What is purpose of titrating up to high dose and steadily lowering Bac?

[Rupert]

Hi,

I was wondering what the actual purpose of this is - do people think that they really must hit a 'switch' and then come back down, or is it just because over time, being AF, you need less Bac to combat the cravings? I always found the worst cravings in the first 2 weeks after giving up. So is the 'switch' more for people who are still actively drinking and need a higher amount initially, or is it really a 'switch' you must press?

[Xadrian]

What is purpose of titrating up to high dose and steadily lowering Bac?

Compare the "switch" like pushing a car. When it's standing still, you have to push very hard to get it rolling. When it's rolling, keeping it rolling will cost you less effort.

It's really a point you heve to reach, before going down to find your maintenance dose.

After I was cured by baclofen, I stopped taking bac completely. I derailed. After that, I started taking bac again, hoping my former maintenance dose would work. It did not. I had to go all the way up to my former switch dose.

[man on mars]

What is purpose of titrating up to high dose and steadily lowering Bac?

Ameisen was not drinking when he hit his switch at 270 mg. For him, it was the moment when he was at a restaurant, saw other people drinking, and realized that for the first time in his life (since becoming an alcoholic), he really, truly did not care, and did not feel at all like he wanted one, too. From there, he was eventually able to reduce his dose and maintain that effect. So for him, it really was a switch that had to be pressed.

Rupert;1520592 wrote: ... is it just because over time, being AF, you need less Bac to combat the cravings? I always found the worst cravings in the first 2 weeks after giving up. So is the 'switch' more for people who are still actively drinking and need a higher amount initially ...

I think that what you are saying may be somewhat accurate for those who are taking baclofen but haven't been able to go AF. For me, I feel like the dose I've been at (~200 mg) for the last couple of weeks has me *almost* there. But every evening that I approach with an "I'm not going to drink tonight" attitude falls apart by 8 PM when the cravings finally reach peak intensity and I end up drunk. For me, the switch will be when those cravings cease and I can finally start chalking up AF days. It makes absolute sense it will get a hell of a lot easier after that, and that the lower doses I'd been a few weeks ago, which felt like they were working except for the evening surge of cravings, will be sufficient to keep me in that no-longer-daily-drinking state.

[kronkcarr]

What is purpose of titrating up to high dose and steadily lowering Bac?

Hi, Rupert,

You've received good answers. Here's my 2 cents: at the switch cravings for alcohol are suppressed and we are indifferent to alcohol. Not everyone has to titrate high up on baclofen to hit the switch. I switched low (80 mgs) as did a few others here.

[Ne/Neva Eva]

What is purpose of titrating up to high dose and steadily lowering Bac?

Titrating up and then back down again is not unique to baclofen. There are several meds that call for that. The purpose is to find the dose at which the desired effect takes place, and then to back off of that dose so the person is taking the least medication while still achieving the desired effect.

[Xadrian]

What is purpose of titrating up to high dose and steadily lowering Bac?

kronkcarr;1520621 wrote: Hi, Rupert,

You've received good answers. Here's my 2 cents: at the switch cravings for alcohol are suppressed and we are indifferent to alcohol. Not everyone has to titrate high up on baclofen to hit the switch. I switched low (80 mgs) as did a few others here.

My switch was at 90 (twice), but not everyone is so lucky. It is not clear why the switch doses are so varying between different inviduals (Having to go way over 200 are no exception).

[ifulovelife2]

What is purpose of titrating up to high dose and steadily lowering Bac?

Hmmm, 'The Switch'. It's a tricky one. I'm not entirely sure there really is such a thing, except it's the point at which you realise you no longer have to drink alcoholically. I suspect it's a combination of a number of factors coming together: yes the dosage, but also the length of time you've been using baclofen (for some people), what your present incentives are, how much repair you've managed to effect (on your body, neurochemistry and/or emotions) and also factor X.*

*I have a limited supply of factor X I may be willing to sell. PM me with your offers.

[Ne/Neva Eva]

What is purpose of titrating up to high dose and steadily lowering Bac?

ifulovelife2;1520756 wrote: Hmmm, 'The Switch'. It's a tricky one. I'm not entirely sure there really is such a thing, except it's the point at which you realise you no longer have to drink alcoholically. I suspect it's a combination of a number of factors coming together: yes the dosage, but also the length of time you've been using baclofen (for some people), what your present incentives are, how much repair you've managed to effect (on your body, neurochemistry and/or emotions) and also factor X.*

*I have a limited supply of factor X I may be willing to sell. PM me with your offers.

Yep.

*If you buy the factor X from this guy, make sure he promises it's not adulterated with his own factor Y. just sayin'

[BetterAndBetter]

What is purpose of titrating up to high dose and steadily lowering Bac?

Rupert;1520592 wrote: Hi,

I was wondering what the actual purpose of this is - do people think that they really must hit a 'switch' and then come back down, or is it just because over time, being AF, you need less Bac to combat the cravings? I always found the worst cravings in the first 2 weeks after giving up. So is the 'switch' more for people who are still actively drinking and need a higher amount initially, or is it really a 'switch' you must press?

I think that is an excellent question/obversation. I have, personally, witnessed a dramatic reduction in "day after withdrawal symptoms" through using low dose (10-30mg) of baclofen. It may be that "titrating up" allows an addicted individual to surpass the initial, relatively short-lived acute withdrawal symptoms, that generally last from a couple of days to a week? Then, once one has had those symptoms negated by high dose baclofen, the body, now more in a state of baclofen-induced "homeostasis", is able to benefit from a lower dowse of baclofen, because baclofen is no longer needed to "overpower" the acute, but temporary, immediate symptoms of alcohol cessation (mental and physical nervous agitation, which includes high blood pressure, perspiration, muscular tremors, etc.). Perhaps, if one is able to persevere through the milder manifestations of said withdrawal symptoms while on a lower "maintenance" dose of baclofen... say a couple of days to a week... they would find themselves at "the switch" via a route other than titrating up to a higher dose and then backing down. I would think that maintenance dose would be higher than the 10-30mg I mentioned, according to all the reports I have read, based on personal experience. But I've read about maintenance doses of 60 mgs a day... can't recall anything lower, but your comment is food for thought. It seems, from what I've read, though, that titration to a high dose and then backing off to find where the cravings begin again is the most well-worn route thus far. If you've got time and aren't necessarily desperate for a quick "cure" it would be interesting to hear about personal experiments with lower dose bac and a self-imposed week or two long abstinence and see how the cravings are after that while maintainting what most consider a "maintenance" dose.

[bleep]

What is purpose of titrating up to high dose and steadily lowering Bac?

Iful, how much do you charge just for factor 'Y'?

On topic, I think most people titrate past indifference simply because they don't recognise it. This then allows you some room to reduce once you are aware that indifference has set in, and find the dose that works for you. If someone took it really slowly, and was looking for it at each step, I think they would have little room to reduce once they became indifferent.

[Xadrian]

What is purpose of titrating up to high dose and steadily lowering Bac?

BetterAndBetter;1520804 wrote: But I've read about maintenance doses of 60 mgs a day... can't recall anything lower

Mine was 50, some others are on low doses.

[Xadrian]

What is purpose of titrating up to high dose and steadily lowering Bac?

bleep;1520928 wrote: Iful, how much do you charge just for factor 'Y'?

On topic, I think most people titrate past indifference simply because they don't recognise it. This then allows you some room to reduce once you are aware that indifference has set in, and find the dose that works for you. If someone took it really slowly, and was looking for it at each step, I think they would have little room to reduce once they became indifferent.

After I derailed, I stayed at 80 the second time up for some time (first time the switch was at 90), but it didn't do the trick. Went to 90: Click.

So in my case, your theory doesn't work.

[Rupert]

What is purpose of titrating up to high dose and steadily lowering Bac?

Well I've been on Baclofen for 2.5 weeks now and AF for 7 days and not been particular tempted at all in those 7 days. I know that 100mg wasn't enough at first but now maybe its enough simply because I am getting past the initial acute withdrawlal symptons now as B&B was saying. The Baclofen helped me reduce my drinking almost immediately except for one major blow-out.

I'm not trying to de-value this concept on 'The Switch' because it seems of obvious value for people to work towards, however I am not entirely convinced that its something that you have to press before you can descend to a lower dose. I am going to stick at 100mg and only increase if I have unmanagable cravings moving forward. I'm more comfortable with doing it like this although I am quite prepared to change to the other method if it doesn't work so well.

[Colin]

What is purpose of titrating up to high dose and steadily lowering Bac?

Looks like an excellent course of action; taking it slowly and with good reasons for small changes.

The goal with baclofen is to get alcohol under control. Before baclofen that meant complete abstinence broken by zero or more periods of unknown duration when alcohol was firmly in control. Now we have the option of limited alcohol consumption being kept under control by baclofen.

There have been a number of reports in MWO where abstinence was followed by rapid reduction in baclofen and sudden increase in alcohol consumption. Carry on with your slower course of action and this might be an alternative for you.

I never had the magic "switch" moment but it doesn't seem to matter.

[bleep]

What is purpose of titrating up to high dose and steadily lowering Bac?

Xadrian;1520995 wrote: So in my case, your theory doesn't work.

That's why I said most people. And it could still very well be thoroughly and completely wrong.