Professor Malcolm H. Lader says it well: “It is more difficult to withdraw people from benzodiazepines than it is from heroin.” For this reason we need to say NO to benzodiazepines for anxiety (and other conditions)!
Benzodiazepines are a class of psychoactive drugs that work by enhancing the effect of the calming neurotransmitter GABA, and are used to treat anxiety, insomnia, pain, muscle spasms and a range of other conditions. They are widely prescribed, particularly among elderly patients and may even be used off-label with children with autism.
Use of this medication is very controversial. We know long term use leads to tolerance, dependence, and many adverse psychological effects and even physical effects. Short term use is generally considered safe but even using them for 2 – 4 weeks can lead to problems for certain individuals.
This presentation provided an overview of benzodiazepines; when they are used; who they are prescribed to; details about tolerance, dependence, and the many adverse effects; how to taper, including nutritional support during the taper; what to do instead of saying yes to a benzodiazepine prescription in the first place; and additional resources.
I’d love questions/feedback/comments/your benzodiazepine experiences/additional resources etc. You can also comment on the other benzodiazepine blogs here and here.
Thank you soooo much for the replay! I was crushed when I missed the webinar but thank goodness you allowed a replay:-) lots of info and resources. You rock! Wish me luck on my attempt and conquer of benzos! This info will be great also for my mentally and physically challenged son! I love you and your passion and commitment.
Kelly
You are most welcome and I wish you much success – thanks for your very kind words!
I was on benzoes for 7 years at 4 msg a day. I was prescribed them for anxiety and insomnia. In 2013 i fell down a flight of stares and fractured my neck and has to have surgery. After I woke from the surgery my short term memory was all but gone. My GP suggested that I try and get off of the Benzos and said it may help with the short turn memory problem. I also had a lot of other symptoms that no one seemed alarmed by. For example my digestive system was shut down completely. If I ate, 30 minutes later i past what I ate just as I ate it. My reaction time was so slow I was asked to quit my job as a dog groomer because I was a liability. I was awake and going thru the motions of life but I was not present at all. With all that i decided it was time to get off them not k owing what was in store. I went to Townsend detox program thinking they would be able to help me. I was ok for about 2 weeks with out the Benzos and then week three came And through me into a world i never want to return to. It started with crying spells all the time. And then the sensation of jelly fish stinging me from head to toe. My sense of smell was out of con troll. Hallucination paralyzed me with fear. I could not tolerate light or sound at all. I stayed in my beds under my covers protected from every thing for a good month and then the seizures And the high blood Presure put me i. The hospital. I went to the ER and three days later I woke up in a mental hospital where they kept me for 14 days and still had no clue how to help me. They kept telling me it was a mental addiction and I just needed to get over it. At the 14 day mark my insurance would not pay for me any more so they let me go with out any where to turn. I really believed i was going to be schizophrenic for the rest of my life with no help at all. With where to turn i started researching the Benzos with drawl on my own to try and find and answer and that’s when I came across Astons method. I brought it to my dr and had him read it and him if would please fallow the how protocol written by dr Aston and he agreed. It been a year and 1/2 and im finally completely off. My last one was taken in March 2014. I do still have a lot of symptom and im not sure if they will ever go away. It is very frustrating to the people around me because they don’t under stand how I can get lost going to a store I’ve been to my whole life. Or why I. The middle of a sentence I can’t recall what we were talking about. I am so glad I came across this sight and am hopeful it will help me Continue my recovery from this killer drug.
Thank you so much tanya.
Tanya
Thank you for sharing your awful journey. Well done for finding and taking the Ashton protocol to your doctor. Congratulations on finally being off and I wish you continued healing.
Be sure to nourish yourself with nutrient-dense foods, eat to control blood sugar, and get rid of gluten, sugar, caffeine if they’re still part of your diet.
You may find this blog and list of nutrient helpful for the word recall and getting lost https://www.everywomanover29.com/blog/nutrients-for-dementia-benzodiazepine-withdrawal/
Does amitriptyline fall into the same category as benzos? It’s listed as di-benzo.
Terrie
Amitriptyline/chlordiazepoxide is a combination tricyclic antidepressant and benzodiazepine http://www.drugs.com/cdi/amitriptyline-chlordiazepoxide.html It’s not one I’m familiar with
Hi Trudy, do you know if the drug Gabapentin has the same effect as benzos as far as withdrawal is concerned?
Kat
Yes, unfortunately Gabapentin withdrawal can be very problematic in some individuals.
Here is a snippet from this paper: Withdrawal Symptoms after Gabapentin Discontinuation (http://www.medscape.com/viewarticle/722526) “Patients who have abruptly discontinued gabapentin have reported symptoms of anxiety, diaphoresis, irritability, agitation, confusion, tachycardia, catatonia, and status epilepticus. The symptoms that have been associated with gabapentin withdrawal tend to mimic some of the same withdrawal symptoms associated with ethanol and benzodiazepine withdrawal, possibly because gabapentin augments GABA levels, as does ethanol and benzodiazepines.”
Have you observed issues with withdrawing from it?
Trudy, I have been on Ativan for 13 years and cannot find anyone to help me get off of them. i’ve tried weening off them myself but I’ve only gone from 4 mgs to 3mgs in the last year. I’m stuck at this point, and I really don’t know how to do it correctly. I eat 3 meals a day, and I do have protein with my meals, mostly organic. I also only drink water and chamomile tea. I do have one decaffenated tea a day with a tablespoon of milk, other than that I really don’t do dairy. I also tried the gluten free for about six months, but I didn’t see a difference in my anxiety or depression. Can I take b6 zinc and gaba an evening primrose oil while still taking the ativan? Will it help me taper off the Ativan? Thank you , Michele
The best resource I know of is http://www.benzo.org.uk. You will need to educate yourself and your doctor and/or find a doctor willing to help you with the adjusted prescription. It does need to be done very very very slowly. Finding a good support group like http://www.benzobuddies.org is very helpful. Just be aware that this group and some of the other support groups say no to any supplements during the taper process. I find it to be very individualized and have many clients that see great benefit by using GABA, tryptophan etc. That being said some people tapering can only tolerate very slow amounts of the aminos (like a dab from a capsule) and some can’t tolerate any supplements.
There is no issue with taking vitamin B6, zinc and EPO when on a benzo
Buy a 100 ml graduated cylinder and a 50 ml one too. Take the pill, for example, 1mg or 2mg and put it into the 100 ml cylinder. Fill with water to 100ml. Let dissolve completely, shake. The solution settles quickly so you have to do this fast while the solution is totally cloudy without settlement. Pour off 10 ml into the 50 ml cylinder. Drink the 90 ml. Add more water to the 100 ml cylinder and shake to drink the residual that wasn’t totally consumed. Discard the 10%. Do that for 7 days, constituting a reduction of 10%. Next week, pour off 20%. Repeat. Next week discard 30%, etc. You need the cylinder to measure tiny amounts. You can’t control a pill cutting. This works if you do exactly as I say. Now at the conclusion, you will have to stack Gaba with Theanine, to give the cell sites a chance to recover. Or whatever Judy thinks best, but the physical withdrawals will not be an issue. Insomnia or other dependence issues may rise but you will have to research and analyze your brain chemistry to determine the best neutraceutical program.
Terry
Thanks for sharing here. When sharing something like this this it helps to share your source (via a link) and your qualification. If this approach is what you have used personally that’s fine too, but it’s best to simply state this.
For other blog readers, this is called the water titration method – more here http://www.benzobuddies.org/benzodiazepine-withdrawal-methods/titration/
Trudy Ive posted this on my big meetup. Thankyou. I was highly addicted to Temazepam for army trauma, going through a pack of 25 X10mg in 2 1/2 days. for years. i was jailed on remand for something I didnt do and no temazepam or substitute so from that level to nothing. for over a month. I so could have died. I now have diabetes and adrenal fatigue (4 years later). It is so scary reading the long term side effects esp in elderly. I have not found a doctor or psych or naturopath here in Perth Australia who thinks this is even a concern. Please advise.
Pip
So sorry to hear you went through that! The best you can do is become informed and educate the health professionals you work with. It’s not uncommon for many to be unaware of this issue. The information from Dr. Catherine Pittman is often very useful (https://www.everywomanover29.com/blog/anxiety-summit-benzodiazepines-risks-vs-benefits/)
I’d love to hear if any of these applied to you? (from this blog https://www.everywomanover29.com/blog/world-benzodiazepine-awareness-day-say-no-benzodiazepines-anxiety)
Taking Valium/ diazepam [Temazepam is similar to Valium] and have the CYP2C19 polymorphism (about 10-20% of Western populations are defective in genes of the CYP liver enzyme superfamily)
Taking any benzodiazepine and also
– Taking oral contraceptives
– Taking a course of antibiotics
– Taking a course of one of the fluoroquinolone antibiotics
– On an SSRI prescription
– Taking a course of antifungal medications
– Drinking alcohol on a regular basis
– On an opioid such as oxycodone
– Drinking grapefruit juice on a regular basis
I am on 6 mg Valium and have tapered from 10 mg in the last 4 months. I am doing pretty well with the side effects but will have spikes with morning anxiety which if I don’t stop will last all day. I was prescribed Valium for pelvic muscle spasms 10 years ago and knew nothing about Valium.
I had spinal cord surgery which damaged my sacral nerves. The cysts in my spinal cord and endometriosis were probably the cause of my pelvic and bladder floor and retention issues. My back pain is improving but I am still on 2 mg of hydromorphone because of pelvic pain and a terrible pain disorder called PGAD treated with hormones and opioids, at this point they have no other treatment for PGAD. I have hashimotos and lichen sclerosis – 2 autoimmune disorders. I also have 1 methylation snip so folate is difficult to process. During my taper I got a bladder infection and had 2 rounds of cipro and high doses of ibprophen under a doctors care even though I later learned the cipro was black boxed and ibprophen not recommended during withdrawal according to the Aston manual. The doctor had no idea. Since the cipro my pelvic pain will often become internal itching which no one seems to know how to address but is worse than the pain. So as you can see my issues are complicated.
Last April on vacation I woke up with an anxiety attach and have had debilitating issues ever since. The Valium will stop the anxiety but if I go for long periods of time say 10 -12 hours my anxiety doesn’t increase I just feel sick – chills,weakness, achy all over, weakness etc. the anxiety by and large is upon waking. I have had adrenal testing an my adrenals are low with a spike in the afternoon. My doctor prescribed Seriphos which caused an anxiety spike after 3 days that I am still dealing with but last night was my first night without it so it is still in my system. I fall asleep between 7 and 9 to 11- 12 then have busy nights getting about 4-6 hours on average but am not tired during the day. I have a clean gluten dairy caffeine free diet.
I take magnesium, coconut oil, a probiotic, Inulin, desert harvest aloe for bladder pain. I can’t take a b supplement because it hypes me up. B 12 is like taking speed. I am very sensitive to drugs or supplements.
I read your book and fit the gaba profile. I have taken 500 mg Now gaba and it helps some if the anxiety hasn’t gotten too intense. I took Pharma gaba which doesn’t help at all. I just got gaba calm but haven’t taken it because I want to get the Seriphos out of my system. I took the gaba with vit 6 and it seemed to cause bladder pain but might give it another try.
I really want to get off Valium because it is so uneven. Some days I don’t need the full 6 mg and it makes me feel bad and tired. Some days I go through withdrawal between doses so I rarely feel normal. I did neurobiofeedback and that seemed to be the most helpful so far. I am still up and down having a few better days and starting to swim again. I was having some small seizures causing dry mouth extreme weakness difficulty talking then feeling sad for several hours. The neurologist found a spot on my prefrontal cortex that can cause seizures and anxiety but suggested neurobiofeedback instead of seizure meds. Since I went off Mmj and had the neurobiofeedback the seizures have stopped and I was able to go down 4 mg of Valium which was much easier than before. I will be having 10 more sessions in a month. I know this is long and involved. I have read your book and have a couple of questions. How much gaba can I take? Especially for that anxiety attach upon waking. I feel like I could take a lot more than 750 mg. at a time. I cannot take SSRI’ s because they make me feel horible. They were prescribed for pain and anxiety. I am distressed no depressed. Paxil caused a panic attack so is increasing serotonin a good idea. What about vit c. Does that help with anxiety? I am in the sun in Colorado and my D is good. I eat flax and walnuts so don’t think I need the omegas. My practitioner wants me to try kava kava for the pelvic spasms but can that cause more anxiety? I appreciate any help I can get. Anxiety is as bad as pain of which I am very familiar. I also try to meditate and try to be pretty social when my issues allow and have a supportive family so have good people in my life. Thanks again for your help and support. Knowing you got over your anxiety is a light at the end of my tunnel.
Kathy
I am sorry to hear what you have been through. It’s wonderful to hear that neurofeedback is helping you so much! Meditation and having a supportive family is great too.
I have my clients do a trial of GABA to figure out how much they need (https://www.everywomanover29.com/blog/how-to-do-an-amino-acid-trial-for-anxiety/). It’s different for everyone. I’d suggest basing it on your previous good results. If it helps with the anxiety it is likely to help with PGADs too and the benzo taper.
Are you aware of the interaction between fluoroquinolones and benzos? I would talk to your doctor about other antibiotics for any future need. I interviewed Lisa on the recent Anxiety Summit on this topic https://www.everywomanover29.com/blog/antibiotic-anxiety-fluoroquinolone/
Looking at the list of factors that may make it more challenging to taper from the benzo you meet a number of them: antibiotics/fluoroquinolone (Cipro), SSRI prescription, and an opioid med. So go super slow and be gentle on yourself and continue to do what you’re doing.
I was aware about tapering and cipro but the doc had already prescribed it and I didn’t know about the interaction at the time. Cipro is now on my list of meds I can’t take.
I will increase my gaba intake. What is the spray?
It is so frustrating because one morning I will wake up physically anxious and won’t the next morning. I never know. I can barely stay awake by around 7-10 then wake up anxious at 3-4.
I know my adrenals are struggling because of the spit test but the Seriphos prescribed to help that set me off on another bout with anxiety.
I still wake up every 90 min after a rem sleep cycle.
I am so frustrated. Yesterday I was great, swam laps for 1/2 hour, shopped , dinner with friends now today it is 3:30 and I have physical anxiety symptoms not a racing brain.
I was feeling so good I did have a very small gin and tonic which I haven’t done for years could that cause my anxiety?
Thank you Trudy for responding and giving me support and advice. It is so hard to know where to get help and what to do when you feel like you are doing everything right, diet, exercise etc. I am reading the adrenal reset diet because I think I will have a problem with meds so am hoping I can get some tips I may be missing in my diet. I am not over weight and am pretty fit but I definitely have thyroid and adrenal issues.
I can’t tell you how much I appreciate what you do to help people like me.
Kathy
I have my clients keep a food mood log so they can see what triggers their anxiety. It’s possible the gin and tonic can do that
A few clients have not tolerated Seriphos and I’ve used Biotics Research De-stress instead. It helps to lower cortisol and helps with sleep and anxiety
I can not find detox schedule to taper off of Colonopin using both colonopin and valium
Rob
The best source for the Ashton protocol is http://www.benzo.org.uk I find my clients do much better tapering from benzos when they are nutritionally sound ie no gluten, no sugar, no caffeine, real whole food, good gut health, good adrenal health and good levels of zinc, B6, D, iron, magnesium etc etc
The Ashton taper is very fast for many people who have been on benzos for a long time. It is way to fast for me and has caused me protracted withdrawal symptoms. I would go much slower.
Kathy
Thanks for sharing your experience. I like to at least have folks start here because doctors are not often familiar with a slow taper. I’ve had clients be told to taper in as quickly as 2 weeks! Horrors!
But I agree that each person needs to find a pace that works for them and slow down and even stop the taper protocol for certain periods if needed. That being said I have found many do really well on this Ashton taper when they are nutritionally stable (quality protein/paleo diet, blood sugar control, no gluten, no sugar, no caffeine, adrenals in good shape, good zinc/D/magnesium/B6 etc) and are also using supportive nutrients like GABA, niacinamide, melatonin etc (based on unique needs)
Would you mind sharing how long you had been on benzos and how slow you had to go? Did you also have the nutritional support in place at the time?
I have been on Valium for 10 years. I was put on Valium for pelvic spasms and pain and knew nothing about the drug. I was fine for 4 years on 5 mg. I swam on a masters team, white water canoed, mountain biked, backpacked and did yoga 2-3 times a week. I was retired so skied 20-25 times a season. Then I was put on Bactrim an antibiotic for a sinus infection for 21 days developed vertigo and nausea. The vertigo went away but had chronic nausea for 6 months. Nothing helped with the nausea but Valium. I eventually was taking up to 35 mg daily. I still lost 35 pounds. I am 5’9” and ended up weighing 115 pounds. My gallbladder was removed it had attached to my diaphragm. The nausea went away. My doc told me to go off Valium 5 mg every other day. At 2 mg Valium I developed a bladder infection because it was very difficult to urinate. I was given 3 rounds of cipro and my life has never been the same.
I couldn’t sleep and was very sick from withdrawal. I went to a psychiatrist and he upped my dose of Valium to 15 mg. I was still in terrible withdrawal but didn’t understand it. He also put me on seroquel for a few months so I could get some sleep and stop moving all the time. My Hashimotos wouldn’t stabilize for a year and a half. After going off gluten for 4 months it finally stabilized. I went to 5 endocrinologist and not one suggested going off gluten. The last one was going to remove my thyroid.
My pelvic pain worsened and my lower back which had always been a little sore began to really be painful. Went to a chiropractor who used his little device that tapped on my sacrum. He didn’t know what he was doing because the X-ray he took didn’t show the cysts in my sacrum. So after 24 visits my pain worsened. I had a genetic disorder called Tarlov cyst disease. The cysts get bigger from trama and age. I had 5 cysts in my sacrum which was operated on because the cysts had enlarged and were reforming my sacrum. I was put on hydromorphone for 3 years. I have been off that for a year and a half but still have chronic back and pelvic pain. I would say the surgery made my pain worse although I don’t know what would have happened without it. The whole time I was lowering my Valium dose in fits and starts. I realize now that in the past 5 years I have always been in tolerance going through withdrawal almost daily. I have never stabilized even on 10 mg for 6 months. So my titration hasn’t been steady. 2 years ago i finally understood why I felt sick every day and started to do a steady taper. That was interrupted by going off opioids. That was difficult but nothing compared to going off Valium. When I got down to 5 mg the psychiatrist wanted me to go off in 3 weeks to just get it over with. I did more research and decided that was too quick for me but did go off 1 more mg which puts me at 4 mg. This has been the worst cut since I started to taper 2 years ago.
So I decided to go to a psychiatric PA who was supposed to be knowledgeable about slow tapers. She had a 2% reduction compounded because I thought going off slowly and carefully would be best for me. The Valium they used in the compounded pill was much stronger than the generic Valium I take so I actually went up in dosage but don’t know how much. She finally talked to the pharmacist and they figured it out. she told me to go back to 4 mg. So I probably cut more than 1 mg. She said it would be horrible for a while never apologized and charged me $125. We are no longer working together.
So currently I am on 4 mg very weak sick fatigued a lot of other terrible symptoms with a difficult pain flare. I am mostly in bed or on the couch. I also have some digestion issues from the opioids.
I eat a very clean healthy diet just real food no caffeine or sugar. I did the Viome test and am following their recommendations to hopefully help with digestion anxiety withdrawal. I use psyllium and flax for constipation. That is starting to get better. I am very sensitive to any meds even supplements.
There is no one in Northern Colorado who specializes in benzo tapering and support so I am going to doctor google. That drug rehab centers all have fast tapers. I now know that a fast taper just makes things worse. It doesn’t allow your gaba a receptors heal. So a very slow taper is always best. I bought a scale and am going to start a micro taper in a month. Hopefully I will be somewhat stable by then or at least better than I am currently.
I haven’t had good luck with the medical community. I actually think they have made me sick.
So I have read your book and others and have addressed what I can on my own. The Ashton manual is a starting point for information. But a very fast taper for sensitive systems. There are so many unknowns and not a lot of things that help or support groups like there are for getting off opioids or alcohol. There is benzo buddies and I found a Facebook support group that is great but there is nothing like personal contact for me.
I think this is a huge problem and one that isn’t really being addressed or understood by the medical community.
This is a long story but nothing is simple with health issues and our current medical care. With my muddled brain I still have to figure out how to help myself.
Kathy
Kathy
I’m sorry to hear what you have been through and appreciate you sharing your story – and you are correct – none of this is understood by the medical community and many people need a super super slow taper.
It’s good to hear you “eat a very clean healthy diet just real food no caffeine or sugar” but taking things to the next level with no gluten, then no grains and possibly even ketogenic is something I consider with all clients. Adding in nutritional support and addressing deficiencies are key too.
I suggest looking for a functional medicine doctor or nutritionist to help guide you. Dr Billica has a center north of Denver and is someone I recommend.
Thanks for the recommendation Trudy. I sure wish you we close by.
Hi Trudy,
I took xanax 2 years ago for about two and a haf months. I developped tinnitus around week 8 which I never had before. Today 2 years later having completely stopped xanax I still hear the ringing in the ears although slightly less loud. I tried everything to mae it go away but nothing wored. From magnesium, to zinc, gingko biloba etc. nothing helped. Today I’m consdering Glutamine to heal my gut and help with anxiety and blood sugar. Maybe it will help with the tinnitus too since it enhaces gaba. What do you think?
Thank you and god bless
Steve
Steve
Tinnitus is common with prior or current benzodiazepine use. When someone has anxiety and tinnitus I have found both GABA and serotonin support to be helpful but it depends on each person’s underlying biochemistry. This paper states that “…any imbalance of neurotransmitter-related chemistry could disrupt auditory processing in such a way as to produce tinnitus.” https://www.ncbi.nlm.nih.gov/pubmed/25477858
Hi Trudy,
Thank you for your answer. I think I have an imalance even two years now after I stopped xanax. I think I need to support GABA and Serotonin as I feel I’m missing both. I take zinc and b6 now; I dont know if that’s enough. Glutamine is not giving me great results; Im afraid it might be increasing Gltamate instead of GABA.
I also struggle with caffeine binging and I use espresso shots in excess, maybe tha’s contributing to anxiety and tinnitus. I have horrible withdrawal whenever I try to quit it. I have symptoms like dead brain and incapacity to form any thought or cognitive task.
help me please!
Steve
The precursors like zinc and B6 can make serotonin and GABA but using tryptophan and GABA is much more effective. And coffee has to go if there is any anxiety. I have clients use tyrosine and vitamin C to break the coffee addiction and help with focus/motivation/energy.
Hi trudy,
So how should I go first? Is it the tyrosine? How much? Then should I do the tryptophan and gaba as well? Both of them? I do have a sense of unease and many of the pyroluria symptoms. I have the tinnitus and the brain fog as well.
Thank you so much for your support and kindness
How do you feel about Bactrim or Macrobid for UTIs? Any issues?
Mackenzie
UTIs cannot be ignored but psychosis can happen and at-risk individuals should discuss with the prescribing doctor and be monitored – Antibiotic-associated psychosis during treatment of urinary tract infections: a systematic review https://pubmed.ncbi.nlm.nih.gov/24911441/
Bactrim – “Although trimethoprim-sulfamethoxazole (TMP-SMX) seldom causes psychosis, the side effect of visual and auditory hallucinations has been described previously, principally among immunocompromised persons and elderly patients. We are aware of only a single case report of psychosis in an immunologically competent teen and of no suicides or attempts attributed to TMP-SMX. Here, we report a case of catastrophic self-injury resulting from TMP-SMX–induced psychosis.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874755/