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Can Reducing Restoril Dosage Cause Any Withdrawal Symptoms?
Question: Hello Dr. Rynne,
I am in the throes of a Restoril (temazepam) taper gone wrong. Temazepam belongs to a class of drugs known as benzodiazepines which are extremely hard to get off of, and this one is specifically used for insomnia. I was on a high dose (90mg. It is almost impossible to find a doctor to give you a script for over 30mg per night, but my doctor is pretty relaxed with the prescription pad!) for over a year, and on July 2nd I cut the dose from 90mg to 60mg and faired pretty well during that month (no noticeable withdrawal). Well exactly 4 weeks later on July 30th I decided to cut down to 45mg (a 45mg, or half, decrease in less than a month: way too fast), and didn't supplement/cross taper with 7.5mg of Valium as I should have (I didn't add any valium on my first taper of 30mg, so I figured I would be okay with another 15mg drop). According to my research, for every 30mg drop in temazepam, you are supposed to add 15mg Valium and then SLOWLY discontinue the Valium once you are SAFELY off temazepam. So I did two things wrong: 1) I tapered the temazepam way too fast (50% decrease in 28 days from such a HIGH DOSAGE), and 2) I never cross tapered with valium to help prevent/ease withdrawal symptoms. Well a couple days after I dropped down to 45mg my whole mind and body went into shock: most of you will be familiar with what I am talking about when I list the symptoms I had and am currently having - EXTREME anxiety, tremors, shaky voice, unquenchable thirst, loss of appetite, vomiting, chest pains, worsened insomnia, and crippling muscle/body aches. I thought I just needed to tough it out and the withdrawals would eventually subside so I waited two weeks before telling my psychiatrist. He immediately put me back on 75mg of temazepam and 80mg of Valium but the symptoms have persisted (I've been on the increased Restoril and Valium for over 4 weeks now). Every day seems to be getting WORSE rather than better. I would've thought that after 6 weeks my body would've adjusted to the dose by now? About 10 days ago we tripled my gabapentin intake from 300mg 3 times per day to 900mg 3 times per day. That has helped the situation SOMEWHAT but not enough. I called my psychiatrist in desperation yesterday and he said to increase my gabapentin to the maximum dosage of 1600mg 3 times per day. I am very weight and image conscious, and I feel like I've put on some abdominal fat since tripling the gabapentin. Am I putting myself in danger of putting on a lot of weight by going up to 4,800mg per day? Also, how long would I need to be on this dose? Because it feels like I'm in protracted withdrawal syndrome, which can last 1-2 years. Is gabapentin a good solution to counteract the benzo withdrawals? Thank you for taking the time to read this long message. I am in a desperate situation and cannot handle the stress and pain much longer. God bless, Nathan
I am in the throes of a Restoril (temazepam) taper gone wrong. Temazepam belongs to a class of drugs known as benzodiazepines which are extremely hard to get off of, and this one is specifically used for insomnia. I was on a high dose (90mg. It is almost impossible to find a doctor to give you a script for over 30mg per night, but my doctor is pretty relaxed with the prescription pad!) for over a year, and on July 2nd I cut the dose from 90mg to 60mg and faired pretty well during that month (no noticeable withdrawal). Well exactly 4 weeks later on July 30th I decided to cut down to 45mg (a 45mg, or half, decrease in less than a month: way too fast), and didn't supplement/cross taper with 7.5mg of Valium as I should have (I didn't add any valium on my first taper of 30mg, so I figured I would be okay with another 15mg drop). According to my research, for every 30mg drop in temazepam, you are supposed to add 15mg Valium and then SLOWLY discontinue the Valium once you are SAFELY off temazepam. So I did two things wrong: 1) I tapered the temazepam way too fast (50% decrease in 28 days from such a HIGH DOSAGE), and 2) I never cross tapered with valium to help prevent/ease withdrawal symptoms. Well a couple days after I dropped down to 45mg my whole mind and body went into shock: most of you will be familiar with what I am talking about when I list the symptoms I had and am currently having - EXTREME anxiety, tremors, shaky voice, unquenchable thirst, loss of appetite, vomiting, chest pains, worsened insomnia, and crippling muscle/body aches. I thought I just needed to tough it out and the withdrawals would eventually subside so I waited two weeks before telling my psychiatrist. He immediately put me back on 75mg of temazepam and 80mg of Valium but the symptoms have persisted (I've been on the increased Restoril and Valium for over 4 weeks now). Every day seems to be getting WORSE rather than better. I would've thought that after 6 weeks my body would've adjusted to the dose by now? About 10 days ago we tripled my gabapentin intake from 300mg 3 times per day to 900mg 3 times per day. That has helped the situation SOMEWHAT but not enough. I called my psychiatrist in desperation yesterday and he said to increase my gabapentin to the maximum dosage of 1600mg 3 times per day. I am very weight and image conscious, and I feel like I've put on some abdominal fat since tripling the gabapentin. Am I putting myself in danger of putting on a lot of weight by going up to 4,800mg per day? Also, how long would I need to be on this dose? Because it feels like I'm in protracted withdrawal syndrome, which can last 1-2 years. Is gabapentin a good solution to counteract the benzo withdrawals? Thank you for taking the time to read this long message. I am in a desperate situation and cannot handle the stress and pain much longer. God bless, Nathan
Brief Answer:
I think your doctor is doing the right things
Detailed Answer:
Dear XXXXXXX
Thanks for using HealthcareMagic.
I am Dr. Ashok Kumar, psychiatrist and will answer your questions
I read your query and understand the problem in fine details.
It is not surprising to develop extreme anxiety and other symptoms when there are abrupt dose changes of Temazepam which is a short-acting benzodiazepine and you are right to say that not adding valium acted as a trigger for above-mentioned symptoms.
Having said this I like to inform you that it is also true that the deranged homeostasis can take up to three months in restoration. This is important to understand because rather than losing patience you need to hold on for some more time to get the normal status of functioning (before 2nd July).
In regard to your current concerns, first of all, I like to inform you that your doctor is taking right step in the management of protracted withdrawal of Restoril. Gabapentin is one of the medicines which act on the same receptors where Temazepam and other benzodiazepines act and there is good possibility that it will help you in the restoration of your health. I agree that it may cause some weight gain but often the weight gain is of limited nature. It is also important to note that once the medication is tapered off there is the possibility of regaining previous weight as withdrawal of gabapentin helps in reducing weight in otherwise obese individuals.
To conclude it can be stated that the weight gain is of limited effect on Gabapentin use and it may take further six weeks to control anxiety properly.
I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
I think your doctor is doing the right things
Detailed Answer:
Dear XXXXXXX
Thanks for using HealthcareMagic.
I am Dr. Ashok Kumar, psychiatrist and will answer your questions
I read your query and understand the problem in fine details.
It is not surprising to develop extreme anxiety and other symptoms when there are abrupt dose changes of Temazepam which is a short-acting benzodiazepine and you are right to say that not adding valium acted as a trigger for above-mentioned symptoms.
Having said this I like to inform you that it is also true that the deranged homeostasis can take up to three months in restoration. This is important to understand because rather than losing patience you need to hold on for some more time to get the normal status of functioning (before 2nd July).
In regard to your current concerns, first of all, I like to inform you that your doctor is taking right step in the management of protracted withdrawal of Restoril. Gabapentin is one of the medicines which act on the same receptors where Temazepam and other benzodiazepines act and there is good possibility that it will help you in the restoration of your health. I agree that it may cause some weight gain but often the weight gain is of limited nature. It is also important to note that once the medication is tapered off there is the possibility of regaining previous weight as withdrawal of gabapentin helps in reducing weight in otherwise obese individuals.
To conclude it can be stated that the weight gain is of limited effect on Gabapentin use and it may take further six weeks to control anxiety properly.
I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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