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1mg xanax = ?mg valium?


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[9f...]

Hi everyone,

 

I have an appt tomorrow with the psych who is going to be monitoring me during my taper. I am currently on 4mg per day of Xanax. Through a phone call with my personal psych (not the psych who's going to help me taper) I was told that the dr I'm seeing tomorrow suggested that the slow crossover from Xanax to Valium would end up like this: 10mg Valium 4 times a day (40mg total) = 1mg Xanax 4 times a day (4mg total).

 

Now, from what I've read and researched that doesn't seem right but I could be wrong. I don't know. Isn't it supposed to be like this: 0.5mg Xanax = 10mg Valium? That would mean that the crossover should be aiming for 80mg Valium instead of 40mg Valium. That would be half of what the crossover should be, right?

 

Thanks for any / all input,

thrive

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Hi thrive

 

1mg valium = 20mgs xanax

You are right, 0.5mg xanax = 10mg valium.

 

If you were to do a gradual crossover from xanax  to valium, prior to your taper, you would start at 80mgs valium per day.

Tell your prescriber this and take a print of the equivalency table http://www.benzo.org.uk/bzequiv.htm

Going from 80mg to 40mg is very dangerous indeed.

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Hello Thrive,

Just so you know, many doctors use a different equivalency table. Here is a link from the AMA. See table 4.

 

Good luck with your appointment!

Flip

 

http://www.aafp.org/afp/1998/0701/p139.html

Hi

 

I just emailed that site, because if doctors use that info, it could have some very dangerous consequences for patients, say if someone was hooked on 6mg xanax, and was only crossed over to 60mg valium, it doesn't bear thinking about what consequences there would be.

 

Here is a copy of the email, what do you think?

 

"Dear Sirs,

 

With the greatest of respect to you, I felt I must point out an error on your page http://www.aafp.org/afp/1998/0701/p139.html

This page has information on benzodiazepine dose equivalency.

 

I am pointing this information out to you because prescribers may use the information on this page when prescribing drugs to patients, and this could have very serious or life threatening consequences for the patient.

 

The page says that 6mg Xanax is equal to 60mg valium. I have to correct you and say that as 0.5mg xanax = 1mg valium, then 6mg xanax = 120mgs valium.

I am telling you this because if doctors look at this page, and prescribe, based on this information, patients with addictions to high doses of benzodiazepines could be at great risk of serious illness or even death. For example, if a patient wants to taper off 6mg xanax, and the doctor prescribes him/her 60mg valium, the 60mg decrease in valium could be a serious risk to the patient. 10% of the dose is the maximum recommended size of cut, when reducing benzodiazepines.

 

Professor C Heather Ashton, (DM, FRCP, Emeritus Professor of Psychopharmacology, School of Neurology, Neurobiology and Psychiatry,

The Royal Victoria Infirmary, Newcastle upon Tyne), did some very lenghthy, and in depth studying, of patients withdrawing from benzodiazepines, and her benzodiazepine taper protocol is widely used in the medical profession. Many tranquiliser support groups across the world use Professor Ashtons methods.

 

Here is her manual benzo.org.uk Benzodiazepines How They Work & How to Withdraw, Prof C H Ashton DM, FRCP, 2002

 

and here is the benzodiazepine equivalency table.benzo.org.uk : Benzodiazepine Equivalence Table

 

Many thanks"

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I think it's great, Journey! I doubt they will believe it, but we can keep trying. I was pretty stunned when I found it but that explains a lot about the weird prescriptions I've been given over the years.

 

Thanks, Journey,

Flip

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[9f...]

That's what I thought.

 

Oh, wow. And uh-oh.

 

I don't like arguing with doctors but it seems like that's what I may be doing tomorrow morning. Or I can just thank him for his advice and walk out.

 

I'll bring the Ashton Manual equivalency table with me tomorrow but he'll probably tell me it's wrong. Then what?

 

Why does this have to be so hard just to get started!

 

thanks for all the help bb friends,

thrive

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I think it's great, Journey! I doubt they will believe it, but we can keep trying. I was pretty stunned when I found it but that explains a lot about the weird prescriptions I've been given over the years.

 

Thanks, Journey,

Flip

Hi, I felt I had to do something, because part of the anxiety in my withdrawal is keeping my conscience as clean as I can, and worrying that I have done things that my conscience doesn't like.

 

It looks like I have forgot to put the links for the ashton manual and the equivalency table, because when i did it I was in a lazy mood.

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:2funny:

 

Can you just copy it and insert the links and resend? I'm sure they get so many emails, they will never realize it's a duplicate. Good job Journey. I try to stay true to my conscience, too. As I am physically and mentally capable, anyway. I'm like you - I think it's good for the healing process.  :thumbsup:

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Panic over, I just looked at the email i sent and the links were included in there.

 

I just looked in my email and saw I got a reply too:

 

Here's the reply

 

Thank you for your interest in American Family Physician.  We have received your e-mail, and are looking into your comment regarding a possible dosing error.  We will be investigating the content and will publish a correction if deemed appropriate. 

 

 

 

If you have any questions or concerns, please let us know.  We appreciate you taking the time to point out a potential error.

 

 

 

Thank you,

 

 

 

Lisa

 

 

 

Lisa Hauk | Sr. Associate Editor, Online

American Family Physician

American Academy of Family Physicians

11400 Tomahawk Creek Parkway | Leawood, KS 66211

Office: (913) 906-6000 Ext. 5116

lhauk@aafp.org

 

 

 

 

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Wow! I didn't expect them to respond except with a form email that is sent automatically. It appears someone actually read your email. Great job, Journey. I hope you'll keep us posted if you hear back from them!!  :clap:
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Wow! I didn't expect them to respond except with a form email that is sent automatically. It appears someone actually read your email. Great job, Journey. I hope you'll keep us posted if you hear back from them!!  :clap:

 

I will do myself a reminder to email them if I don't hear back from them.

 

I feel good that I am saving future potential benzo people from being prescribed the wrong thing and suffering un-necessarily.

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That's what I thought.

 

Oh, wow. And uh-oh.

 

I don't like arguing with doctors but it seems like that's what I may be doing tomorrow morning. Or I can just thank him for his advice and walk out.

 

I'll bring the Ashton Manual equivalency table with me tomorrow but he'll probably tell me it's wrong. Then what?

 

Why does this have to be so hard just to get started!

 

thanks for all the help bb friends,

thrive

I received some great advice from Battle Against Tranqulisers.

So long as you remember, some docs have big egos, and to treat them with kid gloves.

Not to grovel, just to get them on side so they will be more responsive to our needs.

 

Can you go to a pharmacy and verify the equivalents with them. You could then tell your doctor that the pharmacists said so, and docs cannot really disagree with them.

 

 

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Hello Thrive,  Just so you know, many doctors use a different equivalency table. Here is a link from the AMA. See table 4. http://www.aafp.org/afp/1998/0701/p139.html

 

Here is a comparative table of different equivalence recommendations which someone put together for another forum.

 

http://www.drugs-forum.com/forum/showthread.php?t=82696

 

-zoner

 

Isn't the poster of the thread pointing out discrepancies in equivalences?

His table includes the ashton taper.

 

I emailed the owner of the other site, because I was under the impresssion that american doctors were using it to refer to when prescribing valium to patients crossing over from other benzos.

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Hi everyone,

 

I have an appt tomorrow with the psych who is going to be monitoring me during my taper. I am currently on 4mg per day of Xanax. Through a phone call with my personal psych (not the psych who's going to help me taper) I was told that the dr I'm seeing tomorrow suggested that the slow crossover from Xanax to Valium would end up like this: 10mg Valium 4 times a day (40mg total) = 1mg Xanax 4 times a day (4mg total).

 

Now, from what I've read and researched that doesn't seem right but I could be wrong. I don't know. Isn't it supposed to be like this: 0.5mg Xanax = 10mg Valium? That would mean that the crossover should be aiming for 80mg Valium instead of 40mg Valium. That would be half of what the crossover should be, right?

 

Thanks for any / all input,

thrive

 

Hi Thrive,

 

Well you already know about the equivalences of xanax.

I hope you find a understanding doctor to help you with the c/o. Anyway 80mg valium is just too much and I doubt any doctor would approve it. What you can do is start tapering xanax directly until you reach an equivalence of 30-40 mg and then you can start the c/o.

 

If you take xanax only once per day, splitting the dose is a good idea to avoid interdose w/d. Once in a lower dose you can start the c/o.

 

Another choice is to do a partial c/o, lets say only 1.5mg xanax to 30 mg valium and once you finish the c/o you can taper the rest of the xanax first. This may be a good idea if the interdose w/d is just too much for you to handle.

 

Lets us know what you decide and what your doctor says.

Laura

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[9f...]

Hi Laura,

 

Thanks so much for that information and for your concern. It's always such a warm feeling to know that there are people here who truly care.  :mybuddy:

 

My new doctor ended up being surprisingly accommodating. I brought with me the Ashton equivalency table and tapering schedule for him to have a look at. He wasn't familiar with it but he did mention that he has had the Ashton Manual bookmarked on his computer for a long time but hasn't gotten around to reading it yet. I think he will now because he was really intrigued by her c/o technique and her tapering methods. He thought they seemed very reasonable although a bit too fast (c/o and tapering) and is more than willing to work with me on it.

 

You're right, though. He did think the 80mg of Valium was a bit on the high side but I think he must have seen something in the Ashton taper that made him feel more comfortable about the high dose of Valium because he agreed to it without any fuss at all.

 

So, I'm a lucky lady to have found this doctor. But, as with most things that seem too good to be true, he will be moving office mid-summer to a town 2 hours away from me and will have to transfer me to another doctor to continue the c/o and withdrawal. I'm really seriously bummed out about that but there's not much I can do. He's going to do everything that he can to switch me to a doctor that will continue down the Ashton path with me. And I do believe he'll find one. But still I'm scared of the possibility that he won't. I won't let the fear stop me though. Especially because there will always be something frightening down the road, right?

 

T

 

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I am really pleased your doctor turned out to be a benzo good-guy, keen to learn more.

Sorry to hear he will be moving office mid summer.

It sounds as if he will find another doctor to oversee your taper.

For more peace of mind you could have a think about asking him to write a letter for you to give to the other doctor. Ask him to write on the letter that you have enbarked on a taper from xanax using valium  and other relevant facts you think of.

 

Once yu have done everything in your power to increase the chances of the next doctor carrying the present doctors work on, there is nothing you can do and worrying about it will just make it worse.

 

Yes, there will always be something frightening down the road, right?

But, so long as we keep in mind that the benzos are making things seem more frightening, that should lessen the worry.

 

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[9f...]

Hi journey,

 

Well, I'm guaranteed a new doctor and my current one will have plenty to pick from since we have hmo insurance. All my records are there for any potentiial new doctor that he may choose for me. I'm sure he'll be careful to pick the one that will suit my case in the best possible way. He's a very compassionate doctor. So, I have to leave it up to him and hope that the dice roll in my favor.

 

I've had many bad experiences with the doctors under my insurance plan so I'm really suspicious of them all. A lot of them have said that they'd do this-n-that but in the end some have betrayed me. That is what I fear may happen again. All I can do is hope that it doesn't.

 

Thanks for your suggestions. Every little bit helps.

 

T

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Hi Thrive

 

Sorry to hear you had many bad experiences with other doctors, and, understandably you are going to be afraid to use another new doctor.

Can you tell your concerns to your existing doctor?

Also, I am not in the US so I don't know how doctors work, but could you ask on this site if there are any benzo friendly doctors near where you live?

 

Whatever you do, please dont worry about this as it will just make things worse.

 

Take care

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[9f...]

Yes, I've already told him of my concerns. He's very aware of my suspicious nature toward doctors especially because my other doctor already told him that I had that tendency before I ever saw him (the doc I'm seeing now).

 

As far as benzo friendly doctors in my area goes, the closest one is about 2 hours away. Normally that wouldn't be such a big deal for me to drive that far once a month or so but if I have a tough withdrawal then I won't be in any shape to do it.

 

And, no, I'm not going to worry about it now. It is, of course, in the back of my mind all of the time but it's not to the point of scaring me senseless yet. At this time, I'm trusting that I'll be placed under the care of a cooperative doctor and when the time comes, if that is not the case, then I'll start the pro-active thing. I'm fairly well-known for being a squeaky wheel which is sometimes a good thing and sometimes not.  ;)

 

In any case, like they say, I'll cross that bridge when I come to it!

 

T

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It's good that your doctor already knows your concerns.

 

As far as benzo friendly doctors in my area goes, the closest one is about 2 hours away. Normally that wouldn't be such a big deal for me to drive that far once a month or so but if I have a tough withdrawal then I won't be in any shape to do it.

I'm of the schjool of thought that if you taper carefully and slowly enough, symptoms should be  kept to a minimum.

I don't like going out unless I have swallowed a couple of painkillers to quell the mental distress I feel but I have a lot of situational, non benzo stress, which I am sure, when this stress is lifted, or even lessened, I will have a new lease of life and will be able to happily go out without painkillers.

Just to offer you encouragement. I am only on 3mg val, but have no physical symptoms apart from night sweats and irregular periods.

 

I would keep the concern on the back burner, no need to get scared senseless about it.

Also, I find, when a worry pops up for me regarding my doctor, so long as I have prepared all I can for it,  if I say to myself, "I don't have to worry about this till the next doc appointment" this lifts weight and makes life easier.

When I first started my taper, I would spend the time before the appointment worrying  and would sometimes phone the doctor earlier, which didn't always go down well.

 

What is a squeaky wheel, does that mean someone who raises concerns and gets things sorted?

 

Yeah crossing the bridge is a good idea, cos the bridge we may think, at the time, we will have to cross in future, often doesn't arise.

 

All my worries with the doctor (obtaining valium obtaining liquid valium) got sorted and worked out well.

 

Take care.

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[9f...]

hi journey,

 

Thank you for your encouraging words. I'm so glad for you that you're not having any really horrible w/d sx. I don't know how old you are but the night sweats and irregular periods could be due to peri-menopause and not have anything at all to do with the Valium. Wouldn't that be great? Not that night sweats are comfortable, mind you. Nor are the other (been there, done that...blech!), but still...?

 

As far as the painkillers go, I'm glad that works for you. The only painkillers I can take are Tylenol (paracetmol) or Motrin. After I had my daughter I was in a lot of pain for a very long time and was prescribed opiate painkillers for months and months on end. They never found out what was wrong with me but in the process they got me both physically and psychologically addicted/dependent on opiate painkillers. The withdrawal from those was killer for me. And every time since then that I've had to take them after various operations, I've ended up having to withdraw from them all over again. There's no going back and this will be a problem for the rest of my life. So, for me it's either tylenol or motrin and that's it.

 

Oh, a "squeaky wheel" is a person who won't stop niggling until they get the attention they deserve. Imagine hearing "squeak, squeak, squeak" ad infinitum and my bet is you'd go out and oil that wheel, right? Well, that's what I'm like in life. A doctor's worst nightmare!

 

I hope you're doing well today,

 

T

 

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Thanks for explaining squeaky wheel to me.

 

So you've conquered opiate addiction, you are a warrior, and show strength, endurance and determination.

 

I'm 46 this september.  :o:brickwall: @ the thought of peri-menopause or menopause and withdrawals together.

 

I wonder, how do people with night sweats protect their matress, I should raise a ? on a thread in whatever forum I think it would fit.

 

I am psychologically dependent on opiates for going out, but I don't want to be.

Battle against tranquilisers said that my not wanting to go out will get better once I have healed from this whole thing.

 

I hope you never suffer pain enough to need opiates.

 

I had a good day today, because I masked the mental pain with painkillers, bumped into a friend I hadn't seen for a while and spent the afternoon at their house.

 

Thank you for asking.

 

 

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[9f...]

good morning, journey,

 

Do you think you could make it to the doctor's office for a blood test to see if you're in peri-menopause? They have ways of greatly reducing the sx to a either a tolerable level or to having no sx at all. I was put on a small dose of progesterone and some estrogen cream and it did wonders for the night sweats, length of periods (i had really longggg ones!), and headaches. I don't really know how the NHS works but if they will help you with the sx of peri-menopause it would be well worth it for you to pay them a visit.

 

I ended up having to have a hysterectomy and oophorectomy due to adenomyosis this past february so now my doctor is trying to stabilize my estrogen levels to alleviate my night sweats, daily headaches, and mild confusion. We haven't got it quite right yet but we're still working on it. So, I feel your misery as far as those sx go.  :therethere:

 

Thank you for your hopes that I'll never suffer pain enough to take opiates but at 54yrs old I have to face the reality of more health problems in future that will require opiates. I've had to take them so many times since I became addicted to them because they simply have no other method of treating moderate to severe pain here. And every time that I've had to take them, I've had to go through the withdrawal process all over again. It's really nasty and takes about 2 weeks for the physical symptoms to dissipate and another 2-3 weeks before my brain is working properly again. That is going c/t which is how I choose to w/d from them. Tapering from opiates for me is not the way to go as it just prolongs the misery and I'd rather just get it over with as quickly as possible. Benzos, of course, are an entirely different ball game so I'm going to take the benzo tapering very, very, very slowly!

 

I probably don't need to tell you this but I just feel I must: please be careful not to create physical addiction with the painkillers that you take. The w/d's are just not worth it. They are absolutely freaking miserable and completely debilitating to the point where you can barely get out of bed to go to the bathroom let alone do anything else at all. You have to have someone deliver meals to you in bed, do your laundry, change your sheets, and on and on. Oh, and taking a shower? Forget it! When I go through w/d's I'm lucky to manage a shower once every 4 days or so and it really hurts. The pain on the skin from the water...oh, wow, ouch!!! Just be careful, okay?

 

How are you doing today? Or, rather, how has your day gone? I guess you're now at about 5pm (I'm still in my 'jammies...still a.m. for me).

 

T

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