Transition from Ativan to Diazepam

[[...]]

 

So my doctor is very clear he wants me to move from Ativan to Diazepam only. 

3mg Ativan to 30mg Diazepam (he wants it at 10mg Diazepam in the AM and 20mg in the PM)

Please suggest best ways to transition into this.

Would like to retain sleep. 

Should I go slow as per the Ashton Manual? Can I tweak it to be a bit sooner? I might have a big trip coming up in May so would like to settle in with the long lasting benzo before that.

Many thanks!

 

Edited March 18 by [...]
Added info

[[Id...]]

Hi @[...],

as you probably know the Ashton manual gives the exact example of what you are asking for:

https://www.benzoinfo.com/ashtonmanual/chapter2b/#schedule8

differently from your provider it involves breaking down the dose you are taking in three daily assumptions and a slow, cautionary substitution with the equivalent long lasting benzodiazepine; then a total reduction. Everything is meant to be evaluated with the patient symptoms to decide if he/she can endure it and if a different pace (slower or faster) is needed. Because every situation is different.
 Keep in mind that to feel your exact reaction to a newer diazepam dosage could take 2/3 weeks, due to his higher half life.

You could have a talk with your provider to see if this could be an appropriate route for you.
 

What are your doubts about this possible solution?

Evaluate also that many patients don’t have many problems with a faster approach. Both in switching and reducing. It usually depends on the patient, the situation, the period you were on the medication and there’s no way to know before. 
 

About retaining sleep also everyone is different you just need to see what happens. 
 

I tried this schedule and I wasn’t able to complete the switch (but I am a limit situation coming from years of kindling), so I had to find a balance midway and reduce both together. I am in a much better place than I was just few months ago 

[[je...]]

If it were me I would start off by following Ashton because it is tried and tested. Then evaluate as I go through the process. I understand your reasoning for wanting to be used to the new drug for your trip but there’s also no purpose in rushing it and be miserable because the crossover itself was rushed and went wrong. 

[[Hu...]]

Hi Nlav, from all the medications I took, lorazepam, seresta, zopiclon, mirtazapine... valium scared me the most. Because it made my breathing very slow. I started crossing to diazepam from lorazepam last december. But not without testing what 0.5 mg D would do to me. And it is so different from lorazepam.

I didn't swap more than 0.25mg of lorazepam for 2.5 diazepam per week.

And I also did some time holding because some weeks I was so tired.

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[[...]]

How does this plan look? 0.5mg substituted at a time. Initially, at night.

[[Ch...]]

Your dosing of lorazepam is atypical in that you dose 3mg once a day, instead of 1mg three times a day. It has a short half-life. Are you experiencing discomfort between doses?

The issue with diazepam is the opposite. It has a long half life, and after you've fully transitioned over to it, dosing needs only to be once daily.

Someone already referred you to the Ashton method. That is what I followed when I transitioned to diazepam. Slow and methodical.

[[je...]]

Hi @[Ch...]

Welcome to BenzoBuddies!

Thanks for sharing your experience. 

[[de...]]

Welcome to Benzo Buddies @[Ch...]!   Glad you found us!  

[[An...]]

@[...]

I agree with what the others said about using Professor Ashton's protocol if you can b/c it is tried and true. If you can't for whatever reason, I also think an abrupt switch could also work.

@[Ch...], welcome to BB friend.