Benzos, nal and baclofen

[aduggan]

I am on my second week of sinclair, and I am doing fine, already quite a good reduction in AL. However, I am on a benzo called oxazepam, only at night to help me sleep, but I tried stopping it and it gave me awful anxiety and sleepless nights. I know I need to stop it and I also was thinking of adding baclofen to help with the anxiety.

Does anyone know if you can mix these drugs, ie titrate up with the baclofen whilst down with the benzo. Or even better, can I just switch the benzo for baclofen.

Any info would be really helpful. Thanks

[Pete1]

Benzos, nal and baclofen

I don't know anything about benzos but I am pretty sure you have to slowly titrate off of them. Also, I think they interfear with the Sinclair method. Bac might be a good substitute for the benzo, but I don't know how you get off of one and onto the other. It does sound tricky though, so get some good advice before makig a move.

[paula]

Benzos, nal and baclofen

Oxepam is the same as diazepam, if you have been taking for a long time you will need to titrate down. It would be best to consult your doctor or pharmacist. Best of luck.

[Bill.P.]

Benzos, nal and baclofen

When I was taking organic chemistry/biochemistry my lab professor told us several tiems that benzodiazepines are just "alcohol in a pill". It turns the same receptor sites on and off like a key. Only thing is that before the depressant effects of alcohol are noted there is an "excitatory" stage before they get the depressant effects. Benzos lack that initial "buzz"
Otherwise, its the same receptors.
So it would make sense that baclofen would work on alcohol as well as benzo withdrawal. And in fact, its being studied as a possible treatment for benzo withdrawal. I could find no studies that have been completed to demonstrate that> But it would make sense

You should be fine to titrate down your benzo use to be safe while titrating up your baclofen starting @ 5mg 3x daily. As you move up with the baclofen dose, move down your benzo dose til you discontinue.
The baclofen dose is very small initially.
The initial treatment for alcohol withdrawal with substituting baclofen for alcohol [withdrawal] which it is shown to be as effective as benzos, is a 10mg dose every 8 hours.
If you want to be safe, then start with half that and slowly titrate you benzo as there is no clear study available on this.
Just be wary of drowsiness initially which 5mg doses are unlikely to cause

As to whether you can just switch benzo to baclofen. If you have only been taking it for a month at low dose. Yeah, no probs, but if you are taking a hefty dose and have done so for a long period of time Well the evidence is not there yet on that.

Tapering oxazepam down while titrating up baclofen would be the most logical and safest method

I am sure your physician would agree with that. This advice should not replace advice from your physician

Excerpt:
"Use in Addiction & Physical Dependence"
Baclofen is being researched for use in people addicited to alcohol and opioids and possibly benzodiazepine withdrawal and the craving and breakdown in self-control in recovering cocaine addicts. The effect on the latter is apparently much like that of clonidine whereas the mechanism in reducing cocaine craving (as seen in self-administration of cocaine in lab aminals &c.) appears to be a newly-discovered pharmacological effect.

[christyacc]

Benzos, nal and baclofen

I have a silly question, what are benzos? I have read of them in sites and the dangers of them, but I am not aware of them.

[Bill.P.]

Benzos, nal and baclofen

christyacc;627678 wrote: I have a silly question, what are benzos? I have read of them in sites and the dangers of them, but I am not aware of them.

Well most are familiar with benzodiazepines when they hear of valium or xanax or ativan.

Its just the name of a class of drugs generally used for anxiety. The differences between the various medications in this class is how fast or rapid the onset of the medication and also how long the drug stays in the system or more technically known as the half-life of the medication. Some fast onset, fast out of the system. Some long onset, fast out, some fast onset slow out etc...
They all work in the same receptors in the brain.

When you valium, ativan, xanax, librium and more then those are benzodiazepines or shortened it is benzos.
The generic names generally end with the suffix -pam o -am
lorazepam, oxazepam, alprazolam
Off the top of my head I think librium also known as chordiazepoxide which is used for alcohol withdrawal doesnt follow the naming convention. I think it was the first benzo as why

[christyacc]

Benzos, nal and baclofen

Thank you Bill for filling me in. I have heard many discussing it, but wasn't sure what they were.

[aduggan]

Benzos, nal and baclofen

thank you for all your replies. Bill P you really seem to know your stuff. Can you advise me please. I only take 50mg of oxazepam at night to help me sleep and in fact I have managed to reduce that to 25mg this last week with 10mg in the early evening because of anxiety.

As I said I am on TSM and taking NAL, so I am still drinking.

If I took 5mg 3 x day of baclofen. How much oxazepam should I take and should I just take it at night again.

When and how should I increase the baclofen and decrease the oxazepam. I have been on the oxazepam for about 6 months.

Also, if baclofen is the same as alcohol, will the opoid suppresant, supress the baclofen.

Last question for now, I am worried that this is all a dangerous mix with alcohol. I am currently drinking between 2 and 8 UK units per night. Can you advise?

Thanks

[Bill.P.]

Benzos, nal and baclofen

aduggan;627772 wrote: thank you for all your replies. Bill P you really seem to know your stuff. Can you advise me please. I only take 50mg of oxazepam at night to help me sleep and in fact I have managed to reduce that to 25mg this last week with 10mg in the early evening because of anxiety.

As I said I am on TSM and taking NAL, so I am still drinking.

If I took 5mg 3 x day of baclofen. How much oxazepam should I take and should I just take it at night again.

When and how should I increase the baclofen and decrease the oxazepam. I have been on the oxazepam for about 6 months.

Also, if baclofen is the same as alcohol, will the opoid suppresant, supress the baclofen.

Last question for now, I am worried that this is all a dangerous mix with alcohol. I am currently drinking between 2 and 8 UK units per night. Can you advise?

Thanks

Well I work in cardiac medicine so I am not supposed to know anything about this stuff, so bear that in mind that this isnt my area of expertise, I have studied neuropharmacology in Univ. but that was years and years ago and so its important to recognize I am not an expert in this.
Having said that. there are some things going for you. One is, you are only taking it at night for sleep as opposed to a regimen of morning, noon and night for anxiety which multiple dosing throughout the day ups the withdrawal risk.
Another thing is, oxazepam is a slow onset, fast out benzo. Fast onset benzos are more likely to cause withdrawal. So that lowers the risk of adverse withdrawal with oxazepam. Slow onset benzos are used for people who have problems waking up at night so the slower onset allows for better steadier sleep states. Its fast out so there is less hangover from it. Thats why they chose that for you, I assume you have difficulty with insomnia and concomitant anxiety.

Baclofen does not work on the same GABAa as benzos and alcohol. It works on GABAb. Its also a muscle relaxant, reduces anxiety significantly and causes drowsiness.

The usual discontinuation method in heavy benzo users, which you are not, is tapering over 6-12 weeks. Cutting the dose by 10mg per week if you take 50mg would put you at about 5 weeks would probably have been reasonable. Since you already cut to 25mg plus 10mg prn.
I would start the baclofen at 5mg 3x day and cut out the 10mg altogether. You should not need as baclofen is a wonderful antianxiety. And you should give it a week at 25mg, then drop it to 15mg 2nd week.
10mg 3rd week
5mg 4th week then discontinue.

You probably could do it faster since baclofen likely will prevent withdrawal, but there just isnt evidence to point to on that. Just would make sense hypothetically given how benzos and alcohol work on the same receptors and whats good for the goose is good for the gander.

You dont need to worry about whats called "potentiation" of baclofen and alcohol.
You DO have to worry about it with benzos and alcohol. Where the effect is simply not additve or cumulative, it potentiates each other to where its like taking a much higher amont of each which sometimes leads to respiratory collapse.
Baclofen will not do that to either so the addition to your relatively small benzo dose would not be a concern.

Start the baclofen at 5mg 3xday, and add 5mg daily every 3 days until you get the desired effect of losing cravings. You can accelerate or decelerate depending on how you feel. If you feel like hey. I dont need the oxazepam, see how you go as far as withdrawal symptoms. Keep some handy while you are doing it just in case you feel funky, then return back to the tapering schedule if significant withdrawal symptoms occur

This really is a bit of conjecture on my part on the internet, so you have to take everything with a grain of salt and consult a physician. This serves as a way for you to understand and ask questions when you do go to your doctor.

As far as Naltrexone, I have no clue. I dont logically see a need for nal with baclofen but others have found they like the combo. Im not a medication taker so the less I take the better. Baclofen worked for me amazingly fast and never drank since I lost my cravings completely. I dont know what the actions or cross reactions are with the combo.


As far as the last part, a dangerous mix. balcofen, no worries. Nal, not sure as I have not researched it or had previous knowledge of it like I do benzos. Benzos are safe as directed and tapering is needed. Alcohol, the worst of the lot is a poison and affects all organs, liver, kidneys, brain, skin, pancreas, stomach and intestines. You name it, alcohol particularly the aldehydes (caustic byproduct of alcohol metabolism) cause damage systemically. Not to mention the damage to your social life and people who care about you etc....
So the safest thing to do is get off the alcohol using the baclofen. I dont know if nal is a help or a hinderance to baclofen's action, at some point you shouldnt need it. The oxazepam once you are on baclofen will not be necessary, you will sleep like a baby. Some transient drowsiness as well during the day as you adjust to the medication

Hope that helps

I should add, my point of view is from that of a person that wants to never drink again b/c of the carnage I have left in my wake> As well as I have seen over and over again the negative health effects of alcohol use.
So I do not want to moderate my drinking. I am done with it. That is why I do not care for the Sinclair method from what I read. I am of that thought coming from my own goals, but to each their own.I think that if you get to the point to where you need to take medications, then you are an alcoholic and should quit and baclofen is all that is needed for that and trying to continue to drink when you cant control it without medications, just doesnt make sense to me. At some point, people have to bite the bullet and just come to terms with not drinking. Its much healthier as well and I tell you. Walking around not thinking about alcohol is a wonderful wonderful thing, havent known that feeling for 20 years until I dosed high on baclofen

[Goin4More]

Benzos, nal and baclofen

Hi Bill P. I'm a regular on The Sinclair Board, and have followed the baclofen/naltrexone discussions avidly. I've read Dr. Ameisen's book, as well as Dr. Eskapa's. My BF and I have been taking naltrexone per TSM for 16 weeks. His drinking is down by at least half, mine by about 1/3 - but then, I drank heavier, and for a longer period of time, than he did. (I also may have some mal-absorption issues due to GP surgery, which could slow the process.) But, there is definite progress, albeit slow.

You often mention that you work in cardiac medicine and we have the impression you are a cardiologist MD. Is this correct? Were you ever acquainted with Dr. Ameisen?

Some of us are wary of taking baclofen alone, in high doses, for what could be the remainder of our lives. Sudden withdrawal from this drug can be dangerous - and, having lost my purse with our Naltrexone script in it last week, I can only be grateful we weren't in a hairy situation whereby we'd lost our baclofen pills, and couldn't immediately replace them. Not all of us are able to do this with our physicians' blessing, as few physicians agree with these alternative therapies, and we can ill afford to have 'alcoholism' on our medical reports, as that can result in the loss of insurance. So actually getting these drugs is not an overnight matter.

This is why I personally believe that a person should first give The Sinclair Method a 6 or 8 month try, before resorting to a drug that will be a life-long commitment. Many practicing TSM DO go abstinent - even when that wasn't their initial plan. Many of us, like you, are sick and tired of being sick and tired, and the refreshment that comes with sobriety is a priceless gift.

While TSM is successful at eliminating addiction to alcohol in about 80% of people, it's good to know that if someone doesn't experience success - or doesn't experience it as quickly as they would like - it's possible to safely add baclofen to the regime to help reduce/eliminate cravings. I would try that next, should my drinking levels not be reduced to 25 units per week or less at the end of six months (further extinction takes place for 3+ years). However, I would not discontinue the naltrexone, as my goal is to be independent of all drugs, including alcohol, naltrexone, and baclofen. Only The Sinclair Method can extinguish the addiction entirely, so that one is not dependent upon any drug to maintain sobriety.

I think baclofen as a primary treatment is good for those who want near immediate results, who are commited to taking this drug several times per day, for life, and who perhaps don't respond to Naltrexone/TSM treatment. It is my opinion (for whatever that is worth) that combination treatment modalities such as naltrexone/baclofen will one day be the norm for alcoholism and other addictions.

Thanks for your postings - they are most informative!

[Prest4time]

Benzos, nal and baclofen

Wow. I have spent a long time this morning reading these posts. Bill P, thank you so much for all of your insight and personal experience. I have a question though; you said the baclofen worked well for you and that you do not like to take medicine. Do you still have to take it? Will the cravings for alcohol return if you stop? I know personal commitment is important as well and it sounds like you have that part solidified.

[Bill.P.]

Benzos, nal and baclofen

Prest4time;627958 wrote: Wow. I have spent a long time this morning reading these posts. Bill P, thank you so much for all of your insight and personal experience. I have a question though; you said the baclofen worked well for you and that you do not like to take medicine. Do you still have to take it? Will the cravings for alcohol return if you stop? I know personal commitment is important as well and it sounds like you have that part solidified.

Yes, I do not like to take medicine, mainly b/c I forget. I do take blood pressure medications, but when I dont drink and walking everyday, my bp plummets so when I dont need to take it, I stop it. Currently stopped.

Having not stopped baclofen and terrified to do so b/c if the cravings return and I drink I know from experience that I will totally stuff up my life and be right back where I was. Not willing to take that risk. And for me I ask myself "why would I?"
Baclofen is dirt cheap, my prescription cost me 5.5 cents per 10mg tablet.

Many state that alcoholism is a lifelong illness and studies have shown that the disease progresses even with several years of abstinence and that modified drinking is often a "mirage" says a Harvard researcher who followed alcoholics for 60 years that nearly all of them returned to alcoholism. And other studies show that people who start even after decades of sobriety return to drinking at levels higher than the levels at which they drank when they stopped. Their tolerance and disease progressed at the same level as if they had never stopped at all.
Dr. Ameisen states that he believes it needs to be treated long term like diabetes or the like. I may toy with the dosage after at least a year under my belt. Too soon for me to have an opinion on continuing. Evie Lou who I found was an early proponent on this board before I accidentally stumbled across here intending only to make one post and split. Has stated she lost all craving for alcohol and subsequently does not take it unless she has a craving. I'll let you take that subject up with her as I have no plans to discontinue.

To the other poster who seems a bit too perturbed about that I am a baclofen advocate. I have as I stated worked in cardiac medicine for approx. 10 years. I have chosen not to disclose my profession on here, I am more concerned about accrediting bodies than anonymous posting. I will have a bio page on my baclofen information website so you'll just have to wait for that.
I stated that is my opinion on nal and the sinclair method. Some people whom Ive PMd with use nal. and I am quite friendly with them and wish them luck like OO. As far as this lost purse with dire consequences that could kill someone scenario. That's pretty easy to solve by "not putting all your eggs in one basket". Leave your medications in your medicine cabinet and just take what you need in a travel container, problem solved and that's recommended to all patients with meds. Like a few days worth. And urgent care clinics would easily prescribe baclofen if you discussed the situation and you can pay that with cash, hence no insurance. If you did, in fact, put all of your medications in your purse and then lost it.
If you like the Sinclair Method, good luck, I like the baclofen method. As I said, to each their own. For me, I am not into moderating alcohol. Ive drank all the fun out of the bottle and it nearly killed me as well. I am done with it and baclofen has completely ceased the overwhelming cravings for alcohol. That's the only reason why I posted the first time here. I have answered questions that I could answer and made a few friends that kept me longer than I anticipated with PMs and questions

[aduggan]

Benzos, nal and baclofen

I have very little time to reply now, but I would just like to thank you all for your most informative replies. This site is surely a life saver. Thank you I will reply with my progress tomorrow. Night. x

[Prest4time]

Benzos, nal and baclofen

Bill,
Thank you for your response. I find that posts with a lot of information help me the most. You saved a lot of research time for those of us who do a lot of research on this stuff. Your inside world into medicine on whatever level has proved helpful... to me anyway. Thanks.

[bob3d]

Benzos, nal and baclofen

Bill.P.;628027 wrote: ...To the other poster who seems a bit too perturbed about that I am a baclofen advocate. I have as I stated worked in cardiac medicine for approx. 10 years. I have chosen not to disclose my profession on here, I am more concerned about accrediting bodies than anonymous posting. I will have a bio page on my baclofen information website so you'll just have to wait for that.
I stated that is my opinion on nal and the sinclair method. Some people whom Ive PMd with use nal. and I am quite friendly with them and wish them luck like OO. As far as this lost purse with dire consequences that could kill someone scenario. That's pretty easy to solve by "not putting all your eggs in one basket". Leave your medications in your medicine cabinet and just take what you need in a travel container, problem solved and that's recommended to all patients with meds. Like a few days worth. And urgent care clinics would easily prescribe baclofen if you discussed the situation and you can pay that with cash, hence no insurance. If you did, in fact, put all of your medications in your purse and then lost it.
If you like the Sinclair Method, good luck, I like the baclofen method. As I said, to each their own. For me, I am not into moderating alcohol. Ive drank all the fun out of the bottle and it nearly killed me as well. I am done with it and baclofen has completely ceased the overwhelming cravings for alcohol. That's the only reason why I posted the first time here. I have answered questions that I could answer and made a few friends that kept me longer than I anticipated with PMs and questions

Kind of a harsh response for someone as nice as G4M. I mean she was nice to you and even said that your posts are informative. I don't think she was perturbed at all. She just wanted some additional information about the person who is doling out all this advice.

In fact you're such a convincing advocate, that I myself have decided to start taking Baclofen based on your recommendations. Your dosage chart is quite informative and very specific medical advice. Also, thank you for specifically recommending 4RX. I compared prices and they are indeed the lowest of the online pharmacies. Thanks!

Anyway, I am tired of TSM and I have no desire to moderate alcohol intake; I'd rather go abstinent. The Sinclair Method doesn't always lead there, though. But it appears that Baclofen does. I have no reason to stop taking Naltrexone, so I'll stay on it until I am truly abstinent. I am currently down to 7mg per day diazepam (Valium). A far cry from 60mg diazepam per day last year! It'll take another 12 weeks to get to zero mg diazepam, if I don't want those horrible withdrawal symptoms again (one time is enough to convince anyone).

I will continue to take 50 to 60 mg Buspirone ( a non-benzodiazepine anxiolytic) until I start on Baclofen, since I need something for my anxiety and hypomania. Buspar (Buspirone) can be stopped very quickly since it is not addictive as are benzodiazepines.

Anyway, I am really looking forward to getting started.:thanks:

Bob