seeking advice for ativan to valium cross

[[Mo...]]

Hi there,

 

In May 2022 I started a liquid micro-taper of the Ativan I've been taking since 2021. So far I've only been targeting my daytime doses since I can't manage the coordination of dealing with liquid doses in the middle of the night (daily total is now 0.67mg). I'm now quite low in the daytime (0.0425mg/dose) and would like to start crossing the nighttime doses to valium in order to make tapering those doses more feasible. (I know that it's generally recommended to stay with the current med for the duration of a taper but I really can't see how I can go lower than what I am on now without crossing  -- though if you have ideas please let me know).

 

My GP is not the best but generally goes along with what I request. In the past I asked him in a hypothetical way if he would be open to switching me over to Valium at some point and he said yes although he indicated that the equivalent is 1mg Ativan = 5mg Valium. I know that this is half of what is indicated in the Ashton manual. I've done searches to see what other sources say and it seems like there's a really broad range of opinions typically ranging from 1mg Ativan being equivalent to 2.5-8mg Valium. Are the Ashton equivalency tables still considered to be accurate? As far as my GP knows I am still on my earlier dose of 2.5mg/day so I do have some wiggle room but would like to know if others have thoughts about this.

 

Thank you so much.

[[Pa...]]

I’ve read Professor Ashtons equivalencies are pretty generous but she was working with her patients in a clinical setting so she probably opted to provide the most comfort.  Some members have reported feeling too sedated on hers so don’t panic if your doctor doesn’t want to prescribe that dose, you can maybe do okay on it.

 

Are you suffering interdose withdrawal, that’s about the only reason I can see for switching to Valium. It can be difficult to switch benzo’s, you have to really want and need it because you’ll most likely feel depression and sedation until your body acclimates, some never do and have to switch back.  This takes extra time and pain of course, as does everything about this process.

 

I’m not sure I understand why you can’t continue tapering Ativan as you are, granted, I don’t have taper experience so maybe I’m missing something?  How often do you dose, are you getting up in hte middle of the night to take your dose?