Struggling with my taper
 

I am seriously looking into the option of using an Ativan, etc. to attenuate the bad 2nd day withdrawal after a reduction. Someone on another forum has said to me "...I would strongly recommend against taking Ativan or any other Benzo. These drugs further 'dull' or down regulate your gaba receptors and therefore will only postpone your recovery. My recommendation would be to slow down your taper significantly rather than adding other meds...." Ideally I would like to reduce 200mg/week w/ one day of benzo relief — is this just completely ridiculous plan? My doctor still tells me "there is no such thing as Gabapentin withdrawal and any benzos for attenutation are unjustified!" What do you think? :confused:

To clarify, the person who said this was on 9mg Xianax/day 2005-2010 tapering to 5mg 2010 and on 2700mg Gabapentin 2005-2008 tapering to 900mg by 2008 but has held at this until now while tapering off 5mg Xanax until zero now. She still uses 900mg of Gabapentin today. I think this a NIGHT AND DAY difference from what you advise about my situation when you recommend attenuating with a one day a week use of a benzo during a step-down from my 1900mg of Gabapentin which rightly say is: "...different than taking it every day for a month or more, and is less likely to produce/trigger another dependence (or one for another)." Am I correct in understanding that after a dose reduction of Gabapentin when the level in the blood drops the over stimulation of the dulled Gaba receptors causes withdrawal symptoms but that unlike other drugs this imbalance levels off relatively quickly? In my case the second day after a dose-reduction is real BAD! I am hoping by getting past this day with benzo-attenuation I will not be too discouraged or scared to move on to the next dose reduction. After all, the most important point is to continually forge ahead towards being free of this s***, right?!

Most obliged for you counsel in this regard. Like you, I too more so than most other people depend on the sharpness and acuity of my intellectual/analytic faculties to do my work.

It's going to be difficult to convince a physician who has already made up his mind despite any evidence to the contrary. Almost every credible site on the net acknowledges gabapentin withdrawal. To be honest, I think you need a doctor who believes you and has better knowledge of this medication, but I'm just some guy on the internet, and I can't/won't tell anyone what to do.

For evidence, I might start here: scholarly gabapentin withdrawal
Preceding a search with "scholarly" usually nets scholarly/scientific papers, studies, etc. There are other sources—PubMed, medical journals... some others here may have other ideas, or ask a good librarian...

But I have to add that IME, most doctors dismiss anything that comes from the internet. Some don't, but they're few & far between. It may or may not help to ask him outright what it will take in the way of credible evidence to convince him, but... :Dunno:

Whether a benzodiazapine is the best attenuator, I'm going by what has been offered to patients for withdrawl from other substances (i.e. opioids, alcohol) because some sources have compared gabapentin withdrawal to those in some respects. Also that the risk of dependence with occasional use is far less than with regular use. If you run into problems, I would think you'd find out rather quickly—before any dependence kicked in.

I know what this stuff (gabapentin) can do to you, and my wife is having issues with it right now, but as it has some therapeutic effect for her, it's a more difficult decision.

Ultimately, I think you have to do some digging and decide for yourself. We'll all be here to help any way we can.

Doc

I thought I missed this, then noticed the time-stamp on the edit. :D

That is my understanding, but one thing I've learned here is that everyone (and everyone's responses) are different. Times, dosages, durations, other variables—are all based on bell curves established by studies, so it stands to reason there are certain people who will fall at either end of the bell/outside the "norm".

I think it's great that you've been able to nail down that 2nd day, and hope it's reliably constant.

Doc

What was your experience withdrawing?
 

I know you are not a doctor just a fictional one. I too am a Dr. (but merely a Ph.D.). Of course I will have to make up my own mind. I've read a lot of articles about Gabapenitn withdrawal on the internet. The anecdotal accounts of people are filled with reports that it is as bad as or worse than benzos, alcohol, heroin, etc. What was your experience withdrawing from Gabapentin? Did you use anything to attenuate it, or did you just taper off or just quit? How long were you on it? Did it take you a long time?

My nickname has always been "Doc", and when my spine deteriorated (degenerative disc disease) and left me in chronic pain, Dr. Smith's catchphrase (to my warped sense of humor) seemed a natural, and has helped me deal with it.

I stuck gabapentin out for a month, then stopped due to the side effects I described (post #29). I know I didn't use anything to attenuate, and I tapered within a week. I was in a lot of pain at the time, and since the gabapentin wasn't helping it, the pain may have masked or overridden some or all of any withdrawal, if there was any. It was hell just to be on the stuff, so getting off of it was a relief, and I still felt foggy/unable to think properly for a few weeks afterward—maybe another month.

I have some cognitive trouble, and I'm a little slower than I used to be. I have difficulty with vocabulary, usage, grammar, and expressing myself. I don't write/communicate like I used to; I know that I know the words—I just can't always find/call them up like I used to, or decide on one, so I use a lot of slashes /. I thought it was just middle age—at least I hope so. :Dunno:

Doc

dear fellow sufferer of chronic pain
i hear you screams of frustration
i suffer with chronic pain that my surgeon
just swept me under the rug like i
was a piece of dirt
and to stay on point
being a recovering alcoholic for over 20 years
and only a fellow addict be able
to understand my choice of drug
was alcohol i am now a slave to meds
as you talk of because
if i miss one dose i start withdrawal
and the medicine i am on is a direct
result of my ever so screwed up surgery
i wish i did not have to have the second surgery
that when my life ended as i knew it
E V E R Y T H I N G HAS CHANGED LIVING
I C O N S T A N T P A I N
YOU READ RIGHT SWEPT ME UNDER THE RUG
WHILE I HAD MY BREASTS REMOVED AS I FOUND
A LUMP
HE NEVER CONTACTED ME WHY I YET TO FIND
OUT
I AM BEING TAKEN TO COURT
HE IS SUING ME FOR THE BALANCE
OF THE FAILED SURGERY

I WILL INTEND TO MAKE A DIFFERENCE
FOR NOW I HAVE TO TAKE MED THAT
PERSONS SEEK A "HIGH" FROM
TO BE IN RECOVERY AND FOR MY MEDS
OF WHICH I NEVER ABUSED FOR OBVIOUS
REASONS


WILL BE FOREVER A SLAVE TO DRUGS THAT
YOU JUST CANNOT STOP
AND FOR THOSE LIKE YOURSELF
I EMPATHIZES WITH YOUR WITHDRAWAL DILEMMA

i believe doctors do such things
as getting them hooked
to may have to loose in this corrupt world

i wish you comfort in having to go
through this because doctors aren't all
about the oath they took

someone who cares

Hi Adamo
 

All the discomfort you feel will have an end. Guess that is what I told myself getting off a medication. You need your doctor to address your discomfort more. My doctor gave klonopin which took the edge off the first several months. If you can reduce at a slower rate, the symptoms may ease up. I know it isn't fun. I know another person on NT, going through this same issue with your same medication. He had tapered himself down. It is really important however that your doctor be a big part of this. He needs to support you while you don't feel very well. Keep as hydrated as you can be. Keep coming back. All of us who have gone through similar issues will be here to give support. ginnie:grouphug:

Ginnie
She is a special angel
Love you girl

Someone who cares

Glad to have you on the forum. Umm gabapentin is an anticonvulsant used for seizures and chronic pain. That might be why its not helping with your depression. Hope your docs get your meds figured out.

Using a rescue med on an as-needed/occasional basis
 

Hi Adamo,

Sorry to hear that your taper is still problematic. :( You really don't sound good. In these circumstances, it could be useful to choose the "in between" route of using a benzo as a rescue med every 5 days or so (i.e. on the second day after you decrease your gabapentin dose)

Unfortunately, to be able to use a benzo, you need a prescription so it is essential to find a supportive doctor. It wouldn't need to be a specialist though. If you have a good relationship with your GP, he or she might help you.

Many doctors do resist the notion of "withdrawal" from gabapentin, regardless of any documentation. As I've suggested before, you'll do yourself a favor if you use vocabulary that is compatible with their mindset. Specifically, I'd avoid the word "withdrawal" when it comes to gabapentin.

You could describe your situation thus:

• You are undergoing gradual suspension of Gabapentin, using reductions of only 100 mg every few days.
  
  
• You have severe anxious symptoms after each reduction. Describe the symptoms -- they speak for themselves.

You'd then need to ask if the doctor can give you a rescue medication to use only on an occasional basis, for the severe bouts of anxiety.

--------------------

IF you are given something, ask the doctor for precise instructions on the time between doses, in order to avoid addiction.

waves