Has anyone ever switched to Klonopin from Valium?

[[Md...]]

I have been on Valium since last June/July (switched from Xanax to counteract interdose withdrawals). I started at 10mg 3 times a day. Then about a month ago started doing a liquid microtaper. The problem is that the liquid hits so much harder than the pills do. The Valium has also caused a lot of lethargy, depression, and lack of motivation. I just don’t feel like myself, and being sedated so frequently has made me non functional in many regards.

I know that some people just can’t tolerate Valium, so im wondering if there has been anyone who has switched from Valium to Klonopin and what their experience was like.

Thanks!

[[Br...]]

I hope you get a response soon from someone who has experienced switching from Xanax to Valium and then to liquid form of Valium.  

In the meantime, here's my two cents: from what I've seen from other members it can take some time to adjust to a different form of a med eg. pill to liquid. And as I'm sure you know,  sedation and depression are common effects  from valium that are intolerable for some individuals but for others those effects lift over time so that members who have crossed to valium are glad they did.  My sense is that you may need to give it longer than a month for to adjust to the liquid. What dose are you at right now?

[[Li...]]

@[Md...] Might I ask why you are considering a switch from Valium (diazepam) to Klonopin (clonazepam)?  Is it because of the sedation you are experiencing with the Valium or something else?

[[Md...]]

6 minutes ago, [[L...] said:

@[Md...] Might I ask why you are considering a switch from Valium (diazepam) to Klonopin (clonazepam)?  Is it because of the sedation you are experiencing with the Valium or something else?

Yes, it’s mainly the sedation, as well as bouts of depression here and there. 
 

 

[[Md...]]

16 hours ago, [[B...] said:

I hope you get a response soon from someone who has experienced switching from Xanax to Valium and then to liquid form of Valium.  

In the meantime, here's my two cents: from what I've seen from other members it can take some time to adjust to a different form of a med eg. pill to liquid. And as I'm sure you know,  sedation and depression are common effects  from valium that are intolerable for some individuals but for others those effects lift over time so that members who have crossed to valium are glad they did.  My sense is that you may need to give it longer than a month for to adjust to the liquid. What dose are you at right now?

Thanks.

It’s honestly difficult to tell what dose I’m at, since the micro tapering is so miniscule. 

But i started at 30mg of Valium (half pills and half liquid). I’ve been tapering for 43 days now, so subtract 5% every 4 weeks, and that’s the dose id be at.

[[Li...]]

7 minutes ago, [[M...] said:

Yes, it’s mainly the sedation, as well as bouts of depression here and there. 
 

 

I thought that might be the case.  I don’t have experience with diazepam but I do with clonazepam. I find clonazepam to be quite sedating — so much so that I do not tolerate daytime doses (even tiny ones in the range of 25 micrograms). However, having said that, we have many members who do fine with daytime dosing,

You are an intrepid researcher, so I suspect you already know that clonazepam is one of the more challenging benzodiazepines to taper due to its high potency, limited dosage forms and strengths (see note) and unfavorable solubility profile.  However, where there’s a will, there’s a way.  For example, I’ve been using a stability-tested compounded 0.1mg/mL suspension made with brand Klonopin tablets as the source of the active ingredient.

Note: In the US, a manufacturer’s liquid for clonazepam is not available; the lowest strength solid dosage form available is a 0.125mg orally disintegrating tablet which is still a hefty dose.

 

[[Md...]]

1 minute ago, [[L...] said:

I thought that might be the case.  I don’t have experience with diazepam but I do with clonazepam. I find clonazepam to be quite sedating — so much so that I do not tolerate daytime doses (even tiny ones in the range of 25 micrograms). However, having said that, we have many members who do fine with daytime dosing,

You are an intrepid researcher, so I suspect you already know that clonazepam is one of the more challenging benzodiazepines to taper due to its high potency, limited dosage forms and strengths (see note) and unfavorable solubility profile.  However, where there’s a will, there’s a way.  For example, I’ve been using a stability-tested compounded 0.1mg/mL suspension made with brand Klonopin tablets as the source of the active ingredient.

Note: In the US, a manufacturer’s liquid for clonazepam is not available; the lowest strength solid dosage form available is a 0.125mg orally disintegrating tablet which is still a hefty dose.

Yes, exactly. I’ve read/heard from multiple people that Klonopin is one of the more difficult benzos to taper.

I also don’t know how I would even respond to Klonopin, so that’s a risk as well. I could find it to be just as sedating as Valium, so there are multiple variables to consider. 
 

I sincerely appreciate your feedback. 👍

[[Li...]]

You’re most welcome @[Md...].  I neglected to mention two other challenges associated with clonazepam — its half-life and major metabolite. Although clonazepam’s reported half-life is long (at least compared to alprazolam and lorazepam), some individuals seem to metabolize it rapidly, which can lead to interdose withdrawal. In addition, at least one animal study found that its major metabolite was a GABA antagonist.

[[Ko...]]

@[Md...] HI -we have corresponded before as we were both switched to valium for tapering purposes.  I was on .5 mg klonopin and switched to 10 mg valium. I am now on 7.25 mg. I was just as depressed and low energy on klonopin for what its worth although it seems that everyone is different. I would say that valium makes me feel more unmotivated although that could also be effect of tapering. I definitely don't feel like myself at all.

Not sure if this is allowed on here but there are a couple facebook groups for people trying to come off benzos if you want more personal accounts of switching from one particular benzo to another. I asked about switching from klonopin to valium and received lots of replies for and against. Some felt the switch was miraculous and others felt it was horrible. There were people who couldn't tolerate valium and switched back to their original benzo. There are also people who feel that multiple switches from one benzo to different ones impacted them in a negative way. So, like most everything with regard to benzos, it seems everyone is different.  If you don't want to join these, i would be happy to ask your question on there and report back to you. I have to say that the facebook groups are very active and you can get a lot of responses within a few hours...

I don't know if it would be helpful to get your doc to order the genesight test to see how you metabolize the different benzos?

[[Ko...]]

14 minutes ago, [[L...] said:

You’re most welcome @[Md...].  I neglected to mention two other challenges associated with clonazepam — its half-life and major metabolite. Although clonazepam’s reported half-life is long (at least compared to alprazolam and lorazepam), some individuals seem to metabolize it rapidly, which can lead to interdose withdrawal. In addition, at least one animal study found that its major metabolite was a GABA antagonist.

That's interesting. I wonder if that 's why I had such problems with clonazepam after a short period of time.  

[[Md...]]

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

@[Md...] HI -we have corresponded before as we were both switched to valium for tapering purposes.  I was on .5 mg klonopin and switched to 10 mg valium. I am now on 7.25 mg. I was just as depressed and low energy on klonopin for what its worth although it seems that everyone is different. I would say that valium makes me feel more unmotivated although that could also be effect of tapering. I definitely don't feel like myself at all.

Not sure if this is allowed on here but there are a couple facebook groups for people trying to come off benzos if you want more personal accounts of switching from one particular benzo to another. I asked about switching from klonopin to valium and received lots of replies for and against. Some felt the switch was miraculous and others felt it was horrible. There were people who couldn't tolerate valium and switched back to their original benzo. There are also people who feel that multiple switches from one benzo to different ones impacted them in a negative way. So, like most everything with regard to benzos, it seems everyone is different.  If you don't want to join these, i would be happy to ask your question on there and report back to you. I have to say that the facebook groups are very active and you can get a lot of responses within a few hours...

I don't know if it would be helpful to get your doc to order the genesight test to see how you metabolize the different benzos?

Thank you. Yes, I remember our conversation. 🙂

I am a member of some of those groups and what you said is spot on. 

Can i ask what your tapering speed is and what your withdrawal symptoms are? I’m cutting at 5% every 4 weeks, and am not doing well. The first 30 days were a breeze and i didn’t notice anything, then i got hit hard after getting sick. 

[[Md...]]

34 minutes ago, [[L...] said:

You’re most welcome @[Md...].  I neglected to mention two other challenges associated with clonazepam — its half-life and major metabolite. Although clonazepam’s reported half-life is long (at least compared to alprazolam and lorazepam), some individuals seem to metabolize it rapidly, which can lead to interdose withdrawal. In addition, at least one animal study found that its major metabolite was a GABA antagonist.

Thanks again! So good to know this info.

[[Ko...]]

3 minutes ago, [[M...] said:

Thank you. Yes, I remember our conversation. 🙂

I am a member of some of those groups and what you said is spot on. 

Can i ask what your tapering speed is and what your withdrawal symptoms are? I’m cutting at 5% every 4 weeks, and am not doing well. The first 30 days were a breeze and i didn’t notice anything, then i got hit hard after getting sick. 

I watched a video that Mark Horowitz did about slow diazepam tapering that he made based on diazepam receptor occupancy. From 10 mg through 4 mg he recommended .4 mg decreases every 2 weeks and from 4 mg to 0 he recommended .2 mg decreases. I decided to err on the side of being conservative and am doing .25 mg decreases every 2 weeks (would hold up to 3 weeks if necessary) until probably 5 mg if tolerable and then will switch to the liquid and do .1 mg decreases every 2 weeks which hopefully I can tolerate. I need to keep my job through this tapering situation so I am keeping things slow and hoping for the best. Thankfully, today I have a snow day and not needing to work....

I have a taper friendly nurse practitioner who will use the liquid valium and lets me go as slowly as I want but she feels that microtapering is unnecessary so I have not had support with regard to that method of tapering which of course worries me. 

As far as symptoms go- I have depression, fatigue, amotivation, and anhedonia. I have anticipatory anxiety and really have to force myself to do most anything.  These developed while I was on the klonopin and not sure if they were symptoms of tolerance of some kind as I did not have them before. 

Now that I am reducing, my sleep is disrupted with 3 am awakenings,  muscle twitching/fasciculations, patches of burning skin, episodic muscle pain, declining vision, and strange body odor.  

What have your withdrawal symptoms been?

 

[[Md...]]

4 minutes ago, [[K...] said:

I watched a video that Mark Horowitz did about slow diazepam tapering that he made based on diazepam receptor occupancy. From 10 mg through 4 mg he recommended .4 mg decreases every 2 weeks and from 4 mg to 0 he recommended .2 mg decreases. I decided to err on the side of being conservative and am doing .25 mg decreases every 2 weeks (would hold up to 3 weeks if necessary) until probably 5 mg if tolerable and then will switch to the liquid and do .1 mg decreases every 2 weeks which hopefully I can tolerate. I need to keep my job through this tapering situation so I am keeping things slow and hoping for the best. Thankfully, today I have a snow day and not needing to work....

I have a taper friendly nurse practitioner who will use the liquid valium and lets me go as slowly as I want but she feels that microtapering is unnecessary so I have not had support with regard to that method of tapering which of course worries me. 

As far as symptoms go- I have depression, fatigue, amotivation, and anhedonia. I have anticipatory anxiety and really have to force myself to do most anything.  These developed while I was on the klonopin and not sure if they were symptoms of tolerance of some kind as I did not have them before. 

Now that I am reducing, my sleep is disrupted with 3 am awakenings,  muscle twitching/fasciculations, patches of burning skin, episodic muscle pain, declining vision, and strange body odor.  

What have your withdrawal symptoms been?

Thanks for sharing, and sorry to hear about your symptoms.

My symptoms are random bouts of anxiety, even more lethargy, brain fog, extreme lack of motivation, and head pressure, bouts of extreme depression.

It honestly feels like a really bad flu, but without some of the flu symptoms. Not sure if that makes any sense. 

I definitely don’t feel like myself, and have trouble finding any kind of enjoyment in things i used to love. 

I honestly didn’t think 5% cuts every 4 weeks could cause such symptoms. But i know others have it much worse than I do, so maybe I should be thankful. I’m also wondering if i should hold and try to stabilize to see if symptoms will improve, or just keep pushing through. It’s hard to make these kinds of decisions. 

Part of me also feels stupid for even tapering in the first place, because I originally got on this medication to treat debilitating facial neuropathy, and I don’t really have a backup plan yet in case the pain comes back full throttle.

I think i would psychologically feel so much better if i knew what the neuropathy would be like after the benzos were out of my system. 

[[Ko...]]

When are you due for another cut? I am not sure what is recommended for maximum holding time. 

Our symptoms sound similar with the depressive symptoms, extreme lethargy and lack of motivation.  I don't enjoy anything I used to enjoy either.  I used to be a workout fanatic and super healthy, always planning vacations and excursions. I loved to go out and do all kind of things. I have already missed out on so much.  So this really stinks as I don't feel like my old happy self.  But, like you said, I know it could be much worse.  And I'd rather be tired than constantly agitated.

As far as staying on a benzo, I have read too many horror stories of people who ended up in even worse situations on high dosages and in tolerance withdrawal.  I have come to the conclusion that these medications affect us adversely in so many ways.  I know my mental health and physical fitness has declined since being on them.   I considered delaying taper for another 10 years with hopes that I could try to retire before attempting this but I don't think I could bear feeling like this for 10 more years and fear that I would end up in an even worse situation.

I hope that we both get some relief from the depression and don't suffer too much...

[[Li...]]

@[Ko...]  Is this the video you watched?  If so, I thought @[Md...] might find it of interest as well. 

 

[[Md...]]

7 minutes ago, [[L...] said:

@[Ko...]  Is this the video you watched?  If so, I thought @[Md...] might find it of interest as well. 

I listened to the holding part. I am heavily considering it.

[[Ko...]]

@[Li...]yes, that's it. He has charts near the end w/r/t slow diazepam tapering.

what does he say about holding?

[[Li...]]

57 minutes ago, [[K...] said:

I have a taper friendly nurse practitioner who will use the liquid valium and lets me go as slowly as I want but she feels that microtapering is unnecessary so I have not had support with regard to that method of tapering which of course worries me. 

@[Ko...]  If you have access to liquid valium, you can do a daily microtaper if you wish.  For example, if you wish to reduce your dose by 0.25mg every 2 weeks (14 days), you simply divide 0.25 by 14 to get a daily reduction amount of 0.0178mg.  

 

 

[[Md...]]

17 minutes ago, [[K...] said:

When are you due for another cut? I am not sure what is recommended for maximum holding time. 

Our symptoms sound similar with the depressive symptoms, extreme lethargy and lack of motivation.  I don't enjoy anything I used to enjoy either.  I used to be a workout fanatic and super healthy, always planning vacations and excursions. I loved to go out and do all kind of things. I have already missed out on so much.  So this really stinks as I don't feel like my old happy self.  But, like you said, I know it could be much worse.  And I'd rather be tired than constantly agitated.

As far as staying on a benzo, I have read too many horror stories of people who ended up in even worse situations on high dosages and in tolerance withdrawal.  I have come to the conclusion that these medications affect us adversely in so many ways.  I know my mental health and physical fitness has declined since being on them.   I considered delaying taper for another 10 years with hopes that I could try to retire before attempting this but I don't think I could bear feeling like this for 10 more years and fear that I would end up in an even worse situation.

I hope that we both get some relief from the depression and don't suffer too much...

I cut everyday in tiny increments, as opposed to cutting and holding. I do this with liquid valium and syringes. This is supposed to make the tapering process not as rocky. I still feel like i may be tapering too fast though.

Oh, yes. I have experienced bouts of agitation as well. Not very fun. 

And yes, there are many horror stories of tolerance withdrawal. That’s the main reason why i decided to start tapering. Simultaneously, i have a very rare and debilitating condition in which i have not been able to find relief yet from other meds, so it’s a crapshoot either way for me.

Edited January 19 by [Md...]

[[Li...]]

5 minutes ago, [[K...] said:

what does he say about holding?

Horowitz addressed the topic of holding in a recent podcast.  See my post about it at: 

 

[[Ko...]]

3 minutes ago, [[L...] said:

@[Ko...]  If you have access to liquid valium, you can do a daily microtaper if you wish.  For example, if you wish to reduce your dose by 0.25mg every 2 weeks (14 days), you simply divide 0.25 by 14 to get a daily reduction amount of 0.0178mg.  

I don't have access to it right now but may end up doing that later. I am trying to keep it simple as long as I can as I am already stressed with the pharmacy dispensing both 2 mg and 5 mg tablets on time. 

I am hoping to make it down to 5 mg first before going to part liquid. My prescriber is fine with switching to a portion of the dosage in liquid but still wanted to keep it cut and hold. She even expressed that drops of .1 mg seemed ridiculous. Easy for her to say!

[[Ko...]]

11 minutes ago, [[M...] said:

I cut everyday in tiny increments, as opposed to cutting and holding. I do this with liquid valium and syringes. This is supposed to make the tapering process not as rocky. I still feel like i may be tapering too fast though.

Oh, yes. I have experienced bouts of agitation as well. Not very fun. 

And yes, there are many horror stories of tolerance withdrawal. That’s the main reason why i decided to start tapering. Simultaneously, i have a very rare and debilitating condition in which i have not been able to find relief yet from other meds, so it’s a crapshoot either way for me.

Did you switch from cut and hold to daily microtapering?  That is the advantage of having Dr Witt-Doering as your doc as he is open to different ways of tapering and really gets it.  I have read that with the daily microtapering sometimes you need to hold as the dosages catch up with you so I guess that's what you are wondering about?

Mine doesn't rush me but she does not understand all the nuances of benzo tapering as those of us who are forced to do a crash course in it. 

Was your agitation physical or mental? Sorry to hear about that.

I am also sorry for your dilemma about your painful condition.  Keep us posted on how things go. This is a lonely experience.

[[Md...]]

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

Did you switch from cut and hold to daily microtapering?  That is the advantage of having Dr Witt-Doering as your doc as he is open to different ways of tapering and really gets it.  I have read that with the daily microtapering sometimes you need to hold as the dosages catch up with you so I guess that's what you are wondering about?

Mine doesn't rush me but she does not understand all the nuances of benzo tapering as those of us who are forced to do a crash course in it. 

Was your agitation physical or mental? Sorry to hear about that.

I am also sorry for your dilemma about your painful condition.  Keep us posted on how things go. This is a lonely experience.

I started off microtapering per Dr Josef’s instructions. He has always been flexible with whatever decision i make, but simultaneously offers his advice/guidance, which is nice.

I specifically asked him how long tapering would last at the current rate im going, which would be 19 months, but he also said, “I don’t like to give people finish lines, because tapering can be unpredictable.” He was definitely right about that, as i feel like i might need to slow down or hold, especially since i am not as functional as id like to be. He was even open to me switching to Klonopin, as he was saying that some people just can’t tolerate Valium that well, and Ive been having issues with it ever since i started it, especially the liquid.

Btw, thanks for the kind words. I’m hoping i can somehow beat this condition, even though the prognosis is low. 

 

Edited January 19 by [Md...]

[[Ko...]]

A few more questions- do you find the microtapering to be simple and is the liquid valium palatable? How much do you reduce per day? Is it like the water tapering that so many people on facebook do?