valium taper

[[Buddie]]

Looking for advice about a valium taper after having switched from klonazepam. Trying to figure out how to post things at this time.

[[Buddie]]

Looking for advice about a valium taper after having switched from klonazepam. Trying to figure out how to post things at this time.

Hi [...],

Welcome to BenzoBuddies,

Let us know how much valium you have been switched to from how much clono. We can help you with a taper from valium We recommend cutting approximately 10% off your total daily dose every week or two depending on how you are feeling. Just give us some more information and we can help you! Are you familiar with The Ashton Manual? You can also find some tapering schedules in there in Chapter II, here's a link to that....http://www.benzo.org.uk/manual/index.htm


T2

[[Buddie]]

I am looking for answers to some questions for my husband. He was placed on Klonazepam 1mg BID originally 10months ago for anxiety and extreme insomnia related to a job situation. He got out of the job, but stayed on the med as prescribed. After one month his MD wanted him to start reducing his dose to get him off of it eventually. He decreased him to 0.5mg BID, but for some reason he never weaned down from there because of some stressful life happenings. So a little over a month ago he agreed to get off the med according to his doctor's encouragement, but we had no idea how hard this would be and what it entailed or how to safely do this. His doctor put him on valium 2mg BID without a gradual cross over and my husband has been suffering from many withdrawal symptoms over the last 4wks. They have been very severe and the MD doesn't seem to understand the correlation between the sudden drop in benzo in his system and the aweful symptoms he is having. He still just wanted to give him valium 2mg BID. After much research on our part we realize this was all gone about the wrong way. I need advice on how to get my husband back to a functioning level so we can start a very gradual, slow taper from there. Over the last couple days I have encouraged him to take 2mg TID. We haven't been able to talk to his MD over the last couple days and can't get an appointment til Tuesday. The MD basically is asking us what we should do instead of managing the taper himself and he seems to not understand the need for more valium at this time. Very frustrating. My main question is this: Since the initial taper was very rapid and not appropriate (Klonazepam 0.5mgBID, equivalent Valium 10mg BID switched to Valium 2mg BID without a slow switchover), do we need to increase his valium back up to a level so he is having less adverse affects and completely re-start the taper from that higher dose? Or should he struggle through each day until the Valium 6mg/day is stabalizing him? At this point he is having great fatigue, occassional numbness in fingers/toes, mood swings, hypersensitivity to everything, the list goes on. Would it be ok to jump him up to 10mg per day and re-start the taper from there? We will need our own plan when we see the MD on Tues b/c he really doesn't know what to do for my husband. I think I understand how to do the slow taper following the Ashton Manual but I need to know where to start with him. Please Help!

[[Buddie]]

I am looking for answers to some questions for my husband. He was placed on Klonazepam 1mg BID originally 10months ago for anxiety and extreme insomnia related to a job situation. He got out of the job, but stayed on the med as prescribed. After one month his MD wanted him to start reducing his dose to get him off of it eventually. He decreased him to 0.5mg BID, but for some reason he never weaned down from there because of some stressful life happenings. So a little over a month ago he agreed to get off the med according to his doctor's encouragement, but we had no idea how hard this would be and what it entailed or how to safely do this. His doctor put him on valium 2mg BID without a gradual cross over and my husband has been suffering from many withdrawal symptoms over the last 4wks. They have been very severe and the MD doesn't seem to understand the correlation between the sudden drop in benzo in his system and the aweful symptoms he is having. He still just wanted to give him valium 2mg BID. After much research on our part we realize this was all gone about the wrong way. I need advice on how to get my husband back to a functioning level so we can start a very gradual, slow taper from there. Over the last couple days I have encouraged him to take 2mg TID. We haven't been able to talk to his MD over the last couple days and can't get an appointment til Tuesday. The MD basically is asking us what we should do instead of managing the taper himself and he seems to not understand the need for more valium at this time. Very frustrating. My main question is this: Since the initial taper was very rapid and not appropriate (Klonazepam 0.5mgBID, equivalent Valium 10mg BID switched to Valium 2mg BID without a slow switchover), do we need to increase his valium back up to a level so he is having less adverse affects and completely re-start the taper from that higher dose? Or should he struggle through each day until the Valium 6mg/day is stabalizing him? At this point he is having great fatigue, occassional numbness in fingers/toes, mood swings, hypersensitivity to everything, the list goes on. Would it be ok to jump him up to 10mg per day and re-start the taper from there? We will need our own plan when we see the MD on Tues b/c he really doesn't know what to do for my husband. I think I understand how to do the slow taper following the Ashton Manual but I need to know where to start with him. Please Help!

Hi [...],

I am so sorry for your husband's suffering. Most doctors are not aware of proper benzo tapering. In my opinion, I would let him go back up to at least 10mg per day and see if he can stabilize there over the next week or two before considering tapering him again. The initial 50% drop from 1mg to .50mg was extreme and would cause these symptoms. Please try and educate your husband's doctor by suggesting he read The Ashton Manual which chronicles benzo use and withdrawals, again here is the link.... http://www.benzo.org.uk/manual/index.htm

Another option is to go back to taking 1mg of klonopin and taper from it. We have many here that are able to titrate from klonopin successfully.

Let us know how he does with stabilizing.

T2

[[Buddie]]

I am looking for answers to some questions for my husband. He was placed on Klonazepam 1mg BID originally 10months ago for anxiety and extreme insomnia related to a job situation. He got out of the job, but stayed on the med as prescribed. After one month his MD wanted him to start reducing his dose to get him off of it eventually. He decreased him to 0.5mg BID, but for some reason he never weaned down from there because of some stressful life happenings. So a little over a month ago he agreed to get off the med according to his doctor's encouragement, but we had no idea how hard this would be and what it entailed or how to safely do this. His doctor put him on valium 2mg BID without a gradual cross over and my husband has been suffering from many withdrawal symptoms over the last 4wks. They have been very severe and the MD doesn't seem to understand the correlation between the sudden drop in benzo in his system and the aweful symptoms he is having. He still just wanted to give him valium 2mg BID. After much research on our part we realize this was all gone about the wrong way. I need advice on how to get my husband back to a functioning level so we can start a very gradual, slow taper from there. Over the last couple days I have encouraged him to take 2mg TID. We haven't been able to talk to his MD over the last couple days and can't get an appointment til Tuesday. The MD basically is asking us what we should do instead of managing the taper himself and he seems to not understand the need for more valium at this time. Very frustrating. My main question is this: Since the initial taper was very rapid and not appropriate (Klonazepam 0.5mgBID, equivalent Valium 10mg BID switched to Valium 2mg BID without a slow switchover), do we need to increase his valium back up to a level so he is having less adverse affects and completely re-start the taper from that higher dose? Or should he struggle through each day until the Valium 6mg/day is stabalizing him? At this point he is having great fatigue, occassional numbness in fingers/toes, mood swings, hypersensitivity to everything, the list goes on. Would it be ok to jump him up to 10mg per day and re-start the taper from there? We will need our own plan when we see the MD on Tues b/c he really doesn't know what to do for my husband. I think I understand how to do the slow taper following the Ashton Manual but I need to know where to start with him. Please Help!

Welcome to BenzoBuddies, [...]. 

You are fortunate to have realized what is causing your husband's symptoms.  Many people end up going through a lot of tests trying to find a medical reason when it's withdrawal symptoms all along. 

If you are in the US, you may find it difficult to get a script for a higher dose of valium.  Of course, if your doctor is willing to go along with what you request, I think Theresa's suggestion of at  least 10 mg valium is a sound one.  There are a lot of variables in figuring out an equivalent dosage to 1 mg klonopin but Prof Ashton found that 1mg klonopin = 20 mg valium in effectiveness.  Also, since valium takes longer to build up, your husband probably should have been kept on a portion of his klonopin dosage while starting to substitute the valium.  I would think the combination of too little valium and no crossover would certainly account for his current symptoms.  If the doctor is not willing to prescribe that much valium, see if hubby can go back on .75mg-1mg klonopin/day spread out over 2-3 doses and taper from there.  Get the .5mg tablets since they are easier to cut in small pieces. 

[[Buddie]]

Do you think going back on Klonipin would be the best bet? He has been off of it now for a couple weeks with trial and major error with the little valium that the MD gave him. The 6mg per day of valium has not been working for him over the last 4-5days and we run out of the few pills given to us tomorrow morning. How long does it take to get a steady amount of the valium in the bloodstream? We can't get him in for an appointment until Tues. Tomorrow we can get 10more 2mg valium pills from pharmacy. I plan to give him 10 or 12mg total tomorrow since we will have more pills and convince his MD on Tues of what is really going on and request the suggested Ashton Manual Taper. Would it be going backwards to put him on Klonipin again and start all over or should we just try to start again on higher doses of Valium. I want to avoid too much backtracking, but my husband is miserable. If you do suggest going back on Klonipin initially, do we only start the taper again once he starts to feel normal and functioning on the Klonipin? I don't want my husband to suffer, but I want to avoid a more prolonged withdrawal by starting the taper back at the beginning. Basically, is there any harm at completely backtracking and starting over at Klonipin 0.5mg BID? or has he gained anything through the last couple weeks to not have to start at the beginning and we should just try to increase the Valium to where he is feeling normal and functioning and start from there. I need a good plan.

[[Buddie]]

Do you think going back on Klonipin would be the best bet? He has been off of it now for a couple weeks with trial and major error with the little valium that the MD gave him. The 6mg per day of valium has not been working for him over the last 4-5days and we run out of the few pills given to us tomorrow morning. How long does it take to get a steady amount of the valium in the bloodstream?

I don't think there's a full-proof answer to either question, [...].  Since Prof Ashton used valium for her patients, I suppose staying on the valium would be the better option if your doctor will go along with prescribing an adequate dose and tweaking it if necessary.  Valium has the most variable half-life of any benzo I know of: 20 to 100 hours according to Ashton. She also states that the half-life can vary considerably between individuals.  (Half-life: time taken for blood concentration to fall to half its peak value after a single dose).  Also, researcher disagree on the equivalencies between benzos.  We go with Ashton's as a starting point but you and his doctor need to know that he might require more or less valium than indicated in the Ashton Manual.

We can't get him in for an appointment until Tues. Tomorrow we can get 10more 2mg valium pills from pharmacy. I plan to give him 10 or 12mg total tomorrow since we will have more pills and convince his MD on Tues of what is really going on and request the suggested Ashton Manual Taper. Would it be going backwards to put him on Klonipin again and start all over or should we just try to start again on higher doses of Valium. I want to avoid too much backtracking, but my husband is miserable. If you do suggest going back on Klonipin initially, do we only start the taper again once he starts to feel normal and functioning on the Klonipin? I don't want my husband to suffer, but I want to avoid a more prolonged withdrawal by starting the taper back at the beginning. Basically, is there any harm at completely backtracking and starting over at Klonipin 0.5mg BID? or has he gained anything through the last couple weeks to not have to start at the beginning and we should just try to increase the Valium to where he is feeling normal and functioning and start from there. I need a good plan.

I don't think it would be necessary to go back to his original dose of .5mg 2x/day of klonopin.  It does seem that since he has had a number of weeks at a drastically lower level of benzos, he shouldn't need to go back on as much as he started from.  We usually recommend that people who need to reinstate, do so at the lowest level at which symptoms are manageable.  Finding that level takes experimentation.  If he stays on valium and you increase the dose to 10-12mg/day, it could be a week before he notices any real change in how he feels.  Makes it hard to know if he's on enough but valium just takes a long time to build up in his system.  That's why Ashton put her patients on a slow crossover as you have seen in the manual.  Do you think the doc would go for him being on both the klono and valium at the same time?  If so, it might work well to have the faster acting klonopin to stabilize him sooner while the valium builds up and then continue to substitute the valium for the valium according to the Ashton schedule until he's just on valium and then taper from there.

I wish I had some definitive answers for you.  And I am by no means an expert.  I imagine you will get other suggestions and opinions over the next day or so.  Is his appt. in the morning or afternoon on Tuesday?

[[Buddie]]

Thanks so much for all the help so far. His appointment is Tues am. We are going to try him on 12mg valium total today and see if he notes a difference. I'm kind of scared it won't decrease his symptoms right away as you pointed out because of the slower affect as opposed to Klonipin. We thought yesterday would be the last horrible day since we were getting more valium today, but now I'm not too sure. This is taking it's toll on our time with my stepson who is only going to be with us for a few more days this summer. I am sad he had to witness his dad over the last week with this. I've decided to cool it with talking about plans for taper and all the symptoms around him anymore because he's already heard too much so far. He's only 13 and probably wishes he was with his other family during this time which in retrospect would have been better, but this was the time he was supposed to be with us this summer.

Anyways, I think his MD will give him a small amount of Klonipin to stabalize, but I don't know. I'll suggest the small dose of Klonipin and Valium together and we will see what he is willing to do. I have a couple plans laid out. Luckily, I was at a dinner last night where I talked with some of the doctor's I work with at the hospital (I am a med/surg nurse) and they were willing to give me some advice and encouragement and one of them is willing to work with my husband if his regular MD is not comfortable with the taper. They suggested not going back on the Klonopin and just tapering from the valium, but I can't imagine him going through another week like this waiting for the valium to level him out. We'll see! thanks so much for all your help and support