How to Avoid Alp Tolerance

[Raven]

I know, the easy answer is don't ever go there to begin with!

Valium was my cure for many years, I used nothing else, but tolerance was building to what I considered an unacceptable level. So, I decided that I needed to try some other benzo alternative to obtain the level of medication required in order to control my GAD and associated tremors. I chose alprazolam and it has proven to be a perfect fit for me. I read a lot about this med. before I started taking it and developed a healthy respect early-on that this med. was a potential trap.

To date, after two years since I started taking alp as my go-to med., I have managed to keep my tolerance down. I try to cycle days-off when I can, but I have noticed that I have now hit a 72 hour "wall" when I cycle-off. The "wall" involves rebound anxiety, changes in heart rate, and related insomnia.

I do not want to stop taking alp, but I know that the symptoms I have experienced are related to a developing physical dependence on this med. That scares the hell out of me and I do not want to allow this dependence to develop further. So, where do I go from here? Does anyone have a recommendation for an intermediate med. that will help me to avoid a full-on physical dependence on alp? It works very well for me when I need it and I do not want to lose that effectiveness.

Thanks for your support.
Raven

[Sanzilla]

Raven I have been on alp for 20 years I know that is ridiculously long but true    I have had short periods where i have weaned down and completely off and always end up back on. In my personal experience I do obviously build up a tolerance but not so high that I consider it "to high". And by that I mean 2mg thrice daily. Good luck I wish you success.

[Bowser]

I have a tendency to ramble so apologies in advance but maybe i can be of help.

After 2 years, diaz again is your best bet. Are you familiar with the Ashton method?

I know that most people familiar with benzos are familiar with the method but just in case, please don't consider the following to be patronizing. Also, this IS IN NO WAY PERSONAL MEDICAL ADVICE. I will provide a source at the end from which you can draw your own conclusions.

The Ashton method (named for the UK professor Heather Ashton whom was the driving force in the development of this practice, not that that's important currently) involves a slow taper from long acting benzos. Since long term use of benzodiazepines interferes with the body's GABA production, most rebound symptoms are actually caused by under production of GABA by the user's body.

Benzodiazepine equivalency isn't a precise thing but it's generally accepted that ROUGHLY 1mg alprazolam= 1mg clonazepam= .75mg lorazepam= 10mg diazepam (just for examples of the 4 "big guys" and this comparison also varies from source to source and also depends on a person's physiology as well). Because of this it's generally a switch from clonazepam or, as is your case, alprazolam to diazepam because of the dosages.

Let's say you take a dose of alprazolam 3 times a day. Since diazepam is longer acting, you'd be a drooling mass of sleeping for days if you replaced all 3 doses with diazepam at once so you'd switch one dose a day out over a few weeks.

Once all daily doses are switched to the longer acting med, you very slowly taper your dose down, 1-2mg every one to three weeks. Once you've gotten yourself down to where you'd like to be, you can stay with diazepam or switch back to alprazolam, whatever you feel comfortable with.

This is meant to be a permanent solution but in my experiences there is no finality to dependence on alprazolam. To be totally honest, this can take up to 60 weeks to comfortably get to a small, manageable dosage. I personally have gone through this process myself 3 times though I must admit they were all significantly shorter periods of time because of relatively small doses. I do adore this method and the professor responsible for its creation, benzo dependency can cause a lot of problems and is only comparable to what I imagine he'll to be.

Oh, it also may be worth looking into chlordiazepoxide (Librium). I know that can be helpful with some people.

I'm not sure if it's alright to post links so I'm sorry if I'm breaking a rule I overlooked but this is a short guide to this method. http://www.benzo.org.uk/manual/

[Goyakla1]

I Can Highly recomened Heathers site.. I have used it for comparison and gain knowledge of how to manage doses and What NOT to do..ull have to go Down very slowly over weeks and use a long acting
Diazepam as vals in the proces.

[Raven]

After 2 years you are already dependent on it. Your option is to continue, or wean off with your doctor's help.

Thanks all for your helpful replies. I think Mrchuckey is right on dependency, but let me add a bit more perspective. Since dropping V and switching to Alp. I have found that a baseline dose of 1 Mg. / Day allows me to get through the day without any withdrawal effects. However, under stressful situations, I need to boost to a short term (1 day) dose of up to 6 Mg in order to control my conditions. Next day, I go back to my baseline dose and everything seems to be fine. I know this is not the way this med. was meant to be administered, but it seems to be working for me. What worries me is that my low baseline dose may, in the near future, no longer prevent the on-set of withdrawal. I need to check out Ashton as recommended. I may need to consider replacing the 1 Mg. / Day Alp with V for non-stress inducing days. To have an alternate med. that would help me to prevent building further tolerance to Alp would be my ultimate goal.

Thanks again to all for your helpful comments.
Raven

[Goyakla1]

Good... We are glad to be of help

[Bowser]

After 2 years you are already dependent on it. Your option is to continue, or wean off with your doctor's help.

Thanks all for your helpful replies. I think Mrchuckey is right on dependency, but let me add a bit more perspective. Since dropping V and switching to Alp. I have found that a baseline dose of 1 Mg. / Day allows me to get through the day without any withdrawal effects. However, under stressful situations, I need to boost to a short term (1 day) dose of up to 6 Mg in order to control my conditions. Next day, I go back to my baseline dose and everything seems to be fine. I know this is not the way this med. was meant to be administered, but it seems to be working for me. What worries me is that my low baseline dose may, in the near future, no longer prevent the on-set of withdrawal. I need to check out Ashton as recommended. I may need to consider replacing the 1 Mg. / Day Alp with V for non-stress inducing days. To have an alternate med. that would help me to prevent building further tolerance to Alp would be my ultimate goal.

Thanks again to all for your helpful comments.
Raven

Most welcome for any help I contributed. I thought I'd add something else... I only taper when I over think things. I have almost the same dose schedule as you. I don't go as high as 6mg, though. Usually .5 twice a day, some days I'll occasionally have to take 3mg but never past that. That's been about 3 years or so. If you're anything like me, you have about 6 months left to start to work your way down. I'm by no means saying wait to start, whenever you're ready, you're ready. Only you can decide that. Either way, don't rush into it and don't rush once you do start. I'd personally get down to 1mg across the board but that's just me.

One last thought... I don't know if you're familiar with RC benzos but there are a few that could help you but you'd need to be EXTREMELY confident in your measuring/dosing abilities. If you're not, stay the hell away, it could end up VERY badly. The upsides though are half lives longer than diazepam and extremely low active dose thresholds. If you would be interested in that id be happy to talk it over with you.

[bio2016]

Sorry to hear about your situation Raven ...there is no easy way to solve this ...the only thing you can do is switch around your benzos you go from Xanax to Clonazepam,sometimes to valium ...they all have a similiar molecular structure as we all know they are in the same benzo family ...however as their molecula still has differencies ,think about this that way ..when you go to the gym to loose weight your treiner gives you a set of excersize for the next 20-30 days and your body spends a lot of energy to adapt to these excersizes ..however with the days passing your body learns to make these excersizes withought spending the same amount of the energy,our body is smart that way ..so what the treiner does he changes the set of the excersizes to make your body work again...he makes your same muscles work but in a little different manner ....the same we do when we are switching the the benzos around these little differencies in the molecular structure are kind of doing the same thing as a  treiner in the gym chnaging your excersizes..i deffiniatly recomend that Raven