Trying to help a friend who has been on heavy sleeping medication for nearly 10 years. Wants to come off and is having trouble reducing the dosage after getting down to 70% of original dosage over the past year. I want her to see a specialist who may be able to offer a more scientific approach to reduction in dosage and may be able to substitute with less harmful medications.

Can anyone recommend a good doctor for this either in Chiang Mai or Bangkok?

I'm not totally clear if the problem is physiological dependency (i.e. withdrawal symptoms, or craving for a "high" the drug provides, unnrelated to need to sleep) or just to not being able to sleep well without the drug. Makes a difference in terms of whether she would be best served by a pyschiatrist specializing in addcition disorders or a specialist in sleep disorders.

Can you clarify?

I think doctors are more a problem than a solution when it comes to dealing this type of addiction.

Tell your friend to visit these sites:

http://benzowithdrawal.com/forum/ http://www.benzobuddies.org/

The number of people addicted to this drug is large and stopping is very difficult, but it can be done.

I'm not totally clear if the problem is physiological dependency (i.e. withdrawal symptoms, or craving for a "high" the drug provides, unnrelated to need to sleep) or just to not being able to sleep well without the drug. Makes a difference in terms of whether she would be best served by a pyschiatrist specializing in addcition disorders or a specialist in sleep disorders.

Can you clarify?

Without it she can't sleep at all. When she wakes up, she starts to feel withdrawal symptoms along with general malaise. She doesn't take it outside of sleep.

Without it she can't sleep at all. When she wakes up, she starts to feel withdrawal symptoms along with general malaise. She doesn't take it outside of sleep.

Sadly there's no such thing as a pharmaceutical free lunch, and she will feel malaise.

That 70% being doable but further being more difficult rings true, because the less you take the more the reductions "hurt". You need to do the reductions proportionately. So rather than reducing every ten days or two weeks by a fixed amount, a half milligram, or 100 mg, or whatever an initial dose proportion is, the reduction needs to be itself reduced. I'm guessing there are websites suggesting protocols for that.

I will offer one thing.

Your friend may like to take a tricyclic antidepressant like anafranil or dothiepin for a limited time. Tricyclics are well understood but double check for compatibility. The dose needs increasing gradually if a small dose is not enough.

It is a sleep inducing drug and is sometimes used as a sleeping pill. The tricyclic will be much easier to drop afterwards.

Do not expect it to be a cakewalk however. A certain amount of stiff upper lip is required. I reduced from lorazepam after 14 years to nothing. It took a long time, and every couple of weeks when I made a reduction I had to hang on to the arms of the chair.

Get her to do as much heavy exercise as she can.

Good Luck

Without it she can't sleep at all. When she wakes up, she starts to feel withdrawal symptoms along with general malaise. She doesn't take it outside of sleep.

Sadly there's no such thing as a pharmaceutical free lunch, and she will feel malaise.

That 70% being doable but further being more difficult rings true, because the less you take the more the reductions "hurt". You need to do the reductions proportionately. So rather than reducing every ten days or two weeks by a fixed amount the reduction needs to be itself reduced. I'm guessing there are websites suggesting protocols for that.

I will offer one thing.

You may like to take a tricyclic antidepressant like anafranil or dothiepin for a limited time (I think anafranil is the more sleep inducing one), until the present pills are kicked and a further time. Tricyclics are well understood but double check for compatibility.

It is a sleep inducing drug and is sometimes used as a sleeping pill. The tricyclic will be much easier to drop afterwards.

Do not expect it to be a cakewalk however. A certain amount of stiff upper lip is required and tricyclics make you feel rather odd at first. I reduced from lorazepam twice, last time after 14 years to nothing. It took a long time, and every couple of weeks when I made a reduction I had to hang on to the arms of the chair. The second time the tricyclic definitely helped me a lot however, getting a decent sleep is a great start to withdrawal..

Get her to do as much heavy exercise as she can.

Good Luck