09-07-2016, 02:40 PM
(This post was last modified: 09-07-2016, 02:47 PM by GreekDuck.)
(07-07-2016, 11:38 AM)Exxplorer Wrote: Hi, what's about Subutex ? I won't find any good reason to take Trazodone for opoids withdrawals ..apart providing an easier sleep (and not always working, if not you get a worrying headache, not welcomed).
Maybe it will calm you down, for me it doesn't really helped, ok in rare cases as sleep pill, often it's slowing racing thoughts, and anxiety related to it, longer night; but for me it was quite useless regarding Subutex/Suboxone, and Buprenorphine is only a partial agonist not like Methadone, it's easier to get ride of it, with Methadone much more peolpe keep taking brown.
And the good old loved benzos of course.
Some comments on substitution treatment and buprenorphine versus methadone.
Normally, you will read that methadone will influence cognition, memory and energy level negatively to a much higher degree that buprenorphine making buprenorphine preferable from methadone in many cases. You will also see people claiming that the withdrawals caused by methadone are a lot worse that what buprenorphine cause. Thus, there are many reasons to prefer buprenorphine from methadone if you are in substitution treatment. One more reason is, as you say, that you can take heroin while being on methadone while buprenorphine blocks heroin unless you take a very high dose. However, I have seen many say that buprenorphine do not bind strongly enough to receptors to block Fentanyl, due to the potency of fentanyl. Thus, abusing fentanyl while being on buprenorphine is a possibility. It is a very dangerous possibility however, as people OD even more from the combination of buprenorphine and fentanyl as the buprenorphine still might reduce the effects of fentanyl resulting in people taking high and dangerous doses of fentanyl. There is very little difference between the dose of fentanyl that makes you high and the dose that kills you. People often underestimate how little one microgram actually is compared to one miligram.
However, methadone is often much more succesful in handling opiat cravings compared to buprenorphine as buprenorphine is only a partial agonist, as you point out, while methadone is a full mu opioid agonist. Methadone is said to be able to block other opioids, as well as buprenorphine, but this only happens at higher doses - mostly 80 mg is mentioned as close to the dose where methadone starts to block other opioids. I have been on 60 mg of methadone in combination with 200 mg oxycodone for pain management, and I had no difficulties feeling the oxycodone.
Most people agree that in substitution treatment, buprenorphine is to prefer from methadone as buprenorphine normally causes less side effects and by many accounts it is easier to quit buprenorphine than it is to quit methadone. However, methadone might be better at preventing relapses as it is a full agonist whereas buprenorphine do not remove cravings to the same degree. So for some, methadone is after all the best solution as it might be better at preventing relapse. After all, it is better to take methadone than being on buprenorphine and relapsing.
12-07-2016, 10:56 PM
(This post was last modified: 19-07-2016, 06:29 PM by Exxplorer.
Edit Reason: edit
Hi, gratefully I'm out of it now, but I keep this new chem in mind..just in case, and maybe it will help friends with their withdrawal, some of them actually really want to quit it, but the pain and these flu-like symptoms are one of the big deal, the other to be craving.
About my benzo taper, I quit it for a few days, but had severe anxiety attack, horrible paranoia, so for now I'm up to 10 mg Diazépam / day, and 0.5 mg Alprazolam once or twice a days or one half generic Lorazepam ( so 1.25 mg ).
I was feeling really bad, maybe not only because of no benzos, there are always reasons that put you at tension.
Will see the doc this week to talk about that, because for now I take 10 mg Diazepam preventative, to avoid hard panic attack (the come-up is slower/delayed, so I gain about 5-10 minutes, I feel the physical symptoms first and have the time to take Alprazolam before I go crazy).
But that's non-sens for one that want to quit benzos, so I will ask him if it may be ok, to reduce Diazepam again, and have Alprazolam ''in case'' , so I no longer have to take Diazepam to slower the panic attack peak (Alprazolam works after only 15-20 minutes, and they can seem to be hours when you have a serious panic attack; Diazepam is quite useless for acute attack, to slow to peak (about 30-45 min for me).
All good all, I will keep it on date.
Witch would be the best for occasional panic attacks between Lorazepam and Alprazolam, regarding rebound anxiety and the fact that I'm at 10 mg Diazepam / day ?
Just wan't to know what you think about it, as the 2 works great for me, but I used to be at 30-40+ mg Diazepam / day at the time I took Alprazolam for acute anxiety, so I may not have experienced these rebound effects ?!
As I plan to quit benzos, stop taking Diazepam but still want (need) something in the case it feels out of control.
For me Alprazolam worked faster and it's really welcomed while having a panic attack, time gets slow......
Many thanks all !
No one? I go see my doc tomorrow and will ask for one of them, no advice?
I'm very sad right now, I know I can't go without it for now, ...
Results: I told him what was going on, I'm now on Quietapine, Diazepam just to end my taper (I will no longer take it, doesn't prevent a panic attack) and Alprazolam for my anxiety, when needed. I had Quietapine quite a time back and all I remembered was that it sedated me a lot, now I tried it again, it has greatly reduced my anxiety and no more paranoid thinking I'm just good again, but it will not last I don't want to be zoned all the time, I will need to face and cope with my anxiety crisis as good as I can, but thankfully I get a ''pause'' in my life, I really needed that, I was turning badly mad.
Hope to be out of it soon.
Freedom is something you have to fight for, or it slowly leaves humanity'soul.
20-07-2016, 11:02 PM
(This post was last modified: 20-07-2016, 11:04 PM by cichlids.)
21-07-2016, 11:42 PM
(This post was last modified: 02-01-2017, 02:13 PM by Exxplorer.
Edit Reason: edit reason
Note: I feel way better now, it's all good, I don't feel impaired, just more stable, less confusion and anxiety/paranoia I build new social interactions and want to live again.
For someone who feels lost in drugs, lost in life.
For someone suffering with anxiety...
I went trough several years of benzos and many kind of drugs, mainly illegals ones, I loved psychedelics, and I think I still love them, with more respect.
I had to quit Brown, with +/- 4 years of ''occassional use'' and 2 years of daily use, mostly smoked, I got used to smoke coke also, so you see the picture, I was living to be drugged, unless I would be really sick, and mad...with huge mixed feeling of anger and sadness...
I switched from Diazepam to Bromazepam, far more effective against anxiety, and less sedating in fact it's somehow giving me energy/motivation and let me enjoy my all-days time better.
To get off opiates I had Suboxone (before seeking help by a Doctor I was taking Methadone, no to have a ''crash'', in between doses), went from 18 mg to zero, in about 4 months, the longer and harder part was at the end, I struggled the last month when I had to get below 3 mg, tipical withdrawal, but less intense, but overall Suboxone is a nasty drug, but it can save you (as if you take opiates while on it you wast your material, you don't get that rush anymore...it makes opiates almost ineffective, or weird).
Before tapering from opiates I had to taper from benzo, to find the ''equivalent dosage'' with what I was taking I had something like, daily:
->7 to 9 times Diazepam (10 mg each, so total 70 to 90 mg)
->2 times Lorazepam (2.5 mg, morning and night, total 5 mg)
->Alprazolam (1 or 2.5 mg) ''as needed'' while I had a panic attack, yeah even with all these benzos in my body I still had horrible panic attack with extreme paranoia.
So I took it sometimes twice a day, someday whiteout it...(Average, let say 1-2 mg).
That was per day, I let you image all the benzo boxes I had here and there in the house...chaos!
First I reduced Diazepam and in the same time I got ride of Lorazepam (switching to 1 mg then zero), first hard part, also tried to take less Alprazolam, I had really bad ideas at that time, I wanted to stop all of this, I was at the point to quit my taper, but with a bit of time to accommodate myself to new lower dosage.
Then I lowered Diazepam dosage to 50 mg and completely quit Lorazepam, and took as few Alprazolam as possible (once all 2 days approx...) again I had to ''stabilize'' myself, it took me 3 months, it was hard at the begining.
Thirth stage was putting Diazepam consumption down to 30 mg, but on the other side I took a bit more often Alprazolam as I was getting really confused, paranoid and almost anti-social.
Again I stayed at this stage for about 2 months.
Then 20 mg Diaz daily....then 15, then 10, again, new stage to stabilise, about a month.
I went to the point I no longer took benzos, it lasted about 2 weeks, but for now I take them occasionally, and I've found the perfect benzo that switch my anxiety issue: Bromazepam, really good one!
I still have Alprazolam in case of heavy panic attack, but it's really less commun than prior to my taper, but I must admit I still ''need'' benzos sometimes, they are really helpful in some cases.
Also for anecdotal report, I tried Lormetazepam as sleep aid, yes it's effective, I would range it's hypnotic potency like this: 1 mg equiv <= 2 mg Lorazepam, equiv <= 20-25 mg Diaz, but nothing stunning...
Yo yes, I forgot to mention that I use Quetiapine in the range of 25-75 mg (sometimes 100 mg, exceptions) as sleep aid, it also calms down parasites thoughts...
Note about Bromazepam (pure anxiolytic no sedation at all)
Bromazepam is something between Lorazepam (but almost no sedation) and Alprazolam, but with a duration slightly greater than Lorazepam, with a come-up at t+20/t+30 min, and peak at 1-2 hours, full effects lasting about 6-7 hours, after effects (come-down) lasting about the same time, total duration is near to 14-15 hours with a relatively nice afterglow.
Good for social anxiety (I'm more talkative) and general anxiety, the come-up is a bit slow for a panic attack, I would recommend Alprazolam for this purpose, but it's ok if you take it right before the panic attack, when you feel it's coming one.
There is no much infos about this benzo, sadly, because it's a winner old-timer benzo.
All good people, I may not come back here, as the site seems to be almost down.
Always keep in mind that things change, time passes, and things also go away, we have to catch the good things and wait for the bad ones to go.
Free of drugs, benzos, opiates,... I'm back, but I don't know who I prefer, me now, or the other one I used to be when drugged all the time, that's another question, IT's DONE!
FINISH tapers , now free of all these shit.
Took me over a year to come off benzos (and I still need them sometimes, and appreciate them..) and 5 hard months to come off opiates, during all my taper I had a lot of confusion, memory and personality issues, flashbacks, and hallucinations (like enlightened spots moving, seing shadows, earing people talking about me, but it's more paranoid than hallucinations, depression...and physically I felt pains, loss of energy, really poor sleep and sweating a lot with cold sweets...
But if I could do it, you can to!
ALL GOOD MATE! Tomorrow can only be better...I kept telling myself that.
PEACE to the reader.
Freedom is something you have to fight for, or it slowly leaves humanity'soul.
02-01-2017, 01:32 PM
(This post was last modified: 02-01-2017, 02:25 PM by Exxplorer.)
Goodbye, good luck, one unique life, it's time to live not just to exist.
Freedom is something you have to fight for, or it slowly leaves humanity'soul.
Fair play to you Exxplorer for sorting it out & I'm sorry to not have seen this page before. I hope you're still well and you're right, living is so much more than just existence
This.....is real life
I only drop by occasionally, but I am very glad to hear that things are going well for you.
With all the usual disclaimers (educated opinion and hearsay evidence is not medical advice as to what's right for you):
A couple of notes about quetiapine, of which I have had a couple of courses over the years but never seen fit to stay on it for long. You may wish to be aware that it has a dose-dependent mechanism of action, whereby at low doses (< 100mg) it binds firstly to the histamine receptor H1, producing much the same effect as a sedating antihistamine (e.g. hydroxyzine, promethazine) with little in the way of mood stabilising or anti-psychotic effects. Many people use it as a sleep aid, but where it is not needed at mood-stabilising or anti-psychotic doses, it may not be ideal for that use. As you will probably be aware, quetiapine is a thienodiazepene anti-psychotic, and whilst it's a distinct improvement compared with opiates or benzodiazepenes, you sound like you don't want to use heavier drugs than you need.
The important bit: whilst quetiapine no doubt impacts on GABA levels, the mechanism that assists with sleep in low dose quetiapine is that of the first generation antihistamines and not the same mechanism as with predominantly GABAergic drugs such as alcohol, the benzodiazepenes, pregabalin or whatever. Meaning, in essence, that it's less habit-forming and more easily substituted - if 25-75mg of quetiapine now assists with sleep, well, so might lesser drugs. You could ask your doctor about this - it's great that you are consulting with one and not doing it all on your own.
At slightly higher doses (~200mg daily, so I am told) quetiapine starts to exhibit more affinity for the serotonin receptors and produces more in the way of serotonin reuptake inhibition, essentially an 'anti-depressant' effect, hence why quetiapine is prescribed as a 'mood stabiliser' at ~200mg daily. There is a degree of dopamine reuptake inhibition too (I find it too sedating at these doses and am not recommending it where not indicated) but it does not exert a 'heavy-duty' anti-psychotic effect at these doses. Last time I consulted with a psychiatrist about it, a few years ago, his understanding from relatively recent research was that for that application (mood stabilisation) the majority of patients derived optimal benefit from 200mg daily and that for that application, 300mg doses tended to produce excess and unwelcome sedation to no added benefit. Essentially, the lower dose improved the chances of the patient continuing with the medication (personally I didn't welcome it at 200mg either, but would agree that the aforementioned advice seems accurate, at least to some degree.)
On doses of ~300mg and above, having saturated the histamine receptors and bound to some of the serotonin receptors, higher concentrations of quetiapine start to blockade the dopamine receptor D2, which is the primary mechanism for the anti-psychotic effect. There's also some alpha-1 blocking activity, not worth getting into here, but I'll link you to an excellent article on the dose-dependent affinity of quetiapine
if you wish to understand further. The drug referred to in the article by its US brand name, Seroquel, is quetiapine, whilst the comparisons drawn in the article with Zyprexa are referring to olanzapine.
This makes quetiapine either a wonder drug or a curse (you decide!), because it's a completely different drug in terms of its functional pharmacodynamics at a dose of 25-50mg as compared with 200-300mg. The potential good news about this, for your situation, is that what you're occasionally using as a sleep aid is producing the effect that it does primarily by the mechanism of a sedating anti-histamine, which may mean that quetiapine at those doses is not more or less useful to you than a sedating antihistamine (less habit-forming, prescribable virtually anywhere, in some places available via pharmacies without prescription). My suggestion would be, if you have a doctor who has supported you through tapering off a benzodiazepene, that it would be very reasonable to ask whether there are lesser alternatives to using low dose quetiapine pro re nata
as a sleep aid.
Finally, I'd echo a big "well done" for getting yourself into a position where this becomes at all relevant and I can suggest discussing that with your doctor - in the face of an opiate addiction, a benzodiazepene addiction or a need for quetiapine as an anti-psychotic, I couldn't have suggested that a sedating antihistamine (sold here as over the counter sleep aids) would have been any more use to you than a cup of cocoa. You're now in a position where it is my understanding and experience (you can discuss with your doctor what's appropriate to you) that low dose quetiapine for a sleep aid isn't obviously more effective than a first generation antihistamine, which provides the same primary pharmacological action (H1 receptor blockade) as does low dose quetiapine. Whether or not you choose to act on it, it is excellent
news that you are in a position to contemplate it and to discuss the idea with your doctor or pharmacist if you so decide.
I will conclude with a personal note - no suggestion that it applies to you, but does to me. The same issues previously diagnosed in me as various forms of bipolar disorder and treated less than successfully with quetiapine (insomnia and disturbances of circadian rhythm, instability of mood, impulsive behaviours, addictive behaviours, irritability, hypomanias, flight of ideas) have since been rediagnosed as ADHD (increasingly now diagnosed in adults) and are now treated with 60mg/day of dextroamphetamine in divided doses, which as a central nervous system stimulant couldn't be much more opposite to quetiapine. The effects have included a reduction in impulsive/addictive behaviours, increased focus (some of the time) and a general stabilisation of mood.
I have no idea whether ADHD is relevant to you or what is the state of play here, now, today with diagnosing adults in your country of residence. However, it's perhaps worth mentioning that addictive behaviours, sleep disturbances and so forth are quite typical with ADHD, and it can be the case that behaviours or needs that we or the medics have sought to knock on the head with sedatives (prescribed and otherwise) respond (in 80% of patients with ADHD) to a very different approach. Of course, this is another thing that can only usefully be considered now that the issue is no longer "a substance misuse problem". It may not be relevant to you - and with a history of addiction I would unequivocally advise against any self-medicating with stimulants, for the record - but you seem highly motivated to avoid using sedatives of all sorts, prescribed and otherwise, which would suggest to me that you don't find them very helpful. This may or may not imply a case for treating the opposite side of the problem - if nothing suffices, why add to it? - but equally, a history of addictive behaviours suggests that perhaps nothing doesn't entirely 'suffice', more that you've established that sedatives are not helpful and acted accordingly. If the problem was only your use of sedatives, then well done, you've fixed it already. If after that you find yourself struggling with attention, impulsive behaviours or sleep disturbances beyond what might be expected, that may vaguely resemble a mental illness but don't seem to answer to one, and that do not benefit from sustained anti-psychotic treatment, then you might want to look into developments in the understanding of ADHD in adults. Hopefully you face no such issues, but there's a very strong correlation between ADHD and "substance misuse issues". If it becomes relevant, it's another line of enquiry that should not prove controversial to a doctor familiar with a patient's history of addictive or impulsive behaviours, although the state of services for ADHD in adults varies from country to country.
Either way, well done for all the progress to date and thank you for dropping by to let us know. Whilst it's you who's done the hard bit, we are invariably glad to hear about it when advice or input from the forum leads to an improvement in someone's quality of life. If that last post should be your final farewell, peace and all good wishes for the future. If not, well, we take a broader view of harm reduction and quality of life than merely ceasing to use a drug that proves troublesome, so if you think we might be of help, try us. All the best.