Advise on my Alprazolam > Diazepam taper.

[[Buddie]]

Hello, I'm looking to taper off Alprazolam.  I've been taking about 1-1.5mg daily for about a month now.  Earlier this week, and before I found this site, I attempted to taper off by myself over the course of 3 days (1mg, .5mg, .25mg).  A trip to the hospital later, I now know I'm supposed to taper off over a much longer period of time.  Would the below chart be OK for me? I plan on taking it to my doctor as soon as he's back from vacation.  I'm also thinking of asking for propranolol (20mg tid?) to go alongside it, the physical symptoms of anxiety seem to throw me into a negative feedback loop.


            AM                   PM
Week 1  diazepam 10mg   diazepam 10mg
Week 2  diazepam 8mg    diazepam 10mg
Week 3  diazepam 8mg    diazepam 8mg
Week 4  diazepam 6mg    diazepam 8mg
Week 5  diazepam 5mg    diazepam 8mg
Week 6  diazepam 4mg    diazepam 8mg
Week 7  diazepam 3mg    diazepam 8mg
Week 8  diazepam 2mg    diazepam 8mg
Week 9  diazepam 1mg    diazepam 8mg
Week 10  ----------     diazepam 8mg
Week 11  ----------     diazepam 7mg
Week 12  ----------     diazepam 6mg
Week 13  ----------     diazepam 5mg
Week 14  ----------     diazepam 4mg
Week 15  ----------     diazepam 3mg
Week 16  ----------     diazepam 2mg
Week 17  ----------     diazepam 1mg

[[Buddie]]

It looks like you are planning on using the substitution method of tapering.  If so, you would need to replace a dose of xanax with a dose of valium every week until you are on just valium (diazepam). then you could start tapering the way your table shows.

Here's a link to a table in the Ashton Manual for substituting diazepam for 4 mg of xanax as an example.
http://www.benzo.org.uk/manual/bzsched.htm#s7

You can adapt it to the 1-1.5mg/day you are taking.  Valiuim takes much longer to build up in the system than xanax so you want to go slow with the substitution.

BTW, you really should stabilize the amount you are taking for about a week and take the same daily dose during that time.  I presume you are splitting it up 2x/day now? 

[[Buddie]]

Like so?


            AM                   PM
Week 1  xanax .5mg      xanax .5mg
Week 2  xanax .5mg      xanax .25mg
                                 diazepam 5mg
Week 3  xanax .25mg     xanax .25mg
            diazepam 5mg   diazepam 5mg
Week 4  xanax .25mg     diazepam 10mg
            diazepam 5mg
Week 5  diazepam 10mg   diazepam 10mg
Week 6  diazepam 8mg    diazepam 10mg
Week 7  diazepam 8mg    diazepam 8mg
Week 8  diazepam 6mg    diazepam 8mg
Week 9  diazepam 5mg    diazepam 8mg
Week 10  diazepam 4mg    diazepam 8mg
Week 11 diazepam 3mg    diazepam 8mg
Week 12 diazepam 2mg    diazepam 8mg
Week 13 diazepam 1mg    diazepam 8mg
Week 14  ----------     diazepam 8mg
Week 15  ----------     diazepam 7mg
Week 16  ----------     diazepam 6mg
Week 17  ----------     diazepam 5mg
Week 18  ----------     diazepam 4mg
Week 19  ----------     diazepam 3mg
Week 20  ----------     diazepam 2mg
Week 21  ----------     diazepam 1mg

[[Buddie]]

 

One thing you don't suffer from is "benzo brain".  Good work. 

You have a good starting plan but it is just a plan.  As you go along, you could and should adjust it depending on how you feel. 

You are on your way!

[[Buddie]]

Thanks.  I'm still scared to death of the whole process.

It's hard to believe that only 1 month's use of this drug is going to take 6 months to get over.

[[Buddie]]

One other thing, what do you think about adding propranolol?  My heart is beating like crazy and I'm nauseaus all the time.  Would this help?

[[Buddie]]

I know that rapid heartbeat and GI issues are common withdrawal symptoms and that you can get them when you've reached tolerance to your benzo.  I don't know about  propranolol.  You could do a search on the term in the Search box (top right) and see what other members have had to say about it.  Prof. Ashton put this in her online manual for withdrawing from benzos:

"Beta-blockers. In a few cases, severe palpitations, muscle tremors or motor jerks develop during benzodiazepine withdrawal and hinder progress. These symptoms can be controlled or ameliorated by beta-blocking drugs such as propranolol (Inderal). Drugs of this type inhibit the effects of excess epinephrine and norepinephrine (adrenaline and noradrenaline) released by an overactive sympathetic nervous system. They slow the heart and prevent excess muscle activity. Although they have little effect on psychological symptoms, they can cut the vicious circle in which palpitations or tremor create anxiety which leads to yet more palpitations. Some people in benzodiazepine withdrawal take small doses of these drugs (10-20mg Inderal three times daily) regularly, while others reserve them to take only if the physical symptoms of a panic attack seem uncontrollable. They are not a cure, but can sometimes help people through a difficult situation. In larger doses, beta-blockers are used for raised blood pressure and angina, but such doses are not advised in benzodiazepine withdrawal. They should not be taken by anyone who has asthma as they can cause constriction of the bronchial tubes. If beta-blockers have been used regularly for any length of time, they should be withdrawn slowly by tapering the dosage, as they too can cause a withdrawal reaction of increased heart rate and palpitations."

Here's a link to the manual in case you want to do a little looking around on your own.
http://www.benzo.org.uk/manual/index.htm

[[Buddie]]

Hi Patrick,

You can also dry-cut your Xanax by using the .25 mg tabs, too.  I was actually able to cut these pills into 1/8ths (some would be a little bigger and you could take the bigger ones first).  I have noticed that Valium does tend to give some members depression during their taper.  Just for your info.  There are several that are dry-cutting from Xanax and the process can be a little shorter.  Just another alternative for you to ponder.  Good luck in your tapering journey.

[...]  xo