What to do after the switch? Taper or not which protoclol?

[ignominous]

What to do after the switch? Taper or not which protoclol?

Thanks Ne
Its such a relief to me to hear that there is still at least a contingency plan which allows for titrating down slowly.
Would love to hear more about the reasoning for the protocol change. Souds like he's not too clear on that or ready to give that info out. Maybe you can ask him for OA's telephone no!
Thanks again for the info. It means a lot to me to know I'm not heading for certain disaster by titrating down.

[Road to Recovery]

What to do after the switch? Taper or not which protoclol?

Ig,
Here is my situation. I started Bac in Feb of this year - hit the switch very early on (80mg). I have been AF since Feb 08. I stayed at this dose until mid September I believe and then started tapering off. I reduced gradually in case the cravings came back but I did not notice any changes in cravings. I have been off Bac for about 2 months with no changes in cravings. The only thing I miss about Bac is how well it made me sleep! I will be interested in seeing what path you chose.

[ignominous]

What to do after the switch? Taper or not which protoclol?

Perfect

[ignominous]

What to do after the switch? Taper or not which protoclol?

Apart from the sleep part that is.
Also Road let us know if any cravings do come back.
That really is the ultimate though, which I want to believe so much.
Thanks for sharing.

Reduced to 220mg yesterday

[Isolde]

What to do after the switch? Taper or not which protoclol?

I'm here, I made it! Have hit the switch and am ready to chime into this discussion.
Nev, thanks so much for sharing some of your conversation with Dr. Levin with all of us here. Considering how he will not actually say WHY he believes (or why OA believes) that people should stay at the switch dose if at all possible makes me extremely wary. If there's not a good reason to do it... then why should/would we?
What I am taking away from that conversation for myself personally, is his statement (or paraphrase, lol) that success is the most important thing. So to me, that says that if we can titrate down to a more manageable dose and still remain indifferent to alcohol (which is what "success" is) then that is fine.

I think I'd go nuts if I had to stay at 155mgs for much longer.

Ig, over on my thread you invited me to join in over here, saying that if you knew when you hit your switch what you know now, you would've gone down by 20mgs right away. I was thinking I would find the reason why you said that somewhere in this thread. Maybe I've missed it? Is it just because your switch dose gave you rough SEs and you know now that titrating down right away wouldn't affect your success?
I'm thinking that's what it is, but you know, got the bac brain going on!

[ignominous]

What to do after the switch? Taper or not which protoclol?

That's exactly it Isolde, it wont affect your success.

My theories have always been tied up with Bac having an increasing effect over time.

I stayed at 240 for about a week and the day I went to 250 I stopped drinking. That tells me that I hit the switch at 240 at the highest.

I stopped drinking that day despite myself, maybe I forgot or something, maybe I thought I'd give it a chance but it really didn't dawn on me for a couple of days that I might have finally reached the proverbial nefarious switch.

I suspect that a similar thing was happening with you. You had already reached the switch but your contraryness or 'Powerful alc devil' kept telling you that you hadn't.

Like me you've been suffering the SEs for some time, they are still there and now need to be addressed. This will become more important to you the more you realise that getting AF has been firmly implanted!

What I got here:
A few of people have come forward who advocate titrating down and don't don't sound like nutters. This information is available elsewhere on MWO but its always nice when someone is talking directly to you.
2ndly, Now recieved permission from the one medical authority that we have that in some circumstances it permissible to titrate down.

This is from one Bac'd brain talking to another Bac'd brain and I hope it makes some sense. lol

[Sunnyvalenting]

What to do after the switch? Taper or not which protoclol?

I, too, define success as the ability to easily stay AF. I have been Af since mid January. Currently take bac 20 mg at night. May not need it but it makes me feel secure if that makes any sense. It is like a nightly commitment to my new life. I may or may not stop it next month after a year AF.
Sunny

[Dabhar]

What to do after the switch? Taper or not which protoclol?

Congrats.

Wow...great news. You have been AF for a time than most of us here wish we could accomplish! Way to go!!!

As for titrating down...sure, go for it...you have nothing to lose other than being AF (Alcohol FREE)...and when you find that point where you want to drink again...then titrate back up till you find the magic spot. OA went up to 270mg/day until he became free....and then he titrated down to 120 (that's where I am in his wonderful book)....but I think he is around 50 mg per day now.

Just experiment my friend...WE are the ones whose experience will bring to the rest of the world the gift and magic of Baclofen...just as OA (Dr.Oliver Ameisen) did. And he NEEDS us are further evidence of Baclofen's efficacy!!!

So, keep on, keeping on. Be just as OA was and experiment to find your maintenance dose. For you it might be much higher than it was for him...SO!??? Everyone is different.

Keep on keeping on Ig....and congratulations on reaching your point of FREEDOM. I'm still looking for mine....increased 10mg today to a total of only 60 mg/day. I'm feeling very close to reaching my "switch"....

Cheers and take care.
Dab

[ignominous]

What to do after the switch? Taper or not which protoclol?

That's good news about feeling close to the switch, I think that's when the Bac is doing its best work. Keep it up Dabs and you'll get there soon.

I am going to titrate down and hopefully will be able to speak with Dr Levin tomorrow morning in order to get things a little clearer.

It's dawned on me recently what a brave man OA really is. All my fears and trepidations would have been so hard to deal with without the support I've had here and from OA's book. That guy really was going into the unknown.

[Ne/Neva Eva]

What to do after the switch? Taper or not which protoclol?

I'm just going to throw this out there:

We have access to all of the studies that have actually been done, (both reputable/conclusive and questionable, or inconclusive since they're mostly done with loooow dose bac.) Which I won't pretend to be able to debate, but which have been thoroughly discussed by those that can.

We have substantial, if not thorough, anecdotal evidence from members here, that titration up to the switch, and that titration up to abstinence have been achieved. And also, ftr, that moderation might be possible for those of us who want that option. Across the board, these people have titrated down to a manageable or non-existent bac intake. There isn't anyone here, as far as I can tell, who has stayed at the switch dose.

We have, from Dr. Levin, that quality of life matters as much as baclofen intake. My take on that is, like Is pointed out, titrating down from the switch depends on the SEs one is experiencing. And that his understanding is that it is unclear yet if relapse is due to lowering baclofen intake too drastically. So, cautious and consistent seem to be a good way to navigate the unknown, imho.

There are several people that were here when I first signed up 6 months ago that I would like to hear from: Birdy and Cinders to name two. Bill P, before my time, but still...? Many others... I am much more curious about the members that are not posting regularly then I am about OA. And for this reason: The guy is not a god. He is a man who has a very vested interest in both his own sobriety and the introduction of bac as a cure for addiction (of all kinds, ftr.) Professionally, emotionally, personally, you name it. He has much more riding on this than we do, in a way. (Except of course I want personal freedom from the beast and that's more important than anything in my eyes...And it's not an easy path, I'd hate for it to be a wasted effort.) I hope that this does not seem hypocritical. I have, in a sense, a blind adoration and devotion to OA and Levin for their work and their kindness. But I also have a healthy dose of realistic expectations (or cynicism...depending on your take and my mood.)

Thanks again to the stalwarts that remain. Tip, Lo0p, Sunny, Road, Mog to name a few. And to those that are posting regular updates about their journey. Matters much more than you could imagine, I think.

Also, Publius, does your doctor have any input about titration after the switch? I admit I haven't been keeping up like I should, so maybe I missed it?

Love and gratitude, people.

[Sunnyvalenting]

What to do after the switch? Taper or not which protoclol?

One reason I wanted to titrate down was the risk of acute withdrawal should I need to stop suddenly or not have access to the medicine for any reason. Imagine an accident or illness in which the docs couldn't give the bac or didn't know they could treat with the high doses we used to reach our switch. For this reason I told a few people about my dose ( the ones who might be able to advise the hospital if something happened) and further was inclined to taper to this low dose, which if stopped suddenly, would be a non issue. Just something to consider in the long run. Also, expense, especially if getting without Rx can be a significant drain on financial resources if continued indefinitely. Why pay for or/take something if it is not truly needed?
Each of us is going to run the equation based on our individual factors.
All the best.
Sunny

[Full English]

What to do after the switch? Taper or not which protoclol?

Hi Ig, I can't really feed into how to titrate down after the switch.
I hope it goes OK for you. It is great it is still working for you 2 weeks in.
I am in this limbo land. 190mg is stopping me drinking which is great - I love it. Most days, no problems at all. I have had a couple of days though, where I could have, which makes me think that I haven't hit my switch. I know you suggested I drink to test if I have hit my switch, and I don't think I'm brave enough to try that. Anyway, went up to 200mg today. I may well be at the switch at 190mg, but I thought I'd try it. I know Dr A said that there were days when he upped his dosage when he had cravings and stress.
Anyway, you've had lots of feedback here on this thread. I hope you are getting the answers you are after.
Full English

[ignominous]

What to do after the switch? Taper or not which protoclol?

Thanks Full
I sort of 'get it' where you are mentally now. I just posted a congrats over on your thread because you used the word 'switch'. Ha.
This is why I suggested a drink, just to find out, have you or haven't you hit the proverbial switch. The 1st night I didn't drink was an abberation, the 2nd I couldn't bother or something, on the 3rd night it dawned on me that maybe I had arrived but like you I wasn't sure. Now I'm sure: you have to do what it takes for you to be sure.
Just one last thought; look up to seethepony's input, it hit a nerve for me here. I think it may help you, this is not AA, if we have one drink then all the hard work is not lost.
Keep us posted and good luck.

[ignominous]

What to do after the switch? Taper or not which protoclol?

Sunny, I've only just read your post, sometimes (often) I do that, go tho the new posts and just read the last entry. I'm busy or worried that my internet connection will drop before I've had a chance to open my big mouth!
The thing you say about forced withdrawal is very pertinent where I'm living. Not so many people speak English and Baclofen is by no means to be found in all the cities. Even carrying a card would be unlikely to help if I was unconscious.
The money aspect is ever present in my mind due to my diminished finances.
Thanks for the thoughtful response

FTR:
21st Nov SWITCH 250mg
24th 240
28th 230
2nd Dec 220
5th 210
Still super confident that I've kicked alcohol for good. The thought of a cold one has crossed my mind in this hot climate but so has the thought of having some ice cream.

[Sunnyvalenting]

What to do after the switch? Taper or not which protoclol?

just thinking of doing something, IMO, is not the same as an intense craving like it use to be. I go to the gym daily in the mini mall where my main liquor store was. It crosses my mind to "cross the parking lot". But then my thoughtful mind reminds me that I no longer WANT it with a capital W. It is always a surprise that I don't! It is almost like that was a different person.
You are doing so well in such a short time.
Congrats,
Sunny