Hi Kompota - I have been following your progress since I have tapered off klonopin . I am 10 months off benzos but like you have severe paws. I told my wife your recent post at 2 years off has you back almost at 100 percent. I saw another thread were you interested in a group buy on an experimental drug which made me realize you might not be better to your satisfaction. I was really hoping you are fully back as your progress has given me hope. I think you continued to work during all this and I am trying to hold on to my job as a project manager. The stress is doing a number on me but when I read you were a computer programmer still able to work you really gave me hope. Please let me know how you are doing now. How is your anxiety level now as compared to ore benzo and your ability to work. Thank you in advance ! I appreciate you keeping this thread up to date.
Well, it is true I had some "window" days when cognition felt so close to normal. Also, in the early mornings when Cortisol is high, it feels that way as well, but with a slow decline after that in course of the day. However my baseline is still below 100%, at 90% perhaps.
UPDATE
I see my last post was about six weeks ago. Some interesting development since then. I have been extremely lucky to meet a top medical person from Russia, who lives here in Bulgaria. A professor, a member of the Academy of Sciences, 30+ years of work experience and so on. His primary field is anesthesiology / reanimatology, but he has been specializing and shown extensive interest in brain study. He has several papers published on the topic, particularly about the aspect of "individual's brain functional asymmetry and interaction of the hemispheres" and how there are certain patterns which determine our minds. More importantly - the effects of psycho- and neuroactive drugs on all of this. All in all the ultimate person to have a talk with for a benzo-sufferer. As opposed to the utter ignorance of psychiatrists and neurologists, who basically deny the existence of PAWS, I was so glad to finally meet a member of the medical profession, who is knowledgeable in this very specific subject. He fully acknowledges my condition and said it is all very real. He believed every single word of mine and was not surprised from anything.
He had some very interesting things to mention. If we consider our brains as a puzzle: at 24+ months off I already have most of those pieces - 93-94% perhaps. But it will not be until I find those last few pieces before I feel like my old self. Cognition with memory (short-term especially) and learning ability is the very last symptom to get back to normal, he said. It should happen by 3 years off.
On the means to speed up the process.
I mentioned to him that I consider using some neurotrophic compounds like Cerebrolysin. He said there is one russian-made neurotrophic drug, which was supposedly MORE EFFECTIVE than Cerebrolysin - Mexifin. Maybe people here have heard of various russian nootropic / neurotrophic compounds like Semax, Actovegin, Cortexin and Mexidol. Actually, Mexifin is a "newer version" of Mexidol. I believe there are three reasons why Mexidol does not have more supportive reviews.
Firstly - it has been used not only per IM and IV-injection, but it also has a peroral version. We know that IM / IV may increase the effect of a certain drug dramatically, not by mere %, but by few times. This may be the case here.
Secondly - Mexidol in ampules for injection includes a preservative in the form of sodium bisulfate. In fact, that is a limiting factor on the possible dosage, since sodium bisulfate is toxic.
Thirdly - as all neurotrophic compounds, positive effects are not immediate, but rather commulative. It takes time to reap the benefits. People are impatient though, and tend to rush with their verdicts.
Simply explained: Mexifin is basicaly Mexidol without the preservative (so no limitation on dosage) and it comes only in ampules for IM / IV injection. No peroral option - it is just pointless.
I was sceptical initially -"more effective than Cerebro ?" Looking at the molecule of the compound it appears to be very similar to Vitamin B6. The doctor however said that despite similarity in chemical structure, it has nothing to do with simple Vitamin B6. It has a very high rate of blood-brain barrier penetration, a cholinergic effect on neurons, prevents oxidative stress and so on. Also, the description states that it "potentiates the action of benzodiazepines". For the unaware, this may sound bad at first glance, but it means it works towards restoring normal receptor function. Of course, that wouldn't happen overnight. It is not GABAergic in direct sense ! Unlike Cerebrolysin, it is fully synthetical and this lowers the risk of some allergies and - arguably - eliminates the possibility of carrying over encephalitic diseases (altough I generally don't believe in such risks with Cerebrolysin).
The doctor gave me a standard package of 10 ampules x 5ml. He is getting it straight from the manufacturing plant in Russia, since the manager there is a friend of him. It is dirty cheap - the package cost me about 14 USD. He suggested the best way is an IV-infusion, but as I was going to do it all myself, and I obviously can't handle an IV myself, he said to do an IM-injection each 2 days. So I did a 20-days course (10 ampules).
Here is my experience.
The innitial short-term effect may rather be a bit unpleasant - increased agitation (anxiety if you call it that way) and sleep got a bit worse as well. However, this whole benzo mess has teached me to look beyond short-term discomfort. When I am talking about "discomfort", I am putting things into perspective. I am so far past beyond acute withdrawal, the intensity of symptoms is at such a level, that it no longer bothers me. It is not about "anxiety" any more. I have fully accepted temporary discomfort with an outlook of long-term benefits.
And indeed, I feel things started to shift into the right direction. It is almost a week since I completed the course and I sense an evolution of overall condition. I wake up with more energy and although there is still a way to go, I feel a breakthrough. Somehow, I have the feeling the fog has started to lift. In a subjective sense, earlier it was rather about a slow and sluggish mind with a complete lack of mental energy. Now it has somehow shifted towards more agitation, but at the same time it comes with more energy. It is if the brain has started to work at higher revs than needed, for it to be able to process complex information and this affects cognition in a negative way. However, even this is slowly resolving. The brain is definitely waking up.
I tend to attribute the "more energetic, but at the same time more agitated brain" to some Glutamate hyperactivity, not because of impaired GABA function by itself, but as part of all complex neuroadaptations due to benzodiazepine use, in form of a long-term potentiation of the glutamergic system. During our conversation, the doctor said something like "let's see how things unfold for you, and we may consider a NMDA antagonist OR agonist, depending on that". I didn't ask about details (he has something in mind), but it seems at the later stages of PAWS it is rather about glutamergic hyperactivity rather than gabaergic underperformance. It is about finding a very fine balance of NMDA activation. Too little - bad, too much - even worse. In my present condition, it seems to go rather into the "too much" direction.
I have looked at information about Memantine here on Longecity. It seems it may be the right substance for me. It states that Memantine eliminates only excessive NMDA activity, being a "low-affinity voltage-dependent uncompetitive antagonist". The question mark is if it could attribute to normalization of glutamergic activity in the long term. I have just asked the doctor per e-mail about his opinion on Memantine and if it could be beneficial in my condition. I am awaiting his reply.
I plan to go for another Mexifin - course in about 3-4 months time as suggested by the doctor. In the meantime I am considering doing a monthly Cerebrolysin course (in about 1 month from now). Maybe I could perform a comparison between Cerebro and Mexifin, although that would be difficult, since in subjective sense things are constantly evolving and shifting.
I wanted to say that, although there is still road ahead of me, improvements really kicked in recently (with some help).
LongeCity
