Substitution from Valium to Klonopin. Advise please!

For the past 10 days I have become more and more desperate and reached out to people here on the boards.  I am writing in the substitution taper board as someone advised this was the best place to ask for advice on subsitution issues.  Also I want to let know  so that people understand what I am trying to do right now, what my original dose of K was, how my crossover to V was done and what I am doing now.  Because a lot of people have asked me to explain my history of dosing in order that they can help me with advise I am trying to explain it here!.

 

I started Klonopin .5mg x 2 or 3 per day in oct 2010 + zimovane sleeping aid.

Then I upped to .5mg K x 3 or 4 per day in jan 2011 for 2/3 weeks because of a very stressful event

So on average I was on 1.5 per day most of the time since Oct.

Then I tried to cut too quickly at the end Jan/start Feb over a 2 week period and stopped altogether on 7th Feb which led to further  withdrawl hell

Then I reinstated on 1.25 mg Klonopin on 11th Feb, even though I didn't realise I should have just went back to the original dose.  I was still in withdrawal hell.

On 14th Feb 2011 my Psychiatrist switched me straight to 25mg valium per day based on the information that I was taking 1.25 mg of K per day even though she was prescribing the tablets in the first place and knew how much I had been taken before that (i.e. 1.5 mg). 

She told me to take Valium at 5 mg x 3/day, and 10mg night time and she stopped the zimovane ct.  This was a straight crossover not an ashton crossover, even though I gave her the Ashton Manual. 

After 2 days I rang her in desperation as I was still in withdrawal hell, so she told me to add a bit of klonopin back in. She said to take .5 k for 2 days and .25 k for another 2 days.  I thought this was nuts, so I took, the .5 mg K for 5 days, and then dropped to .25 for a further 5 days.  This was probably just as nuts.  She told me she had never heard of anyone go through such w/d!!  Really I should have been on a higher dose of valium.  I should have done the ashton crossover.  The last day I took the .25 mg K was on 26th Feb.  So I have still been taking 25 mg valium since then, but instead of waking during the night with severe withdrawal, this started to happen during the day aswell for the past 10 days.  I played with the dosage and found that I needed to take 12.5 mg to sleep at night, then take 7.5 to help with the w/d at whatever time i woke. Then I took 2.5mg twice a day. I could get 2 hours - 4 hours sleep and then wake up in a state (shakes, palpitations, freezing cold, stomach cramps, shock, crying )and then take the 7.5 mg V which would take a couple of hours to help, but no more sleep.  But this has become increasingly worse in the past 10 days.  The withdrawals started during the day aswell which meant that my functioning abilities decreased and decreased to the point where I cannot leave the house.  This is hell.  I think it is the K leaving my body, plus the fact that I am not on the right dose of valium. It should be 30mg if I was on 1.5 K.  I have been trying to contact my doctor to no avail today.  Apparently she will be around on Wednesday.  For the past 10 days I have become more and more desperate and reached out to people here on the boards.  I have learned  about the long half life of valium and believe my body needs more and that it might be best to take the larger dose at night time so I wont feel so sedated during the day.  This has definitely helped with the sedation effects.  I feel no choice but to updose to 30 mg of Valium, taking most of my dose at night.  Since last night I took 15mg going to bed (got hardly any sleep), woke and took 10 mg (no more sleep), but the w/ds were not as bad.  Will take the other 5mg spread out over the day.  Already took one of those 2.5 mg doses and will take the other later.  I feel I am far from reaching a stabilizing point, whatever that means.  I just hope i reach a point where the w/d wont be so bad and can function at some level.

 

Still in deep despair and crying all over the place.  Finding it hard to "hang in there" any longer.  Lets see what the updose does.

Hi starbar,

 

I know you're miserable, and you might be right that you need to be on more Valium.  I'm not sure what stabilizing means either, since I didn't taper, but I know it doesn't mean feeling good, that much I do know.  I'm sorry you're in such a state, and I hope you and your Dr can figure this out, but please know that there will come a time when you'll need to accept that you're not going to feel better until you're off the drug and healed from it's effects.  It would be nice though to at least begin this journey from a place that's bearable. 

 

 

Thanks Pamster.  I thought I was possible to begin this journey from a place that's bearable.  I do feel a little better.  Less w/d since I upped the dose. But it makes me impatient.  Klonopin never did that to me.  It is not me.  I am such a patient person normally.  Too patient my mother has said.  I find it hard to manage my 3 year old.  He's a normal boy bouncing around and not doing what he's told.  I sometimes have to walk away from him to calm myself.  I keep telling myself it is the drugs.  This is not me.  I have never felt thus way in my life and it breaks my heart that I am losing such a good quality.  Does anyone have any advice on patience and remaining calm ? Maybe it is acceptance.  But I feel like totally losing it sometimes.  It's not normal for me.

Does anyone have any advice on patience and remaining calm ? Maybe it is acceptance.  But I feel like totally losing it sometimes.  It's not normal for me.

 

Hi Starbar!

It's so hard to be patient when it seems like it'll never end.  Even harder to be calm while being attacked by w/d symptoms.

But time will heal.  Eventually you will be off of benzos (if you stay committed to that goal), and you'll look back and be amazed at how far you came.

Trust me, that day will eventually come

 

All my best to you!

Thank you cwj,

 

I hadn't  heard from anyone in a while on this thread so its nice to get a post.  My w/d hasn't subsided anymore than it did since the updose.  I mean the w/d subsided then when i updosed, but no more improvement.  I continue to wake at 4-5am with the shakes, shivers, freeezing, palpitations and generally a sense of weepyness and quite frankly despair. Because I just cant help but hope it will somehow get slowly better.  I think this is matural human nature.  And I can only hope it will start to get better,  What other option do I have but to hope or just accept?  The bad w/ds last for at least 5 hours.  Until 9am at least.  The day time is better, but I have high anxiety and lesser palpitations, but bad enough stomach cramping.  As you can see from my above post i haven't even began to taper, nor stabilize at my dose, which I dont know what that means at this stage.  I find it all quite scary and frightening. and i have horrid dreams.  It is now 5am and  I will just go back to bed and hope to get more sleep, but it never happens because of the way i feel.  Sometimes I nearly get back to sleep, but i am jolted out of it.  I try to read a bit and make sure my son in bed beside me is ok.  He will wake up at 7 and be bouncing around the place.  I will remain freezing cold until at least 9am. 

 

I an meeting my doctor today and was thinking of asking for asking her for low dose of amytriptaline to try and help me sleep, although i dont really want to do this.  I know it is sedating and I hope it would help me sleep.  I usually have bed reactions to all meds, so I dont really know if i would even try it even if she gives it to me.  But I know thid drug could help with sleep.  However I have mixed feelings about adding in anything else.

 

I am going through a divorce right now, so all my dreams are anxiety related about that.  I know lack of sleep must be a hindrance to healing as i have't had a good night sleep since mid January and I wonder will I ever get this nights sleep until 18 months time like I hear other people say.

 

The good thing is my patience levels have risen again somewhat.

 

What do you think of amytriptaline?

 

Thanks

starbar

Hi Starbar,

 

To get through your rough mornings, you might try to practice some of these techniques.

 

Understanding Early Morning Anxiety

By Deanne Repich

           

Are mornings the worst time for your anxiety? When the alarm clock rings do you experience a feeling of dread? Do the symptoms kick in, making you tempted to roll over and snooze for hours so you don't have to face the day?

 

One reason why anxiety can be worse in the morning is that waking up is a sharp contrast to the sleep environment, which is perceived as pleasant for most people.

 

Picture this: You're sleeping peacefully in your warm, cozy bed, (for some, after many hours of insomnia). You are at peace, finally getting a break from the cares and tasks of the day. Then, BOOM! Suddenly, the shrill sound of your alarm clock jerks you awake. It triggers the "fight or flight" response, our body's inborn self-protective mechanism. And to top it off, the room is cold and dark. The dreaded worries and symptoms kick in.

 

There are several things you can do to make your "waking up" environment more pleasant. For example, get a radio alarm clock that wakes you up to your favorite music. Another alternative is an alarm clock that wakes you up gradually with pleasant chimes of increasing volume and frequency.

 

Keep a robe and slippers next to the bed so that you can warm up quickly and minimize a drop in body temperature as you get out of bed. If the bright lights of the room bother you, install a dimmer switch near your bed. You can gradually increase the light's intensity over a period of several minutes after you awaken.

 

Another reason why symptoms can be worse in the morning is because your blood sugar is low when you first wake up. You have gone all night without food. It's important to maintain a constant blood sugar level because the brain uses glucose as its fuel. If blood sugar levels are too low or drop too fast, then the brain starts running out of fuel. This causes the brain to trigger the "fight or flight" response.

 

The "fight or flight" response sends a rush of adrenaline, cortisol, and other neurotransmitters through your body to prepare you to fight or flee the perceived threat (low fuel). This process can trigger physical reactions ("symptoms") such as trembling, rapid heartbeat, sweating, panic attacks, fatigue, insomnia, mental confusion, nervousness, dizziness, and more.

 

To balance your blood sugar levels and minimize symptoms, keep a snack that contains "good" complex carbohydrates and protein by your bed. Eat it when you first wake up. You will likely notice that your symptoms improve shortly after eating the snack. You might try a combination of whole grain crackers and a handful of nuts, or a high-protein granola bar with some whole-wheat pretzels. The "good" carbohydrates will give you energy, and the protein will help to keep your blood sugar level steady over time.

 

Finally, dead-end thoughts play a huge role in creating early morning anxiety, as well as anxiety at any other time of day. Once you learn to overcome dead-end thoughts, you stop the anxiety cycle in its tracks.

 

Dead-end thoughts are negative, anxious, obsessive, or racing thoughts, that do not promote your well-being. They are based on faulty thinking patterns. These thoughts of helplessness, negativity, or anxious predictions about the future, give away your personal power and create the anxiety cycle. Here are a few examples of dead-end thoughts:

 

    * "I can't get out of bed feeling like this."

    * "Why do I feel this way? There must be something really wrong with me!"

    * "Everything is going to go wrong at the work meeting."

    * "It's a horrible day."

    * "When will this ever stop!"

 

The most important thing you can do to conquer early morning anxiety is to change how you PERCEIVE waking up. Change the dead-end thoughts that create the anxiety. Remember, physical symptoms by themselves are not anxiety. Negative perceptions are what create and perpetuate the anxiety cycle.

 

Choose to perceive waking up as a positive event - yes, you have a choice! Habitual dead-end thoughts can be unlearned and replaced with healthier self-talk. Of course, like any new skill you learn, it requires practice and patient persistence on your part to make healthier thoughts automatic.

 

Change your perception by creating a morning ritual that replaces the dead-end thoughts with healthier ones. Create a sequence of positive steps you can take when you first wake up to conquer early morning anxiety.

 

Positive rituals are helpful because they get you fully involved in the present moment (instead of the future), by focusing on one task at one time. Make the ritual automatic by taking the same steps every day in the same sequence. Here is an example of an anxiety-busting morning ritual. Use the ideas in this ritual as a starting off point to help you create your own personalized morning ritual.

 

    * Step 1: As you get ready for bed at night, place your alarm clock out of arm's reach from the bed. This action will motivate you to get out of bed to turn off the alarm when it rings the following morning.

 

      When the alarm rings, get out of bed immediately. Turn off the alarm and put on the robe next to your bed. As you do so, say aloud three times in an enthusiastic, cheery voice: "I am SO glad to be alive! What a WONDERFUL day!" Make sure to smile as you do this.

 

    * Step 2: Mentally and physically "check in" with the present moment. Accept any physical sensations without placing a negative judgment on them. Simply observe. Touch your face, hands, and legs a few times and observe the sensations. Focus intently on a few items in the room for several seconds. These simple activities help you to switch your focus from the future back to the present moment.

 

      If dead-end thoughts occur at this time (which they likely will), immediately replace them with healthier thoughts. It often helps to say the positive thoughts aloud. For example, if you're thinking: "I can't get out of bed feeling like this," replace it with: "These physical sensations might be uncomfortable, yet I know they are harmless. I am completely safe. I am physically able to get out of bed and have a great day. Watch. I can get out of bed just fine!" Then DO it!

 

    * Step 3: Turn on your favorite upbeat music CD. (Keep a CD player in your bedroom.) Sing along and dance for a minute or two.

 

    * Step 4: Eat the snack on your bedside table to help level your blood sugar.

 

    * Step 5: Take a shower and dress. Then continue with your day.

 

Once you find a pattern that works for you, use the same morning ritual -- the same steps in the same sequence -- every day. Repetition helps you to effectively unlearn old thoughts and behaviors and make the new ones automatic.