Which should I taper first using the Ashton manual?

Hi everyone. I'm beginning the crossover from 3 x 1mg daily of lorazepam and 7.5mg nightly of imovane onto diazepam.

I'm hoping someone can offer experience or guidance as to which one I should begin tapering first, once I made the crossover.

Would it be an easier taper if I keep the nightly dose of diazepam while tapering the daily dose, or visa versa?

 

Are you going to use schedule #8 to cross to Diazepam? https://www.benzo.org.uk/manual/bzsched.htm#s8

 

What did your Dr prescribe for your crossover, was it 35 mgs Diazepam per day?

 

I'd start out crossing over just the Ativan, you may find out with the sedating effects that you'll need less of the Imovane which means you may not have to add that last 5 mg equivalent dose of Diazepam.

 

As far as tapering, as long as you take the required amount in a day you can choose which doses to taper according to your needs.  If sleep is an issue you can leave your nighttime dose heavy, if mornings are a nightmare of anxiety, you can make that one larger.  We have very little control in this process but this is one part we do. 

 

One warning, many find reducing 2 mgs according to Ashton's schedule to be too much, you might want to start out with a 1 mg reduction to see how you do.

If you look at the example charts in Ashton's manual, you'll note that the midday dose is the one you would start with. You would eventually taper completely off the midday dose, and start tapering the morning. The last you taper is the nightime dose, the reaason for this is Valium helps with sleep. The charts are guides, some people find they still need the daytime dose, and keep a small dose for the morning, while tapering over the larger nightime dose. Ashton mentions that the tapering process is patient-controlled. The example charts are successful tapers taken by real patients. But they are flexible and you need to individually adapt them to your situation and how you are feeling symptom-wise.

 

When I crossed over from Klonopin 2 x's a day plus Ambien at night. I cut out the midday dose from the get go. I just went with a small morning dose of Valium and a large nightime dose. This worked very well for me, because I shifted my middday dose to nightime, and added it to the existing nightime dose, thereby making my elimination of Ambien easy and painless. I preferred the twice a day dosing, and it was working well for me. 10 mgs at bedtime, 2 mg in the morning. But this may not work for somebody else, our bodies are different and we all respond differently to these meds.

 

Simply put, there isn't one answer, but srarting the taper with the midday dose is the the typical initial approach.

Hi Pam. Thank you for your recommendations - much appreciated.

Yes, I'm using schedule 8 for lorazepam and schedule 12 for imovane.

My doctor and I worked it for 35 mgs diazepam.

I've already started the replacement for imovane - 3.75mg imovane and 2.5 mg diazepam nightly.

Hmmm...

BenzoLottie. Thank you so much for sharing your experience and insights.

I'll see what works best for me as I go along. I've only just begun the crossover, so fingers crossed.

Keep us posted on your progress, it helps me learn so I can help the next person.  I look forward to hearing how it's going. 

 

I'm glad you got the right equivalent from your Dr, some don't get it right but yours has. 

Hi Pam. I actually figured it out for him - he had never heard of the Ashton manual. He did thank me for educating him though! He is very interested to learn.

I will post my progress when I crossover and start the taper off of diazepam.

Hi Pam. I actually figured it out for him - he had never heard of the Ashton manual. He did thank me for educating him though! He is very interested to learn.

I will post my progress when I crossover and start the taper off of diazepam.

 

You've found a gem Soulandara, we encounter many doctors who aren't savvy about benzo's but if they're open and willing to learn we celebrate!

I'm happy that he's listening now. I also opened my appontment with him by giving him a letter I wrote for him - it detailed my history with the medical community (including him) from 2003 - 2020. It was affective in getting his attention!