Tolerance withdrawal or effects from switching to Valium?

[[Md...]]

So I’ve been switching to Valium over the last few weeks from Xanax (.5mg X for 10mg V) 3 times a day. Half and half, basically. 

 I totally swapped out my evening dose of Xanax without any real issues (aside from some lethargy and some dark, dark depression). I spent about two weeks doing that. Then felt fine.

I then spent a week crossing over my afternoon dose. More lethargy and depression came on, but it wasn’t as bad.

I am now trying to crossover my morning dose, but seem to be having issues that arise during the afternoon. I experience some anxiety, irritability, and minor cognitive impairment. 

Keep in mind that I have been holding the same dose for the last 3 months, so I’m wondering if I’m starting to experience tolerance withdrawal, or just the effects from my brain trying to get used to Valium.

These issues didn’t arise until the cross over, so I’m thinking it has something more to do with that. 

If it is tolerance withdrawal, how exactly is this handled? I don’t want to upside on this poison. 

If it’s my brain adjusting to the Valium, how is that handled? Just tough it out until my brain gets used to it? 

I’m honestly wondering if I made the afternoon switch to Valium to fast, and maybe should have given it two weeks instead of just one.

I’m also under a lot of stress right now and started drinking energy drinks, so who knows? Maybe that’s a big part of it as well.

Should some issues crossing over to V be expected?

Thanks for your help!

 

 

[[Pa...]]

I just watched this video, he mentions how adding stimulants had a negative effect on him, it might behoove you to avoid them. 

Stress in my opinion is the number one contributor to increased symptom severity so I'd say you could have many factors involved in what you're experiencing.

When you say you've been holding your dose for 3 months, do you mean you're at the same dose for 3 months while you're crossing over?  If that's the case I don't believe tolerance is a factor, switching benzodiazepines and especially the stress seems more plausible.  

Ashton I believe mentioned crossing in one and two week intervals but of course, we're all different. 

[[Md...]]

15 minutes ago, [[P...] said:

I just watched this video, he mentions how adding stimulants had a negative effect on him, it might behoove you to avoid them. 

Stress in my opinion is the number one contributor to increased symptom severity so I'd say you could have many factors involved in what you're experiencing.

When you say you've been holding your dose for 3 months, do you mean you're at the same dose for 3 months while you're crossing over?  If that's the case I don't believe tolerance is a factor, switching benzodiazepines and especially the stress seems more plausible.  

Ashton I believe mentioned crossing in one and two week intervals but of course, we're all different. 

Thanks for video as well the info!

Dr Josef is actually my psychiatrist who I’ve been working with for this tapering and transitioning plan. Well, actually I’ve been working with his wife, until recently. 

Anyway, I’ll have to check out that video. I also just emailed Dr Doering and will be meeting with him on Monday, so I’ll see what he says.

A little history that’ll answer your question…

I started taking Xanax about 5 months ago to manage neuropathic pain in my gums/teeth, but didn’t know wtf I was doing at that point when it came to benzos. The pain seemed to diminish over a few agonizing months,  so I cut my dose in half overnight (went from 2.5mg to 1.5). That was about 3 months ago, and I’ve been holding that dose ever since.
 

I began experiencing interdose withdrawals shortly after the cut, and dealt with that for a while until I found these doctors, and they’ve been switching me over to V at the same dose, so no tapering has been occurring. The V has definitely taken care of the painful interdose withdrawals I was having though! 

But just to clarify, I haven’t tapered at all since that initial drop a few months back, so yes, same dose while crossing over, or at least the equivalency (.5mg X for 10mg of V, then cutting that in half and taking them together for a week or two, basically the Ashton method).

And btw, I haven’t experienced anything extreme, just minor stuff, well, the depression from the V at first was like some of the worst despair I’ve ever felt. That’s been diminishing though. 

 

 

 

 

[[Pa...]]

Thanks for the background, it appears you’re in good hands but even with the best medical advice, this process is uncertain and painful. 

t feels like to me that you’ve got a combination of factors, the stress, getting used to the effects of the Valium and possibly the transition timeline.  I’m hopeful things will settle as the depression seems to be doing but it looks like you’re still going to experience discomfort, not many of us here can avoid that. 

[[no...]]

On 20/08/2023 at 00:00, [[M...] said:

and started drinking energy drinks,

I'd stop drinking them, they're high in caffeine and sugar and could be adding to the over stimulation of your nervous system 

[[Md...]]

Thanks for the advice here, everyone. 

[[Md...]]

On 20/08/2023 at 05:37, [[P...] said:

Thanks for the background, it appears you’re in good hands but even with the best medical advice, this process is uncertain and painful. 

t feels like to me that you’ve got a combination of factors, the stress, getting used to the effects of the Valium and possibly the transition timeline.  I’m hopeful things will settle as the depression seems to be doing but it looks like you’re still going to experience discomfort, not many of us here can avoid that. 

So would you say it’s pretty normal to feel some anxiety when transferring from Xanax to Valium?

Aside from some extra fatigue, not being able to completely focus, and some anxiety, I’m not really experiencing anything aside from that.

I think most of my anxiety stems from what got me on benzos to begin with, tbh. Currently suffering from some PTSD from that trauma, and not knowing if the pain will come back full throttle once I start to taper. It’s mental torture if I think about it too much.

[[Md...]]

14 hours ago, [[n...] said:

I'd stop drinking them, they're high in caffeine and sugar and could be adding to the over stimulation of your nervous system 

Yes! I’m done with these. They just helped me focus, and got rid of some of the sedation, but like you said, the caffeine could also be stimulating my nervous system, even though I’ve been drinking low carb energy drinks (so hardly any sugar).

[[Pa...]]

12 hours ago, [[M...] said:

So would you say it’s pretty normal to feel some anxiety when transferring from Xanax to Valium?

Oh yes, any changes we make, especially with medication can ramp up anxiety, this is a big deal!  Fear is a huge component of benzo withdrawal, I was afraid of things I’d never given a second thought to.  So something like changing medications, the stuff that got us here is bound to have an affect.  

[[Md...]]

3 hours ago, [[P...] said:

Oh yes, any changes we make, especially with medication can ramp up anxiety, this is a big deal!  Fear is a huge component of benzo withdrawal, I was afraid of things I’d never given a second thought to.  So something like changing medications, the stuff that got us here is bound to have an affect.  

Thanks for explaining! 

 

[[Md...]]

Today was the first day replacing my last xanax dose with Valium. The sedation, depression, and agitation were pretty heavy. Annoyed by lots of things and just wanted to sleep all day. 

Will this eventually fade away? If so, is there a general time frame? Because I can’t really function like this.

I felt much better taking half Xanax half Valium.

[[Pa...]]

I’ve asked someone with experience to drop by, hopefully they will.  I’ve read it does fade away but I don’t know the time frame, not sure we can nail it down but hopefully you can get some reassurance it will go away. 

[[or...]]

@[Md...] I switched (gradually) from Ativan to Valium and the last phase of the switch was the hardest. I know now that it was my body getting used to the ABSENCE of the short-acting benzo and building up the long-acting effects of the valium, but as I said the last part was super hard. I was agitated times 100. Not depressed, but feeling really anxious and squirrely.  That lasted for about a week, gradually ebbing day by day. Finally I didn't feel like throwing things across the room. So, agitation was the worst for me. If this pattern proves to be the same for you, I'd guess that the valium would have completely covered the rotten effects from the loss of xanax in your system in about a week or 10 days Just a guess. Oh, just an idea . . . I know you feel sedated, but maybe re-think the energy drinks? They may be making you feel worse.  Wishing you the best in this final stage of your switch. 

[[Md...]]

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

I’ve asked someone with experience to drop by, hopefully they will.  I’ve read it does fade away but I don’t know the time frame, not sure we can nail it down but hopefully you can get some reassurance it will go away. 

Thank you!

[[Md...]]

47 minutes ago, [[o...] said:

@[Md...] I switched (gradually) from Ativan to Valium and the last phase of the switch was the hardest. I know now that it was my body getting used to the ABSENCE of the short-acting benzo and building up the long-acting effects of the valium, but as I said the last part was super hard. I was agitated times 100. Not depressed, but feeling really anxious and squirrely.  That lasted for about a week, gradually ebbing day by day. Finally I didn't feel like throwing things across the room. So, agitation was the worst for me. If this pattern proves to be the same for you, I'd guess that the valium would have completely covered the rotten effects from the loss of xanax in your system in about a week or 10 days Just a guess. Oh, just an idea . . . I know you feel sedated, but maybe re-think the energy drinks? They may be making you feel worse.  Wishing you the best in this final stage of your switch. 

Thank you so much for providing this info. It helps a lot, especially knowing about the agitation. 

And yes, the coffee and energy drinks are a done deal. I spoke to Dr Doerring about this and he said that they will make tapering much harder, so I imagine the same is true for crossing over to other benzos. 

Btw, how was getting off the Valium for you? (Assuming that you’re no longer on it).

[[or...]]

@[Md...] I had a long and hard taper, I won't kid you. But the difficulty was due to my own mistakes. I followed the Ashton Manual from 15mgs down to 5 with no distress . . .  and then had trouble. I now realize her cuts were too big for me and they all kind of caught up to me at 5mgs. I got really sick but like a jerk, I continued on down to 3 when I got  even sicker. Several of my buddies had to help me out. I held for about a month while I tried to figure out what to do. I eventually made my cuts smaller, went to 2 doses a day and got "straightened out". I continued down to 1 mg, then went to a  daily liquid microtaper which allowed me to get to zero without any more trouble. So lesson learned: if/when you feel crappy, stop and try to fix things. Don't be a butt-head like I was. It's always possible to tinker with your taper even though the time spend tapering will be longer. The goal is to get to zero, yeah, but to get there being able to function along the way. 

I realize I didn't address the issue of sedation. When I was crossed to all valium I was REALLY sedated. I felt like I was falling over my feet. but that passed in about 2 weeks and I felt pretty normal. It sounds like you're feeling sedated as the valium builds up in your body. Try to be patient and hang in there. Your body/brain will acclimate and you won' t feel the sedation after a while. I never did feel depressed, although I understand that others do/did. Everyone's different.

Good luck with all this. 

Edited August 23, 2023 by [or...]
more info

[[Md...]]

12 hours ago, [[o...] said:

@[Md...] I had a long and hard taper, I won't kid you. But the difficulty was due to my own mistakes. I followed the Ashton Manual from 15mgs down to 5 with no distress . . .  and then had trouble. I now realize her cuts were too big for me and they all kind of caught up to me at 5mgs. I got really sick but like a jerk, I continued on down to 3 when I got  even sicker. Several of my buddies had to help me out. I held for about a month while I tried to figure out what to do. I eventually made my cuts smaller, went to 2 doses a day and got "straightened out". I continued down to 1 mg, then went to a  daily liquid microtaper which allowed me to get to zero without any more trouble. So lesson learned: if/when you feel crappy, stop and try to fix things. Don't be a butt-head like I was. It's always possible to tinker with your taper even though the time spend tapering will be longer. The goal is to get to zero, yeah, but to get there being able to function along the way. 

I realize I didn't address the issue of sedation. When I was crossed to all valium I was REALLY sedated. I felt like I was falling over my feet. but that passed in about 2 weeks and I felt pretty normal. It sounds like you're feeling sedated as the valium builds up in your body. Try to be patient and hang in there. Your body/brain will acclimate and you won' t feel the sedation after a while. I never did feel depressed, although I understand that others do/did. Everyone's different.

Good luck with all this. 

Thank you so much for sharing! This actually gives me some hope.

And yeah, the sedation is bonkers. I’ll I want to do is sleep, which I think is the main contributor to this newly experienced agitation, tbh. Kinda like a baby who gets cranky when they’re tired.

The problem is that I’m not functional this way and have obligations. It’s very frustrating, so I’m gonna have to find some outside help.

Btw, what were your main symptoms when you were tapering, and did you have to deal with protracted withdrawals?

The whole reason for me switching over to V is because everyone says it’s the easiest benzo to taper from, and those liquid titrations seem to really help.

[[Ko...]]

I can't provide advice but am in a somewhat similar situation so can commiserate...

How long did you take to transition over completely to valium? I am in process of switching from 0.5 of klonopin to 10 mg of valium- did 1 week of .375 klonopin and 2.5 mg of valium then 1 week of 0.25 klonopin and 5 mg of valium and I should start with .125 klonopin and go to 7.5 of valium tonight for a week before I go completely to 10 mg valium.  But I feel as if I am more depressed, fatigued, and anhedonic than before the switch.  was not great with all of these things on the klonopin either. 

I haven't tapered dosage wise and continue to work but basically just want to lie on the couch when i get home.

[[or...]]

@[Ko...] I think your fatigue and lethargy will dissipate gradually.  I felt the same when i was entirely crossed to valium from Ativan, but it did pass. It took a couple of weeks. I never did feel depressed,  although some do. Just fatigued to the max. But, as I said, gradually that passed, I got more energy,  and I felt just "normal" (ha, as "normal" as someone can  feel on a taper . . . but I mean, even, no ups or downs). Hope this helps. 

[[Ko...]]

@[or...]don't want to hijack @[Md...]'s thread but I think the klonopin (started April 2023 for insomnia) started to cause anhedonia and fatigue, exercise intolerance in June - I became depressed when I tried to taper by pill-splitting in late June and developed intolerable withdrawal symptoms (tinnitus, electric surges).  So maybe the valium is just magnifying the same issues I had on klonopin. 

 

[[Md...]]

3 hours ago, [[K...] said:

@[or...]don't want to hijack @[Md...]'s thread but I think the klonopin (started April 2023 for insomnia) started to cause anhedonia and fatigue, exercise intolerance in June - I became depressed when I tried to taper by pill-splitting in late June and developed intolerable withdrawal symptoms (tinnitus, electric surges).  So maybe the valium is just magnifying the same issues I had on klonopin. 

Not hijacking and at all, and I appreciate the feedback.

[[Md...]]

So I just wanted to check in today and offer an update.

So today was the first day where I took Valium without feeling too sedated or depressed. The difference is that I ate a meal before I took the medication. 

So something to do with digestion and metabolism definitely seems to play a role here.

Ive also read that when you eat before you take medication that not as much of the medication is absorbed, so maybe I’m actually absorbing less Valium, and that’s why I’m not as sedated or depressed.

Zero agitation today as well.

Regardless, the difference is night and day!

[[Ko...]]

@[Md...]I am glad that you are feeling better.

How many weeks have you been taking the valium now? I just finished my 2nd week of it and will spend 1-2 more weeks crossing over.  Any advice here? I am curious to see how your doc managed things as mine wanted to just have me switch directly.

I only take my dosage at bedtime so usually don't have a full stomach.

[[Md...]]

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

@[Md...]I am glad that you are feeling better.

How many weeks have you been taking the valium now? I just finished my 2nd week of it and will spend 1-2 more weeks crossing over.  Any advice here? I am curious to see how your doc managed things as mine wanted to just have me switch directly.

I only take my dosage at bedtime so usually don't have a full stomach.

It’s been about a month total to get me where I’m at today (3 days of no Xanax).

I spent about two weeks crossing over my first dose, then a week for my other two doses.

My doc did half X and Half V per dose every one to two weeks. As soon as I transferred one dose, I would move onto the next dose. Once again, with about a week or two of doing half and half.

This last dose has definitely been the hardest though! 

I definitely don’t recommend doing a straight swap. Even going slowly for me has been a challenge, and I can only imagine how much worse it would be if I did a straight swap.

Then again, I guess it depends how long you’ve been taking your previous benzo for and how dependent you are on it.

I knew for a fact I was crazy dependent on Xanax, because I started having interdose withdrawals that were absolutely horrendous, so I can only imagine how bad it would be if I did a straight swap.

So my advice is to listen to your body and do a slow transfer. Hopefully your doctor will allow this. Show them the Ashton Manual, as this can be an effective way of transferring. 

The way Witt-Doerring psychiatry (the docs i work with) do things when it comes to both switching benzos and tapering is all based off of how functional you are. They want to make sure that you are functioning and are able to take care of yourself and your loved ones. They realize that you have a life to live, so they go at YOUR pace, and truly do believe this process should be patient lead.

I also really do think that transferring from one benzo to another can be a type of withdrawal, hence some of the symptoms that arise when crossing over. 

I still feel weird from not having Xanax in my system, but I think it will continue to get better! If not, then Dr Josef told me that we can even go back to Xanax and do a half and half taper if need be, as this process needs to be as comfortable as possible! 

I wish more doctors were benzo smart and believed in a patient lead process, but most are completely clueless when it comes to this stuff.

For example, my previous GP not only cut my Xanax dose in half when I was having interdose withdrawals, but she also completely cut me off as a patient and told me to go to a substance abuse center. 

So many uneducated boomer doctors with huge egos that never learned anything beyond med school have created this situation. 

Thankfully, I think more and more doctors are waking up to this epidemic, especially the younger ones who are questioning things.

Best of luck with your crossover and taper! And please keep us posted!
 

 

[[Ko...]]

Thanks for your detailed response.  I am still on half klonopin and half valium. (I took 0.5 mg klonopin since 4/23 and found out I was dependent on it in 7/23.  I will make the final part of the switch this week. I have definitely been feeling weird with some withdrawal symptoms with the crossover but wasn't feeling well on the 0.5 mg of klonopin either. 

I will be curious to see how your doc does your taper as he is an expert in this. I looked into going with their group (super expensive though!!) but don't live in one of the states that they serve. I anticipate getting to 10 mg of the valium but not sure how I will proceed down from there yet. I know my NP seems to think the microtapering is unnecessary but I do not know how I will fare with the 0.5 mg cuts once I get down to the lower dosages.