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|10-14-2006, 06:56 AM||#1 (permalink)|
Join Date: Feb 2006
Location: middle earth
Benzo equivalency tables.
Here is the site which will give the correct equivalencies for the various benzos and related drugs.
(Just scroll down and you will see the table of equivalent doses)
There is a comprehensive list on the site and I quote just the familiar ones.
So if you are substituting one benzo for another - make sure that you have the correct amount.
1 mg of xanax would be the equivalent of 20 mg valium.
1 mg of ativan would be the equivalent of 10 mg valium...........
1 mg of klonopin would be the equivalent of 20 mg valium
(Taking the standard of 10 mg valium being = 0.5 mg xanax = 1 mg ativan = 0.5 mg klonopin etc)
Apologies - I cannot work out how to put the table up here - so you should refer to the site - which also gives relevant details on half life of each benzo. This half life information is so important in this whole process of tapering. The half life of xanax is 6 - 12 hours while the half life of valium is 20 - 200 hours. So you can see why people have such trouble coming off xanax with its short half life - which means it leaves the bloodstream rapidly causing peaks and troughs in blood concentration. Valium's long half life allows for smooth steady reductions with no spiking etc and so allows for easier withdrawal without interdose withdrawal symptoms. Explained in detail on the site.
If you were taking 3 mg of klonopin then you would need to take 60 mg valium on crossing over.
It seems that doctors in general seem very ill informed on this topic. So often too you see someone trying to cross over to valium for taper purposes only to be scuppered because the doc prescribed far too low a dosage.
The figures above seem to be the best available - world wide - as they are based on clinical trials in the UK by Professor H Ashton.
Dosage tapering. There is absolutely no doubt that anyone withdrawing from long-term benzodiazepines must reduce the dosage slowly. Abrupt or over-rapid withdrawal, especially from high dosage, can give rise to severe symptoms (convulsions, psychotic reactions, acute anxiety states) and may increase the risk of protracted withdrawal symptoms (see Chapter III). Slow withdrawal means tapering dosage gradually, usually over a period of some months. The aim is to obtain a smooth, steady and slow decline in blood and tissue concentrations of benzodiazepines so that the natural systems in the brain can recover their normal state.
2) Switching to a long-acting benzodiazepine. With relatively short-acting benzodiazepines such as alprazolam (Xanax) and lorazepam (Ativan) (Table 1, Chapter I), it is not possible to achieve a smooth decline in blood and tissue concentrations. These drugs are eliminated fairly rapidly with the result that concentrations fluctuate with peaks and troughs between each dose. It is necessary to take the tablets several times a day and many people experience a "mini-withdrawal", sometimes a craving, between each dose.
For people withdrawing from these potent, short-acting drugs it is advisable to switch to a long-acting, slowly metabolised benzodiazepine such as diazepam. Diazepam (Valium) is one of the most slowly eliminated benzodiazepines. It has a half-life of up to 200 hours, which means that the blood level for each dose falls by only half in about 8.3 days.
Some doctors in the US switch patients onto clonazepam (Klonopin, [Rivotril in Canada]), believing that it will be easier to withdraw from than say alprazolam (Xanax) or lorazepam (Ativan) because it is more slowly eliminated. However, Klonopin is far from ideal for this purpose. It is an extremely potent drug, is eliminated much faster than diazepam (See Table 1, Chapter I), and the smallest available tablet in the US is 0.5mg (equivalent to 10mg diazepam) and 0.25mg in Canada (equivalent to 5mg Valium). It is difficult with this drug to achieve a smooth, slow fall in blood concentration, and there is some evidence that withdrawal is particularly difficult from high potency benzodiazepines, including Klonopin
I would recommend anyone who is trying to quit benzos to download and print off this manual - it is so comprehensive. You will find detailed tapering schedules to follow and being fore-armed with knowledge will make the whole process so much more doable. Time after time I see people trying to substitute the wrong amount of valium - and its so sad to watch - there is just no hope if the correct amounts are not used in substitutions.
And the logic in using valium is well explained and is so obvious. Why doctors refuse to prescribe valium is a real mystery?
Having read this manual then there are a couple of sites where you may get excellent support and advice. So - it really is all out there for anyone to access if they really want. Sometimes in here you see criticisms of these sites - but surely that is to be expected? The taper itself is hard hard work and people become so fraught.............. and people do fall out with one another. But in general the moderators of the sites use common sense and most people manage to struggle on together. And there is such hope to be gleaned from reading the stories of those who have sucessfully tapered off.
It can be done. You can do it.
Here is a site on which such a sufferer - Jack - has crossed over to valium and tapered off over a couple of years. This is his story and he has put it in print - in an attempt to help others. He is very perceptive and I think his story is fairly typical ............ and of course ultimately hopeful. It's a good read which is bang up-to-date. I would urge people to spend a little time in reading his story.
And just in case you miss it - Jack offers the book free to be read online (downloading only takes a few minutes and you can read at your leisure!) to all benzo sufferers. Here it is in pdf format. All 260 pages. Not to be missed!!
Last edited by woops; 10-14-2006 at 07:16 AM.
|10-14-2006, 07:29 AM||#2 (permalink)|
Big Idiot Man Child
Join Date: May 2004
my valium equivalency was so far off the charts that it scared the hell out of my doctor. i can't remember now but it was an insane/toxic amount of valium. didn't matter though cuz there was no way i could taper. i had to just kick it and take my chances. thank goodness i did it in a medical setting....crazy as it was. psych wards aren't soothing places.
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