Crossover Ignorance....Need Advise

Have a friend who I’m concerned about....  She is taking Klonopin and was at 1mg.  She reached tolerance (not knowing what was wrong) having severe symptoms almost CT like in nature for nearly a year, and after millions of tests she was told it was the Benzo.  She has tried tapering using dry cuts but the Klonopin is making her very sick.  Her new Pdoc wants to switch her over to Valium so that she can taper.  She would need to stabilize on the Valium first, but she is still having severe symptoms from the Klonopin.  If you are using two different Benzos that act differently in the brain how would the Valium help with the Klonopin symptoms?  Any insight would be greatly appreciated. 

 

Thank you for your time. 

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No ideas.....Really

Who do you have to know to get some help? 

Hi fighting for me

 

Awesome you are looking out for your friend, keep it up. When you joined this site I'm sure the admin sent you a link to the ashton manual, I think you'll find the answer in there if you have a read. Basically, I don't think they act differently in the brain so much and the important thing for your friend is how they come out of your system. Valium is much slower and thus the withdrawal effects should be less pronounced.

 

 

Happy to be corrected by anyone out there.

Let me try wording it this way.  If someone is in tolerance, on a short acting Benzo.  Should they cross over to a longer half life Benzo or try to taper off of what they are on even though they are highly symptomatic?

The reason Ashton advises tapering from Valium is because of the short half life of drugs like Xanax and Klonopin.  These drugs only stay in your system for a very short amount of time, which means  fast tolerance and severe interdose withdrawals.  Valium has an extremely long half life, which means it decays at a smoother rate in your blood.  My guess is that your friend has hit Klonopin tolerance and is in interdose withdrawal, meaning it's either up or out for them.  If they're not willing to updose on Klonopin (and I hope they're not), then a good move is to cross to Valium, which will eliminate the interdose issues. 

The reason Ashton advises tapering from Valium is because of the short half life of drugs like Xanax and Klonopin.  These drugs only stay in your system for a very short amount of time, which means  fast tolerance and severe interdose withdrawals.  Valium has an extremely long half life, which means it decays at a smoother rate in your blood.  My guess is that your friend has hit Klonopin tolerance and is in interdose withdrawal, meaning it's either up or out for them.  If they're not willing to updose on Klonopin (and I hope they're not), then a good move is to cross to Valium, which will eliminate the interdose issues.

 

This sounds like good advice!  I am not sure I would have crossed over but I certainly would have tapered differently.  Knowing that she is in tolerance (which I was in for a year on the same dosage); the symptoms are only going to get worse so she may as well be productive about it and start the tapering process.  I hope that this is good advice.

I think that is good advice.  The other issue with Xanax and Klonopin is that it doesn't come in the really small doses you need toward the end of your cut.  This means some sort of scale or liquid titration method, which would have been WAY too much for me to think

about in the midst of withdrawal. Valium comes in small doses, so in addition to ensuring smoother blood concentrations, it's also much easier to cut. 

She’s noticing that the V isn’t doing much to cover the K.  Like “It’s not calming her brain”.  I thought all Benzos crossed the blood brain barrier.  Maybe has to build up more?  .50 K = 5 mg V right?

No, .5mg K is equivalent to about 8mg V. 

I am new and may not understand , but it sounds like once you begin to hit tolerance and have troublesome symptoms there is no getting rid of those breakout symptoms until you complete withdrawal? It seems to make sense, at least in a single drug perspective, that if the drug is creating symptoms from tolerance that those symptoms are not likely to get better as you taper down. It sounds like what is being said that it is unlikely that drugs other than K are going to relieve the tolerance symptoms?

Matt,

 

Well, the reason they suggest crossing to valium is to avoid interdose withdrawals, which are common when you hit tolerance (your body needs more benzo, more often, to feel normal). Klonopin has a longer half life than Xanax, but it's still much shorter than Valium.  Valium decays in your blood at a smoother rate, so some find their symptoms alleviated a bit when they cross and start a slow Valium taper. 

Thanks gogoGaba That makes sense, but you can, I am not sure of the term, microdose your Xanax with really small doses throughout the day usually suspended in liquid. Is that a big hassle or expensive? Does that make things more tolerable for X or K folks?

I'm not sure if it's expensive, but I know I would never have been able to deal with liquid titration in the state I was in (I could barely get out of bed when I was on X)!  Some people do, it though--I just crossed over to Valium and dry cut.

I'm not sure if it's expensive, but I know I would never have been able to deal with liquid titration in the state I was in (I could barely get out of bed when I was on X)!  Some people do, it though--I just crossed over to Valium and dry cut.

 

How did you find to cross over to Valium?  You started a AD, according to your sig.

No.... 1 mg Klonopin = 15 mg Valium 

 

www.clincalc.com/benzodiazepine

Mary,

 

Fighting's original question was the conversion of .5mg K (which is 8mg V). 

 

Fighting,

 

I found the Valium crossover to be OK, but I first crossed from Xanax to Klonopin, and then to Valium (I was only on Klonopin for a very short time).  Valium take a bit of time to get used to, and its effects are different than Xanax.  Xanax tends to make you more

euphoric, and Valium tends to make you more sedated.  I'm not sure if that makes sense...

 

And, yes, I started 50mg Zoloft while I was tapering Valium.  Still on 50mg daily.

 

 

If you’re already in tolerance don’t you need to crossover to a dosage that eases your symptoms, regardless of the Equivalence?

Yes, Gogogaba, that’s what I’m wondering is happening to my friend.  The Valium isn’t doing anything for her K tolerance symptoms.  She does feel sedated on top of her K symptoms.  Maybe she’s been in tolerance so long it’s stuck that way.