Lorazepam to Valium

[[mo...]]

 

New doctor was chosen because he uses the Ashton method. I’m so confused though as he is changing me over directly from .5 loraz 3 X a day to v without crossover. He prescribed 5 mg v twice  a day with a 2 mg for any breakthrough symptoms. I thought he would reduce 1 mg at a time after holding for a certain period of time but he is letting  me self pace. I can’t cut a 5 mg down and he just said if I’m feeling fine I can just go from 5/5 to the 5/2 or just skip the second dose. None of this sounds right to me.  Another question is this… does the conversion sound right? 1.5 mg loraz to 10 mg V? Some calculators say 7.5? 

I wake up with tremors, fast pulse, and higher BP. I’m scared! I thought he was going to give me a schedule of small cuts and how long to hold in between.

 

[[Re...]]

Hello @[mo...], Welcome to BenzoBuddies!

I approved your post so that others can comment on it, I am sure our Buddies will share their thoughts very soon. 

I am glad you joined us!

RR

[[Pa...]]

Hi @[mo...], welcome.

I'm glad you found a doctor who has at least heard of the Ashton method, even if he doesn't follow it to the letter.  As for the equivalency, Professor Ashton put it at 1.5 mg Ativan would equal 15 mgs Valium, she was very generous with her clients but I think 10 mgs is probably adequate in your case.

Has your doctor given you the freedom to cross over slowly with enough of a supply?  If so, I'd suggest following Ashtons protocol for that.

But I guess we need to first ask why you're crossing over the Valium, are you dealing with severe interdose withdrawal and how long have you been taking benzodiazepines?

@[Pa...]

[[mo...]]

I’ve been on Ativan since February. Only took 12 out of 20 .5 mg between 4 February and 24 April. Started taking it more regularly around second week of May. Had a breast cancer scare with biopsy in June//July so increased dose and daily use. Luckily, no cancer.  He isn’t having me do a crossover but straight switch. I have been having inter dose withdrawal with shaking, increased pulse and BP and restlessness. The last month I’ve been taking, for the most part, .5 mg at 7:30 am .25 mg at 12:30 pm and .5 mg at 5 pm. A few times it has been .5 three times a day. I take a sleep medication twice nightly for narcolepsy  so my first and last dose of Ativan have to be at least 5 hours away from that med. 

I’m concerned about not doing a crossover though I see some have done well with it. I also am afraid of reducing too much too fast. 
 

Where would I find the crossover for Ativan to Valium. I don’t want to upset him this early I to our doctor/patient relationship by asking to change his plan to allow for crossover. 
 

 

Edited August 3 by [mo...]

[[mo...]]

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

Hi @[mo...], welcome.

I'm glad you found a doctor who has at least heard of the Ashton method, even if he doesn't follow it to the letter.  As for the equivalency, Professor Ashton put it at 1.5 mg Ativan would equal 15 mgs Valium, she was very generous with her clients but I think 10 mgs is probably adequate in your case.

Has your doctor given you the freedom to cross over slowly with enough of a supply?  If so, I'd suggest following Ashtons protocol for that.

But I guess we need to first ask why you're crossing over the Valium, are you dealing with severe interdose withdrawal and how long have you been taking benzodiazepines?

@[Pa...]

 

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

Hello @[mo...], Welcome to BenzoBuddies!

I approved your post so that others can comment on it, I am sure our Buddies will share their thoughts very soon. 

I am glad you joined us!

RR

Thank you! 

[[Pa...]]

@[mo...], the problem with not doing a proper crossover is you can end up a medication deficit because the Ativan leaves quickly and the Valium takes days to build up.  This could have you begin your taper in a place of instability, could you do a quick two step crossover?  Maybe you could do an abbreviated crossover, convert half of your dose to Valium the first week, then the rest the second. 

You've been on the medication for such a short time, I hate to see you spend too much time on a crossover which will increase your time on the drug and really, for short time users, we hope to see a more rapid taper.  But, if symptoms won't allow this, then settling in for a slow taper is best. 

You mentioned not being able to cut the 5 mg pill, why is that, are you worried about accuracy?

[Guest [Do...]]

Hi @[mo...] I switched from lorazepam to diazepam very fast after very short time of daily use of lorazepam like yourself, it took me like a week or so and i did not have any bad symptoms, in fact, as @[Pa...] said

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

Professor Ashton put it at 1.5 mg Ativan would equal 15 mgs Valium, she was very generous with her clients

Ashotn was generous in het equivalence, in my case i switched to 5mg diazepam and only did a week of 2.5mg night diaz, and 1.25mg diaz + 0.125mg loraz morning and then afeter a week i went full diazepam, 2.5mg twice a day and it worked well for me, i went symptom free and didn't and could even drop to 4mg cutting without problem, only when i tried to go under 4mg i got hit hard by symptoms and then i had to stabilize at 4mg and start micro daily liquid tapering.

You will be alright with the crossover

[[mo...]]

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

@[mo...], the problem with not doing a proper crossover is you can end up a medication deficit because the Ativan leaves quickly and the Valium takes days to build up.  This could have you begin your taper in a place of instability, could you do a quick two step crossover?  Maybe you could do an abbreviated crossover, convert half of your dose to Valium the first week, then the rest the second. 

You've been on the medication for such a short time, I hate to see you spend too much time on a crossover which will increase your time on the drug and really, for short time users, we hope to see a more rapid taper.  But, if symptoms won't allow this, then settling in for a slow taper is best. 

You mentioned not being able to cut the 5 mg pill, why is that, are you worried about accuracy?

I am worried about accuracy and thought it was recommended to do a small 1 mg taper. Cutting 5 mg down to allow a 1 mg taper couldn’t happen. I honestly don’t know how much is withdrawal symptoms vs ongoing anxiety.
 

I had a surgery end of last year that caused some unwanted changes to the anatomy of my eyes and permanent nerve damage. This led to high stress, anxiety, panic attacks, loss of appetite with a 25 pound weight loss in 6 weeks, insomnia, and hair loss. I always had long thick hair and it is now 1/3rd of what it was and is now much shorter and wispy with ongoing loss very day. Now, they found I have high prolactin levels and I’m awaiting a MRI to look for a tumor. Being on Ativan and busprione (started in February as well) has changed me. I feel dull and can’t find joy or happiness in anything. I don’t feel like myself at all. I attribute much of that to these meds and want off of them as quickly as possible but am terrified of symptoms being more than I can handle. 

[[mo...]]

2 minutes ago, [[D...] said:

Hi @[mo...] I switched from lorazepam to diazepam very fast after very short time of daily use of lorazepam like yourself, it took me like a week or so and i did not have any bad symptoms, in fact, as @[Pa...] said

Ashotn was generous in het equivalence, in my case i switched to 5mg diazepam and only did a week of 2.5mg night diaz, and 1.25mg diaz + 0.125mg loraz morning and then afeter a week i went full diazepam, 2.5mg twice a day and it worked well for me, i went symptom free and didn't and could even drop to 4mg cutting without problem, only when i tried to go under 4mg i got hit hard by symptoms and then i had to stabilize at 4mg and start micro daily liquid tapering.

You will be alright with the crossover

He didn’t offer a crossover but a straight switch. I have no clue how to do the crossover. I have 5 mg and 2 mg pills. 

[Guest [Do...]]

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

I honestly don’t know how much is withdrawal symptoms vs ongoing anxiety.

This is the answer to your question, you answered yourself, if you ad fear to the fear is like adding gasoline to the fire. Wait for the results of your MRI and try to keep clam, don't anticipate. If everything is right and you don't have a tumor, just focus on your taper and keep the calm, always keep the calm.

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

am terrified of symptoms being more than I can handle. 

 

[Guest [Do...]]

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

He didn’t offer a crossover but a straight switch. I have no clue how to do the crossover. I have 5 mg and 2 mg pills. 

Do you have any ativan pills left? if you do, just take night dose of diazepam and mornig dose take half of diazpeam and half of lorazepam as the example i wrote before, there are more examples in the asho¡ton manual, just look at the 3mg lorazpeam switch to diazpeam and do half of that as you are switching from 1,5mg to diazepam and is it half of the axample dose of 3mg

Edited August 3 by Guest

[[mo...]]

8 minutes ago, [[D...] said:

Do you have any ativan pills left? if you do, just take night dose of diazepam and mornig dose take half of diazpeam and half of lorazepam as the example i wrote before, there are more examples in the asho¡ton manual, just look at the 3mg lorazpeam switch to diazpeam and do half of that as you are switching from 1,5mg to diazepam and is it half of the axample dose of 3mg

Makes sense. Thanks! My brain doesn’t work like it used to sadly. 

[Guest [Do...]]

Just now, [[m...] said:

Makes sense. Thanks! My brain doesn’t work like it used to sadly. 

I know how fear can makes us freeze and noy let us think, just dont let the fear dominate you.

I would wait for MRI results and then take care of the taper, hold on there meanwhile and then, when you are free from that worry, go for the taper. It not may be a good moment to start the taper when you're under such a stress and waiting for tumor results.

Hold there and let us know and we will help you figure out your taper.

[[mo...]]

23 minutes ago, [[D...] said:

Hi @[mo...] I switched from lorazepam to diazepam very fast after very short time of daily use of lorazepam like yourself, it took me like a week or so and i did not have any bad symptoms, in fact, as @[Pa...] said

Ashotn was generous in het equivalence, in my case i switched to 5mg diazepam and only did a week of 2.5mg night diaz, and 1.25mg diaz + 0.125mg loraz morning and then afeter a week i went full diazepam, 2.5mg twice a day and it worked well for me, i went symptom free and didn't and could even drop to 4mg cutting without problem, only when i tried to go under 4mg i got hit hard by symptoms and then i had to stabilize at 4mg and start micro daily liquid tapering.

You will be alright with the crossover

Do you think I would do ok with trying a straight crossover? How long would it be before I would know if it causes issues? I’m sorry for asking so many questions. I’ve had some really bad panic attacks the last few months and not sure if I can handle any right now. 

[[mo...]]

8 minutes ago, [[D...] said:

I know how fear can makes us freeze and noy let us think, just dont let the fear dominate you.

I would wait for MRI results and then take care of the taper, hold on there meanwhile and then, when you are free from that worry, go for the taper. It not may be a good moment to start the taper when you're under such a stress and waiting for tumor results.

Hold there and let us know and we will help you figure out your taper.

Thank you! Unfortunately, the MRI can’t be scheduled until October and I don’t want to wait to get off this med until then. I’m tired of letting fear rule my taking it. Life is going to continue to be full of challenges, as it tends to be for many,  and I know I won’t be running back to Ativan to handle them. 

[Guest [Do...]]

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

Do you think I would do ok with trying a straight crossover? How long would it be before I would know if it causes issues? I’m sorry for asking so many questions. I’ve had some really bad panic attacks the last few months and not sure if I can handle any right now. 

Think you'd be allright with straight crossover but it is different for eveyone. Panic attacks are just generated by yoour own fear. We helped another member with that a few days ago, check this thread out, it might help you.

 

[Guest [Do...]]

2 minutes ago, [[m...] said:

Thank you! Unfortunately, the MRI can’t be scheduled until October and I don’t want to wait to get off this med until then. I’m tired of letting fear rule my taking it. Life is going to continue to be full of challenges, as it tends to be for many,  and I know I won’t be running back to Ativan to handle them. 

I suspect you think the taper would be fast enough to have ended by october?

I started my taper at 5mg 6 months ago and i am not even halfway. This sohuld take around a year to complete it safely.

As i said we never know cause this is different for everyone but be prepared for a long slow taper, i didn't want to acknowledge it at first but finally i had to admit the only way safe and functional is slow way, that meand 5-10% taper of the remaining dose every month.

[[mo...]]

No, I only meant I don’t want to wait to start my taper until after the MRI in October. Thanks for all the advice and reassurance! 

[Guest [Do...]]

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

No, I only meant I don’t want to wait to start my taper until after the MRI in October. Thanks for all the advice and reassurance! 

Ok, you can start then by figuring out your crossover and stabilize in diazepam, and when you get the good news of your MRI you can go a little more aggressive in your taper.

Remember there is a whole chapter in Ashton's called BEFORE STARTING BENZODIAZEPINE WITHDRAWAL

and you should be prepared to it in everyway, it gets too frustrating and too long.

[Guest [Do...]]

Special attentio to this part:

Get into the right frame of mind.

● Be patient. There is no need to hurry withdrawal. Your body (and brain) may need time to
readjust after years of being on benzodiazepines. Many people have taken a year or
more to complete the withdrawal. So don't rush, and, above all, do not try to stop
suddenly.
 

Edited August 3 by Guest
Deleted parts that are obsolete

[[mo...]]

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

Do you have any ativan pills left? if you do, just take night dose of diazepam and mornig dose take half of diazpeam and half of lorazepam as the example i wrote before, there are more examples in the asho¡ton manual, just look at the 3mg lorazpeam switch to diazpeam and do half of that as you are switching from 1,5mg to diazepam and is it half of the axample dose of 3mg

Last question for now, I promise. We are driving back from visiting our daughter in SC so I’m sitting here with nothing but thoughts to occupy my mind.

Repeating what I posted before, I’ve been taking Ativan at 7:30 am, 12 - 12:30pm and 5 pm. The sleep medicine I take for narcolepsy is a twice a night dose and has to be at least 5 hours from the benzo. I typically take it at 10 - 10:30 and again 2 1/2 - 4 hours later. 
 

Would dosing the Valium at 7:30 and 5 be ok or do they have to be 12 hours apart? Does it need to be on a strict schedule? 

[Guest [Do...]]

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

Last question for now, I promise. We are driving back from visiting our daughter in SC so I’m sitting here with nothing but thoughts to occupy my mind.

Repeating what I posted before, I’ve been taking Ativan at 7:30 am, 12 - 12:30pm and 5 pm. The sleep medicine I take for narcolepsy is a twice a night dose and has to be at least 5 hours from the benzo. I typically take it at 10 - 10:30 and again 2 1/2 - 4 hours later. 
 

Would dosing the Valium at 7:30 and 5 be ok or do they have to be 12 hours apart? Does it need to be on a strict schedule? 

@[mo...] you are welcome to ask all day if you need to, that's what BB is for, there will always be someone willing to help.

About the narco`lepsy and the interaction with the benzos i don't dare to reply anything cause i really no nothing about it. Maybe @[Li...] @[Pa...] or @[Cr...] can help or know who can.

What i can tell you is that diazpeam has a very long half life lasting and you won't have to worry about interdose symptoms, in fact, if i could go back to my first day of taper i would switch to one single diazepam dose, i had many issues with my morning dose as it igets too oversedating and go my blood preasure too low, weak muscles, fatigue, etc so i had to break that dose in 2 and taper only from it in order to the rid of those side effects, i never had a problem with the night dose whatsoever.

Diazezapam is pretty forgiving with the schedule, you don't notice if you delay 1 hour or more in a dose, just don't skip any doses. But usually if you mess up or taper too quick you won't notice untill maybe a few days, in case is at the 4th day when the train hits me hard.

 

[[Li...]]

32 minutes ago, [[m...] said:

The sleep medicine I take for narcolepsy is a twice a night dose and has to be at least 5 hours from the benzo.

Hello @[mo...].  Have you checked for interactions between the narcolepsy medicine you take and diazepam?  Diazepam has different pharmacokinetics and is metabolized differently than lorazepam. 

[[mo...]]

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

@[mo...] you are welcome to ask all day if you need to, that's what BB is for, there will always be someone willing to help.

About the narco`lepsy and the interaction with the benzos i don't dare to reply anything cause i really no nothing about it. Maybe @[Li...] @[Pa...] or @[Cr...] can help or know who can.

What i can tell you is that diazpeam has a very long half life lasting and you won't have to worry about interdose symptoms, in fact, if i could go back to my first day of taper i would switch to one single diazepam dose, i had many issues with my morning dose as it igets too oversedating and go my blood preasure too low, weak muscles, fatigue, etc so i had to break that dose in 2 and taper only from it in order to the rid of those side effects, i never had a problem with the night dose whatsoever.

Diazezapam is pretty forgiving with the schedule, you don't notice if you delay 1 hour or more in a dose, just don't skip any doses. But usually if you mess up or taper too quick you won't notice untill maybe a few days, in case is at the 4th day when the train hits me hard.

I didn’t realize I could do once a day. That would probably work better for me. I’ll ask my doctor about it to see if he thinks it’s a viable option. Would certainly make it easier with my nighttime med. 

[[mo...]]

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

Hello @[mo...].  Have you checked for interactions between the sleep medicine you take and diazepam?  Diazepam has different pharmacokinetics and is metabolized differently than lorazepam. 

Yes, they have a major interaction. I am on xywav. But, if Valium makes me sleepy, then I might be able to take it at around 8 and only take one dose of xywav around 2 or 3 am.