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My Ambiem withdrawal


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Hello all,

 

I’m seeing a pdoc currently and yes he is placing me on the ambien doses 5 times a day precisely because of the short half life of the drug.

 

My current schedule is:

 

8am - 60mg ambien

12pm - 40mg ambien

3pm - 40mg ambien and 1mg lorazepam

7pm - 120mg ambien, 50mg Valdoxan, 150mg diphenhydramine

1am (or anytime I wake up throughout the night) - 80mg ambien, 1mg lorazepam

 

We have tried converting the 40mg doses to Valium but somehow my body takes it really rough. I still get very anxious, jittery and breathless. I know the reasoning behind the cross taper to Valium but I am wondering if a direct taper off ambien can be done somehow.

 

Sleep wise with all the meds at 7pm, it knocks me out at about 10pm till I wake up at about 3.30am for my middle of the night dose.

 

I constantly feel depressed and anxious at the same time throughout this exercise and would anyone else have any wise words of advice? It would be much appreciated.

 

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Hi pamster, sorry if I don’t really understand the timeline involved.

 

The Valium crossover I attempted was to convert the two afternoon ambien doses (40mg each) to the Valium equivalent, which as I understand to be 20mg. The doc even went as high as 50mg for one dose.

 

This was done for a period of about one and a half weeks with disastrous results. I was wrecked with anxiety, suicidal thoughts, panic attacks all the while hanging in there till my 7pm heavy dose of ambien.

 

Should I have allowed time for the Valium to build up in my body?

 

Once again, sorry I’m not really understanding the chart.

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That sounds awful, I don't blame you for wanting to avoid doing that again.  Yes, Valium takes awhile to build up in the body, did you allow for that or just withdraw the two 40 mg doses immediately exchanging them for the Valium?  Also, did you still take the Lorazepam at 3:00 pm?

 

I just want to make sure you've exhausted all of your options with the Valium crossover, I'm not trying to push you in that direction, I can understand if you're gun shy about it now.

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I just withdrew the two 40mg ambien doses and immediately exchanged them for Valium.

 

At the time it was a direct exchange, there was no added lorazepam at 3.00pm.

 

If I attempt the crossover to Valium once again, how should it be done? I’m not sure how to allow my body to let the Valium build up.

 

Many thanks Pamster.

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Holy cow, so you didn't even take the Lorazepam, my goodness, no wonder you felt terrible!  Without the Lorazepam, you didn't have the benefit of a fast acting benzo and the Valium didn't have time to build up. 

 

The table I showed you earlier illustrates the process of slowly introducing the Valium.  In week 1, 1 mg of Lorazepam is replaced by 10 mgs of Valium for the evening dose, in week 2, .5 mgs of Lorazepam is replaced by 5 mgs Valium in the morning dose.  It isn't until week 12 that all of the Lorazepam has been converted to Valium. 

 

This is the kind of taper you'd be looking at, taking away your Ambien and Lorazepam slowly while introducing the Valium.  It's not a pleasant process, Valium has some side effects which can be unpleasant, but so do they all.

 

We can help you figure this out if you have a supportive MD, or you can taper the Ambien and Lorazepam directly, it's up to you.

 

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Hi Pamster, I would be really really glad if you could, in my case, show me exactly what the correct way to do the crossover taper to Valium is.

 

My pdoc is very supportive and I’m sure he will be open to suggestions.

 

Thank you so much in advance for your always insightful advice.

 

Is it possible to advise me on the crossover with regards to my latest schedule as posted below?

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My updated schedule:

 

8am - 50mg ambien

12pm - 40mg ambien

3pm - 40mg ambien and 1mg lorazepam

7pm - 110mg ambien, 50mg Valdoxan, 150mg diphenhydramine

1am (or anytime I wake up throughout the night) - 80mg ambien, 1mg lorazepam, 150mg diphenhydramine

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According to my calculations of which there could be numerous errors, so hopefully other members will correct me if I'm mistaken, this is what I see in the way of equivalent Ambien and Lorazepam doses.

 

8:00 am -    50 mg Ambien = 25 mg Valium

12:00 pm -  40 mg Ambien = 20 mg Valium

3:00 pm -    40 mg Ambien/1 mg Lorazepam = 30 mg Valium

7:00 pm -    110 mg Ambien = 55 mg Valium

1:00 am -    80 mgs Ambien/1 mg Lorazepam - 50 mgs Valium

 

Total of 180 mgs of Valium

 

Professor Ashton has a table for substituting Valium for a z drug but it's not much help in your situation, I've never seen anyone on a high dose as yours.  I'm hoping others will stop to help guide you.  https://www.benzo.org.uk/manual/bzsched.htm#s12

 

For now, though, you might want to think about adding the Valium in place of one of the doses you can afford to feel unpleasant, which dose would that be?  I'd suggest your noon dose and hold that pattern for a few days.

 

Something you need to understand, this will not be pleasant, crossing to Valium comes with it's own set of side effects until your body becomes used to it, such as sedation and depression.  And once you cross over, you will need to do this very slowly so you can remain functional.  I don't know how you're functioning now to tell you the truth.

 

Ambien is a hypnotic, you must be sleepwalking through your days, have you had memory issues, there have got to be huge chunks missing.  I know the horrible depression and dark thoughts you may be dealing with, my own experience with Ambien an attest to this.

 

Lets keep talking so we can get this worked out.

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Headspace, You have been given good advice by Pamster  :). I am sorry, but I know so little about Ambien, I would be afraid to suggest anything here.  However, there is a Z med Support Group, just scroll down the Homepage until you see it, click there.  People on that thread will have much better experience with what you need.  Hold on, we will find the right people to help you through this.

Good luck!  Mary  :)

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Headspace, You have been given good advice by Pamster  :). I am sorry, but I know so little about Ambien, I would be afraid to suggest anything here.  However, there is a Z med Support Group, just scroll down the Homepage until you see it, click there.  People on that thread will have much better experience with what you need.  Hold on, we will find the right people to help you through this.

Good luck!  Mary  :)

 

Thanks Mary, could you let Headspace know a little about how it feels to crossover to Valium, what side effects might be expected and perhaps how long it takes from them to settle down once fully on the Valium?

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Wow---

 

I don't understand ! 2.5mg of Ambien one at night knocks me out !

 

Hi Never take a Benzo,

 

Tolerance, that's what it's all about and tolerance to z drugs can happen fast, just like with benzo's.  But I agree, this is a dangerous dose to be on.

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Headspace, I crossed to Diazapam from Xanax.  Diazapam was an extremely sedating drug for me.  I could hardly hold my head up at 20 mgs.  I had to add back .25 xanax and lower the Diazapam just to survive.  I was down to 10 mgs of Diazapam before it quit making me so sedated.  I have had a rough taper.  Now, you need to understand, everyone doesn't have as much trouble as I did.  I am concerned about the Ambien and Diazapam for you. It is such a high dose.  I hope you have asked the question on Z drug Support and get more people on the z drug thread that can give you more information.  Wishing you lots of luck.  Mary  :)
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Thanks Mary, well as you can see Headspace, there is no easy way to do this and Mary is right, everyone will have a different experience.  If you'd like to jump into the Z-drug support group thread, here is the link:  http://www.benzobuddies.org/forum/index.php?topic=97331.0

 

You just pop in with your post, letting them know pretty much what you've said here and someone will usually respond.

 

If you'd like to consider a direct taper from the Ambien, we can work something out, let us know your thoughts.

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Per this chart https://physicians.utah.edu/echo/pdfs/sedative-hypnotic-equivalency-chart.pdf the equivalents are 2:1 (Ambien: diazepam).this chart also illustrates the half-lives (Ambien 2.5 to diazepam 20-100).  Keeping in mind these are rough equivalents.

 

Frankly, I don’t see any easy way to taper directly from Ambien with such a short half-life. Even taking it 5 times a day must be causing some inter-dose issues. I’m not usually in favor of crossing to a long-acting benzodiazepine unless the current benzodiazepine taper is failing, but I just don’t see dosing every 2 1/2 hours.

 

So let’s move this thread to Substitution and see if we get some more replies.  You’ve gotten some great input from Pamster and Mary but the more heads the better.

 

:)

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Thank you all Pamster, Mary and Challis.

 

Pamster, with my current schedule I’m functioning with barely controllable anxiety, panic attacks and unabating nausea during the day. Having to keep dark suicidal thoughts at bay are frustrating.

 

My experience with Valium is that it’s never done anything to me, knocked me out or in anyway kept me sedated.

 

It’s just that when substituted in my schedule in place of the equivalent ambien dose, as I’ve tried with both my afternoon doses, my body did not tolerate this well and anxiety levels and dark thoughts shot sky high. After which my pdoc put me back on the ambien to hopefully cut down from there.

 

I hope I don’t sound like I’m flip flopping but would you guys reccomend a direct taper then?

 

Also, I know this is a very high dose and I’m extremely scared and wish someone could help.

 

Lastly, where I live, there’s no such thing as a detox center or anything similar thus it’s just me, my pdoc and all the knowledgeable members on this forum.

 

 

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We’re here to help you and though understandably frightening, this is doable.  We just want to help you explore options and find out what you’ve tried and what works and doesn’t work for you.  A cross to Valium must be gradual so if your first attempt to cross was abrupt it explains why it was so difficult.

 

Have you considered splitting the Ambien doses into a 2.5 hour dosing schedule to see if that helps with the anxiety/panic symptoms?

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Hi Headspace,

 

You're not flip flopping, it's important to talk it through because this is a very serious situation, one that will affect your life for some time to come and what we do here, what we decide here will have a big impact on your life.

 

I know the thoughts being forced on you by the Ambien, but you must tell yourself that these are simply a bi-product of the drug, they are not you, they are not your life and when you get off of this drug, don't give them any power.

 

We can work out a direct taper, your total dose of Ambien is 320 mgs, you could 10% off of your total dose and hold that for a week or so, choosing which doses you can afford to muscle through the symptoms. 

 

A direct taper might look like this:

 

8:00 am  30 mg

12:00 pm 40 mg

3:00 pm  25 mg  1 mg Lorazepam

7:00 pm  110 mg

1:00 am  80 mg  1 mg Lorazepam

 

 

I'm just thinking out loud here, I wonder if crossing over to Clonazepam would work, it's longer acting than both Lorazepam and Ambien? 

 

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Dear Challis, the dosage intervals are what my pdoc worked out in favor of minimizing the interdosing withdrawal symptoms of the ambien. But I will have a talk with him to see what he thinks of a 2.5hr dosing schedule.

 

Pamster I see what you mean about a direct taper, no more than 10% per week. Is anything greater than that harmful to the recovery process?

 

Also I’m not sure about clonazepam versus lorazepam so once again I’ll have to see what my doctor says about that in a few days.

 

As always thanks for the help and encouragement guys, if anyone else would care to chime in with any advise, it would be a big big help as well.

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Dear Challis, the dosage intervals are what my pdoc worked out in favor of minimizing the interdosing withdrawal symptoms of the ambien. But I will have a talk with him to see what he thinks of a 2.5hr dosing schedule.

 

Pamster I see what you mean about a direct taper, no more than 10% per week. Is anything greater than that harmful to the recovery process?

 

Also I’m not sure about clonazepam versus lorazepam so once again I’ll have to see what my doctor says about that in a few days.

 

As always thanks for the help and encouragement guys, if anyone else would care to chime in with any advise, it would be a big big help as well.

 

Good! It wouldn’t be any higher in terms of daily dosing, just spreading it out to attempt to alleviate symptoms.  :thumbsup:

Then if you decide to direct taper from Ambien you have lots of doses to work with.

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Pamster I see what you mean about a direct taper, no more than 10% per week. Is anything greater than that harmful to the recovery process?

 

 

I have been on both Klonopin and Ambien and quit both cold turkey.  The Klonopin withdrawal symptoms were horrific and lasted for about 14 months, but I've completely recovered from that.  Quitting the Ambien for me was relatively easy, I couldn't sleep for awhile and when I did, I had horrible slasher type dreams.  But the awful and dark thoughts, the extreme anxiety and nausea were gone in less than two days once the Ambien left my body.  From what I've seen on the forum, this isn't the case for everyone, just as not everyone will suffer withdrawal symptoms from discontinuing benzo's, some not all are able to quit z drugs with ease.

 

I'm not recommending a cold turkey for you, but my point is I feel you will recover, no matter what route your take to rid yourself of this drug.  I've seen people taper and I've seen them quit cold turkey and I've seen them recover, so I can see this for you too.

 

Your attitude while doing this will play a large part in your recovery, your brain will be healing no matter what, but how you choose to live through it is important.  I hope that soon, after working with us and your Dr, you can embark on this journey with your end goal in sight.  The freedom you're going to feel is worth the pain in getting there, I promise.

 

 

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I'm so sorry for what you are enduring but it does sound like you have a doctor who is willing to learn and really wants to help so that's a huge plus. 

 

There are a handful that are on this board that are using Librium in place of Valium (for varying reasons) - many dry cut/microtaper (opening capsules and taking small amounts and weigh) but one gal has hers compounded with a suspending vehicle.  I had some nasty start up side effects of Valium that did go away for me (burning muscle pain, itching) and then I got severe head pressure as the Klonopin was leaving my system.  I got some relief from Valium right away from some of the severe symptoms I was having on Klonopin; however, I was in acute when I crossed and was suffering tremendously.  I almost did not cross over, though, because of these side effects and withdrawal symptoms (from K) but a buddy here told me she had all that I experienced and it went away and she was right, it did for me too.  I did my cross over 5 weeks.  I considered Librium as an alternative as I was desperate but my doctor said we were giving Valium more time and really, I'm glad that I did (at least at this point).  But some have adverse reactions to Valium, unfortunately and I've seen it with another buddy and it's really rough.  So if you are not getting any relief, can you consider Librium or (and I even hesitate to suggest it but for some, it works), Klonopin.....and then have the Klonopin compounded into a suspending vehicle or capsules for tapering. 

 

One thing that I know others have done when crossing is to "front load" the longer acting benzo (Valium/Librium) for a few days before dropping the equiv dose of their short acting benzo.  It takes quite a while for the long acting benzo to build up but the short acting benzo is leaving quickly so this helps to mitigate some of the more severe withdrawals.  I didn't front load and I really think it took like 4-5 weeks for the Valium to fully build up for me. 

 

I hope you find something that works for you - I understand the feeling of desperation that you are in and it's so hard. 

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Dear Pamster and Momo, thank you both for the kind advice.

 

Pamster your encouragement will take me through my darkest times and I’m strongly encourage by the fact that you say I will recover.

 

Momo, I’ll talk to my pdoc about Librium but I know whatever crossover I attempt will be hard. That’s why mainly considering a direct taper now.

 

Lastly Keagan, where I’m at, we do not have such things as detox facilities.

 

Also, I keep reading through the “front load” portion but I still don’t understand it, my apologies.

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