Hi there,
I currently take 0.25mg of Xanax twice daily. I self-tapered the second dose to 0.125 and did not do great. I was advised to updose back to 0.25 2x. Because the thought of having to calculate everything on my own, weigh, etc is very daunting to me, I found a deprescribing pharmacist willing to help. He suggests crossing over to Valium as per Ashton. However, I am a little concerned about the plan. My understanding of Ashton is that you are supposed to keep the total equivalent levels the same and to to slowly introduce the v by decreasing 1 dose of x at a time.
I know that 0.5mg of Xanax is equal to 10mg Valium.
Here is the original plan (which can be amended as needed)
STEP 1: 0.25 X in AM/ 0.125X + 5mg V In PM (equivalent to 12.5)
Step 2: 0.125X + 5mg V In AM/ 0.125X + 5mg V In PM (equivalent to 15
Step 3: 5 V in am/ 0.125 X + 5mg V in pm (equivalent to 12.5)
Step 4: 5mg V in am and pm = 10
Step 5: 3.75 V in am and 5V in pm = 8.75
Step 6: 3.75 V in am and pm = 7.5
Then it lowers to 2.5, 1.25, jumping at 1.25
After I updosed back to 0.25 2x, I found that I have unfortunately reached tolerance and it did not help.
Here’s the proposed plan to stabilize:
Week 1: 0.25X in am + 5mg/0.25mg X in pm= total of 15 (up from 10)
Week 2: 0.25X in am/5mg V+ 0.25mg X 5V in pm = 20 (up again)
Week 3: presumably start decreasing X
The proposal is to keep the Xanax the same, but add 5mg of Valium in the am, to stabilize and help with interdose w/d. I took the 5mg yesterday and felt like a zombie. Total brain fog/head heaviness, but not sleepy. I didn’t take the Valium this morning and at least I’m able to think a bit better today.
The way I read Ashton, this is my interpretation of a plan: is it correct?
Week 1: 0.25x in the am/0.125x pm + 2.5v=10
Week 2: 0.125x + 2.5v in am/ 0.125x + 2.5v in pm = 10
Week 3: 5mg V in am / 0.125x + 2.5v in pm = 10
Week 4: 5mg V in am and pm = 10
Week 5: start decreasing V
I’m worried that by adding the Valium without decreasing the Xanax will only prolong things. I’m also worried about depression, as I have a history of it and I’ve read that Valium can make it worse.
Basically, I’m second guessing everything and am wondering if I should just taper directly from Xanax.
I know I have to find a plan and stick to it, but am looking for advice. I also don’t want to alienate the pharmacist who is trying to help me.