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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45225
Experience:  Board Certified Physician
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there. After a couple of traumatic family events, I went

Customer Question

there. After a couple of traumatic family events, I went on a bit of a Valium binge - 200mg a day . I didn't really understand what I was doing, and now hate the stuff and want to taper asap. Years aga, my GP prescribed me 40mg and then dropped me straight down to 15mg after 2 months with no ill effects. In fact I (and my father) have a high tolerance to benzodiazepines. My question is, how quickly can I taper and what would be a good starting dose? I was thinking 60 - 100mgs dropping 10mgs every 4 days, but is this dangerous?
Also, will I be safe to drive 6 or so hours after dosing?
Many thanks!
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

you can start at 60mg a day.

JACUSTOMER-2gn0oblc- : again, Dr David!
Dr. David :

and drop 10mg every 2 days is fine.

Dr. David :

JACUSTOMER-2gn0oblc- : I'm afraid I went a bit downhill after our last chatt!!
Dr. David :

yes, it sounds that way.

Dr. David :

sorry about the traumatic family events.

JACUSTOMER-2gn0oblc- : Fantastic - Ii've been fed horror stories about fits and the like - should I be concerned??
Dr. David :

no, you will be fine.

Dr. David :

you are letting your anxiety get out of control.

Dr. David :

you need something else besides valium to help treat your anxiety.

JACUSTOMER-2gn0oblc- : There were a few things I didn't understand though - I hadn't realised that Valium wears off after 4hrs and not 20 -no wonder I was popping them like sweeties!
JACUSTOMER-2gn0oblc- : i have an appointment to see my GP on Tuesday:)
Dr. David :

you really need to see your doctor about your high doses and severe anxiety.

Dr. David :

good

Dr. David :

see your doctor on tuesday.

JACUSTOMER-2gn0oblc- : i shall!
Dr. David :

you need to go on SSRI agents like zoloft or paxil to help decrease your anxiety.

Dr. David :

and you might need drug counseling

Dr. David :

excessive use of valium.

Dr. David :

and you need to slowly taper down on your valium.

JACUSTOMER-2gn0oblc- : i also have spare valium should I encounter any withdrawal problems, but I will follow your instructions :)
JACUSTOMER-2gn0oblc- : is there anything in particular that I should be wary of?
Dr. David :

your anxiety could get worse as you taper your valium.

Dr. David :

you need to go on other anxiety medications to help decrease your anxiety.

JACUSTOMER-2gn0oblc- : so, 60mg to begin with, dropping by 10mg
Dr. David :

yes.

Dr. David :

every 2 days.

Dr. David :

let me know if you have other questions.

Dr. David :

if done, please leave positive feedback below.

Dr. David :

we only get credit clients after positive feedback.

Dr. David :

do you see the ratings area below?

JACUSTOMER-2gn0oblc- : Ok - I think I will finally be able to sleep more easily tonight! Many thanks😊
Dr. David :

you are welcome

Dr. David :

don't forget to leave positive feedback

Dr. David :

thanks JustAnswer.com

JACUSTOMER-2gn0oblc- : I did - and I left you good feedback last time!
Dr. David :

thank you time.

Dr. David :

I don't see your rating this time.

Dr. David :

do you have any other questions?

JACUSTOMER-2gn0oblc- : No, but I rated you as Excellent 😃
JACUSTOMER-2gn0oblc- : Ah - it doesn't like my smileys!!
JACUSTOMER-2gn0oblc- : i rated you as Excellent, but I think I had an email reminder las time, anyway :)
Dr. David :

you might have to submit the rating.

JACUSTOMER-2gn0oblc- : Oh there they are! I shall do, and goodnight !
Dr. David :

thanks.

Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45225
Experience: Board Certified Physician
Dr. David and other Medical Specialists are ready to help you
Customer: replied 2 years ago.
again Dr David 😊 I was just wondering if it is normal person to have such a high natural tolerance to benzodiazepines? At my brother's funeral I took Valium first time - 60mg. Apart from not having a nervous breakdown, I was able to function completely normally - no drowsiness, no dizziness... I realize that this sort of "virgin" dose would render a lot of people unconscious, or at least make them feel extremely weird. When I spoke to my surgeon father at the time, he reported the same lack of potency. Either of us could easily drop 100mg and feel almost nothing right from the start.
I have managed to reduce to 70mg since we last spoke, and intend to hold this week, and then drop 10mgs a week. Will a high natural tolerance make withdrawal easier, do you think? So far I feel fine.
I will still discuss with my GP on Tuesday, of course, but I would value your opinion.
All the best,
JM
Expert:  Dr. David replied 2 years ago.
that is good you feel fine.

that is good you are talking to your doctor this tuesday about your tapering schedule.

I guess you started higher than I recommended at 60mg.

you are unusual to have such a high natural tolerance to benzos.

hopefully it will make things easier .
Customer: replied 2 years ago.
70mg is a strip, so it seemed easier! I could taper faster, but I am worried about increased anxiety, especially as I still managed to be so agitated after a large dose the last time we chatted.
If I need more specific information about (natural/acquired) benzo tolerance, should I maybe approach a different expert?
Again, many thanks help! 😊
Best regards,
JM
Expert:  Dr. David replied 2 years ago.
there have been medical articles written about natural benzo tolerances

you can see here

http://www.ncbi.nlm.nih.gov/pubmed/2908516
Customer: replied 2 years ago.
OK - thanks ref! I know I'm not a medical doctor, but I am a qualified mathematical physicist with a questioning mind, retentive memory, an orthopod father and an interest in medicine.
The last time I tried explaining orbital radar and liar tomography to my Dad his response was "Oh yes - some of us wrote a paper on 3-d knee injury scanning a couple of years ago using X-ray CT!).
So I've always been a little bit up against it - maybe a little bit vying . But I do like to think of myself as well-read; in lots of areas, not just medical.
So I will enjoy reading the articles very much 😀
Thank you very much again, Dr David!
Expert:  Dr. David replied 2 years ago.
you are welcome

thanks JustAnswer.com
Customer: replied 2 years ago.
Lidar - stupid autocorrect again! 😕
Expert:  Dr. David replied 2 years ago.
I don't understand what you are typing.
Customer: replied 2 years ago.
LIght Detection and RAnging like in RAdio Detection and RAnging in radar. Sorry, I have a nasty habit of assuming that everyone else understands the things that I do!
I read your abstract, which was all I could access, but is always the best bit 😀
I think I have formed an embryonic opinion which I will refine/completely abandon with a bit more reading over the next few days!
Merci ***** ***** effet, Médecin! :)
Expert:  Dr. David replied 2 years ago.
you are welcome

thanks JustAnswer.com .
Customer: replied 2 years ago.
Actually Dr David, I do have a couple more questions:
I have been suffering from severe diarrhoea since just before Christmas - might this have inhibited my uptake of benzodiazepine? I started taking them again because I was feeling so awful. Could this have been because nutrients weren't being absorbed properly by my body?
I have been taking high doses of Movicol (24hr diarrhoea every half hour or so best part of two weeks) which I have now thankfully been advised to stop by a very kind local doctor. I slept 5hrs last night, which is more than I remember in weeks!
I still intend to drop my 60mg valium by 10mg every few days or so - but returning to work on Mon I think will be very stressful - is it OK to have the odd lapse and up my dose day? The spiral would still be downwards, and as I said before I want rid of this stuff.
Also, if tapering seems too hard, is it OK to up my dose by 10mg couple of days and then start again?
Expert:  Dr. David replied 2 years ago.
don't up your dose. you would be going backwards

you need additional treatments anxiety such as an SSRI agent to help decrease anxiety

keep tapering down.

you need to talk to your doctor about this taper schedule.
Customer: replied 2 years ago.
And the Movicol wouldn't have affected the uptake?
Expert:  Dr. David replied 2 years ago.
no, Movicol wouldn't affect the uptake.
Customer: replied 2 years ago.
Thanks - I do wonder why I seem to have such a natural resistance to these drugs, though. Z drugs are the same - I might get 4/5hrs sleep if I'm lucky and then im up again. Any ideas?
Expert:  Dr. David replied 2 years ago.
you need possibly more treatment symptoms with an SSRI agent along with benzos

so you can have less anxiety and easier time to taper down on benzos.
Customer: replied 2 years ago.
Ok - no good news then, but thak you so much help 😊
Expert:  Dr. David replied 2 years ago.
you are welcome

please leave positive rating below the chat box so I can get credit you today

you can always reach me with "a question . David" if you have any other questions

Thanks JustAnswers.com
Customer: replied 2 years ago.
I don't have a rating tab!
Expert:  Dr. David replied 2 years ago.
thats ok

start a new question next time here

http://www.justanswer.com/medical/expert-dr-david/
Customer: replied 2 years ago.
I suppose I'll have to wait email reinder! 😒
Expert:  Dr. David replied 2 years ago.
what is email reinder?
Customer: replied 2 years ago.
Lol - reminder!!
Expert:  Dr. David replied 2 years ago.
ok.
Customer: replied 2 years ago.
there again Dr David - I hope, again, this will be my last question!! Something I'm taking is making my mouth spasm on the left side. It usually only lasts 10mins or so, and then stops. Promethazine ? I've also noticed transient body tremors that occur within the same hour or so. I'm not taking massive doses of promethazine - to deal with nausea so 25mg/50mg. Of course this could also be my tapering diazepam (holding steady on 60mg which will become 50mg tomorrow days please give me a virtual hug!).
I'm slightly worried because I had a full on tonic clonic seizure in 2004 although I've been clear ever since 😊
Expert:  Dr. David replied 2 years ago.
it sounds like benign fasiculations.

most likely it is your anxiety causing these twitching.
Customer: replied 2 years ago.
Ok -- thanks - good feedback coming your way again!
Customer: replied 2 years ago.
Fascination.
Expert:  Dr. David replied 2 years ago.
thanks you.
Customer: replied 2 years ago.
FASCILUTATION. Sorry - am a total wordnerd and from th UK.
Expert:  Dr. David replied 2 years ago.
yes, fasciculations.
Customer: replied 2 years ago.
Correct - my mistake - FASCICULATION 😉
Expert:  Dr. David replied 2 years ago.
please leave positive rating below the chat box so I can get credit you today

Thanks JustAnswers.com
Customer: replied 2 years ago.
Once again your rating tab is nowhere to be seen. Time to have a word with your techs, I think!
Expert:  Dr. David replied 2 years ago.
time to start a new question

http://www.justanswer.com/medical/expert-dr-david/
Customer: replied 2 years ago.
Ok - kind of unrealtated question here: if I were to drink, say, two pints of beer quickly (in under an hour) would my body absorb less alcohol as I would also pee it out again pretty quickly? I don't drink that much, but was wondering how this might affect my blood levels. Don't worry - I refuse to drive even after one drink.
On other previous matters, I have a further appointment to see my doctor on Fri, so hopefully we can reach some kind of resolution to my anxiety soon.
I have read that Movicol alone can cause depression - especially in the high doses I was taking . I'm not sure whether this is related to my current feelings of hopelessness and anxiety, coupled with so many days of not absorbing nutrients properly? Might this be the case?
However, I am trying to do things right - eating very well (my appetitite is mostly back) and taking extra vitamins/minerals/ electrolytes.
Diazepam usage is down to 40mg a day, and I intend to keep dropping 5mg maybe once a week, now. I don't expect this to cause me problems given my high intrinsic tolerance.
I am back at work 😊
Expert:  Dr. David replied 2 years ago.
unrelated questions 8 days out need to start a new question

you can start one here

http://www.justanswer.com/medical/expert-dr-david/
Customer: replied 2 years ago.
Oh - Ok then - I don't have the money to continue beyond my trial, so all I can do is wish you all the best future, and thank you help so far ☺️
Expert:  Dr. David replied 2 years ago.
ok.

thanks JustAnswer
Customer: replied 2 years ago.
How would it cost me to get that last answer?
Expert:  Dr. David replied 2 years ago.
you have to start a new question.

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