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**Cinders** · April 5, 2011, 08:23 AM

Another note from Dr Ameisen

Bleep,

At least that information tells us all that we need to be careful titrating down. Go down and sit on it a bit until you feel comfortable you are still indifferent. Then go down a bit more....

Thanks for checking with OA and posting that information!!

Cindi

**redhead77** · April 5, 2011, 11:57 AM

Another note from Dr Ameisen

Thanks Bleep. That's what Dr L told me too. He said they feel that no one fails on bac if they remain at the switch dose. Some may be able to come down, but we should wait to try till we have some time to let our brains recover. He thought 18 months was a good estimate. I think it depends on how long one's been drinking, the recovery time needed. I guess we'll see!

Thanks Dr Ameisen for responding to us again.

**Guest** · April 5, 2011, 01:25 PM

Another note from Dr Ameisen

redhead77;1091911 wrote: Thanks Bleep. That's what Dr L told me too. He said they feel that no one fails on bac if they remain at the switch dose. Some may be able to come down, but we should wait to try till we have some time to let our brains recover. He thought 18 months was a good estimate. I think it depends on how long one's been drinking, the recovery time needed. I guess we'll see!

Thanks Dr Ameisen for responding to us again.

Then why have people on this forum been telling me to titrate down?With the inevitable, and distressing result that once again I have relapsed, and quite badly too?

I reported feeling terrible at my switch dose, then I was asked why I stayed at that and didn't titrate down. Once again I am in a very bad state. I was keeping at the switch dose because is was reported that those who titrated down relapsed, then quite a few questioned why I was still as that dosage.

Sorry but I am really not very happy at seeing this when I was questioned about staying at a high dose!

**scot98** · April 5, 2011, 04:01 PM

Another note from Dr Ameisen

No disrespect UKB, but we are all on relatively new territory here regarding Baclofen. I am sorry to hear of your relapse, but in no way can you expect an exact protocol on what level each individual needs as a maintainence dose when there is nothing documented in that respect!
Hope you get things bac under control

Best wishes

**redhead77** · April 5, 2011, 05:09 PM

Another note from Dr Ameisen

Hey UKB!

Haven't seen you in a while. :l

I'm not a doctor, so I can only report what my doc says. I knew you were questioning, and I read about it. I guess I could've, should've responded. I just always keep up on my reading around here, but don't always respond, don't have the time to.

I also know that some, due to lack of affect, or depression are told to titrate down. I don't agree. I think in some of us, alcohol masks other problems, and we have to medicate or deal with those. That's of course my opinion, but my doctor's as well. I also believe very much in PAWS, so we have to deal with that after drinking. Tons of meds to help with it, though. I'm truly sorry you have relapsed, and had to go through that. Truly! Good news is, you can come back up, and go back to where you were. Even if that sucks, it's better than being a drunk, or is it?

**Cinders** · April 5, 2011, 05:18 PM

Another note from Dr Ameisen

Red,

As a matter of fact, the 18 months that Dr. Levin alluded to for staying at your switch is about the time PAWS abates.

It sucks that it takes so long but shoot, I have been a drunk for a whole lot more than 18 months!!

UK, please don't be upset. As scot98 said, "this is new territory."

I HATE that you relapsed and it has been so difficult. Please try again. I am. We can do this!! My SEs were bad the first time, too. I refuse to let them stop me.

We will do this. Okay?

Love,
Cindi

**Murphyx** · April 6, 2011, 12:50 AM

Another note from Dr Ameisen

OK what does "PAWS" mean? I Googled it and it appears to be an American animal shelter. I'm assuming you're referring to a different PAWS, if not...

**bleep** · April 6, 2011, 01:00 AM

Another note from Dr Ameisen

PAWS stands for Post Acute Withdrawal Syndrome. It covers a wide range of symptoms that can continue for up to two years in alcoholics and addicts. It should not be confused with Acute Withdrawal, which is over in roughly 72 - 96 hours, and can be immediately dangerous if not life-threatening in the case of alcoholics and people addicted to certain benzodiazipines, and in other cases make us feel as though we are going to die.
PAWS is too complex to go into in detail here. Treatment includes therapy, nutrition, exercise, medical and emotional support and patience, along with faith in the process. See the "Related Links" below for much more. (Don't confuse them with the ads.)

The above was taken from wikianswers, I'm sure there is a wikipedia entry somewhere, but my brief search failed to turn one up.

UK, scot said it perfectly - nobody is certain as to what works, and why. Perhaps try going up past your switch dose, you may find a different level of SE's? I hope you find a solution.

Staying at my switch dose, which I'm assuming to be 300mg's, will cost me about $10 a day, so 18 months sounds quite grim! $5 400 worth of baclofen. I suppose the alternative is much costlier though, so there's really not much of a comparison.

**Murphyx** · April 6, 2011, 01:29 AM

Another note from Dr Ameisen

Thanks Bleep, that makes much more sense. Well I say it makes sense, but I'm not so sure this bit does: "Treatment includes therapy, nutrition, exercise, medical and emotional support and patience, along with faith in the process.". I have no idea why "faith" could be listed as a treatment.

Anyhoo, here's the Wikipedia entry: Post-acute-withdrawal syndrome - Wikipedia, the free encyclopedia

The list of symptoms is extensive:

Psychosocial dysfunction
Anhedonia[19]
Depression
Impaired interpersonal skills
Obsessive-compulsive behaviour
Feelings of guilt
Autonomic disturbances
Pessimistic thoughts
Impaired concentration
Lack of initiative
Craving
Inability to think clearly
Memory problems
Emotional overreactions or numbness
Sleep disturbances
Physical coordination problems
Stress sensitivity
Increased sensitivity to pain
Panic disorder[14]
Generalised anxiety disorder[14]

Sounds pretty much like being a pisshead to me. What fun.

**bleep** · April 6, 2011, 02:04 AM

Another note from Dr Ameisen

Sounds more like a hangover to me!

**Cinders** · April 6, 2011, 03:26 AM

Another note from Dr Ameisen

:H:H A really long hangover. and it is.

Murph, faith doesn't always have to be about religion. I have faith the sun will come up tomorrow. That doesn't have anything to do with religion, unless you are a Mayan.

Faith means hope. We all have hope. You have done well, I have faith you will continue to do well and Baclofen is one of the reasons.

Faith.

Cindi

**Murphyx** · April 6, 2011, 03:55 AM

Another note from Dr Ameisen

So that's what the 'faith' part of the treatment is referring to? Faith that the treatment works?

**Cinders** · April 6, 2011, 03:59 AM

Another note from Dr Ameisen

Well, yeah. Why would you embark on the treatment if you don't have faith?

If I didn't have faith the treatment would work, I would not have put a rubber mattress on my bed and wear diapers at night.

Geez.

I know, tmi, tmi.

No, the treatment posted was about faith in a higher power. But, we can bring this into the 21st century, after all.

Take what what works and leave the rest behind.

Cindi

**Murphyx** · April 6, 2011, 04:02 AM

Another note from Dr Ameisen

So it was about religion then?

As I said, I have no idea why faith would be listed as a treatment option.

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