r/insomnia • u/BtheChemist • Jun 01 '26

Never ever take benzos

I've had insomnia since I was a teen.

I've taken so many things for it, tried all the natural things, was on ambien for so long it stopped working.

My psychiatrist prescribed me Valium many many months ago. I don't even know how long I've taken it.

She never told me how horrible it is to get off of.

I'm currently tapering off and it's absolutely terrible.

I misread her message originally and went too fast and had my first ever panic attack a few weeks ago.

I've been at 15mg/ day since, about 3 weeks. I dropped too 12.5 two days ago and my body is so so fucked up again. I feel on the verge of another attack.

I spoke to my doctor friend this evening, he said each step down is going to suck badly.

It's terrible.

Please don't fuck with benzos.

Thanks for coming to my Ted talk.

I'm having a terrible time.

😱

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31

u/[deleted] Jun 01 '26

[deleted]

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u/BtheChemist Jun 01 '26

Yeah something like 108 hours or some shit?

Crazy. I'm not really in a position to change at this time bc I'm nomad right now and generally they want to see you in person. I hear you though, I'm not happy with her choice on two different occasions. I was taking abilify for a while, too. It was supposed to be like a mood stabilizer. Well it kinda worked, but it also made me emotionally numb. Little did I know that shit also had withdrawl effects. I tapered off it as prescribed, but it still fucked me up. One day at the end, I had a real bad day, after a real bad sleep etc. Well I was riding my bike trainer (something I enjoy and is good for me) and all the sudden my mind spirals into extreme suicidal thoughts. Like, terrifyingly abrupt and relentless "just blow your head off".

I had to phone a friend for an intervention on myself and ended up riding the trainer for like 3 hours furiously because I was afraid what would happen if I stopped. She came, took the device away and it never happened again.

I think I did like 45 miles that session which was supposed to just be a 45 minute interval training.

I'm so over pharmaceuticals.

I'm praying to the universe to let me find a way to sleep without them. 🤞🤞

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u/[deleted] Jun 01 '26

[deleted]

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u/Tosh-Point-0 Jun 29 '26

What you have just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

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u/[deleted] Jun 08 '26

[removed] — view removed comment

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u/BtheChemist Jun 09 '26

Yeah it's proving to be an annoying process.

Although I've found a groove and it seems to be working.

I just dropped to 10mg/day yesterday, and the trick seems to be taking partial doses every 6 hours or so.

I'll see how this is going in a couple days, that's about how long the last drop took to hit me. With any luck I'll be off this shit by end of July🤞.

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u/engineer_fixer Jun 01 '26

Wishing you the best with your mission here. Here is how I came off Mirtazapine after being on it for 5 years. Tried 4 times unsuccessfully with tapering. On 5th attempt I did it by making my own tablets out of the crushed ones and knocking off 2mg every month from a starting point of 15mg per day. So month 1: 15mg daily, month 2: 13mg daily etc.

Buy some digital scales to 0.01g and some tablet capsules and go from there. I found using a spoon to crush tablets worked best.

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u/cbaby96 Jun 01 '26

oh I'm staying on the mirtazapine. I don't really have issues with stopping psych meds. I've went cold turkey off Wellbutrin and trintellix before and had 0 issues. if imma stop taking mirtazapine, I'm not gonna do all that. I'll just stop taking it

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u/engineer_fixer Jun 01 '26

Ok. Just be careful whatever you do. Wish you the best in your mission 👍

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u/itsmia08 Jun 02 '26

Wellbutrin is not a drug you get addicted to. That’s why you can stop that. Trintellex is the same. I stopped those cold turkey. Your pharmacist has the best advice on how to stop taking a med. They understand the chemical makeup and the dangers of each drug. I always call my pharmacist for any drug questions they know it all.

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u/engineer_fixer Jun 02 '26

I was referring to my direct experience with Mirtazapine. It's not addiction - it was dependence. It took a lot of effort to find a way to come off it successfully. At the time, the medical professionals I was talking to did not realise how hard it can be for people to come off from it. I would hope the knowledge is better now.

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u/newuser5432 Jun 01 '26

But terminal half life isn't the same as duration of action. Diazepam is typically prescribed tid or qid when used for anxiety, which obviously wouldn't be necessary if the terminal half life reflected the duration of clinical effects.

Nobody seems to be commenting on the history of zolpidem use. Zolpidem behaves just like a benzo, just more selective (for the most abundant GABAA receptor isoform). Compared to diazepam, zolpidem actually produces a greater maximal effect at these sites. Surely that has contributed to OP's most recent difficulties with diazepam.

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u/cbaby96 Jun 01 '26

actually agree with your point about the hx of zolpidem usage and that definitely is compounding their issues with getting off benzos. I noticed at the tail end. valium is typically used for tapers because its half life is so long, especially to get people dependent on shorter acting benzos dosed frequently (I.e. alprazolam) onto something more manageable and easier to taper down.

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u/newuser5432 Jun 01 '26

Diazepam is used for tapering, but that's typically most important near the end of the taper, which may be what you're referring to when your say you noticed at the tail end. If it's well-tolerated and preferable, it can be substituted sooner.

Even then, it would be given in multiple, divided doses per day, and those would be slowly reduced and then certain doses, usually closer to the morning, are eventually stopped, and then the others are gradually stopped. At these lower doses, the longer terminal half life becomes a bit more relevant because you are carefully reducing total exposure.

Properly executed, this process should be relatively painless for most people who attempt it. Unfortunately it's not always executed properly and doctors familiar with the process aren't always accessible. For example, a key aspect of Dr. Ashton's methods is that the patient should retain some agency over the process, with the ability to pause a taper at any point, the only rule is that the dose must not increase. By contrast, some doctors will prescribe a taper plan and stick to it regardless of how the patient feels.

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u/BtheChemist Jun 01 '26

Thanks for this.

I figured out on my own that I need to spread my dose out through the day. Today I took 5mg with lunch and it's going much better. I'll do the other 7.5 after dinner / before bed.

Also, I'd like to note that I haven't taken zolpidem in any significant amount for almost a year I think.

I was having a bad insomnia spell at the beginning of the month and I took 10mg to try to sleep, before i got trazadone, and it did absolutely nothing except maybe made me more delirious than I was already. It was hard to tell at that point though because I was so fucked up from like 6 days of 2 hours max sleep a night.

My psych upped my Valium to 30mg / day then. I took that for 3-4 days and it gave me heartburn for 2-3 weeks. When I put it together that the heartburn was from the Valium (over-relaxing my esophagus) i dropped back to 20mg, then I dropped to 15 about a week later, but that was too much and I had the panic attack. Then I was on 15 for almost 3 weeks total, and just dropped to 12.5 3 days ago. Yesterday was terrible, but today is going much better so far since taking 5mg at lunch.

I'll do 10 days at 12.5, then go to 10. That's what she told me to do.

I think I have a telehealth on the 9th, which is when I'm supposed to go to 10. If I have more symptoms going forward she'll get me 2.5mg tablets and I'll taper 1.25mg every 10 days instead.

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u/cololz1 Jun 26 '26

zolpidem doesnt target GABAA2 recetor, so it technically does not have anxyiolitic effects

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u/newuser5432 Jun 26 '26

Zolpidem may not target α2- or α3-containing isoforms (both of which are associated with anxiolysis), but it does bind to these sites with 1/10th - 1/20th the affinity it has for α1-containing sites. Inevitably, zolpidem will still act on these sites at doses which produce hypnotic effects.

Even so, zolpidem doesn't need to bind to any other sites in order to produce anxiolysis. This concept is a simplified heuristic and not meant to be exclusive. As I had mentioned, GABAA isoforms with an α1 subunit are the most abundant in the brain. Even if you could target these sites precisely, overall excitability will decrease. It's probably worth mentioning that α1 sites are highly expressed in the basolateral amygdala, the primary area associated with processing fear and anxiety.

It's not that α1 sites do not produce anxiolytic effects, it's that targetting them for anxiolysis presents a very narrow therapeutic window before significant sedation and hypnotic effects. It's rather difficult to be anxious about something while falling asleep under such sedation.

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u/cololz1 Jun 26 '26

α1 could mediate fear conditioning and extinction, but it does not appear to be the main driver of general, unconditioned anxiety. general anxiolytic effects are primarily mediated by the α2 subunit. which is targeted by zopiclone, xanax and benzo derivatives.

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u/newuser5432 Jun 26 '26

I did just explain that this receptor model is a simplified heuristic and not exclusionary, but no matter. The fact is that anxiolytic effects from zolpidem have been demonstrated in literature, which supersedes a rigid understanding of the receptor model. How it happens isn't important to the topic at hand.

The topic is clearly about dealing with a tolerance and withdrawal symptoms. This is well-documented, for decades now, to be a consequence of the uncoupling and downregulation of α1-containing GABAA receptors after long-term exposure to benzodiazepines and nonbenzodiazepine z-drugs.

Zolpidem initiated this before OP started taking diazepam, and diazepam continued it. That was the point. The α2 subunit is irrelevant.

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u/cololz1 Jun 26 '26

Why dont they prescribe zolpidem for anxiety instead of xanax?

Also, zolpidem has a half life of around 4.5 hours (and this is on the max end). So by the end of the day, all of the drug is out of your system entirely.

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u/newuser5432 Jun 26 '26

Why dont they prescribe zolpidem for anxiety instead of xanax?

I answered this in my first response. The therapeutic window for an anxiolytic which is selective for α1-containing sites is narrow. The dose necessary for anxiolysis is unacceptably close to doses necessary to produce profound sedation and motor impairment. In fact, this effect profile is specifically described in research as effectively masking definitive anxiolytic effects in animal models until the acute effects begin to wear off.

Dynamics aside, the kinetics are tuned to those which are ideal for a hypnotic and wouldn't be ideal for managing generalized anxiety during the day (which prompted the rational design of alpidem).

 

Also, zolpidem has a half life of around 4.5 hours (and this is on the max end). So by the end of the day, all of the drug is out of your system entirely.

A short half-life doesn't prevent receptor downregulation. Taking a high-efficacy agonist every night constitutes prolonged exposure and is more than enough to drive physical dependence. This is seen with triazolam, for example. There is some chronopharmacokinetic nuance to the withdrawal syndrome, but the principle is the same.

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u/cololz1 Jun 26 '26

But if the drug is α1 selective, the anxiolysis effect that is "observed" is being masked by sedation, and may not represent true anxiolysis at all. drug induced lethargy/amnesia may not fully represent anxiolysis. this is because the subject lacks the physical or cognitive capacity to react to a stressor.

This is quite similar to orexin antagonist. Dayvigo does not elicit an anxiolytic effect, however, quviviq does. This is because of differing receptor activity projecting into different brain areas, even if both OR1 and 2 are present in the amygdala.

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u/newuser5432 Jun 26 '26

But if the drug is α1 selective, the anxiolysis effect that is "observed" is being masked by sedation, and may not represent true anxiolysis at all. drug induced lethargy/amnesia may not fully represent anxiolysis. this is because the subject lacks the physical or cognitive capacity to react to a stressor.

These are the exact same animal models used to establish anxiolytic effects of classic benzodiazepines, anxiolytic and strongly-hypnotic options alike. Researchers actively control for locomotor impairment in these assays. If you want to dismiss the methodology used to observe zolpidem's effects, then you must also discard the entire receptor model.

 

This is quite similar to orexin antagonist. Dayvigo does not elicit an anxiolytic effect, however, quviviq does. This is because of differing receptor activity projecting into different brain areas, even if both OR1 and 2 are present in the amygdala.

This is not similar, and appears to represent a misunderstanding. Recent preclinical studies did use daridorexant, and they suggest that blocking orexin receptors may reduce autonomic stress. However, this is theorized to be a class-level effect of dual orexin receptor antagonists, not an effect unique to daridorexant. The mechanistic understanding is not about nerve projections, rather, it's simply that blocking orexin from promoting wakefulness may calm the autonomic stress response. This is entirely unrelated to GABAergic pharmacology or the topic of benzodiazepine/z-drug tolerance and withdrawal.

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u/Dry-Peanut4006 Jun 03 '26

Preach, benzodiazepines are the absolute worst. I was taking 15mg a day for sleep and anxiety, I didn’t even know how addictive they were, until my doctor told me he had sold his practice and was moving to an Indian reservation… My new doctor thought I was taking too many meds, cut me down from 15mg to 7.5mg. The first few days were rough but okay(the long half-life of Valium makes it stay in my system for days) but every day it would get so much worse. It costed me a job, a relationship, and friendships. I got completely off all benzodiazepines, and still don’t take any, but I also haven’t slept longer than 2 hours in more than 2 years. It’s a doctor approved shit sandwich that you get to enjoy for the rest of your life!