I NEED SOME HELP guys....ok nuff caps. Run out of one thing, switching 4 5 days

[colourshurt]

Hey all, Im new here so will attempt to get this right.

My friend J has been tapering from Diazepam (not the first time) and is down comfortably to twenty five or twenty mgs depending on the day. He ran out but was able to get some clonazepam (klonopin?) to tide him over until his next repeat. I am wondering if J should use the new Benzo and whether or not it will effectively mask the symptoms of withdrawal for the five day stretch. He has seen a bunch of mg vs mg charts and understands the basics of chopping the pill to meet his needs and dose requirements but is unsure of the safety and effectiveness as a stopgap measure.

Any advice (sensible would be best) to help him would rock. He is also on methadone and betablockers and ssri's which all interact in one way or another but he has found (being a large lad) that it is the least of his problems, given they all increase the sedation.

Please help me to help him as its dose time tomorrow morning and he will only have the clonazepam (klonopin) and is not even sure what mg the pills will be. Hoping for 2's but with his luck they will be .25's. He will have between five and ten of them for the five days.

Thanks in advance and thanks for creating a place where someone can ask these kinds of questions...fairly tame I imagine....but then J is at the "stuff this Im done with taking stuff" phase of his life nearing forty and was born with benzo addiction so they are the hardest to cut out of his life.

TL:DR Need to know if Clonazepam (klonopin) will work in place of Valium (Diazepam) for five days at similar doses (using charts).

Cheers!

 

[pasha]

homeless -> basic drug discussion

 

[Felonious Monk]

Yes, you shouldn't have too much trouble switching from Valium to Klonopin for a few days. They both have fairly long duration as well as half-life.

 

[Rybee]

Hi colourshurt and welcome to Bluelight

I'm assuming your friend J is actually yourself? Unlike other drug/harm reduction/drug recovery/substance rehabilitation forums, at Bluelight we actively discourage terms such as SWIM/My Pet Dog/My Uncle's Horse because it is often frustrating and long-winded to read, and serves absolutely no legal protection at all. That said, your post was was actually well written and easily understood, so just remember that for future use! Also, if it is about yourself, you'll likely get more people on here looking to help YOU. If it's for a friend, people tend to be less helpful as there's no direct interaction between your friend and the BL members. If this post genuinely concerns your friend - absolutely fine! But if it is genuinely about you, it allows us to get to understand you as a person better and in turn you'll get better help.

As Felonious Monk says, if you've interpreted some reliable chart you should be okay. All Benzodiazepines are fairly similar but do also act in different ways (anxiolytics/hypnotics/anticonvulsants - and even within any one of those groups, some are not still suitable for substituting as others). So you're right to ask!

Although Diazepam (Valium) and Clonazepam (Klonopin) are good substitutes for one another, there is often quite some dispute/debate for Diazepam's equipotence to Clonazepam in particular, and as such, particular care is needed when converting to this drug.*

I'll demonstrate this below:

20mg Diazepam = 0.5mg Clonazepam Click for Source '(Global RPH.)'
20mg Diazepam = 1mg Clonazepam Click for Source '(Benzo.org.)'
20mg Diazepam = 1mg Clonazepam '(Benzo Docs.)'
20mg Diazepam = 1mg-2mg Clonazepam pp.245-247 of 'The Maudsley Prescribing Guideline. 10th Edition. London. (2009).'

So depending on what guidelines you rely upon, 20mg Diazepam is equipotent to anywhere between ~0.5mg-2mg of Clonazepam. With Bazire stating that 20mg of Diazepam could be equipotent at 1mg (but anywhere between 0.5mg-8mg).** However, the general vibe is 20mg = ~1mg, which is also cited in the Ashton Manual - with Professor Ashton being one of the leading Psychiatrists on Benzodiazepine use, withdrawal, and rehabilitation programmes.

Also there is a very common mistake between Blueligthers, Benzodiazepine Users, Pharmacists and even Clinicians in thinking that the the half life of a drug (such as Diazepam and Clonazepam) indicates how the time in which is effective for. Taking Diazepam for example, with a half life of the active metabolite being ~200 hours, does NOT mean that the drug will be active for ~200 hours. Far from it! I've been on Lorazepam (Ativan) for ~6 months for pro re nata use and I no longer find it effective and wanted to go back to Diazepam instead of Alprazolam (Xanax) or Clonazepam (Klonopin) but was hesitant to go back to it because of his half life. At this point I was made aware that half life does not mean time in which it remains effective. I shot off a mail to my Psych saying I found Diazepam to be much more effective than Lorazepam but favoured Lorazepam because it has a much shorter half life than Diazepam, and I didn't want the anxiolytic effects to hang for days. To which he replied stating:

'...well done re limiting your Benzodiazepine use. Your confusion re ½ life is not unique as many clinicians will also get this wrong re: thinking it has something to do with how long people experience effects! The truth though is more so to do with the differing levels of hypnotic effect vs anxiolytic effect vs muscle relaxation effect. This however is very individual to the patient if that makes sense...

This point was also picked up by the member 'Lorne???' earlier in the week, (who appears both lovely and very knowledgeable on the topic) and I'm hoping to find the time to write an article on this often misunderstood issue to help the BL'ers.


*Source: p.2 of 'NHS Sussex Partnership NHS Foundation Trust. Calculating Equivalent Doses of Oral Benzodiazepines. (2010).'
**Source: p.211 of 'Bazire's Psychotropic Drug Directory. The Professionals’ Pocket Handbook and Aide Memoire. (2012).'


I hope that helps - feel free to reply to this thread if you/your friend wants any further support through the transition or future advice. And once again, welcome to Bluelight, it's a great forum!


Rybee

 

[colourshurt]

Thank you guys/gals, yeah it was for me, and I have subsequently recovered sufficient Diazepam to go a little longer (ten days short of next script) before changing to the seven 2mg Clonazepam tabs I have stored away. Guess cos I use between 20 and 35 mgs daily (trying all the time to keep close to 20mgs, I will sub with 1mg of Klonopin (clonazepam) twice daily and see how that works....Half lives are notoriously ridiculous to understand without an individuals schematics, ratios, tolerances and weight all considered against other meds etc...I find its like the old eat eggs, now dont eat eggs, now eat as many as you like history of the health benefits of said eggs in my forty odd years...its just up to the individual with little significant science behind any one persons use. I did notice that Clonazepam takes longer to kick in, so hoping a total shift from 20-25diazepam to 1mg Klonopin wont be too much of a shock to my system. Also on 36mgs of Done, down from seventy over two years...so not too bad I think. I just find drugs make me feel less conspicuous as the freak barely contained....so thanks again guys. I will make sure I am succinct and direct in future.

 

[colourshurt]

Hey thanks Rybee and Felonious Monk. I am now on 2mg per day clon, broken into four .5 tabs. Easily superior to Diazepam for me as it does not seem as sedating nor does it hit so fast that I can enjoy it. It just keeps the "hunger" at bay. PS: down to 14mg Methadone as of today...so looking forward to the end of that road. Again, thanks. I would also agree that 1mg Clonazepam = 20mg Diazepam approx but takes a while to actually kick in. No Stone for me, just stable and comfortable. Regards, Colourshurt.