Experiences - Tolerances & different Benzo's..

[TheSpeedBall32]

Hi all, I am a newbie to the forum (posting-wise anyway), so firstly I'd just like to say hi to everyone out there, hope everyone is happy & safe.

My question here, is, if say, someone has been taking 1 particular 'benzo' for a period of time, then switches to a different one (diazepam to Alprazolam for example), will the patient already have a tolerance to the benzo they are changing to? My first thought would be yes, however SWIM is keen to find out, and any infomation you guys could provide would be most useful.

(Apologies if this has been discussed before, I have looked but couldn't find anything anywhere).

Thanks in advance for replies.

[Solinari]

Yes, it is known as cross tolerance. There is a Benzodiazepine Equivalance Chart that uses diazepam as the benchmark but there are lots of other things to consider not least of which is half life. Going from diazepam to alprazolam would require an equivalent dose, however the alprazolam has significantly lower half life compared to diazepam which i guess would be a consideration.

Benzodiazepines are not only cross tolerant which each other but with barbiturates and the so called nonbenzodiazepine "Z" drugs such as zopiclone as well.

[TheSpeedBall32]

Thanks a lot for infomation. Do you have to wait for a completely negative sample to be less tolerant, or if you say, for example, had taken diazepam every day for a couple of weeks, then have a week break, will that affect the tolerance level if you took say, Bromazepam, or Alprolazam after the week off? Is it a case of the longer you have off them the less tolerant you become? That would be my first thought, but any other input would be much appreciated.

Thank you.

[Solinari]

Yes, with time tolerance will subside but if there is sufficient tolerance to cause withdrawal then that has to be a consideration as well, in that situation the dose would have to be tapered to avoid withdrawal.

A two week every day dose of any benzodiazepine is likely to cause some sort of dependence and withdrawal with an abrupt cessation, especially with diazepam because of its huge half life and cumulative effect, as to the severity of the withdrawal, i couldn't say. After that, it really wouldn't matter what benzodiazepine was taken after a long enough break to reduce tolerance, while they all have slightly different effects they act pretty much all in a similar way.

[DirtRacer]

Hi, I am also new to this site and this is my first post. I am prescribed 2mg xanax (told to take 3 a day) for about 7-8 months now (before that I was on colonzapam) for about 3 months. I developed a tolerance to the xanax, and when I noticed this, I started gradually taking less (for withdrawal reasons). I have been off them for about a week. Does your tolerance come back when you start taking them again, or would it be like I never was on them. I'm sorry if this was answered already, I read the post and saw a post concerning this from Solinari but was a little confused. I am conerened because my anxiety is coming back and I haven't slept in 3 days because of this. I don't want to have to take more than I am supposed to just to become dependent on them again or God forbid overdose. Any help would be appreciated. Thanks in advance.

[bosch man]

Originally Posted by DirtRacer

Hi, I am also new to this site and this is my first post. I am prescribed 2mg xanax (told to take 3 a day) for about 7-8 months now (before that I was on colonzapam) for about 3 months. I developed a tolerance to the xanax, and when I noticed this, I started gradually taking less (for withdrawal reasons). I have been off them for about a week. Does your tolerance come back when you start taking them again, or would it be like I never was on them. I'm sorry if this was answered already, I read the post and saw a post concerning this from Solinari but was a little confused. I am conerened because my anxiety is coming back and I haven't slept in 3 days because of this. I don't want to have to take more than I am supposed to just to become dependent on them again or God forbid overdose. Any help would be appreciated. Thanks in advance.

...when you say you developed a tolerence what do you mean you started not to feel sedated and sleep problems, or was it anxiety returning whilst at the stated dose? Many people i see think that if they dont feel anything they take more, yet for anxiety disorders you are still anxiety free but because you are not sedated or feel the same as at the start of the course you think you are tolerant....

[tyranny4u]

@ first a welcome to the members who introduced themselves in
this thread, TT hopes you will enjoy visiting this place and like to
exchange information and experiences with the community!


@ DirtRacer: You are told to take 6 mg Alprazolam per day? that is
pretty much. TT doesn't know how this substances pharmacological
properties are considered in your country, what TT can tell from his
place is, that the info-sheets that come with the packages of the
medication, for Alprazolam tell that 3 mg per day should not be excee-
ded*. TT had a long time abuse of Alprazolam, going from 3 - 4 mg in
the beginning up to 8 - 10 mg ( for a quite short period of time), and
had one of the worst benzo withdrawals ever.
Well, if your doctor is a responsible physician he will put your dosage
on that high level for a reason.

* (some years ago it was 4 mg, but in the last 2 years TT read 3 mg,
no matter which generic he got at the pharmacies.)

you can't avoid building up a tolerance by switching benzos, even other
substances (barbiturates were mentioned above) but also GHB, GBL,
meprobamate (and its prodrug carisoprodol), the "Z-Drugs, etomidate,
propofol, and TT thinks valproic acid, too, would keep up tolerance.
there for sure are more substances that act on the GABAA receptors
"subunits" that are crosstolerant and make one stay tolerant to
this benzodiazepines.

TT doesn't know what the role of Ethanole (Alcohole for consumption)
is in the tolerance thing, maybe someone with more knowledge could
give some information?

once someone is fully addicted to benzodiazepines after using them
in high doses for a longer time, then the time to get the tolerance
back to "zero" would almost be 6 months. so if someone gets into
a detox clinic and after 2 or 3 months of abstinence, he / she then
would need a higher dose in case of a relapse or the need of using
a benzo for medical reason, therefor the doc should get informed
when the detox was ended and what substance was (ab-) used for
how long, to give a higher dose of the medication. a zero tolerance
is quite impossible, as the body once knows the substance, he knows
how to get rid of it. so TT would call it a " 0.0001 % " tolerance rather.
the "0.00... thing" is just to give an example, it's not a medical value
at all.

Please correct TT if he was wrong, especially with the substances that
act on the GABAA, or give some additional information!

Greets,

The Tyrant