Here, I have simply posted what a 6mg alprazolam taper would look like if I followed the Ashton Manual to the dot. After thinking and revision, I must add these modifications... For myself only, knowing my body.
- The Taper would not involve direct Alprazolam cuts - What do I mean by this? Well look at the chart. In Stages 5 - 6 for example, during the night dosage you are supposed to cut from 1mg alprazolam to .5mg alprazolam. Never would I directly cut Alprazolam. So...
- To make the cuts that are not yet diazepam but the benzodiazepine put on, I would simply switch to diazepam, 1mg at a time.
EG: Go to step 1. During night, you go from initially 2 to 1.5 and you add 10mg diazepam. I like that, and instead of cutting from 1.5 - 1 in stages 5-6, my nighttime dose would be 40mg and it would then be tapered, instead of a direct cut in alprazolam by .5mgs.
A quick sum of how I would do mine:
Let's create a chart in our heads. We've got 6mg alprazolam. Were we to convert all of this to diazepam, we would need over 200 10mg tablets in one week! So this is what I'll do. I'll take 5mg alprazolam and 20mg diazepam. I will taper from that 20mg to 0. Then I will be on 5mg. I would switch to 4mg and 20mg diazepam. Continue. And when I get down to 2 mg, that's when I'm going into the 40mg diazepam and not staying on 1mg alprazolam, 20mg diazepam. It'll be 40mgs because that's when the taper really can make or break someone. That's when the cuts become so small your body normally wouldn't even feel it had you increased it.My cuts would last much longer as well. My first 1mg I cut will take, I plan, 15 days. I will go from 20mg (while taking 5mg alprazolam as usual) to 15, then 10, then 5, then 0.
But as I get lower, let's say I am going from 3 to 2mgs.... I'll take my 2mg alprazolam and with the 20mg diazepam I will go from 20 to 15 after a longer period, then to 15, then to 12, then 8, then 4, then 1.
Again, get to 2mg, time to switch to just Diazepam. You will be a wreck if you try staying on alprazolam and making a .5mg cut!
Well, this entails several factors. First, you must have an outlined set of goals. My goal is not to taper off of benzo's completely. My goal is to at least lower my dose to a more realistic level, being instated on a long-term benzo, and take more as needed of a short term, but no longer daily. But I will listen to my body. Right now I just said I'm lowering my dosage but staying on them. This is premise based that I will impossibly get under 10mg diazepam. I think, based on other times, I will get stuck. But shall my body let me move on, and I will not give up, I will make the smallest of cuts after months of waiting, shall my body let me, I will.
I still want to take a benzo while tapering. There is one benzodiazepine known to rarely cause dependence. Let's be real, for those of us who were put on large doses without knowing a damn thing. We were told to take 2mgs at a time, and you know what? Our eyes were heavy, we didn't care, an when we said we had no anxiety, we mean it. Ask for $50, receive. Of course we become so tolerant that 2mg is nothing.
As stated elsewhere in this blog, benzo's aren't meant to be an all-day tranquilizer. They are meant to help stop a panic attack in its tracks. And there is a great benzo, Trilazopam, that is very short-term acting, so much to where it's hard for the body to build a tolerance. It stops the attack. It calms you down. It gives you enough time to let the event pass or to conceptualize. But it's not taking over your day. It calmed you from wrecking havoc, but it didn't keep you so lazy you threw the keys at your 16 year old kid as well as a debit an let them go wherever they chose.
We do need long-term benzo's, don't get me wrong. Oops! I just said what any person tapering on benzo's would say I've lost credibility. But there are people like me who have gotten physically sick not from dependence, but from anxiety and not being on meds. It's a double edged sword. I've fainted in public. Had stomach issues. I needed benzo's. Right now if I stopped completely, even if there was no withdrawal, I would go bizerck. Last time I tried? 3 hospital visits. Time before? Suicide attempt. I have had a psychiatrist straight up tell me I need to be on benzo's like a diabetic on insulin even if it's a huge amount. He would completely be against me trying to taper right now. In his eyes, I should stay on them forever an just not worry. And you know what? Quite frankly, I agree with him. I really do. 6mg alprazolam is not as much as people think. Developing a tolerance to benzo's is common with regards to the sedative/hypnotic effects. But developing a tolerance to benzos and their anti-anxiety effect takes over 3 times longer on average than an antidepressant. But my doctor seems like he doesn't want to continue benzo management without a stringent approval from a specialist, which makes sense due to the ACA and its stipulations. I don't have money to see a psychiatrist, nor transportation, nor are psychiatrists who accept health insurance very pro-benzo these days because you don't see new benzodiazepines popping up. No patent. I'm not risking one day moving and being told I must get off in a manner of a few weeks. Nor do I want my doctor to quit treating me when I'm not ready.
I don't want off benzo's and the harms they do to us are real, but are seldom compared to antidepressants. But I trust my doctor. I trust he knows best. Unless I pay out of pocket, I will not find a psychiatrist who will prescribe me benzo's probably. Not in Austin. There is a stigma in the Austin community and based on my cooperation with psychotic emergency rooms, they haven't the slightest idea how to taper. I've heard emergency psychiatrists say some of the most preposterous things ever. I have a chance to taper in a great fashion. So I'm going to.
Wish me luck!
This is known as the Ashton Taper of course, but modified a bit because the Ashton Manual allows room for modification to fit your needs. This is the most realistic plan I could do without harming myself via a seizure. It would take years. But the goal is to get off medication eventually, not cramp a time frame you know personally won't work. My immediate goal as one with PTSD and major anxiety is to lower my tolerance achieve the therapeutic effect, see a therapist, and eventually be off benzo's as a regimen. I had accepted and do not decry the notion of staying on benzo's forever. But my anxiety is bad enough. I need a benzo to work!
ReplyDeleteUpdated with the modifications I would make as to how I would cut my initial doses. :) Realistic thoughts as well. Many people, including me in my opinion, should perhaps be on benzodiazepines for life. But there is no guarantee a doctor wouldn't taper me based on the empirical data we now have and based on that I wish to at minimal lower my dosage under the doctor I have now who is very understanding and open.
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