switching from clonazepam to diazepam

[[Ko...]]

I went to a new provider who uses the Ashton method for helping me to taper 0.5 mg of clonazepam that I took at bedtime. The plan was to switch me over to 10 mg of diazepam over the next 3-4 weeks.  Week 1 was 0.375 of clonazepam and 2.5 mg of diazepam which went well.  I am now on week 2 of the switch which is 0.25 mg of clonazepam and 5 mg of diazepam and the sedation of diazepam is overwhelming to me in the morning.  It takes me 2 hours to get out of bed in the morning.  I need to work and tend to my family.  Should I just try to get through this or should I consider splitting the 5 mg diazepam tablets into quarters and taking 3/4 tablet or 3.75 mg of diazepam this week instead?  Or maybe give it a few more days? I wonder if for me the equivalence for 0.5 mg of clonazepam is more like 8 mg of diazepam instead of 10 mg ?

I know a lot of people don't recommend the switchover but I didn't have a lot of options as far as providers go and this one was pretty insistent on going this route.  I started 0.5 mg of clonazepam in April of this year for severe insomnia, discovered in July that I could not do a rapid taper without going into severe withdrawal, and have been miserable since then trying to find a way off this stuff without becoming incapacitated. 

 

 

[[Fa...]]

Hi, @[Ko...],

I'm sure others will chime in.  I have no personal experience with the transition.  I would recommend 2 weeks in between transitions however to allow time for your body to acclimate.  I've heard the sedating effect wears off fairly quickly.  If your doctor agrees, you could try a 2mg diazepam tablet next drop in .125mg clonazepam (instead of 2.5mg diazepam). In essence, you'd be transitioning to 9mg diazepam instead of 10mg.  

Or you could stick to the plan and wait 2 weeks between transitions.  I've attached a thread of a member whom successfully transitioned over and discontinued their benzodiazepine.  I believe he used the 2.5mg diazepam per .125mg clonazepam transition, and he too felt sedated at transition completion.  As a result, I believe he tapered a little quicker at the beginning then slowed down.  Hopefully it is helpful and you have a successful transition and taper.  Keep us posted!

 

[[Ko...]]

Thank you for your reply. None of this is easy to figure out.  I was already experiencing fatigue on the clonazepam 0.5 but this seems worse. Its hard to know what is possible withdrawal vs side effects....

[[Ko...]]

Also, I only have 5 mg tablets to work with for the next 2 weeks.

[[Fa...]]

You are exactly correct in your statement:

1 hour ago, [[K...] said:

None of this is easy to figure out

My opinion, and again only my opinion.  The wheels are in motion.  You are crossing to diazepam.  I would suggest asking your doctor if you could hold at least 2 weeks currently and in between stages/transitions going forward.  I believe this will help alleviate some current and/or potential issues and allow you to make a smoother transition. 

Most likely easiest at this point to remain at your current (and doctor) transition schedule of .125mg clonazepam for 2.5mg diazepam as you have already completed 2 stages at this conversion and only have 5mg tablets.  Again, I would just suggest you kindly ask him/her if you could possibly hold for 2 weeks between each stage/transition vs. one week.  It is too many changes, too quickly, with 2 long half-life benzodiazepines in my opinion.  

[[Ko...]]

Thank you for your feedback.  I have enough to do 2 weeks of 0.25 clonazepam  with 5 of diazepam before I meet with her again. I then could ask her to do .125 mg of clonazepam with 7.5 of diazepam for a week before fully converting to diazepam.  At our visit yesterday, she seemed to think I was overly anxious about this.  Its hard not to be when our lives are so affected by it.

 

 

[[Fa...]]

Hi, @[Ko...].  I completely understand.  I need to work and tend to my family as well.  Listen to your body and if you feel you need more than 1 week for the remaining "stages", I would certainly calmly suggest this to your prescriber.  Hopefully she will allow you to control your transition, and your taper, based on your symptoms and your desire to remain functional while still getting off your benzodiazepine.