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Switching from 0.5mg Clonazapem to 10mg Diazepam and tapering slowly - need help


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I've been on 0.5mg Clonazapem for 6 weeks. I plan to switch to Diazepam and taper. I read Diazepam is available in 2mg, 5mg and 10mg tablets. How do I construct a slow taper schedule? Does this make sense? Any issues with making the switch from Clonazapem to Diazepam?

 

switch from 0.5mg Clonazapem to 10mg Diazepam - Weeks 1 and 2

Diazapem 5mg+2mg+2mg - Weeks 3 and 4

Diazapem 5mg+2mg+(half of 2mg) - Weeks 5 and 6

Diazapem 5mg+2mg - Weeks 7 and 8

Diazapem 5mg+ (half of 2mg) - Weeks 9 and 10

Diazapem 5mg - Weeks 11 and 12

Diazapem 2mg+2mg - Weeks 13 and 14

Diazapem 2mg+(1/2 of 2mg) - Weeks 15 and 16

Diazapem 2mg - Weeks 17 and 18

Diazapem (1/2 of 2mg) - Weeks 19 and 20

Diazapem (1/4 of 2mg) - Weeks 21 and 22

Stop taking Diazapem

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Hello aidrite,

Your information about diazepam tablets matches what I think is available in the US. There can be issues switching from clonazepam to diazepam; crossovers are a bit of a gamble. Many buddies taper their original benzo, especially if it's as long-acting as clonazepam. But I agree that diazepam is much easier to taper, both with it's much longer half-life and lower potency tablets, compared to clonazepam.

 

In the Ashton Manual, Dr. Ashton typically does a 4-week step-wise crossover to diazepam from clonazepam, without any reduction in equivalency dosage during this time. Here is an example of a schedule for transitioning from 1.5mg/day clonazepam to diazepam and then tapering: https://www.benzo.org.uk/manual/bzsched.htm#s5

 

A slower crossover is generally better tolerated, in my opinion. Diazepam's primary metabolite desmethydiazepam seems to take a week or so to become significantly effective enough to warrant the equivalency that Ashton gives the diazepam dosages, especially when compared to benzos like clonazepam; as I understand it, a large part of this delay is because the half-lives of the consecutive doses need to overlap enough times. The half-life of desmethydiazepam can be as long as 200 hours, making for potentially weeks of accumulation to reach "full strength".

 

I suggest creating a step-wise 2-4 week crossover schedule first. Do you have a decent pill splitter? I like the aluminum ones, and I'm able to get perfect 1/2s and 1/4s of my clonazepam tablets. I suspect something similar can be done with diazepam tablets. So if you could get prescribed 2mg diazepam tablets, I could help you create a 4-week crossover schedule that involves doses comprised entirely of split tablets.

 

Here's an example if you have 0.5mg K tablets and 2mg V tablets:

Week 1 - 0.375mg K, 2.5mg V

Week 2 - 0.25mg K, 5mg V

Week 3 - 0.125mg K, 7.5mg V

Week 4 - 10mg V

 

In this example, I would suggest waiting a full week or two after arriving at 10mg diazepam, to make sure that you are stable and functional on the new full dose of diazepam. Some common complaints are increased sedation and increased depression; my understanding is these symptoms improve in many cases with continued use.

 

Let me know how we can help!

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Hey Aidrite,

 

I just came off of 0.5 Clonazepam 3 months ago. I used it every day for a year, and it took me 4 months total to get off. At first I wanted to cross over, as I heard nasty things about Klonopin tapers. However, I heard even more about the difficulties Clonazepam users specifically had switching over to Diazepam.

 

So in the end, I decided to do a liquid taper and come off of Clonazepam directly. It was a long road, and quite tough at times...but I'm happy I didn't cross over in the end...as I think that would've only elongated my suffering with little benefit.

 

Especially considering you've only been on Clonazepam 6 weeks, I'd suggest you do a taper directly from that....I don't think a crossover will be worth it for you based on the info you've provided. However, everyone is different!

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Got it, thanks

 

Can you share your tapering plan from 0.5mg?

 

Is it easy to find liquid clonazapem? Do I just need a script written for the liquid form? And a syringe?

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I called my local Walgreens pharmacy and they said the liquid form isn’t available. Are you outside the US? I’m in the US. They just have tablets 0.125mg, 0.25mg, 0.5mg. How do I deal with that?
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I assume you're responding to reg123, but I am also tapering clonazepam directly in the US.

 

In my opinion, direct tapering K is tricky if you're sensitive. If you're not, maybe you can do what my doctor suggested and stop in 2 weeks! I went 4x slower than instructed and tried to stop 2mg/day K in two months after only two months of use; I went insane with depression and anxiety, reinstated a week later, and went to the ER for good measure. I got a new doctor and a flexible compounding pharmacy; Massachusetts is good like that.

 

I now taper 6%/14 days, using a hybrid liquid/tablet DMT; my tapering notes are in my signature. My story is laid out in some detail in my buddy blog, also linked in my signature. Personally I find it's difficult tapering clonazepam directly, a gradual crossover to diazepam is ideal, but I'm managing.

 

Have you done a reduction of your clonazepam dose before?

Have you taken benzodiazepines before?

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Got it, thanks

 

Can you share your tapering plan from 0.5mg?

 

Is it easy to find liquid clonazapem? Do I just need a script written for the liquid form? And a syringe?

 

Hey aidrite,

 

Sorry for the late response, I didn't see the notification of your comment until today for some reason.

 

As far as how I tapered goes...I did not get prescription liquid Cpam. Instead I just made my own solution with water and alcohol and my pills.

 

First, I split up my dose to be .25mg in the morning and 0.25mg at night to hold off interdose withdrawals...this made taper much easier as my blood levels were more steady throughout the day.

 

For the taper, I would crush up my .25mg dose for that time into powder with the handle of a knife. Then I would put it in just 1 mL of Everclear alcohol and just let it sit for a few minutes.

 

From there, I would fill up a cylinder with 99mL of water, and then mix the 1 mL of Everclear with the dissolved Cpam in it (to make 100mL total solution). And I would vigorously shake it up.

 

Then, I would take out whatever percentage I needed to that day with a syringe (for 100mL, 1mL = 1%). So on the first day, I took out 1mL, 10th day I took out 10mL, 20th day I took out 20 mL, etc. And then drank the dose for that morning or night.

 

Towards the second half of my taper I needed to slow down, and only took out 1mL every 2 days instead. But the process was the exact same nonetheless.

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  • 2 weeks later...
@slownsteady - sorry to bud in, but can you tell me more about why you think tapering K directly is hard if you're sensitive? Thank you!!!
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@slownsteady - sorry to bud in, but can you tell me more about why you think tapering K directly is hard if you're sensitive? Thank you!!!

 

I mention it's difficult because of the insurance-covered pharmaceutical options being so limited. Regular tablets go down to 0.5mg, and there are orally dissolving tablets in the US that go down to 0.125mg. A suggested jumping dose is 0.025mg, and some people need to go lower. No manufacturer liquid solution of K is available in the US, which is maybe the largest issue.

 

If you're sensitive, the difficulty lies in getting a consistent percent reduction rate. This is hard to do in general with split tablets, and isn't possible to stay in the 5-10% reduction range even with 0.125mg tablets once under 0.25mg or so. I cut 6%/14 days fairly accurately by using a liquid/tablet hybrid taper, and a compounded liquid K of pure clonazepam dissolved in 30% ethanol by volume. There are many ways to do a fairly accurate titration of K, it's just more difficult than diazepam or benzos with a manufactured liquid solution available at ordinary pharmacies, such as lorazepam.

 

I hope this helps.  :thumbsup:

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