As an American we like to think we have the best of everything. However that’s far from the case, especially when it comes to Healthcare. I’ve learned the hard way that’s far from the case. Especially when it relates to mental health. My last post about Benzodiazepines I explained how difficult it is to get off these meds especially after long term use.
When I want the most progressive medical treatment I look to the European countries. Professor Ashton a psychiatrist in the U. K has developed the most successful method of tapering off benzos . You would be hard pressed to find a U. S. doctor to follow this method but it worked for me.
So I summarized the different methods to successfully withdraw from Benzodiazepines. I hope it helps.
Overview: straightforward taper by gradually reducing the number of tablets (or fractions of tablets – pill-splitting) you take per day. You should obtain the lowest dose tablet available in your particular benzodiazepine.
Advantages: simple; wide support from doctors; probably all that’s required by the majority of people in the general community looking to quit benzos.
Disadvantages: many benzos are too potent to allow a smooth taper for some people (or the pills prescribed are too large in dose for successful pill-splitting); many benzos have too short a half-life to allow a smooth taper (interdose withdrawal is often a problem); can be tricky to split pills accurately.
I suggest that unless past experience of attempted tapering indicates otherwise, people should initially try cutting their dose by no more than about 10%, and will probably make new cuts (about 10% of their dose at the time of the new cut) every 7-14 days. These figures are intended as ballpark estimates – mileage will vary.
Overview: gradually reducing your dose of one benzodiazepine while, at the same time, introducing a second, more suitable benzodiazpine. Some benzodiazepines are easier to taper than others. So, switching to another benzodiazepine might aid withdrawal. You must talk to your doctor about substitution. Valium (diazepam) is usually considered the benzo-of-choice (for the purposes of substitution) of the vast majority of people .
Advantages: switching to an equivalent dose of Valium from a short half-life benzo (this must be carried out gradually) virtually guarantees that you will experience no interdose withdrawal effects; switching from a very potent benzo to Valium allows for much smaller cuts to your dose (more frequent small cuts are better tolerated than less frequent large cuts); if you have had problems sleeping, you may benefit from the sedating effects of Valium.
Disadvantages: some planning is required with a switch to Valium (but will help you with this); an equivalent dose must be calculated and tweaked where necessary to suit the individual; many doctors (particularly in the USA) do not support a switch to Valium; switching will likely add to the overall time taken to withdraw; a small number of people appear to not tolerate the switch to Valium very well (this sometimes might be due to the wrong equivalent dose being prescribed or a failure to tweak the dose for the individual concerned according to how they react).
A general rule of thumb. 1mg of Klonopin is equal to 20mg of Valium (diazepam). 1mg of Ativan is equal to 10mg of diazepam.
Prof. Ashton achieved very good results in her clinic by switching patients to Valium. Usually, her patients had already failed to quit benzos via the Direct route. If your doctor is supportive, and willing to adjust the equivalent dose as required, you are more likely to benefit from substitution.
Overview: Titration involves the daily preparation of a liquid using your benzodiazepine pill. This allows you to make small reductions to your dose.
Advantages: allows for a very smooth taper, even when tapering from a large dose pill and/or potent pills; does not require a sympathetic doctor (one that is willing to discuss the potential use of substitution).
Disadvantages: ties you down to the kitchen, as a fresh batch must be prepared each day, and refrigeration is required too; your doctor might be unsupportive if you explain that you are ‘titrating your benzos’; interdose withdrawal effects still might be a problem if you are taking a benzo with a short half-life; it is more complicated, and requires the purchase of some equipment.
Suggestions, opinions and/or advice provided by the author of this post should not be regarded as medical advice; nor should it substitute for professional medical care. Consult your doctor before making any changes to your medication.