HELP- baclofen for butalbital (fioricet/butalbital), problems questions

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

COSgringo wrote: does it have acetaminophen in it like Fiorcet? That is really bad for your liver and combining it with alcohol makes it pretty bad overall. You don't want to drink and take things like tylenol. Not to nag but 1500 mgs of a barb sounds very high but I have limited experience in that realm. At least you are not taking sedabarb or some heavy barb. I would really work on lowering that dose and upping the baclofen dose. I don't think that little you are taking is going to help a whole lot but don't jump up quick. Maybe 10mg per week. Divide it up through the day.

First, yes, that's my current plan: to slowly titrate upwards w/ baclofen while simultaneously titrating down w/ butalbital. Second, yes- butalbital is an intermediate-to-long acting barbiturate, its actually similar to phenobarbital than it is to any other commonly prescribed barbiturate. Third, 1500 mg is a high daily intake; but this was achieved after 2 years of titration in response to tolerance (and a previous tolerance to carisoprodol on top of it--which i no longer take--which is cross-tolerant w/ barbiturates & benzodiazepines' but for some reason, not as highly cross-tolerant with alcohol as butalbital/barbiturates are).

Finally, I am aware of the high hepatotoxicity of acetaminophen- I am prescribed two formulas: one with just butalbital (for late afternoon till night); and the other formulation does contain both w/ caffeine & acetaminophen. However, I usually do a cold water extraction; as this preserves the butalbital & caffeine while discarding the APAP (& then just take the APAP separately if needed). And I do not use alcohol regularly, actually, i use quite sparingly--only after this whole ordeal have used it nightly, albeit at amounts that probably wouldn't even get give my 90-year old grandfather a buzz! But, even when i DON'T do a cold water extraction, the formula I have for morning doses contains only 325 mg of APAP; not 500mg in the original fioricet formula.

And you're not being a nag I appreciate the concern and all & any questions!

[COSGringo]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Sounds like you have it down to a science. Pheno was what I was trying to refer to. The strong stuff in seconal I think is a bit more dangerous or just more potent form of pheno. What I see floating around on online meds seem to be considered weak. I don't know much about it. One site has pheno cheap as heck but suspect it much be weak.
Now if I could figure out a good pain med for my gout as I can't use naprosyn anymore. It was starting to cause edema. Tramadol doesn't seem to do much.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

COS
Yes- Secobarbital is the active drug in the trade-named pharmaceutical Seconal... and PENTOBARBITAL as well is very strong- they're both ultra-short or short-acting barbiturates.. they're both highly inductive to tolerance & dependency (and overdose). But, neither of these however are really derived from or related to phenobarbital any more so than any other basic-barbiturate (common denominator being they're all derived from barbituric acid and/or an intermediate; except from some more synthetic, obscure barbiturates--which were barely used).

Phenobarbital is the longest known acting barbiturate (unless there's some obscure research barbiturates out there...) & its classified as an "ultra-long-acting" barbiturate.. very little abuse potential (at least relative to other barbiturates). Being an intermediate-to-long acting barbiturate, butalbital is much more closer in action to phenobarbital than secobarbital or pentobarbital.

COSGringo wrote:

One site has pheno cheap as heck but suspect it much be weak. Yes, phenobarbital is weak, in that its effects aren't acute--which is is why phenobarbital is primarily used for long term maintenance of epilepsy (or for GABAergic withdrawal). Although barbiturates do have some painkilling effect unlike all other GABAergics (aside from treating neuropathic pain, which GABAergics are actually superior than traditional opioids in this respect)... again, due to pheno's very long acting effects, you'd unlikely realize any noticeable benefits for pain. Not to mention, if you're on baclofen, this may interfere with its effects (at least going by my dreadful experience!!)- & you'll need to become dependent upon phenobarbital, taking it for at least a few weeks due to its ultra-long acting mechanism, until you realize any beneficial pain relief (if any).. which, i wouldn't recommend

Tramadol doesn't seem to do much.

Yes, no surprise! Tramadol's efficacy for pain management is on par with codeine, it actually possesses even LESS agonist activity at mu-opioid receptors (the main receptor responsible for pain relief). And tramadol also has nasty effects as you increase your dose, especially SNRI activity (selective norepinephrine reuptake inhibitor)--much like some atypical, non SSRI antidepressants & antipsychotics (which are HUGE no-no's during even the slightest of alcohol abstinence snydrome or withdrawal--if this applies to you--since antipsychotics & tramadol both lower the seizure threshold).

And this can DEFINITELY complicate side effects of baclofen (again, if you take it), or exasperate post-acute-withdrawal-syndrome from alcohol (if you have it).. and tramadol in higher doses is infamous for causing nausea as well!

I'd recommend codeine above tramadol (unless you're allergic), there are other lower potency opiates that are available in some states (i don't know how it is in Colorado, though) upon asking the pharmacist (the drug MUST be schedule V federally, & equally lax in regulation in your state).. But its up to the pharmacist to comply & you will have to fill out a ledger & show ID. Aside from tramadol, opiates are very tricky & rare via online sources; you'll risk being ripped off if such opiates/opioids are publicly offered on a website (unless its an international pharmacy; but there's still risk there, do you're homework). The EXACT same applies to phenobarbital, it is a scheduled drug (for some reason butalbital w/ caffeine & APAP isn't?).. unless you're certain of your source, it wont be available via a US based online vendor. India based pharmacies are typically the most notable; Canadian ones as well, they're less risky, but the strongest you'll get is codeine (w/ APAP & caffeine), or related drugs like norcodeine or normorphine.

If you are still interested in phenobarbital for pain relief, i'd recommend forgetting the idea. Butalbital can give you better relief, its readily available via online pharmacies & vendors, & you can take it as needed, and not on a regular basis! PM me if you'd like, I have some sources I could recommend that I have used for years! I also have a source for opiates, although its shipped internationally--and i've never personally tried them from this source.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Update:
Well, i've titrated my baclofen dose up tonight! I experienced no ill-effects the last 4 days from 10 mg of baclofen nightly. So, I took ~15 mg roughly an hour ago & plan on sleeping soon. We'll see how it turns out tomorrow! But, i will say this: in regards to my small amounts of alcohol i've been taking at night recently to reduce my butalbital/barbiturate intake, I have absolutely no desire or need to do so (i'm thoroughly tired, in a healthy sort of way--not in a "dirty" sort of way, like w/ diphenhydramine, for example)! So, I plan on not sipping my nightly 1/3-1/2 shot of bourbon, unless I can't sleep.

I'll report back! Thanks for everyone's interest & help so far! I really appreciate it! I'm very surprised w/ everyone's feedback & assistance, seeing as though i'm not alcohol dependent, but dependent upon butalbital/barbiturates.
:thanks: :goodjob:

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

6-21-12.. Update:
Last night, I increased my baclofen dose by 50% (from 10mg to 15mg) & used no alcohol.. It is 4:22p.m. as I write this.. aside from a bit more physical (not mental) "slowness" or drowsiness (although I did manage to cut the grass in 85 degree weather! so that may contribute to the perceived exhaustion), I have noticed no ill or adverse effects so far! To the contrary, I slept very well & w/o interruption (VERY rare for me) and i've used 500 mg of butalbital so far; whereas i'm usually at around ~750mg by now.

I am tempted to dose another 5-10mg of baclofen here during the day to help stay at these lower doses of butalbital throughout the day; but I think i'll refrain given my original adverse experience. I have to be careful, b/c butalbital is a longer acting barbiturate & titration down should not be done quickly.. so a perception that I don't need to use butalbital may put me into minor-barbiturate withdrawal after a few days (which is what I think contributed, at least partially, to my original horror story w/ my higher baclofen dose some ~11 days ago). SO- I will wait a few days (at least two days, so maybe i'll try morning/afternoon baclofen between Friday-Sunday if all goes well) and see how the my increase to 15mg at night works; & then introduce a morning/afternoon dose. I just have to be careful!

I willl say, w/ my current dosage regime of baclofen- there doesn't seem to be much of a blockage of physiological and/or neurological effects of butalbital now (last ~4 days). Actually, I experience more effects from butalbital (and re-dose less often) than before. I think the key is to not concurrently use butalbital/barbiturates & baclofen, use one or the other. So, if i don't have any major adverse baclofen effects & as a result start morning or afternoon doses; i'll likely dose in between butalbital doses.

Anyway, so far: :thanks:
Please.. if anyone has any comments, questions, info, suggestions whatsoever, PLEASE post! (even if you've never been dependent upon barbiturates; but just alcohol--as my long post above explains: barbs, BZPs, & alcohol produce end physiological effects that are very much the same due to GABA-a agonist action, albeit all via different mechanisms & at different receptor sites)

[COSGringo]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Sounds like you are on track. My only advice would be to try and take it at least 3X per day. You can break up the dosage. Maybe do 5-5-5. If you go up add it to your last dose. According to Dr L the night dose should be your highest. If you add a bit more then add that to the morning dosage. Mid day should be the lightest. I don't know if that is accurate for all people it's just what that Doc said.
But you do want to spread it out since it is short acting.
Drink a lot of water to when you move up in dosage. You'll see what I mean if that day comes.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

COSGringo wrote: Sounds like you are on track. My only advice would be to try and take it at least 3X per day.

Yea, actually before I even read your post I just took a shot in the dark & about 20-30 minutes ago decided to bite the bullet & take a daytime dose of baclofen, roughly ~2-3mg (w/ 250 mg of butalbital.. this is why I took such a low baclofen dose. & I combined the two medications b/c: 1. to see if there is an impact there on the butalbital effects and/or blocking of its effects; and 2. this is my usual butalbital dosage time). But so far, although I usually take 300-400mg of butalbital at this time of day, i'm already feeling effects similar to my higher doses only 15 minutes in (except w/ slightly higher sedative effects, which i'm attributing to the baclofen). If all goes well, I will plan on taking my usual 15mg again tonight before bed; and within the next week, i'll slowly introduce small amounts of morning & afternoon doses of the baclofen, too. I'll report back with any relevant info (if there is any) after tonight!

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Continued from above...
A question though to anyone w/ any info on this: i'm also concerned about titrating upwards to higher doses of baclofen b/c of possible withdrawal, since money is quite a severe problem right now for me. Although the butalbital is costing me much more; I don't want to be in a position of having to spend similar amounts of money, just on a different drug; the point/endgame is to titrate down in general.

I will research it more on here, BUT, since this thread has been somewhat active- anyone experience any severe withdrawal symptoms from baclofen? If so, at what daily doses were being used & for how long (meaning, how long was consistent/daily use before withdrawal was experienced)? And also, mention any other GABAergic drugs, if you've taken them during this time (either prior to withdrawal or during withdrawal or to relieve withdrawal), including: alcohol, benzodiazepines, barbiturates, etc. And please mention any interactions you've noticed between effects and/or withdrawal. Also, was the withdrawal from baclofen a result of cold-turkey or a wean? If it was a wean, please detail it, if you don't mind!

I know GABA-B agonists certainly cause physical withdrawal, so I guess i'm also hesitant b/c I have never experienced withdrawal symptoms from GABA-B agonists, it would be something very unfamiliar. And, seeing as though baclofen is not widely used or known, in an emergency situation if I had to go to the hospital for withdrawal (down the line) for whatever reason... i'd likely receive much less treatment due to lack of understanding, than say w/ my current situation of dependency on barbiturates which is must more documented & known in the medical community!

...Anyway, just a question!

[COSGringo]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

If you want to w/d go slowly but you are at such a low dose it won't be much. Maybe to 10 for a week. then 5mg for a week. Then you are done. I really doubt it would be a big issue for you are that dose unless I am reading you wrong.
If you went to the E.R. they would probably just shoot you up with some ativan, maybe watch you for a while, and send you home. I would guess you would feel like you were having a panic attack. At least that's what happened to me on baclofen but I did not stop I was actually just going up in dosage and Dr. L never warned me to throw a bunch of benzos back if that happens. That probably would have worked since that's pretty much what they did to me in the hospital.

[COSGringo]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Oh and BTW, where are you getting this baclofen from? Compared to those barbs it's dirt cheap.
Check out River Pharmacy dot com. They advertise on this site. They are very reliable and make a living out of supplying us addicted types. The biz is out of Canada but the meds are all India. They take 2-3 weeks and you do have to sign for it. I think you have to use a CC.
It's like $.25 pill for the 10mg.
Also, how are you taking 2-3 mgs? The smallest tabs I've seen are 10mg. I buy 25's from them as back ups from my real scrip just in case. Must be hard to cut those into quarters. Sounds like propecia. Don't ask why I know about that.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

COSGringo wrote: Where are you getting this baclofen from? Compared to those barbs it's dirt cheap.
Check out River Pharmacy dot com. They advertise on this site. They are very reliable and make a living out of supplying us addicted types. The biz is out of Canada but the meds are all India. They take 2-3 weeks and you do have to sign for it. I think you have to use a CC. It's like $.25 pill for the 10mg. Also, how are you taking 2-3 mgs? The smallest tabs I've seen are 10mg. I buy 25's from them as back ups from my real scrip just in case. Must be hard to cut those into quarters.

I'd prefer not to divulge my source publicly (i can PM you if you're that interested) but i'm paying a little under $1 per 20 mg pill; but its from a US based pharmacy, I receive it within 2-3 days of placing the order, & its COD (which is really all I can afford right now, since i pay WHEN i get my medicine, rather than paying in advance & waiting a couple of weeks to get my Rx). Although, if I can get some income here; or find a JOB (was laid off 8-10mo ago).. i'll definitely use River- I have checked out their site. The butalbital I am paying anywhere from $0.82-$0.88 per pill (50mg per pill, this is the only mg amount available for butalbital in the US); although, this really adds up due to my tolerance.

And I have 20mg pills... they're scored so I can break it up easily into 10 mg doses. for Doses less than 10mg, I crush the pill using a spoon & split up the resulting powder in equal piles & combine it with cranberry juice. And actually.. I can barely taste it!

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

COSGringo wrote: If you went to the E.R. they would probably just shoot you up with some ativan, maybe watch you for a while, and send you home. I would guess you would feel like you were having a panic attack. At least that's what happened to me on baclofen but I did not stop I was actually just going up in dosage and Dr. L never warned me to throw a bunch of benzos back if that happens. That probably would have worked since that's pretty much what they did to me in the hospital.

Ehh doubtful i'd get lorazepam (or "Ativan"--sorry, i have a habit of using the actual drug's name instead of the trade name)... or any other benzodiazepines, pfft, i'd be lucky if I got a shot of benadryl in my butt & half a pill of clonidine! heh! But its b/c i'm still logged in their system as an "addict" -- from when i would go relatively often for opioid withdrawal before I got on suboxone (even though this was more than 5-6 YEARS AGO!!). Oh well!

I was just asking for future reference. I'm not having any problems now, i took an evening dose (around ~2.5 hours ago) & am still feeling fine! And it didn't seem really to interfere w/ butalbital, other than slightly added sedation & being able to tolerate a lower dose of the butalbital (which is a good think, of course!). I was asking those questions about withdrawal in case I end up titrating up on baclofen, replacing it w/ butalbital and then come across a situation where I have ZERO cash to afford refilling my Rx.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

^^^
And... we're sort of treading unknown territory here w/ butalbital/barbiturates & baclofen; so thats why i'm taking it absurdly slow in upwards titration. Who knows? Due to barbiturates more selective action at GABA-A, maybe lower doses of baclofen are more effective in treating this sort of dependency relative to treating dependency on more generalized GABA-A agonists like alcohol? Preferably, I'd like to use the lowest possible effective dose! And, even at these miniscule doses i'm currently taking, I am noticing a healthy reduction in my daily intake w/o any adverse side effects! ...We'll see! I think this thread could turn out to be very helpful, seeing as though i'm using myself as a guinea pig and all

Information on this process i'm currently undergoing (i.e., baclofen use for reduction of barbiturate intake) is sparse at best. It isn't even available on major drug forms... such as bluelight--which i personally consider the gold standard of forums in reference to the use of psychoactives. & I have been a member of bluelight for 10 years, moderated their Health forums for 2 years, & the forum has been in existence for 13 years, since 1999. YET- It has absolutely NOTHING on this situation i'm in. I had to create a whole new thread, & even then, i've gotten only about 5-6 replies, and the conversation is basically more general--ultimately devolving into a discussion on concurrent GABA-A & GABA-B agonist use & their hypothesized, potential, and/or theoretical impacts upon one another. So i turned here & have gotten exponentially higher quality responses, anecdotal information, & support!

I am just glad I decided to resume small amounts of baclofen about 2-3 days after my severe effects resided! B/c I originally planned to never touch the stuff again... i'm glad I thought otherwise; And i have this forum & the helpful responses i've gotten to thank for this! (Especially you COS.. & Nev too)

:thanks:

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

(reduced my dosage even further of butalbital & ready for bed shortly!) ..feeling fine; finally took the leap & dosed baclofen during the day (and not just at night). I'm about to take my night dose... making my total daily dose slightly above 20 mg of baclofen! So, we'll see how i feel tomorrow

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

UPDATE!!!!!

I finally took the leap & dosed baclofen during the day (and not just at night) yesterday. As a result, I was able to reduce my dosage even further of butalbital (w/ no trouble at all! no withdrawal effects) & slept very well after my normal baclofen dose. I took, i believe, around 18mg-20mg total yesterday. & today, I'm feeling fine; and actually, quite normal! And, I've only taken 700 mg of butalbital so far (no desire/need to dose higher), which is considerably lower than usual.

I haven't dosed yet any baclofen today. I think I will try it mid-afternoon in place of my butalbital dose, or in conjunction w/ half my typical butalbital dose... since I did this yesterday, took baclofen & butalbital at around 2/3 my typical dose for that time of the day, w/ no ill effects!

If there's still some feedback in my thread from you guys... i'll continue my updates! Thank you so much to everyone who's posted here!