Is Substitution actually usefull to get off Benzos?

This was mi idea to switch from Diazepam to something else to be able to taper faster because of all the horrible symptoms and pains I have from Diazepam but is it actually usefull since all benzos touch the same brain receptors?

Any logical explanation to give me please. Highly interested.

You’ve answered your question, all benzo’s touch the same receptors, there is no easier faster way to eliminate these drugs.  Most who cross over to Diazepam are on short acting benzo’s like Xanax to address interdose withdrawal.

If you're taking diazepam now, you should stay with it. You should not switch to another benzo. This is because diazepam is less potent than other benzos. For example, alprazolam and clonazepam are about 20-times as potent as diazepam. With diazepam you will be able to make much small cuts in the equivalent dose, and you will be able to get down to a much smaller equivalent dose before you end your taper, leading to a much smoother and easier taper. The only reason you might consider switching from diazepam to some other benzo is if you are experiencing intolerable side-effects from diazepam, such as depression, and then only if such side-effect is unlikely to diminish over time.

If you're taking diazepam now, you should stay with it. You should not switch to another benzo. This is because diazepam is less potent than other benzos. For example, alprazolam and clonazepam are about 20-times as potent as diazepam. With diazepam you will be able to make much small cuts in the equivalent dose, and you will be able to get down to a much smaller equivalent dose before you end your taper, leading to a much smoother and easier taper. The only reason you might consider switching from diazepam to some other benzo is if you are experiencing intolerable side-effects from diazepam, such as depression, and then only if such side-effect is unlikely to diminish over time.

 

Do you have peer reviewed evidence to back that up? Are they really 20 times more potent than Valium or are they simply dosed differently? You are also telling someone flat out “you should not switch to another benzo. You should stay with diazepam. Pretty bold of you to be that sure of what’s best for someone else. And to tell someone that making cuts in Valium is easier is merely a subjective opinion and nothing more. I lost many months from crossing to Valium from alprazolam and I simply could not reduce at all. I literally couldn’t do it. 7 months I stayed on Valium and I still kick myself for ever crossing to the stuff. And to the OP, I don’t know if Valium helped my interdose withdrawal because I was dealing with so many other nasty side effects that it was too hard to distinguish.

Do you have peer reviewed evidence to back that up? Are they really 20 times more potent than Valium or are they simply dosed differently? You are also telling someone flat out “you should not switch to another benzo. You should stay with diazepam. Pretty bold of you to be that sure of what’s best for someone else. And to tell someone that making cuts in Valium is easier is merely a subjective opinion and nothing more. I lost many months from crossing to Valium from alprazolam and I simply could not reduce at all. I literally couldn’t do it. 7 months I stayed on Valium and I still kick myself for ever crossing to the stuff. And to the OP, I don’t know if Valium helped my interdose withdrawal because I was dealing with so many other nasty side effects that it was too hard to distinguish.

 

I based the estimates of the comparative potency of the various benzodiazepines on the BENZODIAZEPINE EQUIVALENCE TABLE published by benzo.org.uk, which in turn is based on "the extensive research and clinical experience of Professor C Heather Ashton, DM, FRCP, Emeritus Professor of Clinical Psychopharmacology at the University of Newcastle upon Tyne, England. Sources: NRHA Drug Newsletter, April 1985 and Benzodiazepines: How they Work & How to Withdraw (The Ashton Manual), 2002." These numbers are generally accepted as approximately accurate and you will find them widely, if not universally, used. Google Search Results for "benzo equivalence table" Certainly they are the equivalencies generally used at Benzo Buddies. In the same general range are the equivalency values given here:

 

https://www.schealthviz.sc.edu/Data/Sites/1/media/downloads/tipsc_resources/tipSC%20Mar%202018%20benzoequivtable%2042018.pdf

 

I don't really understand what you mean when you ask "or are they simply dosed differently?" One mg of clonazepam is approximately 20 times as potent as 1 mg of diazepam. That's what I'm saying, based on the reports I've read, and that is the reason Dr. Ashton and many others have recommended tapering off diazepam rather than more potent benzodiazepines such as alprazolam or clonazepam: because it is possible to make smaller cuts and taper down to a smaller dosage using the less potent diazepam - and also because diazepam's longer half-life tends to smooth out the bumps, as it were.

 

You will notice that I also cautioned Thefrenchman that, in spite of all the good reasons for using diazepam to taper off benzos, it may not be possible to do so, if he experiences intolerable side effects from the diazepam. I based that on the experience of many members, including myself, who could not use diazepam to taper, because of its side effects - particularly the depression it often causes. In my 11-plus years on this forum, I have never once advised anyone to switch to diazepam from some other benzo - even though that is the generally accepted protocol. I have always cautioned them that, if they decide to switch to diazepam, they should be aware that it may not work for them and they may end up changing back to their original benzo. But Thefrenchman asked whether he should switch from diazepam to some other benzo in order to speed up the taper. That is a very different question. I said "If you're taking diazepam now, you should stay with it." I did not advise Thefrenchman, or anyone else, to switch to diazepam from some other benzo. Yes, I suppose it was "pretty bold" of me to offer an answer to someone's question about diazepam, but I had assumed that was the entire purpose of this forum.

 

My assertion that it is easier to make cuts from diazepam may indeed be subjective. But it's the opinion of a multitude of people who have used diazepam to complete their taper off benzos. Some subjective opinions are nearly universal. I could tell you that burning to death is painful, and you would not dispute it, even though the pain of burning is merely subjective.

 

If you're looking for "peer reviewed evidence" to back up every piece of advice given on this forum, you won't find much of it. Research into benzo withdrawal is very limited, likely because no one stands to profit from it, and many stand to incriminate themselves. Most of the evidence we do have on the subject is clinical. Dr. Ashton's writings, for example, are based mainly on her clinical experience, since she had no luck getting funding for proper studies. Such is the nature of the beast we confront. We do what we can.

 

So I repeat my answer to Thefrenchman's original question: If you're currently taking diazepam, I think you should stay with it to complete your taper, unless you find diazepam's side-effects intolerable, in which case, you might choose to switch to some other benzo to complete your taper. That is my opinion, based on my own experience and that of many other members whom I have observed over the past 11 years.

Hi everyone,

 

Long story short - Redevan is spot on. I was on benzos (all kinds, you name it), used all the references he has provided in the previous message and it worked. I am saying this as a fellow sufferer and medical scientist. Diazepam kept me sedated the whole day, but surely didn't exacerbate my withdrawal to the point of "hell on earth chemical imbalance". It was more manageable withdrawing from diazepam compared to the other benzos, and I have been off diazepam using the Ashton manual carefully.

 

MM

Hi everyone,

 

Long story short - Redevan is spot on. I was on benzos (all kinds, you name it), used all the references he has provided in the previous message and it worked. I am saying this as a fellow sufferer and medical scientist. Diazepam kept me sedated the whole day, but surely didn't exacerbate my withdrawal to the point of "hell on earth chemical imbalance". It was more manageable withdrawing from diazepam compared to the other benzos, and I have been off diazepam using the Ashton manual carefully.

 

MM

 

 

MM it looks like my taper will be similar to yours. I am currently on 10 lexapro and .25 klonopin and .25 xanax. I am tapering both of those over to Valium starting tomorrow. Did you find the direct switch tolerable? How did your taper go and how long were you on the Xanax and lorazepam before starting to taper?

 

Thanks!

AZE

Hi Aze2,

 

I found a direct switch from Klonopin to Valium rather unpleasant; my psychiatrist thought it was the best move at that time. But by the 2nd day of my direct switch, I was barely hanging on to a thread. It was then I decided to do a cross taper using the Ashton manual for over a week, and it did help with the withdrawals.

 

Looking back at the entries in my daily journal, I was on Xanax (three times a day) for good 4 months, Lorazepam for about 5 months. I know it is relatively a short time for dependence (other Benzobuddies have more experience with this), but I can confidently say it was "enough" time for me to get withdrawals from benzos. They are indeed that potent.

 

I hope this helps. Would it be too much to ask if I requested you to share your problems being on Lexapro (if any)? Have you tried cutting down on your dose? How does that feel?

 

MM

Hi MM,

 

Thanks for the response. I actually found out that I am a rapid metabolizer of Valium so we aren’t going to be switching me off the Klonopin and over to Valium anymore. So instead, my doc has prescribed a liquid compounded clonazepam that I will slowly reduce from the .5. (Switching my .25 if x to Klon) Had you tried to taper off the clonazepam directly before you switched to valium? I am a bit nervous.

 

I currently don’t have any issues with the Lexapro - most days. I think it greatly helps with my anxiety in general - except when uprising and then I get a myriad of effects, including increased anxiety.I just updosed to 10mg from 7.5mg, so I am letting this settle before I start the taper from clonazepam.

 

I do get a bit of fatigue on changing doses as well. I’ve had some loss of libido but not as bad as when I was on Zoloft. Other than that, I find it pretty tolerable. I plan to stay on for a year and see how I feel after that to determine if I will reduce dose or continue.

 

Can I ask what you are on the Lyrica for? Withdrawal symptoms or something else? Also, how did you feel your taper went overall? Manageable?

 

Thanks!

 

Dear Aze2,

 

Glad to hear from you and thanks for sharing. What I can gather from the entries in my daily journal is that I never actually weaned off Clonazepam directly; I was already having withdrawals from Xanax + Lorazepam at that moment and my doctor thought a Valium substitution would do me good. One thing is for sure; Clonazepam is a really nasty benzo (tried many benzos) in my opinion. Extremely difficult to wean off on it's own.

 

Lyrica was started by my doctor for various reasons. She mentioned it works really well with Lexapro (I was suffering from debilitating anxiety, finding no relief from many antidepressants at that point). And yes, you are right - it did help me with my benzo withdrawals. On the other hand, it also worked really well with the chest pains I had as a result of a concurrent health issue. I really should give myself a pat on the back, completely weaned off Lyrica close to a week and counting. They are a lot similar to benzos and I had a rough 3 days initially, but certainly nothing I can't handle after experiencing benzo withdrawals.

 

Long story short, my journey withdrawing from benzos is pretty much bittersweet - hellish 6 months, followed by a period of unknown instability and then some reprieve a little later.

 

Lexapro was a game changer for me. It took a long time to work and I had to see my psychologist to deal with all the mess that I never thought existed in my life previously. Lexapro dampened my libido which was literally on overdrive previously (perhaps due to anxiety), so I welcome this unintended side effect to a point. I agree with you, I am on my 38th week of Lexapro 15mg and I am going to give it a year (with stability) before I think about getting rid of it. But otherwise, I had no other serious adverse effects from Lexapro (unlike the crazy roller coaster ride I had with Mirtazepine, Amitriptyline, Prozac, Seroquel and Agomelatine).

 

I suggest you taper Clonazepam carefully and slowly. Easy does it. And with every cut, be prepared everything to endure a  quite messed up week or two. When I mean "prepare", you should make preparations in terms of changing your job responsibilities, stocking up food provisions (I could barely function at times, thankfully my girlfriend and mom helped me out), creating a peaceful home environment (I had horrible noise and light sensitivity that kept me in a constant state of panic), drinking plenty of fluids and getting some much needed exercise. I meditate quite a bit (it requires practice) but I believe, in the long run, it is the single most important habit that keeps me grounded.

 

Please do let me know if you wish to learn more. I wish to give back more to this community and I see it is only fair to do so - they were the only ones who really had my back when I was really down in the dumps. Take care!

 

MM