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Valium dosing question maybe builder(?)


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I was taking 5mg at 7am, 5mg at 3pm and 5mg at 11pm.  I changed the 3pm dose to all liquid and cut it down to 7ml from 50ml. I am having a lot of ups and downs.  I thought about evening out all of my doses, and doing 2.5mg in pill form, and the rest in liquid for all three doses.  Then, cutting one of those doses down each day and trying to keep them even.  Or, should I try to completely eliminate the middle dose, then move the other two doses to 12 hrs apart so I’m not waiting so long?  My GeneSite test said I am a rapid metabolizer of Valium.  I’ve thought of doing all liquid, but that’s a lot of PG and nasty Valium water a day.  :sick: I’m just wondering what has worked for others...  I started at 20mg and I’m down to 10.7.  Doing about a 7.5% cut a month. Thanks!
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Even at the short end of the scale ("rapid metabolizer"), the half life is 18 hours!  And because of the accumulation factor (approx. 8:1), small changes in the daily dose schedule will probably never really be felt.

 

And all that PG would be about 1/2 oz.  (Why does everyone obsess about the inactive components in a liquid, but never seem to worry about the 7-8 inactive ingredients in their tablet?)

 

Every one needs to choose a taper plan that they believe will work for them.  But IMO, a DLMT taper with a true, uniformly-distributed solution (vodka/water, PG/water, or diluted Rx liquid) is the easiest, most comfortable option.

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Even at the short end of the scale ("rapid metabolizer"), the half life is 18 hours!  And because of the accumulation factor (approx. 8:1), small changes in the daily dose schedule will probably never really be felt.

 

And all that PG would be about 1/2 oz.  (Why does everyone obsess about the inactive components in a liquid, but never seem to worry about the 7-8 inactive ingredients in their tablet?)

 

Every one needs to choose a taper plan that they believe will work for them.  But IMO, a DLMT taper with a true, uniformly-distributed solution (vodka/water, PG/water, or diluted Rx liquid) is the easiest, most comfortable option.

 

I have been doing a DLMT using 100ml of PG and 400ml of water.  I dissolve 50mg in the Pg then add the water.  I was just wondering if I should dose 2 or 3 times a day, really.  And, assuming by your answer, doing half a pill and part liquid isn’t best.  All liquid would be, correct?  I have been fine with it and am just trying to do what is best.  I changed all doses to even doses today, before I put this up this morning.  However, I am open to all good options. You helped me to set up my taper.  I think we even talked about what I should do when I got down to 2 pills.  But my brain can’t remember. 

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

You have a very valid point.  I appreciate your wisdom.  You originally had me do 100ml pg and 400ml of water with 50mg of Valium.  I cut .25ml a day. 

Is there a more concentrated formula I might try (that you’d recommend) so I’m not drinking close to 50ml per dose? 

I know everyone bothers you for taper advice, I truly appreciate that you take the time to help people who are still trying to get off of this crap.  2x a day would be easier.  I’ve made 3 changes in the past 3 days, but I agree, Valium is valium, either way.  Thank you.

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

Specifically, what 'BS' here at BB? Really - I'd like to know!

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

You have a very valid point.  I appreciate your wisdom.  You originally had me do 100ml pg and 400ml of water with 50mg of Valium.  I cut .25ml a day. 

Is there a more concentrated formula I might try (that you’d recommend) so I’m not drinking close to 50ml per dose? 

I know everyone bothers you for taper advice, I truly appreciate that you take the time to help people who are still trying to get off of this crap.  2x a day would be easier.  I’ve made 3 changes in the past 3 days, but I agree, Valium is valium, either way.  Thank you.

 

The only part of the ratio that's important is 2ml PG for each 1mg of diazepam. You can add as much, or as little, water as you wish.  The .1mg per ml suggest concentration is just for convenience.  As long as you use 2ml solvent for each mg diazepam, you can dilute as you choose.

 

But remember, dilution makes measuring easier, and dramatically reduces the error factor.

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

Specifically, what 'BS' here at BB? Really - I'd like to know!

 

Seems like you missed my post, Builder.

 

Actually, I now have two questions for you:

 

1) To what 'BS at BB' do you refer?

 

2) Can you provide a citation in support of your argument that 'home brew' liquids possess an identical pharmacokinetic profile to regular prescribed pills? Inquiring minds must know!

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

Specifically, what 'BS' here at BB? Really - I'd like to know!

 

Seems like you missed my post, Builder.

 

Actually, I now have two questions for you:

 

1) To what 'BS at BB' do you refer?

 

2) Can you provide a citation in support of your argument that 'home brew' liquids possess an identical pharmacokinetic profile to regular prescribed pills? Inquiring minds must know!

 

Yes, I guess I missed that post. sorry.

 

The BS is all of the precautions I read here on BB that one must "adapt" or "gradually transition"  to liquid, that it somehow is metabolized differently.  A concept completely unsupported by any med or pharma science.  (...and thankfully,  that view actually seems to be slowly diminishing here on BB  ;))

 

A simple google search for the Rx  liquid benzos will show that the each contains 3 common ingredients, 1) a benzo, 2) a solvent (alcohol or propylene glycol) and 3)water.  Different formulations will also have some stablizers, extenders, colorants, flavorants, etc, the add to its commercial acceptability, but really don't effect it's functionality.  The common solvents, alcohol or PG, will dissolve the benzo into a uniformly distributed solution, and water will dilute to a more convenient concentration.

 

 

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

Specifically, what 'BS' here at BB? Really - I'd like to know!

 

OK, I found it.

 

Surely you must know for a long time there was a proliferation of posts here on BB that one could not simply begin taking a liquid benzo, that it was somehow metabolized differently, and 1) that one needed to gradually transition to liquid, and 2)  that some folks would probably not be able to take a liquid benzo.  Even I followed what seemed to be the "generally recommended" procedure of "testing" liquid doses for a trial period before actually starting to taper.  (Yes, I ignored Jana's advice, and bought into the paranoia here on BB.)  BTW, Jana once banned me from BDR because of my activity here on BB.  ::)

 

Colin, I'm not suggesting that was in any way an "official" BB position, but it certainly was the state of "conventional wisdom". 

 

And there are tons of BS shared here on BB every day, because that's just the way message boards work.

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OK, I found it.

 

Surely you must know for a long time there was a proliferation of posts here on BB that one could not simply begin taking a liquid benzo, that it was somehow metabolized differently, and 1) that one needed to gradually transition to liquid, and 2)  that some folks would probably not be able to take a liquid benzo.  Even I followed what seemed to be the "generally recommended" procedure of "testing" liquid doses for a trial period before actually starting to taper.  (Yes, I ignored Jana's advice, and bought into the paranoia here on BB.)  BTW, Jana once banned me from BDR because of my activity here on BB.  ::)

 

Colin, I'm not suggesting that was in any way an "official" BB position, but it certainly was the state of "conventional wisdom". 

 

And there are tons of BS shared here on BB every day, because that's just the way message boards work.

 

Okay, so, changing from pills to liquid or back and forth doesn’t seem to matter.  I was taking 5mg/.7mg/5mg daily.  I switched to 3.575/3.575/3.575 daily for the last two/three days before posting here.  I would love to only take 2 doses.  Since I just switched them from two and a very small one to three even one, can I simply switch to just two?  I know supposedly some people have issues.  I listened to you when I switched my middle dose to liquid and didn’t wait to start tapering.  I had no ill effects.  The liquid isn’t really the problem.  Now, I’m curious about how I can get to two doses since I messed up and made it three. Gradually or simply switch? Thanks.  Not trying to add to the BS, trying to debunk it.  Everyone says to do it gradual.  I know you’d know. Thanks.

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Even at the shortest end of the scale, diazepam has an 18 hour half-life.  The average half-life is over 2 days.  So the implications of that are variations of your intra-day dosing schedule are unlikely to have any real effect.  Diazepam is commonly Rx'd 2X/day dosing, and that is NOT because of concerns about level blood concentrations.  The reason for the usual 2X dosing is to spread the powerful sedating/depressant effect of the med.

 

 

So it's extremely unlikely that switching from 3X/day to 2X day will have any effect whatsoever (other than being more convenient!)

 

During my DLMT, I started at the usual 2X day, but varied the distribution widely, solely based on convenience.  And at 3mg, I went to 1X/day, and all liquid.  I never felt any effects from varying my doses throughout my taper.

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Even at the shortest end of the scale, diazepam has an 18 hour half-life.  The average half-life is over 2 days.  So the implications of that are variations of your intra-day dosing schedule are unlikely to have any real effect.  Diazepam is commonly Rx'd 2X/day dosing, and that is NOT because of concerns about level blood concentrations.  The reason for the usual 2X dosing is to spread the powerful sedating/depressant effect of the med.

 

 

So it's extremely unlikely that switching from 3X/day to 2X day will have any effect whatsoever (other than being more convenient!)

 

During my DLMT, I started at the usual 2X day, but varied the distribution widely, solely based on convenience.  And at 3mg, I went to 1X/day, and all liquid.  I never felt any effects from varying my doses throughout my taper.

 

Thank you. 

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Sorry to the OP, here we are again...

 

I had problems switching to liquid (vodka)... I dont expect anyone to have the exact same problems I did, Yet many people have reported issues, -Some I have seen as far back as 2013/14... There was also a little survey some time ago that had a number of negative responses... I also have had a number of people PM me saying same...

Whatever the reasons might be, I dont particularly care.. We dont need “debunking” nor to be told its BS... And I guess while it might be true that its “in some peoples heads” Bluntly stating it is so, is far from supportive for most people... I tend to be pretty quiet on it due to the potential fear factor, but that said, many of those I have spoken to about it are pretty clear and realistic or whateva people...

 

As I have said before, Often people are suffering and pinning their hopes on “Builders magic liquid” when it is only a tool in the box, and if it goes bad for them it can be a very dangerous time as those hopes are seemingly dashed on the rocks.. I would suggest we be very careful in what we say, and it has become my opinion that a slower/partial, or even a second attempt has shown very positive results with those that initially had problems...

 

Calling BS does not solve anything, I for one just get sick of bashing my head against Builders brick wall, thus perhaps in part, the possible illusion that “that view might be diminishing”.. And if infact it is, It may be for the wrong reasons that are infact contrary to the supportive BB mission...

 

“Your Story is Not My Story..”

 

... Till next time...

:(

 

 

 

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I had problems switching to liquid (vodka)... I dont expect anyone to have the exact same problems I did, Yet many people have reported issues, -Some I have seen as far back as 2013/14... There was also a little survey some time ago that had a number of negative responses... I also have had a number of people PM me saying same...

Whatever the reasons might be, I dont particularly care.. We dont need “debunking” nor to be told its BS... And I guess while it might be true that its “in some peoples heads” Bluntly stating it is so, is far from supportive for most people... I tend to be pretty quiet on it due to the potential fear factor, but that said, many of those I have spoken to about it are pretty clear and realistic or whateva people...

 

As I have said before, Often people are suffering and pinning their hopes on “Builders magic liquid” when it is only a tool in the box, and if it goes bad for them it can be a very dangerous time as those hopes are seemingly dashed on the rocks.. I would suggest we be very careful in what we say, and it has become my opinion that a slower/partial, or even a second attempt has shown very positive results with those that initially had problems...

 

Calling BS does not solve anything, I for one just get sick of bashing my head against Builders brick wall, thus perhaps in part, the possible illusion that “that view might be diminishing”.. And if infact it is, It may be for the wrong reasons that are infact contrary to the supportive BB mission...

 

“Your Story is Not My Story..”

 

I'm sorry that you are having such a difficult time and were not able to make a transition to liquid microtapering.  It must have been really frustrating to try a different way of tapering that you hoped would be better and have it not work out.  I agree that everyone is different and we each have to find the method that works best for us.  I think we all are suffering, but to different extents.  In some case it may be the difference between a sprained finger and a traumatically amputated arm.

 

I don't think Builder or anyone else has ever claimed that liquid tapering is magical--only that it allows you taper by a much smaller amount with less sxs than cut and hold-often quite a bit less  This has certainly been the case with me.  Dry-cutting Valium became too painful and incapacitating when I got down to a certain level.  Liquid microtapering has allowed me to keep tapering with significantly less SXS than I was experiencing when I was dry tapering.

 

For all of this criticism of Builder, I don't see anyone who provides anywhere close to as much help and information as he does.

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I had problems switching to liquid (vodka)... I dont expect anyone to have the exact same problems I did, Yet many people have reported issues, -Some I have seen as far back as 2013/14... There was also a little survey some time ago that had a number of negative responses... I also have had a number of people PM me saying same...

Whatever the reasons might be, I dont particularly care.. We dont need “debunking” nor to be told its BS... And I guess while it might be true that its “in some peoples heads” Bluntly stating it is so, is far from supportive for most people... I tend to be pretty quiet on it due to the potential fear factor, but that said, many of those I have spoken to about it are pretty clear and realistic or whateva people...

 

As I have said before, Often people are suffering and pinning their hopes on “Builders magic liquid” when it is only a tool in the box, and if it goes bad for them it can be a very dangerous time as those hopes are seemingly dashed on the rocks.. I would suggest we be very careful in what we say, and it has become my opinion that a slower/partial, or even a second attempt has shown very positive results with those that initially had problems...

 

Calling BS does not solve anything, I for one just get sick of bashing my head against Builders brick wall, thus perhaps in part, the possible illusion that “that view might be diminishing”.. And if infact it is, It may be for the wrong reasons that are infact contrary to the supportive BB mission...

 

“Your Story is Not My Story..”

 

I'm sorry that you are having such a difficult time and were not able to make a transition to liquid microtapering.  It must have been really frustrating to try a different way of tapering that you hoped would be better and have it not work out.  I agree that everyone is different and we each have to find the method that works best for us.  I think we all are suffering, but to different extents.  In some case it may be the difference between a sprained finger and a traumatically amputated arm.

 

I don't think Builder or anyone else has ever claimed that liquid tapering is magical--only that it allows you taper by a much smaller amount with less sxs than cut and hold-often quite a bit less  This has certainly been the case with me.  Dry-cutting Valium became too painful and incapacitating when I got down to a certain level.  Liquid microtapering has allowed me to keep tapering with significantly less SXS than I was experiencing when I was dry tapering.

 

For all of this criticism of Builder, I don't see anyone who provides anywhere close to as much help and information as he does.

Yeah thanks, but im over a year off valium, and it wasnt a biggie that liquid wasnt for me at that time, -Pill splitting worked out quite well... But yes, Im aware of the principals of a DLMT, and that many people find it works quite well..  Im glad it did for you also.. That was not my point..

(This subject has a long history)

 

 

 

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

Specifically, what 'BS' here at BB? Really - I'd like to know!

 

Seems like you missed my post, Builder.

 

Actually, I now have two questions for you:

 

1) To what 'BS at BB' do you refer?

 

2) Can you provide a citation in support of your argument that 'home brew' liquids possess an identical pharmacokinetic profile to regular prescribed pills? Inquiring minds must know!

 

Yes, I guess I missed that post. sorry.

 

The BS is all of the precautions I read here on BB that one must "adapt" or "gradually transition"  to liquid, that it somehow is metabolized differently.  A concept completely unsupported by any med or pharma science.  (...and thankfully,  that view actually seems to be slowly diminishing here on BB  ;))

 

I note that you have still failed to provide a citation. You know, as the party making the claim, it really is incumbent upon you to back up your claims with verifiable and reliable sources. Can you not provide even a single source to support your claims? That's rather discouraging, since you have repeatedly made similar unequivocal statements about 'home brew' liquids being pharmacologically identical to the pills from which they have been formed.

 

As for, "a concept completely unsupported by any med or pharma science" - that a very strange statement for you to make. Your claim that it is a "concept completely unsupported by any med or pharma science", is counter to the science of pharmacokinetics. Specifically, how have you determined that by grinding up a pill does not effect:

 

  • Disintegration
    • Penetration Rate
    • Excipients
    • Degree of tablet compression
    • Coatings (particularly in extended/slow release pills)

    [*]Dissolution

    • Diffusion Coefficient
    • Surface area of the particles
    • Diffusion area thickness
    • solubility

In addition to the above:

  • how is Cmax affected by turning the pills into a liquid?
  • How is stability of the active ingredients affected?
  • How have you mitigated against alcohol evaportaion - which will affect concentration and therefore dose for a given volume?
  • How have you determined the saturation point for each benzodiazepine for a given volume of alcohol?
  • How is the saturation point affected by the addition of each of the possible fillers included in the pill?
  • What studies are there to determine the extended effects of vodka upon each benzodiazepine?

 

I am no pharmacologist, but I understand that the delivery system employed certainly affects bioavailability. It is not just the the amount of the active ingredient, but everything else included in the medicine. And with pills, even how the pill is constructed. On the one hand there is your word that the two delivery systems are essentially analogous, and on the other, I have the whole field of pharmacokinetics, science and stuff.

 

A simple google search for the Rx  liquid benzos will show that the each contains 3 common ingredients, 1) a benzo, 2) a solvent (alcohol or propylene glycol) and 3)water.  Different formulations will also have some stablizers, extenders, colorants, flavorants, etc, the add to its commercial acceptability, but really don't effect it's functionality.  The common solvents, alcohol or PG, will dissolve the benzo into a uniformly distributed solution, and water will dilute to a more convenient concentration.

 

Yeah. None of that answers any of my concerns.

 

Builder, please forgive my slightly sarcastic tone. I do actually and honestly appreciate that you have been working very hard to help fellow members. And it is OK to discuss titration, what you did, and what may or may not work. After all, BB is a primarily a discussion platform. But I see no basis for your unequivocal statements about there being no difference in the absorption profile between a properly manufactured pill and a 'home brew' formulation. On the contrary, there is a huge body of evidence and research to suggest that the absorption profile will change, which necessarily affects Cmax, and - unless you can prove me wrong - we have little to no idea of the effects of your 'home brew' upon bioavailability. This does not prevent individuals from doing what they feel they must, given the constraints they face with being able to obtain their benzodiazepine is smaller, more manageable doses. But when discussing this stuff, we must be transparent in acknowledging what we do not know.

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Whether you dose 2 or 3 times a day isn't going to make any difference. Your blood levels aren't going to vary enough to have any real effect.

 

And whether it's pills or liquid, 1mg diazepam is 1mg of diazepam.  Your body won't know how it got to your stomach.  I did a pills + liquid taper, because I too was intimidated by all the BS I read here on BB.  If I had to do it al over, I would have just done liquid, for the convenience. 

 

It's whatever your comfortable with.  If you like the tablets + liquid, then stay on  it.  If you think all liquid would be more convenient, then switch.

 

1mg diazepam is 1mg diazepam.

 

Specifically, what 'BS' here at BB? Really - I'd like to know!

 

OK, I found it.

 

Surely you must know for a long time there was a proliferation of posts here on BB that one could not simply begin taking a liquid benzo, that it was somehow metabolized differently, and 1) that one needed to gradually transition to liquid, and 2)  that some folks would probably not be able to take a liquid benzo.  Even I followed what seemed to be the "generally recommended" procedure of "testing" liquid doses for a trial period before actually starting to taper.  (Yes, I ignored Jana's advice, and bought into the paranoia here on BB.)  BTW, Jana once banned me from BDR because of my activity here on BB.  ::)

 

Colin, I'm not suggesting that was in any way an "official" BB position, but it certainly was the state of "conventional wisdom". 

 

And there are tons of BS shared here on BB every day, because that's just the way message boards work.

 

As per last post, really. And, although not an 'official position'* as you put it, many other and I have posted concerns that changing the delivery system will have effects upon how the medicine is absorbed.

 

* This might change.

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Even at the shortest end of the scale, diazepam has an 18 hour half-life.  The average half-life is over 2 days.  So the implications of that are variations of your intra-day dosing schedule are unlikely to have any real effect.  Diazepam is commonly Rx'd 2X/day dosing, and that is NOT because of concerns about level blood concentrations.  The reason for the usual 2X dosing is to spread the powerful sedating/depressant effect of the med.

 

 

So it's extremely unlikely that switching from 3X/day to 2X day will have any effect whatsoever (other than being more convenient!)

 

During my DLMT, I started at the usual 2X day, but varied the distribution widely, solely based on convenience.  And at 3mg, I went to 1X/day, and all liquid.  I never felt any effects from varying my doses throughout my taper.

 

Please refer to an old post of mine. It provides the math required to estimate the change in blood levels over time, based upon assumed half-life:

 

http://www.benzobuddies.org/forum/index.php?topic=6177.0

 

By the way, for diazepam (if we include the active metabolites - which we should for our purposes), the lower half-life value is usually stated as 36 hours.

 

Let's assume that an individual metabolizes diazepam (Valium) at the extreme fast end. And let's also assume that a dose is taken twice per day, and blood levels have reached steady state (after extended regular use - some weeks or more).

 

So:

Half-life: 36 hours

Time between doses: 12 hours

 

12/36=0.333

 

0.50.333=0.7937

 

That's a drop in blood levels of just over 20%.

 

Now, let's try that with a 8h interval:

Half-life: 36 hours

Time between doses: 8h

 

8/36=0.222

 

0.50.222=0.856

 

That's a drop of 14.4%

 

Let's assume a more realistic 48 hours half-life (it varies from individual to individual).

And the patient doses three times per day, 8 hours apart:

 

Half-life: 48 hours

Dosing interval: 8 hours

 

8/48=0.16666

 

0.50.16666=0.89

 

That's an 11% drop to blood levels. The above calculations take no account of the absorption profile, but that is a relatively minor effect.

 

Now, let's repeat the above, with the dose taken just twice per day:

 

Half-life: 48 hours

Dose interval: 12 hours

 

12/48=0.25

 

0.50.25=0.84

 

I think a 16% drop is a significant enough difference from 11% (and the difference would be slighter greater for those who metabolize benzodiazepine faster than the assumed 48hour half-life).

 

But it is more complicated than this. Since the total daily dose is now split into two rather than three doses, the Cmax value (maximum blood concentration) will rise. Though each dose is now 50% greater, maximum blood levels will not be 50% higher. This is because there is a greater fall in blood concentrations between doses, so it starts from a lower point. In short, blood levels oscillate a little more with the twice per day regimen, but the AUC (Area Under the Curve) -  that's the total amount of the drug absorbed - should remain unchanged.

 

I do not have time to attempt to work out (or approximate) the actual blood concentrations for a given, chronically administered dose. But I expect the above to be about right and good enough for our purposes. Besides, I expect there are utilities on the Net to allow members to better model what occurs, depending upon the assumed staring values.

 

I am not suggesting that for a long half-life benzidiazepine like diazepam switching a daily dosing regimen from three to two (or vise versa) will be a great shock (so long as the total dose for the day remains unchanged), but there will be an effect. For some, I expect the effect will be noticeable.

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Sorry to the OP, here we are again...

 

I had problems switching to liquid (vodka)... I dont expect anyone to have the exact same problems I did, Yet many people have reported issues, -Some I have seen as far back as 2013/14... There was also a little survey some time ago that had a number of negative responses... I also have had a number of people PM me saying same...

Whatever the reasons might be, I dont particularly care.. We dont need “debunking” nor to be told its BS... And I guess while it might be true that its “in some peoples heads” Bluntly stating it is so, is far from supportive for most people... I tend to be pretty quiet on it due to the potential fear factor, but that said, many of those I have spoken to about it are pretty clear and realistic or whateva people...

 

As I have said before, Often people are suffering and pinning their hopes on “Builders magic liquid” when it is only a tool in the box, and if it goes bad for them it can be a very dangerous time as those hopes are seemingly dashed on the rocks.. I would suggest we be very careful in what we say, and it has become my opinion that a slower/partial, or even a second attempt has shown very positive results with those that initially had problems...

 

Calling BS does not solve anything, I for one just get sick of bashing my head against Builders brick wall, thus perhaps in part, the possible illusion that “that view might be diminishing”.. And if infact it is, It may be for the wrong reasons that are infact contrary to the supportive BB mission...

 

“Your Story is Not My Story..”

 

... Till next time...

:(

 

Hi Cantfly,

 

I agree with your concerns. The problem is not only theoretical, but the anecdotal evidence also suggests that titration using vodka is far from plain sailing, at least for some.

 

I'm sorry that you are having such a difficult time and were not able to make a transition to liquid microtapering.  It must have been really frustrating to try a different way of tapering that you hoped would be better and have it not work out.  I agree that everyone is different and we each have to find the method that works best for us.  I think we all are suffering, but to different extents.  In some case it may be the difference between a sprained finger and a traumatically amputated arm.

 

I don't think Builder or anyone else has ever claimed that liquid tapering is magical--only that it allows you taper by a much smaller amount with less sxs than cut and hold-often quite a bit less  This has certainly been the case with me.  Dry-cutting Valium became too painful and incapacitating when I got down to a certain level.  Liquid microtapering has allowed me to keep tapering with significantly less SXS than I was experiencing when I was dry tapering.

 

For all of this criticism of Builder, I don't see anyone who provides anywhere close to as much help and information as he does.

 

I agree that builder has gone to extraordinary lengths in his attempts to help fellow travellers. I fully acknowledge that - you make a fair comment. But there is also a distinct lack of nuance in how he describes the method he used or advises. The general tone has not been one of discussion. Rather, there has been a great deal of imparting opinion and ideas as though they are 'truths'. We cannot allow that to go unchallenged. To do so would be against the whole ethos of BB, as a peer-support discussion space.

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Why is BB so committed to discouraging/intimidating folks from using this simple way to do what is almost always a more comfortable way to discontinue benzo use?

 

1) I have read literally hundreds of pages (PDLs, mfgr's professional disclosures, solvent research, etc) and I have never read a single word that suggests that a mg of liquid benzo is pharmaceutically,  medically or metabolically  any different than a mg of tablet benzo.  Not a single PDL ever suggests that the dosing instructions (other than the physical mechanics of drinking a liquid vs swallowing a tablet) should  any different for a liquid  than a tablet.  Never a word that the dosing protocol (size, frequency, timing, etc) are any different.  Never a caution that a liquid might have a different effect.

 

 

And anecdotally, both my (highly competetant) GP, and my very knowledgeable pharmacist assured me at the outset that 1mg of liquid diazepam was exactly the same as 1mg of tablet diazepam (other than the physical form)

 

And BTW, they both told me the active ingredient uniformity, and dose-to-dose constistency will be much better with liquid.  5mls of Rx liquid will always contain exactly 5mgs of diazepam, but a 5 mg tablet might range from 4.75mg to 5.25mg.  (The US Pharmacopia/FDA standards for dry tablets are actually much broader than that!)

 

2) And I remember from high school chemistry (and I don't think the physical laws of the universe have changed)…

 

When a dry substance is dissolved in a solvent, its physical structure is changed (from a discrete particle to a uniformly distributed liquid), but its chemical composition remains unchanged.  So chemically, 1mg of diazepam dissolved in 2ml of vodka or PG is still chemically the same as 1mg of dry diazepam  (And there is extensive published research on the solvency ratios, including a chart and citations in the BB archives.)

 

And diluting a solution only changes the concentration ratio, again, it will NOT change the chemical structure of the uderlying ingredients.

 

Is a "home-brew" liquid benzo as good as the Rx alternative?  Probably not.  But it's definitely "good enough"!

 

 

1mg of benzo = 1mg of benzo.

 

And no one here on BB has ever submitted a shred of  validated evidence to the contrary.

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[2e...]

I think you guys are scaring everybody to death in here with this discussion, including me.

 

I started vodka taper, because Milk didn't work for me. And now that's possibly bad?

 

I can't read the whole texts at the moment, my focus is too bad.

 

Why would vodka taper be bad?

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builder,

 

I do not have time to address all this now. But I strongly suggest you make a study of bioavailability. Yes, 1mg is 1mg. But that is not whole story. Blood levels do not vary between brands of pills simply because of differences in dosage of the active ingredient. They also vary due to bioavailability. Converting to a liquid probably incurs even greater changes to bioavailability. Then there are issues around stability with home brew formulation. I do not understand how you can dismiss these potential problems as non-existent when there is a whole branch of chemistry dedicated to their study.

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[2e...]

builder,

 

I do not have time to address all this now. But I strongly suggest you make a study of bioavailability. Yes, 1mg is 1mg. But that is not whole story. Blood levels do not vary between brands of pills simply because of differences in dosage of the active ingredient. They also vary due to bioavailability. Converting to a liquid probably incurs even greater changes to bioavailability. Then there are issues around stability with home brew formulation. I do not understand how you can dismiss these potential problems as non-existent when there is a whole branch of chemistry dedicated to their study.

 

Let me just ask you directly, Colin.

 

I'm using tablets of 2 mg, 1 mg, 0,5 mg, 0,2 mg, 0,1 mg. From taperingstrips.

 

Now I'm at 3,3 mg.

 

I take the following pills. 2 mg, 1 mg, and 0,2 mg.

 

Then I get 0,1 mg. Crush it, add 1 ml vodka. Add 49 mm water. Take 5 ml out every day.

 

Could you please explain me if there would be dangers in that? In any of that? Just for my personal reassurance?

 

Thank you!

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