Alprazolam to Valium taper does not appear right to me

I just received a crossover taper email from my NP. Beginning today, I am to take 10mg of Diazepam in the morning. If needed I may take 0.25mg alpralolam 1-2 hours after for any “uncomfortable” symptoms. Repeat the process in the afternoon, as well as at bedtime. I am also to take clonidine 0.1mg up to 3 times a day, as needed, for anxiety and/or sleep. Presently I take 0.5mg alprazolam am and 8pm, with 0.25mg midday to barely get through the day. I have been experiencing daily tolerance withdrawal symptoms since going CT last month. The NP says that I should keep an open mind in trying her plan, but it seems to me to not be a taper at all.

Sounds more like a crossover than a taper for now, assuming that 1mg Alprazolam is roughly = 10mg diazepam. I'm guessing the plan is for you to stabilize on 10mg diazepam first before starting the actual taper. I'm a little surprised she's making you switch all at once since it takes time for diazepam to build up in your system. Also, taking 10mg at once made me very sleepy when I first started so maybe it would be better to take it at night instead of in the morning. The drowsiness really hit me hard.

The first 2-3 weeks on diazepam makes many people very fatigued, but then the body adjusts.

Strangest part of this crossover is that week 2 has me decrease the diazepam to bid, and by week 3, I will have tapered to 8.75mg of diazepam bid. My next scheduled appointment is not until 11/28. Does this seem like a fast crossover or is it just my paranoia? I have no support network and am flying by the seat of my pants. I read the Ashton Manual for guidance, but this schedule does not make sense. Thank you for your validation and insight, Grapejuice.

Yes it all seems pretty fast.  Slowing down hasn't hurt anyone, but sometimes going too quickly can...

And many stabilize after a crossover for a few weeks before tapering..... just saying.

Listen to your body around this and ask lot of questions of your NP as to what her experience is with tapering folks.....

Just my two cents.

SS

SS,

She will certainly be answering a lot of questions when we meet next. I want to know where she is getting her empirical data from. I have had little success in finding any US studies other than one funded by Roche. This is like a dirty little secret that no one wants to talk about or deal with.

Mary

 

 

Hi Mary,

 

Is there a reason that you are crossing to V?  I decided to taper xanax all the way down and it worked out well.  I was concerned about a crossover after reading that so many developed serious depression after crossing to V.  Some have found the V very difficult to taper.  Also, my brain was used to xanax and I knew how I reacted to it.  Just something to consider.  Unless one finds a xanax taper intolerable (and I think a slow enough taper can be tolerable for just about all of us) I don't know if a cross is worth the unknowns.  I'm glad I didn't.  I'd almost have to believe that withdrawing one benzo and introducing a new one would cause some serious adjustment for our CNS - at a time when we want/need to be as stable as possible on order to start tapering.

 

It does sound like the NP is pushing for a very fast taper.  I did a "symptom-based" taper and (after some hard lessons) went at the pace that my brain could adjust to and was able to keep symptoms low.  My pdoc had the same attitude as your prescribing doctor and said that I needed to be on for life.  I just collected my refills and tapered at my own pace with some advice from the buddies here.  I never had any pressure from my pdoc.  I'd be very proactive/assertive with the NP.  Taper shouldn't be torture.

 

I do know of many successes with crossovers to V and these are just my thoughts and experience.

 

All the best.  Sorry about the misunderstanding.  I'm not on much anymore but you can always pm me.

Hi Lynn,

Since my CT experience I have been having serious interdose withdrawal symptoms. Am hoping that the Valium will stop or at least reduce them. Am on day one of her taper and have already required a .25mg Xanax between the afternoon and hs Valium doses. Hoping tomorrow is better, as she holds the golden ticket to my refills. Thanks for the advice, and offer of my being able to pm.

Mary