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Dr_Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience:  Psychiatrist
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I have been taking valium 1 to 3 times a week at 2.5mg for

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I have been taking valium 1 to 3 times a week at 2.5mg for the past 6 months. When I don't take it, I am fine the next day.

I had an acute medical issue a few weeks ago I subsequently, took .25 mg of xanax for 11 nights, discontinued then the next 4 nights took oxycodone for broken rib pain.

After 14 nights, I am insomniac, tired, anxious- I went to a doctor and he gave me two choices, but just as good. Reinstate at 2mg of valium and taper off or stay withdrawn. The risk to staying withdrawn is protracted withdrawl.

Would I get protracted withdrawl from having taken xanax and oxycodone for about 14 nights? Is it more common in chronic, high doseage users? I am nervous to reinstate because I don't want to deal with this withdrawl again... Give me some good advice.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr_Anderson replied 2 years ago.

Dr_Anderson : Greetings, and thank you for your question. I wanted tyo clarify something - did you take both the Valium and the Xanax? Did you stop the Valium during the time of the Xanax? Why was the Xanax given for the medical issue rather than opting for increasing the Valium? I'll be able to better answer your question with a bit more info, but the long and short of it is it is very unusual to get protracted withdrawal from only 2 weeks (or less) of Xanax use.
Dr_Anderson : I look forward to your extra information and to helping out!
Dr_Anderson : Regards,
Dr_Anderson : Dr. Anderson
Expert:  Dr_Anderson replied 2 years ago.
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Customer: replied 2 years ago.

The valium was what I take during the course of the 6 months as needed.

 

I took the xanax because I had an abscess that was very painful and i though xanax would be better than valium since its more powerful. I may have taken valium once during the course of the 11 days I took xanax, but I only took xanax in the past year during those 11 days.

 

 

Customer: replied 2 years ago.

My real concern has been this withdrawl has been particularly hard even for the short duration of the xanax.

 

If i reinstate valium, I'd go to 2 mg and taper off. I am very concerned that if I get to 1mg or .5, I will be right back to where I started. But I would potentially limit my risk of protracted withdrawl.

 

If it means anything, 2 years ago I came off taking ambien for 5 years nightly and also an acute 3 months of xanax for a major stomach issue. That was a cold turkey withdrawl that was hard, but I do beleive I tapered off 2mg in 2 weeks with success. I am really nervous now about putting benzos back into my body.

Customer: replied 2 years ago.

One concern I have is that my brain is going to take into consideration the sporadic use of Valium over the past 6 months (1-3x a week, but never on consecutive days) as part of the package in determining if I go protractive. Could my mind remember the ambien from 2 years ago?

 

I probably also want to note that I took xanax for 11 days, then oxycodone for 4... (turns out i broke a rib from a fall during the absess)

Customer: replied 2 years ago.

I did not take the xanax and valium together.... it was one or the other during the time of my abscess.

 

xanax at .25 or valium at 2.5

Customer: replied 2 years ago.
Last night was Day 14 from xanax and I didnt sleep a minute... my sleep has been really poor. Restless legs all night with anxiety.
Expert:  Dr_Anderson replied 2 years ago.
Ok, thank you for the extra info. So, in essence what most likely happened is the combination of Xanax and the follow-on opioid medications led to a withdrawal syndrome when stopped. The symptoms of fatigue, anxiety, and insomnia are common withdrawal symptoms for both medications. The anxiety fits more with the Xanax than it does with the opioids, but it is most likely a synergistic effect. That's the bad news.

The good news is, you are probably in the peak of the withdrawal, which means you should be feeling better soon. Withdrawal symptoms usually peak within 3-5 days following stopping of the medication, although for some people it can peak up to 2 weeks later. Since you are experiencing it now, I think it is safe to say you have hit your peak time - and therefore ought to see improvements in your symptoms over the next few days, even without using Valium.

Hope this helps! Sorry you are going through this, but it will get better! Please let me know if I may be of further service.

Regards,

Dr. Anderson
Customer: replied 2 years ago.

The xanax was last taken 14 days ago, the oxcodone 10 days ago... Am I still at the peak? Or do I have 4 more days to go?

 

Are you concerned about protractive withdrawal with what I have told you?

Expert:  Dr_Anderson replied 2 years ago.
Yes, you are still at the peak, so you have a few more days to go yet.

I'm not terribly concerned with the delay in when this hit you (although I am concerned that you have to even go through it!), given that some of my patients have had the same experience. In each of them, though, once we got through the rough patch, they were fine. Some of them do opt to take something like Valium to help ease the withdrawal symptoms (since Valium has a long half life), others prefer to "gut it out" until it passes. But, what they both have in common is that the withdrawal symptoms do go away.

I'm sorry you're going through this! It will end, but it is misery in the meantime. Well, on the bright side, I guess we now know that Xanax is not the best fit for you!
Customer: replied 2 years ago.

Is benadryl a good alternative to get through the next few days?

 

And lastly, you are probably advising me not to reintroduce valium right now? Will that prolong my withdrawl if I actually do? (very important question)

 

If II take valium at 2mg and cut the dose over the next two weeks, is that beneficial or detrimental to recovery?

 

Are you concerned with protractive withdrawl considering I have taken the valium a couple times a week for the past 6 months alongside this issue with the xanax? The valium was really no more than 2 or 3 days a week.

 

Do you normally see protractive withdrawal in patients that are on low doses?

 

Do you have any advice for sleep while I battle this out over the next few days?

 

You state "Some of them do opt to take something like Valium to help ease the withdrawal symptoms (since Valium has a long half life), others prefer to "gut it out" until it passes. But, what they both have in common is that the withdrawal symptoms do go away."

 

Do you introduce valium in the middle of withdrawal? Is this a small dose a few times or do you do a taper?

 

 

Thats the end of my questions! I am going to leave you a tip btw.

Expert:  Dr_Anderson replied 2 years ago.
Benadryl is reasonable to help, from the sedation point-of-view, but it may not do much for the actual withdrawal symptoms themselves.

You can reintroduce the Valium, and it ought to help with the withdrawal symptoms. But, whether or not you add it in, the withdrawal will taper off. By adding the Valium, because you have not had problems with it before and it is long-acting, it may help to shorten the length of time you have in the withdrawal. But, the counter-point to that is you are re-introducing a benzodiazepine. Because Valium is a long-acting benzo, I'm not worried about withdrawal from the Valium per se.

For sleep, Benadryl as mentioned above is an option. Another one that is natural and over-the-counter is melatonin, at 3-5 mg nightly.

Whether or not to introduce Valium really depends upon the patient and what they are trying to get off of and what they are going through. I have a motto, "dance with the one you came with." Since Valium has been helpful for you, it is a good option. But, another option would be to try and use Xanax to manage the withdrawal. I don't recommend that, however, because Xanax is so short-acting and landed you in this predicament in the first place! :)

I think I hit all the questions - please let me know if I missed any! Happy to be of service. :) This is a rough time for you, so I'm glad to help.

Regards,

Dr. Anderson
Customer: replied 2 years ago.

Ok, this will be the last one then..

 

If I take valium for 5 nights now at 2mg, I can discontinue it in 5 nights without any adverse affect to my recovery or dependency to valium? Do i taper coming off? Doesnt this distrupt the gaba receptors trying to heal? How will I know that my symptoms have abated beacuse of valium vs they actually are healing?

 

Remember, I do take valium (2.5mg) regularly (sometimes 3x per week at night, sometimes 2x per week at night), however, I dont have any problems sleepig on nights i dont take it. this xanax/oxycodone issue is the mess.

 

Does the fact that I went through ambien and xanax withdrawal 2 years ago make me more likely to have a worser withdrawal or protractive withdrawal?

Expert:  Dr_Anderson replied 2 years ago.
Correct - since you have had Valium before and been able to stop it with no problems the next day, the same ought to be true here. Valium is long-acting, so it tends to taper itself. At that low dose, there ought to be no need to taper, although you certainly can if you do feel any kind of withdrawal symptoms. The GABA receptors are going to be ok, they have just been confused by all the chemicals thrown at them. So, the more consistent a dose/medicine (like the Valium), the better it will be.

Having had withdrawal from Ambien and Xanax before doesn't mean this will be worse, but it certainly does serve as a warning that withdrawal is very likely for you with certain kinds of medicines. Prior withdrawals in this case don't set the stage for a worse withdrawal now. They do teach us to either go slowly coming off certain medicines for you, or to avoid them outright! :)
Customer: replied 2 years ago.

Thanks. I promise this is the last one.

 

Is it typical that on day 12, 13, 14 I get bad anxiety, whereas no anxiety in the beginning, just terrible sleep?

 

I have to admit- my anxiety levels are through the roof right now trying to figure out how to live, if I am going to introduce the valium, am i going to go protractive...

 

You will be getting a good tip from me!

Expert:  Dr_Anderson replied 2 years ago.
Not a problem, happy to help out, so ask away!

Every person differs in how the symptoms present, so this is typical, yes. On a side note, it is important to make sure nothing else medically is going on, like other medication changes, infection, thyroid issues, etc. But, barring that, we must presume your initial insomnia and then jittery anxiety are due to stopping the opioids and Xanax. The bad news is, this is the worst part. The good news is, this is the worst part that will pass!

Given that your anxiety over the withdrawal and anxiety are so high, I think if you begin a low dose of the Valium it will help tremendously. We already know you're able to tolerate it without any problems, and stop it with no bad ramifications.

Hang in there!! :)
Customer: replied 2 years ago.

Actually- I do have infection still from my absecess... My white blood count was a tad high, my neutrophils were a bit high as well. But this feeling I don't beleive is from infection.

 

My blood tests showed by thryoid to be ok...

 

Here is the blood tests attached... Remember, I had a painful ano colorectal abscess and the doc says its normal that the results are still showing infection. They actually didnt change much from the original results when I went in. The first night i stopped the oxycodone I got no sleep. It started then. I am exhibiting all the right symptoms, restless legs, insomnia, anxiety, vision issues, etc..

 

does this concern you?

 

graphic

Expert:  Dr_Anderson replied 2 years ago.
These labs don't look too concerning given you just had an abscess drained. I expect a bandemia (neutrophil elevation) in the setting of acute bacterial infection, and the lower lymphocytes are typical in that scenario.

The rest, then seems most consistent with the opioid and Xanax cessation. It is hard to say which is the worse contributor to your symptoms, so they both should probably never be used in combination in order to avoid this kind of struggle. Also, given that you have had Xanax withdrawal problems in the past, I recommend black-listing Xanax for you. :)
Customer: replied 2 years ago.

Do you suspect this being a long struggle with the dosing i told you?

Expert:  Dr_Anderson replied 2 years ago.
Depends upon your definition of long. If by long you mean it could be a couple weeks at most, then yes. If by long you mean months, nopers, I don't think it will be long. But, as noted above, I think you are in the worst of it now, which also means you're on your way up and out. :)

Hang in there! :)
Customer: replied 2 years ago.
You made me feel good today Thank you.
Expert:  Dr_Anderson replied 2 years ago.
I am humbled to be of service. Best wishes, and please let me know if I may be of further assistance.

Regards XXXXX XXXXX wishes,

Dr. Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience: Psychiatrist
Dr_Anderson and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.

Dr Anderson, We spoke the other day regarding the issues i was having coming off xanax after taking it for 10-12 days, then oxycodone for 4 day. I am on day 17 now and showing improvement in some areas but not in others. I did take your advice and I took 1.25 mg of valium two nights in a row and actually slept. I am going to taper off that over the next 2-3 weeks, probably cut .25 every 5 days. I probably get very anxious and wonder if when I come off the valium will I be worse off? Whats started about 5 days ago is anxiety. Usually around lunch time and last about 4 hours, I get this burst of anxiety that sticks with me and is uncomfortable and then subsides at nighttime. Right now my symptoms of this withdrawal are anxiety and insomnia. Is this anxiety normal, especally at this point? I am getting very discouraged right now that my symptoms will never improve or I will never sleep again, or I will have a hard time coming off the 1.25 taper and be back to where I started. Now I wonder if I have something entirely wrong with me that isnt even withdrawal (although it all started the night I didnt take oxycodone) I also wonder if I will enter a protracted state or I am already in it and thats why I am gettng this anxiety which seems to go away around nighttime. Give me some words of advice please from your experience. In your experience, would someone with such a light dose taken acutely for 10-12 days, then for half a week for 6-9 months have a long drawn out with drawal? Or should I see the light in a few weeks?


 


One thing I wanted to mention is that I now recall during that 10-12 day time period that I took xanax, one night instead i took 7.5 mg of valium if that means anything. I may have also take a 2.5 of valium one night as well.


 


 

 

 

Expert:  Dr_Anderson replied 2 years ago.
Greetings, and thank you for the follow-on questions.

Every person is different, so the typical case scenario is not necessarily the actual one. I have had patients for whom a short term of opioid and benzo medication treatment led to protracted withdrawal - on the order of many weeks or even a couple months - so it is not unheard of.

You mentioned that you are improving, but the spike of anxiety, coupled with the insomnia, tells me the withdrawal symptoms are still there. BUT, they do sound like they are improving, slowly. It also sounds like, in your case, the withdrawal is a bit on the protracted side, on the order of weeks instead of days. Keep heart! They will pass, even though it might take a little longer.

I think I mentioned above that other things have to be considered if the anxiety persists, but if not, yes, that needs to be examined closely. If the anxiety persists and/or worsens as the tapering off continues and the withdrawal symptoms improve, I think it would be necessary to have an evaluation for an underlying anxiety disorder. There is a personal history of prior anxiety-like episodes which required treatment, so this is not outside the realm of reason.

Hope this helps! Remember, you will get through this, and are already well on your way to getting through it. Hang in there!

Regards,

Dr. Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience: Psychiatrist
Dr_Anderson and other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.

In your opinion, do you think I am on the mend?

 

Or will i get worse before I get better, in your experience. Is the protracted period more difficult than my first two weeks which werent so good? With my doseage of a short period, does that possibly make my recovery less protracted or less severe, in your experience?

 

I did start up on 1.25mg of valium once at night and will taper that over two weeks. Do you think this will help or hurt?

 

My symptoms right now are anxiety and difficulty sleeping. Most of the other symptoms have subsided. I think I have alot of anxiety over whether I will get better, whether I will get worse and from just being tired.

Expert:  Dr_Anderson replied 2 years ago.
Greetings,

Yes, I think you are very much on the mend! It is a slow process, but from what you have noted, you are moving in the right direction.

As for worse before better, think of it like a stock market drawing, you know where it is up one day, down the next? But over time, the trend of the curve has been ever upward. It is the same for you - good days, bad days, but the overall trend is of improvement. Hope the analogy works - if not, let me know and I'll try a different one!
Customer: replied 2 years ago.

Can I still be on the mend even though I am back to a very small dose of valium or did that move me back?

 

With what I told you, should I improve by the week from what you have seen in your practice?

Expert:  Dr_Anderson replied 2 years ago.
The presence of the Valium most likely re-introduced a bit of withdrawal, but the counter point to that is it took the severity of what remained and dampened it down. It's a mixed bag, but I think you made the right choice.

From what I have observed in my practice, it would be safer to say you should be improved by the next 2 weeks rather than one. You are still having some symptoms, in spite of the improvement. This way, if you are 100% better by week's end, it is a wonderful surprise, but if there is some residual, you do not feel bitterly disappointed or despondent. I wish I could say for certain you'll be 100% in that time, but I don't want to mislead you. BUT...better you will be!
Customer: replied 2 years ago.

You mentioned I may be protracted. I read that the acute phase is from 5-28 days, and I am at Day 17.

 

Will the protracted phase be worse than the acute one in your experence?

 

Remember, this was basically a low dose of xanax or valium for 11-14 days.

Expert:  Dr_Anderson replied 2 years ago.
Generally, no, the protracted phase is one more of discomfort and inconvenience than the intensity seen with the more acute symptoms. Even low doses of these medications (and they have been coupled with opioid pain medicines, too) can precipitate this kind of withdrawal, although it is hard to predict. In your case, you went through withdrawal with Xanax before, correct? That serves as very clear evidence for possible withdrawal in any future application of these kinds of medicines, so they should be prescribed with caution.

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