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    #1

    Important re: titrating down

    Hey folks

    I don't know where the general debate stands regarding titrating down - there was some concern a bit back about Dr. Levin's suggestion that one should not titrate down from their switch point. I managed to get an email through to Dr. Ameisen and he responded promptly. Here's what was said:

    Hello Dr. Ameisen. I've heard recently, with some alarm, that you are now recommending that one should remain at the dosage where one reaches their "switch point". I know that for myself, and many others, remaining at that dosage (380 mgs in my case) would be completely intolerable. I have titrated down to 160/day and am managing quite well. I fear that this new regimen will dissuade many from continuing the medication. Any response or direction to further information would be greatly appreciated. Thank you, Paul.

    To which he responded

    Hello Paul,

    I have never made such a statement. It probably has been misunderstood.
    What I say officially is in papers in medical journals, in my book and on my website.

    Please pass this information along.
    Best,
    Olivier Ameisen, MD

    There you have it peeps...
    Tags: None
    #2
    Important re: titrating down

    Oh.

    Ahhhh!

    Thanks Paul
    Started Baclofen 3/9/10 Hit my switch at 250mg on 21/11/10 Present maintenance dose of 50mg : started drinking after 1 year, upped dose to 80mg and stopped: Tapered to 30mg, started 6 months of drinking, upped dose to 240mg to stop 12/7/12

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      #3
      Important re: titrating down

      Thanks Paul! Great news and TFS!!

      I reached my switch last week at 275 and I've been staying at 250 all week just to be safe. So happy to read your message. Clears up a lot of questions I've been toying with.

      Ally
      Indifference is in your future with Baclofen. It works!

      My frustration with Baclofen, which is shared by Dr. Oliver Ameisen, is that because Baclofen is an off patent medication there is no profit motive for drug companies to support clinical trials that would demonstrate its efficacy in treating addiction.

      Comment

        #4
        Important re: titrating down

        Nice to hear, but it still doesn't make a lot of sense to me. If you are cured, why is there a need to have a maintenance dose at all? Are there other drug treatments that operate in this fashion?

        It would appear OA and Dr L are in disagreement over this?

        Either way, I'm so thankful this option exists

        Comment

          #5
          Important re: titrating down

          You make a good point Bleep, what is the definition of being cured. The post switch protocol doesn't clear up a lot for me either unfortunately. Still unsure of what I should be doing with the dosage and my personal development.

          The one thing that OA does seem to say is that sticking at the 'switch' dose is not law.

          Loop reported that OA was now taking in excess of 300mg/day which would mean he is above his switch dose. (Hope I got that right Loop, correct me if I'm wrong - which I'm sure you will).

          I was reluctant to stay at my switch dose and would ultimately like to come off the drug completely if at all possible.

          Alcoholism was a symptom of my dysphoria and now I've come to my senses I should concentrate on attending to that. From my life experience I believe if I can stay away from alcohol for a year or so, with a healthy attitude, then my addiction will be cured - the rewiring in my brain will be complete - quid pro quo. Possibly then I will be able to wean off the bac completely. This remains to be seen.

          The calm, non agitated, happy catholic (Low's expression), feeling that I get from baclofen is indeed welcome in many respects. It is not however the reason that I decided to take baclofen in the first place, it is a pleasant SE. It may or may not transpire that this is the most suitable remedy for my dysphoria but for the time being the jury is still out.

          Having tapered from my 250mg switch to 80mg over a period of 7 weeks, I am now back to 120mg. I've been on this dose for about 2 weeks now along with the accompanying SEs one of which is having to make a concerted effort not to forget to take my dosage. At this level, strong urges and convincing arguments in my head to have a drink have again receded. I am still noticing the prices of whiskey at duty free and comparing offers at the supermarket but I hope as the 120mg gets fully into my system that this will also diminish.

          Sunny, as some of you may remember, often use to urge the use of will power to supplement the effects of baclofen. At time it was unintelligible and antagonistic to me, however with the recovery of the part of my brain that can 'reason' it now makes perfect sense to use some will power in the fight against this disease.

          Apologies for the long and laborious post, I like the title of the thread.
          Started Baclofen 3/9/10 Hit my switch at 250mg on 21/11/10 Present maintenance dose of 50mg : started drinking after 1 year, upped dose to 80mg and stopped: Tapered to 30mg, started 6 months of drinking, upped dose to 240mg to stop 12/7/12

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            #6
            Important re: titrating down

            I absolutely do have some things to say, but I'm a lil' burnt out at the moment. :ranger
            :nutso: I take pride in my humility :nutso:
            :what?:
            sigpic
            Graph of My Drinking From July '09 to January '10

            Consolidated Baclofen Information Thread




            Baclofen for Alcoholism and Other Addictions
            A Forum
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              #7
              Important re: titrating down

              A quick reply before bed.

              Whatever the definition of "cure" is, I'm certainly not addicted to drink anymore, as long as I keep taking the medication.

              Ignomious, the fact is that taking the medication is a life-long thing - which is just fine with me. Whatever I spend on it is just a fraction of what I spent on booze, and my SEs are nil now. I just came home from a movie and opened a beer and drank half of it, and capped it for another day. I'm fine with that - the urge to continue on and on is just gone. Anyhow, I suppose that's a whole other topic.

              But it's not a "cure" I suppose in that one can be treated with the medication for a time and be done with it. And yet it cures me. Who knows. But does it matter?

              Best to all - P

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                #8
                Important re: titrating down

                Paul, you hit the nail on the head there. Whatever it happens to be, it's just worth doing.

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                  #9
                  Important re: titrating down

                  Cure or not wasn't the subject of my post. Sorry that it came across as such. Baclofen works and whatever name one chooses to give the results is OK by me.

                  The point I was trying to make is that we still have precious little knowledge or guidance on what to do/expect post switch.

                  Paul's original post stated that sticking rigidly to the 'switch' dose was not OA's proclamation but doesn't say what we should be doing or even if the clues are to be found in his publications.

                  Paul, I would also like to say that I would rather take baclofen for life than be addicted to alcohol. Only that, all things being equal, I would prefer not to be dependent on any drug. If I am going to be taking a drug for life then I think it bears consideration which one is best for my dysphoria. At this time I am talking as a non alcoholic with the newly found information that I do have dysphoria!

                  Loop ... Swallow another can of spinach.
                  Started Baclofen 3/9/10 Hit my switch at 250mg on 21/11/10 Present maintenance dose of 50mg : started drinking after 1 year, upped dose to 80mg and stopped: Tapered to 30mg, started 6 months of drinking, upped dose to 240mg to stop 12/7/12

                  Comment

                    #10
                    Important re: titrating down

                    Does anyone know what dose Dr. A is currently taking 7 years after his switch?
                    Indifference is in your future with Baclofen. It works!

                    My frustration with Baclofen, which is shared by Dr. Oliver Ameisen, is that because Baclofen is an off patent medication there is no profit motive for drug companies to support clinical trials that would demonstrate its efficacy in treating addiction.

                    Comment

                      #11
                      Important re: titrating down

                      I recently saw Lo0p post that it was 320mg's, but I can't confirm that.

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                        #12
                        Important re: titrating down

                        Crap, 320? Hope that's wrong.

                        Comment

                          #13
                          Important re: titrating down

                          Great question, Paul. Thanks to Dr. A for answering that. It's very important!

                          I've been re-reading that particular section of the book. Don't have it with me, but I think it's around p. 165 in the hardcover edition (The End of My Addiction.

                          I think we have real cause to reevaluate the titration schedules. Dr. A went down to ?mg (not sure) and then titrated up 20mg every 3 days. He got up to 270mg (threshold/indifference) where he stayed for a short time, due to increased somnolence, and then titrated down to 120mg (maintenance dose.)

                          That's also what is in the research, I believe, although I haven't reread that as thoroughly this week. It'll have to wait until later unless someone wants to take a look at the stuff Dr. A published. Which can be found on the first page of the Consolidated Baclofen Thread.

                          EVERYTHING else is hearsay or conjecture. Best not to assume anything about what Dr. A is taking or doing, since we simply don't know. Ya' know?

                          What do they think over on the French connection???

                          (Also have to avoid any medical advice here, ftr. I am not a physician and never will be! but I CAN read. and listen sometimes.)

                          Thanks again Paul and Dr. A.

                          Ig, I think you and Tip started this discussion over on the other thread a couple of months ago and it got derailed. (maybe by me? can't remember.) Someone could look at that, too, to try and suss out where we might have gotten waylaid about staying at the threshold dose, etc...
                          Best, folks!


                          K/Ne

                          Comment

                            #14
                            Important re: titrating down

                            ignominious;1062099 wrote: Loop reported that OA was now taking in excess of 300mg/day which would mean he is above his switch dose. (Hope I got that right Loop, correct me if I'm wrong - which I'm sure you will).

                            Not exactly, here is what I said: https://www.mywayout.org/community/f2...ml#post1058678 I don't know what he takes today.

                            That is exactly what Dr. L told me. However, given recent revelations concerning the differences between their titration protocols (among many other thing                            , I'm left wondering how "on the same page" these two actually are.

                            With all due respect, and I'm cringing as I write this, I think that what Dr. L told me about Dr. A's dosage may be just hearsay. :no:
                            :nutso: I take pride in my humility :nutso:
                            :what?:
                            sigpic
                            Graph of My Drinking From July '09 to January '10

                            Consolidated Baclofen Information Thread




                            Baclofen for Alcoholism and Other Addictions
                            A Forum
                            Trolls need not apply

                            Comment

                              #15
                              Important re: titrating down

                              neva eva;1062446 wrote: EVERYTHING else is hearsay or conjecture. Best not to assume anything about what Dr. A is taking or doing, since we simply don't know. Ya' know?
                              Oh

                              my

                              gosh...

                              I was formulating this thought in my head all day long. I read yours after I posted this: Lo0p;1062597 wrote:                               With all due respect, and I'm cringing as I write this, I think that what Dr. L told me about Dr. A's dosage may be just hearsay. :no:
                              You free for dinner anytime soon? Say in October? :blinkylove:
                              :nutso: I take pride in my humility :nutso:
                              :what?:
                              sigpic
                              Graph of My Drinking From July '09 to January '10

                              Consolidated Baclofen Information Thread




                              Baclofen for Alcoholism and Other Addictions
                              A Forum
                              Trolls need not apply

                              Comment

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