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Liquid Diazepam


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You and your wife have a good plan in place, Helping Husband. Now, as you have noted, you just need to get through each day the best you can.  Distraction is a powerful coping strategy.  Does your wife have activities she enjoys to help take her mind off her current situation?

 

Per your request, here are resources on diaphragmatic breathing and progressive muscle relaxation:

 

Part 1: Intro to Diaphragmatic Breathing

 

Part 2: Diaphragmatic Breathing While Lying Down

http://youtu.be/BckGYBfN5e0​

 

Part 3: Diaphragmatic Breathing While Seated

http://youtu.be/1vXlTkrNxyw​

 

Progressive Muscle Relaxation Training

 

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Libertas,

Sorry I messed up your name.  Remember, I'm old!

Today was constant waves all day with no relief, but they were not unbearable either.

When she feels up to it, we will try some of your suggestions,

Thank you for the links.

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  • 2 weeks later...

So it has been 4 weeks since her last taper (to 1.9 mg Valium).  It was pretty rough time as she perhaps made too many adjustments (trying liquid, splitting the dose, etc.) She has had 3 consecutive days of just some mild waves.  If this continues, she plans on dropping down 5% in a couple of days, still just using tablets.  She wants to introduce liquid slowly (like 1/4 of her daily dose) but not yet.  She is afraid to change too many things in a short time.

We will see what the next few weeks bring.

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Hi - I have been following.  I am glad she is feeling better.  Myself I am on a day 28th of a hold.  I hit a wall, and was just in benzo flu and all waves.  Just in the past 4 days or so has the widow opened.  Five days ago I C/O to liquid V that I had compounded at a local compound pharmacy.  After researching (pills included, and my own experiences) I didn’t want to go with the “liquid brand” offered at my big brand pharmacy.  My C/O went well and I trust the solution they are using.

 

Maybe she should hold a couple more days, just a thought.  Taking the C/O slow sounds like a good plan, and also check what brands you are getting.  I really think this plays a huge role.  I believe some of my 2mg generic tablets were useless.....and when I did some research it was confirmed, by other peoples experience with the same brand.  When talking with my Psychiatrist he also isn’t surprised because of the way the so called, “compliance” testing is done.  I’m not trying to scare you, but just trying to say there could be other factors too.  I do believe some of my issues were do to the bad generic brand I was on.

 

Hope things improve..... :thumbsup:

 

Marie

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Thank you for sharing your good news update with us, Helping Husband.  It sounds like your wife’s withdrawal symptoms are stabilizing.  It also sounds like you and your wife have mastered two of the most important principles of successful tapering.  First, “Make only one change at a time.”  Second, “After you make a change, wait a sufficient amount of time to fully evaluate the impact of the change made.” (In the case of diazepam/Valium, this can be a while because of the drug’s long half-life.) Congratulations and well done!

 

PS: Has your wife tried diaphragmatic breathing and/or progressive muscle relaxation yet? If so, please let us know if one or both techniques helped the next time you check in.

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  • 3 weeks later...

Update:  My wife has been doing "okay" over the last couple of weeks.  Her waves have been tolerable until yesterday.  She tapered from 1.9 mg to 1,8 mg on March 17th.  We are still filing down tablets because she is afraid to c/o to liquid, even slowly right now.  So she is still nervous about the accuracy of her doses.  She is taking 0.9 mg in the morning and 0.9 mg in the evening.

However, on March 24th, she somehow missed her morning dose and didn't realize it until that evening when she went to take her evening dose.  Not being sure what to do, she took both doses together that night.  Things went OK until yesterday (04/01) when she had terrible, constant waves that began at night and lasted all day long.  It was pretty bad.  Things were calmer today.  We are not sure if it was because of the missed dose or not.

She has been using the breathing and relaxing exercises and they help somewhat.  The problem is that she does them at night and that is when she gets intestinal cramps, bloating, and gas.  Therefore, she cannot relax.

That's about it for now.  Thank you your continued support.

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Ur doing a great job helping her x she’s lucky to have u x snd please tell ur wife she’s amazing and keep going girl! Not long now x
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Thank you for the update, Helping Husband.  That’s terrific news your wife has been doing “okay” after her latest reduction in dose.  She is nearing the finish line at 1.8mg of diazepam!

 

I’m glad the breathing and muscle relaxation exercises have helped, but sorry to learn about the gastrointestinal (GI) issues. Unfortunately, GI symptoms are common during withdrawal. If you have not already done so, you might want to investigate possible adjustments in diet and nutrition. To learn more:

 

The Role of Nutrition in Optimizing Healing During Psychiatric Drug Withdrawal

https://withdrawal.theinnercompass.org/page/role-nutrition-optimizing-healing-during-psychiatric-drug-withdrawal-0

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  • 2 weeks later...

Update from Helping Husband.

She stepped down from 1.8 mg diazepam (Tablets) to 1.7 mg on Sunday, 4/11.

Today was the first day of a significant will very fatigued.  Sleeping slightly better at night, but still not enough.

Thank you for your interest.

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Update:

After stepping down to 1.7 mg Diazepam on 4/11, bad wave on 4/18.  Not so bad thereafter.  Thinking of stepping down to 1.6 mg next and then slowly switching to Liquid Diazepam.  Currently taking half of the daily dose in the AM and half in the PM in tablet form.

Are there any suggestions as to how to transition to the liquid dose?  We don't want to do it all at once, but cutting and measuring the tablets is difficult and inaccurate at these lower doses.

Any suggestions would be appreciated.

Thank you.

 

 

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Hello, Helping Husband.  Thank you for the update.  It sounds like your wife tolerated the most recent reduction in dose and is stabilizing. Well done!

 

Re: your question about transitioning to the prescription diazepam oral solution ...

 

Given that your wife used a combination of regular tablets and liquid successfully before, one approach to consider would be to split the 2mg tablets into 4 quarters of 0.5mg each. Assuming a total daily dose of 1.6mg, she would take one of the quarters (0.5mg) plus 0.3mg in liquid in the morning followed by a second quarter and 0.3mg liquid in the evening.  The next day, she would take the remaining two quarters of the tablet plus the liquid. She would continue this dosing scheme for as many days as needed for her to feel stable on the liquid/tablet combination. Then she could begin reducing her dose by reducing the liquid portion(s). 

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Further updam is te:

Since stepping down to 1.7 mg valium tablets on 4/18/21, she had a few bad wave days, but got thru them. Now the problem is sleep.  She has gotten scant, if any sleep for the last 4 nights.  Cannot sleep in the daytime.  Is doing the breathing and relaxing exercises, but they are not helping.  Any suggestions? 

She had been getting 3 to 4 hours of sleep before this, but now she can't even get that.

Thank you.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Regrettably, insomnia/sleep disturbances are common in withdrawal.

 

One of our members put together a list of what worked/what didn’t work for him at:

http://www.benzobuddies.org/forum/index.php?topic=235100.0

 

In addition to diaphragmatic breathing and progressive muscle relaxation, other “helpers” I’ve read about here on the forum include:

 

Sleep hygiene

Sound machine

Lavendar oil

Epsom salt bath

Weighted blanket

Melatonin (lowest effective dose, starting at 0.25mg - 0.5mg)

Camomile tea

Unisom (1/2 of a 25mg tablet)

Benadryl

 

For additional information and coping techniques:

 

Insomnia/Sleep disturbances | The Withdrawal Project

https://withdrawal.theinnercompass.org/symptom/insomniasleep-disturbances

 

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Thank you very much.  We will see if anything works.  She has already done some of them.  Last night was pretty good - 6 hrs.  Night before was horrible.  There seems to be no rhyme or reason to it.  Every day/night is a new adventure.  She is often losing patience, which is understandable.

Thanks again.

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you could try a liquid taper by dropping the pill in the water.  You can make smaller more precise cuts.  There are videos online of how to do this.  The more water...the longer the taper.  100 ml  versus 200 ml.  pulling 1 ml per day 
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Thank you very much.  We will see if anything works.  She has already done some of them.  Last night was pretty good - 6 hrs.  Night before was horrible.  There seems to be no rhyme or reason to it.  Every day/night is a new adventure.  She is often losing patience, which is understandable.

Thanks again.

 

I’m in the same boat as ur wife x it’s very difficult sleeping so little x if she ever needs someone to talk to I’m here for her, u both actually. I got 5-6 yesterday, last night nothing. Very upsetting x

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Update:  Sorry for the on going saga.  On 4/26, while still at 1.7 mg Diazepam, she began taking her morning dose with half tablet and half liquid.  She had some good days and some bad days.  On 5/3 she added 1/2 liquid to her evening dose.  Last night (8 days from the last change on 4/26) she didn't sleep at all  and now she is afraid that she changed her evening dose too soon.  She usually gets her worst waves about 8 to 10 days after making a change.  She wants to go back to all tablet for the evening dose and keep her morning dose at half and half.  She is afraid things will get really bad around 5/13.

She would like to know what you think.

Thank you for your thoughts.

 

 

 

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I'm celebrating the progress both you and your wife have made Helping Husband! I wanted to chime in here, but I haven't been following closely, so I apologize if it's not helpful.

 

It is possible to taper with a combination of tablets and liquid. I personally prefer this approach because I find tablets to be the most tolerable/portable/cheap and liquid to be the most risky/difficult/expensive. I currently take 92% of my daily doses in tablet form, and the remaining 8% in a liquid form that I'm daily reducing (daily micro taper).

 

If switching entirely to liquid isn't going well, I suggest considering a liquid/tablet hybrid approach in some form. That might mean just leaving the evening dose as tablets, keeping the morning dose half-and-half and when she's feeling stable, carefully titrating the morning dose liquid until it's gone. You could then try substituting the remaining morning dose with liquid and titrating that until the entire morning dose is gone. Valium has such a long half life that I think your wife might be comfortable without a morning dose, if you get there slow enough.

 

Just thoughts!

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Hello, Helping Husband.  Please do not apologize for posting. The reason this community exists is to provide support for individuals such as yourself and your wife. We are happy to help.

 

First and foremost, give your wife a pat on the back for giving liquid another try.  That took real courage on her part. 

 

It sounds to me like she may have needed more time to adjust to the first tablet-to-liquid change.  Her plan is a good one — go back to all tablet for evening and keep her morning dose at half and half for a longer period.  You have indicated her withdrawal symptoms typically peak at 8-10 days —  after this occurs about how many days does it take for her to feel ready to make another reduction?  That will give you an idea of how long she should maintain this dosing pattern.  Perhaps 14 days?

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Thank you for all your help.  When she doesn't get any sleep and then bad waves the next day, she gets very anxious about what caused it.  Your suggestions are ones we discussed, but she needs validation from you.  She wants very badly to get off the Diazepam completely, but is also concerned about the accuracy of the dosage.  That's why she wants to get onto all liquid asap.  We realize that only one change should be made at a time.  Thus everything continues to drag out.

When she began tapering over a year ago from 7.5 mg, she used a combination of tablets and liquid and seemed to tolerate it very well.  But maybe not because she had many bad waves.  We just assumed that it was part of the withdrawal process.  We hadn't discovered BB at that time.

Any way, she is going back to tablet/liquid combo in the morning and all tablet at night for a while.  We will see how that works for a while.

Also, regarding accuracy, at 1.7 mg, how much difference do a couple of  thousandths (0.001 or 0.002) of a mg actually make?

Thank you.

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You are most welcome, Helping Husband.

 

badsocref, one of our senior moderators, just answered your question about tiny fluctuations in dose better than I can. He was responding to another member with the same concern who is dry tapering using a different benzodiazepine (and hence different amounts/weights) than your wife, but you’ll get the point:

 

“Just know that it's fine for your dose to weigh out at 0.121 grams when you're trying for 0.122 or 0.120 grams.  It's fine for the weight to be off by a couple of milligrams.  That really bothers some people, but it shouldn't.  One dose you'll be up 0.001 g.  The next dose you may be down 0.002 g.  It all kind of averages out.”

 

My understanding is that badsocref’s “it all averages out” observation is particularly true when applied to diazepam due to its low potency and long half-life. 

 

I hope this will reassure you and your wife.  I also hope it will reassure you to know we have many members who have successfully discontinued their benzodiazepine using dry tapering methods.  So even if the switch to back to liquid doesn’t work out, she can still be successful in her quest to discontinue.

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Thank you.  All your comments are comforting and reassuring.  They reaffirm what we already figured, but it is good to hear it from others.  She gets more unsure about things where she doesn't get enough sleep.  That's when she gets anxious over small details.  It's understandable when you've had no sleep and experiencing long, difficult waves.  I need to have more patience.
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I”m glad the comments helped, Helping Husband.  I respectfully disagree that you need to have more patience.  You have demonstrated time and again that you are a remarkably patient and supportive spouse.
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So now she has been on 1.7 mg valium (1/2 liquid & tablet in the morning and all tablets at night).  As you know, we are trying to gradually get on all liquid for accuracy purposes.  She is experiencing upper body burning sensation, which she had when she first began her taper.  She was taking part liquid at that time as well, but we assumed it was part of the withdrawal syndrome at that time.  It went away when she began taking all tablets.  Now we are wondering if it has something to do with the liquid diazepine.  Dissolving the tablets seems very wasteful and tedious.

Not sure where to go from here.

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Hello, Helping Husband.  I was hoping other members would share their thoughts, but since they haven’t I’ll share mine.  Although most of the members I’ve read about who use the commercially manufactured oral solution of diazepam have been ok with it (other than disliking the taste), I do recall reading about one member who could not tolerate it so it’s possible your wife falls into that camp.  I wonder if diluting the liquid with distilled water would make a difference?  Perhaps from 1mg/mL to 0.1mg/mL?  Members do this so they can make smaller reductions in dose, but I wonder if it might also lessen the reaction your wife is having?
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