Does this board have a consensus on switching from K --> V? Sticky poll?

[[Buddie]]

Does this board have a consensus on switching from K --> V?

I've had my head in old thread's and so far it seems I've found more negative stories than positive ones.

Given that it's such a prominent technique in the Ashton Manual, is it possible to make, and sticky, a poll on this forum so that those who've tried it can offer their opinion?

Considering that the Ashton Manual recommends, with reservations, that one switch from K to V it seems like maybe the community would have formed a consensus by now.

Not that Ashton ever did:

Some doctors in the US switch patients onto clonazepam (Klonopin, [Rivotril in Canada]), believing that it will be easier to withdraw from than say alprazolam (Xanax) or lorazepam (Ativan) because it is more slowly eliminated. However, Klonopin is far from ideal for this purpose. It is an extremely potent drug, is eliminated much faster than diazepam (See Table 1, Chapter I), and the smallest available tablet in the US is 0.5mg (equivalent to 10mg diazepam) and 0.25mg in Canada (equivalent to 5mg Valium). It is difficult with this drug to achieve a smooth, slow fall in blood concentration, and there is some evidence that withdrawal is particularly difficult from high potency benzodiazepines, including Klonopin. Some people, however, appear to have particular difficulty in switching from Klonopin to diazepam.

[[Buddie]]

I am very interested in this as well.  I am in the ER for the 4th time in a week.  I am at 0.14 mg of clonazepam and the panic is unbearable.  It is constant.  I have difficulty breathing, swallowing.  I feel non functional. 

I’m thinking of continuing on this taper but switching to Valium.  Life is just so unbearable. 

[[Buddie]]

I think the overall consensus has shifted by itself towards tapering from your original benzo if possible. It’s certainly what I would’ve done had I been more knowledgeable at the time, but few of us ever have that knowledge in the beginning and so we usually learn through mistakes, either our own, or mistakes made by doctors. Whenever I think of the perfect taper, it begins and ends with a process that revolves around stabilisation, so it makes sense to me to taper your original benzo and avoid the potential destabilisation that seems to so often occur during a crossover to a longer half life benzo. I sometimes wonder how much less sensitive to reductions I would have been had I not gone through such a traumatic crossover, although I should say that mine was a switch from a 19 day c/t from clonazepam directly to Valium, which kept me in the c/t for much longer than necessary whilst waiting for the Valium to build up in my body and then adjust to it. I can’t really speak as to a slow crossover except to say that I’ve seen many have great difficulty acclimating to the Valium before eventually choosing to switch back to their original benzo, which then only causes more confusion and destabilisation, not to mention the period of time it takes to crossover, wait to stabilise, only to then cross back and wait to stabilise again. In my own opinion, I can’t help but think all of this has to take a lasting toll on your CNS and could potentially even play a role in making future taper reductions more symptomatic than what would have been had you just tapered from the original benzo from the beginning. Of course, I have absolutely no proof to the validity of this hypothesis, it’s just a personal view. However, that’s not to say that crossing to a longer half life benzo isn’t the correct choice in certain circumstances, for multiple reasons, like bad inter-dose withdrawals or difficulty making such small reductions from a much more potent benzodiazepine. When it comes to a symptom based reason to crossover, there are risks associated… like there’s no guarantee that if you are having intense symptoms from your original benzo that you won’t have those same intensity of symptoms after crossing to the new benzo. It’s important to take everything into consideration and weigh it up very carefully, but even then, as I said, there are no guarantees you’ll be better off one way or another. It really is an individual choice that we can only make on our own. 

[[Buddie]]

I switched from K to V and it was the best decision for me. K really knocked me down, I functioned better on V. I even sped up the crossover from Ashton's protocol. Once I was on V, I rapid-tapered off Ambien I was taking, with no problems. The V was knocking me out at night, until I got down to 10 mg. Didn't need Ambien. I find on this forum I am somewhat of an exception. There is no way I would have tapered off of K. Give me V any day. I know many cannot tolerate V, so they stick with their original benzo. Everybody is different.

[[Buddie]]

This is of great interest to me. As a new member here and showing up in distress as most do, I have awakened to the nightmare of Benzos at the crossroads of interdose and what the heck ave.
I was doin .5 mgs of Xanax to get to sleep only to wake a few hours later to do another .5 for an hour or 2 more of sleep. Eventually after about 2 years  I am up to 2.0 mgs and welcome to wall.
Interdose withdrawls during the daytime.
Thanks to BB and a gut load of interwebbing it seems I best space out my dosing to attain stabilisation.
That’s good, but now what?
Prescriber gave me a 60 tabs of .5mg V and said get off.
Currently spaced out my Xanax to .5 evenly over 24 hrs, give or take but am in total freeze frame mode.
With any luck I can find a more understanding prescriber but from what’s on the web and BB that seems unlikely. Pardon my grammatical errors 

[[Buddie]]

Appears to me it is reasonable to shift from K to V in my humble experience. The crossover was a little tumultuous but certainly feels better being on V than K. Having said that, higher doses of V made me less functional (better than K of course) but felt better at lower doses of V. So yes, V helped me but I am still out of the woods yet.

[...]

[[Buddie]]

It was an absolute disaster for me. Had extreme paradoxical effects on a very low dose for only 2 days. I just jumped as there really wasn’t another option.

[[Buddie]]

Appears to me it is reasonable to shift from K to V in my humble experience. The crossover was a little tumultuous but certainly feels better being on V than K. Having said that, higher doses of V made me less functional (better than K of course) but felt better at lower doses of V. So yes, V helped me but I am still out of the woods yet.

[...]

How did you do the cross If we may? Ashton?
Would you do it differently in hindsight?
Feels better? I like the sound of that.
Less functional on higher doses?

[[Buddie]]

Hi [...],

 My doc suggested we cross after I weaned of Xanax (was on K too), but at that time she wasn't really aware of such thing as Ashton Manual (I was fully aware what it was). So when we switch from K 0.5mg to V 5mg, I knew it wasn't really the equivalent dose of K and suffered as a result. I looked up Ashton manual and did a cross taper myself with whatever remaining Klonopin tablets I had. This step made some difference (I just read my own log to reconfirm), I felt the transition was smoother. Valium at higher doses made me more tired and less functional (I was able to "function" though - driving, going for meetings etc.).

 In hindsight, I wish I knew what I was getting myself into way in advance, because doctors don't really tell you about all this. At least I would have been prepared beforehand. Secondly, taper slowly and hold hold hold, hold until you stabilize before you make another cut in your dose. Thirdly, Xanax taper is way worse than Klonopin (but then again I was on both at that time, so I can't tell for sure) and the Valium switch over was a good decision. 

[...]

[[Buddie]]

K to V failed for me.