Tapering 1.11 mg Diazepam: Need input

Buddy Family & Team, I've read through several (not all) posts within the tapering topic. I'm finding good information but have some outstanding questions. I'm looking for as MUCH of your personal experience/feedback as possible specific to experience with a Diazepam Taper.

In June of 2020. I was at an est. 2.5 mg daily, from 6/15/20-6/15/21. Since 2021, I've been tapering very slowly. It's been methodical but not precise. I'm currently holding at an estimated 1/9th to 1/10th or so of a pill (1.11 mg/daily). I'm cutting the pills but not weighing them (obviously my process needs to improve and I'm seeking guidance on this also).

Ongoing symptoms include brain fog, some anxiety, trouble sleeping and a fair amount of headaches/numbness and tingling in feet and extremities-lots of irritability. While I AM able to perform most of my daily functions currently, they're becoming a bit more challenging.  I would like to continue my taper but need to start being more 'calculated' as I’m tapering off of a previous Dr's prescription.

I have 44, 10 mg pills remaining (44 weeks or more depending on taper plan). I am NOT in a position to ask my existing physician for another prescription. (The physician who prescribed me retired a year ago. I've been tapering with the script that was already dispensed). Currently, 1 10mg pill, lasts me at least one week, often longer.

I have reviewed the 'spreadsheet' on the liquid taper. This is a bit overwhelming for me - I'd like to TRY a dry taper, your thoughts?

I know my post is a bit ambiguous... I'm just trying to look out over the next year or so and figure out the best plan to taper. I'm committed. I'm motivated - but I'm scared. Specific questions include: How have you successfully dry tapered off Diazepam? Is there a recommended scale I should use? Is 44 pills over one year reasonable? Is this too aggressive? (I know subjective based on the person). Thank you for your time and energy the support of this community. With gratitude, F

Be at peace.  You have 44 pills left and you are only using 1 per week.  That gives you at least 44 weeks, more then enough time to taper.

However, I think you need to consider something.

You are on 1.11 mg of diazepam.

That is 0.055 mg of Xanax or Klonopin.  I know people who have jumped to zero at that point.

Are you sure the symptoms are not from other sources beside withdrawal?  Why did you get put on Benzos in the first place? 

Be at peace.  You have 44 pills left and you are only using 1 per week.  That gives you at least 44 weeks, more then enough time to taper.

 

However, I think you need to consider something.

 

You are on 1.11 mg of diazepam.

 

That is 0.055 mg of Xanax or Klonopin.  I know people who have jumped to zero at that point.

 

Are you sure the symptoms are not from other sources beside withdrawal?  Why did you get put on Benzos in the first place?

'Be at Peace' – I love this. Thank you Bob.

You bring up a very relevant point about how low of a dose I'm on, with the Diazepam. Thank you for 'validating' what I was beginning to wonder/consider.

I am ALSO tapering off of .50 Alprazolam. I've been on the Alprazolam for about three years. Started taking for flying and...well, you know the rest. The good news is, I'm at a fairly low dose of the Alprazolam, however tapering off of two Benzodiazepines has been challenging. Through this exchange/correspondence I'm beginning to think tapering off the Alprazolam first while maintaining the Diazepam... once off the Alprazolam then discontinue the Diazepam.

Note, I do take 8 mg Buprenorphine daily for Opioid dependence. I've been on this medication for five years. I have not recentlly altered my dose of this medication. But I've heard that being on opioid's can influence a taper. (I did read some great literature on this topic within the forum.)

Open to your thoughts. Endlessly grateful for your time.

What is your current daily dose of alprazolam?  What is your daily dosing schedule (how many milligrams of drug do you take at what times)?

What technique are you using to taper the alprazolam?

(It would be helpful if you would add this information to your signature.)

What is your current daily dose of alprazolam?  What is your daily dosing schedule (how many milligrams of drug do you take at what times)?

 

What technique are you using to taper the alprazolam?

 

(It would be helpful if you would add this information to your signature.)

Hi Libertas - Thank you for your reply and suggestion about my signature; I've updated my signature. Let me know if I'm missing relevant details.

Existing dose of Alprazolam: About... .40-.50. I've been trying to reduce but struggling even at this small amount. I was previously taking the Alprazolam .25, 2 X daily, up until two weeks ago and finally transitioned to .50 mg, once daily. The impetus of changing to once a day - was to be more consistent in my approach. The transition from twice daily, to once daily, was more challenging than I anticipated, but I've leveled out a bit at once daily. I'm still feeling some of the WDs from this transition, but slowly 'leveling out'. Re: Technique; I'm trying to reduce about .10 mg every 2 weeks. Unsure if this is the right approach.

Diazepam, holding at 1.11 mg daily. Just recently made a reduction over the last two weeks, from 1.50 mg Diazepam to 1.11. WD symptoms during this reduction included insomnia, lots of numbness in extremities. I welcome your feedback.

Thank you for the additional information!

Although 0.5mg of alprazolam does indeed sound like a low dose, it isn’t because alprazolam is a very potent benzodiazepine.  To give you a sense of how potent, 0.5mg of alprazolam is equivalent to 10mg of diazepam per Ashton’s equivalence table for substitution.

Might I ask why you decided to change your alprazolam dosing schedule from twice a day to once a day?  (Alprazolam has a short half-life so many members dose it multiple times a day to help with interdose withdrawal while tapering.)

Your case is complicated.  You’ve made two changes in two weeks — a change in dosing schedule for the alprazolam and a large (26%) reduction in your diazepam dose. (Generally speaking, it’s preferable to make only one change at a time when tapering so you can evaluate the effect of the change.)

You also are now taking two benzodiazepines at the same time of day (7pm).  What time do you take the buprenorphine?  As I’m sure you are aware, concomitant use of these three drugs conveys risk.

Re: your technique for reducing the alprazolam … are you pill-cutting?  Shaving and weighing?  Other?

Reducing by 0.1mg every 2 weeks would be a very rapid taper.  For example, decreasing your dose from 0.5mg to 0.4mg would be a 20% reduction.  We typically suggest reductions in the range of 5-10%.

Now that we have a better understanding of your medication history, I hope other members will stop by to provide input on how you might proceed.

In the interim, I suggest you refrain from making any other changes.  Your system needs time to adjust to the changes you’ve made over the past two weeks.

Thank you for the additional information!

 

Although 0.5mg of alprazolam does indeed sound like a low dose, it isn’t because alprazolam is a very potent benzodiazepine.  To give you a sense of how potent, 0.5mg of alprazolam is equivalent to 10mg of diazepam per Ashton’s equivalence table for substitution.

 

Might I ask why you decided to change your alprazolam dosing schedule from twice a day to once a day?  (Alprazolam has a short half-life so many members dose it multiple times a day to help with interdose withdrawal while tapering.)

 

Your case is complicated.  You’ve made two changes in two weeks — a change in dosing schedule for the alprazolam and a large (26%) reduction in your diazepam dose. (Generally speaking, it’s preferable to make only one change at a time when tapering so you can evaluate the effect of the change.)

 

You also are now taking two benzodiazepines at the same time of day (7pm).  What time do you take the buprenorphine?  As I’m sure you are aware, concomitant use of these three drugs conveys risk.

 

Re: your technique for reducing the alprazolam … are you pill-cutting?  Shaving and weighing?  Other?

 

Reducing by 0.1mg every 2 weeks would be a very rapid taper.  For example, decreasing your dose from 0.5mg to 0.4mg would be a 20% reduction.  We typically suggest reductions in the range of 5-10%.

 

Now that we have a better understanding of your medication history, I hope other members will stop by to provide input on how you might proceed.

 

In the interim, I suggest you refrain from making any other changes.  Your system needs time to adjust to the changes you’ve made over the past two weeks.

Wow - I had no idea .5 mg of Alprazolam equates to 10 mg of Diazepam. That REALLY puts things in perspective. Thank you! Looking back, I wanted to transition from two doses to one, to try and 'create more space' between doses as I thought this would create maybe some discomfort on the front end, but mitigate more discomfort toward the end of my taper...? Maybe not a smart move.

In terms of how I'm tapering - I'm simply cutting the pills and 'eyeballing' it - not precise or effective. However, I just purchased a scale on Amazon - after reading some recommendations through the forum. I need to be more precise when I reduce in the future - and actually weigh out the amount I'm taking to ensure accuracy and consistency. Going forward, It sounds like I need to reduce by 5-10% each reduction, and wait until my body adjusts. Thank you for reiterating the importance of this. I'm very 'type-A' and just want to get to the finish line, but this is just going to further complicate things.

I am aware of the risks involved with Opioids and Benzos. (And it cannot be stated enough given the dangers) I take my Bupe around 2-3 PM daily. I used to be on 12 mg of Bupe but over a long period tapered down to 8 mg. Eventually I plan to taper off the Buprenorphine, but not during my benzo taper.

I can't thank you enough for your input and feedback. I have a plan: For now I'll hold at existing doses, wait until my body levels off and then try a 5% reduction on ONE of the medications. Appreciate your energy.  Much Gratitude. -F