Withdrawal or anxiety

[dally]

Hi
I cold turkied Valium 18months ago. (Due to very bad advice from my GP)
So you are very lucky your G.P. Understands how important tapering off Valium is.

I was only taking 2-4mg twice a week, but eventually was developing tolerance withdrawal symptoms in between doses. (I didn't know what withdrawal was at the time. I just thought my anxiety was getting worse. Never for a minute thought it was the drug)

About 2weeks after I stopped taking it, I developed terrible neck and head muscle tightness head shooting pains. (That no painkillers helped) Also tinnitus, worsening IBS, tremors, sweats, worsening anxiety, tearfulness, anger, memory loss, loss off appetite, and lots more. This went on for two months. My GP couldn't find a cause. I googled my symptoms and hey presto ...withdrawal came up!

I too was really worried, because there are horror stories out there and no one can tell you how long it will take for the withdrawals to stop. I was very scared I would never heal.
But please be assured everyone does..
Taking Valium basically stops your body from producing its own relaxing chemicals, and when you stop, your body's anxiety has no counterbalance...until it starts to reproduce it again. This might take a couple of months.
Every person is different in their withdrawals and their timescale to heal. But. You will heal. Whilst the symptoms are distressing, they will ease and eventually stop.

So, the answer to your question is. It is withdrawal. Not your anxiety. You will come to realise just this when you have healed .

I cold turkeyed, so my withdrawal was extreme. You are tapering, so any withdrawals will be gentle, and from what I have read from OP experiences they ease after a few days from each lowered dose.

[Mermaid16]

Hi Dally. Thank you for your reply and information. I have been on 3 x 2mg a day for the last month. I am going to start to cut down by .5mg for a week and see how I go, so your knowledge and experience is very helpfull. I have been seeing a psychiatrist who has prescribed an antipsychotic to help come off the valium. I have anxiety (which is severe) and feel this is a bit heavy handed, plus at some stage I will have to come off the antipsychotic. I have decided to get a second opinion from another psychiatrist, for my own peace of mind before I start any further medication.

[dale12345]

Go luck honey.

[Mermaid16]

I'm scared how long I'm going to feel like this. I've already gone through 2 months of hell waiting for the fluoxetine to work and now this. I can't do it anymore.

Hi Emma. I'm sorry that you are feeling like this. Try and take one day at a time. Go slow. You will get there. Tracy xx

[Emmarolo]

I'm so tempted to go back up to 5mg and start again but I won't. I've cut down to 1.25mg now. It's the doctors fault for tapering me too quickly. Mornings tend to be worse and then the afternoons ease a little. I'm so done with this. I just want to be a good mum again.

[MyNameIsTerry]

Sorry for all the posts. I think Valium has a really long half life as well, so when you do a drop, you may not feel it for about a week. Not sure exactly how it works, but mynameisterry is the guru on stuff like that.

---------- Post added at 20:05 ---------- Previous post was at 20:01 ----------

What are you scared of? You are tapering off a medication that is a very small dose and you have been on it for s very short amount of time. You have already made great progress. I know it's hard, but worrying about it is only going to make it worse. You've got this. Be positive, you have already done so well. Just be patient with it and you will be fine

There is often confusion over the half life and it's partly because we think of things in terms of other antidepressants like SSRI's. SSRI's are meant to be distributed slowly reaching a peak after so many hours and then slowly being eliminated. Benzo's are different to this because they have are fast acting and their half life tends to mean less.

With Benzo's you have to look at the "Absorption" and "Distribution" half life. This is the bit where the drug is doing something for you. The half life we tend to otherwise be talking about, like I mentioned with SSRI's, is the "Elimination" half life. But with Benzo's, a long half life just means they are still in your body, not that they are helping you.

So, if you look at Diazepam it has the following:

Absorption half life = 15mins to 2.5 hours (it's typically 1-1.5 hours for it to reach it's peak)
Distribution half life = 1-3 hours
Elimination (active drug) = up to 48 hours (active metabolite) = up to 100 hours

We all know that when you take a Diazepam, it hits you very quickly. So, the absorption half life matters when you are thinking how fast will it help me? Plus that peak mentioned above is the point when you are getting the absolute most if can deliver. It will stay at peak for a bit and then start dipping. You've probably noticed this by how you start feeling it wearing off?

So, if you are wondering about how fast your body will eliminate the stuff you need to use the elimination hours. The standard pharmacokinetic calculation works on the premise that each elimination half life reduces the remaining volume by 50% e.g. at 1 half life it's down to 50%, then by 2 half lives it's down to 25%, etc. 5 half lives puts it <5% which is class as "clinically insignificant" and 7 half lives gets it to 100%.

Active metabolites are usually pretty week and not having an effect like the active drug. But something I don't know about with this med is whether the active metabolite plays a part in dependence. The active drug clears pretty quickly but this much longer active metabolite may account for cases like dally's where interdose dependence has come along. I'm guessing at that, it just feels likely to me.

Something else you have to remember with Diazepam is that unlike many other drugs, such as antidepressants, it doesn't just accumulate in your blood plasma, it also accumulates in fatty tissue. This is sometimes why people fail drug tests many months after stopping taking it because the body is slowly eliminating a build up from fatty tissue. There are sites out there that explain how long after a final dose you can expect to be drug free for a drugs test. This is probably less of an issue though when it comes to how you physically feel and since you've not been on long, it's not like you built up a lot of the stuff (and many people take much larger doses than you do) so I don't think this is going to be an issue but I would be asking someone like dally that question who has direct experience (my dependence was Zopiclone, I've never used much Diazepam).

Each time you take another pill, you add a new cycle of half life to the mix. However, the previous pill's active drug & metabolites will be eliminating as per the above so it's not like you keep adding more & more hours on top of the last lot. Does that make sense? Once you take the final pill, that's when you can certainly say "I will be drug free in X half lives".

But every time you reduce your dose, that elimination equation is going to apply because a % above what yo are now taking is no longer being replaced and this is where withdrawal can come in - and that's the same for all the antidepressants too. So, if you were taking 2mg 3 times a day and then started taking 1mg 3 times a day, the % of the old dose you no longer take will be eliminating as it normally would but you are putting less back in your body which means you may feel the drop. Does that make sense?

Benzo's are hard to come off from speaking to others but people on here, like dally, have done it. It's just a matter of doing it right. Those like dally who've been there understand the importance of pacing this. And it's really encouraging to hear this new doctor's response because when I read your other thread and how you were feeling, withdrawal was would stood out due to reducing too much at once. This new doctor obviously has experience of this as he/she spotted it straight away and they've even put you on the liquid form which GP's are usually unhappy to do with any med as they cost a lot more. So, it sounds like you've got yourself a good doctor there.

A few others on here have said it can often be easier making big drops when you are on a lot but when you get to the small remaining doses, it gets harder. So, take it slow and if you don't feel right, speak to this doctor and see what they say.

[dally]

Terry, as usual very factual.
Wth respect withdrawal schedules can be mindblowing to somenew to this problem.
Without going into gabbaA receptors etc.

In layman's terms

One dose works for 2-4 hrs approx
But
The remnants of the drug (which has NO antianxiety effect) will not be fully eliminated from your body for
23 DAYS!!!!
This is ONE DOSE.
So if you take it regularly, non anxiety remnants build up in your body.

Taking valium takes over your own body's ability to produce antianxiety chemicals, and if taken for longer than 2-4weeks, can halt the body's production drastically. So, when you reduce or stop taking valium, your body does is not able to reproduce the antianxiety chemicals needed and withdrawal symptoms arise.

Over time, your body does start to produce these antianxiety chemicals again, and people do get better.

Getting through this time can be difficult. Propanol can help reduce adrenaline , provided you to not have asthma or low BP. And the plus point is it is not addictive.