Just started my crossover

[[Pa...]]

I’m currently in the middle of increasing my Zoloft dose from 50 up to 100.  Not sure if I should wait on increasing my Zoloft during this benzo transition or if I should just continue.

 

What does your doctor say to do?

[[mr...]]

Go up but I may just tie traits slowly.  67.5 …75…..etc

[[mr...]]

Here is what I am gonna do.  Look ok?

 

 

At start

AM 0.5mg K

PM 0.5mg K

 

7 Days

9 AM - 0.25mg K

3 PM - 0.25mg K

BED - 10mg V

 

7 Days

9 AM - 5mg V

3 PM - 0.25mg K

BED - 10mg V

 

7 Days

9 AM 5mg V

3 PM - 5mg V

BED - 10mg V

 

At end

AM 10mg V

PM 10mg V

 

Once stable…move to 15mg Valium

[[mr...]]

What is the difference between a 3 step vs 6 step crossover?

 

 

Below is what I am going to do.

 

 

 

At start

AM 0.5mg K

PM 0.5mg K

 

7 Days

9 AM - 0.25mg K

3 PM - 0.25mg K

BED - 10mg V

 

7 Days

9 AM - 5mg V

3 PM - 0.25mg K

BED - 10mg V

 

7 Days

9 AM 5mg V

3 PM - 5mg V

BED - 10mg V

 

 

[[sl...]]

Thanks for starting your own thread mrcybershow!

 

What is the difference between a 3 step vs 6 step crossover?

 

A 6 step crossover has 3 more steps and takes typically twice as long as a 3 step crossover. IMHO, the more steps in a crossover the easier it is to make the transition (to a certain point), so I think a 6 step crossover is much more likely to be better tolerate and thus have a higher chance of success than a 3 step.

 

Your 3 step crossover plan, including a switch from 2x per day to 3x per day, is much better in my opinion than a sudden crossover. The steps are uneven; your first step is both a dosage scheduling adjustment AND a 50% substitution, while your last two steps are each 25% substitutions. I think this isn't the smoothest way to implement a 3 step crossover.

 

I do like the 1 week hold times; I personally would use this as a minimum hold time, but I know your probably pushing the limits of the current medical support and medication you have on hand. I suspect this is also what you're making such a large substitution in your first step.

 

So if this is your best option, and you're comfortable with the risks and limitations of this approach, I think it could definitely work. Alternatively, I wonder if you've considered finding a new prescribing doctor; personally I've had good success scheduling and getting support with slow tapering from psyche nurse practitioners here in the US.

 

I hope this helps. 

[[sl...]]

I gave you feedback on this crossover schedule in your tapering thread here:

http://www.benzobuddies.org/forum/index.php?topic=263894.msg3328213#msg3328213

 

But to summarize...

 

Your 3 step crossover plan, including a switch from 2x per day to 3x per day, is much better in my opinion than a sudden crossover. The steps are uneven; your first step is both a dosage scheduling adjustment AND a 50% substitution, while your last two steps are each 25% substitutions. I think this isn't the smoothest way to implement a 3 step crossover.

 

I do like the 1 week hold times; I personally would use this as a minimum hold time, but I know your probably pushing the limits of the current medical support and medication you have on hand. I suspect this is also what you're making such a large substitution in your first step.

 

So if this is your best option, and you're comfortable with the risks and limitations of this approach, I think it could definitely work. Alternatively, I wonder if you've considered finding a new prescribing doctor; personally I've had good success scheduling and getting support with slow tapering from psyche nurse practitioners here in the US.

 

I hope this helps. 

[[mr...]]

Then how would I do a smaller replacement at the beginning?

[[sl...]]

Then how would I do a smaller replacement at the beginning?

 

I think this might depend entirely on how many clonazepam tablets you have available. If your supply is very limited, I think cutting your clonazepam dose in half at the beginning might be the only way to get more than two steps.

 

Alternatively, if you have enough tablets, I'd consider doing 4 steps, each substituting 0.25mg of clonazepam for 5mg diazepam, with a 1 week minimum hold time between steps. These 4 steps could be taken either by dosing 2x per day and substituting a half a dose at each step, or by transitioning to 4x per day and substituting one dose at each step (with my preference being the former).

 

From my perspective a lot about your situation is constrained. Your lack of medical support, lack of preparedness in terms of stashing clonazepam or adjusting your dosage schedule in advance, and your preference to not dose diazepam and clonazepam at the same time of day; these are not, in my opinion, optimal conditions. I'm not trying to be negative, I'm just telling you why I said your 3 step crossover schedule wasn't "the smoothest way", but why I also said I thought that given your situation if this was your best option, I think it could work.

 

I hope this is some help. 

 

EDIT: P.S. If you did a 4 step crossover, from 1mg/day clonazepam at the start and reducing 0.25mg/step with 1 week minimum holds between steps, it seems to me that you'd need a minimum of 10.5mg of clonazepam or 21x 0.5mg tablets to complete the crossover.

[[mr...]]

So if I was to do four times a day what times would you recommend?

 

 

9 AM - 0.25mg K

3 PM - 0.25mg K

BED - 10mg V

[[mr...]]

Does this look better?

 

At start

9 AM - 0.25mg K

3 PM - 0.25mg K

BED - 0.5mg K

 

7 Days

9 AM - 5mg V

3 PM - 0.25mg K

BED - 0.5mg K

 

7 Days

9 AM - 5mg V

3 PM - 5mg V

BED - 0.5mg K

 

7 Days

9 AM 5mg V

3 PM - 5mg V

BED - 10mg V

[[sl...]]

So if I was to do four times a day what times would you recommend?

 

For dosing schedules, I like to leave a minimum of 8 hours between two doses for sleep and then dividing the remaining time up as evenly as possible.

 

For 4x per day two possibilities I like are 8-5-6-5 and 9-5-5-5; those are the times between doses. For 9-5-5-5 for example, I'd wake up and dose, wait 5 hours, dose, wait 5 hours, dose, wait 5 hours, dose, and go to sleep for 9 hours before waking up to repeat this again. I'm not being specific about the exact times of day because these dose times can be earlier in the morning or later at night depending on individual sleep preference, but for example 9-5-5-5 could be 7am, 12pm, 5pm, 10pm.

 

Regarding your new 3 step crossover schedule, I like that you start having already adjusted to 3x per day. I like that you start by replacing and adjusting to only 25% of your total benzo dosage, which I suspect will be easier at that point. However, since your still only doing three steps, I see that your last step is now the 50% substitution, which is still a potential increase in symptom intensity and doing this at the end of the taper really doesn't save your clonazepam tablets like it would at the beginning.

 

How many clonazepam tablets do you have, if you don't mind sharing?

[[mr...]]

The reason I went to the three steps because I have really bad insomnia I need my largest dose at night time. 

 

 

I have about 15 .5mg pills left.

[[mr...]]

Or is it best to change the evening dose first?

[[sl...]]

Hi mrcybershow,

After hearing about your insomnia, I started to think that your last taper plan, the 25%, 25%, 50% substitution, leaving the large PM substitution for last, could be the best tolerated in your situation. I would hope that the two ongoing diazepam doses in the AM would then support you in some ways through the PM transition at the end. Unfortunately for this crossover plan you'd need, at a minimum, 17.5x 0.5mg tablets. If my math is correct, even if you started today you'd run out of clonazepam four days into Step 2.

 

I wish I could give you some of my tablets! I have made it a priority to have extra, ever since I realized how disastrously dependent I was on clonazepam.

 

I know you previously felt better on diazepam, but I'm wondering if in your present situation it might be better to keep an ongoing prescription for clonazepam at 1mg/day and taper at home down to at least 0.5mg/day, the Ashton-equivalent of your previous diazepam dose. At that point I think you may have relieved some of the issues you're experiencing on higher doses of clonazepam (I had MANY, just due to excess dosage) and potentially a stockpile of tablets, IMO putting you in a much much better position to slowly step-wise cross to diazepam.

 

Is there anything keeping you from collecting an ongoing clonazepam prescription and direct tapering this drug as a first phase of your recovery?

[[mr...]]

I am working on collecting more Clonazepam. 

 

 

I didn’t care for Klonopin because I am still a little Shaky.  I believe the valium with fix that in terms of calmness. 

[[sl...]]

I didn’t care for Klonopin because I am still a little Shaky.  I believe the valium with fix that in terms of calmness. 

 

I wonder if this shakiness isn't a side effect of a rapid short-to-long crossover, your dramatic forced updose in benzo equivalency, and/or ongoing neurological instability.

 

In my experience, psyche medications are very very complex in their effects; what one of these drugs and dosage did last week or last year may never happen again, or may persist despite every effort to adjust dosage, drug form or drug. The interrelationship between how we think and feel and the chemistry altered by these psychotropic drugs is so troublingly complex, I think those of us who accept these delay-tactics as remedies do so at incredible personal risk; a risk which is vastly underplayed by advertising, the medical industrial complex, and prescribers.

 

I hope you find the calmness you're looking for. I suggest in the meantime taking any opportunities that you have to learn self-soothing skills. Keep us posted on how we can help. 

[[mr...]]

I haven’t started the crossover yet. 

[[sl...]]

I haven’t started the crossover yet.

 

Sorry, typo. I meant "rapid long-to-short crossover" in my first sentence of my previous post; I was referring to the effects of jumping suddenly from diazepam to clonazepam which like any long-to-short crossover causes a spike in total benzo blood serum levels, and a potentially uncomfortable withdrawal from this spike in the weeks following.

[[mr...]]

This hospital did it.  Been on K since Nov 20, 2021

 

 

Long story I was on 10mg of Valium a day but mainly at night for sleep anxiety since 2012 to 2021 due to military PTSD.

 

I switched to Ambien 5mg back in early 2021 which I then increased to 30 mg a night for a few months.  On 7 Sept 2021 I had a major panic attack from a buildup of stress.

 

When this happened I developed bad anxiety and agoraphobia and was bedbound for 2 months and took Ambien 30mg a night to sleep and stop the anxiety.

 

When this occurred, I stopped my Zoloft 50mg cold turkey when my panic attack happened because too much time passed and I was scared to restart. When I was bed-bound from Sept-Nov 15, I was taking 30mg Ambien night and each day was having horrible inter-dose withdrawals which I never knew about.

 

I went to a behavioral hospital for 10 days because I wanted to get back on track and got out the day before Thanksgiving. 

 

The hospital put me back on 50mg Zoloft, 1mg Klonopin (I assume to replace the Ambien) and 300mg Gabapentin 3x a day.

I’ve been on the Klonopin Gabapentin for about a month so far.

 

Medication History

 

2012-Mar 2021

25-100mg Zoloft / stopped C/T

5-10mg Valium / Nightly - stopped C/T

 

3/21 - 09/21

5mg Ambien / Nightly

 

09/21 - Nov 15 2021

30mg Ambien / Nightly

(Experienced bad inter-dose withdrawals)

 

Nov 15, 2021

Admitted myself to a behavioral hospital to get stable. 

 

 

Nov 24 2021- Current

1mg Klonopin .5mg AM / .5mg PM

150mg Gabapentin 3x a day

50mg Zoloft

50mg Trazodone

[[mr...]]

Does something like this look better?  I just wish my nighttime dose was higher.

 

 

At start

8 AM - 0.25mg K

1 PM - 0.25mg K

6 PM - 0.25mg K

BED - 0.25mg K

 

7 Days

8 AM - 0.25mg K

1 PM - 0.25mg K

6 PM - 0.25mg K

BED - 5mg V

 

7 Days

8 AM - 0.25mg K

1 PM - 0.25mg K

6 PM - 5mg V

BED - 5mg V

 

 

7 Days

8 AM - 0.25mg K

1 PM - 5mg V

6 PM - 5mg V

BED - 5mg V

 

 

7 Days

8 AM - 5mg V

1 PM - 5mg V

6 PM - 5mg V

BED - 5mg V

 

 

I eventually only want to take Valium only at night

[[sl...]]

Hi mrcybershow,

I remember about the hospital; I wasn't meaning to imply you did that rapid crossover to yourself, nor would I be judging if you had. Thank you for telling us more details about your journey; it sounds like the diazepam has not been enough support for your PTSD in general (and whatever other diagnoses you've accepted). You probably know this, but benzodiazepines (including diazepam) are not recommended by trauma-informed resources as any sort of long-term support for PTSD.

 

Benzodiazepines are medications given by a doctor to improve symptoms such as anxiety and sleep. They have not been shown to help with PTSD symptoms and can have serious side effects over time. There are better PTSD treatment options, like trauma-focused psychotherapies (a type of talk therapy) and certain antidepressant medications.

Read more from the source: https://www.ptsd.va.gov/understand_tx/benzos_ptsd.asp

 

Yes, your proposed 4-step crossover looks better to me. This is just based on my opinions and experience supporting other members; I have never crossed before. If I remember, 4 steps like this 1 week apart will require a minimum of 21x 0.5mg clonazepam tablets.

 

You could consolidate your diazepam doses to the evening after crossing, but I think having your doses spread out during the cross may help to make your crossover symptoms more manageable. I suggest playing this consolidation by ear once you've crossed, consolidating one dose at a time and evaluating the effects.

 

Not to beat a dead horse, but I think using diazepam as a sleeping pill is dangerous and not a viable long-term strategy for sleep; a family member (also a doctor) told me that it has been shown in recent years that benzodiazepines significantly impair sleep quality. I am also a PTSD survivor, and IMO sleep is extremely important for healing.

 

The Insomnia board has a great post pinned at the top about ideas for approaching insomnia. I've found many of the ideas listed there true and relevant to my own recovery. Mostly this consists of getting over a fear of insomnia, and using any time I'm awake in the night to practice self-soothing my nervous system using progressive relaxation or just a "whatever" attitude. This might sound impossible, but I've been a paranoid nervous insomniatic wreck before and during my initial benzo recovery, and everything has changed with sleep practice and slow tapering. I also do regular trauma-informed psychotherapy...

 

Let us know how we can help. 

[[mr...]]

Been on 1 mg of Klonopin per day for 1 month.

 

I am only looking for anyone who has crossed over from Klonopin to Valium.

 

 

I currently take:

 

0.25mg AM

0.25mg AFTERNOON

0.50mg NIGHT

 

 

Please let me know what your schedule was crossing over.

 

 

 

 

Medication History

 

2012-Mar 2021

25-100mg Zoloft / stopped C/T

5-10mg Valium / Nightly - stopped C/T

 

3/21 - 09/21

5mg Ambien / Nightly

 

09/21 - Nov 15 2021

30mg Ambien / Nightly

(Experienced bad inter-dose withdrawals)

 

Nov 15, 2021

Admitted myself to a behavioral hospital to get stable. 

 

 

Nov 24 2021- Current 

1mg Klonopin .25mg AM / .25mg AFTERNOON / .5mg PM

150mg Gabapentin 3x a day

50mg Zoloft

50mg Trazodone

[[sl...]]

Have you considered searching the forum?

https://duckduckgo.com/?t=ffab&q=klonopin+to+valium+site%3Abenzobuddies.org

[[Tr...]]

I did this recently. You can look back on my posts 👍🏻

[[mr...]]

Do you think a schedule like below looks ok?

 

 

 

At start

8 AM - 0.25mg K

1 PM - 0.25mg K

6 PM - 0.25mg K

BED - 0.25mg K

 

7 Days

8 AM - 0.25mg K

1 PM - 0.25mg K

6 PM - 0.25mg K

BED - 5mg V

 

7 Days

8 AM - 0.25mg K

1 PM - 0.25mg K

6 PM - 5mg V

BED - 5mg V

 

 

7 Days

8 AM - 0.25mg K

1 PM - 5mg V

6 PM - 5mg V

BED - 5mg V

 

 

7 Days

8 AM - 5mg V

1 PM - 5mg V

6 PM - 5mg V

BED - 5mg V