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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by qbsbrown on December 9, 2006, at 0:08:17
I know there's a debate for the ages, as valium is hardly prescribed in the states any more, i'd say a lot to do w/ stigma. Although it's still top choice by most Euro docs.
From personal exp, i'd say this is very true. Probably that it's less potent and longer acting. Even on Klonopin, im waiting for the next dose.
I'd like to hear others' experiences.
Brian
Posted by med_empowered on December 9, 2006, at 2:05:28
In reply to Is Valium less habit forming cause long half life?, posted by qbsbrown on December 9, 2006, at 0:08:17
where i live in the US, valium is actually kind of popular...maybe docs are just more old school here?
Anyway, yeah, I think the whole "Mother's Little Helper" image makes RX-ing valium "bad" but xanax...OK (even though xanax is more problematic). Also notice how if someone is on Klonopin its viewed as more of a medicine, but valium is viewed more as a drug...its kind of ridiculous.
Posted by qbsbrown on December 9, 2006, at 2:07:11
In reply to Re: Is Valium less habit forming cause long half l, posted by med_empowered on December 9, 2006, at 2:05:28
> where i live in the US, valium is actually kind of popular...maybe docs are just more old school here?
Where do you live medempowered?
Brian
Posted by Phillipa on December 9, 2006, at 10:26:43
In reply to Re: Is Valium less habit forming cause long half l, posted by qbsbrown on December 9, 2006, at 2:07:11
I get it prescribed in the South. Not many docs will use a benzo though. Love Phillipa
Posted by Maxime on December 9, 2006, at 11:15:51
In reply to Is Valium less habit forming cause long half life?, posted by qbsbrown on December 9, 2006, at 0:08:17
Valium is just as habit forming as any other benzo. Yes, the half life is longer, but if you had to stop the valium, you would still need to taper off and it wouldn't be easy. And you build a tolerance to it just like any other benzo.
Maxime
> I know there's a debate for the ages, as valium is hardly prescribed in the states any more, i'd say a lot to do w/ stigma. Although it's still top choice by most Euro docs.
>
> From personal exp, i'd say this is very true. Probably that it's less potent and longer acting. Even on Klonopin, im waiting for the next dose.
>
> I'd like to hear others' experiences.
>
> Brian
Posted by Quintal on December 9, 2006, at 11:39:53
In reply to Is Valium less habit forming cause long half life?, posted by qbsbrown on December 9, 2006, at 0:08:17
Well Xanax and Klonopin aren't used at all for anxiety in the UK unless you happen to find a way to get a private prescription as I did. Xanax can't be prescribed on the NHS and GPs balk at the suggestion of using it on private prescription due to its perceived highly addictive nature. Klonopin is used only very rarely for controlling some obscure types of treatment resistant epilepsy according to my GP.
I've been on good old Valium many times and it's a good tranquillizer in my experience. I get the impression it causes more unwanted sedation vs. anxiolysis per unit dose than Xanax and Klonopin, but this varies between individuals of course.
I have been able to abuse Valium and get a nice buzz off it. I'd say it's a little 'warmer' and softer than other popular benzos - a bit like a low dose opiate to me. It is definitely easier to withdraw from Valium than Xanax and Klonopin. It's a smoother come down rather than the crash landing I got from Klonopin and Xanax.
Valium is the most popular benzo here in the UK and my GP says she has lots of people on it (and also temazepam as a sleep aid I suspect - Ambien has not been popular here in the UK).
Q
Posted by Maxime on December 9, 2006, at 12:15:55
In reply to Re: Is Valium less habit forming cause long half life? » qbsbrown, posted by Quintal on December 9, 2006, at 11:39:53
YES BUT, when you have to come off of Valium you will still go through a nasty withdrawal.
Maxime
> Well Xanax and Klonopin aren't used at all for anxiety in the UK unless you happen to find a way to get a private prescription as I did. Xanax can't be prescribed on the NHS and GPs balk at the suggestion of using it on private prescription due to its perceived highly addictive nature. Klonopin is used only very rarely for controlling some obscure types of treatment resistant epilepsy according to my GP.
>
> I've been on good old Valium many times and it's a good tranquillizer in my experience. I get the impression it causes more unwanted sedation vs. anxiolysis per unit dose than Xanax and Klonopin, but this varies between individuals of course.
>
> I have been able to abuse Valium and get a nice buzz off it. I'd say it's a little 'warmer' and softer than other popular benzos - a bit like a low dose opiate to me. It is definitely easier to withdraw from Valium than Xanax and Klonopin. It's a smoother come down rather than the crash landing I got from Klonopin and Xanax.
>
> Valium is the most popular benzo here in the UK and my GP says she has lots of people on it (and also temazepam as a sleep aid I suspect - Ambien has not been popular here in the UK).
>
>
> Q
Posted by Quintal on December 9, 2006, at 12:33:13
In reply to Re: Is Valium less habit forming cause long half life? » Quintal, posted by Maxime on December 9, 2006, at 12:15:55
>YES BUT, when you have to come off of Valium you will still go through a nasty withdrawal.
As I said, Valium softened the withdrawal compared to the shorter acting more popular benzos. Obviously if you were to quit a 120mg a day Valium habit cold turkey you would indeed suffer a horrible withdrawal syndrome. This is never recommended for any benzo though and generally speaking so long as you follow a taper, Valium produces the most kindest and most gentle return to sobriety.
I'm sure this is confirmed by Prof. Heather Ashton's research.
Q
Posted by zmg on December 9, 2006, at 12:41:39
In reply to Re: Is Valium less habit forming cause long half life? » Quintal, posted by Maxime on December 9, 2006, at 12:15:55
Sure, of course Maxime. But the nice thing is because its so much longer lasting then most other benzos titrating is much more forgiving. If you forget a dose (I noticed when I started to withdraw I became *much* more absent minded then normal) you don't have an immediate crash or anything. This is relatively important, especially with the risk of having seizures.
In fact a typical protocol to my understanding is to substitute a short acting benzo with a long acting one, then titrate slowly as usual.
So Valium isn't exactly less habit forming but with the blood-serum levels remaining more stable I can imagine it might be (along with the other long acting benzos) a better alternative for people using it for prolonged periods.
Posted by Maxime on December 9, 2006, at 18:34:14
In reply to Re: Is Valium less habit forming cause long half life? » Maxime, posted by Quintal on December 9, 2006, at 12:33:13
> >YES BUT, when you have to come off of Valium you will still go through a nasty withdrawal.
>
> As I said, Valium softened the withdrawal compared to the shorter acting more popular benzos. Obviously if you were to quit a 120mg a day Valium habit cold turkey you would indeed suffer a horrible withdrawal syndrome. This is never recommended for any benzo though and generally speaking so long as you follow a taper, Valium produces the most kindest and most gentle return to sobriety.
>
> I'm sure this is confirmed by Prof. Heather Ashton's research.
>
> Q
Dr. Ashton .. my favourite person. :)Yes, what you said is true. But the original post in this thread made it sound as if Valium is not addicting. Even if you use the Ashton method to come it, it still takes some time. It is addicting. That is the main point I am trying to get across.
Maxime
Posted by Quintal on December 9, 2006, at 19:23:54
In reply to Re: Is Valium less habit forming cause long half life? » Quintal, posted by Maxime on December 9, 2006, at 18:34:14
Agreed, Valium is certainly addictive, but perhaps less likely to induce a compulsive habit than short acting benzos like Xanax? Take too much Xanax and it will wear off within the day and you'll probably be left wanting more, but Valium is another story. I once ate half a month's prescription of Valium (about 280mg) an hour before giving a presentation to my physics class. I don't remember the presentation to this day, or how I got home either. I woke in bed the next afternoon with my coat zipped up and shoes still on my feet. I've taken other benzos compulsively like this since, (mostly Klonopin) but it was a mistake I never repeated with Valium.
>Dr. Ashton .. my favourite person. :)
My *ex* psychiatric nurse was trained in psychopharmacology by that same lady professor and to my dismay remained a fan all throughout his career.
Q
Posted by Phillipa on December 9, 2006, at 19:43:40
In reply to Re: Is Valium less habit forming cause long half life? » Maxime, posted by Quintal on December 9, 2006, at 19:23:54
And valium in the tx centers I've worked in always started the person on a large dose in the first few days then cut down til 0. The effects last. Not like xanax. Love Phillipa
Posted by bassman on December 9, 2006, at 20:07:59
In reply to Re: Is Valium less habit forming cause long half life? » Maxime, posted by Quintal on December 9, 2006, at 19:23:54
Dr. Ashton's logic goes like this: you have a severe flu and are taking aspirin to relieve some of the symptoms. You decide to stop taking the aspirin and you say, "oh, I feel weak, I have a headache, my joints hurts, etc. I must be withdrawing from the aspirin"-which then is borne out because you don't feel back to normal for weeks, proving aspirin is "addicting". Every class of psychoactive drugs has its extreme detractors- Dr. Ashton is sort of the Tom Cruise of benzos, in my opinion. I think she has done a lot of damage to a lot of people by convincing people/docs in the UK of the evils of benzos. I strongly disagree.
Posted by valene on December 10, 2006, at 10:16:58
In reply to Re: Is Valium less habit forming cause long half life? » Quintal, posted by Maxime on December 9, 2006, at 18:34:14
> > >YES BUT, when you have to come off of Valium you will still go through a nasty withdrawal.
> >
> > As I said, Valium softened the withdrawal compared to the shorter acting more popular benzos. Obviously if you were to quit a 120mg a day Valium habit cold turkey you would indeed suffer a horrible withdrawal syndrome. This is never recommended for any benzo though and generally speaking so long as you follow a taper, Valium produces the most kindest and most gentle return to sobriety.
> >
> > I'm sure this is confirmed by Prof. Heather Ashton's research.
> Dr. Ashton .. my favourite person. :)
>
> Yes, what you said is true. But the original post in this thread made it sound as if Valium is not addicting. Even if you use the Ashton method to come it, it still takes some time. It is addicting. That is the main point I am trying to get across.
>
> Maxime
>
Valium is indeed a benzo and all benzos do cause "dependence" or whatever you choose to call it, after a time. I tried the good old "Ashton" method to withdraw from xanax and failed - I crossed over very slowly completely to valium, and began reducing the valium from about 25 mg. and got down to 11mg. before I felt I was losing my mind. I found valium extremely depressing. I tapered directly off xanax before and when I go off xanax again, will do a direct taper - very slowly. Hated valium, so Ashton method does not work for everyone. Just my 2 cents.Val
Posted by Quintal on December 10, 2006, at 10:46:06
In reply to Re: Is Valium less habit forming cause long half l, posted by valene on December 10, 2006, at 10:16:58
> Valium is indeed a benzo and all benzos do cause "dependence" or whatever you choose to call it, after a time. I tried the good old "Ashton" method to withdraw from xanax and failed - I crossed over very slowly completely to valium, and began reducing the valium from about 25 mg. and got down to 11mg. before I felt I was losing my mind. I found valium extremely depressing. I tapered directly off xanax before and when I go off xanax again, will do a direct taper - very slowly. Hated valium, so Ashton method does not work for everyone. Just my 2 cents.
>
> Val
>Yes, I was just reading about this on the benzo.org site actually. Ashton says herself that Valium seems to have a stronger hypnotic effect than the shorter acting benzos, and people who have been taking short acting benzos for many years may feel depressed and drowsy when the switch to an equivalent dose of Valium. While using a smaller and more tolerable dose of Valium initially to lessen sedation may provoke withdrawal symptoms in a person tolerant to a higher equivalent dose of Xanax. I wonder if this is what happened to you val?
I'm not sure what her recommended strategy is in this scenario. Possibly transfer to Klonopin with its longer half-life? Klonopin is notorious for exacerbating depression though. I'll have a look and see what I can find.
Never thought I'd see the day where I would be defending Heather Ashton's work. She has produced some very detailed protocols for benzo withdrawal and is very supportive of people withdrawing *only* when they choose and *only* at a rate that is acceptable to them, not the doctor, and I like her for that after my experience of enforced rapid benzo withdrawal at the hands of my GP.
Q
Posted by Quintal on December 10, 2006, at 16:00:06
In reply to Re: Is Valium less habit forming cause long half l » valene, posted by Quintal on December 10, 2006, at 10:46:06
Here is a good passage that explains better her position on cross tapering high potency benzos:
--------------------------------------------------
16. SHOULD I SWITCH TO ANOTHER BENZODIAZEPINE SUCH AS VALIUM BEFORE TAPERING?Keep in mind that some people feel that switching to Valium is not for everyone and many have tapered their drug of dependency and have recovered very well. However, if you are considering this recommended method, there are three reasons that are often cited for switching to Valium for purposes of withdrawal.
First, Valium has a far longer half-life than most other benzodiazepines (see above). This allows for a steady, smooth reduction in dose over time. It also permits you to take your dose less often. In some cases, you can take your entire daily dosage before bedtime. This reduces problems of micro-managing your dose by taking another pill every few hours. It also can aid in sleep, which can be a large issue during withdrawal.
Second, Valium is low in potency relative to most other benzodiazepines and comes in tablets of 2mg, 5mg and 10mg. As a practical matter, you can make cuts as small as 0.5mg. This is the equivalent of somewhere between 1/20th and 1/40th mg of Xanax or Klonopin. Given the importance of making the smallest cuts possible, particularly as you approach the end of your taper, this is a very large benefit.
Finally, some people, including some experts believe that the newer, high potency benzodiazepines such as Xanax, Klonopin, and Ativan tend to produce more severe withdrawal syndromes. So far the evidence of this is purely anecdotal. There do not appear to be any studies that conclusively correlate severity of withdrawal with benzodiazepine type.
If you do decide to switch to Valium it is important to observe the proper dose equivalencies. These are special equivalencies for purposes of switching to Valium. (see table above)
The cross-over process also needs to be carried out gradually, usually in stepwise fashion, substituting one dose at a time. Many people have suffered because they have been switched too quickly. Making the changeover one dose (or part of dose) at a time avoids this difficulty. Depending on the size of your dose, the period of dose substitution may be anywhere from 3 weeks to about 3 months.
Valium is a more potent sleep agent than most high potency benzodiazepines even at the equivalent therapeutic dose and many people may find it initially more sedating. However, most benzodiazepine users rapidly develop a tolerance to the sleep inducing (hypnotic) effects of benzodiazepines, so that it is likely that this oversedation will recede within the first few weeks.
During this period of dose substitution, sometimes cuts to your total dose are made, and other times, slight increases are made. If you experience extreme oversedation and no withdrawal symptoms, that is a sign that the equivalency dose is too high for you, and you may wish make a small cut in your total dose as you cross over. If, on the other hand, you begin to experience heightened withdrawal symptoms during cross-over, you may wish to make a small increase in your dose during cross-over. Because the proper equivalencies vary from person to person, the cross-over process can be a matter of trial and error. However, it is important to understand that the end result of switching to Valium should be that you are relatively stable after the switch is complete, meaning that you are experiencing either no withdrawal or very mild withdrawal symptoms.
Professor Ashton has circulated detailed protocols based upon switching to Valium and explaining the method in detail (see above and below).
Librium is another long acting benzodiazepine that is sometimes (but rarely) used as a substitute. This author has insufficient information regarding the effectiveness of Librium substitution to provide a meaningful comment at this time. It is not necessary to switch from Librium to Valium. Librium may be tapered directly, although there is a problem in that it comes only in 5mg capsules in North America. Ideally, for Librium withdrawal, the capsule should be opened and the contents halved to make 2.5mg cuts. Of course, if it is possible to make even smaller cuts, that is most preferable."
--------------------------------------------------http://www.benzo.org.uk/FAQ1.1.htm
Q
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