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Long term alprazolam use..need to taper off from 2.5/mg


[Br...]

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Hi,

 

This is my first post. So, please excuse its length. I've been reading the board for a few hours and it is awesome!!

 

Need advice for:

Tapering down from 2.5/mg of X. Actually 3/mg, since I just started a few days ago and I may need to reevaluate my plan.

 

Quick Background:

I know the long term use of X has taken a toll on my cognitive abilities, quality of life, etc., which in my opinion has lead to some major depression and sleep problems.

 

I really want and need to taper off of X. However, after reading this board, I don't think I am going about this in the best way based on the following info from pdocs ( I've had a few pdocs due to job relocations) -

- One pdoc said in general it's O.K. to cut X down .25mg a week (didn't discuss percentages).

- Another pdoc told me in order to taper X it's best to keep spreading out the times between doses until the last dose (at night) is eliminated and then keep repeating this method.

- If you wake up late and you feel OK, just skip your morning dose....which I never could because my body/mind reminded me. :)

 

When I had discussed physical dependence with a former pdoc he said it was basically all psychological since X has a short 1/2 life and it is out of the body pretty fast AND if it was physically addicting had could I go from 8pm to 8am the next morning without it.

 

I started tapering:

 

I had been taking 1/mg of X 4xday (8am,noon,4pm,8pm) although the dosage and times had varied over the years. I never realized or knew about inter -dosage W/D.  Although, I pretty much could tell the time of day cuz my body/mind would let me know when the 4 hours was up. :D

 

On 10-22-07, I adjusted my X dosage and schedule from 1mg @ 8am,12,4pm, & 8pm TO 1mg@10am, 1mg@3pm, .5mg@7pm, and 1mg at 10pm (total 3.5mg). Obviously these changes messed me up but I hard time identifying whether these changes were affecting me or the new meds for depression that the pdoc was trying to introduce in my system . Again, the depression only started after about 8 years on X and which I feel was a major contributing factor.

 

A week later, on 10-29-07, I cut out another .5mg/day, which eliminated my 7pm dose and I readjusted my schedule again. I was then at 1mg@9am, 1mg@3pm, and  1mg@ 9pm (total 3mg). Over the next month, I needed to adjust the times to 9am,1pm, and 7pm, which affected my sleep. So, now I'm taking Ambien CR 6.25 everyday (for the last month or so) to get to sleep.

 

On 2-13-08, after seeing my pdoc (who has been advocating getting off the X but with no real plan as outlined in this forum) I decided to  drop another .5mg a day from my morning dose. So, I'm now at .5mg at 8am, the 1mg at 1pm has been moved to noon, and the last dose is 1 mg at 6pm...then an Ambien CR at 9pm, which does let me sleep.       

 

Conclusion:

 

Needless to say, this has been a very frustrating roller coaster,  which I'm sure most of you know. I can now see that I have also been  experiencing inter-dosage W/D and playing havoc with my mind/body by adjusting times/doses in this manner.

 

Questions:

 

1. At one point in a discussion with my pdoc about getting away from X (and not necessarily as a substitution for tapering) we discussed Valium but he said I wasn't a candidate for that. I'm not sure if he meant that after long term use of X he didn't want me to start using a benzo with a longer 1/2 life??? Should I address this with him again..or, since I have been able to taper off 1mg of X in the past 4 months (albeit in a difficult manner) should I try and continue to taper of X since I know the effects??  BTW, I had tried Klonopin for a very short time a few years ago and at that time it wasn't effective for me.

 

2. I'm thinking (from what I have read) that I should probably take more small doses of X during the day and eliminate Ambien to effectively taper off. What would be the suggested dosage and times?  My body seems to remind me after about 4-5 hours, perhaps going to .5mg at 8am,noon,4pm,8pm, and 11pm (total 2.5mg) would be OK for now. Or, would this be too much of a change again?

 

* I read about making the liquid to titrate down and it sounds logical but how does that work if one is out and about and can't have that refrigerated dose available?

 

Sorry for all the questions......I'm really glad to see a forum like this and I appreciate any advice. 

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hi brian welcome to benzo buddies.

 

in order for someone to help you please provide dosage you are on - exact total dosage you are on - the drug name would also be helpful and the length of time you have been on it - just the numbers so as not to confuse.

 

someone will drop in to help - and benzo's do need to be tapered at a reasonable rate - any doctor that does not know that does not know drugs - or at least not benzos.

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hi brian welcome to benzo buddies.

 

in order for someone to help you please provide dosage you are on - exact total dosage you are on - the drug name would also be helpful and the length of time you have been on it - just the numbers so as not to confuse.

 

someone will drop in to help - and benzo's do need to be tapered at a reasonable rate - any doctor that does not know that does not know drugs - or at least not benzos.

 

Hi..thank you for the welcome. 

 

I apologize for the confusion- I used X as shorthand for Xanax. I thought I saw it used that way in another thread and I put the drug name in the subject and signature line so I thought I was Ok.... sorry...my error...leave it to a newbie  ;D

 

Anyway, I just (less than a week) tapered down to 2.5mg of Alprazolam a day and I had been at 4mg/day (4 x 1mg) in 10/07 after building up to that for the past 13 years.  Right now I'm taking Alprazolam as followed: .5mg at 9am, 1mg at noon, and 1mg at 6pm (total-2.5mg/day). Since, my nightime dose of Alprazolam has been pushed forward (in the last 3 months) to 6pm I have been taking Ambien CR 6.25mg at 10pm to sleep.

 

Just to eliminate any confusion, my entire original post (except for where I specifically mentioned Ambien) dealt with times and doses for Alprazolam.

Thank you very much!   

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great job - clear and concise.

 

ok - i am the official cheer leader - and help people get info organized - however - i do not help with tapering beyond that point - some of our members and other team members can help you.

 

please feel free to read anything you would like on the forum - you may be particularly interested in the withdrawal/taper threads.

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Hi Brian,

 

Welcome to BenzoBuddies.

 

I think some of the information you received is based upon some very muddled thinking. The logic of short acting meds not being addicting is often voiced, but the plain facts of the matter is that it is repeated quick hits that are associated with addiction more than long acting substances. All benzos are addicting, irrespective of the their half-lifes. Crack cocaine is a very short acting drug - only a lunatic would suggest that is not addictive!

 

Additionally, even if the short acting theory is true, you took/take Xanax throughout the day, so you always have significant levels of Xanax within your system!

 

How long is the half-life of Ambien CR? Ordinary Ambien has a half-life of about 2 hours - even if this is doubled, it is still shorter than the half-life of Xanax (6-12 hours). And if you split these CR tablets, the half-life effect is lost - they also usually don't split very well. I would suggest that Xanax is the better candidate for withdrawal, but both are far from ideal. Titration will make it lot easier though. An alternative to liquid titration would be to use some accurate scales, some empty capsules (they can bought online very cheaply), and something to the cut the powdered Xanax (lactose would be a good choice). This is something we need to work upon, so maybe if you fancy being a little bit of guinea pig, we can work out this between us. Titration is great, but I must admit, it isn't very practical for a lot of people.

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Hi Brian,

 

Welcome to BenzoBuddies.

 

I think some of the information you received is based upon some very muddled thinking. The logic of short acting meds not being addicting is often voiced, but the plain facts of the matter is that it is repeated quick hits that are associated with addiction more than long acting substances. All benzos are addicting, irrespective of the their half-lifes. Crack cocaine is a very short acting drug - only a lunatic would suggest that is not addictive!

 

Additionally, even if the short acting theory is true, you took/take Xanax throughout the day, so you always have significant levels of Xanax within your system!

 

How long is the half-life of Ambien CR? Ordinary Ambien has a half-life of about 2 hours - even if this is doubled, it is still shorter than the half-life of Xanax (6-12 hours). And if you split these CR tablets, the half-life effect is lost - they also usually don't split very well. I would suggest that Xanax is the better candidate for withdrawal, but both are far from ideal. Titration will make it lot easier though. An alternative to liquid titration would be to use some accurate scales, some empty capsules (they can bought online very cheaply), and something to the cut the powdered Xanax (lactose would be a good choice). This is something we need to work upon, so maybe if you fancy being a little bit of guinea pig, we can work out this between us. Titration is great, but I must admit, it isn't very practical for a lot of people.

 

Hi Colin,

 

Wow, very informative....I really appreciate your prompt response. Your forum and your post is very encouraging.....

 

I would consider the powdered titration as sort of a "guinea pig"  :)

 

I'm also open to the liquid titration. However, since you mentioned practicality, what does one do if they are out and about and it is time for the next dose? Do you just take a pill that is close enough to the next scheduled liquid dosage?

 

Based on the fact that I've been on Alprazolam for 13 years and directly tapered from 4mg to 2.5 last week what would the titration schedule look like. I'm asking mainly about a time frame...and since I was able to do this (albeit with difficulty) should I see if the pdoc would entertain the notion of a substitution taper with Valium (V)?  Is the V substitution that much more effective?

 

BTW, I have just been taking the Ambien CR every night for the last two months for sleep. I didn't mention it as a consideration for a tapering/titration plan just that I guess I need to stop if I'm going to work any plan effectively. Would that be correct? 

 

In any event, I really want to do this right and stabilize my dosage ASAP for tapering/titration and get benzo free. So, please advise....

 

** Hopefully, I used the terms correctly**

 

Thanks again very much for your time!!!!!!!!!!

 

 

 

 

 

 

 

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Hi Colin,

 

Wow, very informative....I really appreciate your prompt response. Your forum and your post is very encouraging.....

 

HI Brian,

 

We do try to take a positive approach around here. Really, there can be far too much pessimism around benzo withdrawal. I'm not suggesting for a moment that some people do not have tough time, but most people, if they follow a sensible taper plan, can withdraw without too many problems.

 

I would consider the powdered titration as sort of a "guinea pig"  :)

 

Guinea pig you are then! ;)

 

I'm also open to the liquid titration. However, since you mentioned practicality, what does one do if they are out and about and it is time for the next dose? Do you just take a pill that is close enough to the next scheduled liquid dosage?

 

The titration method and tables we supply are overkill for all but the toughest of cases. The compounded pills will give you much greater control of your dosage than by pill-splitting, but not to the same degree of titration. Frankly, if someone absolutely needs to titrate one-hundredth of a pill at a time, they are unlikely to be able to be able to go to work anyway. Many who use titration could use a compounding method instead, but titration is pretty convenient if at home, and is easy to carry out (no fiddly filling of capsules).

 

Based on the fact that I've been on Alprazolam for 13 years and directly tapered from 4mg to 2.5 last week what would the titration schedule look like. I'm asking mainly about a time frame...and since I was able to do this (albeit with difficulty) should I see if the pdoc would entertain the notion of a substitution taper with Valium (V)?  Is the V substitution that much more effective?

 

It all depends up the taper rate you choose. 10% every 7-14 days is about average. I've just ran the formula, and it would take nearly 6 months for a rate of 10% every 7 days (remember, the amount cut drops as the dose drops, as the taper rate is relative to the dose); 8 months for 10% every 10 days; and nearly a year for 10% every 14 days.

 

Substituting with Valium is an option, but to a large degree depends upon where you are in world. American doctors are much more reluctant to prescribe Valium than in other countries. Also, there is some disagreement about the equivalent dose. Prof. Ashton used 20mg for 1mg Xanax, but it is usual for doctors to assume an equivalent dose of 10mgs Valium to 1mg Xanax. This is not a huge problem if just a small part of the dose is substituted at a time, and enough time is allowed between each substitution. If the ratio is not high enough, it will result in you tapering at the same time substituting - so long as this carried out slow enough, this is probably OK.

 

BTW, I have just been taking the Ambien CR every night for the last two months for sleep. I didn't mention it as a consideration for a tapering/titration plan just that I guess I need to stop if I'm going to work any plan effectively. Would that be correct?

 

Are you aware that these 'z-drugs' although technically not benzodiazepines, they act so similarly, they can be treated as benzos? In fact, because of their short half-lifes, they can make withdrawal more difficult!

 

In any event, I really want to do this right and stabilize my dosage ASAP for tapering/titration and get benzo free. So, please advise....

 

** Hopefully, I used the terms correctly**

 

Thanks again very much for your time!!!!!!!!!!

 

Yes, stabilising your dose (if it has been a bit erratic or too quick) is a good idea before continuing your taper. If you still fancy compounding your own pills, I would suggest that you first need to switch to Xanax only. If you are switching to Valium (this is the simplest solution if your doctor will prescribe it), you probably will not need to titrate or compound your pills - you are likely to be able taper off Valium by just pill-splitting.

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Hi Colin,

 

Wow, very informative....I really appreciate your prompt response. Your forum and your post is very encouraging.....

 

HI Brian,

 

We do try to take a positive approach around here. Really, there can be far too much pessimism around benzo withdrawal. I'm not suggesting for a moment that some people do not have tough time, but most people, if they follow a sensible taper plan, can withdraw without too many problems.

 

I would consider the powdered titration as sort of a "guinea pig"  :)

 

Guinea pig you are then! ;)

 

I'm also open to the liquid titration. However, since you mentioned practicality, what does one do if they are out and about and it is time for the next dose? Do you just take a pill that is close enough to the next scheduled liquid dosage?

 

The titration method and tables we supply are overkill for all but the toughest of cases. The compounded pills will give you much greater control of your dosage than by pill-splitting, but not to the same degree of titration. Frankly, if someone absolutely needs to titrate one-hundredth of a pill at a time, they are unlikely to be able to be able to go to work anyway. Many who use titration could use a compounding method instead, but titration is pretty convenient if at home, and is easy to carry out (no fiddly filling of capsules).

 

Based on the fact that I've been on Alprazolam for 13 years and directly tapered from 4mg to 2.5 last week what would the titration schedule look like. I'm asking mainly about a time frame...and since I was able to do this (albeit with difficulty) should I see if the pdoc would entertain the notion of a substitution taper with Valium (V)?   Is the V substitution that much more effective?

 

It all depends up the taper rate you choose. 10% every 7-14 days is about average. I've just ran the formula, and it would take nearly 6 months for a rate of 10% every 7 days (remember, the amount cut drops as the dose drops, as the taper rate is relative to the dose); 8 months for 10% every 10 days; and nearly a year for 10% every 14 days.

 

Substituting with Valium is an option, but to a large degree depends upon where you are in world. American doctors are much more reluctant to prescribe Valium than in other countries. Also, there is some disagreement about the equivalent dose. Prof. Ashton used 20mg for 1mg Xanax, but it is usual for doctors to assume an equivalent dose of 10mgs Valium to 1mg Xanax. This is not a huge problem if just a small part of the dose is substituted at a time, and enough time is allowed between each substitution. If the ratio is not high enough, it will result in you tapering at the same time substituting - so long as this carried out slow enough, this is probably OK.

 

BTW, I have just been taking the Ambien CR every night for the last two months for sleep. I didn't mention it as a consideration for a tapering/titration plan just that I guess I need to stop if I'm going to work any plan effectively. Would that be correct?

 

Are you aware that these 'z-drugs' although technically not benzodiazepines, they act so similarly, they can be treated as benzos? In fact, because of their short half-lifes, they can make withdrawal more difficult!

 

In any event, I really want to do this right and stabilize my dosage ASAP for tapering/titration and get benzo free. So, please advise....

 

** Hopefully, I used the terms correctly**

 

Thanks again very much for your time!!!!!!!!!!

 

Yes, stabilising your dose (if it has been a bit erratic or too quick) is a good idea before continuing your taper. If you still fancy compounding your own pills, I would suggest that you first need to switch to Xanax only. If you are switching to Valium (this is the simplest solution if your doctor will prescribe it), you probably will not need to titrate or compound your pills - you are likely to be able taper off Valium by just pill-splitting.

 

Hi Colin,

 

Thank you for addressing each item/concern.

 

Based on your reply and reading a few other topics, not to mention having an American doctor - I think it's best for me to go with compounding my own pills.

 

My dosage in the past 4 months has been eratic and probably too quick.

Just a quick recap- I was at 1mg (4 x day) in 10/07. I then cut my third dose in 1/2 to 0.5mg and about a week later I eliminated what was left of that 3rd dose (0.5mg) to bring me down to 3mg a day.  I then re-adjusted the schedule to accomodate the new 1mg (3 x day) regime.   

 

Last week I dropped to 2.5mg a day by cutting 1 of my 3 daily 1mg doses in 1/2.  This obviously isn't the best way to do it and my pdoc hasn't advised otherwise.

 

So, I could definitely use your expertise on getting started with a 10% reduction taper table. I'll probably try a 7 or 10 day taper rate, but I understand I may need to vary the time frame as needed. Thank you for providing the time frames for 7, 10, and 14 day rate reduction. It was very enlightening.

 

My thoughts- although I don't wish to loose any ground, I'm thinking it's probably best to go back up to 3mg (0.75 x 4) a day to stabilize and eliminate the Ambien. The 4 x day regime (from a few months ago) I think worked better for me and should keep the blood level more even (yes?, no?, maybe?) and give me a dose closer to bedtime, which I had eliminated in Oct and then had to start taking Ambien to make up for the lose.   

 

Does this sound like a good way to get started?  If so, what's the next step? 

 

Thanks again very very much.

 

     

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Hi,

 

If you find that you begin to suffer withdrawal symptoms between doses, then you might well benefit from switching back to a four-times-a-day schedule.

 

Ashton's equivalence for Valium:Ambien is 40:1. If I understand correctly, you take 6.25mg of Ambien; equivalent to about 0.16mg Xanax. In which case, you might be better to take just a quarter of a Xanax pill (0.25mg) to replace the Ambien. Your total daily dose (of benzos and benzo-like meds) would a little (about 0.09mg). You could always shift a little more of your daily dose to the nighttime dose if you find the 0.25mg of Xanax is not enough. Unless you are feeling very unwell from your previous cut, it is better to not unduly increase your dose.

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Hi Colin,

 

I could use some clarification and further info please....

 

Hi,

 

If you find that you begin to suffer withdrawal symptoms between doses, then you might well benefit from switching back to a four-times-a-day schedule.

 

Yes, based on the past few months, I think four-times-a-day would be best.

 

Ashton's equivalence for Valium:Ambien is 40:1.

 

Did you mean the Xanax:Ambien equivalence is 40:1 since I'm not taking Valium?

 

If I understand correctly, you take 6.25mg of Ambien; equivalent to about 0.16mg Xanax. In which case, you might be better to take just a quarter of a Xanax pill (0.25mg) to replace the Ambien.

 

I understand this substitution dosage. I just don't know how I would taper this off at the same time I would be tapering off the other 3 larger doses. Would I just stay at 0.25 to replace the Ambien during my entire tapering schedule?   Or, perhaps the four equal doses would be best????

 

Your total daily dose (of benzos and benzo-like meds) would a little (about 0.09mg).

 

I'm sorry but I don't understand this...what does the 0.09mg refer to?? Did I miss something?

 

You could always shift a little more of your daily dose to the nighttime dose if you find the 0.25mg of Xanax is not enough. Unless you are feeling very unwell from your previous cut, it is better to not unduly increase your dose.

 

I understand. Since I dropped down to 2.50mg from 3.0mg (which was more than 10%) and I should now add 0.25mg to substitute for the Ambien I guess I'm looking right now at 2.75mg per day.

 

I started a spreadsheet (see below) for a withdrawal schedule at the recommended 10% reduction and divided the total daily dosage by four to determine each dose. I didn't complete it yet until you advise if I'm on the right track or is it going overboard?  :idiot:

 

If this looks O.K., what I could really use now is how to compound my own pills:

1. Is this the method you referred to by crushing the pill and filling up empty capsules?

2. Do I need a scale or can it be the crush and cut with a credit card method that I saw in another topic. If so, is this an accurate enough method to divide the doses?

 

 

Thanks again!

 

 

 

                Morning Noon Late afternoon  Night/Bed Daily Total

Starting Dosage      0.69 0.69   0.69      0.69              2.75

Stage 1 (7-10 days)   0.62 0.62   0.62      0.62              2.48

Stage 2 (7-10 days)   0.56 0.56   0.56      0.56              2.23

Stage 3 (7-10 days)   0.50 0.50   0.50      0.50              2.00

Stage 4 (7-10 days) 1.80

Stage 5 (7-10 days) 1.62

Stage 6 (7-10 days) 1.46

Stage 7 (7-10 days) 1.32

Stage 8 (7-10 days) 1.18

Stage 9 (7-10 days) 1.07

Stage 10 (7-10 days) 0.96

Stage 11 (7-10 days) 0.86

Stage 12 (7-10 days) 0.78

Stage 13 (7-10 days) 0.70

Stage 14 (7-10 days) 0.63

Stage 15 (7-10 days) 0.57

Stage 16 (7-10 days) 0.51

Stage 17 (7-10 days) 0.46

Stage 18 (7-10 days) 0.41

Stage 19 (7-10 days) 0.37

Stage 20 (7-10 days) 0.33

Stage 21 (7-10 days) 0.30

Stage 22 (7-10 days) 0.27

Stage 23 (7-10 days) 0.24

Stage 24 (7-10 days) 0.22

Stage 25 (7-10 days) 0.20

Stage 26 (7-10 days) 0.18

 

   

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Hi Colin,

 

I could use some clarification and further info please....

 

Hi,

 

If you find that you begin to suffer withdrawal symptoms between doses, then you might well benefit from switching back to a four-times-a-day schedule.

 

Yes, based on the past few months, I think four-times-a-day would be best.

 

Ashton's equivalence for Valium:Ambien is 40:1.

 

Did you mean the Xanax:Ambien equivalence is 40:1 since I'm not taking Valium?

 

I'm not sure what I meant either. I was switching between a lot of different posts when wrote the above, and you did mention that you might obtain Valium.  I dunno - I was tired. :( Xanax:Ambien ratio is about 1:2 according to Ashton.

 

If I understand correctly, you take 6.25mg of Ambien; equivalent to about 0.16mg Xanax. In which case, you might be better to take just a quarter of a Xanax pill (0.25mg) to replace the Ambien.

 

I understand this substitution dosage. I just don't know how I would taper this off at the same time I would be tapering off the other 3 larger doses. Would I just stay at 0.25 to replace the Ambien during my entire tapering schedule?  Or, perhaps the four equal doses would be best????

 

Yeah, I did mix up some things above. 6.25mg of Ambien is equivalent to about 3mg Xanax. You know, I had a feeling I was doing something wrong at the time. :-[ Forget what I wrote above.

 

Your total daily dose (of benzos and benzo-like meds) would a little (about 0.09mg).

 

I'm sorry but I don't understand this...what does the 0.09mg refer to?? Did I miss something?

 

Forget this too. It was based upon the previous paragraph. It also contained a typo - it should have read: "would be a little less". It is wrong anyway.

 

You could always shift a little more of your daily dose to the nighttime dose if you find the 0.25mg of Xanax is not enough. Unless you are feeling very unwell from your previous cut, it is better to not unduly increase your dose.

 

I understand. Since I dropped down to 2.50mg from 3.0mg (which was more than 10%) and I should now add 0.25mg to substitute for the Ambien I guess I'm looking right now at 2.75mg per day.

 

Of course, again, my figures are wrong. You do not need to shift anything towards your nighttime dose, as it is already large (equivalent to just over 3mg Xanax). When tapering, you might benefit from tapering just your nighttime dose, at first, until it is nearer the amount of your other three doses.

 

I started a spreadsheet (see below) for a withdrawal schedule at the recommended 10% reduction and divided the total daily dosage by four to determine each dose. I didn't complete it yet until you advise if I'm on the right track or is it going overboard?  :idiot:

 

If this looks O.K., what I could really use now is how to compound my own pills:

1. Is this the method you referred to by crushing the pill and filling up empty capsules?

2. Do I need a scale or can it be the crush and cut with a credit card method that I saw in another topic. If so, is this an accurate enough method to divide the doses?

 

 

Thanks again!

 

 

 

                Morning Noon Late afternoon  Night/Bed Daily Total

Starting Dosage      0.69 0.69   0.69      0.69              2.75

Stage 1 (7-10 days)   0.62 0.62   0.62      0.62              2.48

Stage 2 (7-10 days)   0.56 0.56   0.56      0.56              2.23

Stage 3 (7-10 days)   0.50 0.50   0.50      0.50              2.00

Stage 4 (7-10 days) 1.80

Stage 5 (7-10 days) 1.62

Stage 6 (7-10 days) 1.46

Stage 7 (7-10 days) 1.32

Stage 8 (7-10 days) 1.18

Stage 9 (7-10 days) 1.07

Stage 10 (7-10 days) 0.96

Stage 11 (7-10 days) 0.86

Stage 12 (7-10 days) 0.78

Stage 13 (7-10 days) 0.70

Stage 14 (7-10 days) 0.63

Stage 15 (7-10 days) 0.57

Stage 16 (7-10 days) 0.51

Stage 17 (7-10 days) 0.46

Stage 18 (7-10 days) 0.41

Stage 19 (7-10 days) 0.37

Stage 20 (7-10 days) 0.33

Stage 21 (7-10 days) 0.30

Stage 22 (7-10 days) 0.27

Stage 23 (7-10 days) 0.24

Stage 24 (7-10 days) 0.22

Stage 25 (7-10 days) 0.20

Stage 26 (7-10 days) 0.18

 

The above starting dose is based upon my incorrect figures though. I don't think you need to consider titration yet, as your nighttime dose should taperable by pill-splitting - at least until the dose is considerably reduced. I think there is no need for you to complicate your taper with titration at this stage. When you reach a dose that makes sensible cuts by pill-splitting unviable, then we could look at titration again. Does this make sense?

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Hi

Sorry this seems off to me, 6.25 mg 0f Ambien = 3mg of Xanax This seems extremly high, I admit I didnt check Ashton

Bobers

 

Hi Bobers,

 

Thank you very much for reviewing the posts. It's a great "checks and balances" that the forum has implemented.

 

I was surprised by that as well and I checked Ashton. Colin was correct the first time with the 40:1 ratio. It was just mislabeled as Valium instead of Xanax that caused the confusion. Therefore, I could substitute .25mg of Xanax for 6.25mg of Ambien.

 

I'm actually working on a taper schedule starting at 2.75mg/day and cutting .125mg every 7-10 days, which is less than the allowed/suggested 10% and it will allow me to pill cut until I get to about .5mg/day (stage 18) then I need to either reduce the number of doses or titrate down across the 4 doses. I'll post it for advice when I'm done.

 

Thank you very much!

 

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Hi,

 

Seems I was right the first time. I'm a bit feverish - I'm down with a bug. Can't wrap my head around figures at the monent. I'm not too bad, so hopefully I'll be a lot better tomorrow. I'll look at this again then.

 

. . . . I've just checked, and I was right: Xanax:Ambien 1:40 according to Ashton. Other authorities might have it less, maybe half that ratio. Again, I'll check it tomorrow. I'm off to bed.

 

Sorry for the confusion, Brian.

 

Colin.

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I was surprised by that as well and I checked Ashton. Colin was correct the first time with the 40:1 ratio. It was just mislabeled as Valium instead of Xanax that caused the confusion. Therefore, I could substitute .25mg of Xanax for 6.25mg of Ambien.

 

Hi,

 

Our posts crossed.

 

Yes, that makes sense now. I see the mistake I made. Hopefully, I'll look back at this tomorrow.

 

We don't give taper advice over the PM system for this very reason. It is important that others review our posts.

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I was surprised by that as well and I checked Ashton. Colin was correct the first time with the 40:1 ratio. It was just mislabeled as Valium instead of Xanax that caused the confusion. Therefore, I could substitute .25mg of Xanax for 6.25mg of Ambien.

 

Hi,

 

Our posts crossed.

 

Yes, that makes sense now. I see the mistake I made. Hopefully, I'll look back at this tomorrow.

 

We don't give taper advice over the PM system for this very reason. It is important that others review our posts.

 

Hi Colin,

 

I hope you are feeling better today.

 

I stopped taken Ambien last night and have substituted xanax for it so I can deal with one drug to taper evenly. My plan is to proceed with xanax 4-times-a -day and cut the daily dosage by 0.125mg every 7-10 days. The 0.125mg is within the accepted/recommended 10% cut for almost all steps but the last few. If I cut 0.125 on each step it will allow me to just pill split using the manufactured 0.25 and 0.5 pills.

 

Please let me know if the following looks O.K.   Or, if anyone sees something I missed that may be a concern......

 

Thanks!   

 

 

                                  AM     Noon     Eve     Bed      Daily

Starting Dosage         0.750   0.750   0.500 0.750 2.750

Stage 1   (7-10 days) 0.625 0.625 0.625 0.750 2.625

Stage 2   (7-10 days) 0.625 0.625 0.625 0.625 2.500

Stage 3   (7-10 days) 0.625 0.625 0.500 0.625 2.375

Stage 4   (7-10 days) 0.500 0.625 0.500 0.625 2.250

Stage 5   (7-10 days) 0.500 0.625 0.500 0.500 2.125

Stage 6   (7-10 days) 0.500 0.500 0.500 0.500 2.000

Stage 7   (7-10 days) 0.375 0.500 0.500 0.500 1.875

Stage 8   (7-10 days) 0.375 0.500 0.375 0.500 1.750

Stage 9   (7-10 days) 0.375 0.375 0.375 0.500 1.625

Stage 10 (7-10 days) 0.375 0.375 0.375 0.375 1.500

Stage 11 (7-10 days) 0.250 0.375 0.375 0.375 1.375

Stage 12 (7-10 days) 0.250 0.250 0.375 0.375 1.250

Stage 13 (7-10 days) 0.250 0.250 0.250 0.375 1.125

Stage 14 (7-10 days) 0.250 0.250 0.250 0.250 1.000

Stage 15 (7-10 days) 0.125 0.250 0.250 0.250 0.875

Stage 16 (7-10 days) 0.125 0.250 0.125 0.250 0.750

Stage 17 (7-10 days) 0.125 0.125 0.125 0.250 0.625

Stage 18 (7-10 days) 0.125 0.125 0.125 0.125 0.500

Stage 19 (7-10 days) 0.125 0.000 0.125 0.125 0.375

Stage 20 (7-10 days) 0.125 0.000 0.125 0.000 0.250

Stage 21 (7-10 days) 0.125 0.000 0.000 0.000 0.125

Stage 22 (7-10 days) 0.000 0.000 0.000 0.000 0.000

 

 

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Hi Brian,

 

That looks fine. Your initial cuts amount to about 5% of your dose, so you might find that you can make new cuts before 7 days - this fine. So long as you only make new cuts once you feel reasonably recovered from the previous cut, you can make a new cut. As these cuts account for a larger percentage of your dose (as you dose decreases), you might find you need to extend the time between new cuts as your taper progresses.

 

When you are on a low dose, it is less of an issue that your cuts account for more than 10% of your dose. By this stage, so long as you have followed a sensible taper plan, your own natural GABA processes will have largely taken of the role the Xanax used to play. So, Xanax plays only a small part in your GABA functioning by this stage.

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^what are you considering to be a "low dose"?

 

i always thought that when you got down lower you needed to reduce the size of your cuts. but im no expert, that's why i'm here  ;D

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hi mike i am no expert either - i don't even dabble in tapers and titration's- but yes your cuts/tapers/titration need to be smaller the lower you get.
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There is no hard fast rule, some people slow down there taper at lower doses some do not, it depends on how your responding both physically and psychologically.

Bobers

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Hi Brian,

 

That looks fine. Your initial cuts amount to about 5% of your dose, so you might find that you can make new cuts before 7 days - this fine. So long as you only make new cuts once you feel reasonably recovered from the previous cut, you can make a new cut. As these cuts account for a larger percentage of your dose (as you dose decreases), you might find you need to extend the time between new cuts as your taper progresses.

 

When you are on a low dose, it is less of an issue that your cuts account for more than 10% of your dose. By this stage, so long as you have followed a sensible taper plan, your own natural GABA processes will have largely taken of the role the Xanax used to play. So, Xanax plays only a small part in your GABA functioning by this stage.

 

Colin,

 

Ok...thanks again very much for the info.

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There is no hard fast rule, some people slow down there taper at lower doses some do not, it depends on how your responding both physically and psychologically.

Bobers

 

Hi Bobers,

 

Thanks for your input. I will keep this in mind...if I can remember  ;D

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^what are you considering to be a "low dose"?

 

i always thought that when you got down lower you needed to reduce the size of your cuts. but im no expert, that's why i'm here  ;D

 

Mike,

 

Good question. May I ask if you are just pill splitting to get down to the 0.0625mg listed in your signature block?  Are you just taking a "white" (.25mg) and splitting into quarters?  Does it come out Ok?

 

Tks!

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^what are you considering to be a "low dose"?

 

i always thought that when you got down lower you needed to reduce the size of your cuts. but im no expert, that's why i'm here  ;D

 

Hi,

 

Yes, this is true. However, Brian is intending to make smaller cuts than most people can manage at the beginning of his taper. Further into the taper, his cuts are more average is size. He could make even smaller cuts at the end if he uses 0.25mg tablets and divides them into quarters - this, I'd recommend. The biggest obstacle to smaller cuts is the dose of the tablets used during withdrawal. Smaller tablets allow for smaller cuts - this is a good thing. So, yes, cuts of 0.0625mg (a quarter of a 0.25mg tablet) would probably be beneficial once his dose is down to about 0.75mg per day. Brian might benefit from switching to 0.25mg tablets before then. It is for Brian to determin when he might benefit from smaller cuts.

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