When already dependent on a benzo, how long till dependence on diazepam ?

[Baxx]

Sorry about the crude question, there was limited space ...

When you are already dependent on a benzodiazepine and wish to switch to diazepam for tapering purposes, how long does it take to become tolerant to (and dependent on) the specific effects of diazepam ? Let's assume one would start at 40 mg diazepam a day.

This is not about the question IF such a switch is desirable, or WHY I would want to do that ...

Currently on clonazepam. In some ways, diazepam is much more sedating, much less so in other ways. I could guess that tolerance builds quickly to the hypnotic and sedative effects of diazepam. So, becoming both tolerant to and dependent on this specific drug is not desirable ... The question is, how long would that take ?

 

[Solipsis]

There is cross-tolerance, but I don't think the real question is how long it takes to get used to diazepam's particular effects (sorry for being crude) although my guess would be about 1-2 weeks? Rather, when you suddenly switch you basically get partial withdrawals for the part of the diazepam's effect that lack covering for the clonazepam you are used to.

Fortunately diazepam does not only have a very long halflife that allows for a smoother taper but is also a relatively all-round benzo in effects - more even relative to some other benzos. Clonazepam is particularly anxiolytic so yes it is not surprising if diazepam feels more sedating / hypnotic but less anxiolytic. Because it is less anxiolytic you would expect moderate anxiety for a while but it might not be that serious since diazepam is still anxiolytic just relatively less so.

How long it takes for the partial withdrawal from switching doesn't necessarily have to have anything to do with how long it takes to become tolerant to the effects diazepam is heavier on (the particular ones you mention).

I don't know if you'd be taking it twice a day but you could choose the time of day to make use of the hypnotic effects in the evening / at night instead of mostly during the day... although don't take it too late in the day either or getting up in the morning will be that much more difficult.

Anyway best I can do is give you that guess, it may vary depending on a number of factors and per individual... and it is a bit arbitrary to say at which point you are really used to certain effects. The dosage is a factor and 40 mg is quite a bit, so it may take longer the sedation to be more manageable for your ability to function.

 

[Baxx]

Solipsis,

'Clonazepam is particularly anxiolytic so yes it is not surprising if diazepam feels more sedating / hypnotic but less anxiolytic. Because it is less anxiolytic you would expect moderate anxiety for a while but it might not be that serious since diazepam is still anxiolytic just relatively less so.'

I am surprised. The doses as mentioned in Ashton's equivalence table are supposed to be equivalent regarding their anxiolytic properties. Supposedly, that's what it is based on.

?

 

[Solipsis]

Oh sure, but that just means that you are taking enough diazepam to equal clonazepam's anxiolytic effects. I was talking about what they are most selective for. Even if diazepam is less of a selective anxiolytic, you can still take enough for the anxiolysis to equal whatever clonazepam dose you took, it just means you are getting that more hypnotic / sedating effects.

There was recently someone here - a person heavily dependent on clonazepam - who argued that clonazepam also has a lot of additional actions some of which can cause chronic problems or possibly mean a difference in withdrawing. You said you do not want to talk about reasons to switch so that's fine. But what I mean is that diazepam still surely is THE most commonly used tapering benzo (and I believe Ashton suggests always switching to diazepam then tapering), however just be aware that you weigh the pro's against the cons regarding the effects of switching.

I must admit I do not know what would be quite different about tapering clonazepam itself. It doesn't seem so short-lasting that it would be a bad idea... here are reasons given by Ashton:
http://www.benzo.org.uk/ashvtaper.htm

The advantages involving available small taper doses of diazepam is fair for clinical considerations, but it's not like you couldn't overcome it by using volumetric measurement... however medication vs self-medication is the line crossed here. Managing yourself is much harder.
And while it is true what is said there that no typical benzo is selective so you can always find an equivalent anxiolytic dose... what this can mean is that you basically add hypnotic / sedative effects to your tolerance in this case which you then have to get off of again. I interpret it as: just upping the dose enough to compensate for any cross-tolerance giving you 'partial withdrawals'. Best hope at that point is that your taper isn't meant to go so slow that you have time to become tolerant to the hypnotic / sedating effects.

Anyway just thinking out loud, in a lot of cases diazepam is indeed quite ideal to taper. Having to switch just isn't ideal in a few ways, but still a reasonable sacrifice probably.

I tapered diazepam after a poly-dependency. (I did not use for fun but self-medicated up to 15 different benzo's - not mixing them insanely but for certain situations I tried to sophisticate what I took, depending on what my biggest issues were at the time... it was a very hard time in my life, and I liked to try them to have a good view of the options available - I really tried to suppress my tolerance developing though and in the course of 1½ years I didn't go that much higher than 2 or 2.5x standard doses in total. Still I wish I had just gotten a temporary prescription and supervision so that they could have helped me prevent going on too long etc.)

Didn't care much for clonazepam. Well I sort of did in that it is a very effective anxiolytic but it made me feel like a bomb went off in my short-term memory among other things. Just didn't seem that reasonable to me.

 

[Mighty-oak]

Very interesting read to me as I am on both (Clonazepam and Diazepam, both prescribed)

I found reducing the dose of Diazepam a lot easier than reducing the dose of Clonazepam in which I am doing now and feeling terrible as in side effects, muscle aches and anxiety are through the roof. I have a rather strange thing happen to me when I increase Diazepam......I get more anxious, strange as its meant to do the opposite. Been on Diazepam for 16 years and at 10mg a day now, was on 50mg a day. Been on Clonazepam for 7 years, was on 0.5mg a day, now on 0.25mg, taken me over one year to reduce to this dose, so over a year to reduce the dose by half! Took me 6 months to get from 50mg of Diazepam to 10mg. I would love to just stop the Clonazepam and switch it with Diazepam, but it would make me more anxious. Exactly the same Solipsis...... Clonazepam is better for anxiety I found but short term memory is terrible on it....Plus I read long term benzo use actually makes anxiety worse thus me coming off Clonazepam first then going to withdraw from Diazepam.