Announcement

Collapse
No announcement yet.

My Personal Trial Log

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

    My Personal Trial Log

    Hey folks,

    I originally started this “personal case report” when I decided to “take the plunge”. I did so partially for my own records, but mostly for presenting to local doctors after having achieved a successful period of sobriety with high dose baclofen. It was my hope that by this documentation, I could intrigue and educate those affiliated with 12 step ideology, as well as any who prescribe addiction medication. Ultimately, my goal was to get the word out in my area while obtaining a legal script in the process.

    Even now, I’m appalled at how many people I’ve either seen or spoken with over the last couple of years - people who specialize in the field of addiction/recovery and haven’t so much as even heard of baclofen. I’d still like to help change that, but am not all that sure I’d still utilize this trial log for that purpose. One reason is because the method I used is now obsolete. Dr. A has since altered his “Ameisen-Baclofen-Therapy”. Another reason is because of certain reports I logged around my switch dose. I don’t suspect most doctors would deem it a safe medication after reviewing it.

    I should add having mentioned this, that my experience should not defer anyone who wishes to pursue high dose baclofen therapy. You have this community, I didn’t. I was self-administering baclofen for the first time, without the supervision of a doctor; and certainly with little idea of what to expect. The other three times I approached my switch dose; I knew what to expect and didn’t have the same frightening experiences. In other words, please don’t let my log frighten you away from a beautiful thing! Baclofen truly is a safe medication when titrated and/or tapered correctly.

    Anyway, as it has also been a work in progress spanning over two years, it may still prove to be of some benefit. I’m open to questions, comments or suggestions any of you may have. I had to make some edits to correct punctuation, as well as to ensure everything I said was factual. But the original content of the trial log remains unaltered.

    You’ll all note that I miscalculated the milligram per kilogram ratio for determining my ceiling dose. But there’s no harm done. As I’ve learned since, there’s no need to determine a threshold dose – the switch will happen when the switch happens. Though I didn’t express it, the log indicates that I attained my switch dose at a slightly lower dose than what I had calculated at a higher mg-kg.

    You’ll also note that I didn’t appear to be drinking very excessively during the trial. I think most of this was due to the anticipation I felt over having started something I wanted to do for some time prior – I was eager to see where it would take me next. In the last two titrations, I drank quite excessively until the day I hit my switch.

    Also, Any reference to “cyser” pertains to an apple-honey wine I used to make by the five gallon batch. I dubbed it “liquid gold” due to the brilliant golden color and the sweet, yet warm and mellow flavor. It naturally yielded an ABV of 17% - no fortification required. Additionally, any reference to "beer" does not represent your common, average pilsner; but that of "big beer". I particularly enjoyed imports and micro-brews ranging from 8-11% ABV. What I usually drank was 9.6%. Not that this information is pertinent, but I thought I’d clarify.

    Finally, I apologize for the length. I tend to be pretty “wordy” when writing, but that’s only because I like being thorough. As it’s pretty long, I’m going to try and break it up into several posts and add updates. I’m not sure if it would all fit in one post otherwise. If a newcomer to baclofen learns nothing else from this, I hope that at least this much will be gravely noted: Don't Run Out!!!

    #2
    My Personal Trial Log

    INTRODUCTION

    I am a 38 year old male with a history of anxiety and depression from the age of nine years, as well as chemical addiction from the age of 17 years. I am socially reclusive due to debilitating social anxiety, and have been an excessive consumer of alcohol on a daily basis for over a decade. I have attended residential treatment twice; resided in a halfway house for six months; attended over 250 twelve-step meetings; been prescribed several medications for anxiety and depression, as well as standard FDA approved medications for alcohol craving - all of which, without successful results.

    I have been participating in cognitive behavioral therapy since 07/08/08, wherein the following diagnoses have been determined:

    Depression, recurrent
    Anxiety
    Alcohol dependence
    Posttraumatic stress
    Moderate to severe stress



    FOREWORD


    On 01/02/09, I awoke with an only partially functioning left hand, having succumbed to radial neuropathy after an exceptional evening of drinking. As a guitarist, I was devastated. I was relieved of my work duties shortly thereafter, and forced to apply for short term disability as I could no-longer perform my daily work requirements in a safe and productive manner. Thus, I spent most of my time alone at home with little to no social contact; wallowing in shame, remorse and deepening depression.

    Further, my anxiety symptoms were greatly exacerbated; and my head began to twitch and sway uncontrollably from side to side, especially when in public settings. Despite these worsening of conditions (or more so perhaps, due to them), I continued to drink excessively on a daily basis. I explained to my therapist that I no-longer wanted to drink due to this recent, life-altering misfortune; but that I was unable to go even one day without drinking due to the overwhelming craving I had for alcohol.

    He then mentioned a book recently released by a doctor, who had discovered a means of eliminating alcohol craving with an unconventional medication. He couldn’t remember what the medication was, but suggested that it may be worth looking into. Needless to say, I was intrigued. Offering the slightly incorrect title: “How I Ended My Addiction”, I quickly found it online. I obtained a copy and read it all in one day.

    I learned of an exceptional cardiologist who also suffered from anxiety and alcohol craving. Though extremely successful and highly respected among his peers, this doctor found himself in emergency rooms without recollection of the events which brought him there; leaving him no choice but to eventually leave his private practice. He resided in treatment centers; attended countless 12-step meetings; as well as endeavored to overcome his symptoms utilizing the standard medications for anxiety and alcohol craving. However, he continued to succumb to anxiety and overwhelming craving for alcohol despite the negative consequences he incurred from his drinking.

    Based on a New York Times article regarding a drug addict’s reduction of craving with baclofen, Dr. Ameisen began compiling several abstracts on the subject via the internet. He also self-prescribed baclofen for over a year, although retaining an insufficient dose. He eventually learned that when baclofen was administered in doses of 1-5 mg per kg of body weight, rats became indifferent to the substances from which they were addicted. Having tried all else, and desperate for alleviation; he decided to see if these methods could be transposed to a human subject. Thus, he developed a dosing method while submitting himself as the first human test-subject. Within five weeks, he found complete and effortless indifference to alcohol. His story gave me a newfound hope, and further; a newfound mission - I was determined to try high dose baclofen myself.

    It was during this period when I sought out medications to relieve the debilitating symptoms I found to be flourishing beyond manageability. I was immediately refused an off label prescription for baclofen without so much a moment's thought. When I considered the task and financial burden of seeing multiple doctors in hopes of obtaining a legal script for baclofen, I decided it would be quicker and more cost effective to obtain it somehow without a prescription. I scoured the internet and found several pharmaceutical sources through which I could purchase it without a script. With the titration method and dosing schedule outlined for me, I was confident and eager to begin the dosing regimen. However, I abstained from administration while giving the FDA approved medications an opportunity to present satisfactory results.

    In short, topiramate effectively reduced my daily alcohol intake, but proved to be non-effective in reducing my alcohol craving. After two weeks, topiramate was discontinued and was to be replaced with naltrexone. But due to negative reports I had learned of through researching naltrexone, I was hesitant to try it. I then suggested the possibility of trying acamprosate in naltrexone's stead; to which I was informed that though it had good potential as a craving reducer, it was significantly more expensive than topiramate and naltrexone; leading to potential insurance issues.

    So I agreed to try naltrexone next, but insisted on the oral delivery method. This was due to the potential side effects associated with the injectable "delayed-release" method. I awoke the following morning and took my first dose. Within a half hour, I experienced extreme dizziness followed by a pounding headache. I took ibuprofen and lay down. What came next was queasiness that lasted for two days. Needless to say, I have not taken another dose of naltrexone; nor did I so much as retain it for further trials.

    I promptly disposed of the poison (for that is what any substance is when the body rejects it in such a fashion) as well as the doctor who prescribed it. That was two days ago, and was a defining moment in determining which course I intended to take next. As I am presently at home on disability; and continue to drink uncontrollably, I've decided that I do not have further time to waste with medications that not only do not produce satisfactory results, but only present further undesirable side effects.

    Now is the time to start the treatment with baclofen, with or without a doctor’s supervision. The alternatives are to either continue on the path of my own destruction in shame (while risking further injury), or to miserably seek out yet another questionable attempt at recovery via twelve step circles; in light of persistent cravings for alcohol.



    METHOD

    I shall begin self-administration at 10 mg three times daily. Every third day, I shall increase the daily dosage with another 20 mg until a threshold dose is obtained. Determination for the threshold dose shall be based upon my body weight of 165 lbs. or approximately 2.5 milligrams per kilogram (2.2 lbs.). This computes to approximately 190 mg. Once this threshold dose has been obtained and alcohol craving is suppressed, I shall maintain the dosage for a period yet to be determined. Then I shall lower the dose by 10 mg per day until a daily minimum maintenance dose has been obtained.

    My blood pressure is within normal range (120/80) and I have also undergone lab testing to analyze the current status of my liver, which was determined to be yet in excellent condition. Craving and Anxiety levels shall be measured on a level of 0-10. A “10” level representing extreme craving and/or anxiety with “0” representing none.

    Comment


      #3
      My Personal Trial Log

      TRIAL LOG


      3/28/09 9:30 AM: 10 mg. Nothing to make note of.
      Sat. 4 PM: 10 mg. Slight ringing in ears, lips feel a little strange. Feel relaxed.
      30 mg. 7:30 PM: 10 mg. Craving = 5, Anxiety = 3, chose not to drink.

      3/29/09 11 AM: 10 mg.
      Sun. 3 PM: 10 mg. Great circulation throughout, relaxed.
      30 mg. 7 PM: 10 mg. Craving = 5, Anxiety = 3, chose not to drink.

      I think just knowing I had started the treatment produced this effect... comparable to that of placebo or "mind over matter". The hope in decisive action was relieving.

      3/30/09 11:30 AM: 10 mg.
      Mon. 3:30 PM: 20 mg. Spoke with manager and ran errands, minimal anxiety.
      50 mg. 7:30 PM: 20 mg. Craving = 7, Anxiety = 3

      Felt very sleepy by 10 PM but had three beers.

      3/31/09 1:30 PM: 10 mg.
      Tues. 4:30 PM: 20 mg.
      50 mg. 7:30 PM: 20 mg. Craving = 7, Anxiety = 5

      Drank three beers and a glass of cyser.

      4/01/09 10:30 AM: 10 mg. Chatted with a salesman at a store for some time.
      Wed. 3:30 PM: 20 mg. Chatted with a gal at a store for some time.
      70 mg. 9:00 PM: 40 mg. Craving = 3, Anxiety = 0, did not drink.

      4/02/09 11:30 AM: 10 mg.
      Thurs. 4:30 PM: 30 mg.
      70 mg. 8:30: 30 mg. Craving = 9, Anxiety = 7

      Was anxious about trip, drank four glasses of cyser (17 % ABV).

      4/03/09 9 AM: 20 mg.
      Fri. 3:30 PM: 30 mg.
      90 mg. 8:30 PM: 40 mg. Craving = 5, Anxiety = 4

      Drank one beer upon arriving at suite, followed by two beers with dinner. I've always craved a drink after a long trip on the road as a means of relaxing.

      4/04/09 8 AM: 30 mg.
      Sat. 1 PM: 30 mg. Craving = 1, Anxiety = 3, drank one beer in the afternoon.
      90 mg. 11:30 PM: 30 mg. Got back to suite late, did not drink.

      I drank mostly out of an offer from a friend, not as a result of craving.

      4/05/09 8 AM: 30 mg.
      Sun. 3 PM: 20 mg.
      110 mg. 1 AM: 60 mg. Craving = 1, Anxiety = 2, engaged with others, did not drink.

      4/06/09 8 AM: 30 mg.
      Mon. 3 PM: 40 mg. Was a little sleepy during the drive home.
      110 mg. 10:30 PM: 40 mg. Craving = 1, Anxiety = 0, was exhausted and did not drink.

      4/07/09 9 AM: 40 mg. Was a little dizzy.
      Tues. 4:30 PM 40 mg. Was sleepy by 7 PM.
      130 mg. 11 PM: 50 mg. Craving = 5, Anxiety = 4, drank three beers leftover from trip.

      4/08/09 10 AM: 30 mg.
      Wed. 4 PM: 40 mg.
      130 mg. 10 PM: 60 mg. Craving = 2, Anxiety = 1, did not drink.

      4/09/09 8:30 AM: 40 mg.
      Thurs. 4:30 PM: 50 mg. Notable somnolence.
      150 mg. 10:30 PM: 60 mg. Craving = 5, Anxiety = 2, had three glasses of cyser.

      One thing is becoming more evident when I choose to drink. After a day or two of abstinence and with each successive dose increase, the effects of alcohol consumption are accentuated. With my first drink of cyser, I felt the effects. This was virtually an impossible notion in all my years prior associated with alcohol.

      The next morning, I awoke feeling very dizzy and encountered heart flutter and shallow breathing. Alcohol tolerance and resilience of the sympathetic nervous system are apparently reduced significantly while approaching threshold dose. Also, frequent urination appears to be becoming an issue all throughout the day and night.

      4/10/09 7:45 AM: 40mg. By 8:45, breathing and heart rate returned to normal.
      Fri. 5 PM: 50 mg. Experienced somnolence.
      150 mg. 11:30 PM: 60 mg. Craving = 0, Anxiety = 0, did not drink.

      I'm beginning to notice a disturbing trend at 150 mg. - persistent dizziness and somnolence throughout the day consistent with alcohol ingestion. The experience very much resembles that of a hangover without the anxiety, shakes, heart flutter, or shallow breathing. It is also comparable to having a few drinks in the afternoon.

      Additionally, dry; tired eyes as with exhaustion is prevalent. Other side effects are ringing in ears, headache and very deep sleep consistent with heavy alcohol use. Extreme sedation is evident at this dosage. To work would be a dangerous notion.

      4/11/09 10:30 PM: 50 mg.
      Sat. 4:15 PM: 60 mg.
      170 mg. 8:30 PM: 60 mg. Craving = 0, Anxiety = 2, did not drink.

      I awoke this morning having mildly wet myself in bed with no recollection of the event. This episode is comparable to prior experiences related to heavy drinking.

      This evening, I passed out in my recliner sometime after 8:15 PM. I awoke at 9:30 PM with my legs folded, right atop the left. I had been in this position for over an hour, and the area where my right leg had rested was in moderate pain.

      This experience was somewhat frightening as it also mimics previous experiences after bouts of heavy drinking. This has me concerned, but threshold is soon approaching.

      4/12/09 12 PM: 50 mg.
      Sun. 4 PM: 60 mg.
      170 mg. 8 PM: 60 mg. Craving = 0, Anxiety = 2, did not drink.

      I am noticing that I have to get up to urinate two or three times during the course of the night. Also, I experienced very vivid, frightening dreams the night before. I could not differentiate between reality or dream state, or whether I was awake or asleep.

      Circulation issues also apparent at 170 mg. Very cold though thermostat reads at 77 degrees, but this is most likely due to inactivity. I'm concerned over baclofen's influence on nerve enervation - if it will inhibit the recovery of my radial nerve. Mild audible and visual hallucinations are also evident - alcohol withdrawal syndrome?

      4/13/09 12 PM: 50 mg.
      Mon. 4 PM: 70 mg.
      190 mg. 8 PM: 70 mg. Craving = 0, Anxiety = 2, did not drink.

      The trend continued last night - went to bed at 12:30 AM and awoke at 2:30 AM to urinate. I awoke again at 4:30 AM after another vivid, frightening dream. And finally, I arose at 9 AM with my hand under my head. It was numb and non-functional, but returned to normal within a few minutes. I'm not achieving enough sleep.

      Ringing in ears intensifies with each successive dose increase to the point that increasing the volume on the television is necessary. At this point, no cravings for alcohol are evident in the slightest. I've attained the sufficient threshold dose and shall not increase dosage from this point forward. I'm not confident this can be maintained much longer.

      4/14/09 12 PM: 60 mg.
      Tues. 4 PM: 60 mg.
      190 mg. 8 PM: 70 mg. Craving = 0, Anxiety = 2, did not drink.

      I am noticing that as long as I'm awake and active, all is well. As soon as I sit down, I'm very sleepy. Perpetual vertigo as well as ringing in my ears is becoming a nuisance. Mild headache always present as well as muscle weakness and physical exhaustion.

      In contradiction, insomnia is also present at this stage. Surprisingly, I am quite functional throughout the day despite these inconveniences. I haven't achieved more than five hours sleep for the past few days, yet am fine until it comes time to sleep.

      These symptoms are consistent with withdrawal as opposed to overdose, so I'll continue with threshold dose one more day. Upon retiring last night, I experienced vivid audible and visual hallucinations upon closing my eyes followed by the usual interruptions of sleep. However, I did not feel the need to urinate nor did I experience vivid dreams.

      4/15/09 12 PM: 60 mg.
      Wed. 4 PM: 60 mg.
      190 mg. 8 PM: 70 mg. Craving = 0, Anxiety = 2, did not drink.

      Last night I went to bed at 2 AM. As soon as I closed my eyes, the hallucinations began, once again. Audible and tactical sensations followed by a myriad of visual hallucinations upon closing my eyes. The most concerning of my experiences was such relaxed breathing, that I awoke three times having stopped breathing all together.

      This led to such concern that I was fearful in allowing myself to rest. The result was achieving only four hours of sleep. Much of these symptoms may possibly be contributed to lack of rest and indiscipline in maintaining a structured schedule, but I cannot rule out alcohol withdrawal syndrome either (D.T.'s) as I have not experienced this condition before. I shall begin reducing the dosage while attempting to retire earlier.

      4/16/09 10:30 AM: 40 mg.
      Thurs. 3:30 PM: 50 mg.
      170 mg. 8:30 PM: 70 mg. Craving = 0, Anxiety = 2, did not drink.

      Last night I went to bed at 1 AM and slipped into a peaceful sleep without prior altercation. I only awoke once to urinate and did have a dream, though not frightening. I slept until 10 AM but awoke with a pounding headache and extreme dizziness. I took an Ibuprofen and my morning dose of baclofen and went back to bed until 12 noon.

      I awoke feeling much better, though intense symptoms of vertigo persisted. The former symptoms very much resembled that of a hangover. I surmise this was a direct result of having tapered the dose by 20 mg as opposed to only 10 mg. But I shall continue to taper the dosage by 20 mg as I'll be visiting family this weekend, and want to be coherent and in good spirits while I'm there.

      4/17/09 10:30 AM: 40 mg.
      Fri. 2:30 PM: 50 mg.
      150 mg. 7:30 PM: 60 mg. Craving = 0, Anxiety = 0, did not drink.

      4/18/09 9 AM: 40 mg.
      Sat. 2 PM: 40 mg.
      130 mg. 7 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      I arrived at my destination feeling well. Though I was sleepy in the afternoon, I had an enjoyable time with family. That night I slept soundly with the exception of needing to use the bathroom twice during the course of the night. Though I had several dreams, they were not frightening in any wise. Overall, this dosage was kind to me.

      4/19/09 10 AM: 30 mg.
      Sun. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      I have decided to see just how low a maintenance dose is truly required in my case. I shall continue to taper the dose by 10 mg. daily until cravings resurface.

      4/20/09 10 AM: 30 mg.
      Mon. 2 PM: 40 mg.
      110 mg. 6 PM: 40 mg. Craving = 0, Anxiety = 0, did not drink.

      4/21/09 10 AM: 20 mg.
      Tues. 2 PM: 40 mg. Will maintain no less than 120 mg daily per a suggestion.
      120 mg. 6 PM: 60 mg. Craving = 3, Anxiety = 3, chose not to drink.

      This has me very concerned. After nearly two weeks without preoccupation or cravings, I underwent a stressful episode regarding finances followed by anger and frustration.

      While grocery shopping, I passed alcohol sales at two different stores without complete indifference. After having settled in for the night, I experienced mild thoughts and cravings for alcohol. I fear I allowed myself to taper the dosage too quickly and too low.

      An hour after my final dose, I felt fine. But I'm concerned that approaching the threshold dose may now be required once again. I shall see how tomorrow goes. I'll continue with no less than 120 mg daily to ensure that this dosage is still sufficient.

      4/22/09 10 AM: 30 mg.
      Wed. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      Apparently, the maintenance dose of 120 mg remains sufficient. It didn't occur to me until today that increasing my dosage by 20 mg the evening prior would have most likely alleviated my anxiety and subsequent craving. I shall keep this in mind for the future.

      4/23/09 10 AM: 30 mg.
      Thurs. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      4/24/09 10 AM: 30 mg.
      Fri. 3 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      4/25/09 10 AM: 30 mg.
      Sat. 2 PM: 40 mg.
      110 mg. 7 PM: 40 mg. Craving = 0, Anxiety = 0, did not drink.

      I had gone out of town to visit a couple of friends and had miscounted my rations for the evening. However, 110 mg was sufficient.

      4/26/09 12:30 PM: 30 mg.
      Sun. 4:30 PM: 40 mg.
      120 mg. 8:30 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      4/27/09 11:30 AM: 30 mg.
      Mon. 3:30 PM: 40 mg.
      120 mg. 7:30 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      Something has occurred to me over the last week or so. I've been craving sugar constantly. I hadn't had a "sweet tooth" since I was young, but I suppose the sugars in alcohol compensated for this. Because I generally avoid sweets and disdain most sugar substitutes, I've taken to products sweetened with the Stevia plant.

      4/28/09 10:30 AM: 30 mg.
      Tues. 2:30 AM: 40 mg.
      120 mg. 6:30 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      4/29/09 10 AM: 30 mg.
      Wed. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      4/30/09 11 AM: 30 mg.
      Thurs. 3 PM: 40 mg.
      120 mg. 7 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/01/09 11:30 AM: 30 mg.
      Fri. 3:30 PM: 40 mg.
      120 mg. 7:30 PM: 50 mg. Craving = 1, Anxiety = 0, did not drink.

      In the afternoon, I was planting flowers outside when for a brief moment I reminisced of what it was like to perform such an activity with a couple of beers in such beautiful weather. The thought quickly passed, but the craving lingered for a short while.

      In such instances, I am reminded that alcohol must be avoided at all costs to ensure the success of baclofen treatment. Though it eliminates cravings and preoccupation associated with alcohol consumption, thoughts/behaviors still require modification.

      By this point, I'm confident in the ability of high dose baclofen to ensure sobriety within a hopeless alcoholic such as myself. However, success still requires an honest assessment and earnest desire on behalf of the recipient to avoid drinking.

      5/02/09 12:30 PM: 30 mg.
      Sat. 4:30 PM: 40 mg.
      120 mg. 8:30 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/03/09 11:30 AM: 30 mg.
      Sun. 3:30 AM: 40 mg.
      120 mg. 8:30 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/04/09 10 AM: 30 mg.
      Mon. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/05/09 10 AM: 30 mg.
      Tues. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 1, did not drink.

      Experienced minimal head twitch but attributed it to caffeine ingestion. I broke down today and purchased regular soda as opposed to diet soda to curb sugar cravings.

      5/06/09 10 AM: 30 mg.
      Wed. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0

      I found out today that I should be returning to work within a month.

      5/07/09 10 AM: 30 mg.
      Thurs. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/08/09 10 AM: 30 mg.
      Fri. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink

      5/09/09 10 AM: 30 mg.
      Sat. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/10/09 10 AM: 30 mg.
      Sun. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/11/09 10 AM: 30 mg.
      Mon. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/12/09 10 AM: 30 mg.
      Tues. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/13/09 10 AM: 30 mg.
      Wed. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/14/09 10 AM: 30 mg.
      Thurs. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/15/09 10 AM: 30 mg.
      Fri. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/16/09 10 AM: 30 mg.
      Sat. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/17/09 10 AM: 30 mg.
      Sun. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/18/09 10 AM: 30 mg.
      Mon. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/19/09 10 AM: 30 mg.
      Tues. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/20/09 10 AM: 30 mg.
      Wed. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/21/09 10 AM: 30 mg.
      Thurs. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/22/09 10 AM: 30 mg.
      Fri. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/23/09 10 AM: 30 mg.
      Sat. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/24/09 10 AM: 30 mg.
      Sun. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/25/09 10 AM: 30 mg.
      Mon. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/26/09 10 AM: 30 mg.
      Tues. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0. did not drink.

      5/27/09 10 AM: 30 mg.
      Wed. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/28/09 10 AM: 30 mg.
      Thurs. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/29/09 10 AM: 30 mg.
      Fri. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      5/30/09 10 AM: 30 mg.
      Sat. 2 PM: 40 mg.
      120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

      Comment


        #4
        My Personal Trial Log

        5/31/09 10 AM: 30 mg.
        Sun. 2 PM: 40 mg.
        110 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 5, did not drink.

        For a few days now I've been aware of having made a serious miscalculation regarding the time-frame in which to order my next regimen of baclofen. I've been out of town visiting family as of last Tuesday evening (5/26/09) and was hoping to find my order in the mail upon my return this evening. However, it was not there.

        Now I am faced with the nearly impossible task of obtaining a prescription on very short notice. I'm going to visit an urgent care facility tomorrow morning in hopes of obtaining enough baclofen to continue my daily dosage until my order arrives. I'm very concerned about the potentially dangerous side effects associated with abrupt withdrawal.

        I'm also very concerned about having to approach my threshold dose once again. As it turns out, I have recovered from my nerve injury at a level sufficient enough to be released from work restrictions by this Tuesday when I see the doctor next. If it is as I surmise, I'll be returning to work this Wednesday. My anxiety level is rising...

        6/01/09 10 AM: 0 mg.
        Mon. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 0, Anxiety = 7, did not drink.

        I went to an urgent care facility at 11 AM in hopes of receiving a temporary prescription for baclofen and was denied my request. I didn't receive any mail, so all I can do is wait until tomorrow. Insomnia was an issue after only one day of abrupt abstinence. I took an antihistamine at 12:45 AM to induce drowsiness.

        6/02/09 10 AM: 0 mg.
        Tues. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 0, Anxiety = 5, did not drink.

        This morning I awoke to the doorbell which sent me scurrying to get dressed. This effort produced symptoms of anxiety unlike I've known for some time. Rapid heart rate, shallow breathing, shaking head and hands were prevalent. As I'll more than likely be returning to work on Wednesday the 3rd, the timing for this couldn't be worse.

        So far, I haven't experienced notable symptoms of withdrawal other than insomnia and aggravated anxiety. Most of which, may be associated with returning to work. I still have not received my latest order of baclofen. But at this point, it is inevitable that the method of approaching the threshold dose will be required to achieve a successful maintenance dose. That is to say, I cannot resume with 120 mg when it arrives.

        6/03/09 10 AM: 0 mg.
        Wed. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 0, Anxiety = 5, did not drink.

        I've been granted one more day of leave from work due to discrepancies with information on the release form. I'm still very anxious about resuming my work schedule (5:30 AM-4 PM) and subsequent sleeping pattern without baclofen.

        6/04/09 10 AM: 0 mg.
        Thurs. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 0, Anxiety = 7, did not drink.

        I had immense difficulty with sleeping the night before. I checked the clock every hour to see what time it was. Baclofen definitely aided in promoting a restful night's sleep while subduing symptoms of anxiety simultaneously. How I had rested given the opportunity to continue my daily maintenance dose uninterrupted can only be speculated.

        I was perplexed with episodes of panic throughout the day. Most of which I contribute to becoming re-acclimated with my surroundings, duties, supervisors and co-workers after five months at home on disability. Baclofen may or may not have minimized this.

        6/05/09 10 AM: 0 mg.
        Fri. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 0, Anxiety = 5, drank one glass of winebr />
        The night before, I retired at 9:30 PM only to be awakened at 10 PM by upstairs neighbors who had clearly returned from an evening out drinking. As they fought; yelled; slammed doors and the like, my anxiety levels elevated. This activity continued for two hours. As I must awaken at 4:30 AM to prepare for a day at work, I finally resorted to gulping down a glass of cyser at 12 AM to calm my nerves - then I slept.

        6/06/09 10 AM: 0 mg.
        Sat. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 1, Anxiety = 1, did not drink.

        I was very tired and achy towards the end of my shift. Upon returning home for the weekend, I found the long expected order of baclofen waiting in my mailbox. I'm at a loss as to what to do with it at this point. To my knowledge, I cannot return it. And to resume my daily maintenance dose of 120 mg may not only prove to be non-beneficial, but possibly quite risky. I'll have to re-apply therapy standards from the beginning.

        But, given the side effects upon approaching the threshold dose; mingled with the greater quantity of milligrams for daily dosing during that stage of therapy; I should wait until a later time. Though I'll require a more abundant supply of baclofen; and should be better acclimated with my work schedule and duties; I'll commence with the dosing method.

        6/07/09 10 AM: 0 mg.
        Sun. 2 PM: 0 mg.
        30 mg. 6 PM: 30 mg. Craving = 3, Anxiety = 0, did not drink.

        Passing thoughts to short periods of preoccupation with drinking are evident. Abstinence currently relies solely on stubborn self-discipline and sheer will power. However, this may not be sufficient for long. Sugar cravings continue to prevail - it may only be a matter of time now before I give in to the call.

        6/08/09 10 AM: 10 mg.
        Mon. 2 PM: 10 mg.
        30 mg. 6 PM: 10 mg. Craving = 2, Anxiety = 1, did not drink.

        6/09/09 10 AM: 10 mg.
        Tues. 2 PM: 20 mg.
        50 mg. 6 PM: 20 mg. Craving = 5, Anxiety = 3, had two drinks.

        6/10/09 9 AM: 10 mg.
        Wed. 2 PM: 20 mg.
        50 mg. 6 PM: 20 mg. Craving = 1, Anxiety = 0, had one drink.

        6/11/09 9 AM: 20 mg.
        Thurs. 2 PM: 20 mg.
        70 mg. 6 PM: 30 mg. Craving = 1, Anxiety = 0, had one drink after work.

        6/12/09 9 AM: 20 mg.
        Fri. 2 PM: 20 mg.
        70 mg. 6 PM: 30 mg. Craving = 0, Anxiety = 0, did not drink.

        6/13/09 9 AM: 20 mg.
        Sat. 2 PM: 20 mg.
        90 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

        6/14/09 10 AM: 20 mg.
        Sun. 2 PM: 30 mg.
        90 mg. 6 PM: 40 mg. Craving = 0, Anxiety = 0, did not drink.

        6/15/09 10 AM: 30 mg.
        Mon. 2 PM: 40 mg.
        110 mg. 6 PM: 40 mg. Craving = 2, Anxiety = 0, had one drink.

        6/16/09 10 AM: 30 mg.
        Tues. 2 PM: 40 mg.
        110 mg. 6 PM: 40 mg. Craving = 4, Anxiety = 3, had four drinks.

        6/17/09 11:30 AM: 30 mg.
        Wed. 4:30 PM: 40 mg.
        130 mg. 9:30 PM: 60 mg. Craving = 2, Anxiety = 0, had two drinks.

        6/18/09 9:30 AM: 30 mg.
        Thurs. 2:30 PM: 40 mg.
        130 mg. 5 PM: 60 mg. Craving = 0, Anxiety = 0, did not drink.

        6/19/09 9:30 AM: 40 mg.
        Fri. 4:30 PM: 50 mg.
        150 mg. 9:30 PM: 60 mg. Craving = 2, Anxiety = 0, did not drink.

        6/20/09 10 AM: 40 mg.
        Sat. 2 PM: 50 mg.
        150 mg. 6 PM: 60 mg. Craving = 0, Anxiety = 0, did not drink.

        6/21/09 10 AM: 40 mg.
        Sun. 2 PM: 50 mg.
        130 mg. 6 PM: 60 mg. Craving = 5, Anxiety = 3, had three drinks.

        I calculated how long my current supply will last if I proceed with approaching the threshold dose - it will be depleted within eight days. So I'll taper my dosage downward until my next shipment of Baclofen arrives - I don't want to run out again.

        6/22/09 10 AM: 50 mg.
        Mon. 2 PM: 50 mg.
        170 mg. 6 PM: 70 mg. Craving = 7, Anxiety = 3, had five drinks.

        My shipment arrived in the mail today, so I'll now proceed with approaching threshold.

        6/23/09 10 AM: 50 mg.
        Tues. 2 PM: 50 mg.
        170 mg. 6 PM: 70 mg. Craving = 5, Anxiety = 2, had two drinks.

        6/24/09 9 AM: 50 mg.
        Wed. 2 PM: 50 mg.
        190 mg. 6 PM: 90 mg. Craving = 0, Anxiety = 0, did not drink.

        6/25/09 9 AM: 50 mg.
        Thurs. 3 PM: 50 mg.
        190 mg. 7 PM: 90 mg. Craving = 0, Anxiety = 0, did not drink.

        6/26/09 9 AM: 50 mg.
        Fri. 3 PM: 50 mg.
        190 mg. 6 PM: 90 mg. Craving = 0, Anxiety = 0, did not drink.

        As before, I'll commence with tapering down dosage after three consecutive days of maintaining the threshold dose. Unlike the extreme sleepiness, headache, and dizziness I experienced the first time around at home on disability, my days at work are unaffected.

        6/27/09 9 AM: 50 mg.
        Sat. 2 PM: 50 mg.
        180 mg. 6 PM: 80 mg. Craving = 3, Anxiety = 0, did not drink.

        This concerns me. I experienced thoughts of drinking upon returning home from work for the weekend. This was not the case before. Nevertheless, I'll continue tapering down.

        6/28/09 10 AM: 50 mg.
        Sun. 2 PM: 50 mg.
        170 mg. 6 PM: 70 mg. Craving = 2, Anxiety = 0, did not drink.

        Brief occurrences of preoccupation continued today. I'm beginning to wonder if my recent period of threshold dosing was sufficient this time around. Perhaps, the dynamics of my treatment has changed in consideration of environmental changes (e.g. maintaining a work schedule, associated stress, etc.). I'll continue on this course regardless.

        6/29/09 10 AM: 50 mg.
        Mon. 2 PM: 50 mg.
        160 mg. 6 PM: 60 mg. Craving = 3, Anxiety = 0, did not drink.

        Preoccupation and craving persist. I passed the liquor section at a local grocer without complete indifference. I was tempted to inspect the selection. I find the past few days very troubling as I hadn't experienced this during my first course of baclofen therapy.

        6/30/09 11 AM: 50 mg.
        Tues. 3 PM: 50 mg.
        150 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

        I experienced no craving or preoccupation at this dose. I'm not sure why I did at slightly higher doses. It's almost like my system needed to acclimate itself to lower doses than that of the threshold dose. Temporarily retaining this dose is a consideration.

        6/31/09 9 AM: 40 mg.
        Wed. 2 PM: 50 mg.
        140 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

        7/01/09 9 AM: 30 mg.
        Thurs. 2 PM: 50 mg.
        130 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

        7/02/09 9 AM: 30 mg.
        Fri. 2 PM: 40 mg.
        120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.

        I shall taper no further as prior experience has proven 120 mg to be a successful dose.

        7/03/09 9 AM: 30 mg.
        Sat. 2 PM: 40 mg.
        120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 0, did not drink.....

        ================================================== ================================================== ===================================
        I had become lax by this point in maintaining the log as I was back in the routine of normal, daily living. Additionally, the log would have proved to be redundant as I was experiencing
        no cravings or preoccupation with alcohol due to my daily therapy.
        ================================================== ================================================== ===================================

        7/21/09 10 AM: 30 mg.
        Tues. 2 PM: 40 mg.
        120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 5, did not drink.

        My last order of baclofen is long overdue while my current supply is dwindling. After computing my rations, I'll have only one more day to consume 120 mg if my shipment does not arrive. After which, I'll be forced to taper down the dosage in a safe manner.

        7/22/09 9 AM: 30 mg.
        Wed. 2 PM: 40 mg.
        120 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 3, did not drink.

        Upon my return home from work, I discovered that my order has still not arrived. If it does not arrive by tomorrow, I shall commence with tapering down the dosage.

        7/23/09 9 AM: 20 mg.
        Thurs. 2 PM: 40 mg.
        110 mg. 6 PM: 50 mg. Craving = 0, Anxiety = 1, did not drink.

        7/24/09 9 AM: 20 mg.
        Fri. 2 PM: 40 mg.
        90 mg. 6 PM: 40 mg. Craving = 0, Anxiety = 0, did not drink.

        7/25/09 9 AM: 10 mg.
        Sat. 2 PM: 30 mg.
        70 mg. 6 PM: 30 mg. Craving = 0, Anxiety = 0, did not drink.

        7/26/09 10 AM: 10 mg
        Sun. 2 PM: 10 mg.
        50 mg. 6 PM: 30 mg. Craving = 0, Anxiety = 0, did not drink.

        7/27/09 10 AM: 10 mg.
        Mon. 2 PM: 10 mg.
        30 mg. 6 PM: 10 mg. Craving = 3, Anxiety = 0, did not drink.

        7/28/09 10 AM: 10 mg.
        Tues. 2 PM: 10 mg.
        30 mg. 6 PM: 10 mg. Craving = 7, Anxiety = 3, had four drinks.

        7/29/09 9 AM: 0 mg.
        Wed. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 0, Anxiety = 3, did not drink.

        I was hung-over this morning at work, characterized by tiredness, dizziness, headache and aggravated anxiety. I felt better by mid-day and have no intention of drinking tonight.

        7/30/09 9 AM: 0 mg.
        Thurs. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 0, Anxiety = 0, did not drink.

        7/31/09 9 AM: 0 mg.
        Fri. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 2, Anxiety = 0, did not drink.

        8/01/09 9 AM: 0 mg.
        Sat. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 5, Anxiety = 0, had two drinks.

        8/02/09 10 AM: 0 mg.
        Sun. 2 PM: 0 mg.
        0 mg. 6 PM: 0 mg. Craving = 7, Anxiety = 3

        Comment


          #5
          My Personal Trial Log

          UPDATE - 12/?09:

          This last entry was added prior to drinking that evening. What followed was a mindset of hopelessness, frustration and defeat. My method of obtaining baclofen via internet pharmaceutical sources without a prescription had proven to be inconvenient, stressful and a completely unreliable means of pursuing sobriety.

          It was with fierce determination that I attempted to remain sober in the months that followed. However, I succumbed to insomnia, anxiety, and subsequent cravings for alcohol. I started out moderately, but my drinking patterns quickly escalated to that of before. Only something was different. I eventually found myself drinking more than I had prior, and the cravings were stronger. My head began to twitch and shake uncontrollably again, and my anxiety levels reached new heights I had not known prior.

          This called to memory what I had often heard during my attempts at sobriety in 12 step programs - that chemical dependency is a progressive disease. It picks up right where it has been left off. Though I had maintained a consistent (functioning) drinking pattern for many years, it was clearly beyond my control by this point in my life.

          As the negative consequences of my drinking had become unbearable again, I contacted a doctor out of state for consultation in mid-November. He required an initial in-office visit; which made reserving a flight, car and boarding imperative. My finances were in the red due to the medical bills I had incurred due to my nerve injury, but I was desperate by this point to go to these lengths in order to secure a reliable source of baclofen.

          My life had become extremely unmanageable once again, and I knew it was only a matter of time before something extremely unfortunate would befall me as before. But as proven, pursuing baclofen therapy independently was no-longer a viable option. So though the travel arrangements to see this doctor very much exceeded my comfort level per my debilitating anxiety and outright panic (finances aside), they were absolutely necessary to regain the freedom I had briefly known from enslavement to alcohol.

          Comment


            #6
            My Personal Trial Log

            UPDATE - 12/’11:

            As I approached my old "switch" dose of 190 mg under this doctor’s care, I was finding it much more difficult to abstain from drinking. My daily consumption pattern remained wildly out of control despite successive titration with baclofen. For perhaps, this reason (among others unknown to me beyond speculation); this particular doctor had lost confidence in treating me in our long-distance manner. I was forced to find a local doctor who would be willing to continue overseeing my current prescription.

            Upon a short search for local psychiatrists who specialized in addiction medicine, I managed to find one relatively quickly. Possessing an active script for baclofen certainly aided in the ease of this transition, no doubt. Otherwise, I’m certain I would not have found a local doctor willing to prescribe baclofen so readily. This new doctor clearly had no knowledge of baclofen as a craving suppressant, and immediately expressed his concern over my maintenance dose of 120 mg: “I’d like to see it more around 90 mg”. However, he did not address the subject beyond our first meeting. I later learned through his assistant, that I was their only patient receiving baclofen.

            Per my prior doctor's suggestion, I supplemented my baclofen therapy with psycho analysis. In the next several months, I maintained my maintenance dose while attending therapy sessions; much as I had while attending CBT (once every two weeks). During this time, I also tried several more medications for anxiety and depression. Overly confident in baclofen's ability to retain my indifference to alcohol; I had taken to enjoying one (1) of my favorite beers at the close of my work weeks as a means of reward. This was about 2 1/2 months into my third liberation from alcohol's grasp.

            At about three months into my therapy; I experienced a painful life change coupled with an unusual amount of stress. Hopelessness and depression prevailed; and I found myself drinking daily once again, despite my unwavering administration of baclofen (120 mg/daily). I was stunned as to why baclofen no-longer provided me with effective indifference to addictive craving to alcohol, as there was no biological explanation.

            I refrained from disclosing this new-found ineffectiveness with both my doctor and therapist, as I was concerned that they would discontinue my script. But after several months, it was obvious to me that the hope I had found with high-dose baclofen had become nothing more than a wonderful memory once again. Upon informing them, it was much to my surprise when they allowed me to continue the script. As I neared my 40th birthday, I began the upward titration in hopes of finding indifference once again. But I reached my previous switch dose of 190 mg without alleviation from craving.

            In the months that followed, my drinking escalated. And the presence of high-dose baclofen in my system only perpetuated the negative effects of excessive drinking. Due to this obvious altercation, as well as I could no-longer justify the regular purchase of a medication that was clearly not working, I initiated the tapering method for cessation. Once again, I admitted defeat and gave up all hope of ever having long-term liberation from the overwhelming craving to drink (and the misery which accompanies it). Thus, I also discontinued psycho therapy sessions as they provided no benefit.

            Another year went by. How I made it through that year without serious altercations is beyond me. I've always been a highly functioning alcoholic, but my last go-round with alcohol proved to be the worst I had ever experienced. Unexpected daily bouts of vomiting when drinking cheap beer made cheap vodka more desirable in this respect – 1 1/2 pints on work nights, and much more on the weekends. I took to wearing Depends every night before retiring (for obvious reasons). Upon arising, my apartment would resemble a crime scene. It was frightening to find my own belongings overturned, broken and scattered about while I had no recollection of what had occurred.

            Acquaintances and family members were forced to remind me of things they had told me prior - or of things I had already told them. I found it necessary to drink while running errands or while traveling, and took to disguising vodka in bottled water. My job of 16 years was finally on the line due to tardiness and absenteeism, so I contacted my employee assistance program and consulted with more therapists and counselors.

            At a loss, I also began looking into residential treatment centers. But given my previous experience with treatment stays that did nothing to address the pre-existing issues which led to my alcoholism in the first place, I knew that an average treatment center would not suffice. Thus, I searched for centers which specialized in duo-diagnosis; but learned that my out of pocket expense would be $4,000 before my insurance would cover the remainder. Regardless, I took the necessary drug/alcohol evaluation required for admittance into such a center. Then I was referred to another doctor.

            She read through my history and was amazed at what all I'd been through. She was very compassionate and knowledgeable at assessing which medications would best suit my needs from the first meeting. She prescribed Seroquel for my anxiety. Finally, I had found a medication that removed my anxiety driven head twitch. Given my history with other FDA approved craving reducers, she prescribed acamprosate. But despite the price, it proved completely ineffective in any wise. It was void of either positive or negative side effects, and seemed no different than that of a neutral pill used as placebo.

            As our sessions progressed, my schedule changed at work; and the bad aspects of my circumstances became worse. There appeared to be no relief from my daily preoccupation to drink, and I was desperate for yet another shot at Baclofen. During this time, I was introduced to yet another doctor who (unlike all the others I had seen prior) had a full, working knowledge of Baclofen. Meanwhile, it became clear to my other doctor that she would not be able to successfully treat me until I was alcohol free. Like others I had recently seen before her, she insisted that residential treatment was the only sensible option. But I simply couldn't justify spending $4,000 on something with no guarantee. This led to the perception that I was somehow being stubborn and argumentative and thus, she ended of our sessions against my choice. Like the other doctor who had "cut me loose", she evidently also saw me as a liability.

            My new doctor informed me of a change in protocol for baclofen therapy, involving a more gradual titration method (to minimize side effects), as well as dosing schedule. But more importantly, a change to the minimum maintenance dose for unaltered effectiveness of indifference. I learned that I was not the only one to suffer from efficacy reversal, but that there were many others that had succumbed to these unfortunate results as well. The switch dose was now to be retained for optimum success. It was relieving to know that I wasn't the only one, and also to learn why efficacy had diminished during my previous trial. But more relieving still, was to be assured that it would work for me again. I began titration with the new method.

            Despite my recollection of side effects present during the prior three trials, retaining the switch dose seemed completely reasonable when considering the alternative (i.e. the current state I was in). But when I attained my switch dose of 190 mg, I was still plagued by persistent thoughts and cravings for alcohol, as well as daily drinking. Needless to say, I was very concerned. But my doctor assured me that there is no constant in regards to the switch dose – that there was nothing wrong.

            With this consolation, I was greatly relieved; proceeding with my titration regimen with absolute confidence and certainty - eventually finding blessed indifference at 250 mg. My crippling anxiety symptoms which Seroquel had only moderately alleviated were now completely non-existent. However, there were a few intolerable restraints to accompany the beautiful liberties I was experiencing at this dose:

            1.) Incontinence during the day, followed by nocturia at night. At times (sporadically), resulting in mild bladder seepage prior to nocturia induced waking.

            2.) Extremely dry, tired eyes (despite plenty of fluid intake and eye lubricants).

            3.) Poor sleep (partially due to nocturia), despite taking my final dose three hours before bedtime as instructed. Average night: about five hours of rest.

            4.) Bowel elimination issues - not necessarily constipation, but diminished frequency and outcome resulting in distention, water retention; poor stools and persistent, foul-smelling flatulence (despite observing a conscientious diet minimizing hard-to-digest proteins while increasing fruits, vegetables and fiber intake).

            5.) DE (not to be confused with ED).

            So though I maintained complete indifference to alcoholic thoughts, preoccupations and cravings; as well as enjoyed absolute ease and comfort in social surroundings while maintaining my switch dose, these side effects (particularly the final two) proved to render the otherwise miraculous benefits nil. Thus, after 38 days of maintaining 250 mg/daily, I began the usual descent of 10 mg/daily on 12/22/11. The notable difference, is that I'm not tapering down until the lowest dose possible for retaining indifference is achieved - only until the most inconvenient side effects have subsided.

            12/26/11 – Today I’ll be tapering down to 200 mg and have already noted a minor wave of anxiety (though I haven’t so much as left the house) - but continue, I shall.

            12/27/11 – Side effects are much more manageable at this dose (190 mg), but I experienced a moderate wave of anxiety while in public, accompanied by slight head-twitch reminiscent of pre-baclofen conditions. I shall return to 210 mg.

            12/28/11 – Intend to maintain no less than 210 mg/daily. Ordered more baclofen today and it should arrive on Tuesday the 3rd per the holiday weekend.

            12/29/11 – Made an appointment with my doctor for Tuesday the 3rd. Shall discuss the changes I’ve made due to the intolerable side effects which appeared to have no other resolution besides a reduction in dosage. I’ll be open to any suggestions.

            My current dose of 210 mg can be best described as a “happy medium”. Troubling side effects are diminished to an acceptable level. Meanwhile, mild yet manageable waves of anxiety come and go a couple of times daily. I’d like to retain the full benefits from my switch dose if the subsequent side effects could be somehow diminished. Whether or not I’ll return to 250 mg/daily remains to be seen, though I’ve considered the possibility of replacing .05-1 mg Xanax with the additional 40 mg of baclofen – the difference of my switch dose. All I’m certain of at this point is that I have no intention of reducing the daily dose any lower. This dose is working, so there’s no need to “fix” it.

            Comment


              #7
              My Personal Trial Log

              Hi Tre (my nickname for you),

              I'm glad you posted your story. I'm on the up-titration for baclofen. Currently at 60mg/day. Like you during your first trial, I'm choosing not to drink despite cravings as I want this treatment to be most effective with the least amount of side effects.

              What is your daily life like now? Are you, overall, happy and content? Do you feel like your life is sustainable? I hope so, on all accounts.

              - Sabby

              Comment


                #8
                My Personal Trial Log

                Hi "Tre"

                You are a stalwart. Don't give up.

                Cassander
                With profound appreciation to Dr Olivier Ameisen for his brilliant insight and courageous determination

                Comment


                  #9
                  My Personal Trial Log

                  Thank you Cassander for your encouragement, I appreciate it very much.

                  And it's kind of funny you asked Sabby. My life continues to be stressful, and I still feel overwhelmed much of the time. But that's mostly because of multiple factors beyond my control right now. There's so many things I'd like to accomplish, change, start, complete, etc. - so many things and so little time. I 'spose I put this pressure on myself, LOL.

                  But my life is much more manageable now. With my nemesis subdued, I can focus on the important things without the nagging call that always hindered me. I now have a fighting chance at achieving my goals and ambitions, and am hopeful for the future.

                  Sincerely,
                  Tre (er...uh, I mean John)

                  Comment


                    #10
                    My Personal Trial Log

                    John -- that's an amazing story, both in terms of the substance and the level of detail that you've recorded it and laid it out. What comes through for me is that Baclofen seems to be your / our best shot at being able to tame a crippling level of anxiety and related alcohol dependence. I fear that at some point, it will stop working, but your story is inspiration to keep at it, even if it takes constant trying and adjustment.

                    One question -- did the abatement of the neuropathy mean that you were able to resume playing the guitar?

                    Comment


                      #11
                      My Personal Trial Log

                      Hi suneelca,

                      Yep, and how grateful I am for that! I tried to remain hopeful and attempted to play guitar a couple of times, but it was hopeless. Everything was so uncertain as there was no way of knowing if the nerve would ever heal. I was passed out pretty hard and damaged it badly. At three months in, my doctor even told me that I probably wouldn't regain full use of my left hand.

                      But at four months in, my hand started to show signs of recovery. I picked up the guitar more frequently, and actually started composing one of my better finger-style instrumentals to date. I didn't know how to feel about that for a while, but only because I had already adopted the mindset that my condition would be permanent (so as to prepare myself for the worst-case scenario). But after five months, my hand was fully restored and I was back to work. I'm playing guitar and dulcimer now as though the injury had never happened. And for that, I'm very grateful.

                      Thank you for your compliments.

                      ~John

                      Comment


                        #12
                        My Personal Trial Log

                        wow John, that was a great read. really informative, especially about possible pitfalls like running out of bac or sticking to the wrong dose. it's actually really helpful to be able to read the entire story from beginning to end. Your thoroughness and communication style are endearing. I laughed out loud at the comment that DE is not ED! So what is DE??? My only question is why not just stay at 250mg since you did not have anxiety at that dose and you now have some anxiety at a lower dose?

                        Comment


                          #13
                          My Personal Trial Log

                          Hi Andrea, and thank you also for your compliments.

                          I'm actually thinking about going back up to 250 mg for that very reason. I talked with my doctor today and told him about the side effects I was having at that dose. "DE" is "delayed ejaculation", which can be better translated by yours truly as "no climax", LOL. When I told him this, he was insistent that this had nothing to do with baclofen - that there had to be some other cause. He has treated thousands of patients with high-dose baclofen and had never had anyone report such a side effect. Then I told him that I researched the affiliation of this SE with baclofen and found a couple of sources that confirmed it. He then went to his favored data base (epocrates) and found no such report.

                          Then I told him about how it went away when I tapered the dose down, but he still felt the condition was caused by something else. In addition to that, I've been analyzing my diet over the last several days, and now have to question if the "elimination" issues were really caused by maintaining my switch dose. So now I'm eager as ever to go back up to 250 mg, but he told me to stay where I'm at for now to see how things go. I don't know. I respect his educated opinion and wish to honor his recommendation (as I'm grateful for his service), but I may just step up anyway.

                          ~John

                          Comment


                            #14
                            My Personal Trial Log

                            John I appreciate your faith in doctors but it is unfounded. Their knowledge is often based on limited studies and worse no studies at all. Considering how little Baclofen has been studied i would say jump back up to 250 and check it out for yourself and then decide... just my personal opinion and it's not like it is a drastic increase. I will say more tomorrow...

                            Comment


                              #15
                              My Personal Trial Log

                              JWHIII;1238425 wrote: Hi Andrea, and thank you also for your compliments.

                              I'm actually thinking about going back up to 250 mg for that very reason. I talked with my doctor today and told him about the side effects I was having at that dose. "DE" is "delayed ejaculation", which can be better translated by yours truly as "no climax", LOL. When I told him this, he was insistent that this had nothing to do with baclofen - that there had to be some other cause. He has treated thousands of patients with high-dose baclofen and had never had anyone report such a side effect. Then I told him that I researched the affiliation of this SE with baclofen and found a couple of sources that confirmed it. He then went to his favored data base (epocrates) and found no such report.

                              Then I told him about how it went away when I tapered the dose down, but he still felt the condition was caused by something else. In addition to that, I've been analyzing my diet over the last several days, and now have to question if the "elimination" issues were really caused by maintaining my switch dose. So now I'm eager as ever to go back up to 250 mg, but he told me to stay where I'm at for now to see how things go. I don't know. I respect his educated opinion and wish to honor his recommendation (as I'm grateful for his service), but I may just step up anyway.

                              ~John
                              It's funny that you mention the DE. I wasn't going to mention it, but I have been having the same problem. Also, the results are not always what I would have expected. I won't go into any greater description for fear of creeping people out. :blush:

                              Comment

                              Working...
                              X