worried about withdrawal.

[skymaid]

hiya. ive been good progress with managing my anxiety but I still get panic attacks for which Ive been prescribed 2mg diazepam tablets.

I get usually 1 or 2 panic attacks a week and I have to take 4mg diazepam to feel it.

so I guess im taking 8 mg a week. I usually have 2-3 days in between taking any.

is this enough to give me withdrawal/addiction etc? im having therapy so hopefully i'll have less panic attacks and not need them soon.

I cant take ssris due to emetophobia (hence the therapy).

my gp said dont take more than 2-4mg every other day and i'll be fine. but I havent had any in 2 days and I feel kinda achey/tired. could that be withdrawal or just because I had a rubbish sleep?

[skymaid]

this was kinda answered by someone in chat.

I have taken any for 3 days or so now. id have withdrawal or some urge to take them by now is If was addicted wouldnt I?

[dally]

Hi
I took valium for years.
2-4 mgs twice a WEEK or exposure therapy for agoraphobia.

I soon developed a tolerance. (After a couple of months)
Is started getting worsening panic attacks and more frequently, which was relieved by taking another valium and by increasing the dosage.

Eventually I noticed 4mg wasn't working.cso decided not to increase any further and stop taking all together. After a couple of weeks, I developed tremor, sever panic, tinnitus, diarrhoea, brain zaps, severe neck pains, headaches many more symptoms which took between 2 -6 months to ease.

[skymaid]

thanks for the answer. im a bit confused though.

so youre saying I should be ok (as long as I dont do this for long) or im not?

I havent had for 5 days now. dont feel any particular urge to have any either (anxiety is manageable).

[dally]

Valium or any benzodiazepam builds up in your body.
I dose can take up to 8 DAYS to be eliminated from your body. So if you take a second rose within 8 days, your body is never without the drug. After a period of time (roughly 2_4 weeks) if you stop taking valium or reduce the dose, you MAY develop withdrawals.
It is dependant on. Dose, frequency, length of time (months years). As to withdrawal effects and how long they last.
Valium can be withdrawn slowly with minimal side effects

[skymaid]

ok I get it now. I ended up taking another after a 6 day gap. so I would slowly build some up if I did that for a long time. but im only on the lowest dose and I dont plan on being on them at all once my therapy startd to work.

I tried to get an answer on the benzobuddies forum but they were full of horrifying stories of people on mega doses of much stronger stuff for years and years.

thanks for clearing it up. the physciastric seems happy with what im doing so I guess im ok really. just over worrying :)

[dally]

My GP told me I 'was not' having withdrawals from Valium because I took so little 2-4mg, twice a week sometimes less.
I believed him. Because I thought I was being 'careful' and hardly taking them.
My withdrawals were quite severe after stopping for a couple of weeks. I googled the symptoms and benzo withdrawals came up.
I then researched benzo more thoroughly, where I discovered how the drug builds up in your body and the symptoms of withdrawal.
Yes, I agree, some of the horror stories on benzo buddies, CAN be frightening.
But, if you can filter through the horror and try to find the 'informative ' stories you can gain some useful info.
The addiction risk and withdrawal symptoms are so variable with this drug.
Age, health, dosage, frequency, length of time on the drug. But there def is dependency/tolerance/addiction scientifically proved problems.

I always say, Valium IS a very useful drug, it works for anxiety, if used properly and no longer than 2-4 weeks. And, a person CAN withdraw from it, following a slow withdrawal schedule.

[skymaid]

thanks for your replies.

so technically you could take it every 8 days and never get physically addicted. although 8 days is the maximum so you should probably be ok for a while on that.

I find I can distract myself through most anxiety I just dont need another thing to worry about.

I will confirm with my psychiatrist but not seeing him till wednedsay. he didnt seem concerned last time

[MyNameIsTerry]

The body eliminates all drugs at a decreasing rate. If a drug's half life is 20 hours, it's not 40 hours for you to eliminate it. It takes much longer because each half life reduces the drug by 50%. That's a pharmacokinetic standard as found in the books.

Diazepam has a very long half life, well actually it has 2 half lives (the active drug is 48 hours, the active metabolite 100 hours, see further down about some of this) Not only that but unlike drugs like antidepressants, it doesn't just store in your blood plasma and will store in fatty tissue too. So, as a long term heavy user starts withdrawing they not only have to eliminate what they are holding in blood plasma but that tissue too. That's why doctors will tell you that you can fail a drugs test months after stopping taking them.

Isn't the question of dependence based on tolerance? If you feel the withdrawal, you have become tolerant to a dose when you decide to decrease it? And when you take a normal level of it, you start to need more to reproduce the effect?

If that's the case, those would be the questions to consider.

Just to get back to half lives for a moment, we tend to think of antidepressants which are designed to administer the dose across that half life & beyond until full elimination. Benzo's are slightly different since they only deliver a short hit. So, when considering how well they will work to reduce anxiety you look at the "distribution" half life. That's the period where a Benzo is working. When it comes to it being eliminated from the body, you look at the "elimination" half life. Then there is another issue in that there will also be an "active metabolite". Active metabolites are usually much weaker than the active drug (it's what it converts into) but they tend to be in the body longer but have no real effect. Some drugs do have powerful active metabolites so that should always be checked out.

[skymaid]

thanks for the detailed reply. tbh that was a little over my head. but I appreciate the effort.

I dont seem to have any tolerance 2-4mg still blows my head off (sleepy/relaxed).

so since these halflives are so variable from person to person then after 3-8 days between does I'll probably have some still kicking around in my system. so am I right in thinking its just a rule of: take it as little ad posdible as rarely as possible? or is there safe (rough) amount of days between doses you could take it without ending up with withdrawal symptoms?

almost withdrawal symptoms: is it easy to tell youre even having them? after 6 days I felt no different. still anxious and edgey and all the usual anxiety symptoms.

I always feel vaguely hungover the day after I take them which I kinda strange too.

[skymaid]

Didn't seem worth starting a new thread since this is the same old worry but with a twist.

How would I know if I was getting withdrawals?

i'm still on the 4mg twice a week but I had a burst of taking it everyday for 7 days while I started the lyrica (ideally that will do the job of reducing my anxiety levels so I have panic attacks less often and no longer need the diaz at all).

Over the lyrica start week I had 15mg then 10mg, 7mg, 7mg, 6mg, 4mg then 4mg.

Now Ive had none for 3 days. I feel a bit more anxious and my stomach hurts a bit (my ususl ibs crampy feeling). Had a rubbish sleep. Read endless benzo horror stories.

I can't actually find anyone on low dose internittant diazepam who's had any major problems.

How would I know if I was getting withdrawals? As im an emetophobe im worried about the possible vomitting symptom. I dont really know how this withdrawal stuff works.

[skymaid]

ignore this.

this thread should have stayed dead. this is just an old worry coming round again.

As my doctors both have told me unless im on 15-20+ day everyday for years then withdrawal wont that painful with a taper when I need to and lyrica is great for coming off diazepam.

if I dont believe a priory psych over benzobuddies horror stories then i'll just go back and reread this post

[dally]

Valium tolerance and addiction are facts. But are also so variable. Age, dosage, length of time etc etc.
But
They can be withdrawan from successfully with no or little side effects.
And
What symptoms you had may have just been blips in your anxiety and NOT Valium related at all.

[dally]

Benzodiazepines like Valium can stay in the system a pretty long time. It depends on how much you take and for how long. Also your health, age, weight and metabolic rate play a part.

How long a drug stays in your system depends mainly on it's elimination half life.

For Valium (diazepam) the initial distribution phase is followed by a prolonged terminal elimination phase (half-life up to 48 hours). The terminal elimination half-life of the active metabolite N-desmethyldiazepam is, on average, 100 hours.

So you would actually have to account for the elimination of N-desmethyldiazepam.

It takes 5.5 x elimination half lives (hours) for a medicine to be cleared from your system, therefore Valium or it's active metabolite will be in your system for 550 hours (5.5 x 100hrs) i.e. approximately 23 days.

I found this on drugs.com


As I've said before, there are a lot of variables.
Valium is the only med I can tolerate, which is effective, and quick acting.
And although I stopped taking it 18 months ago due to inter dose tolerance,
I took it recently for a hospital op.
It had good effect, and no withdrawals, or side effects.

If you need it, you should take it.
I was scared of the horror stories too, but I'm now reassured.