3mg Ativan Lorazepam to 2.5 mg Valium Diazepam and Q re: can I dose today

Hi 

 

Have been on Ativan for around 6 months. 3mg/day (3x1Mg) for around 3 months, gradually scripted from as needed to the current dose of 3mg.

 

I have just been switched to valium two days ago by GP (due to sleeping issues after also switching from Mirtazapine to Brintillex) who scripted 2.5mg valium in the morning and 5mg valium at night, with instructions to "see how I feel on that dose" and to review if sufficient in two weeks (!)

 

Straight swap from Ativan to valium. Looking for help regarding this switch over the weekend as it's not even close to sufficient in my opinion, and am wondering as I've had 3 x 2.5 mg valium today every 5 hours (it's 9pm now) as I'm starting to feel super anxious if it's still safe to have the 5mg dose, or if I can have even just 1mg of Ativan in the same day.

 

I've read a lot on the forum, have read the Ashton manual, have googled so so much... but I'm still unsure re: having either another dose of Valium because it's so low, but it will be the 4th dose today... or if it's safe to have an Ativan 1mg (or even 0.5) if I've already have Valium

 

How I'm not confusing anyone. I feel confused.  . Poor brain

I'm sure you're seen that Ashton suggests crossovers be done in a few steps to ease the transition.  It takes some time for the level of valium to build up in your system (1-2 weeks).  It doesn't take very long to eliminate the Ativan (1-2 days).  So I think it may take a couple of weeks to actually determine if this new dose is going to be sufficient or not.  Your anxiety may increase for a bit at first, but hopefully, it will ease again as the valium levels slowly build up.  I agree that 7.5mg doesn't seem like enough, but those equivalency tables are just recommendations.  People react differently to the various medications.  So it's possible that 7.5 will work for you.  I'm guessing your doc knows the equivalency ratios, and is trying to cut the total amount of med that you take.  You probably won't like that in the short-term, but it may pay off in the long-term (the less of this stuff you take, the better).

 

fwiw - You might discuss with your doctor the possibility of trying 2.5 mg valium in the morning and 2 x 1 mg of Ativan later in the day (e.g. 1mg in the afternoon and 1mg at bedtime) as a first step.  Then try 2.5mg 2x (morning/evening) + 1mg Ativan at bedtime.  Then going to 2.5mg + 5.0mg valium.  I think that would be a more sensible way to transition.  Just my opinion.

Sorry, if I got something wrong and no offence meant, but Ashton says, 1 mg of Ativan is equivalent to 10 mgs of Valium, not one. So your doctor should have prescribed 3 time 25 mgs of Valium, and this might be sufficient or not.

 

But in my opinion you are extremely underdosed.

 

I made the switch from Ativan (Lorazepam) to Valium myself recently, so I know the equivalency table.

 

Hope that helps

Allt he best

Hasi

Your doc instructed you to "see how you feel" on that dose.  Well, I guess it's time to tell him how you feel and make necessary adjustments.  No need to wait.  If you can't handle it, tell him now.  (He works for you.)  My guess is that you should have maintained 1/2 of your Ativan consumption at the beginning of the switch, then gradually reduced Ativan while bringing up the levels of Valium to comfortably complete the switch.  (Basically Ashton)

Sorry, if I got something wrong and no offence meant, but Ashton says, 1 mg of Ativan is equivalent to 10 mgs of Valium, not one. So your doctor should have prescribed 3 time 25 mgs of Valium, and this might be sufficient or not.

 

But in my opinion you are extremely underdosed.

 

I made the switch from Ativan (Lorazepam) to Valium myself recently, so I know the equivalency table.

 

Hope that helps

Allt he best

Hasi

I spoke to him about equivalence and said 0.5-1mg Ativan is equal to 5mg Valium.

I've looked up the equivalent tables and most of Australian articles says the same thing 

There's even an anaesthesiologist article/table that says 2.5mg Ativan = 10 mg Valium

In fact most tables inc international I've seen say 1:5, apart from Ashton which is the only one so far I've seen that says 1:10

 

So I'm kind of stuck. Hard to argue the point with the doctor when literally everything says otherwise to equivalencies. 

 

He has bumped me to 5mg morn 2.5 day 5mg night, but I'm still having issues.

How do I go about saying it's not enough without coming across as some kind of drug seeker (which I guess I am now, thanks doc, lol, inappropriate)

 

http://www.sahealth.sa.gov.au/wps/wcm/connect/83838b80407711959274ba222b2948cf/Benzodiazepine+equivalents-DASSA-August2014.pdf?MOD=AJPERES&CACHEID=83838b80407711959274ba222b2948cf

 

 

Again - it will take several days for this new, bumped-up dose to fully take effect.  Hopefully, you'll feel a little more therapeutic effect soon.  I still get the idea that your doc is deliberately trying to reduce your dose.