Valium Tolerance/Withdrawal

[Mermaid16]

Hi! Just wondering if anyone has ever experienced this. I just feel like I start to get on top of things and then something changes and I feel right back to where I started when all this started in July. I was prescribed 3 x 2mg valium daily on 30th August when I was tapering off sertraline and starting on Ven. The Psych then upped it to 8mg on the 17th of October. I feel like I am going through withdrawals from it, but I haven't reduced the dose at all. Is this possible? My symptoms are finding it hard to concentrate, having panic attacks that come out of nowhere, especially when I am trying to get to sleep, muscle tightness, severe anxiety. Please don't give me any lectures on how addictive valium is. I never wanted to start on it in the first place, but the psych assured me he wouldn't let me get addicted. I have never taken anymore than what has been prescribed, even on days like today when I am really struggling with intense anxiety.

Or would this just be break through anxiety?

[dale12345]

I wont lecture you! Haven't you had a lot of other med changes recently maybe thats it. I think your doing great by the way!!!

[Shazamataz]

I'd say it is break through anxiety as the dose won't be as effective as at the start. It's so frustrating isn't it? I'd avoid increasing any more if you can. Personal experience is that once you are tolerant, even taking extra won't do much.

Sorry to hear this. I'd hoped the olanzapine was helping?

xx

[Mermaid16]

Thanks guys for your replies. I take the Olanzapine 2.5mg at night about 6.00pm. It stops the anxiety once I take it at night, but the next day, I don't think it is doing much. It also doesn't stop the panic attacks, as I had about 3 when I was dropping off to sleep last night. I have learnt to deal with the panic attacks and not be scared by them like I used to, so that is a bonus). I think it's when I am inbetween the sleep/wake phase (if that makes sense). I think it will be more beneficial to take it in the morning. I see the Psych tomorrow, so will see what he comes up with. I'm sick of taking the valium, but am not at the right place to cut it down at the moment and don't want to increase any more. I have booked in with a different Psych at a different place to get a second opinion on the 8th of November (I've had to wait a month to get in to see her). I have read a research article that Olanzapine is beneficial for anxiety, but that is at an average dose of 8.75mg. So maybe I am on too low of a dose for it to be working it's magic for me. Seriously sometimes think I need a tranquilizer dart to make a difference to my anxiety. I am doing everything I can. Started seeing a psychologist, mediation and reading and trying to distract myself. I have actually been feeling really positive until yesterday, when the panic and anxiety seemed to come back with a vengance.

[dale12345]

I am sorry that you feel this way, I to feel like I need a elephant tranquilizer to help me sometimes.lol I dont think Olanzapine is prescribed in the US and I dont know much about it. I really hope the pych can help you tomorrow.

[dally]

I built a tolerance to valium. Just taking 2-4 mg twice a week....not everyday!!
At first when I was having more and more anxiety and panic attacks, I thought my 'condition' was getting worse and after every dose my symptoms disappeared so the valium was working.

But I soon realised that it was the valium tolerance that was worsening my symptoms and that I was needing higher doses to get any affect.


What I have learned from valium tolerance addiction and withdrawal is

It affects everyone differently.t here are many variables.
It IS a useful anti anxiety drug. And while I suffered with withdrawals, it was not enough to stop me using g it again recently for one day only whilst in hospital. And it was effective.

Imo you have to take a therapeutic dose. Ie that will relieve your symptoms.
You are changing meds and have been prescribed valium to ease you through this.
Your dr. Seems to be monitoring you, so take the valium to help you through this transition on the ADs.

Yes tolerance and addiction MAY develop, but all drugs can be withdrawn from.

[MyNameIsTerry]

Hi Tracy,

Valium has a very short period where it helps you. Outside of these periods, your own anxiety is going to be coming back.

Remember, with Benzo's it's not the "elimination" half life you look at which is what you do look at with antidepressants. With Benzo's, because they are fast acting, look at the "absorption" and "distribution" half lives instead.

Absorption
After oral administration >90% of Diazepam is absorbed and the average time to achieve peak plasma concentrations is 1 – 1.5 hours with a range of 0.25 to 2.5 hours. Absorption is delayed and decreased when administered with a moderate fat meal. In the presence of food mean lag times are approximately 45 minutes as compared with 15 minutes when fasting. There is also an increase in the average time to achieve peak concentrations to about 2.5 hours in the presence of food as compared with 1.25 hours when fasting. This results in an average decrease in Cmax of 20% in addition to a 27% decrease in AUC (range 15% to 50%) when administered with food.
Distribution
Diazepam and its metabolites are highly bound to plasma proteins (Diazepam 98%). Diazepam and its metabolites cross the blood-brain and placental barriers and are also found in breast milk in concentrations approximately one tenth of those in maternal plasma (days 3 to 9 post-partum). In young healthy males, the volume of distribution at steady-state is 0.8 to 1.0 L/kg. The decline in the plasma concentration-time profile after oral administration is biphasic. The initial distribution phase has a half-life of approximately 1 hour, although it may range up to >3 hours.

So, if doses are spread out, could it be your own anxiety coming back?

[Mermaid16]

Thank you for your replies Terry and Dally. Terry you have so much knowledge regarding medications (and other things), it is very much appreciated, all the help you give out on this site. Dally, I have read other posts of yours on similar threads and thank you for being honest about your experience without scaring the beejesus out of people with horror stories. Terry I have printed a copy of the NICE guidelines that you posted on another thread to show to my doctor as i have asked about pregabalin before. His reason to me for not prescribing is that it is too sedating. It was interesting that they state not to offer a benzodiazepine or antipsychotic in primary care. I am sick of taking so many medications...if they worked, I could maybe understand, but days like today, I feel like I'm right back at square one, except I have three other medications in my system.

Just wanted to acknowledge that your help is really appreciated. Tracy x

[MyNameIsTerry]

That's ok, Tracy, just glad to help. :flowers:

It does make you wonder how much all these meds unbalance you. Sometimes I've seen people even have washout periods just to get everything out.

Did you mention you were on 2.5mg Olanzapine on another thread? If so, there are a couple of guys on here I've known have it for their anxiety. It was at 5mg though. It did help but they did put weight on. Anti psychotics tend to be known for this and Olanzapine does have links to metabolic changes, diabetes, etc. What they found what that once they reduced back down <5mg the weight dropped off.

GP's in the UK used to dish out Valium like sweeties years ago. There have been many people dependent on them and still are now. So, anything over about 2 weeks is for psychiatrists now. If psychiatrists believe it is worth becoming dependent to get somebody stable, they do that first and then help them withdraw later. But GP's are not allowed to do this now, largely because they are lazy in follow ups as well as ignorant of many of these meds.

My GP got me dependent on Zopiclone through incorrect prescribing, it only took a month of daily usage. It was easy enough to get off them though, even at the time I had only been on Cit about a month. I suspect even being dependent when you've not been on long, it's not going to be anywhere near like dally's experience & others who've been on them for years and I'm sure she knows much more about all that from her experience.

GP's can be funny with Pregabalin. It's odd sedation is an issue unless they mean on top of the other things you are ok? From listening to the guys on the Preg board, sedating effects tend to disappear fairly quickly. It would be worth talking to hanshan and SmilingAlbert about that, they are the brains on that board. Hanshan is from Australia and he has mentioned issues in getting it before when he was over there (I think he lives in Japan now).

The NICE guidelines are obviously only for the UK but that is the expert panel review system that forms guidance for the whole of our medical community over here. The drug licencing info can also be found on the NICE website if you click on the Evidence Services tab and then BNF which takes you to the British National Formulary (BNF) where all drug guidance is held. The fill licence though would be on the MHRA site here http://www.mhra.gov.uk/spc-pil/index.htm (they licence our meds in the UK).

[skymaid]

i've slowly gone from 50mg to 300mg pregabalin and I can't say i've noticed much sedation. I kinda wish I had.

Only thing I noticed was a dry mouth and very slight tipsy feeling (like maybe a pint or two) but that passed after a day or two of each increase

[Mermaid16]

Just an update. I had psych appointment today. He said it wouldn't be withdrawals from valium if I haven't cut down at all, but it would be tolerance. We have decided to split the dose of the Olanzapine to 1.25mg in the morning and 1.25mg in the evening. I have been feeling better today with the anxiety, so I am going to leave it to just taking it in the evening and try splitting it on the weekend. That way if I get really tired, it won't matter as much as if I did it at work. He also gave me a prescription for propropronol 10mg morning and night. I have read some other threads on here and some people take it as needed, so I am going to keep it until I need it, rather than taking it everyday. I am on so many different meds, I just don't want to add another one to the mix and will test the split dose of olanzapine first and see how that works before making any decisions about the propropronol.

[MyNameIsTerry]

Olanzapine has got a much longer period of affecting you than Diazepam. When I took Diazepam at my worst when starting Duloxetine, after 2.5-3 hours it wore off and back came my anxiety. So, 3 doses might not spread enough to cover you? The Olanzapine will but something to remember is that this split dose will likely mean never hitting 2.5mg unless both peak periods overlap. Does that make sense? It's not an issue, if it works that's all that matters.

[Mermaid16]

i've slowly gone from 50mg to 300mg pregabalin and I can't say i've noticed much sedation. I kinda wish I had.

Only thing I noticed was a dry mouth and very slight tipsy feeling (like maybe a pint or two) but that passed after a day or two of each increase

Hi Skymaid. Thank you for your reply. Your blog inspired me to start one of my own (mainly as a guage to see how I am doing). I read your blog daily and find it interesting. I like how you rate your day.

Tracy

[dally]

Propanalol did help me with anxiety, unfortunately it sparked asthma in me so I had to stop.
I took it when I was going out or anxiety was bad it certainly took the edge off.
It is not addictive. Hope it works for you x