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Help to switch from 2x 0.25 Xanax to V


[Le...]

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Hi buddies!

I have been taking Xanax 2x 0.25 for a decade now, and I finally convinced my surgery (none of them benzo-wise) to start switching to Valium.

 

The Ashton manual doesn't give info for such low dosage, so I calculate it myself. 0.25 morning then half 0.25 evening + 2mg Valium.

 

After a week, my withdrawal symptoms seem to escalate, I feel my heartbeat everywhere in my body, brain fog, constant pins and needles in my feet and legs, I feel unstable if I stand up (I call it wishy woshy).

 

Did I taper too quickly, or is it normal? Did anybody switch to a lower dosage successfully?

Any help will be really appreciated because my Gps have no clue.

 

 

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Hi Leo G,

I think it's great that you've made a plan with your provider to crossover, and you've adapted Dr. Ashton's suggested schedules to your current dosage. Nice work!

 

Your first step looks good to me from a crossover-planning perspective, with one exception.

 

I understand that you substituted 0.125mg of alprazolam for 2mg of diazepam as half of your PM dose. I just looked and Dr. Ashton's equivalency chart has 0.125mg of alprazolam equivalent to 2.5mg of diazepam. Here's a quick tool to check equivalencies:

http://benzo.alwaysdata.net/tools/conversion.php

 

I suggest considering substituting 2.5mg for each 0.125mg of alprazolam. I assume that you're planning to take three more steps, the next one to substitute half your AM dose for diazepam, the following to replace the remainder of your PM with diazepam, and the last to replace the remainder of your AM with diazepam. I think this step-wise crossover would take four steps total, each 1-2 weeks for a 1-month minimum transition time and by Ashton equivalencies end with a total daily dose of 10mg of diazepam. Or do you have something else in mind?

 

Crossovers from short-acting to long-acting benzos are notoriously symptomatic. Even with a step-wise transition, I understand that the short-acting drug eliminates from the body faster than the long-acting drug can get up to potency. This is the simplest way that I understand the challenge of this type of a crossover, and it is generally to be expected to have periods of increased withdrawal (sometimes severely) while making the transition. I suggest trying to hold at your current crossover step until you experience a full return to your previous functionality before taking the next step.

 

Crossovers are a drug trial. This is why I think it's important to go slow and stabilize at each step if possible before taking the next. I believe that only by stabilizing can we get a sense for if the new drug is something that's working for us and justifies a continued transition. Ideally we'll see more benefits than costs symptomatically once stable, and take the next step knowing the withdrawal severity that comes up between steps is only temporary.

 

Lastly I think it's important to recognize that the last step of a crossover isn't the end; it's another period of adjustment that requires holding until adjusted to the full diazepam dose. This also might be an important time for your mind and body to adjust to the different effects of this new medication. I suggest 1-2 weeks between steps, and 1-2 weeks after the last step but again, the goal is to stabilize before continuing with crossing or tapering and stabilizing might take more time than expected.

 

I hope this helps you Leo G! I'm wishing you the patience you need to get the most from this crossover and drug trial; I hope that the benefits of diazepam for tapering will be available to you after all your hard work.  :thumbsup:

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