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Benzos long term/ short term


Kellen
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It's pretty evident I'm going to need clono to get over this lamictal withdrawal and may stay on it for a while until I even out some. I just took one after what was one of the worst mornings I've had I feel a tiny bit better.

I'm just curious what is considered short term vs long term usage? Like how many weeks or months or even years? It literally is the only thing that's helping right now.

Also is it possible for your hppd to heal while you're taking it? Or will it totally inhibit any natural decrease in symptoms?

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The problem with benzos is true with all meds affecting neurotransmitters: namely tolerance.  It is just that with benzos, the receptors can quickly down-regulate.  Valium is the quickest, with Xanax possibly being the next.  Klonopin isn't so bad but when people have been on it for months or years, it takes plenty of time (months) to get off.  What tolerance (down-regulating) means is that neurons reduce the number of receptors in order to compensate for the abundance of stimulation from a drug ... in this case a benzo 'stimulating' a GABA site (GABA sites reduce neuron activity, so stimulating them quiets a neuron).  See https://en.wikipedia.org/wiki/Drug_tolerance

 

Haven't read accounts of Klonopin interfering with recovery.  The main issue is that it doesn't fix the problem, just 'manages' it.  And then when you reduce the dose, symptoms return.  In general (HPPD or otherwise) getting off Klonopin involves increased insomnia and anxiety.

 

So don't feel bad that you can use a med that helps you feel better for now.  Just keep the above in mind.  For what it is worth, some use Gabapentin to get off of benzos.  You may wish to try Gabapentin for your HPPD.  While haven't heard of it helping visuals of HPPD, it usually helps both anxiety and sleep.  For some reason, Gabapentin has very little tolerance issues.  But isn't sexy younger sister Lyrica is reported to have withdrawal issues, so be cautious if a doc offers you that instead of Gabapentin without at least trying Gabapentin first.

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  • 4 weeks later...

Strangely enough klonopin makes me really sad when I take it while lorazepam does not.

And I'm surprised about the gabapentin. I've heard that tolerance and withdrawal/addiction can be a problem with it. Granted that's just from a quick google search but yea I feel like if it didn't have those issues it would be a miracle drug for people addicted to alcohol or benzos. Either way not saying don't try it in the same way I don't dissuade people from trying benzos because GABA can really make a difference in our quality of life.

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Short term is usually 4 weeks or less, at least according to literature and all that. Personally, I would consider it short term use if you're only on it for 3 months or less. Any longer and I would consider that long term use. I've been on clonazepam for 9ish months now, so long term use here.

 

The main problem with benzos is that, while they're not necessarily addictive, it's very easy to become dependent on them, especially with long term use. Not to mention, tolerance for benzos builds quickly, my psychiatrist said that tolerance would start kicking in around the 3 week mark. That's why benzos are risky. Once the tolerance starts to build, people start taking more to get the same effect as they had in those first few weeks thereby worsening their dependence on it. Thankfully, I didn't follow that route and stuck to my prescribed dose (though I have on occasion taken 1 or 2 extra if it was a particularly distressing day). Nonetheless, considering how long I've been on it, there's no doubt I'm dependent on it both physically and psychologically despite (mostly) sticking to my prescribed bounds. I could tell this was evident when I had to go a day without it because the pharmacy said it was too early to pick up my script. I did not feel well at all that day and who knows what would have happened if I had to go longer, and I am certainly not looking forward to tapering off this stuff.

 

Anyways, point is, benzos are a dangerous path to go down and you should tread lightly. Stick to what you're prescription says and you should be fine.

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I'm on 2mg daily (1mg in the morning, 1mg at night preferably an hour or so before bed). I've been on this dose for ~9 months, so this taper is going to be long and hard (probably upwards of a year and a half). I'm planning on doing a liquid taper between 0.1% and 0.5% daily, so about 0.7% to 3.5% per week until I reach about 0.0625mg or lower and then jump off at that point.

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I know the Ashton protocol calls for a dry taper w/ diazepam substitution which I believe takes 26 weeks. The problem is that with a dry taper and diazepam substitution is that as you progress, the actual percentage reductions actually increase. With a liquid taper you can accurately control and maintain your weekly/daily reductions and they don't increase as you continue the taper. A liquid taper, although it takes longer usually affords little to no withdrawal symptoms since the reductions are so small. Another downside of the dry taper is that you have to get a prescription for a variety of diazepam doses plus other dosages of your original prescription, with a liquid taper you just keep your normal dosage and do a little math for your reductions.

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