Unsure about my dr's Valium taper plan - advice?

Hi all!

 

I finally went to my doctor before Thanksgiving and explained I was dependent on ~2 mg Valium daily. Have been taking for the past 2 years. She pretty quickly wrote out a taper plan for 1 month to get off:

 

First 2 weeks: skip 1 day, take 3 days, skip 1 day, take 2 days (repeat)

Second 2 weeks: skip 2 days, take 1, skip 3 days, take 1 day (repeat)

 

I've been trying to follow it but am hitting some rough days now. My confusion is she has me skipping days instead of decreasing dosage. So now when I'm experiencing these symptoms I'm not sure where I'm at even or how to adjust. I'm around day 21. Sat & Sun were zero. Monday was 2mg. So I should be taking nothing for the next couple days. But dang are these symptoms suddenly strong. Anyone have any suggestions on where to go from here?

 

The ‘skipping days’ method doesn’t really make any sense and hasn’t worked for anyone I know of. 

 

Lowering the daily amount in small increments is the easiest on your central nervous system.

Whoops, rereading your post, I see you need some practical advice on how to cut the 2mg. Wish I could help but I’ve never tapered a long-acting benzo. Lots of people here will be able to offer good advice on how to reduce the 2mg, maybe either by getting it prescribed in a liquid form or dry-cutting it with scales.

 

Let me see if I can get someone more knowledgeable to help you.

Thank you so much! I don't want to undo any positive work my body has done, if in fact the past 20 days have been productive in some way. But this feels really intense and I don't know if following through with the planned "zero" day is wise.

I agree. 2mg isn’t much but your body can become dependent on a small amount as easily as a larger amount.

 

Valium has a long life, so the withdrawal symptoms are delayed, that’s why we recommend holding a cut for 10-14 days...it can take that long for withdrawal symptoms from a cut show up.

 

If it were me I’d go ahead with the 2mg daily (I’d take one today if I were in your situation, much as I don’t like usurping a doctor’s recommendation to a patient) until you can be advised on a less radical plan, which we can provide here. I just can’t really help with it myself.

 

Your doc might be open to supporting the Ashton Manual schedule instead. Here’s a link:  Ashton Manual

 

It has complete schedules she can look at, all she has to do is support you by continuing to prescribe until you’re done. But we can help with the nuts and bolts of pill-cutting or reducing with liquid.

Challis99 is right. This skipping days and then cutting never works. Your body needs a consistent dose and only a consistent taper will work, from my personal experience and from the hundreds of thousands of posts I have read here. Not to worry though doctors don’t seem to know much about this and in fact many have to learn from their patients. Since you are on what I consider a very small dose that certainly works in your favor. I was on 200 times that dose. Yes, it’s true. If you did the cut and hold method like I did when I got to your low dose it was not easy.

 

I cut by .25 mg but held for longer periods. So you would cut a 2 mg pill in half for a 1 mg pill. Then you would cut that in half and cut that tiny piece in half, you might say to yourself, how can such a tiny cut even affect me? Well it can and I don’t know why. So you cut based on symptoms. For me I set a high bar and wanted to be highly functional and work. And play. So I would wait anywhere between 10 days to two months before I cut again. I always felt my cut on day 3 and it lasted a different time each time but everyone is different. Please don’t compare yourself to others. Remember as you cut lower the percentage amount will be higher. The last cut will obviously be 100%.

 

Oh how I wish I only had 2 mg to cut. You’ll be fine though at times it might not be pleasant but that will go away.

Here is one link to a support group for those on 3 mg of Valium or less.

 

 

http://www.benzobuddies.org/forum/index.php?topic=151673.0

Thank you for all of this info! So super helpful. Do you think I should post my question on the thread you provided? Also, I guess what I'm confused about is does this mean returning to 2mg a day or after 20 days is that going backwards? No worries if you don't know. Just curious on any thoughts.

Yet another link—very long thread—Valium thread. Now all this should keep you busy but if not, just ask away.

 

 

http://www.benzobuddies.org/forum/index.php?topic=96753.0

I’m concerned that you’re hitting ‘rough days’.  If it’s just a little anxiety, no big deal. So I should ask what you’re experiencing for symptoms.

Thank you for all of this info! So super helpful. Do you think I should post my question on the thread you provided? Also, I guess what I'm confused about is does this mean returning to 2mg a day or after 20 days is that going backwards? No worries if you don't know. Just curious on any thoughts.

 

I can’t tell you what to do but if I was in your shoes, yes I’d go back to 2 mg and hold at that dose for a while until you are stable and you have the correct information. At the very least the people can point you in the right direction......

I’m concerned that you’re hitting ‘rough days’.  If it’s just a little anxiety, no big deal. So I should ask what you’re experiencing for symptoms.

 

Oh that's a good point. Heart racing (like I drank 5 cups of coffee and it all hit me at once), lightheaded, really cold/ goose bumps, ears ringing, short of breadth (sort of feels like I'm breathing through a pinhole if that makes sense). I was taking the Valium for back pain, not anxiety. So maybe this is just what anxiety feels like...?

 

I've had a couple days last week where I felt this way but it only last an hour or so, and happened 2-3 times each day. Now it's just constant.

Well, I call it ‘body anxiety’, yes.  It’s not true anxiety in the sense we usually think of it originating from emotions. Good thing to keep in mind so you don’t panic over it.

 

Are you comfortable with the idea of taking your 2mg of Valium today?

Do you live in the US? Would your doctor be willing to prescribe the prescription 1mg/1mL oral solution of diazepam?

It would be advisable to avoid caffeine and other stimulants for a little while...those will likely hit you harder right now.

 

Try not to look at this as going backwards. 2mg isn’t that much to come off of, but you want to do it in a way that is tolerable. 

Do you live in the US? Would your doctor be willing to prescribe the prescription 1mg/1mL oral solution of diazepam?

 

Thank you, Lib!

 

You’re in good hands with Libertas, Tak. 

Do you live in the US? Would your doctor be willing to prescribe the prescription 1mg/1mL oral solution of diazepam?

 

I do live in the US, California. No clue about what they might prescribe, but I after today I was able to grab a cancellation appt with the NP for tomorrow AM. My dr is out for the holidays. Would appreciate any other helpful advice you might have in advance of that appt! thank you so much

It would be advisable to avoid caffeine and other stimulants for a little while...those will likely hit you harder right now.

 

Try not to look at this as going backwards. 2mg isn’t that much to come off of, but you want to do it in a way that is tolerable. 

 

Thank you so much for all the info. I did go ahead and take the 2 mg today. I'll watch the caffeine tomorrow, as I'm sure you're right. I only drink 1 cup of green tea each morning, but I'll try for half maybe tomorrow.

Liquid Valium can be a much easier way to taper off a small dose like yours. I tried it myself and to be honest I felt pretty bad withdrawal. I’m not saying this happens to everyone but I’ve heard tell in my journey here that this us not uncommon and some think the liquid is weaker. I do...

I do live in the US, California. No clue about what they might prescribe, but I after today I was able to grab a cancellation appt with the NP for tomorrow AM. My dr is out for the holidays. Would appreciate any other helpful advice you might have in advance of that appt! thank you so much

 

Hello, Tak1984.  That’s wonderful news that you live in the US and were able to grab a cancellation appt with the NP tomorrow.  Way to go! 

 

The following is just my opinion based on my experience interacting with medical professionals and what I’ve learned about benzodiazepine withdrawal.

 

If I were you, I’d use the appointment as an opportunity to convey that you still wish to discontinue your benzodiazepine, HOWEVER, you (a) are suffering from multiple withdrawal symptoms using the taper plan your doctor gave you and (b) would like to explore other options. 

 

I would not mention BenzoBuddies (my experience is that some medical professionals do not react well to information derived from online support groups for laypeople). However, you might consider referencing the Benzodiazepine Information Coalition (BIC).  The director of BIC is a physician and BIC has multiple medical/health professionals on its advisory board.  You could say that based on what you’ve read so far, your understandings are:

 

(a) It is helpful to maintain a steady serum concentration of your benzodiazepine during withdrawal.  So you wonder if you might return to taking your dose every day at a consistent time instead of alternating days.

 

(b) BIC recommends a slow, symptom-based taper.  “Slow" means a reduction of approximately 5 to 10% of the current dose (NOT the original dose) every 2-4 weeks. Some patients need to go even slower.  “Symptom-based” means the patient monitors his/her withdrawal symptoms and makes reductions “as tolerable.”  (You might offer to keep a taper log to record the amount of your daily doses and your symptoms.)

 

© A prescription oral solution of diazepam is available in the US that would allow you to implement BIC’s recommendations. Would your NP/ doc be willing to consider writing a prescription for this so you can try it?  You want a prescription for the 5mg per 5mL oral solution NOT the concentrated, Intensol which is 25 mg per 5 mL.

 

In closing, I’ll leave you with a link to the BIC website below and my best wishes for a successful outcome to your appointment. Please let us know how it goes.  Libertas

 

Benzodiazepine Information Coalition

https://www.benzoinfo.com/

 

 

Edit: clarifications

This is so incredibly helpful Libertas - thank you! I reviewed the website and wrote up a small script I'll use in my appt this AM. I'm nervous about asking for anything, but this helps me feel a bit less anxious. Fingers crossed!

 

 

I do live in the US, California. No clue about what they might prescribe, but I after today I was able to grab a cancellation appt with the NP for tomorrow AM. My dr is out for the holidays. Would appreciate any other helpful advice you might have in advance of that appt! thank you so much

 

Hello, Tak1984.  That’s wonderful news that you live in the US and were able to grab a cancellation appt with the NP tomorrow.  Way to go! 

 

The following is just my opinion based on my experience interacting with medical professionals and what I’ve learned about benzodiazepine withdrawal.

 

If I were you, I’d use the appointment as an opportunity to convey that you still wish to discontinue your benzodiazepine, HOWEVER, you (a) are suffering from multiple withdrawal symptoms using the taper plan your doctor gave you and (b) would like to explore other options. 

 

I would not mention BenzoBuddies (my experience is that some medical professionals do not react well to information derived from online support groups for laypeople). However, you might consider referencing the Benzodiazepine Information Coalition (BIC).  The director of BIC is a physician and BIC has multiple medical/health professionals on its advisory board.  You could say that based on what you’ve read so far, your understandings are:

 

(a) It is helpful to maintain a steady serum concentration of your benzodiazepine during withdrawal.  So you wonder if you might return to taking your dose every day at a consistent time instead of alternating days.

 

(b) BIC recommends a slow, symptom-based taper.  “Slow" means a reduction of approximately 5 to 10% of the current dose (NOT the original dose) every 2-4 weeks. Some patients need to go even slower.  “Symptom-based” means the patient monitors his/her withdrawal symptoms and makes reductions “as tolerable.”  (You might offer to keep a taper log to record the amount of your daily doses and your symptoms.)

 

© A prescription oral solution of diazepam is available in the US that would allow you to implement BIC’s recommendations. Would your NP/ doc be willing to consider writing a prescription for this so you can try it?  You want a prescription for the 5mg per 5mL oral solution NOT the concentrated, Intensol which is 25 mg per 5 mL.

 

In closing, I’ll leave you with a link to the BIC website below and my best wishes for a successful outcome to your appointment. Please let us know how it goes.  Libertas

 

Benzodiazepine Information Coalition

https://www.benzoinfo.com/

 

 

Edit: clarifications

Let us know how it goes, but it all sounds very reasonable to me. 

This is so incredibly helpful Libertas - thank you! I reviewed the website and wrote up a small script I'll use in my appt this AM. I'm nervous about asking for anything, but this helps me feel a bit less anxious. Fingers crossed!

 

You are most welcome.  Great idea to write up a script to take to your appointment - I do exactly the same thing! I hereby declare my fingers are crossed.

Just got back. It was such a wonderful and supportive appt! I'm so relieved. She wrote up a detailed taper plan with liquid Valium to make it easier. The current plan is for around 6 months, and she encouraged me to stay in touch via email with issues or questions on symptoms/tapering.

 

I can't thank you guys enough for giving me the guidance to ask for what I needed. That's really hard for me to do.

Well, wonderful news! Hang on to that doctor, she’s a keeper.