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Klonopin or Valium


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I am currently on 10-20mg of Zolpidem per day and am looking to make a crossover. I got a referral to a psych who wants me to cross over to K rather than Valium due to him having seen more more patients become more depressed with V. He also suggested a minor AD lexapro which he believes can help some with Akathisia (I’m def on the fence about this because it can maybe cause it and I don’t want to make my minor symptoms worse). Anybody else given the suggestion to do K rather than V? Any quantifiable reason I should object one or the other?
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I just tried to cross over to valium unfortunately my Dr. refused to give me the correct crossover amt. and I had bad withdrawals. She had no problem giving me the correct crossover amt for klonipin, so I tried that and it was terrible  made me feel messed  up and shaky all day.  I would push for the Valium, it is much less potent and in my opinion much less dangerous...My Dr. tried to put me on Lexapro and it made me so much worse. I knew that was going to happen but she kept pushing me to try... AD's seem to be too stimulating for people withdrawing from Benzos. I see no reason to take an AD if you do not have depression, but all these Drs. push are SSRI's these days...
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Ok, thanks for your response. I will definitely take that into consideration... I hope to get some more responses soon so I can make a well informed decision.
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Here’s a key paragraph from the link to the Ashton Manual chapter Kate08 provided above:

 

Some doctors in the US switch patients onto clonazepam (Klonopin, [Rivotril in Canada]), believing that it will be easier to withdraw from than say alprazolam (Xanax) or lorazepam (Ativan) because it is more slowly eliminated. However, Klonopin is far from ideal for this purpose [benzodiazepine discontinuation]. It is an extremely potent drug, is eliminated much faster than diazepam (See Table 1, Chapter I), and the smallest available tablet in the US is 0.5mg (equivalent to 10mg diazepam) and 0.25mg in Canada (equivalent to 5mg Valium). It is difficult with this drug to achieve a smooth, slow fall in blood concentration, and there is some evidence that withdrawal is particularly difficult from high potency benzodiazepines, including Klonopin.

 

Since the Ashton Manual was published, a new clonazepam dosage form was approved in the US - Orally Disintegrating Tablets (ODTs).  Although 0.125mg and 0.25mg ODTs are now available, these are still high doses compared to the diazepam equivalents.  Regrettably, a commercially manufactured oral solution of clonazepam is not available in the US.

 

I agree with Ashton that diazepam is a more ‘taper friendly’ drug than clonazepam due to its longer half-life, lower potency, and multiple dosage forms (in the US: 2mg, 5mg, and 10mg tablets; 5mg/5mL oral solution).

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  • 2 weeks later...
Yes, I dose 4 times a day 5mg each time for a total of 20. This is an effort to get through the inter-dose withdrawal. I just found a Dr. whom specializes in benzo withdrawal using methods similar to Ashton. However, he actually wants me to switch over to Librium citing that in patients he sees less depression, and it has a less potential for abuse. A downside though is it comes in capsules rather than pills.
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Before, not really, because I am so scared of adding something new. However, currently I am pretty miserable and am having a hard time getting out of bed. With multitudes of s/x, I know it could probably get a lot worse. My next appointment is on Friday to try and decide. I am over time becoming more open to the idea of a C/O. I'm just not sure how I can survive an Ambien (zolpidem) taper unless for some lucky reason it gets better on the way down.

 

Again, thanks for being a prompt responder pamster, kind of crazy considering i'm sure you've got 1000 messages to look at each time you open this site up. I'll take a look at that link right now.

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Cali, is Klonopin still on the table as an option to taper from??  Many of our members taper from Klonopin, me included.  It has a decent half-life and I don't recall it causing depression with me.  I dosed three times a day initially as I tapered, then dropped to two, and at the end was only on one dose a day.  I did a water taper for the last bit that was too small to cut.  I had some withdrawl symptoms but looking back, they weren't impossible and I kept up all my usual activities.  Insomnia was my biggest struggle and that took quite a while to work itself out but even that is okay now.

 

There are going to be 'issues' no matter which way we choose to taper and I guess at the end of the day, pick the plan that sounds most doable to you.

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Thanks Kate for the perspective. It’s interesting that you suggest klon as one of my psych’s did too. It’s funny because (maybe I’m seeing biased info) that klon seems to be the one to avoid crossing over to.
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