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Just started my crossover


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Mixing is the whole point of a slow crossover, its to make the transition back to Valium less painful.

 

If you have enough Klonopin, I'd take more time to give the Valium a chance to work before you take away the Klonopin, it could really hurt if the Valium hasn't taken effect yet.

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Yeah but that’s the dilemma.  How do you cross if your doctor doesn’t help?

 

Finding a doctor that goes with this is not easy and I need to start soon. 

 

 

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Here is the reply from my doctor.

 

 

Valium is longer acting than Clonazepam so it should not be an issue.  We would have done a slow crossover if  we were switching from Valium to Clonazepam not the other way around .  Please refrain from reading  the internet . I got your back. You understand how Valium works for you . Besides Clonazepam lasts 60 hours in your system and can be there for more than a week therafter. Valium will have a steady state in your blood way before  Clonazepam is gone.  Since you already took the Clonazpeam this AM. You can start Valium 10 tonight and that should be good enough cross over.  The above Benzo cross over schedule is not  standard of care so  please don't let it make you nervous.  The sooner you switch to Valium, The better you will feel.

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I have a better week and a half worth of Klonopin.

 

I just need someone who understands this type of stuff to give good input.

 

I thought staystill gave you some good input.

 

Anyone have success crossing from Klonopin to Valium?

 

I crossed from 0.5mgK to 10mgV over about 2 weeks, introducing 2.5mgV every 5 days while reducing K by 0.125mg, making sure that total equivalent dose remained 10mgV at all times. This was faster than 1wk per step (per Ashton, but her steps are 0.25mgK, mine 0.125mgK) because K was paradoxical for me and very hard to continue. Once at full V dose, I held for 4 weeks to allow for its full accumulation in the body (due to its active metabolites). By the end of those 4 weeks things became a bit more stable where I could start daily dry tapering V. There is a good description of this Phase II accumulation period here: http://www.benzosupport.org/crossover_schedules.htm

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I just need someone who understands this type of stuff to give good input.

 

All I can say is that Pamster has been around the forum since 2008 and has seen hundreds of crossovers. I would trust her advice with my life.

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Here is the reply from my doctor.

 

Valium is longer acting than Clonazepam so it should not be an issue.  We would have done a slow crossover if  we were switching from Valium to Clonazepam not the other way around .  Please refrain from reading  the internet . I got your back. You understand how Valium works for you . Besides Clonazepam lasts 60 hours in your system and can be there for more than a week therafter. Valium will have a steady state in your blood way before  Clonazepam is gone.  Since you already took the Clonazpeam this AM. You can start Valium 10 tonight and that should be good enough cross over.  The above Benzo cross over schedule is not  standard of care so  please don't let it make you nervous.  The sooner you switch to Valium, The better you will feel.

 

Wow...

 

I'm sorry; your doctor is making blatantly false claims. I don't know why; maybe he doesn't know the actual pharmacokenetic properties of the drugs he's selling, or how half-lives work, or he just thinks it's okay to say what he likes to force an approach that's easier for him to prescribe rather than more likely to succeed for his patient.

 

Crossing over to diazepam from clonazepam (and other shorter-acting drugs) is well documented by doctors and clinicians and your doctor is describing the situation backwards. Long-acting benzos will build to up to higher cumulative potency and thus their individual doses are less significant and less potent. ANY shorter-acting drug is eliminated faster than the longer-acting builds to potency (that's how half-lives work), especially if an appropriate benzo-equivalency dosage is prescribed, so there is absolutely NO chance of a "steady state" of diazepam before the clonazepam is eliminated. Some doctors try to "fix" this by doubling the new drug dosage equivalency, but anyone with any understanding of medicine should know that doubling a critical dose drug isn't a safe or effective practice, and IME even this extreme strategy didn't prevent the dip in blood serum levels for the buddies I've heard from.

 

Unless your doctor has done extensive testing on your clonazepam elimination rate, clonazepam is NOT known to last "for 60 hours" in your body; if you have a very slow metabolism it is expected be at half it's strength in 60 hours, but it's average half-life is 39.5 hours, with some people eliminating half the drug in 19 hours. This drug information is perfectly clear on Wikipedia.org; part of that internet your doctor is so afraid of you browsing.

 

I think this line is the worst... "The sooner you switch to Valium, The better you will feel." He knows that? More likely he doesn't expect to be held accountable for this gross exaggeration of confidence; what he wants you to believe has apparently taken priority over his ethical practice of medicine. Your doctor sounds so much more like a salesman than a caregiver, and also like he's not familiar with his own products.

 

I suggest keeping a daily journal of your experience with this sudden cross. I hope you will consider reaching out for support from another prescriber if you lose functionality, which I think could happen around day 5-10 or so of your diazepam switch. I think support could look like either reinstating on clonazepam and starting again step-wise, or implementing an appropriate step in the middle of a slow step-wise transition between these two pharmacokenetically different drugs.

 

I really don't know what will happen in your body; while your doctors claims are patently false, for all I know this sudden switch could go well.

 

I'll be praying for you to get the support you need.  :thumbsup:

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Can someone help me with a stepwise crossover schedule from K to V?  I don’t want to take two benzo at the same time and would rather substitute a dose at a time even if that means changing from 2 times a day to 3.

 

 

.5mg k morning / .5mg k night

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Just to be clear, do you wish to only take one benzo each 24 hour period, not a combination of the two to equal your prescribed dose or am I missing your point about mixing?

 

Other than the plan you suggested at the top of this thread being too rapid in my opinion, why don't you want to use it?

 

Day 0

AM - 0.5mg K

NIGHT - 0.5mg K

 

Day 1

AM - 0.25mg K

MID - 0.25mg K

NIGHT - 10mg of V

 

Hold for 3 days

 

Day 4

AM - 5mg of V

MID - 0.25mg K

NIGHT - 10mg of V

 

 

Hold for 3 days

 

Day 7

AM - 5mg of V

NIGHT - 15mg of V

 

 

Hold for 3 weeks

 

 

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I’m talking about taking k and V at the exact time.  I don’t mind taking both of them throughout the day I just don’t want to take them together at the same time. 

 

So I would rather substitute a morning dose for Valium for example but not combining at the exact same time of day.

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I see, so then we're back to your plan, why can't you use that?  As I said, other than it being too fast, it looks like it suits your needs.

 

One another note, if you're going to go to 3 doses a day while crossing over, I feel it would be wise to switch to 3 doses before you cross over to Valium, your body may see going from 2 to 3 doses as a reduction so if you do this while crossing over you may suffer more than neccessary.

 

 

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Hi Mrcybershow,

I don't want to belabor the point, but what is your concern about taking two different benzos at the same time of day? They are both relatively long-acting benzos, and thus during any crossover (even a sudden one, at least initially) they are going to be swirling around in your blood together all day. The whole point of taking steps during a crossover is to minimize the side effects of replacing one drug with a longer-acting (less potent) one; thus dividing doses in half and replacing just one half with the new drug is often a suggested step in the Ashton Manual's crossover schedules. I really can't fathom the root of your concern for this superficial aspect of mixing doses; if you'd be willing to help us understand, perhaps there is a way to better meet this need of yours.

 

If you absolute don't want to take two drugs at the same time of day, despite their long-acting effects and ongoing blood-serum presence, then yes, I guess you could benefit significantly from having three or more daily doses so as to substitute one at a time. But as it has been pointed out, making this adjustment from 2x per day to 3x or more per day can be uncomfortable.

 

I took my very first updose on clonazepam as a result of going from 3x per day to 4x per day (same daily total) and experiencing my first debilitating withdrawal symptoms. Everyone is different, but I think Pamster's suggestion to make this adjustment first and stabilize on your new dosing schedule before crossing is wise. :thumbsup:

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My doctor wrote me back and told me to do this.

 

 

Day 1

9am: 0.25mg k.

3pm: 0.25mg K

Bedtime: 10mg V

 

Day 2

9am: 5mg V

3pm: 5mg V

Bedtime: 0.5mg K

 

Day 3

9am: 5mg V

3pm: 5mg V

Bedtime: 0.5mg K

 

Day 5

9am: 5mg V

3pm: 5mg V

Bedtime: 10mg V

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My doctor wrote me back and told me to do this.

 

 

Day 1

9am: 0.25mg k.

3pm: 0.25mg K

Bedtime: 10mg V

 

Day 2

9am: 5mg V

3pm: 5mg V

Bedtime: 0.5mg K

 

Day 3

9am: 5mg V

3pm: 5mg V

Bedtime: 0.5mg K

 

Day 5

9am: 5mg V

3pm: 5mg V

Bedtime: 10mg V

 

We don't want to go against your doctors orders so I hope you'll keep us posted how you're doing so we can all learn from this experience.  :thumbsup:

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Good to hear, we don't want you to suffer.  Are you planning to get off the Valium once you cross back over or do you plan to stay on it indefinitely?
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I’m currently in the middle of increasing my Zoloft dose from 50 up to 100.  Not sure if I should wait on increasing my Zoloft during this benzo transition or if I should just continue. 
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