Ryan-switching from Xanax to Valium

[Jade59]

Hey Ryan, I spoke to my dr a few weeks ago about switching from Xanax to Valium.  I currently have 1mg tablets of Xanax and usually take no more than 1.5mgs at night and only sometimes 2mgs.  I have read your posts about staying at 2mgs or under in order to make the switch to Valium with minimum discomfort and have tried very hard to not go over this dose for several months now.  Sometimes, I will take .25mgs during the day because of the rebound anxiety.  As I posted a few months ago, the Xanax is predictably not working well anymore as I have been on it for over 12yrs.  

Just to be clear, I don't normally have panic attacks, just anxiety and terrible insomnia so I would mainly be taking this for sleep.

My question is, what is the equivalent of 1mg tab Xanax to Valium?  Does it sound like I'm doing the right thing?  I didn't get an rx for Valium from my dr when I went because I wasn't sure I was ready to make the switch at that time so I have to call the pharmacy and I want to make absolutely sure I have the right equivalent.  

I appreciate any response or suggestion you might have for me.  Your posts have educated me far more than my dr ever has.  

Thanks so very much...

[RCA7591]

Hello,

Transitioning from Xanax to Valium can be very problematic (and perhaps, hazardous). You see, Valium's active metabolite Desmethyldiazepam carries a 200-hour half-life. For Valium to fully replace Xanax, it must accumulate to "steady-state". This is a one-month process.

Thus, one would experience what I refer to as a "window of vulnerability", a time frame in which you would undergo Xanax withdrawal before the Valium ultimately accumulated to steady-state. This "window of vulnerability" may range from two weeks to one month. During this phase, the withdrawal phenomena from the Xanax would be severe to extreme, and seizure is a possibility (particularly after 12 years of Xanax use).

A better (safer) option would be to transition from Xanax to Klonopin. Klonopin carries an intermediate half-life of 50 hours, and as such, will replace the Xanax more rapidly. The "window of vulnerability" is reduced to 3-14 days when transitioning from Xanax to Klonopin. Once stabilized on Klonopin, it may be withdrawn from directly in 1/8 mg increments every four weeks, or a transition to Valium may be made. One should be stabilized on Klonopin for at least one month before transitioning to Valium to minimize potential withdrawal phenomena.

If you are looking to re-establish clinical efficacy, the Klonopin would also serve this purpose. In this case, you'd want to increase the dosage of the Klonopin by an additional 0.5 mg. Klonopin and Xanax are dose equivalent, and 0.5 mg of either agent is equal in potency to 10 mg of Valium. Hence, if you are not looking to discontinue Benzodiazepines, Klonopin 1 mg, b.i.d. would be a reasonable choice to re-establish efficacy.

Fortunately, you did not obtain a prescription for Valium for the reasons outlined above. I would speak with the doctor about prescribing Klonopin instead. If you desire to discontinue Benzodiazepines, Valium can be implemented at a later time more easily.

Ryan

[Jade59]

Thanks for your response Ryan. It's not that my dr didn't give me a script for any kind of reason...she is letting ME decide what I want to do!!  If I wanted to make the change when I saw her, she would have written the rx for Valium; I seem to be in control.  I brought Klonopin up to her, maybe a year ago and she didn't seem receptive to that.  I'm probably going to have to hook up with a psych to get the klonopin.

Meanwhile, I'm pretty sure she has approved the Valium.  What would be the repercussions of taking say .5 Xanax and .5 Valium just to get some sleep since I'm already so addicted to a benzo anyway.  With the holidays here, I am not excited to take any kind of benzo all day long.  So if I began seeing a psych in a month let's say, would taking both Xanax and Valium be terrible?  What do you think of that?  

I feel so trapped and frightened!!

Thanks again...

[Orobinson]

why did your doctor switch you from xanax to valium?