Clonazepam to Diazepam

I take 0.75 mg Clonazepam once a day in the morning.

If I were to switch to Diazepam what would be a good start?

I am thinking maybe 0.625 mg Clonazepam and 2 mg Diazepam for week 1.

Then maybe 0.625 mg Clonazepam and 1 mg Diazepam for week 2?

Hi benzodamaged,

I agree with your interest in a step-wise crossover to diazepam. Your suggested schedule doesn't make sense to me; perhaps there is a typo?

Do you have a doctor willing to prescribe diazepam on an ongoing basis?

I suggest asking for the Ashton equivalent of 0.75mg clonazepam, which is 15mg diazepam.

I suggest considering a 3-step crossover; this could look something like:

Week 1: 0.5mg K, 5mg V

Week 2: 0.25mg K, 10mg V

Week 3: 15mg V

I suggest considering taking the diazepam doses in the PM, and transitioning to doing only PM dosing by the end of the cross. From what I've read this is often better tolerated due to the depressing and sedating effect of diazepam.

I suggest holding at least 1-week between steps, but longer if you have not recovered your functionality. IMO a crossover to a new benzo is a drug trial, and the steps are not just to make the crossover; the steps are to trial the drug incrementally to determine if you can stabilize on it and tolerate any side-effects. I think this process is best done slowly and mindfully with daily symptom monitoring and holding as long as necessary at each step to get a sense for if and when your body is ready to proceed.

I've never done a crossover; these are just my opinions from what I've read here and in the Ashton manual. Let us know how we can help. 

My doctor suggested Diazepam so I am willing to give it a try since dry micro tapers were not successful.

Another option is to try Gabapentin or Pregabalin, but I am not thrilled about adding more drugs to the mix.

Also, if I can replace the Prozac and Remeron with one antidepressant that would actually work, I would not need the benzos.

The only reason I started taking Clonazepam 10 years ago was because the Prozac did not work anymore.

If it did, I would have not started the Clonazepam to begin with.

In any case, something needs to change because not only the medications that I take don't work, but the adverse effects make me sicker.

My doctor suggested Diazepam so I am willing to give it a try since dry micro tapers were not successful.

Another option is to try Gabapentin or Pregabalin, but I am not thrilled about adding more drugs to the mix.

Also, if I can replace the Prozac and Remeron with one antidepressant that would actually work, I would not need the benzos.

The only reason I started taking Clonazepam 10 years ago was because the Prozac did not work anymore.

If it did, I would have not started the Clonazepam to begin with.

In any case, something needs to change because not only the medications that I take don't work, but the adverse effects make me sicker.

Hi benzodamaged,

I'm glad to hear that your doctor is flexible and willing to support you in trialing diazepam. I hope they will also support a slow, step-wise, patient-led crossover.

To my research and experiences it appears that antidepressants, like benzodiazepines and perhaps all other psyche meds, are delay tactics. I think they buy us time, in the same way that taking a loan or using a credit card buys us time; if we can use that time to replace the need for delay tactics with more sustainable sollutions, I think that the delay tactics can be a necessary short-term strategy. But if the goal is to rely on these medications to remedy our hurts and fears, it's like using loans or credit cards to fix an income deficit; it seems inevitable that at some point these delay tactics will no longer be effective and we can find ourselves in a worse situation than we began with.

This is just my opinion, but I would not put my faith in any psyche drug serving as a long-term solution for mental health challenges. I hope that a successful crossover can support you in gradually reducing your benzo dosage, and I hope that skill-building can support you in reducing your need for medications.

Let us know if you need more help planning or navigating your cross. 

I got a doctor to prescribe me diazepam and do the cross over as follows:

Week 1: zero clonazepam 8 mg diazepam

Week 3: 7 mg diazepam

Then continue tapering 1 mg diazepam every 2 weeks.

Is this a good plan?

Hi

I would recommend the crossover plan Slow sent you earlier in the string. My doc tried to get me to do a similar cross like the one you just said and the problem is that the Valium will not have enough time to metabolize in your system to cover the withdrawal from the Clon and you will suffer immensely. I did mine similar to the one Slow provided you and it worked well. But ultimately it’s your choice

Here is a link to the Dr Ashton manual who ran a clinic for many years and explains in detail why it’s important to do a stepwise crossover

https://www.benzoinfo.com/wp-content/uploads/2020/08/Ashton-Manual.pdf#page33

There are also sections describing taper strategies but I’m sure Slow will reply again he is very experienced and helps a lot of buddies on this site. Good luck

Yeah I am more comfortable with a stepwise crossover than what my doctor suggested.

I also need to change my prozac and remeron because they don't work.

I would like to be on one medication for anxiety instead of these two antidepressants.

I tried other ssri and they don't work either so I am considering trying Buspar.

Perhaps I should hold off on the crossover until I get these meds sorted out first.

I hate Remeron, but from I’ve learned on this forum is to get off the benzos first for a number of reasons one of which the AD may help with the benzo w/d (hard to tell for sure) and also they will probably come with their own set of W/d symptoms. There is a Remeron w/d support group on this forum you may want to check it out also. Even though my docs say it’s easy to get off,,,,the forum of suffering people show otherwise as well as what I’ve researched on the internet. Again we are all different and you have to decide what to do. I’ve decided to wait til I’m off the Valium first.

Hope your doc will let you properly cross over and slow taper to what you decide your symptoms bear in terms of maintaining your life functionality. I made the mistake of going to fast on Ativan so I intend to go slower and symptom based on this one.

There are many tapering options and approaches that you can learn on this site also.

Good luck with your decision

Yeah I am not going to stop the AD but try and switch to something that will work. I am thinking of switching to Buspar and then if it works then I can get rid of the benzos. I was able to taper the Remeron with no w/d symptoms and also the Prozac when I tried Zoloft (which also did not work) The issue with benzos w/d is I can't take the anxiety, so if Buspar works then I can start the benzo crossover.

Thanks Joeb for sharing your personal experience with making your cross!

I agree, benzodamaged, that the sudden crossover prescribed by your doctor is likely to be very symptomatic and may result in a failed attempt.

There are a number of problems that happen in a sudden short-to-long benzo cross, one of which is a drop in blood serum levels which can be quite severe, and another is the inability to distinguish withdrawal symptoms from this blood level drop from intolerance to the new medication, making deciding whether to stay on the new drug or cross back a very difficult decision.

IME, slow and step-wise has helped many taperers expand or improve their tapering options, while sudden short-to-long crosses have instead caused much unnecessary suffering.

Most of us struggle with anxiety as a result of benzo use and withdrawal, among other things. I highly doubt that a new AD is going to be a reliable solution for this, even on the short-term. I suggest exploring skill-building for anxiety management; basically anything that reliably down-regulates your nervous system, from a hot bath to breath exercises to calm music. I go so far as to do developmental trauma therapy, somatic therapies, and both formal and informal meditations; I don't regret any of the money or time I've spent on these explorations.

Also, if you can keep your taper rate manageable, this could go a long way to feeling capable of managing your anxiety with your growing self-soothing skills.

Lastly, I suggested a 3-step crossover really as a minimum number of steps that I would use personally. I would be more inclined to do a 6-step crossover, and I expect I would then experience significantly less withdrawal between steps, and with 0.5mg clonazepam and 2mg diazepam tablets I think this 6-step cross could be done reliably with tablet splitting alone.

I hope this helps. Let us know what you decide to do next.