The hell that is diazepam withdrawal

If you've just received the Mental Healthy newsletter and missed my regular blog entry within it -- I'll share a secret with you.   I'm in diazepam withdrawal ... AGAIN!    For 8 years now psychiatrists have been trying to withdraw me from the highly addictive benzo and there've been two suicide attempts along the way.

Well I'm down from 10mg to 2.5mg as things stand -- for the past two weeks I've been on two and suffering severe generalised anxiety, paranoia, depersonalisation, derealisation and panic attacks and feeling extremely low in the evenings -- and because I felt suicidal last night my NHS keyworker has increased the diazepam from 2mg to 2.5mg as a compromise from the 3 that I was taking before.

Now anyone who's been on the drug, or any professional, will know that there is no such dose as 2.5mg ... or 3mg.  So how am I taking that?  Well it's 1.5 x 2mg or 1/2 a 5mg.   The next move will be liquids as diazepam is available in a solution of 2mg/5ml -- essential for us long-term addicts!

The most suicidal and biggest panic attacks I've ever had

It angers me when I think back to 2003 and my first acute psychotic episode.    There was no early intervention in psychosis then, there were no crisis teams -- I was presenting with prodromal phase symptoms of schizophrenia for some months before a psychiatrist treating me for depression decided to put me on 2mg of risperidone, an anti-psychotic.   Having a chief hospital pharmacist for a dad is a mixed blessing -- I looked up the drug, told everyone: "I'm not psychotic" and refused to take it.  Nobody intervened for several months later until I was sectioned. My mum is a medically retired A&E ward sister too ... not unaccustomed to people walking through her ward entrance with psychosis!  Because the background to my psychosis is that the BBC vets all of its journalists for political leanings and this is a fact, and because it's been in several newspapers and books that MI5 used to do this vetting on the BBC's behalf, my family believed me, my friends believed me, even my NHS clinical psychologist believed me -- although he did warn me "be careful what you publish -- these are powerful people!"

So - the worst panic attack -- well I've had to get off trains in the wilderness because I've thought I was dying and got stuck in lifts but nothing prepared me for a panic attack induced by benzos.  Well stricly speaking it was an epilespy medication unlicensed for psychiatric use called clonzepam which triggered off my worse ever panic attack -- requiring a hospital visit -- in 2004.  It was the abrupt cold turkey off this drug that did it.  I'd been sectioned six months previously and put on a cocktail of psychiatric drugs, all without my consent and with no knowledge of what drugs I was taking, and I was also titrated (tapered) onto a high dose of 6mg risperidone in just three days (2mg, 4mg, 6mg).   This isn't something anyone could cope with without other medication as the akathisia (restless agitation) is so severe so I needed a tranquiliser.   Clonazepam was the drug of choice -- it's fast acting and very powerful and sedating.

Unable to cope without the drug I'd been addicted to for 6 months, my psychiatrist substituted diazepam.  My dad explained: "With its much longer half-life [the time it takes the level of the drug in your blood to fall by half] diazepam will be much easier to withdraw from and it can be done gradually".   I started on 10mg.   Then 8.  Then 5.  Then 3.  Then cold turkey.  Then two suicide attempts within 24 hours, one in hospital.

Fast forward 8 years and I'm still not off the darned drug!

Every time -- and it's never by my choice -- the NHS reduces my diazepam I get crippling panic attacks, generalised anxiety, low mood, paranoia, and ultimately become suicidal -- as last night.   Then we have to put the dose back up a bit again, and it defeats the whole object of reduction.  Indeed I hadn't taken a single dose of PRN (additional/emergency) diazepam since 1st June this year until last night, until suddenly I needed half a 5mg tablet to control the suicidal ideation (thoughts and feelings).  These were strong, and although I've been struggling to cope lately anyway, it was obvious that the root of the problem was diazepam.  It's no wonder it's a controlled Class C drug -- schedule 4 -- and that the NHS are so keen to get me off it.

The Ashton Manual - definitive handbook on diazepam

Some years ago I bought a copy of The Ashton Manual by Professor Heather Ashton -- the definitive guide to benzo withdrawal.  There is nothing so helpful or so complete on the market, and I will link to it at the bottom of this paragraph.  It's now available free as webpages online and if you're in withdrawal, or considering it, it's well worth reading.   It will scare you -- but you need to be prepared.   I'm only on a small dose and look at the effects it's having on me.  What if you are on a high dose -- the British National Forumarly says guidelines for anxiety disorders allow a usual dose of 15-30mg per day.  I'm on 2.5mg!!! I know someone who took 10 x 10mg a day and took a decade to withdraw.

http://www.benzo.org.uk/manual/

So what exactly is the range of withdrawal symptoms?

Well it's a very personal thing and varies from benzo to benzo but, taken from the Ashton manual, the list of individual symptoms includes the following:

• Insomnia, nightmare, sleep disturbances
• Intrusive memories
• Panic attacks
• Generalised anxiety, panics and phobias
• Sensory hypersensitivity
• Depersonalisation/derealisation
• Hallucinations, illusions, peceptual distortions
• Depression, aggression, obsessions
• Muscle symptoms and bodily sensations
• Problems with heart and lungs, digestion, immune system, endocrine problems
• Fits and convulsions

This always reminds me of the warning in the patient information leaflet (PIL) about my anti-psychotic medication: "May cause sudden unexplained death".  Well diazepam has nearly caused me highly explained death on many occasions now, including last night.

Watch Professor Ashton on benzo withdrawals

Other help available for benzodiazepine addiction/withdrawal

There are an increasing number of sites targeting people suffering from benzo addiction, such as:

benzosupport.org/index.html

benzoexodus.com/

non-benzodiazepines.org.uk/withdrawal-guide.html

en.wikipedia.org/wiki/Benzodiazepine_withdrawal_syndrome

I cannot vouch for any of these resources and neither can Mental Healthy and you must check out any advice contained within with your medical professionals before acting on them.

Good luck!

If you're in the same situation as me, and are addicted to benzos, don't despair - I know lots of people who have shown great courage and determination and who have succesfully managed it.  But a decision was taken by my consultant to leave me on 3mg until now as this prevents all these symptoms and helps to prevent suicidal ideation and intent.  A disclaimer here - diazepam does not cause people to become suicidal, but it is used as a treatment to mask those feelings.   Clonzepam does have "suicidal ideation" listed under cautions in the BNF -- and this is what happened to me.

I don't know how long it's been public that Prozac (fluoxetine) causes suicidal ideation but I knew in 1993 because my pharmacist dad told me and stopped me taking it.   In the end, the result of not taking an antidepressant was that I became suicidal eventually anyway, so these things have to be looked at with balance and seen in context, but psychiatric drugs are powerful and dangerous and many psychiatrists have a cavalier attitude to prescribing as many of them as like to patients on sections without informed consent and with no regard to the future consequences.