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Dear Membership Approval Board:

I am 68 years old. I have been on 1.5 mg of Xanax for over 20 years for panic disorder and because of tolerance have been going through withdrawal on a daily basis. I contacted my psychiatrist a few months ago about getting off Xanax and he said normally one would have to go from Xanax to Ativan to Valium to Klonopin and then taper off. However, because I overdosed in going from Xanax to Ativan ten years ago, he "is not going there." I can understand his position. I tried going cold turkey and ended up in the emergency room. I am truly "kneeling on scorpions."

(I hope I have posted this correctly. I am not totally computer savy.)

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Hi there, KOS,

 

Welcome to BenzoBuddies. I'm sorry you've been having a rough time because of the tolerance and then the c/t. Have you reinstated your Xanax?

 

I'm not sure what your doctor is trying to achieve with his cross-over plan. It's nice of him to try to get you off, but has he familiarized himself with the work of Dr. Heather Ashton? Her recommendation is to cross straight to Valium, no matter what benzo you are on. And I have never heard of anyone taking such a circuitous route.

 

Actually it doesn't make a whole lot of sense to go from Xanax to Ativan. The reason people cross over is to get on a benzo with a longer half-life, which usually helps alleviate withdrawal symptoms. At least a little. But the half-life of Ativan is shorter than that on Xanax. You would sort of be going backwards.

 

I think maybe you should ask your doctor to read up on Ashton and then see what he says?

 

-P-

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Hello,

Still taking 1.5 mg/day of Xanax. Next appt. with psychiatrist not for another 16 months. Got primary care physician to put me on a low dose of Topamax, an anti-convulsant, for extreme light sensitivity and migraines.

(Still figuring out how to use this site. From what I have seen it is very professional and caring at the same time).

KOS

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Thank you! Thank you! Thank you! Thanks to your urging for an earlier appointment with my psychiatrist, I contacted him by e-mail. He is willing to do the cross-over from Xanax to valium (instead of first to ativan, which you questioned) and then to klonopin for the taper. I will start this weekend. I am still trying to figure out how to use this site to post my progress, rather than go through the Approval Board postings.

I know that I will have to endure physical and psychological suffering to get through this. I view it as similar to the subject matter of the "Saw" films. To me they are not merely "horror" films, but really about rehabilitation and redemption through suffering. Once again I thank you from the bottom of my heart for your solid advice.

Well, as Jigsaw would say: "Let the game begin."

KOS (kneelingonscorpions)

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Okay great! We've gotten rid of one problem, now to the next.

 

Here is the link to the Ashton manual: http://www.benzo.org.uk/manual/bzcha02.htm

 

You really want to be tapering off Valium, not Klonopin. K has a much shorter half-life than V, resulting in the same conundrum as with the Ativan and the Xanax.

 

In other words, according to Ashton, you need to cross from Xanax to Valium and then taper from there. No Ativan, no Klonopin. In fact a lot of people on this site cross from K to V in order to taper.

 

Okay, on to the next thing. You are on 1.5mg Xanax, correct? That is the equivalent of 30mg of Valium. It's extremely important to get this right. Crossing over to too little or too much V will be painful. Is this the dose your doctor prescribed you with? Because if not, you're going to need to call him back. The equivalency table I used to calculate 30mg is also on the Ashton site.

 

Third: Has your doctor given you instructions for crossing over? It must be done very slowly. You can't drop your entire dose of X and just take V instead. You are likely to crash and burn. The half-life of the V is so long that it builds up more slowly than X leaves your system. The thing to do is to drop to 1.25mg X for example, with 5mg V for one week. The next week drop to 1mg X with 10mg V. Etc. Schedules for crossing over can also be found on Ashton's site.

 

Fourth, we have a section for progress logs. Just make a new post here and keep adding to it. You'll want to bookmark your new post in your browser for easy access. http://www.benzobuddies.org/forum/index.php?board=87.0. Here is the link to a plog of a buddie who crossed from Ativan to Valium: http://www.benzobuddies.org/forum/index.php?topic=23003.0. Might prove helpful to see what she did.

 

And finally, don't get accustomed to the idea that you'll be tortured the entire time. Your taper, once done PROPERLY, might be relatively uneventful. I certainly hope it will be.

 

Best of luck.

 

-P-

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Well, the good news is that my doctor has prescribed 30mg of valium/day. The bad news is that he told me to completely stop the Xanax before starting the V. I will get up the nerve to e-mail him about the X/V balance in crossing over. Thanks again.
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