What is `abrupt` ?

[joethelion]

There is a risk my wife might stop taking bac, or she might (hopefully) agree to go to rehab where they won`t be eager to give her bac, and we are already at 90mg/day. What happens if she stops suddenly ? I know it`s not good to stop abruptly but is 90 mg/day a high amount ?

[spacebebe01]

What is `abrupt` ?

Really joe its up to your wife whether shes prepared to titrate down or not and I cant say what will happen to her if she just stops. Have you asked her to come on here and talk to some of the women who take bac that could help her massively. Why does she want to stop, is she getting bad se's. I think she is so lucky to have your support, and do hope you find a way through this, how are you doing by the way?

[RedThread12]

What is `abrupt` ?

How long has she been taking baclofen?

That would be a major consideration in how much to reduce in what period of time in order to "quit" without evil consequences. And what's the deal, anyway? She's been taking it, but she doesn't know that stopping the use of baclofen abruptly can result in disastrous withdrawal symptoms?

I'm sorry, but . . . sheesh! Alcoholism is a DEADLY disease. Apparently you and your wife understand that, if she wants to go to rehab. Taking baclofen to address a disease that, left untreated, ends with a gruesome death, should be taken as seriously as the disease itself. I've been on this board for almost for years, and taking baclofen for most of that time. I read Dr. Ameisen's book. I've read what has been posted on this board, and anything else I could find. It would never, ever, even occur to me as a remote possibility to stop taking baclofen abruptly.

In short, it's actually possible that she could quit taking 90mg/day and be okay. I REALLY don't know. But WHAT are you thinking????? Have you not seen, nor read, the horror stories from people who for one reason or another went through "baclofen withdrawal?" What part of this story am I missing?

The downward titration actually seems to be one of the ONLY issues around baclofen that is fairly consistent among all takers. But, then again, I'm totally uninformed about your wife. Totally.

[Kradle123]

What is `abrupt` ?

Wow Joe,

I don't know your circumstances but may I just say how wonderful to see you post here in support of your beloved. I'm sure it's been hard but your still there researching and exploring ways to help.

You 2 are bound to to win through this together. :h

:goodjob:

[jaddyday]

What is `abrupt` ?

Hi Joe,

As you've probably gathered, your wife should titrate down slowly. I would like to ask why she has decided to stop Baclofen and go into rehab. If the side effects are unbearable or it simply isn't working then that's fair enough but if your wife thinks that rehab is going to be some sort of magic bullet I'm afraid she is likely to be disappointed. I spent 28 days in The Priory which, although very effective in sorting out my extensive emotional baggage, did absolutely nothing to solve the cravings which I experienced to an unbearable extent even after two years of abstinence. In addition, a great deal of time was given over to 12-step stuff - something to which I do not subscribe. At over four grand a week I rather resented paying for something I could have had for free in an AA meeting (even if I had wanted it).

If your wife is not having horrendous side effects with Baclofen I strongly council against discontinuing her treatment. If she does have emotional problems and/or a mood disorder then rehab might not be a bad idea. I would suggest that you look at a variety of treatment providers to see which program your wife prefers. There is no one road to recovery no matter what others may tell you. I would also suggest that when you contact these treatment centres your wife tells them that she is taking Baclofen and that she will be continuing with it during and after rehab - assuming of course that that is what she wants to do. Most of these places are commercial enterprises and will be keen to have your custom. Don't let them dictate to you.

Just my opinion and experience for what it's worth. Good luck to you and your wife.

Justin

[Ne/Neva Eva]

What is `abrupt` ?

Hiya Joe! I'd respectfully counter some of the very insightful suggestions w my own thoughts:

An abrupt withdrawal can lead to seizures and pulmonary problems. It's very rare. But if she's got a bunch of underlying health problems, she'll need to go down slowly and she might need a doctor.

Not a good idea to go down too quickly of course, but if she's been erratic w it anyway she can probably safely go down faster than 10 or 20 mg per week. I have. The people who suffer profound consequences often have serious underlying physical or mental issues or have taken a lot of other drugs. Going cold turkey is a really bad idea, and you run that risk, perhaps, if she's admitted to detox and they try to treat her with benzos for baclofen withdrawal. That doesn't work. Benzos in combination with baclofen works, but the only thing that (I know of) that works for baclofen withdrawal is more baclofen. There is research behind this, and any doctor would be able to find the information just so long as you make sure they know it's there. You might have to insist.

So. I am going to offer some specific advice about this situation. Please keep in mind I am NOT A DOCTOR. No medical experience. No medical knowledge.

If I were in your/her shoes I'd take 20mg less today. And wait three days. If anything goes seriously haywire, (it won't) I'd take more baclofen. I'm referring to hallucinations, aural or visual. Any really weird physical symptoms, and it's time to take more baclofen. The only thing to treat baclofen withdrawal is baclofen. If after 3 days, everything is relatively okay, I'd go down 10-20mg more.

I think it's great that she's ready and willing to go to rehab. I think that as long as she is taking less than the FDA amount (80mg) they'll be willing to admit her. I think if she's taking more than that amount, they might not admit her. I also think any amount of sobriety will help her in the long run. That is HUGE. It helped me every time I dried out. Plus it's safe. And comforting to have three meals and lights out on a regular schedule.

I know this seems very scary, but it doesn't have to be. Use caution. Use observation and common sense. If she has any blood pressure problems at all, you'll want to keep a close eye on her blood pressure.
In general, she hasn't been taking it long enough or consistently enough (I'm pretty sure) to have the whole thing go completely haywire. And I have jumped around a great deal more than 20mg at a time. It can be extremely uncomfortable, but it is not inviting death and doom.

It would probably not be a good idea for her to try to go off of baclofen and stop drinking cold turkey. That would likely be a very dangerous combination that could lead to very serious complications.
It would also be a good idea if she is really, really struggling and having trouble keeping track of what she's taken for you to help her with that. You know?

Please let us know what you decide and how it goes. Hang in there, Joe. It sounds as though you're turning a corner. It's scary when you don't know what's on the other side, but it is often a really great thing that awaits.

[joethelion]

What is `abrupt` ?

First of all many thanks to all who commented, or gave their warm support; you can not imagine what this means to me (both emotionally and as information). We are going through a very difficult period.

Here`s the situation. My wife has been drinking very heavily for the last 15 years except the pregnancies. It`s been two and a half years after her last one, and this time she totally lost control. Making the situation even worse; for the last maybe 8 months she has a depression and apathy because of which she closed herself to outer world. The doctors say this can not be solved while taking 2-3 bottles of wine daily. For this reason she has to go to rehab, which she doesn`t even want to talk about, but I`m trying to convince her this way or that.

She has been taking naltrexone (Sinclair method) for the last 10 months with only some success (she stopped 20 day long binges, stopped having hangovers and didn`t even drink once after bedtime during these months, but still drank daytime most of the time and her intake got more), maybe because she hasn`t been very loyal with the 1 hour rule.

We started baclofen around 6 weeks ago (btw I`m taking the same exact pills with her -although I controlled my drinking problem with naltrexone 6 months ago- just to be able to understand where she is and the side effects). We are at 90 mgs now. I think she benefited from bac in that she can control her daytime drinking much more easily now when she wants to, but she still drinks the same total daily amount after 6pm (3 bottles in 3 hours!). By the way the se`s are very manageable maybe because we`re only going up 10mgs per week.

The big problem here is, she doesn`t want to admit her illness, and with her awful apathy and depression she doesn`t even care to listen to what bac or nal are all about. She just takes the pills to stop my nagging I guess. She doesn`t have a clue about how the medicine works, or why she should titrate. I guess we could go up to 300 or whatever it takes, but I`m just afraid something will happen and she`ll be on her own for sometime (I`ll have to travel or something).

Honestly I`m not even sure if she`ll certainly switch if she goes to a certain level. Especially because she doesn`t have the will.

I asked her if she`s ready to go up to a high dose, she said yes, but again possibly just to make me happy. I think I`m at that point where I either have to go ahead or back. I wish she didn`t have the depression and then we could`ve been more together in this.

[RedThread12]

What is `abrupt` ?

Wow . . . Rock. Hard Place, huh?

I think it may be time for you to decide for yourself what you want to do regarding baclofen, Joeth, and let your wife decide for herself whether or not she wants to change her drinking habits. The baclofen trail certainly can be a miraculous blessing. If you decided to continue, and she observes positive changes for you, it might give her some impetus to get on board. But, just in my gut, it feels very precarious, if you are doing all of the "work," for both of you, to continue to take her dosage up. #1, the higher the dose, the longer the titration down; #2, using baclofen really does require some degree of self-responsibility. Do you give her each of her doses? Would she take them herself, if you were not there?

Sounds as if you've been wise and conservative with your upward titration, but 90 mg is a pretty low dose, in the big picture of possibilities. And there could be some completely unpredictable and totally weird things happen at some point. For both of you. AA says that it's really not possible to help someone who doesn't want it, so. short of an intervention and carting her off to re-hab (which might not be a bad idea), I think you have to make your OWN plan, then either help her titrate down, according to Ne's suggestion, or somehow get her to actually participate with you. It feels more than little scary to me, to think about both of you heading into higher doses, but only one of you being responsible. Actually . . . doesn't work AT ALL!!

But congratulations to YOU, for starting down the path. I don't think I've really helped here, very much. Still feels like Rock. Hard Place. But a more dangerous Hard. Place., IMO, would be to have someone who is taking no responsibility for themselves, in this situation, taking High Dose Baclofen.

[spacebebe01]

What is `abrupt` ?

I agree with everything Red has just said, your wife needs to make this decision herself, and to take responsibility herself. If she wanted to do that them you can help her, but she needs to have her own commitment in the first place. I dont know what she has said to you about this, really you need to ask her honestly what she wants and thinks.

[joethelion]

What is `abrupt` ?

Exactly my concerns. Unfortunately intervention is not an option where we live. It`s she who has to do something about this in the first place.

I think we`ll just keep at something around 70-80mgs and I`ll do my best she follows at least this. Now her parents are coming to visit us and I`ll leave. This can`t go on like this, I hope she`ll think about this and maybe want a rehab, then if she does we can start going up with bac again.

[MusiciansMallet]

What is `abrupt` ?

RedThread & Neva's advice were spot on. I sympathize with your situation- to me, its frustrating when people take medications or drugs and refuse to gain any understand on how they work.

Just to add- by going into a typical detox facility, i can guarantee you they will not be prepared to treat withdrawal from baclofen. It is a GABA-B agonist; it produces similar effects to GABA-A agonists like alcohol, benzodiazepines, and barbiturates- but there is no cross tolerance. Only high levels of barbiturates or extremely high levels of benzodiazepines will provide symptomatic relief of baclofen withdrawal (but not *resolve* its symptoms). And not a single detox facility will give out such high levels of phenobarbital or a benzo--unless the patient is in full delirium; resembling delirium tremens (and even then, they'd most likely transport her to a hospital). The only drugs that act on GABA-B to significant degrees (at least that we know of in current medical literature) include GHB & GHB-analogs like GBL, GVL, etc; phenibut; and baclofen.

SO: I recommend taking the prescription bottle with you. Depending on the facility, pharmacy-board regulations in your state (or country if outside the US), or the policies of the facility- they should at least hold onto the medication while in detox. I would recommend, if possible, YOU advising them of this information as well. Unfortunately, there is an inherent distrust among medical practitioners and addicts & alcoholics during treatment.

I would still do this even if she has successfully weaned off the baclofen. But alcohol detoxification usually only includes a 7 day stay (30 at most in severe cases), using diazepam or a similar benzodiazepine, sometimes in conjunction with phenobarbital in high dosages (along w/ other drugs; but these medications I mentioned are the first line, minimal treatment in most cases). This of course helps with stopping alcohol w/o severe withdrawal, but, I have a feeling withdrawing the baclofen will make this moot.

If you can successfully titrate her down on the baclofen I would HIGHLY recommend a rehab program if possible/affordable after detox, especially since she isn't concerned with what drugs she's taking, what doses, and how they affect her (unless you think this is related to her alcohol use?). Dependence on alcohol and other GABAergic drugs/meds include very very severe long term effects & disruption of coping skills.

Good luck, I hope all goes well for you and your wife. You're a great husband man, if she gets well; I hope she realizes this.

[joethelion]

What is `abrupt` ?

Thanks a lot MusiciansMallet, that`s great information. If ever she`ll agree to detox/rehab I`ll have a prescription with me. No one understands bac here, so I just won`t tell them it`s for alcohol.

[Rainyday]

What is `abrupt` ?

Joe - great work on your part. I'm in your shoes and my husband is in your wife's shoes. He doesn't think he has a problem. Or rather, he thinks he can stop on his own. Yet, night after night he continues.

Can someone look after your wife when you're gone? I'd be worried she would forget to take the meds. And then a withdrawl.

Also, is she on antidepressents? Might be a good idea. What about group therapy? How old are your kids? Does she need a break from family-duties? Does she work?

Can she try another medicine? Topomax is my choice.

[joethelion]

What is `abrupt` ?

Rainyday, thanks for your concern.

Her parents just arrived and I left home, hoping maybe she`ll think about the loss. I will not leave her really, but I`m hoping she`ll at least think about this. Whatever; her parents will be there for at least a couple of weeks, and I told them about the pills, which I`ll also check daily. We also have a great nanny thankfully (here it`s normal), otherwise I don`t know what we would do with three small kids with her condition.

She uses prozac, but the doctors say this won`t help while she keeps drinking three bottles of wine daily. There is some AA activity here, but she`s far from even considering that. We tried but couldn`t find a good addiction specialist or even any good therapist that she felt comfortable with.

Topamax was mentioned but we haven`t tried yet. I also fear the side effects, although they are a minor concern compared to our situation.

[Rainyday]

What is `abrupt` ?

Can you give her some cold hard truth that you will leave her and take the kids? Then make sure her parents are there to prevent a catastophy?