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Possible switch from Klonopin to Diazepam


[fo...]

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I have been planning a taper from Clonazepam 1 mg but I’m in tolerance and it’s really become quite severe. I was told my symptoms were all long Covid, but I kept telling doctors I felt it was my body suddenly hating the clonazepam. They didn’t listen. 
I’m wondering at this point if it may be advantageous to switch to diazepam to taper. I know I would start at 20 mg. My psychiatrist supports it and wants to substitute .25 K for 5 mg diazepam and hold 2 weeks and repeat until off clonazepam. I would then want to slowly taper off the diazepam. Is the easiest way to do this by liquid and if so, how big of decreases and at what intervals would be a slow taper? I could also use tablets so my body doesn’t have yet another change. 
Has anyone switched to diazepam due to tolerance on their med and found relief? Thanks everyone 

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You might find it helpful to read through past posts by Momof7babes.  She hasn’t been active on the forum for over a year, but here’s a May 2022 update from her:

 

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Thank you, Libertas. I’m happy for her that she was able to get her life back. 😊 I read through the posts. 
I see her discuss getting relief from getting on diazepam and the fact she had a very very long taper. I am just curious in regards to an actual taper plan for diazepam. I’ve been concentrating on clonazepam this entire time and I have focused on taper plans for it. I just don’t have a taper plan for diazepam. I know I don’t want to stretch it out 2.5 years. 
Can anyone assist in a taper plan for getting off diazepam? Guidance as far as the pace to go? Is it easier to use Rx liquid or just the tablets…etc? 
 

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Anyone able to share how to taper from diazepam 20 mg? Wanting to possibly switch but unsure how to taper down from 20. Is it best to use liquid? Or just tablets? What pace? I know it’s individual just needing to start so looking for suggestions. 

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Hi @[fo...]

Personally, I would just taper the tablets if that’s what you’re taking now. Why switch to another delivery system if it’s not necessary. You can switch to a liquid option as you get lower in dose, if necessary, but the fact you are tapering diazepam, less potent, with a long half life, you should be able to taper off using tablets. 

It would be best to have a combination of both 5mg and 2mg tablets, making your reductions from the 2mg tablets. If you only dose once per day, then you could also use 10mg tablets as part of your dose, but always using the 2mg tab to make your reduction. 
 

If you reduce by 2mg from 20mg, that is a 10% reduction, which is the highest reduction we would suggest a member make. If you reduce by 1mg (half a 2mg tab), that would be a 5% reduction. Keep in mind that once you make that first reduction, each following reduction of 1 or 2mg will mean that your reduction percentage will continue to climb with each new cut, so it’s best to use a jewellers scale so you can calculate (by weight) each new 5 or 10% reduction at each new remaining dose. 

You may do okay making two or three 2mg reductions and then switching to 1mg reductions until you get down to about 10mg daily, after which you would most likely do best to switch to calculating your reduction percentages by weight of tablet and using a jewellers scale. 

Below explains how you would calculate each new dose using a calculator and jewellers scale. The below is also based on another members daily dose, so you would just weigh your own daily dose to get your total weight and then use the same method and calculate accordingly. Keep in mind that once you reach a point where it’s necessary to start calculating your reduction percentages by the weight of the tablet, you want to use all the same strength tablets. Once you are at about 10mg daily, it would be best to use all 2mg tablets for dose accuracy when weighing. 

 

“If you have any reservations about purchasing and using a jewellers scale to make accurate cuts, please know that they are relatively cheap, and calculating you reductions is very simple.

You would simply weigh your total daily dose (11mg), which I’ll calculate right now to get an average total weight…

If one of my 2mg valium tabs weighs an average of 0.172grams, then 5 1/2 tablets (11mg) weighs 0.946grams. I did that in my head, but your tablets may weigh slightly different weight, so you would simply weigh 5 1/2 tablets on the jewellers scale for the total weight. Keep in mind that doing it this way you are no longer calculating in terms of API (active pharmaceutical ingredient), but simply calculating percentages based on weight of the tablets. 

If you want to calculate 5% of that 0.946grams, you would simply multiply… 0.946 x 95% using the calculator on your phone = 0.8987 (forget about the 7 as it’s an inconsequential weight with Valium and only complicates the equation with benzo brain). So, the reduction will be 0.048…. 0.946g down to 0.898.g

So, you would simply shave or file (I just break and crumble bits with my fingers) 0.048g from one of your tablets, or even the half (1mg) tablet which would have a total weight of 0.086g, half of 0.172g. If you discard 0.048g from that 0.086g half (1mg) tab, it leaves you with 0.038g to add to your other 5 x 2mg tablets, a tottal daily dose of 0.898. You have reduced by 5%. 

You would simply recalculate that 5% again before each new reduction from your remaining total daily dose to get your new total daily dose.

‘If you wanted to reduce by 10% rather than 5%, then you would multiply total weight of your dose (at the moment 0.946) by 90%.… 0.946 x 90% =0.8514(drop the 4…inconsequential), so you would simply shave or file your dose down by 0.095 from 0.946g to 0.851g.

I hope I have explained this simply enough and not confused you. I just wanted you to know that it’s all very simple to use a jewellers scale and make the calculations.” 
 

@[fo...] We will provide you with a link to a commonly used, affordable jewellers scale when you think you are ready to make the switch. You should be okay reducing by 2mg and then 1mg (half a 2mg tablet) for a while. 

Keep us informed of how it goes. 

WS

 

 

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I don’t have much luck getting feedback but I’m terribly stuck. I am on 1 mg clonazepam x 12 years. I hit tolerance exactly one year ago. Doctors told me the symptoms I am having were all long Covid but they aren’t. Many are tolerance and they are bad and getting worse. I can’t get my CNS stabilized in any way. 
My doc offered to switch me to clonazepam to try to stabilize me and make the taper process more doable. Is it best just to start tapering from the clonazepam even though I’m not stable and can’t get stable? Or is it possible I could calm my CNS switching to diazepam to taper? I plan to start tapering asap. Any advice is very welcome. Thank you 

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Hi @[fo...],

For me, I sometimes struggle if I am seeing, or listening to too much advice, or just being overwhelmed by it all.  I find it is better for me to make a decision with the info I've gathered from others, but really decide based on my own opinion of what I've gathered.  It's also about what I decide "might" work for me personally.  We all have things in common, but we can't necessarily follow someone else's path.

Even the decision to do nothing is valid.  This is all about timing for me, things I am learning today, were offered way back in March when I first found BB.  But only today am I  hearing, reading and seeing them as something I can put to good use in my taper.  I just couldn't comprehend, but as I started a very slow taper, a simple one I could handle, the fog began to lift, and I gained more confidence in my decision-making.

I know many people responded to my cry for help, and believe the same has happened for you.  But once I took just a baby-step in a taper, I'm now on a roll I am happy to say.  Not without issues though, but I see my CNS improving with each "window" whether it's just for a couple hours, a day, or maybe some days in a row.  I wrestled with numbers for I'll bet at least a month, finally got fed up and realized any start was better than no start at all.  Maybe it's the same for you, maybe not, but each day it's about one foot in front of the other.  If not, I can do nothing and waste another precious day of my life, Denise :smitten::hug:PS I hope this comes off as encouraging, it's all I want to do is encourage and be there for others.  I've led a very selfish life but now BB has opened a door for me where I can share my journey and I so hope to help others ♥️ the good life is giving ♥️ (title of a book by Randy Alcorn)

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@[fo...],

I did cross to diazepam but frankly I never stabilized to the point I had no symptoms. My taper was very unorganized. I continued to taper in my effort to get off benzos. I cut on Thursday so I had the weekend to recover a bit. 
 

Basically, this is your withdrawal. You have to decide what is best for you. I don’t personally believe there is a perfect taper, the cns is very sensitive and will react.

No matter how rough my taper was or how long it took me to recover, it was so worth it. No longer being tethered to a drug that was making me sick was the best thing I’ve done for my future health and wellbeing. 
 

Withdrawal is challenging but it is doable. Whatever taper plan you choose, we’ll be there for you. The support I got from this forum was key to my recovery.

 

piqnogirl :smitten:

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Thank you both. I mistakenly wrote switch to clonazepam in my post. I of course meant diazepam. It’s such a dark time. Yet I will dig deep to make this taper leave me functioning. My only daughter is getting married in 10 months and we have dress shopping and showers, etc. I won’t miss a moment. I just fear starting out in this poor of condition. The tolerance hit like a sledgehammer and I mistakenly relied on my medical doctors to confirm for me that that’s what is occurring. They denied it even exists….tolerance. By the time I knew that was my issue I was in deep. I pray I will stabilize some as I come down. Or if I switch. I don’t trust my brain right now. 😢 

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31 minutes ago, [[f...] said:

Thank you both. I mistakenly wrote switch to clonazepam in my post. I of course meant diazepam. It’s such a dark time. Yet I will dig deep to make this taper leave me functioning. My only daughter is getting married in 10 months and we have dress shopping and showers, etc. I won’t miss a moment. I just fear starting out in this poor of condition. The tolerance hit like a sledgehammer and I mistakenly relied on my medical doctors to confirm for me that that’s what is occurring. They denied it even exists….tolerance. By the time I knew that was my issue I was in deep. I pray I will stabilize some as I come down. Or if I switch. I don’t trust my brain right now. 😢 

Congratulations on the upcoming wedding. You know, I had to do things out of my comfort zone, my bedroom, during withdrawal. It’s amazing how the body allows us to do these things. I went to see my brother after he had complications from a knee replacement when I was pretty new off benzos and very symptomatic and did just fine. So will you and this is a time to enjoy and create beautiful memories! 

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Thank you. I think my post was very confusing 🤷🏻‍♀️ I’m currently on 1 mg clonazepam. I’m in tolerance and trying to decide whether to switch to diazepam. I didn’t know if it may help me find some stability TO taper because right now I can’t imagine tapering from this spot. I’m lost but need to do something stat. 

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On 09/09/2023 at 00:53, [[W...] said:

Hi @[fo...]

Personally, I would just taper the tablets if that’s what you’re taking now. Why switch to another delivery system if it’s not necessary. You can switch to a liquid option as you get lower in dose, if necessary, but the fact you are tapering diazepam, less potent, with a long half life, you should be able to taper off using tablets. 

It would be best to have a combination of both 5mg and 2mg tablets, making your reductions from the 2mg tablets. If you only dose once per day, then you could also use 10mg tablets as part of your dose, but always using the 2mg tab to make your reduction. 
 

If you reduce by 2mg from 20mg, that is a 10% reduction, which is the highest reduction we would suggest a member make. If you reduce by 1mg (half a 2mg tab), that would be a 5% reduction. Keep in mind that once you make that first reduction, each following reduction of 1 or 2mg will mean that your reduction percentage will continue to climb with each new cut, so it’s best to use a jewellers scale so you can calculate (by weight) each new 5 or 10% reduction at each new remaining dose. 

You may do okay making two or three 2mg reductions and then switching to 1mg reductions until you get down to about 10mg daily, after which you would most likely do best to switch to calculating your reduction percentages by weight of tablet and using a jewellers scale. 

Below explains how you would calculate each new dose using a calculator and jewellers scale. The below is also based on another members daily dose, so you would just weigh your own daily dose to get your total weight and then use the same method and calculate accordingly. Keep in mind that once you reach a point where it’s necessary to start calculating your reduction percentages by the weight of the tablet, you want to use all the same strength tablets. Once you are at about 10mg daily, it would be best to use all 2mg tablets for dose accuracy when weighing. 

“If you have any reservations about purchasing and using a jewellers scale to make accurate cuts, please know that they are relatively cheap, and calculating you reductions is very simple.

You would simply weigh your total daily dose (11mg), which I’ll calculate right now to get an average total weight…

If one of my 2mg valium tabs weighs an average of 0.172grams, then 5 1/2 tablets (11mg) weighs 0.946grams. I did that in my head, but your tablets may weigh slightly different weight, so you would simply weigh 5 1/2 tablets on the jewellers scale for the total weight. Keep in mind that doing it this way you are no longer calculating in terms of API (active pharmaceutical ingredient), but simply calculating percentages based on weight of the tablets. 

If you want to calculate 5% of that 0.946grams, you would simply multiply… 0.946 x 95% using the calculator on your phone = 0.8987 (forget about the 7 as it’s an inconsequential weight with Valium and only complicates the equation with benzo brain). So, the reduction will be 0.048…. 0.946g down to 0.898.g

So, you would simply shave or file (I just break and crumble bits with my fingers) 0.048g from one of your tablets, or even the half (1mg) tablet which would have a total weight of 0.086g, half of 0.172g. If you discard 0.048g from that 0.086g half (1mg) tab, it leaves you with 0.038g to add to your other 5 x 2mg tablets, a tottal daily dose of 0.898. You have reduced by 5%. 

You would simply recalculate that 5% again before each new reduction from your remaining total daily dose to get your new total daily dose.

‘If you wanted to reduce by 10% rather than 5%, then you would multiply total weight of your dose (at the moment 0.946) by 90%.… 0.946 x 90% =0.8514(drop the 4…inconsequential), so you would simply shave or file your dose down by 0.095 from 0.946g to 0.851g.

I hope I have explained this simply enough and not confused you. I just wanted you to know that it’s all very simple to use a jewellers scale and make the calculations.” 
 

@[fo...] We will provide you with a link to a commonly used, affordable jewellers scale when you think you are ready to make the switch. You should be okay reducing by 2mg and then 1mg (half a 2mg tablet) for a while. 

Keep us informed of how it goes. 

WS

This is another excellent reply of yours @[Wi...]  Thank you for the time and explanation, Denise ♥️

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Hi @[Wi...]. I appreciated the time you spent in your response to me. Very kind. I am on clonazepam 1 mg and in tolerance. I hear two points of view: one says to taper from the drug I’ve been on, the other says if I’m tolerance it’s helpful to switch to diazepam. My CNS is SO sensitive that I’m really quite lost right now. 
 

I have a water taper plan that incorporates adding water in throughout so the percentages stay even . I don’t know if my body is going to like the change to water. I have 2 dry plans. One is a microtaper removing .001 x 4 days, holding 2 and repeating throughout. I like the idea of a microtaper but didn’t know if this looked like a doable plan? The second is cut 3% and hold 2 weeks and repeat. I just am so sensitive I don’t feel comfortable with 5%. Can you help with math? If I’m starting with 1 mg K which weighs .34 how long would it take to complete using 3% every 2 weeks? Thank you so much. 
 

 

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Hi foremykids,

Just want to say good for you for recognizing your tolerance issue and not up dosing. 1mil of klon is a lot and getting off can be very hard for some people. But once you do it,you'll be so happy it wasn't more.

SPhyc yourself up to get off, don't lose sight of the goal. It's poison and getting it out of your life/body will greatly change your life for the better.

I had and having a tough time, BB saved me many times. It really helps for figuring out what symptoms you feel could be the benzos, and your not crazy. Also helps to save money and frustration with the ignorant doctors. The word is getting out to them. If your doctor seems ignorant of possible long term symptoms get another. You  should have at least one doctor that is aware a patient guided discontinuance is the only safe method.

 

I really hope you have an easy discontinuance.

 

 

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10 hours ago, [[f...] said:

Hi @[Wi...]. I appreciated the time you spent in your response to me. Very kind. I am on clonazepam 1 mg and in tolerance. I hear two points of view: one says to taper from the drug I’ve been on, the other says if I’m tolerance it’s helpful to switch to diazepam. My CNS is SO sensitive that I’m really quite lost right now. 
 

I have a water taper plan that incorporates adding water in throughout so the percentages stay even . I don’t know if my body is going to like the change to water. I have 2 dry plans. One is a microtaper removing .001 x 4 days, holding 2 and repeating throughout. I like the idea of a microtaper but didn’t know if this looked like a doable plan? The second is cut 3% and hold 2 weeks and repeat. I just am so sensitive I don’t feel comfortable with 5%. Can you help with math? If I’m starting with 1 mg K which weighs .34 how long would it take to complete using 3% every 2 weeks? Thank you so much. 
 

It would take me far too long to figure out how long it would take you to taper off at 3%, @[fo...], and I really don’t think it’s helpful to figure it out. If you can only tolerate 3% reductions, then you can’t go any faster anyway, so it’s best to just take it one reduction at a time and finish the taper when you finish. The most important thing is that you choose a taper method and get it started. Also, at some point in your taper as it gets very low, you will have to abandon the 3% reductions and use a more linear taper. We can discuss this as you progress towards that point. Just focus on getting started for now. I’ll give you the first few reductions based on your 1mg dose weight of 0.340grams. That should be enough for you to understand how to calculate further reductions every 2 weeks, and if not, I can always provide further reduction figures when you are ready for them. 

Using a calculator, you would multiply the weight of your remaining dose (at this point… 0.340) by 97%, which = 0.3298

As your jewellers scale will only weigh to 0.000 and not 0.0000 you would dismiss the 8 and simply reduce your dose to 0.329 on the scale. 

Below are your first several 2 weekly reductions 

0.340 x 97% = 0.329

0.329 x 97% = 0.319

0.319 x 97% = 0.309

0.309 x 97% = 0.299

0.299 x 97% = 0.290

0.290 x 97% =  0.281

0.281 x 97% = 0.272

0.272 x 97% = 0.263

0.263 x 97% = 0.255

Use a nail file to gently file back to your desired weight.

You won’t be filing off much to begin with, so be careful to not over file. 

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Thank you @[Wi...]. I truly have no idea what I can tolerate, but my CNS was hit very hard by long Covid and I’m still struggling so I thought it best to start low and slow because I can always increase. I’m in tolerance and have been told I should speed things up since that’s the case…..but if I can’t tolerate it then what’s the point? I appreciate the calculations. I have one question: how do I then know which dose I am at currently? I’d like to include that in my log book. I thank you so much. Yes getting started is my goal…..I can get down to .75 or something and make adjustments if I can. I appreciate you. 
 

 

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You’re welcome, @[fo...]

I think it’s sensible to taper at this lower percentage, especially given you were hit hard by Covid 19. 

Here are the active pharmaceutical ingredient doses (approx) at each of those above weight reductions 

0.9700

0.9409

0.9126

0.8852

0.8587

0.8329

0.8079

0.7837

0.7602

Those 9 reductions will see you remove almost 25% of your current dose in 16 weeks. 

 

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You are a gem @[Wi...] thank you! I would love to pick up the pace at some point so I’m praying getting out of tolerance may allow me to do that at some point but this at least gets me started.  Getting down 25% in 4 months is great. I’ll buy some confidence and recalculate. 
I have seen a psychiatrist at the long Covid clinic and a local one as well. They both wanted to increase my benzo and I explained I was tolerant. One said “that doesn’t happen” and the other said then let’s switch you to a different benzo. I’m not considering that but is it not true that if you’ve reached tolerance, you are most likely tolerant to ALL benzos? Sorry to keep bothering. 

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@[fo...]

If you are in tolerance, you will remain in tolerance as you taper down, although, there is a possibility that you could notice symptoms easing to some extent the lower you get in your taper. 

The doctor who said “that doesn’t happen” has been ill-informed. It most certainly does happen with all benzodiazepines. 

As far as I know, once tolerance has been reached at a specific dose of one benzodiazepine, you will have reached tolerance at that same equivalent dose of any other benzodiazepine.

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@[Wi...] hello. I’m starting my taper right now. My husband is doing the cutting and I’m so sorry but 1 mg K is 0.17. The plan given me for the first 9 cuts has it at 0.34. I believe I told you that and I was incorrect. 
I hate to ask you if you can do the math for the first 9 cuts again for me with the correct weight and what dose that leaves me at? I apologize I don’t know how I got .34.  I appreciate you. 

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I took a stab at it using @[Wi...]‘s numbers, no idea if that was what you needed. 

0.17 x 97% = 0.165

0.165 x 97% = 0.160

0.160 x 97% = 0.155

0.155 x 97% = 0.150

0.150 x 97% = 0.146

0.146 x 97% =  0.142

0.142 x 97% = 0.138

0.138 x 97% = 0.134

0.134 x 97% = 0.130

 

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Thank you, @[Pa...]

@[fo...]

The dose of active pharmaceutical ingredient remaining at each lower dose won’t change from the numbers I provided earlier. 

I had ‘assumed’ the 0.340g you provided was based on your 1mg dose using 2 x 0.5mg clonazepam tabs instead of 1mg tabs.  2 x 0.170 = 0.340

This Is one of the reasons no member should ever break forum rules and seek tapering advice from admin, moderators, or other members via the PM system.
Mistakes easily occur, so, tapering advice needs to be discussed on the open forum to allow other members, moderators and admin to point out any potential mistake. It’s for the safety of all members. 

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I’m confused. I talked to you on the open forum. You offered your advice on the open forum. I didn’t PM you? 
I stated I had made the error. I am using 1 mg tablets that weight 0.17 not two 0.5 mg tabs and there was a recent reason that had to change. I’m confused what I did wrong???

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