Liquid Diazepam

[[Buddie]]

Hi.  My wife has been tapering off 7.5 mg of Diazepam (Valium) since last March (2020) using both tablets and liquid (for the fractions).  She has tapered 0.15 mg every 2 to 3 weeks.
Last night she tapered to 1.9 mg of all liquid (from 2.05 mg Tablet and liquid).  She has not been feeling well all day.  Wave symptoms are all intensified quite a bit all day with no windows plus some shakiness, which is new.
Does the liquid work differently from the tablets?  Was it a good idea to switch to all liquid?
We switched for accuracy as the tablets do not divide accurately.
What do you recommend as the best way to taper below 2 mg valium.
Not sure how to post this question.
Thank you.
[...]

[[Buddie]]

Was last night the first night she used all liquid?

Am I understanding correctly that in addition to switching to all liquid, she also made a reduction in dose?

What is she using for liquid?  The commercially manufactured 5mg/5mL oral solution or something else?

Was she anxious about making the switch to all liquid or did she view this as “no big deal”?

[[Buddie]]

I’ve read it can take some time for body to get used to this form of Valium. There is a crossover period where some people struggle for a while but then stabilize x I hope she feels better soon x

[[Buddie]]

Hi.  My wife has been tapering off 7.5 mg of Diazepam (Valium) since last March (2020) using both tablets and liquid (for the fractions).  She has tapered 0.15 mg every 2 to 3 weeks.
Last night she tapered to 1.9 mg of all liquid (from 2.05 mg Tablet and liquid).  She has not been feeling well all day.  Wave symptoms are all intensified quite a bit all day with no windows plus some shakiness, which is new.
Does the liquid work differently from the tablets?  Was it a good idea to switch to all liquid?
We switched for accuracy as the tablets do not divide accurately.
What do you recommend as the best way to taper below 2 mg valium.
Not sure how to post this question.
Thank you.
[...]

I'm using a compound liquid diazepam and yes, the CNS has an adjustment period.  My compound pharmacist explained manufactured tablets have been researched for absorption rates in the stomach in order to deliver the drug in a user friendly manner.
Obviously the liquid is often absorbed long before it gets to the stomach, most often in the mouth, tongue and throat.
2) As far as "the best way" to taper below 2 mg V - the best way is whatever works for the patient.  Personally I like it because it allows for a very small and exact cut.  As you can see below, I use a combo of tabs and liquid.
FYI - there is a support group called something like "under 3 mg Valium group" or something like that.  I'd say you'll probably get some really good input.

[[Buddie]]

[...],

She has been using 2 mg tablets combined with liquid (5 mg=5ml) (Roxanne labs) .
Last night was the first time she used all liquid because she went under 2 mg and the tablets do not split accurately.  She had tapered from 7.5 mg last March to 2.05 before last night.  she was tapering to 1.9 mg last night, so she used the liquid for accuracy sake.  Waves were intensified and non stop all day.  Very bad.
Don't really know what to do tonight.  Very anxious.

[[Buddie]]

Hello, [...].  Thank you for answering my question.  It’s good she is using the commercial liquid.  Am I understanding correctly that, in addition to switching to all liquid, she also made a reduction in dose?  From 2.05mg to 1.9mg?  That’s a 7.32% reduction in dose in addition to a change in drug format.  How did your wife feel about switching to all liquid?  OK with it or uneasy/anxious?

Options to consider include: (1) increase dose to 2mg in tablet form and hold, (2) increase dose back to 2.05mg using tablet + liquid and hold, (3) increase dose to 2.05mg all liquid and hold, and (4) split 2mg tablet in half; take 1mg in tablet form and the rest in liquid (the other half of the tablet would be used for the next consecutive dose).

[[Buddie]]

[...],
Thank you for your input on this.
Yes, she tapered to 1.9 mg and went to the all liquid for accuracy sake.  She thought it would be fine since she had been using the liquid for fractions over the 2 mg tablets.  So last night was the first time on all liquid, along with the reduction at the same time.
She slept well last night, which doesn't happen too often, but today was bad all day long.
She is worried, uneasy, and anxious along with some new symptoms with no windows at all.  We are trying to get a jeweler's scale and will file down the tablets to 1.9 mg and hope it helps.  For tonight we will just guess at the dosage of a tablet.  She is afraid to take all liquid again.
We are both elderly and a little helpless.
Any guidance is greatly appreciated.
Thank you.

[[Buddie]]

You are most welcome, [...].  My best guess is that your wife’s issues are due to a combination of the reduction in dose and a change in drug format. As a general rule of thumb, it’s best to change only one variable at a time when tapering.  If I were in your shoes, I would give liquid another try (it’s a very helpful tool, especially when tapering at lower doses).  When I switched to liquid, I kept my dose the same, switched, and then held at the same dose until I was confident I had acclimated to the liquid.  It took me a week or so to get used to the liquid. 

[[Buddie]]

Thank you [...].  We will see what the next few days will bring.

[[Buddie]]

So last night my wife, Ingrid, slightly shaved a 2 mg tablet (estimating 1.9 mg).  She slept pretty well and today is back to a "normal" bad day.
Thank you for your help.