I'm back, but

Specific Illnesses & Conditions VM/MAV
1

Hello again…

Well, I’ve been absent since late August. I guess I ran out of things to say (been stuck in a holding pattern for a while) and wasn’t feeling up to being very social.

I’m in a bit of a complicated situation. Scott can attest to this … considering I weighted down his inbox with a book-size e-mail about the matter.

It occurred to me that, except for the first couple of months, I’ve been on drugs for this stupid thing for more than 2.5 years. And, I realized, I have no idea what my baseline is. (That is, if I wasn’t on any medicines at all, how would I be doing?)

I’m not so much concerned about all the preventatives I’ve had – it’s the benzos. From near the onset, I’ve been on a once-daily benzo. First Valium, later Xanax. The dose is a moderate 2 mg.

I know benzos – especially the short-acting ones – can themselves cause lots of symptoms, mainly when taken a for long time. So I wondered: “Am I still experiencing dizziness from migraine-associated vertigo … or from Xanax?”

It’s entirely possible for such drugs to gradually mimic / cause the same symptoms they once relieved. I found a manual by Heather Ashton, a leading expert on benzos. Tolerance / dependence can produce withdrawal-like symptoms, she said, and also: “Drug withdrawal reactions in general tend to consist of a mirror image of the drugs’ initial effects.”

So the upshot of it all is, if I want to know what I’m really dealing with, I have to get rid of the drugs (and allow a few months for some “reprogramming” upstairs). For all I know, the MAV cycle could have been shut off months ago (from one drug or another), and I’ve stayed dizzy due to a benzo.

Now I have find a taper plan. Unnerving, considering I’ve had a drug as a daily “lifeline” for so long – and not knowing what’s down the road. But I guess it’s the only way.

Well, that’s the “slightly less than fascinating” story of the last two months of my so-called life.

George

2

George,

If you’re still having dizziness while on these meds and have been for 2.5 years, I would say that they’re not working for the dizziness anyway right? I would taper off these meds and if there is no improvement for the dizziness, I’d try a preventative and see how that goes. Most dr.'s say if you don’t get results within the first 3 months, then it’s time to move on and try another med or add another med. Some doctors say 8 weeks and then move on.

Greg

3

(Hmm, knowing myself, maybe starting with “I’m back” wasn’t the best choice of words…)

Greg, I see your point. Thanks for the input, appreciate it.

Except for the very first 1-2 months, I’ve been on both a preventative (lots of them, actually) and a benzo. The idea was that, hopefully, a benzo would ‘get me through the day’ (less dizziness) until one of the preventatives started to help bring the actual condition under control.

As it is now, the benzos still work – somewhat. They aren’t as effective or long-acting as before. Of course, that’s pretty much how tolerance goes, so it’s not terribly surprising. I guess the question is whether the ‘dizzy symptoms’ are still coming from the disorder, or if it’s just one of the negatives of long-term use of a benzo.

The plan definitely is to taper off. I’m sure it’ll be pretty ugly – especially since I’m on a very short-half-life drug. Thankfully, my ‘regular’ doctor is committed to finding a good plan for how to taper and at what pace. Hain had proposed just reducing by 10% – each week. No thanks. I’d rather walk down this hill slowly, not bike down it at fifty miles an hour.

4

George,
can you switch over to Kon or Valium for the long half life value?
Kelley

5

Hi Kelley, (nice hearing from you by the way)

Well, yes, normally. “Crossover tapers” are common for people on Xanax, Ativan, etc – that’s the method I’d prefer. However, I am meeting with some resistance from the rest of the family. They are more of the opinion that I should simply keep the Xanax, drop the dose 10% or so about every two weeks. To summarize their thoughts: “Get it over with, even if it’s difficult. Just deal with it. Taking it slow will just prolong the process and the pain.”

This is completely and utterly at odds with everything I’ve read, including Dr Ashton, who says, “There is absolutely no doubt that anyone withdrawing from long-term benzodiazepines must reduce the dosage slowly.” With Xanax, she says, “it is not possible to achieve a smooth decline in blood and tissue concentrations” and that “mini-withdrawals” will occur between doses.

It seems like it’s all about everyone else. They’re saying, “You’ve had this for 2.5+ years. You have to get your life back. It’s been too long.” And then when I say I’ve researched the options, I don’t get agreement, just a repeated (implied) insistence that my way isn’t the right way.

I hate it.

6

Hi George
I don’t know how old you are, and why you would need the permission or approval of other family members other than the fact that you are a minor or they do not understand these conditions or the meds. Your best bet is to print out medical information on medication discontinuation (the sanitized term for withdrawal) and/or have a family member speak with the doctor that you see. “Cold turkey” or sudden discontinuation of any prescription medication that a person has used for some time can have disturbing or severe medical implications. I am a marriage and family therapist - I’ve had clients decide to discontinue anti-anxiety meds or anti-depressants too soon and land in the hospital or suffer unnecessary discontinuation effects that were quite uncomfortable. You need to follow the medical advice you are given. It’s apparent as well that your family does not understand MAV or migraine, and thinks that you will “get over this” after 2.5 years. All of us on the forum wish that were true. Tapering is by far the safest and wisest choice in discontinuation of a prescription medication unless a person has only take just a very short time.
Gail