases, a prolonged treatment with benzodiazepines as the add-on to an antidepressant may be justified.
 
Tolerance to anti-anxiety effects develops more slowly with little evidence of continued effectiveness beyond four to six months of continued use.

#65 fishinghat

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Posted 23 October 2023 - 02:34 PM

Page 3

 

Curran, H. V.; Collins, R.; Fletcher, S.; Kee, S. C. Y.; Woods, B.; Iliffe, S. (2003-10-01). "Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life". Psychological Medicine 33 (7): 1223–1237. doi:10.1017/s0033291703008213. ISSN 0033-2917. PMID 14580077.
"Holbrook AM. %282004%29. Treating insomnia. - PubMed - NCBI". www.ncbi.nlm.nih.gov. PMID 25282004. Retrieved 2015-12-10.
Poyares, Dalva; Guilleminault, Christian; Ohayon, Maurice M.; Tufik, Sergio (2004-06-01). "Chronic benzodiazepine usage and withdrawal in insomnia patients". Journal of Psychiatric Research 38 (3): 327–334. doi:10.1016/j.jpsychires.2003.10.003. ISSN 0022-3956. PMID 15003439.
Friedman MJ (1998). "Pharmacotherapy for posttraumatic stress disorder: a status report". Clinical Neurosciences Supplement 52: S115–S121.
Heather N, Bowie A, Ashton H, McAvoy B, Spencer I, Brodie J, Giddings D (2004). "Randomised controlled trial of two brief interventions against long-term benzodiazepine use: outcome of intervention". Addiction Research and Theory 12 (2): 141–154. doi:10.1080/1606635310001634528.
Bandelow, Borwin; Zohar, Joseph; Hollander, Eric; Kasper, Siegfried; Möller, Hans-Jürgen; Zohar, Joseph; Hollander, Eric; Kasper, Siegfried (2008-01-01). "World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders HYPERLINK "http://www.ncbi.nlm....49648"HYPERLINKhttp://www.ncbi.nlm....ubmed/18949648" The World Journal of Biological Psychiatry 9 (4): 248–312. doi:10.1080/15622970802465807. ISSN 1562-2975. PMID 18949648.
Ashton, Heather (2005-05-01). "The diagnosis and management of benzodiazepine dependence". Current Opinion in Psychiatry 18 (3): 249–255. doi:10.1097/01.yco.0000165594.60434.84. ISSN 0951-7367. PMID 16639148.
Morin, Charles M.; Bélanger, Lynda; Bastien, Célyne; Vallières, Annie (2005-01-01). "Long-term outcome after discontinuation of benzodiazepines for insomnia: a survival analysis of relapse". Behaviour Research and Therapy 43 (1): 1–14. doi:10.1016/j.brat.2003.12.002. ISSN 0005-7967. PMID 15531349.
Michelini S, Cassano GB, Frare F, et al. (2016). "Long-term use of benzodiazepines: tolerance, dependence and clinical problems in anxiety and mood disorders.". Pharmacopsychiatry 29: 127–134
Several studies (listed above) have confirmed that long-term benzodiazepines are not significantly different from placebo for sleep or anxiety. This may explain why patients commonly increase doses over time and many eventually take more than one type of benzodiazepine after the first loses effectiveness.
 
Discontinuation of benzodiazepines or abrupt reduction of the dose, even after a relatively short course of treatment (three to four weeks), may result in two groups of symptoms—rebound and withdrawal. Rebound symptoms are the return of the symptoms for which the patient was treated but worse than before. Withdrawal symptoms are the new symptoms that occur when the benzodiazepine is stopped. They are the main sign of physical dependence.
 
While benzodizapines may have short-term benefits for anxiety, sleep and agitation in some patients, long-term (i.e., greater than 2–4 weeks) use can result in a worsening of the very symptoms the medications are meant to treat.
 
The relative proportion of long-term BZD users in adult BZD users ranged from 6% to 76% (mean 24%) The estimates were higher in studies only on the elderly (47%). Long-term use involved typically steady treatment with low BZD doses. However, in elderly patients long-term BZD use and exceeding recommended doses was relatively common. Several characteristics associated with long-term use were found.
 
Patients who were able to remain free of benzodiazepines for at least 5 weeks obtained lower levels of anxiety than before benzodiazepine discontinuation.

#66 fishinghat

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Posted 23 October 2023 - 02:36 PM

Page 4
 
Effects of long-term use.
Alzheimer's Disease
During the 4-year follow-up, we found that 45% of individuals with Alzheimer's Disease (AD) and 38% of individuals without AD used BZDRs. The prevalence of long-term (≥ 180 days) BZDR use was more common among individuals with AD (30%) than individuals without AD (26%). The high prevalence of long-term BZDR use among individuals with AD is especially a cause for concern because long-term use may further impair cognition and may be associated with serious adverse events.
 
No association for Alzheimer's disease was found for a cumulative dose <91 prescribed daily doses. The strength of association increased with exposure density 1.32 for 91-180 prescribed daily doses and 1.84 for >180 prescribed daily doses). Benzodiazepine use is associated with an increased risk of Alzheimer's disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.
 
Taking benzodiazepine is associated with an increased risk of Alzheimer disease
 
Cancer Risk
Clonazepam was associated with a higher risk for cancers. Moreover, specific cancer risk among BZDs use was observed significantly increased 98% for brain, 25% for colorectal, and 10% for lung, as compared with non-BZDs use. Diazepam, chlordiazepoxide, medazepam, nitrazepam, and oxazepam are safe among BZDs use for cancer risk.
 
In this population-based study, we found a significant increase in the risk of benign brain tumor development in a cohort of long-term (>2 months) BZD users.
 
BZRD use was not associated with an overall increase in cancer risk.
 
Dementia
Out of the ten studies retrieved, nine reported an increased risk of dementia in benzodiazepine users. The risk increased with cumulative dose and treatment duration and when long-acting molecules were used. Even if the causal nature of this association remains unproved, the reviewed material provides arguments for evoking a causal link. Further research would be necessary to elucidate the mechanism of this effect, if any, to evaluate the risk of exposure in younger population and the influence of risk factors such as depression. In any case, the body of evidence seems sufficient for avoiding prescriptions or renewals that are not fully justified and indiscriminate long-term use.
 
The risk of dementia increased by 22% for every additional 20 defined daily dose per year. Long-term benzodiazepine users have an increased risk of dementia compared with never users.
 
The risk of dementia is slightly higher in people with minimal exposure to benzodiazepines but not with the highest level of exposure. These results do not support a causal association between benzodiazepine use and dementia.
 
In this prospective population based study, new use of benzodiazepines was associated with increased risk of dementia. The result was robust in pooled analyses across cohorts of new users of benzodiazepines throughout the study and in a complementary case-control study.

#67 fishinghat

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Posted 23 October 2023 - 02:38 PM

Page 5

 

Memory/Cognative Function
In the course of the 10 year-follow-up, 3.9% of subjects were defined as occasional users of benzodiazepine and 7.5% as long-term users. The analysis revealed a significant alteration of long-term memory in women whereas there was no significant association in men.
 
Chronic use of benzodiazepine was significantly associated with a lower latent cognitive level, but no association was found between chronic use and an acceleration of cognitive decline, neither on the latent cognitive process, nor on specific neuropsychological tests. Our results suggest that chronic benzodiazepine use is associated with poorer cognitive performance but not with accelerated cognitive decline with age.
 
This study confirmed earlier observations of neuropsychological deficits in long-term benzodiazepine-using patients and demonstrated that these changes (decrease in general intelligence and of nonverbal memory) are at least partly reversible (within a year) by discontinuing drug intake.
 
Sleep
Our findings do not support long-term effectiveness of BZDs; long-term users slept more poorly than nonusers and were even more outspoken in users of long-acting BZDs.
 
Tasman A; Kay J; Lieberman JA, eds. (2008). Psychiatry (3rd ed.). Chichester, England: John Wiley & Sons. pp. 1186–1200, 2603–2615. ISBN 978-0470065716.
Disrupting REM sleep by inhibiting deep stage sleep
 
Long-term benzodiazepine users were more likely to report poor sleep quality.
 
Melatonin ineffective in helping sleep during benzo withdrawal.
 
Benzodiazepines may be efficient in reducing symptoms in the short term, but evidence from this long temporal follow-up study indicates limited positive influences in the long term.
 
Sleep quality in chronic BZD/Z users significantly decreased over 1 year and was significantly worse than in nonusers at the end of this period. This study suggests that using BZD/Zs chronically does not maintain or improve sleep quality.
 
Benzos decrease REM sleep.
 
Elderly
Jackson SG, Jansen P, Mangoni A (22 May 2009). Prescribing for Elderly Patients
The long-term effects of benzodiazepines and benzodiazepine dependence in the elderly can resemble dementia, depression, or anxiety syndromes, and progressively worsens over time. Adverse effects on cognition can be mistaken for the effects of old age. The benefits of withdrawal include improved cognition, alertness, mobility, reduced risk incontinence, and a reduced risk of falls and fractures. The success of gradual-tapering benzodiazepines is as great in the elderly as in younger people. Benzodiazepines should be prescribed to the elderly only with caution and only for a short period at low doses.
 
McIntosh A, Semple D, Smyth R, Burns J, Darjee R (2005). "Depressants". Oxford Handbook of Psychiatry (1st ed.). Oxford University Press. p. 540. ISBN 0-19-852783-7.
American Geriatrics Society 2012 Beers Criteria Update Expert Panel (2012). "American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults" (PDF)
The elderly are at an increased risk of suffering from both short- and long-term adverse effects, and as a result, all benzodiazepines are listed in the Beers List of inappropriate medications for older adults.
 
The relative proportion of long-term BZD users in adult BZD users ranged from 6% to 76% (mean 24%) The estimates were higher in studies only on the elderly (47%). Long-term use involved typically steady treatment with low BZD doses. However, in elderly patients long-term BZD use and exceeding recommended doses was relatively common. Several characteristics associated with long-term use were found.
 
Patients achieved withdrawal or reduced their dose by at least 50% after 6 and 12 months.

#68 fishinghat

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Posted 23 October 2023 - 02:41 PM

Page 6

 

Seizures
 
Since the first report of benzodiazepine withdrawal seizure in 1961, many case reports have followed. Withdrawal seizures have occurred with short, medium, and long halflife benzodiazepine, if discontinued abruptly. Withdrawal seizures usually occur in patients who have been taking these medications for long periods of time and at high doses. Seizures have also been reported with less than 15 days of use and at therapeutic dosage. Almost all the withdrawal seizures reported were grand mal seizures. The severity of seizures range from a single episode to coma and death. Benzodiazepine dose tapering can be done faster in a hospital setting in high-dose abusers, but must be done more slowly in the outpatient setting in therapeutic dosage users.
Many many other articles also address this issue.
 
From the manufacturer drug inserts
 
Xanax (generic name is alprazolam) (Pfizer)
Warnings (Pfizer)
"Even after relatively shortterm use at the doses recommended for the treatment of transient anxiety and anxiety disorder (ie, 0.75 to 4.0 mg per day), there is some risk of dependence. Spontaneous reporting system data suggest that the risk of dependence and its severity appear to be greater in patients treated with doses greater than 4 mg/day and for long periods (more than 12 weeks). "
"Seizures attributable to XANAX were seen after drug discontinuance or dose reduction in 8 of 1980 patients with panic disorder or in patients participating in clinical trials where doses of XANAX greater than 4 mg/day for over 3 months were permitted. The duration of use in the above 8 cases ranged from 4 to 22 weeks. There have been occasional voluntary reports of patients developing seizures while apparently tapering gradually from XANAX. The risk of seizure seems to be greatest 24–72 hours after discontinuation."
Adverse Reactions
"It is suggested that the daily dosage of XANAX be decreased by no more than 0.5 mg every three days. Some patients may benefit from an even slower dosage reduction. In a controlled postmarketing discontinuation study of panic disorder patients which compared this recommended taper schedule with a slower taper schedule, no difference was observed between the groups in the proportion of patients who tapered to zero dose; however, the slower schedule was associated with a reduction in symptoms associated with a withdrawal syndrome."
Drug Abuse and Dependence
"When necessary, immediate management of withdrawal symptoms requires re-institution of treatment at doses of XANAX sufficient to suppress symptoms."
 
Also from Pfizer;
"Demonstrations of the effectiveness of XANAX by systematic clinical study are limited to 4 months duration for anxiety disorder and 4 to 10 weeks duration for panic disorder; however, patients with panic disorder have been treated on an open basis for up to 8 months without apparent loss of benefit. The physician should periodically reassess the usefulness of the drug for the individual patient."
"Withdrawal reactions may occur when dosage reduction occurs for any reason. This includes purposeful tapering, but also inadvertent reduction of dose (eg, the patient forgets, the patient is admitted to a hospital). Therefore, the dosage of XANAX should be reduced or discontinued gradually."
"There have been reports of failure of other benzodiazepines to fully suppress these withdrawal symptoms. These failures have been attributed to incomplete cross-tolerance but may also reflect the use of an inadequate dosing regimen of the substituted benzodiazepine or the effects of concomitant medications."
 
Valium (generic name is diazepam) (Genentech)
Drug Abuse and Dependence
"Diazepam is subject to Schedule IV control under the Controlled Substances Act of 1970. Abuse and dependence of benzodiazepines have been reported. Addiction-prone individuals (such as drug addicts or alcoholics) should be under careful surveillance when receiving diazepam or other psychotropic agents because of the predisposition of such patients to habituation and dependence. Once physical dependence to benzodiazepines has developed, termination of treatment will be accompanied by withdrawal symptoms. The risk is more pronounced in patients on long-term therapy."
"Since the risk of withdrawal phenomena and rebound phenomena is greater after abrupt discontinuation of treatment, it is recommended that the dosage be decreased gradually."
No additional information on the Genentech website.
 
Klonopin (generic name is clonazepam) (Genentech)
Drug Abuse and Dependence
"After extended therapy, abrupt discontinuation should generally be avoided and a gradual dosage tapering schedule followed."
"Following the short-term treatment of patients with panic disorder, patients were gradually withdrawn during a 7-week downward-titration (discontinuance) period."
Dosage and Administration
"There is no body of evidence available to answer the question of how long the patient treated with clonazepam should remain on it. Therefore, the physician who elects to use Klonopin for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient."
"Treatment should be discontinued gradually, with a decrease of 0.125 mg bid every 3 days, until the drug is completely withdrawn."
No additional information on the Genentech website.
 
Ativan (generic name is lorazepam) (Valeant Pharmaceuticals)
Indication and usage
"Ativan (lorazepam) is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms.The effectiveness of Ativan (lorazepam) in long-term use, that is, more than 4 months, has not been assessed by systematic clinical studies."
Warnings
"The dependence potential is reduced when lorazepam is used at the appropriate dose for short-term treatment."
"In general, benzodiazepines should be prescribed for short periods only (e.g., 2 to 4 weeks). Extension of the treatment period should not take place without reevaluation of the need for continued therapy. Continuous long-term use of product is not recommended. Withdrawal symptoms (e.g., rebound insomnia) can appear following cessation of recommended doses after as little as one week of therapy. Abrupt discontinuation of product should be avoided and a gradual dosage-tapering schedule followed after extended therapy."
No additional information on the Valeant Pharmaceuticals website.

#69 fishinghat

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Posted 23 October 2023 - 02:43 PM

Page 7

 

Effects of Discontinuation/Withdrawal
 
Guina, Jeffrey; Rossetter, Sarah R.; DeRHODES, Bethany J.; Nahhas, Ramzi W.; Welton, Randon S. (2015-07-01). "Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis". Journal of Psychiatric Practice 21 (4): 281–303. doi:10.1097/PRA.0000000000000091. ISSN 1538-1145. PMID 26164054.
Michelini S, Cassano GB, Frare F, et al. (2016). "Long-term use of benzodiazepines: tolerance, dependence and clinical problems in anxiety and mood disorders.". Pharmacopsychiatry 29: 127–134
Gelpin, E.; Bonne, O.; Peri, T.; Brandes, D.; Shalev, A. Y. (1996-09-01). "Treatment of recent trauma survivors with benzodiazepines: a prospective study". The Journal of Clinical Psychiatry 57 (9): 390–394. ISSN 0160-6689. PMID 9746445.
Rosen, Craig S.; Greenbaum, Mark A.; Schnurr, Paula P.; Holmes, Tyson H.; Brennan, Penny L.; Friedman, Matthew J. (2013-12-01). "Do benzodiazepines reduce the effectiveness of exposure therapy for posttraumatic stress disorder?". The Journal of Clinical Psychiatry 74 (12): 1241–1248. doi:10.4088/JCP.13m08592. ISSN 1555-2101. PMID 24434093.
Wilhelm, F. H.; Roth, W. T. (1997-09-01). "Acute and delayed effects of alprazolam on flight phobics during exposure". Behaviour Research and Therapy 35 (9): 831–841. doi:10.1016/s0005-7967(97)00033-8. ISSN 0005-7967. PMID 9299803.
Matar, Michael A.; Zohar, Joseph; Kaplan, Zeev; Cohen, Hagit (2009-04-01). "Alprazolam treatment immediately after stress exposure interferes with the normal HPA-stress response and increases vulnerability to subsequent stress in an animal model of PTSD". European Neuropsychopharmacology 19 (4): 283–295. doi:10.1016/j.euroneuro.2008.12.004. ISSN 1873-7862. PMID 19167197.
Curran, H. V.; Collins, R.; Fletcher, S.; Kee, S. C. Y.; Woods, B.; Iliffe, S. (2003-10-01). "Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life". Psychological Medicine 33 (7): 1223–1237. doi:10.1017/s0033291703008213. ISSN 0033-2917. PMID 14580077.
Pary R, Lewis S (2008). "Prescribing benzodiazepines in clinical practice". Resident and Staff Physician 54 (1): 8–17.
Withdrawal symptoms or rebound symptoms in between doses mimicking or exacerbating underlying anxiety or sleep disorders, inhibiting the benefits of psychotherapy by inhibiting memory consolidation and reducing fear extinction, and reducing coping with trauma/stress and increasing vulnerability to future stress. Anxiety, insomnia and irritability may be temporarily exacerbated during withdrawal, but psychiatric symptoms after discontinuation are usually less than even while taking benzodiazepines. Fortunately, for those with benzodiazepine-induced problems, functioning significantly improves within 1 year of discontinuation.
 
Royal Pharmaceutical Society of Great Britain (2009). British National Formulary (BNF 57). BMJ Group and RPS Publishing. ISBN 978-0-85369-845-6.
Opinion as to the time needed to complete withdrawal ranges from four weeks to several years. A goal of less than six months has been suggested, but due to factors such as dosage and type of benzodiazepine, reasons for prescription, lifestyle, personality, environmental stresses, and amount of available support, a year or more may be needed to withdraw.
 
Based on collective findings in this benzodiazepine withdrawal-anxiety model, we propose a functional model illustrating the changes in glutamate receptor populations at excitatory synapses during benzodiazepine withdrawal.
(Physically alters GABA receptor shape and function during withdrawal.)
 
Protracted withdrawal syndromes from benzodiazepines.
Benzodiazepines can give rise not only to slowly reversible functional changes in the central nervous system, but may also occasionally cause structural neuronal damage.
 
This occurred independently of neuronal activity and intracellular calcium and involved GABA(A)R–gephyrin interactions, suggesting that the changes in GABA(A)R diffusion depend on conformational changes of the receptor.
 
Similar to above.
 
Chronic BZ treatment results in allosteric uncoupling of the GABA and BZ binding sites, suggesting changes in receptor subunit composition and/or receptor function (reviewed in ref. 7). Chronic dosing of animals with BZ leads to a reduction in GABAAR synaptic inhibition (8\l "–10) and produces diverse changes in GABAAR transcripts across the brain (7). Direct comparison and interpretation of these and other studies assessing mRNA levels has been challenging due to differences in treatment paradigm (time and dose), brain regions assessed, and the BZ ligand used. Radioligand binding studies have reported mixed results, ranging from decreases to no change in CNS BZ binding sites, likely due to methodological limitations in assessing subtype-specific GABAAR changes.
(Multiple references to changes in the receptors)
 
Impaired hypothalamic-pituitary-adrenocortical (HPA) system is related to severity of benzodiazepine withdrawal in patients.
 
BDNF plasma levels decrease during benzodiazepine withdrawal in patients suffering from comorbidity of depressive disorder and benzodiazepine dependence.

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Posted 23 October 2023 - 02:47 PM

Page 8

 

Patients achieved withdrawal or reduced their dose by at least 50% after 6 and 12 months. Abstinence and withdrawal symptoms were also measured.
 
Among the benzodiazepines, lorazepam seems to have a particularly high addiction potential.
 
 
Specificity and intensity of BDZ withdrawal symptoms were the same for those dependent upon high doses of BDZs and those dependent upon low doses, but a protracted withdrawal was only observed in low-dose BDZ-dependent patients.
 
Protracted benzodiazepine withdrawal syndrome mimicking psychotic depression.
 
 
Withdrawal Notes
 
See..
29% had to go over the ORIGINAL DOSE to stabilize or could not reach a dose high enough to stabilize.
 
Updosing during withdrawal
24% said it was unsuccessful.
 
Ashton, H. (1984). Benzodiazepine withdrawal: An unfinished story. British Medical Journal, 288, 1135-1140.
Ashton, H. (1987). Benzodiazepine withdrawal: Outcome in 50 patients. British Journal of Addiction, 82, 665-671.
These symptoms have often been temporarily alleviated by a moderate increase in dosage or the addition of another benzodiazepine, but eventually re-emerge during further chronic use and only disappear after the benzodiazepine is stopped.
 
If symptoms to bad stabilize dose or go up in dose for 1-2 weeks.
 
Small "extra dose" on any day they feel a special need for
extra help. This helps them to feel in control.
 
Never abruptly stop any benzodiazepine or Z drug. The shock caused by such an abrupt withdrawal is so severe that even after resumption of your drug at the previous dose, it may take weeks or months to "stabilise", and in some cases, you may never stabilise from a cold turkey withdrawal until after you have completed your reduction.
 
 
Withdrawal
 
Suicide
Two recent studies have examined the role of benzodiazepines on actual or attempted suicide. A study examining elderly suicides in Sweden found that between 1992 and 1996, benzodiazepine hypnotics dominated drug-poisoning suicides (216 of 548, 39%) in those aged over 65 years.4 During the same time frame, a population-based cohort study in Canada found a significant association between suicide attempts and benzodiazepine usage (odds ratio = 6.2). While disinhibition and paradoxical reactions inducing suicidal impulses were considered, the authors believed that confounding by the original indication was a more likely explanation.5 Neither study reported withdrawal symptoms as a factor, although both advised examining for depression and restrictive prescribing for groups at risk of suicide.

#71 fishinghat

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Posted 23 October 2023 - 02:50 PM

Page 9
 
Benzo Withdrawal Treatment
 
Benzodiazepine withdrawal treatment. GABA, Vitamin C and niacin.
 
Flumazenil
FLU (iv injection) immediately reversed BZD effects on balance task and significantly reduced withdrawal symptoms in comparison with oxazepam and placebo on both self-reported and observer-rated withdrawal scales. The partial agonist also reduced craving scores during the detoxification procedure. In addition, during oxazepam tapering, group B patients experienced paradoxical symptoms that were not apparent in FLU patients. Patients treated with FLU showed a significantly lower relapse rates on days 15, 23 and 30 after the detoxification week. Our data provide further evidence of FLUs ability to counteract BZD effects, control BZD withdrawal and normalize BZD receptor function.
 
Preliminary data suggest that continuous intravenous or subcutaneous flumazenil infusion for 4 days significantly reduces acute benzodiazepine withdrawal sequelae.
 
The most common AEs (adverse events) in the flumazenil group were agitation and gastrointestinal symptoms, whereas the most common SAEs (significant adverse events)were supraventricular arrhythmia and convulsions.
 
This paper reports the data related to 214 subjects addicted to high doses of benzodiazepine and treated with the FLU-SSI method between 2012 and 2014. This technique is less invasive and requires less nursing intervention than intravenous infusion. Our data support FLU-SSI as a possible efficient strategy for the treatment of patients with long-term, high-dose benzodiazepine addiction
 
This small proof-of-concept study indicates that subcutaneous flumazenil infusion has excellent tolerability, efficacy and improvement on measures of psychological distress.
 
Cyamemazine (antihistamine)
Therefore, the anxiolytic efficacy of cyamemazine in benzodiazepine withdrawal can be due to a 5-HT(2AR) antagonistic activity at the cortical level.
cyamemazine vs. bromazepam
28 patients (total 618) in the cyamemazine group and 18 in the bromazepam group had an adverse event, including anxiety, insomnia, dry mouth and somnolence. No extra-pyramidal symptoms were reported. In conclusion, cyamemazine was comparable to bromazepam in ensuring successful benzodiazepine withdrawal and in controlling the acute benzodiazepine withdrawal syndrome. Cyamemazine may be useful to facilitate benzodiazepine withdrawal in those patients where bromazepam substitution is not appropriate.
 
Pregabalin (Lyrica)
"Common side effects include: sleepiness, confusion, trouble with memory, poor coordination, dry mouth, problem with vision, and weight gain.[6] Potentially serious side effects include angioedema, drug misuse, and an increased suicide risk.[6] It is moderately addictive both physically and psychologically.[1]"
Wiki
Our findings suggest that successful treatment of long-term BDZ use with PGB is associated with a substantial, though only partial, recovery of BDZ-compromised neuropsychological functioning, at least at a 2-month follow-up.
 
The success rates did not differ according to either the benzodiazepine of abuse or the presence of other substance use disorders. Significant and clinically relevant improvements were observed in withdrawal and anxiety symptoms, as well as in patients' functioning. At week 12, tolerability was rated as good or excellent by 90% and 83% of the clinicians and patients, respectively. Our results suggest that pregabalin is an efficacious and well-tolerated adjunctive treatment for benzodiazepine withdrawal.
 
Available evidence suggests that monotherapy with pregabalin, within the dosage range of 150 - 600 mg/d, is a promising "novel" option for the safe and efficacious relapse prevention of both AD and BD. However, its efficacy as monotherapy in the acute treatment of AD withdrawal syndrome is still controversial.
 
Between 15% and 29% of the patients were able to stop using benzodiazepines after starting pregabalin or gabapentin treatment. Psychiatric patients who started pregabalin were able to reduce the amount of benzodiazepines used by 48%, compared to only 14% among starters of gabapentin. This study shows that some patients reduced their use of benzodiazepines substantially after starting pregabalin.

#72 invalidusername

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Posted 23 October 2023 - 04:59 PM

Hi John,
 
Thanks again for your kind words... and I am sorry to hear that you have been through similar circumstances. How you managed to stop alcohol, cigarettes AND the leaf at the same time is incredible! 
 
I have never smoked myself, but I lived with a partner some years ago who quit, and bloody hell did I know it!! She turned into a bitch queen from hell... I just had to keep my distance with my head low!!
 
Your updose to 30mg on the Duloxetine would have got the blood levels up within 5 days as Hat said, and would for sure say that what you are going through is as a result of the Diazepam.
 
I would strongly suggest that you reinstate your diazepam to around 6mg and go with a much much slower withdrawal. A drop of over 50% is going to get a lot worse pretty quick.
 
So... Jeff Beck - you must be a guitarist? :)
 
IUN

#73 looneytune

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Posted 24 October 2023 - 09:47 AM

 

Hi John,
 
Thanks again for your kind words... and I am sorry to hear that you have been through similar circumstances. How you managed to stop alcohol, cigarettes AND the leaf at the same time is incredible! 
 
I have never smoked myself, but I lived with a partner some years ago who quit, and bloody hell did I know it!! She turned into a bitch queen from hell... I just had to keep my distance with my head low!!
 
Your updose to 30mg on the Duloxetine would have got the blood levels up within 5 days as Hat said, and would for sure say that what you are going through is as a result of the Diazepam.
 
I would strongly suggest that you reinstate your diazepam to around 6mg and go with a much much slower withdrawal. A drop of over 50% is going to get a lot worse pretty quick.
 
So... Jeff Beck - you must be a guitarist? :)
 
IUN

 

Thanks for all that info guys will go through it TBS

 

Wife's mother was type 2 and lost her leg and Geraldine and I suddenly had "new jobs" for the next 8 years....Geraldine left her job and we went full time on her elderly parents

 

LOL things got so bad the pair of them moved across the road.....the stories I could tell y'all but there is enough sadness on these here pages

 

Yes, guitarist. Got an acoustic for my xmas DEC 69 it it has been my saviour and life long companion....closing the bedroom door at night to play has always been a sanctuary of sorts for me and I have played pro too. Up until recent illness anything from 1 to 4 hours a night would be my playing/practice routine.....when I stop the playing something major is happening in my world like the death of parents or clinical depression. I have quite the collection of amps/guitars/pedals......some of which are on muso forums and EB right now as I really need to cull the herd

 

My top 3 players

 

1) John McLaughlin of Mahavishnu Orchestra fame

2) Jan Akkerman of Focus fame

3) Jeff Beck

 

JB does not have the chops/speed of the other two but has touch and feel to die for that the other two could never learn in a 100 years  :) I saw Beck in Glasgow twice and both times he knocked lumps out of his whammy bar and never touched his tuning pegs the whole night. He knows something the rest of us don't  ;)

 

PS Been listening to a lot of Pat Metheny lately


#74 looneytune

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Posted 24 October 2023 - 10:30 AM

CBT no worky for me but doc has put me on waiting list to see specialist (trick cyclist) no doubt who can help with "my trauma", says my good lady GP....we'll see how that goes

 

Meanwhile, here is a good wee read

 

https://www.menninge...n-be-a-catch-22


#75 invalidusername

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Posted 24 October 2023 - 05:19 PM

Hi John,

 

I think the reinstate of dose will for sure serve you well, but I will go back to 1mg less as you will have already served an element of withdrawal, but again, you will be looking at around 4-5 days to get things balanced again.

 

CBT didn't really do much for me either - have you tried Kratom? That become my light at the end of the tunnel. A wonderful little leaf.

 

The article was interesting too - something that we all think about. We use the AD's to get better and then we have to brave the coming off the damn things which can send us off into a spin again, this is why it is paramount that the withdrawal is done correctly to avoid such circumstances.

 

Sounds like you have got a nice rig with your guitar! I am a pianist "by trade", but also a guitarist. Just wish I had more time to do more musical-based activities. My last partner and I used to do a load of little local based gigs and open mic nights and such. Good times.

 

My best memory was going to see Steve Vai and right at the end when we thought it was all over... on came Joe Satriani... and then Adrian Legg! All on one stage have a battle. It was amazing!

 

Good times...

 

IUN


#76 looneytune

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Posted 27 October 2023 - 08:49 AM

Guys, De we have the famous BLIP here as on other sites?

 

I can be doing "rather well" for a couple of days (no extra bed time and feeling on the right tracks of some sort of recovery) and then for no apparent reasons CRASH! full on anxiety and low/flat moods and BIG depression....can't get up and can't think of anything other than negative. I convince myself I'm fucked up big time and in the midst of a lifetime to come of despair

 

Then it lifts a bit and I start again on the road of free Fenders and Gibsons......but as much experience I have of this procedure I have never come to terms with it or see it as a blip....I see it every time as a MAJOR catastrophe in my life with no end in site = more depression and anxiety

 

A thought just struck me......normally at a crisis time like this I'd reach for my stash of Dizzypam and self medicate myself out of the bind, and considering how long this shit has been going on maybe,just maybe, I have not yet properly weaned my ass off Dizzypam! and therefore (at least) some of the blips are the result of poor Dizzypam use and taper management....I'm guessing here because I have many similar episodes of despair without the use of Diazepam at all

 

Saw doctor yesterday and was feeling OK so it's another 4x weeks of Duloxetine 30mg. Stomach and shitz a bit better than the mega blow outs of yore but still not right and appetite still no good.....I have protein drinks but I'd rather EAT than drink this protein shit to accommodate the Duloxetine

 

My next appointment will equal 15 weeks (one month shy) of 4 months on D30 and it was not lost on me this morning how apparently ineffective the current dose of DUL30 was against this latest CRASH.

 

If anyone has the patience to read through these posts of mine they will find multiple........."I'm coming off these/I'm staying on these" and if stomach and appetite is still dodgy in 4 weeks I think it would be time to call it a day.......but here is where I get scared shitless

 

It's not been a very pleasant 11 weeks thus far with introductory Duloxetine jitters and skitters but by all accounts that's nothing compared to the outro/the tapering and resulting despair and hardship of stopping. 5 months of hell on Citalopram and 4 months on DUL30 makes me wary of starting anything else but how else to sort this debilitating depression?

 

I've had enough God,it's a holiday I need and some of my old self back, even some old self will do

 

Thanks guys


#77 invalidusername

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Posted 27 October 2023 - 11:44 AM

Hi John,

 

Where are you at with the Diazepam now? Did you updose back to 6mg?

 

Either way, I would almost certainly put these mood swings down to the diazepam. If you did updose, then it will still be a day or two before you see the benefits of reinstating, but the up and down rollercoaster is you brain trying to make up for the sudden difference in the chemicals. So it will be putting a certain amount in, then try another, and another until it gets back to some sort of homeostasis.

 

This is perfectly normal and I have been there enough times to know what it is like - you have my sympathy

 

IUN 


#78 looneytune

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Posted 27 October 2023 - 12:30 PM

because I have now been on the drop down 3mg from 7mg for two whole weeks I thought I'd stick with it,rather than go up again.....expecting the worse to be over

Going down to 2mg Diazepam Sunday for 10 days then 1mg for the last 10 days and then no more Dizzypams for me

 

What also interests me though, and I'd like your input, is the "blips" these episodes apparently happen to folk in recovery whether with or without meds

 

Recovery in never in a straight line and the inet is full of such set back stories.......they also say that having a good afternoon/evening is a good sign, which i often do, and that he last thing to return to normal is regular normal mornings

 

As well as the BLIPS the nervous mornings phenomenon make up two of the most shared and talked about symptoms of Depression and anxiety anywhere online

 

John


#79 looneytune

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Posted 27 October 2023 - 12:43 PM

How you feelin' IUN?


#80 invalidusername

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Posted 27 October 2023 - 05:11 PM

John...
 
I cannot make any suggestion as it goes against our rules, but what I can do is tell you of my experiences and that of others. 
 
Please take a look at the benzobuddies website. You will see a lot of information there. Unfortunately, Hat is having to take a few days leave due to unfortunate circumstances, so I am "holding the fort" if you will....
 
But the drop of 50% of your diazepam WILL affect most people. Maybe it won't affect you, but I would be surprised. It is up to you whether you reinstate the dose you are on, but in my experience, and that which I have seen from the members on the site, you would be far better to reinstate your dose. Any benzo withdrawal is going to be REALLY tough. 
 
Just to give you an example from my own experience. The doctor screwed up and I was without my diazepam for THREE days. I tried to take my life. I didn't put the two together until I regained the balance of neurochemicals. 
 
IT IS DANGEROUS. Don't mess with benzos. Please. 
 
It may not have hurt you quite as bad as me, but I am 90% sure that your issues are as a result of your drop of your Diazepam. 
 
This is NOT a blip. It will remain and potentially make you worse in the long term. If Hat were here, I know he would agree with me. I am a PhD, not an MD, but I have a working knowledge of these drugs. I just want to make sure you are safe.
 
Please feel free to ask any further questions, but you do in terms of gtting back to where you need to be is up to you. But again, I need to offer support as best I can...
 
IUN

#81 looneytune

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Posted 28 October 2023 - 07:59 AM

drop was two weeks ago so gonna stay at 3mg and drop again to 2mg Sunday and 10 days later to 1mg...that's the plan  :)

 

Thanks IUN but my time on 7mg was fleeting and in general (on this occasion of use,and for most of the time during the last 6 weeks) dose has been 5mg one per day.....with occasional 2mg chaser......I thought it safe enough to reduce the dose considering the time scale on this occasion......ODD thing, I felt I could feel my head clearing yesterday and some fog lifting

 

I honestly think the further away I can get with Dizzypams the better....we'll see. Thanks for concern....tell Hat I was askin' for him and hope he is OK

 

John


#82 looneytune

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Posted 28 October 2023 - 10:50 AM

INTERESTING

 

Valium acts on levels of gamma-aminobutyric acid (GABA) and dopamine in the brain. Both are chemical messengers. GABA works on the stress response, acting like a natural tranquilizer to slow down some of the functions of the central nervous system like heart rate, body temperature, and blood pressure as well as minimizing anxiety and stress. Dopamine is a pleasure-inducing neurotransmitter that elevates mood. Valium disrupts the natural production of both of these chemicals in the brain, and over time, these changes can become set. This can cause a dependence to form wherein the individual’s brain relies on Valium in order to feel balanced.

 

Dizzypam can mess with your Dopamine pleasure machine! ergo......make you WORSE!


#83 invalidusername

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Posted 28 October 2023 - 02:34 PM

INTERESTING

 

Valium acts on levels of gamma-aminobutyric acid (GABA) and dopamine in the brain. Both are chemical messengers. GABA works on the stress response, acting like a natural tranquilizer to slow down some of the functions of the central nervous system like heart rate, body temperature, and blood pressure as well as minimizing anxiety and stress. Dopamine is a pleasure-inducing neurotransmitter that elevates mood. Valium disrupts the natural production of both of these chemicals in the brain, and over time, these changes can become set. This can cause a dependence to form wherein the individual’s brain relies on Valium in order to feel balanced.

 

Dizzypam can mess with your Dopamine pleasure machine! ergo......make you WORSE!

 

Bit more complex than that..

 

"diazepam increases the frequency of accumbal dopamine release events by disinhibiting dopamine neurons, but also decreases their amplitude"

 

https://www.ncbi.nlm...les/PMC5741045/

 

So I wouldn't go as far as to say it will definitely make you worse. There are too many factors in the equation - most importantly which other meds you are on at the same time, but that is why it should only be considered a short term drug. I am very upset that my doctor put me on them in the first place.

 

Hat is OK - just needs a few days to sort a few issues, but will be back soon :)


#84 looneytune

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Posted 31 October 2023 - 11:37 AM

I know you guys are interested in the "fringe" meds.......I got this PM from a muso forum friend......

 

Amanita Muscaria (fly agaric mushroom). I microdosed with it to get used to the effects then went higher to trip balls! It was a ride (I think just over 50 hours of coma, a safe coma!) and just came out feeling dandy. It is an amazing funghi but got to be prepped and used properly but I’ve never been better in my head.


#85 invalidusername

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Posted 31 October 2023 - 05:51 PM

This is a new one on me as this does not act on the 5HT serotonin receptor like other 'shrooms do, which is why it is always best to reduce any anti-depressant before embarking on any form of mushroom microdosing.

 

This however act on the GABA. 

 

I feel you know what I am going to say!!

 

This will take the place of that which you have reduced... the diazepam!! 

 

I am not sure as I need to read more about this, but go careful, but it may be ideal for you in the reducing of the benzo. As I said, I am not well known to the Amantia Muscaria. Not many that I am not, but this is one. 

 

I am going to read up about it and see what I can find. 

 

Thanks for bringing this to our attention - this, on the surface, sounds very interesting...

 

IUN


#86 invalidusername

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Posted 31 October 2023 - 06:14 PM

First look was here;

 

https://www.ncbi.nlm...es/PMC10142736/

 

Too many factors to consider a good analysis concerning the means of taking the substance, whether it be inhalation, ingestion or otherwise. The results are too mixed to draw conclusions as the gender differences between taking the substance varied too much between men and women. 

 

It seems that men prefer to take in capsule form and whilst some have noticed differences in mood, there have been substantial side effect - predominantly nausea and GI issues. The study itself did not allow for any participant taking existing meds, and was drawn from data retrieved from social media. How this paper was published I do not know, other than to say that there is so little know that anything will get published.

 

There is also a book available;

 

https://www.simonand...a/9781644115053

 

I have found the pdf download of this and downloaded it as I feel this will be more informative. I suggest you read up on this before you go further. For one, the primary author is Dr. Baba Masha, which in Russian (which I can speak relatively well) means Grandmother Maria. It is a bit odd! But that is not to say anything bad. It just means that they are more involved with the druidic and ancient medicines. 

 

If you want a copy, drop me a message.

 

But for now, I would proceed with caution. I will be reading this purely out of interest, but I cannot be sure how to guide you at present. There doesn't appear to be enough peer-reviewed papers on this at present. 

 

IUN


#87 looneytune

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Posted 01 November 2023 - 09:37 AM

Thanks guys......I have no intention of trying his.....life is hard enough with the legitimate meds  :) I just thought I would pass the info on as I thought you may have an interest....for your files

 

all the best

 

John


#88 looneytune

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Posted 01 November 2023 - 09:46 AM

It came from a muso forum where guys as you can imagine have tried everything and many still do......he has had "trouble with his nerves" and tried all the meds available from doctor but swears by this......I am too much of a scaredy cat to go down this road

 

Guys I am 68, worked my years in a pharmacy and hospital and have tried speed once.......magic shrooms once (old fashioned trad type) Mandrax tab once.....never tried acid proper or coke

smoked a 100000 joints though  :) the red fairy shroom and the resulting Alice In Wonderland Trip is not my bag but thanks for info/concern and advice

 

guy that sent me tip says the dose sorted him big time....each to their own I say  :)


#89 invalidusername

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Posted 01 November 2023 - 07:16 PM

You are absolutely right - it is very much and each to their own.

 

I have tried many things in desperation to have some relief. But the issue with psychedelics is that they are not consistent. To take acid for example. It depends on where/whom you get it from and when you chose to take it. You could have a bad trip when feeling great or a good trip when feeling bad. 

 

There is no knowing. As I said, proceed with caution. 

 

There has been a big uprising for people microdosing with mushrooms with some fantastic results.  

 

Just look into David Nutt's work. It is fantastic. He was a government advisory until he said that natural means were the way forward for mental health rather than the big pharma. He then got kicked out. When back into University work and proved that without a doubt that psyocibilin works far better than any medication on the market.

 

But will the government allow it to be used?! Of course not!! They cannot tax it like they can with regular meds!!

 

There was a great documentary about it all that bought it all out. 

 

If I had the choice of doing it all over again, I would be microdosing. I HATE being stuck on Citalopram. But the other half is slowly and successfully withdrawing off Venlafaxine to switch to psyocibilin. I have read enough to tell you it is far better than any med available. 

 

But the UK government in its infinite wisdom does not permit the sale of such substances purely because they cannot control them or tax them. Nothing other than that. The same with Kratom.

 

It is all a load of b*llocks. I want a good life, and if that means using ways and means of getting such substances, then so be it. 

 

IUN 


#90 looneytune

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Posted 03 November 2023 - 02:23 PM

Guys,whaddy think?

 

Been looking through my PC Health diary and noticed a LOT of Diazepam over the last 7 months or so.

 

Doc gave me them, and I also requested TBH, Dizzypams to help that initially troublesome period of first starting an AD med

 

Sometime I left her office with 3 packs...5's and 2's and after treatment on new AD's I would always have a stash left over

 

This has been going on since late '21 on and off

 

I would would always taper and stop over 3 weeks and some times 4 weeks. Usually 10mg a day/then 5mg a day for a week, then 2.5 for a week then stop. At times I'd be on them for 6 or 8 weeks and at other times just a week or so

 

I'd stop and have a good week of nerves free and then I'd come crashing down FOR SOME REASON and require a Valium to cope!!! Then the process would start again

 

The wife pointed out, and is convinced, Valium is my problem and I have never really stopped and stayed stopped long enough to heal mentally.....it's beginning to make sense to me as I would have reached for 5mg doses this week and last week due to unbelievable stress and moods but decided against dosing myself with them because a) I am already tapering 2mg per day now and B) I finally wanna stop, ride it out, and see if it IS the source of my troubles

 

I can have a few good positive days in a row and then out of the blue, whammo! a feeling of dread and doom and NOTHING has value or meaning....it raises up in my stomach and chest and sometimes can pass in hours...or days

 

It's now day 21 on my new up dose DUL30 and I have now had 14 days of Dizzypam 3mg (from 7mg) and currently on day 6 (of 14) of 2mg

 

I am now wondering if my diazepam merry-go-round has been unresolved and overlooked. Duloxetine 30 played no part whatsoever in reducing the kick of these episodes that I can tell

 

In a long time I have not put enough time and space between myself and last Valium tab to see how I react without them, and in the past if things reared up, I'd drop another and I may have all the time just been reacting to Valium withdrawals.....

 

A very confused patient





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