How to change from Lorazepam to Diazepam

[[Dr...]]

Hello everyone, 

Right now I'm tapering Lorazepam and am using tapering strips for that. 

Since mid November, when I was first prescribed Lorazepam, I was on:

Morning: 1mg

Afternoon: 1 mg

Evening: 1 mg

I started tapering (following a tapering plan from a pharmacy in the Netherlands that is specialised in tapering) from Jan 23rd. I am tapering each intake separately and am now on:

Morning: 0.30 mg

Afternoon: 0 (successfully tapered) 

Evening: 1 mg

Up to 3 weeks ago it went reasonably well although I was still faced, like everyone else, with daily symptoms. Sometimes challenging, sometimes very doable. 3 weeks ago I had to stabilise at 0.35mg in the morning as the symptoms got too bad. I stabilised in 2 weeks time (I'm on a hotline with the pharmacist so he guides me through this as best as possible) and started tapering again this Monday. Tapering feels harder now, somehow, than it did before the symptoms got too bad. 

Anyway, my question is: how would I change from 1mg Lorazepam to Diazepam and over what period of time? 

I am intending to finish tapering the morning intake to 0 on Lorazepam, as I have already successfully done with the afternoon intake. But depending on how difficult this will be, I might consider changing to Diazepam for the last intake, the evening dose. 

Anyone any suggestions on how to go from 1mg Lorazepam to Diazepam? I'm nowhere near done with the morning dose, but I'd like to already give this some thought. 

By the way, I did initially try to go from Lorazepam to Diazepam but the psychiatrist at the time had no clue and made me switch to Diazepam in 1 day and the dose was way too low. Within that first day all the alarm bells went off and I decided not to go down that road. The tapering pharmacy said it was very well doable to taper Lorazepam (up to recently it actually was) and they are supporting thousands of people with it, in the same way that I've been doing it: on Lorazepam and per dosis. 

Thanks in advance for your help! 

With love from The Netherlands 

[[or...]]

@[Dr...] Professor Ashton has crossover schedules and dosing schedules that many of us followed. I did for my cross from Ativan to Valium and had no trouble. The website and info is here:

https://www.benzo.org.uk/manual/bzsched.htm

 

[[Ka...]]

hello @[Dr...] I do remember what you were doing with the tapering strips. 

I myself was switched straight from lorazepam to diazepam & I wasn’t aware back then of any other method! It wasn’t even equivalent in terms of dose so I completely understand & your previous experience. 

Am presuming you’d like a gradual cross over from 1mg lorazepam to equivalent 10mg diazepam and assume this will be ordered as tapering strip. If this were me I’d do something like this:

0.80mg L       2mg D

0.60mg L       4mg D

0.40mg L       6mg D

0.20mg L       8mg D

0L                   10mg D

The gaps between changes could be flexible & led by how you respond - say every 7 days, or 10 days or whatever best suits you. This is purely just an idea. A rate that allows your system to adapt will ultimately lead to less potential WD. 

I hope this might be useful. If not, am sure you have other members input to assist with the objective. I was much more settled on diazepam even though the transition was not approached properly! 
 

 

 

 

 

Edited May 17 by [Ka...]

[[Dr...]]

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

hello @[Dr...] I do remember what you were doing with the tapering strips. 

I myself was switched straight from lorazepam to diazepam & I wasn’t aware back then of any other method! It wasn’t even equivalent in terms of dose so I completely understand & your previous experience. 

Am presuming you’d like a gradual cross over from 1mg lorazepam to equivalent 10mg diazepam and assume this will be ordered as tapering strip. If this were me I’d do something like this:

0.80mg L       2mg D

0.60mg L       4mg D

0.40mg L       6mg D

0.20mg L       8mg D

0L                   10mg D

The gaps between changes could be flexible & led by how you respond - say every 7 days, or 10 days or whatever best suits you. This is purely just an idea. A rate that allows your system to adapt will ultimately lead to less potential WD. 

I hope this might be useful. If not, am sure you have other members input to assist with the objective. I was much more settled on diazepam even though the transition was not approached properly! 
 

That's very helpful, Katrina. Thanks so much! 

[[Dr...]]

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

@[Dr...] Professor Ashton has crossover schedules and dosing schedules that many of us followed. I did for my cross from Ativan to Valium and had no trouble. The website and info is here:

https://www.benzo.org.uk/manual/bzsched.htm

Hi @[or...]. Thanks! I did look at the Ashton manual though, but what I found for Lorazepam was for 3x1 mg change to Diazepam. I am just not sure how it should be done for 1 mg only.