Addicted I know

[Davit]

Ashton is right in all respects except tapering.

Ativan has a four hour half life so max dose is only good for 16 hours out of the twenty four. So you get rebound. The other benzos are designer drugs that work on specific part of the brain where valium works on all parts. They are like valium with parts cut out. Some are very good for restless leg but not so good for the anxiety that comes with it.
Valium is still the safest and always will be the safest benzo because it treats all aspects of anxiety, there are no holes in its effectiveness. You don't actually become tolerant to benzos, what happens is that since all neurons are connected you build a path around it. So you need to do something mental for the anxiety before you can stop the chemical. Cognitive restructuring is that something. All benzos are muscle relaxants. They work on the Serotonin in the synapses in the body also. So they lower blood pressure and pulse when nothing else does. They do nothing to salvage Serotonin so are not antidepressants but do take some of the load off Serotonin. They are anti anxiety because their action is to stop information overload. They do this by blocking some of the receptors at each Synapse. Ativan can do this very fast but not for long. Valium is the opposite. Xanax and clonazepam block specific receptors so are prescribed for specific causes of anxiety. Valium gives you a smoother transition because it blocks all reasons for anxiety.
Unfortunately few GPs have enough information so they do the guessing game till they get the Benzo that works. Like they do with SSRIs.

---------- Post added at 10:30 ---------- Previous post was at 10:22 ----------

Before I get comments, Tapering did not work for me. I increased the time between doses without lowering the dose till the time was twice as long then cut the dose in half and did it again. No side effects of any consequence. Eventually just forgot to take them.

[MyNameIsTerry]

Absolutely NinjaKitty!!!!
Also, I went to the docs once with side effects from a medication and she said, impossible that is not mentioned in the leaflet.
I then found out a lot of people have this side-effect. I can't stand the fact that conventional medicine will not accept anything that is not in black on white...
And it is the same with withdrawal, they only go by what they have studied and don't see people as individuals
Rant over

They don't even follow accepted guidelines anyway given The Royal College of Psychiatrists have guidelines that match the major charity MIND with the 10% reduction in withdrawn of antidepressants. Many GP's just see a dosage as produced by a manufacturer and drop you based on that e.g. I went onto 20mg Citalopram with no taper up and then tapered down at 50% reductions over a few weeks. No scientific method at all, purely based on dosage sizes.

The longer you are on, the longer you spend coming off...yet GP's just do it as standard for all patients.

The funny thing about doctors, especially GP's is that they don't believe something could work until their is suitable clinical evidence accepted yet they forget that every single condition, disease and treatment was at some point without any evidence of existennce or effectiveness. To believe something cannot be a possibility because there is no accepted evidence does not mean it has been ruled out and modern medicine is not at its pinnacle so its pure arrogance to think it is!

---------- Post added at 04:54 ---------- Previous post was at 04:45 ----------

This is info from the Ashton manual.

Speed of elimination. Benzodiazepines also differ markedly in the speed at which they are metabolised (in the liver) and eliminated from the body (in the urine) (Table 1). For example, the "half-life" (time taken for the blood concentration to fall to half its initial value after a single dose) of diazepam is 20-100 hours, and that of an active metabolite of diazepam (desmethyldiazepam) is 36-200 hours. This means that half the active products of diazepam are still in the bloodstream up to 200 hours after a single dose. Clearly, with repeated daily dosing accumulation occurs and high concentrations can build up in the body (mainly in fatty tissues). As Table 1 shows, there is a considerable variation between individuals in the rate at which they metabolise benzodiazepines.

Drugs reach "steady-state" within 4-5 half lives and are mostly there after 3 as a standard.

The things is as well, it takes the same number of half lives to completely remove a drug from the body although if the ratio is the same as the one for reaching steady-state, it will likely mostly be gone by the 3rd half life.

Given NinjaKitty has a degree in pharmocology, hopefully that can be explained in more detail as I'm less sure about the out ratios. I would also assume that given how steady-state works, there is a limit to the level of a drug in the body or it would reach overdose levels. Since people tend to be taking Diazepam over short intervals, the metabolites must somehow be either flushed out or stored outside of the blood where they are beyond the levels seen in steady-state.

---------- Post added at 04:56 ---------- Previous post was at 04:54 ----------

I looked this up .
The only medically researched method of tapering off benzodiazepines that we are aware of was done by Dr. Heather Ashton. Her work in the field of benzodiazepine withdrawal syndrome resulted in what we've come to know as the Ashton Manual.
Dr. Ashton recommends changing faster-acting benzos like Xanax, Ativan and Klonopin for an equivalent dose of Valium and using the Valium to get a smoother, more controlled taper. This is all explained in her manual.


My genuine question is why differenentiate Xanax,Ativan and Klonopin from Valium when they are all benzos.


I could understand like for like in equal dosage and then how to taper off but not the above.

Its because the shorter the half life, the harder the withdrawal syndrome. Its the same with all antidepressants too and frequently a problem with short half lives in such as Venlaxafine so psychiatrists advise to switch to Prozac as that has a much longer half life and it means the impact to your system is much less.

[NinjaKitty]

Ashton is right in all respects except tapering.

Ativan has a four hour half life so max dose is only good for 16 hours out of the twenty four. So you get rebound. The other benzos are designer drugs that work on specific part of the brain where valium works on all parts. They are like valium with parts cut out. Some are very good for restless leg but not so good for the anxiety that comes with it.
Valium is still the safest and always will be the safest benzo because it treats all aspects of anxiety, there are no holes in its effectiveness. You don't actually become tolerant to benzos, what happens is that since all neurons are connected you build a path around it. So you need to do something mental for the anxiety before you can stop the chemical. Cognitive restructuring is that something. All benzos are muscle relaxants. They work on the Serotonin in the synapses in the body also. So they lower blood pressure and pulse when nothing else does. They do nothing to salvage Serotonin so are not antidepressants but do take some of the load off Serotonin. They are anti anxiety because their action is to stop information overload. They do this by blocking some of the receptors at each Synapse. Ativan can do this very fast but not for long. Valium is the opposite. Xanax and clonazepam block specific receptors so are prescribed for specific causes of anxiety. Valium gives you a smoother transition because it blocks all reasons for anxiety.
Unfortunately few GPs have enough information so they do the guessing game till they get the Benzo that works. Like they do with SSRIs.

---------- Post added at 10:30 ---------- Previous post was at 10:22 ----------

Before I get comments, Tapering did not work for me. I increased the time between doses without lowering the dose till the time was twice as long then cut the dose in half and did it again. No side effects of any consequence. Eventually just forgot to take them.

the Ashton Method has always ben reduce slight ammount of the Benzo you are on then taper onto valium (diazepam) and taper from anything from 1-5mg per week or every 6 weeks depending on your withdrawal symptoms and your panic/anxiety issues there is a lot of ways to do it but this method via the ashton method has been worldly known to be the best course of action obviously depending on what you decide to do. Having degrees i have in pharmacology and I was training to be a surgeon i wouldn't divert from Ashton but some people son't want to do it that way, there is another method by someone whose name escapes me but i will post name and website at some point. there is always hope and doing it in a practical way is best. cold turkey and doing it too quickly is lways the worst thing to do

---------- Post added at 12:17 ---------- Previous post was at 12:14 ----------

I looked this up .
The only medically researched method of tapering off benzodiazepines that we are aware of was done by Dr. Heather Ashton. Her work in the field of benzodiazepine withdrawal syndrome resulted in what we've come to know as the Ashton Manual.
Dr. Ashton recommends changing faster-acting benzos like Xanax, Ativan and Klonopin for an equivalent dose of Valium and using the Valium to get a smoother, more controlled taper. This is all explained in her manual.


My genuine question is why differenentiate Xanax,Ativan and Klonopin from Valium when they are all benzos.


I could understand like for like in equal dosage and then how to taper off but not the above.

I kow this very very well considering i have done the Ashton method 3 times...... there are other methods not just Ashton but really depends what country you live in, in the UK it is not known by most psychs or Dr's