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Dr. Vikas
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Category: Neurology
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Experience:  MBBS; MD
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Dr Vikas Please answer this question only

Customer Question

Please answer this question only if you know about the DR Heather XXXX Taper schedule and if you know how benzodiazepams change the gaba brain receptors and if you know all of the symptoms associated with benzodiazepam withdrawl. Also answer only if you know how gabapentin may affect Tapering off of Benzodiazepams. I am trying to taper off of Valium using the XXXX taper method but I am also on gabapentin. I am having severe symptoms and I need to know If I should go back to my starting dose of Valium and taper off of the gabapentin first. I am thinking it may interfere with my Taper from Valium. If you are not familar or have had experience with benzo tapering or gabapentin tapering or with research done by DR XXXX. Please do not get started trying to answer my question. If you do know some other expert who has experience with this subject please have them look at my question . Or at least tell me which expert I should ask my question Thank You


Only get started if you know of Dr Heather XXXX research


Any expert if not neurology but medical trained can answer


 


 

Submitted: 1 year ago.
Category: Neurology
Expert:  Camille-Mod replied 1 year ago.

Hello,

I'm Camille and I'm a moderator for this topic.

We have been working with our professionals to try to help you with your question. Sometimes it may take a bit of time to find the right fit.

I was checking to see if you had already found your answer or if you still needing assistance from one of our professionals?

Please let me know if you wish to continue waiting or if you would like for us to close your question.

Also remember that JustAnswer has a multitude of categories to help you with all your needs from Pet to Legal.

Thank you,

Camille~Moderator

Customer: replied 1 year ago.

Camille, I had asked a question just before this one of a Neurologist, But I was upset with his answers. He said my symptoms were not due to withdrawl but maybe psychological. There is a Neuro scientist in England who has been working like 15 years on this subject and she lists all of the reported symptoms but this neurologist knew nothing about the research that was done. I will continue to wait for an expert who knows about research that has been done and knows about gabapentin withdrawl and tapering also. If you do a Google search using JUst Answer and XXXX or Just Answer and benzodiazepam withdrawl. You will see some search results come up where some expert from Just Answer has answered the question in the past. So I know there may be some expert at Just Answer who may be able to help me. I just wish the expert would research my question before they decide to answer.

Expert:  Camille-Mod replied 1 year ago.

Thank you for your patience, your business is very important to us, we are waiting on another professional with the right expertise to come online. Feel free to let us know if you would like us to continue searching for a professional or if you would like us to close your question. Thank you for your understanding!

Customer: replied 1 year ago.

Will leave open but I expect a well researched and no fake answer. It has to be genuine and exact. I don't want to be told it is a psychological problem and I don't want a general answer. Will give it a few more days and if no expert is willing to do an extensive research and give me an answer I can accept then you can close the question. I understand most doctors and medical people do not know about people with this kind of problem that is why I noted the research done by Dr Heather XXXXXX. If the expert does not know of this research them most likely they will not be able to answer my question accurately

Expert:  Camille-Mod replied 1 year ago.

Hello again :)

We are still working with our professionals to find you the best possible match.

We sincerely XXXXX XXXXX the extended wait time.

Thank you,

Camille~Moderator

Expert:  Dr. Phil, MD replied 1 year ago.
I have reviewed the taper and I am familiar with the interaction with gabapentin in my own practice.

Can I help you?
Customer: replied 1 year ago.

I am taking 300mg gabapentin. I had started on 20mg Valium and strted my taper. 1mg cut every 2 weeks. At my first cut at 19 Tinnitus started. Then when I got down to 16mg V I started getting these burning sensations in my throat, face , mouth and skin on my chest. I uses icepacks and drank ice water to reduce the symptoms. At night I took 200mg gabapentin 50mg Trazodone, Valium and either doxylamine or benadryl. also magnesium supplement. Allof this just to reduce my symptoms and to be able to sleep. Then in the morning the symptoms returned again. These burning sensations are very uncomfortable and I can't tolerate them. Before I was put on the Valium I took a upplement called phenibut for 1.5 years. This was reducing my symptoms from 3 years of klonopin use up to 3 mg. I daon't know if I can Taper off the Valium because of all my past history? I dont know if I stop the gabapentin? if I would need to go on a higher dosage of Valium to feel normal. I dont know how the gabapentin is messing with the Valium Taper? I am thinking maybe I could stay on the Valium and not Taper off of it at all?

Expert:  Dr. Phil, MD replied 1 year ago.
Thank you for this reply

Why did you want to get off valium in the first place?

What is the gabapentin for?
Customer: replied 1 year ago.

I had read that long term use of benzodiazepams can cuase health problems. Have you read Dr XXX XXXreport. Also I became Tolerant to Klonopin and had to take higher and higer dosages and was worried the same would happen to me on Valium. When I stopped taking the phenibut I was getting anxiety, insonia and these burning sensations. When I was in detox off the Klonopin I was given Neurontin and this helped with the burning sensations. When I took phenibut it covered up all of my Klonopin withdrawal symptoms but I became tolerant to phenibut and stopped taking it . Then all of the Klonopin withdrawal symptoms returned. I was in a panic and I took Neurontin and this helped. Then I saw a Doctor and he knew nothing about phenibut so he put me on Valium. I went up to 20mg Valium for my symptoms to go away. But I took the neurontin for sleep and anxiety. I should have stopped it and just been on Valium. I made a mistake and I want to correct it. I just want to be on Valium because if I stop it I will get all of these symptoms . I don't know if I will become tolerant to it and symptoms to valium will appear due to tolerance. That is a great fear. Also what are the health consequences for staying on Valium long term?. Please take your time in looking up phenibut if you must. I was on Klonopin from 2008 to 2011. Then on phenibut from 2011 to March of 2013. Took gabapentin for symptom control until I saw Doctor in March of 2011 but I stayed on gabapentin. Then when I tried tapering slowly off the Valium 1mg cut every 14 days . I got severe withdrawal symptoms. I have had insomnia and worry anxiety issues for a long time. That is what I took the Klonopin for in the first place. I have gone up to 18mg of Valium. from the 16mg of valium from before now my major symptom is Tinnitus.

When I was on 20mg of valium I had no Tinnitus. When I was on Klonopin I had no tinnitus and when I was on phenibut I had no Tinnitus. The Tinnitus strated when I came off the Klonpin. It went away when I was on the phenibut. It came back when I stopped the phenibut. It went away when I went up to 20mg of Valium and came back when I dropped my dosage of Valium. It is very annoying

Expert:  Dr. Phil, MD replied 1 year ago.
Thanks for this excellent questions

I think the first step for you should be stopping gabapentin. You don't need it anymore and it is just making your weaning harder.

I reviewed the doctor's weaning protocol and at your dose I actually disagree with it

Weaning by 1mg per week is not good. Your withdrawal is too sudden

I would recommend weaning by 5 mg per week until you are down to 5 mg then wean by 1mg per week.

at 20 milligrams, your weaning will be too long

Customer: replied 1 year ago.

I disagree. You have not read the Ashton taper schedule. I was not tapering at 1mg per week but at 1mg every 14 days. This was too fast even for me as I had symptoms already at 19mg Tinnitus. Then at 16mg these burning sensations. These are all symptoms associated with withdrawal from benzos. This researcher has spent many years researching how benzos act on the brain and their effects. She has also noted the many symptoms and has even suggested a slower taper is better than a rapid Taper. What you are suggesting is a much more rapid taper. I would rather wean for a longer time than wean by 5mg per week and get symptoms early on in my taper. Maybe some people are able to do this but I can't and I told you I l already started getting symptoms early on. I may have to be on a very slow taper to avoid these symptoms. I don't like your answer and it will lead to disaster

Expert:  Dr. Phil, MD replied 1 year ago.
Please don't accuse me of not reading the article. That is unprofessional.

I read the article and it recommended no more than 10% decrease in 10-14 days.

I disagree with that.

I doubt you will be able to tolerate a long slow taper.

You have to adjust your taper for the individual. You need a fast taper.
Expert:  Dr. Phil, MD replied 1 year ago.
I noticed you rate poor service.

I'm sorry you didn't receive the answer you were looking for.

I'm happy to help you further if you like
Customer: replied 1 year ago.

I do not wish to continue with you. I have not received the answer I was looking for but thanks for your efforts. Most doctors don't understand people withdrawing from long term benzo use or the changes that take place in the brain. Many people even complain that the Aston Taper is too fast because they have difficulties. Of these people the ones that follow a slower taper have better results.So I will discontinue my question. I may have to E mail Dr XXX XXX or some Doctor that knows her research and what is happening in the brain

Expert:  Dr. Phil, MD replied 1 year ago.
Please understand that I have limited information about you as a person.

I cannot see you or examine you. That limits me as a doctor.

I do my best to help people on this site.

Would you please reconsider and work with me on this question more?

Maybe we could come up with a shorter taper for you?
Customer: replied 1 year ago.

As I told you my doctor who has helped people taper off of benzos told me I had tapered off too fast and that is why I had symptoms. His other patients have done slower tapers and have not had symptoms or minimal symptoms. You are suggesting 5mg cut then 1mg cuts once I reach 5 mg. Have you not read what XXXX said is going on in the brain during benzo withdrawal and the brain needs time to go back to normal? My doctor has suggested an even slower taper based on what I have told him but that is not your opinion. So I am not satisfied with your answer. It is typical of other doctors answers and they do not even have exposure to the many years of research done by Dr Heather XXXX.

Expert:  DrThomasMd replied 1 year ago.

Hello from JA

 

I am board certified in internal medicine and integrative medicine and have done a lot of work with withdrawal I am also a clinician of over 20 years practice.

 

Let me clarify what questions remain for you at this time.

 

I will be glad to help.

Expert:  Dr. Vikas replied 1 year ago.
Hello

I am Dr Vikas (M.D Psychiatry) and I will try to answer this question.

Are you still interested in getting an answer. Please do let me know so that we can discuss further.

Thanks

Vikas
Customer: replied 1 year ago.

Dr Vikas, I Need your help. I am on 300mg gabapentin and on 25mg of Valium. Does the gabapentin interfere with my Valium Taper? My Taper failed at 16mg of Valium due to severe symptoms I could not handle. I have been told that the gabapentin creates tolerance rapidly to valium so I will develp Tolerance on valium as long as I am on gabapentin. I was told I need to get off gabapentin immediately and up my dose of Valium to 40 mg to compenstae for not taking the gabapentin. What is the truth and why did my taper fail so soon? This is what someone told me I pasted it below

 

I worry about you since you are on both drugs at the same time. This is a real double whammy since it creates more tolerance rapidly. On one hand your body has less GABA receptors from the benzo and then your feeding your brain extra GABA so your body end's up down regulating the receptors further and faster. I rather see you on 35 or 45 mg Valium and drop the gabaphen as quick as you can. It's a vicious circle that has to be broken. Once your on one drug stabilizing is easy and you can hold there for years if necessary. You would have to drop the GABAPHEN and stand ready with as much Valium as necessary to equalize it out fast. Ask your dr. maybe he has a formula. I'd rather be over medicated and over shot the mark if you know what I mean. Taking both just makes it all the harder and tolerance is a bitch that gabaphen brings with it quickly.

Customer: replied 1 year ago.

This is what someone told me I need the truth.


 


I worry about you since you are on both drugs at the same time. This is a real double whammy since it creates more tolerance rapidly. On one hand your body has less GABA receptors from the benzo and then your feeding your brain extra GABA so your body end's up down regulating the receptors further and faster. I rather see you on 35 or 45 mg Valium and drop the gabaphen as quick as you can. It's a vicious circle that has to be broken. Once your on one drug stabilizing is easy and you can hold there for years if necessary. You would have to drop the GABAPHEN and stand ready with as much Valium as necessary to equalize it out fast. Ask your dr. maybe he has a formula. I'd rather be over medicated and over shot the mark if you know what I mean. Taking both just makes it all the harder and tolerance is a bitch that gabaphen brings with it quickly.

Customer: replied 1 year ago.

Dr Vikas, Did you get my entire question?

Customer: replied 1 year ago.

Dr Vikas, I have some background information of how I got prescribed Valium. I had posted this question in an earlier question but I thought it may help. if you knew some of my history as to why I was prescribed the Valium


Below I pasted the question:


 


I need help and advice for managing symptoms from Klonopin withdrawl. I took Klonopin for 3 years and had increased my dosage from .5mg up to 3 mg taken at night for sleep 1.5 years ago or June 2011 I went to detox and cold turkeyed off of Klonopin. When I came home I could not deal with my horrible symptoms. I had burning sensations in my face ,arms and throat and I had severe insomnia. I could not sleep for days. I looked for sleep aids and I found phenibut. So I started taking phenibut and I was able to sleep and all my symptoms from Klonopin withdrawl went away. Now 1.5 years later I have built up a tolerance to phenibut and it no longer works. It probably would if I were to take a much higher dose. I decided to quit taking the phenibut and now all of my symptoms from Klonopin withdrawl have returned. So to me it appears the phenibut was covering up my Klonopin withdrawl symptoms. So did my progress stop ? How can I manage my symptoms without taking anything? Is anything effective that will not set me back? Also I started getting Tinnitus when I first started withdrawing from Klonopin 1.5 years ago. But this stopped when I was taking the phenibut but now that I have stopped taking the phnibut the Tinnitus is back again. I am going to see a Doctor soon who may be benzo wise. The Doctors I have seen have no experience regarding benzo withdrawl and dependence. Please give me an answer. I am so tempted to take the phenibut again because I just can't stand these syptoms any longer< this doctor put me on Valium to stop the bad symptoms i was having

Expert:  Dr. Vikas replied 1 year ago.

Hello Customer,

Thanks for the detailed information, it was really helpful in understanding your problem :).

Gabapentin has no known direct actions on GABA or its receptors. It has a totally different mechanism of action in comparison to Benzodiazepines like Clonazepam or Diazepam (Valium) which acts on GABA receptors. There are no significant drug interactions reported between these two medicines to the best of my knowledge.

Gabapentin should not interfere in tapering of Valium in my view.

Now regarding Diazepam (Valium), the usual dose range is from 4-40 mg per day. The risk of dependence with this medicine may increase with dose and duration of treatment. We have seen many patients in clinical practice who are not able to taper this medicine even at a very slow rate. In such case, we usually tell these patients to start reducing by 1-2 mg every 3-5 days till they are able to reach 20 mg per day. After this, we ask them to start reducing by .5 -1 mg every week to avoid withdrawal symptoms.

However in few patients, who still experience withdrawal symptoms, dosing may need to be tapered down over many months. For example, Valium can be taper down very slowly by reducing 1% every third day by crushing tablet and suspending or dissolving in 100 ml of fruit juice and then disposing of 1 ml while drinking the rest, after 3-7 days, dispose of 2 mg and so on.]

This method is specially useful in patients who are very sensitive to withdrawal symptoms.

You have mentioned that you start experiencing significant withdrawal symptoms once you reached the dose level of 20 mg per day. You were not able to go below 16 mg per day even though you were reducing the dose by 1 mg every 2 weeks.

In that case, you can discuss with your doctor about the tapering method I mentioned above and try it. Hopefully you will be able to taper it down slowly.

I hope this helps, pleas feel free to discuss further if you have any doubts or query regarding my suggestion.

Kind regards

Vikas
Customer: replied 1 year ago.

Dr Vikas, Even when I started at 20mg Valium and I dropped 1mg to 19mg I soon had Tinnitus. I held for 2 weeks and the Tinnitus did not go away it even got worse. I don't know if I can even Taper and am afraid to. What would happen to me if I don't Taper? The Tinnitus did not go away even when I went up to 25mg. I am very sensitive to any reduction in Valium. I do have a precision scale that weighs down to .001gram. If I weigh the Valium pill and shave a little off with a razor. Can I use the weight to determine what per cent I am cutting? I have heard people titrated down by using a pill crusher and putting the powder in milk. It seems water does not dissolve Valium. Just the fillers and binders in the pills. It seems complicated to use a liquid and crushing the pill. I have weighed a 2 mg pill of Valium and it weighs .172 grams. So if a 5% cut off 20mg is 20*.05 is too much. Could I try 2% cut 20*.04 =.4mg and hold for longer than 2 weeks maybe 3 weeks to a month. I can get Valium in 10,5 and 2 mg pills. I can weigh each pill and then determine how much of a pill I have to shave off with a razor to get .4mg. So then I would take 19.6mg for 3 weeks to a month. I hope I would not get symptoms. Also Valium comes in a liquid. Would this not be easier to taper with? Also could I do a daily reduction So I would not notice the drop in Valium?


I am so sensitive to any reduction I am trying to reduce so slow that my brain has time to adjust, I can shave the Valium pills to reduce by small amounts then weigh the pills. Also I want to Taper off the gabapentin I only have 400mg and 300mg capsules. Again because I am so sensitive to cuts I was going to weigh the capsule then open up the capsule and remove 10% of the gabapentin powder and then take this dose for a month. Then I would in a month reduce 10% of the current dose using the scale again to weigh remove gabapentin powder and then take this dose for a month. I have heard gabapentin is as hard to withdraw from as Valium. SO I am afraid to stop it. Right now the burning sensations are almost gone but the Tinnitus has not gone away. If I were to increase my dose of Valium I think it would go away. I THINK YOUR SUGGESTIONS FOR TAPERING ARE STILL TOO AGGRESSIVE. I will suffer symptoms I would not be able to tolerate. My Doctor said to taper 1mg down every 2 weeks with a hold and if I had symptoms to hold longer. This did not work


I need either to make daily cuts of very small amounts or a cut and hold of a smaller per cent and a longer hold. The more I fail in my Taper will mean less chance for success. I am 57 years old Could I stay on it for life or must I get off of Valium and gabapentin?


 

Customer: replied 1 year ago.

Dr Vikas, another Dr from Just answer gave different advice. Why would he give this advice. He thinks the gabapentin would harm my Taper


 




Friday, June 07, 2013 11:45 AM EST



Thanks for this excellent questions

I think the first step for you should be stopping gabapentin. You don't need it anymore and it is just making your weaning harder.

I reviewed the doctor's weaning protocol and at your dose I actually disagree with it

Weaning by 1mg per week is not good. Your withdrawal is too sudden

I would recommend weaning by 5 mg per week until you are down to 5 mg then wean by 1mg per week.

at 20 milligrams, your weaning will be too long

Customer: replied 1 year ago.

Dr Vikas, I am on a forum on the Internet where people are withdrawing from benzos. What has me really worried was this message I got from a member.


 


I worry about you since you are on both drugs at the same time. This is a real double whammy since it creates more tolerance rapidly. On one hand your body has less GABA receptors from the benzo and then your feeding your brain extra GABA so your body end's up down regulating the receptors further and faster. I rather see you on 35 or 45 mg Valium and drop the gabaphen as quick as you can. It's a vicious circle that has to be broken. Once your on one drug stabilizing is easy and you can hold there for years if necessary. You would have to drop the GABAPHEN and stand ready with as much Valium as necessary to equalize it out fast. Ask your dr. maybe he has a formula. I'd rather be over medicated and over shot the mark if you know what I mean. Taking both just makes it all the harder and tolerance is a bitch that gabaphen brings with it quickly.


 


What truth is there to the statement that tolerance builds up quickly with gabapentin.Also why would Dr Phil MD from JA say I should get off the gabapentin since it makes the weaning of Valium harder?


Every advice I have gotten from either a JA Doctor or someone in a forum seems to conflict with another. Even my own Doctor who is supposed to know about benzos and Tapering gave me advice that caused me to have bad withdrawal symptoms. Does not slow tapering allow the brain to up regulate the damaged gaba receptors while slowly reducing the Valium. Is it now the lack of gaba and excess glutamate in the brain which causes symptoms. I have read Dr Heather Ashtons manual and this is what this Neurologist Scientist says is happening

Expert:  Dr. Vikas replied 1 year ago.
Gayrie,

Thanks for your reply.

It will be too cumbersome for you to shave the pill with the help of Razor.

As I mentioned before, using a fruit juice would be a much better option if you want to taper Valium very slowly. We have tried it in several of our patients with excellent results. Crushing tablet and suspending or dissolving in 100 ml of fruit juice and then disposing 1 ml should not be a very difficult task for you. You can reduce dose by 1% every third or fourth day.

I can't comment on what the other expert or a forum member said about Gabapentin and Valium. I simply mentioned the facts about Gabapentin and Valium.


Valium can also cause dependence being a Benzodiazepine so if you continue taking it,there are high chances that you become dependent on it. If you are finding Gabapentin useful (it is controlling tinnitus and burning in mouth) there is no need to taper it down right now. You can first try to taper down Valium under supervision of your doctor by trying the method I mentioned above. Once you are able to taper down, Valium then you can try to taper down Gabapentin also.

Gayrie, at this stage, you need not to worry about the GABA receptors or glutamate receptors. Doing this will only make you more confuse and will increase your anxiety.

It is still not known, how these medicines really act and all that we currently know is in theories.
Customer: replied 1 year ago.

I don't agree with the fruit juice or that gabapentin is not impeding my taper progress. I had tapered at less than 6% and I had bad reactions and other Doctors have recommened I come off yhe gabapentin. You did not explain what is happeneing to my brain during the withdrawal. I needed more technical and detailed information. I don't understand throwing out 1 ml of the solution. I wanted to know if I shave the pill if it would work and you just said it would be to cumbersome but it would be do able. It could work Also doing very small cuts daily may be possible. I have a precision scale and people can do it. But you never explored this possibility.


 


I just want to give up on JA for advice. Too many conflicting advice and no concensus or technical expanations. Sorry you have tried. I have been reading and reading how people taper off benzos. They are not water solubule and milk is the recommened method for liquid titration since the active component sticks to the fat in the milk.


 


I think I would be better off telling my Doctor and consulting with him then I could explain my difficulties I had.

Expert:  Dr. Vikas replied 1 year ago.
Gayrie,

Shaving the pill is not the right method because it is not possible to determine the exact amount you are going to cut by doing this as the pills you are going to cut are too small for this. There are high chances that you accidentally cut a bigger portion of medicine which can lead to even more severe withdrawal reactions. If you still want to try that method, it is up to you totally.

If you have more faith in that expert who told you that Gabapentin is interfering in your tapering process, I can't help it. I already mentioned it earlier and I am repeating it again here "Gabapentin has no known direct actions on GABA or its receptors. It has a totally different mechanism of action in comparison to Benzodiazepines like Clonazepam or Diazepam (Valium) which acts on GABA receptors. There are no significant drug interactions reported between these two medicines to the best of my knowledge.

Gabapentin should not interfere in tapering of Valium in my view " In fact, it is being used by few doctor to assist in benzodiazepine withdrawals.

So how can Gabapentin affect the tapering process, probably you are having an explanation for that also. I am also interested in knowing that and would appreciate it if you share it with me.

It is not possible for me to explain in detail what is happening to your brain during the withdrawal via this medium. This article can be useful for understanding what is happening in your brain during drug withdrawal.

Drug Withdrawal

This article is full of technical and medical terms and I am not sure whether or not you will be able to understand it.

Actually you don't want to listen but only want a confirmation to what you are thinking. I clearly mentioned the words "Crushing tablet and suspending or dissolving ". There is no need to dissolve the tablet while trying this method.

You should see these articles also mentioned below regarding the relationship between Gabapentin and Benzodiazepines.


Gabapentin-Assisted Benzodiazepine withdrawal






" At present there is no conclusive evidence that any adjuvant drugs are generally helpful in preventing or alleviating withdrawal reactions if they occur. In individual cases antidepressants, beta-adrenoceptor antagonists (for palpitations or tremor) or carbamazepine (for withdrawal from high doses of benzodiazepines) may be indicated(63). Buspirone is ineffective(17,20). Flumazenil is impractical for general use since it is short-acting and requires intravenous administration though it has been used successfully in some trials(54-56). Zopiclone, zolpidem and zaleplon are contraindicated since they act like benzodiazepines and cause dependence and are sometimes abused. Gabapentin was reported to be effective in one patient(64) but has not been investigated in controlled trials."

source - PROTRACTED WITHDRAWAL SYMPTOMS
FROM BENZODIAZEPINES (
Professor C Heather Ashton, DM, FRCP)





Gabapentin Use in Benzodiazepine Dependence and Detoxification

Gabapentin-Assisted Benzodiazepine Withdrawal In A Multidrug Dependent Patient - See more at: http://archive.ispub.com/journal/the-internet-journal-of-pharmacology/volume-4-number-2/gabapentin-assisted-benzodiazepine-withdrawal-in-a-multidrug-dependent-patient.html#sthash.If7CST89.dpuf

Gabapentin-Assisted Benzodiazepine Withdrawal In A Multidrug Dependent Patient - See more at: http://archive.ispub.com/journal/the-internet-journal-of-pharmacology/volume-4-number-2/gabapentin-assisted-benzodiazepine-withdrawal-in-a-multidrug-dependent-patient.html#sthash.If7CST89.dpuf
Customer: replied 1 year ago.

I still find your rate of taper is too fast and I find no agreement or concensus with other experts on gabapentin during withdrawal. I have also read that milk is bettere suited than water based liquids for titration. Your answers are not consistent with information found from other experts and from actual people withdrawing from benzos. What you have said has not worked for them. I am also confused because even a 1% drop every 3 to 4 days is too rapid for me. I need to make a daily taper so I don't experience symptoms. I would need a dily taper schedule and I don't know if my doctor would even agree to titration or crushing pills and putting in fruit juice. I think I will just opt out of asking you anymore questions and Tomorrow ask my Doctor. He is the one who prescribes me the Valium. So I am stuck with his orders. I can't disagree with him or I may go Cold Turkey without any valium and then I will have big problems

Expert:  Dr. Vikas replied 1 year ago.
No problem Customer.

I really enjoyed working with you. Your questions helped a lot in refreshing my own knowledge.

I am not sure, why you always rate the answer as " Poor service " because as an expert I tried my best.

Hoping that you will not give this reply a " Poor Service Rating " again :)

Wishing you a very early and speedy recovery.

Kind regards

Vikas
Customer: replied 1 year ago.

I saw my Doctor who prescribed the Valium for me. He wants me to stop the Neurontin immediately. Then after that he wants me to cut my dose of Trazodone from 50mg to 25mg and stop it also. I told him I was worried about withdrawal and he said I would have none. I told him I had insomnia and he said after a few days I would sleep without medications. He is supposed to have much knowledge about benzos. but I am afraid to abruptly stop both 300mg Neurontin and Trazodone. He says I would not be able to taper successfully off the Valium as long as I am on the Neurontin and trazodone. Dr Vikas you told me there was no problem with taking gabapentin and Valium together. Explain to me why this Doctor who is supposed to have so much knowledge about Valium thinks it is a big problem and wants me to stop it immediately. The lack of concensus and factual information is why I am leary of giving you a good rating convince me he is wrong. Would he know if I am still taking Neurontin . Maybe it is affecting the tolerance level of Valium so he would know if I ask for an increase in Valium due to symptoms. Why can't you doctors agree on anything?

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Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
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  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
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Meet The Experts:

 
 
 
  • Dr. Mark

    Neurologist (MD)

    Satisfied Customers:

    1985
    Neurosurgeon - Brain, spine, and peripheral nerve surgery
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  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Neurologist (MD)

    Satisfied Customers:

    1985
    Neurosurgeon - Brain, spine, and peripheral nerve surgery
  • http://ww2.justanswer.com/uploads/NE/neuromd2012/2012-6-6_171449_frank.64x64.jpg Dr. Frank's Avatar

    Dr. Frank

    Board Certified Physician

    Satisfied Customers:

    6629
    Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
  • http://ww2.justanswer.com/uploads/jesbrain2015/2010-5-21_162329_jack.jpg Jack Scariano Jr's Avatar

    Jack Scariano Jr

    Neurologist (MD)

    Satisfied Customers:

    1056
    Board Certified Neurology 1982 30 years experince. Also expert in Pain Medicine
  • http://ww2.justanswer.com/uploads/PR/pradocs/2012-7-23_23649_201272323220JApicture105x113.64x64.jpg Dr. Bob's Avatar

    Dr. Bob

    Neurologist (MD)

    Satisfied Customers:

    2846
    Neurology & Int Medicine (US Trained): 20 yrs experience
  • http://ww2.justanswer.com/uploads/HE/healthydoc/2011-7-22_193154_LevGrinman2.64x64.jpg healthydoc's Avatar

    healthydoc

    Board Certified Physician

    Satisfied Customers:

    1848
    Board Certified U.S. Neurologist
  • http://ww2.justanswer.com/uploads/BrainLifeDoc/2010-10-04_004701_AMF_2008_2_pix.jpg Dr. F's Avatar

    Dr. F

    Board Certified MD

    Satisfied Customers:

    266
    Neurosurgeon with more than 20 years experience in practice and teaching.
  • http://ww2.justanswer.com/uploads/Phytube/2010-9-7_192331_PicVB1a_164by64.jpg Phytube.com's Avatar

    Phytube.com

    Neurologist (MD)

    Satisfied Customers:

    86
    Pediatric Neurology and Developmental Medicine with Special Research In Pain Medicine/Medications
 
 
 

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