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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by floatingbridge on May 21, 2011, at 8:44:23
I have been taking about 1.5 xanax for a few months. My relationship to xanax has been anywhere from 0.25-1.5 for about ten years. Lately it's no longer effective, rather suddenly, at these doses. (This shift actually predates emsam treatment.)
Yesterday my gp gave me 5-10mg Valium at my request for sleep. I had been
taking the entire 1.5 xanax at bedtime.After Googling, I could use some experienced answers.
I was instructed by my gp to take no more than 10mgs Valium per 24 hours
and to stop xanax completely.Is this reasonable? The equivalences are off as far as I can tell. I only want to take what I need to sleep, but don't want to inadvertently short myself and not know why I could be (if it happens) feel weird.
She said something about valium building up over time, and she said that produces tolerance.
That doesn't sound so great. Is there a point at which this 'build up' stops and blood, or is it fat, levels maintain a steady amount?
Could she be capping my initial dose to see how fast Valium accumulates for me? From what I've read, it varies greatly person to person.
I follow my doctor's instructions and call before making a change in our agreement. I would like to avoid getting in a jam because I can get panicky. Very often at night after hours.
Thanks.
Posted by SLS on May 21, 2011, at 9:05:35
In reply to help switching from xanax to valium part ll, posted by floatingbridge on May 21, 2011, at 8:44:23
What about Ativan (lorazepam)?
- Scott
Posted by floatingbridge on May 21, 2011, at 9:14:45
In reply to Re: help switching from xanax to valium part ll » floatingbridge, posted by SLS on May 21, 2011, at 9:05:35
I didn't bring it up, and no provider in the past has either. I don't understand ativan either, though it certainly knocked me out in the hospital at some unkown dose.
Does it seem more suitable (less treacherous) than Valium?
Valium also has pronounced muscle relaxing qualities. The valium did feel better than xanax at night, but I can still still feel the Valium this morning. At least it is not like klonopin. I only feel a little slowed. Welcome relief from last night, but something to keep an eye on.
Posted by Phillipa on May 21, 2011, at 11:15:05
In reply to Re: help switching from xanax to valium part ll » SLS, posted by floatingbridge on May 21, 2011, at 9:14:45
FB remember also you haven't slept well in a while give it some time as you did well last night. Being relaxed is a great feeling. Phillipa
Posted by sigismund on May 21, 2011, at 13:22:42
In reply to help switching from xanax to valium part ll, posted by floatingbridge on May 21, 2011, at 8:44:23
What you want to be aiming for, I gather, is a real equivalence that is, if anything, on the low side so you can start a taper, without building up more tolerance.
I couldn't do it on Xanax either, even though I prefer it. Though you have XR, which we do not. I expect you have decided against using that.
They are such different drugs in different ways (half life!) that a numerical equivalence will always be wrong for for someone.
But maybe you can say 0.5mg Xanax =< 10mg Valium, but I don't think you can extrapolate from that to take 30mg Valium at bedtime (of course).
Posted by floatingbridge on May 21, 2011, at 13:40:59
In reply to Re: help switching from xanax to valium part ll, posted by sigismund on May 21, 2011, at 13:22:42
sigi, do you know anything about the talk that Valium accumulates in the system?
The limited reading I've done on benzo doesn't mention this accumulation action.
I took klonopin for close to a year and not one peep about it accumulating in the system.
I don't know if it's the cultural references to Valium that worry me or that there really is something more insidious about Valium.
This is, of course, written by a decade long benzo user. Xanax was my friend. We managed. I would reduce or increase back and forth over the years,
but it always worked.I'm not setting out to taper right now, but it wouldn't hurt to look that way. Then again, anxiety agents like the limited AP's I've tried and not so limited AD's haven't worked. Personally, I don't celebrate benzo use, but it's been alright for me.
Posted by sigismund on May 21, 2011, at 13:48:59
In reply to Re: help switching from xanax to valium part ll » sigismund, posted by floatingbridge on May 21, 2011, at 13:40:59
IMO, it is Xanax that is more insidious, because the short half life is an invitation to take it too often.
Why don't you just take (I don't know) 10mg Valium in the evening and see how it goes?
If it is woefully inadequate you can always take more.
You won't want to take more Valium than you have to because it is a little depressing.
Why are you switching? Did you say?
If it wasn't for the short half life, Xanax would be better for me.
Posted by floatingbridge on May 21, 2011, at 14:01:23
In reply to Re: help switching from xanax to valium part ll, posted by sigismund on May 21, 2011, at 13:48:59
1. Sleep!!!!!! (longer half life).
2. Muscle relaxant (so is xanax, but xanax more edgy.)
3. Xanax has become inadequate. I'd have to really bump my dose. Not good. See number 1.
Posted by sigismund on May 21, 2011, at 14:49:50
In reply to Re: help switching from xanax to valium part ll » sigismund, posted by floatingbridge on May 21, 2011, at 14:01:23
It is much more relaxing than Xanax.
Also, Xanax is almost stimulating or almost agitating, and I wonder if it is as good for sleep?
Posted by Phillipa on May 21, 2011, at 21:19:15
In reply to Re: help switching from xanax to valium part ll » floatingbridge, posted by sigismund on May 21, 2011, at 14:49:50
Sigi the slight antidepressant effect? Unfortunately all it does it put me to sleep whether I want to or not now. Too long on that one. I have a bottle of lmg ativan also haven't taken a one maybe should rotate and see what happens? PJ
Posted by floatingbridge on May 21, 2011, at 22:58:32
In reply to Re: help switching from xanax to valium part ll » sigismund, posted by Phillipa on May 21, 2011, at 21:19:15
I did notice a depressant effect today w/ the Valium. Wish I wasn't so sensitive. :(
Oh well. Maybe tonight will be better and my pdoc will have some helpful suggestions on Tuesday. I'll bring up ativan and ask about this Valium accumulation thing.
I can't complain, having found an AD that
seems to be working. The rest is fine tuning. I'm grateful.Thanks.
Posted by Phillipa on May 21, 2011, at 23:07:52
In reply to Re: help switching from xanax to valium part ll » Phillipa, posted by floatingbridge on May 21, 2011, at 22:58:32
I think it's probably the long half life like prozac. Shoot google time. Love PJxxx
Posted by floatingbridge on May 22, 2011, at 12:03:25
In reply to Re: help switching from xanax to valium part ll » floatingbridge, posted by Phillipa on May 21, 2011, at 23:07:52
It's ok Phillipa. I see my pdoc on Tuesday. I just don't see why it's mentioned repeatedly about Valium and not some of the other long acting benzos....
It could be the internet's way of constantly reposting what any web author read on another site. Or maybe there is something different about Valium other than it's infamous reputation as mother's helper.
If I find something interesting, I'll post.
Posted by Sailboat77 on May 23, 2011, at 17:09:13
In reply to Re: help switching from xanax to valium part ll » Phillipa, posted by floatingbridge on May 22, 2011, at 12:03:25
For me personally, it's strange how none of these Benzos help with my sleep. I can take 2mg of Xanax and not feel anything besides a small relaxing feeling. I think it has to do with taking 60mg of Parnate. Even before I began taking small doses of Vyvanse and Adderall, it was still ineffective.
Part of it has to do with your body's own unique way of processing medications (the liver processes chemicals and a person's metabolism plays a role too). Some people may grow tolerant to Benzos while others may not. So I wouldn't worry too much and just let the medication do it's work.
I'm sure a lot of us know the frustration of trying to find the right sleep medication while dealing with depression or bipolar disorder at the same time.... not easy. But you seem resolute and I'm sure that will get you far.
Posted by floatingbridge on May 23, 2011, at 17:22:50
In reply to Re: help switching from xanax to valium part ll, posted by Sailboat77 on May 23, 2011, at 17:09:13
Sailboat, is ativan helping? Valium gets me to sleep (like the dead) but it is depressive like klonopin for me. I was so prepared to like it :(
Posted by Sailboat77 on May 23, 2011, at 17:54:53
In reply to Re: help switching from xanax to valium part ll » Sailboat77, posted by floatingbridge on May 23, 2011, at 17:22:50
Unfortunately the Ativan only calms me down a little. It doesn't really make me sleepy. My P-doc just emailed me and said he would call in a prescription for Restoril.
I'm crossing my fingers.
Posted by floatingbridge on May 23, 2011, at 19:25:14
In reply to Re: help switching from xanax to valium part ll, posted by Sailboat77 on May 23, 2011, at 17:54:53
Crossed here, too. Hope it doesn't make you groggy :-/
Another to add to the short list.
What dose ativan did you take (unsuccessfully) at night?
Scott posted the name of an unfamiliar tca that is said to preserve sleep architecture. These threads are a bit intertwined. I'd be happy to find it for you.
fb
Posted by Sailboat77 on May 23, 2011, at 21:09:08
In reply to Re: help switching from xanax to valium part ll » Sailboat77, posted by floatingbridge on May 23, 2011, at 19:25:14
I took 2mg of Ativan.
This is the end of the thread.
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