Benzos Switching - Xanax to Ativan?

[Scottc]

I use Xanax (alprazolam) (2-4 mg/day and tapering down) for anxiety for around 6 months but it makes it hard to sleep and I get xanax hangover symptoms often (brain fog etc). Have had a hellishly stressful 6 months and hadn’t been on benzos before. Have only a few more weeks before the crisis ends (related my to my business). Had tried ativan (lorezapam) previously and found it less stimulating and without the same hangover effects. Is it possible to switch from one to another at equivalent dosage? Any issues of taking equivalent dosage (2-4 mg) of Ativan I should be aware of?

 

[negrogesic]

Ativan is about half as potent as xanax (ie., 1mg of xanax is equivalent to 2mg of ativan) but has a longer duration of action, thus you wouldn't want to dose it in the same intervals. Metabolism can vary somewhat by individual so you'll have to feel it out for yourself and redose accordingly.

If you've never been on benzodiazepines and want to get off, please do so slowly. Optimally you would switch to an equivalent dose of diazepam, then taper off slowly using the 2mg tablets.

 

[Scottc]

T

Ativan is about half as potent as xanax (ie., 1mg of xanax is equivalent to 2mg of ativan) but has a longer duration of action, thus you wouldn't want to dose it in the same intervals. Metabolism can vary somewhat by individual so you'll have to feel it out for yourself and redose accordingly.

If you've never been on benzodiazepines and want to get off, please do so slowly. Optimally you would switch to an equivalent dose of diazepam, then taper off slowly using the 2mg tablets.

Thanks. That’s helpful.

Already met with psychiatrist to unwind and do a taper, just have these last couple of weeks.

 

[Coffeeshroom]

With my own personal exp i find ativan to work faster then xanax but not as strong. But if you going to taper i would look at a longer acting benzo like valium or klonopin as already mentioned. Good luck and hope all works out for you

 

[Speed King]

I use Xanax (alprazolam) (2-4 mg/day and tapering down) for anxiety for around 6 months but it makes it hard to sleep and I get xanax hangover symptoms often (brain fog etc). Have had a hellishly stressful 6 months and hadn’t been on benzos before. Have only a few more weeks before the crisis ends (related my to my business). Had tried ativan (lorezapam) previously and found it less stimulating and without the same hangover effects. Is it possible to switch from one to another at equivalent dosage? Any issues of taking equivalent dosage (2-4 mg) of Ativan I should be aware of?

I would use them if I had to. They have their own subjective effects that you really don't need to get used to if you don't have to. If your already hooked up with a doctor, don't use them. They are easy to get modish on.

Ativan is about half as potent as xanax (ie., 1mg of xanax is equivalent to 2mg of ativan) but has a longer duration of action, thus you wouldn't want to dose it in the same intervals. Metabolism can vary somewhat by individual so you'll have to feel it out for yourself and redose accordingly.

If you've never been on benzodiazepines and want to get off, please do so slowly. Optimally you would switch to an equivalent dose of diazepam, then taper off slowly using the 2mg tablets.

Its is somewhat subjective, but Valium is usually right on. According to https://wwwbenzo.org.uk, alprazolam/Xanax .05 mg is equivalent to 10 mg diazepam/Valium. So subjectively as fuck, that would be 40 mg to 80 mg of diazepam/Valium to your habit. Diazepam is great because it lasts a while in your system and I find it smooth to adjust the dosage. IMHO, the most you would need for your mixed alprazolam/Xanax habit would be 40 mg of diazepam/Valium a day to start a taper.
You probably wouldn't have a very long taper, but that's up to the doctor.


I missed the clonazepam/Klonopin reference. You could taper with that. Clonazepam/Klonopin doesn't stick around very long compared to diazepam/Valium. I would say taper wise that clonazepam/Klonopin is strictly business.

 

[Scottc]

Ativan is about half as potent as xanax (ie., 1mg of xanax is equivalent to 2mg of ativan) but has a longer duration of action, thus you wouldn't want to dose it in the same intervals. Metabolism can vary somewhat by individual so you'll have to feel it out for yourself and redose accordingly.

If you've never been on benzodiazepines and want to get off, please do so slowly. Optimally you would switch to an equivalent dose of diazepam, then taper off slowly using the 2mg tablets.

Looking into taper off but it’s impossible to find a psychiatrist who will do so. Two have just suggested going cold turkey and one taper on the xanax but not cross tapering to diazepam. Any suggestions for finding none that would thoughtfully cross taper?

 

[Scottc]

I would use them if I had to. They have their own subjective effects that you really don't need to get used to if you don't have to. If your already hooked up with a doctor, don't use them. They are easy to get modish on.




Its is somewhat subjective, but Valium is usually right on. According to https://wwwbenzo.org.uk, alprazolam/Xanax .05 mg is equivalent to 10 mg diazepam/Valium. So subjectively as fuck, that would be 40 mg to 80 mg of diazepam/Valium to your habit. Diazepam is great because it lasts a while in your system and I find it smooth to adjust the dosage. IMHO, the most you would need for your mixed alprazolam/Xanax habit would be 40 mg of diazepam/Valium a day to start a taper.
You probably wouldn't have a very long taper, but that's up to the doctor.


I missed the clonazepam/Klonopin reference. You could taper with that. Clonazepam/Klonopin doesn't stick around very long compared to diazepam/Valium. I would say taper wise that clonazepam/Klonopin is strictly business.

Looking into taper off with Diazepam but it’s impossible to find a psychiatrist who will do so. Two have just suggested going cold turkey and one taper on the xanax but not cross tapering to diazepam. Any suggestions for finding none that would thoughtfully cross taper?

 

[Speed King]

The doctor that said cold turkey must not know how deep your habit is. That is the dumbest thing I heard all day. Do your homework and show them charts . Be honest as you can. The best route is a longer acting benzodiazepine. Klonopin is medication to taper on. You can always try another doctor.

 

[negrogesic]

You could also look to purchase a long acting RC gray market benzo online (like diclazepam) and taper off yourself...

 

[Scottc]

The doctor that said cold turkey must not know how deep your habit is. That is the dumbest thing I heard all day. Do your homework and show them charts . Be honest as you can. The best route is a longer acting benzodiazepine. Klonopin is medication to taper on. You can always try another doctor.

I read a lot about diazepam as the meeidcation yo taper on. Any reason for Klonopin over diazepam?

 

[Scottc]

It may be little rough, but you can taper Xanax without crossover. If the one that supports taper but not crossover would work with you, you may try. It could work. Now, if you decide to taper directly Xanax, first, it would be great if you could get Xanax XR + regular Xanax. Then you could taper something like this:

1) morning: 1mg XR + 0.5mg IR / evening 2mg XR =3.5mg
2) morning: 1mg XR + 0.5mg IR / evening 1mg XR + 0.5mg IR=3mg
3) morning: 1mg XR + 0.25mg IR / evening 1mg XR + 0.50mg IR=2.75mg
4) morning: 1mg XR + 0.25mg IR / evening: 1mg XR + 0.25mg IR =2.50mg
5) morning: 1mg XR only , evening 1mg XR + 0.25 IR =2.25mg
6) morning: 1mg XR , evening 1mg XR=2.00mg
7) morning 0.5mg XR + 0.25mg IR / evening: 0.5mg XR + 0.50mg IR =1.75mg
8 ) morning: 0.5mg XR + 0.25mg IR / evening: 0.5mg XR + 0.25mg IR =1.50mg
9) morning: 0.5mg XR + 0.125mg IR / evening: 0.5mg XR + 0.25mg IR =1.375mg
10) morning: 0.5mg XR + 0.125mg IR / evening: 0.5mg XR + 0.125mg IR =1.250mg
11) morning: 0.5mg XR / evening: 0.5mg XR + 0.125mg IR =1.125mg
12) morning: 0.5mg XR / evening: 0.5mg XR=1mg

At this point you would have to resort to IR. You could spread your dose something like:
13) morning: 0.25mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.25mg/during night if you wake up 0.125mg=0.875mg
14) morning: 0.125mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.25mg/during night if you wake up 0.125mg=0.750mg
15) morning: 0.125mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.125mg/during night if you wake up 0.125mg=0.625mg.
16) Next eliminate the night/if you wake up dose, so, morning: 0.125mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.125mg=0.5mg.

When you get this low it is up to you to make the calls what doses go out first, based on your symptomatology. Of course this is a provisional tapering schedule that could be implemented with Xanax (alprazolam) only. Usage of extended/slow release form in combination with regular instant release make Xanax easier to taper. It is not easy but neither is tapering diazepam or clonazepam. You would modify, if you choose to use Xanax to taper of Xanax, speed of taper, what dosages go low/out first (are you more anxious in the morning, during day or at night), or even if you would try to swap that last milligram of Xanax to 10 milligrams of Valium, but I believe that you could do it in this fashion.


Now, I would like to say that I have read some people state that they felt better weaning off original short acting benzodiazepine then by substituting to long acting one. For others , switching to diazepam or clonazepam (I would say to go with diazepam rather than clonazepam) was more beneficial. I am dependent on benzodiazepines for more than 15 years now. I tried to taper on few occasions but when I get into <10mg territory my world starts falling apart and I never made it to the other side. Last time, 5 years ago, I got down to 4mg but suffered from such multiplicity of disrupting and painful symptoms that I think I got PTSD from it. I so much wanted to be off diazepam before my child was born, but neither that was enough to overcome my personal subjective hellish experience. But I will try to do it again. I am "stable" (you are never stable on benzos after 15 years, but I can function with this much tolerance withdrawal) at 20mg diazepam and at the moment I need this stability so badly. But I will try to taper off again. Benzodiazepines are monsters. They take away your CNS and with it every aspect of your functioning. But it is easier for some than the others and I truly hope that you will not have as much problems as I did/do. I have also read that people have gotten of benzos with very little problems even after many years of use. So there is always hope

Stay safe.

Soma

Thank you so much for this and the encouragement. It’s been about 7 months on benzos so hopefully not long enough to make a taper really hard. Good luck with yours as well.

 

[Scottc]

It may be little rough, but you can taper Xanax without crossover. If the one that supports taper but not crossover would work with you, you may try. It could work. Now, if you decide to taper directly Xanax, first, it would be great if you could get Xanax XR + regular Xanax. Then you could taper something like this:

1) morning: 1mg XR + 0.5mg IR / evening 2mg XR =3.5mg
2) morning: 1mg XR + 0.5mg IR / evening 1mg XR + 0.5mg IR=3mg
3) morning: 1mg XR + 0.25mg IR / evening 1mg XR + 0.50mg IR=2.75mg
4) morning: 1mg XR + 0.25mg IR / evening: 1mg XR + 0.25mg IR =2.50mg
5) morning: 1mg XR only , evening 1mg XR + 0.25 IR =2.25mg
6) morning: 1mg XR , evening 1mg XR=2.00mg
7) morning 0.5mg XR + 0.25mg IR / evening: 0.5mg XR + 0.50mg IR =1.75mg
8 ) morning: 0.5mg XR + 0.25mg IR / evening: 0.5mg XR + 0.25mg IR =1.50mg
9) morning: 0.5mg XR + 0.125mg IR / evening: 0.5mg XR + 0.25mg IR =1.375mg
10) morning: 0.5mg XR + 0.125mg IR / evening: 0.5mg XR + 0.125mg IR =1.250mg
11) morning: 0.5mg XR / evening: 0.5mg XR + 0.125mg IR =1.125mg
12) morning: 0.5mg XR / evening: 0.5mg XR=1mg

At this point you would have to resort to IR. You could spread your dose something like:
13) morning: 0.25mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.25mg/during night if you wake up 0.125mg=0.875mg
14) morning: 0.125mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.25mg/during night if you wake up 0.125mg=0.750mg
15) morning: 0.125mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.125mg/during night if you wake up 0.125mg=0.625mg.
16) Next eliminate the night/if you wake up dose, so, morning: 0.125mg IR / afternoon: 0.125mg IR /dinner time 0.125mg /before sleep 0.125mg=0.5mg.

When you get this low it is up to you to make the calls what doses go out first, based on your symptomatology. Of course this is a provisional tapering schedule that could be implemented with Xanax (alprazolam) only. Usage of extended/slow release form in combination with regular instant release make Xanax easier to taper. It is not easy but neither is tapering diazepam or clonazepam. You would modify, if you choose to use Xanax to taper of Xanax, speed of taper, what dosages go low/out first (are you more anxious in the morning, during day or at night), or even if you would try to swap that last milligram of Xanax to 10 milligrams of Valium, but I believe that you could do it in this fashion.


Now, I would like to say that I have read some people state that they felt better weaning off original short acting benzodiazepine then by substituting to long acting one. For others , switching to diazepam or clonazepam (I would say to go with diazepam rather than clonazepam) was more beneficial. I am dependent on benzodiazepines for more than 15 years now. I tried to taper on few occasions but when I get into <10mg territory my world starts falling apart and I never made it to the other side. Last time, 5 years ago, I got down to 4mg but suffered from such multiplicity of disrupting and painful symptoms that I think I got PTSD from it. I so much wanted to be off diazepam before my child was born, but neither that was enough to overcome my personal subjective hellish experience. But I will try to do it again. I am "stable" (you are never stable on benzos after 15 years, but I can function with this much tolerance withdrawal) at 20mg diazepam and at the moment I need this stability so badly. But I will try to taper off again. Benzodiazepines are monsters. They take away your CNS and with it every aspect of your functioning. But it is easier for some than the others and I truly hope that you will not have as much problems as I did/do. I have also read that people have gotten of benzos with very little problems even after many years of use. So there is always hope

Stay safe.

Soma

I get social anxiety and with tolerance withdrawal, will it screw up the taper if I up the dosage for a night so I can go out and socialize? How do people manage tolerance withdrawal with social and job responsibilities?

 

[Scottc]

Any intake higher than usual will increase tolerance. But if you are asking upping dose once a month then it should not have big effect. Just don't do it too often because you will become unstable and wont be able to maintain benzo taper. Once, or twice a month 0.5mg would not hurt you much. But with higher dosages and more frequent "cheat days" it will become unsustainable. Main thing - if you stumble and fall (take too much and too many extra doses) don't stop! Tapering benzos is one of the hardest things I have to do in my life, so you might slip here and there. But you will ruin your taper only if you stop trying.
How people manage tolerance withdrawal? You do what you can and if you are not able to get off then you deal with it. Life is not so nice as it could be, there is much more anxiety and fear, but you push through. For some people is more pronounced, for others less. There is one more reason why you should take at least some of your Xanax in extended release formulation - there is less withdrawal as you are not spiking and plummeting all day long. If only I had the answer on how to live a happy life with a diazepam tolerance around 50mg (to be relatively anxiety free), but being prescribed only 20mg... I hold on I guess.
I wish you all the luck!

Thanks for all the info. How long had you been on benzos before you realized you needed to get off?

 

[Scottc]

Also have had some decent results with pharma-GABA on amazon. I’m sure you’ve tried everything but just came across them and they do work but I think it depends how close to take to your dose.

 

[Scottc]

Thanks you’ve been a huge help