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Transitioning from Klonopin to Valium...
  1. #1
    [email protected] Guest

    Default Transitioning from Klonopin to Valium...

    Hello folks,

    My name is Bill.

    A brief introduction:

    Starting back in December of 2000, I was stricken with a cardiac
    aliment. Over a span of two years, I developed panic disorder
    secondary to the chronicity of the cardiac symptoms. I had developed
    agoraphobia, a driving phobia, and recurring panic attacks. While my
    cardiac work-up has been abnormal, my symptoms were (are), apparently
    out of proportion to the severity of the findings. In June of 2001, I
    was diagnosed with panic disorder.

    Initially, I was tried on Prozac (20 mg). After taking the Prozac for
    three days, I developed hypertensive crisis (BP 280/150) along with a
    large, 5" rash on my upper back. The Prozac was discontinued, and
    Paxil initiated in its place. The result was comparable, and I was
    deemed as being allergic to SSRI's.

    Other possible choices included the Tricyclics, the Tetracyclics, and
    the SNRI's. Given my abnormal cardiac work-up, my psychiatrist was
    reluctant to try me on any of these various agents. Erroring on the
    side of caution, he prescribed Klonopin/Roche, 0.5 mg, t.i.d.

    Over the years, the Klonopin has been of tremendous value - not only
    at preventing panic and improving quality of life, but physiologically
    as well (reduced blood pressure).

    Recently, I developed Thrombocytopenia secondary to the use of
    Klonopin. My platelet count was 110,000 (lowish). I was withdrawn from
    the Klonopin at a rate of 0.25 milligrams/three days, and the
    Thrombocytopenia vanished. I suffered no form of withdrawal - however,
    my original presenting symptoms of panic have slowly returned. Seeing
    as how I cannot tolerate any of the other agents due to my cardiac
    ailment, my doctor and I made the decision to implement Valium in
    place of the Klonopin.

    At the moment, the doctor has reinstated my Klonopin dosage at 0.5 mg,
    t.i.d.

    He flat out stated that he was uncertain if Valium would be of any
    benefit in panic states, but thought it would be worth a try. He was
    also uncertain about the equivalency between Klonopin and Valium. He
    and I read through a dozen or so pharmacology books in his office, and
    the recommendations were mixed. Six stated that the equivalency was
    0.25 mg Klonopin/ 5 milligrams Valium, four stated that 0.5 mg
    Klonopin /10 mg Valium, and two actually stated that 2 mg Klonopin /10
    mg Valium.

    We decided on Valium 10 mg, t.i.d.

    My question is (and the doctor could not answer this)...If the half-
    life of Klonopin ranges from 18-50 hours (call it 40-50 in my case),
    and the half-life of Valium ranges from 36-200 hours for its active
    metabolite Desmethyldiazepam, can a direct transition be made from
    Klonopin to Valium without untoward reactions? It would appear from
    the numbers that the Valium would need to accumulate in the plasma to
    fully replace the Klonopin. Would it be wise just to simply switch
    directly to the Valium, or should the Valium be stepped in to replace
    the Klonopin gradually?

    It was the doctor's impression that 0.5 mg of Klonopin was equal to 5
    mg of Valium, and that by prescribing a double dose he'd be erroring
    on the side of caution just in case he was mistaken. He's also under
    the impression that the two may be interchanged without incident.

    My concern is not temporary rebound or anxiety, but rather
    hypertension (I have severe controlled hypertension), and perhaps, the
    risk of seizure. I can manage anxiety/panic, but have to be careful in
    regards to blood pressure.

    If anyone could shed some light on this, I would greatly appreciate
    it. Perhaps someone in the group has switched from Klonopin to Valium?
    Here, I've had the prescription for almost a week and have been very
    apprehensive about trying it.

    Sincerely,

    Bill

  2. #2
    Bear Guest

    Default Re: Transitioning from Klonopin to Valium...

    [email protected], wrote:

    >At the moment, the doctor has reinstated my Klonopin dosage at 0.5 mg,
    >t.i.d.


    Interesting that a long acting benzodiazepine, such as Klonopin, would be
    prescribed more than once or twice a day. If it works tho -......

    >He flat out stated that he was uncertain if Valium would be of any
    >benefit in panic states, but thought it would be worth a try.


    While not all benzodiazepines are created equal, they all do pretty much the
    same thing (not unlike SSRIs, for example). Valium has proven to be successful
    in the treatment of panic.

    > He was
    >also uncertain about the equivalency between Klonopin and Valium. He
    >and I read through a dozen or so pharmacology books in his office, and
    >the recommendations were mixed. Six stated that the equivalency was
    >0.25 mg Klonopin/ 5 milligrams Valium, four stated that 0.5 mg
    >Klonopin /10 mg Valium


    That's 10 that said the same thing, since of course, .25 = 5 and .5 = 10 is
    saying the same thing. I've used the charts before, and while nothing is equal,
    it seems to be a good guide.

    >We decided on Valium 10 mg, t.i.d.


    The only area I'd question (you'll have to see how it goes for you) is that
    Valium (and Librium) work for a shorter length of time, and most certainly a
    shorter time, than the long acting Klonopin.
    I know that I took Librium (my first benzo) q.i.d.
    It 'may' be more appropriate.

    >My question is (and the doctor could not answer this)...If the half-
    >life of Klonopin ranges from 18-50 hours (call it 40-50 in my case),
    >and the half-life of Valium ranges from 36-200 hours for its active
    >metabolite Desmethyldiazepam, can a direct transition be made from
    >Klonopin to Valium without untoward reactions?


    Most likely.

    > It would appear from
    >the numbers that the Valium would need to accumulate in the plasma to
    >fully replace the Klonopin. Would it be wise just to simply switch
    >directly to the Valium, or should the Valium be stepped in to replace
    >the Klonopin gradually?


    There should be enough Klonopin remaining in your system to switch from one to
    the other without any problem. It's more about the dose than anything else,
    AFAIK.

    >It was the doctor's impression that 0.5 mg of Klonopin was equal to 5
    >mg of Valium


    You have 10 of 12 sources that showed .5 mg of Klonopin was equal to 10 mg of
    Valium. Odd that he got this impression....


    > He's also under
    >the impression that the two may be interchanged without incident.


    My personal experience is switching from one to another benzodiazepine was done
    without incident.

    --

    Elliott


  3. #3
    Death To X Humans X Guest

    Default Re: Transitioning from Klonopin to Valium...

    On May 25, 5:40*am, klonopinpointfive...@gmail.com wrote:
    > Hello folks,
    >
    > My name is Bill.
    >
    > A brief introduction:
    >
    > Starting back in December of 2000, I was stricken with a cardiac
    > aliment. Over a span of two years, I developed panic disorder
    > secondary to the chronicity of the cardiac symptoms. I had developed
    > agoraphobia, a driving phobia, and recurring panic attacks. While my
    > cardiac work-up has been abnormal, my symptoms were (are), apparently
    > out of proportion to the severity of the findings. In June of 2001, I
    > was diagnosed with panic disorder.
    >
    > Initially, I was tried on Prozac (20 mg). After taking the Prozac for
    > three days, I developed hypertensive crisis (BP 280/150) along with a
    > large, 5" rash on my upper back. The Prozac was discontinued, and
    > Paxil initiated in its place. The result was comparable, and I was
    > deemed as being allergic to SSRI's.
    >
    > Other possible choices included the Tricyclics, the Tetracyclics, and
    > the SNRI's. Given my abnormal cardiac work-up, my psychiatrist was
    > reluctant to try me on any of these various agents. Erroring on the
    > side of caution, he prescribed Klonopin/Roche, 0.5 mg, t.i.d.
    >
    > Over the years, the Klonopin has been of tremendous value - not only
    > at preventing panic and improving quality of life, but physiologically
    > as well (reduced blood pressure).
    >
    > Recently, I developed Thrombocytopenia secondary to the use of
    > Klonopin. My platelet count was 110,000 (lowish). I was withdrawn from
    > the Klonopin at a rate of 0.25 milligrams/three days, and the
    > Thrombocytopenia vanished. I suffered no form of withdrawal - however,
    > my original presenting symptoms of panic have slowly returned. Seeing
    > as how I cannot tolerate any of the other agents due to my cardiac
    > ailment, my doctor and I made the decision to implement Valium in
    > place of the Klonopin.
    >
    > At the moment, the doctor has reinstated my Klonopin dosage at 0.5 mg,
    > t.i.d.
    >
    > He flat out stated that he was uncertain if Valium would be of any
    > benefit in panic states, but thought it would be worth a try. He was
    > also uncertain about the equivalency between Klonopin and Valium. He
    > and I read through a dozen or so pharmacology books in his office, and
    > the recommendations were mixed. Six stated that the equivalency was
    > 0.25 mg Klonopin/ 5 milligrams Valium, four stated that 0.5 mg
    > Klonopin /10 mg Valium, and two actually stated that 2 mg Klonopin /10
    > mg Valium.
    >
    > We decided on Valium 10 mg, t.i.d.
    >
    > My question is (and the doctor could not answer this)...If the half-
    > life of Klonopin ranges from 18-50 hours (call it 40-50 in my case),
    > and the half-life of Valium ranges from 36-200 hours for its active
    > metabolite Desmethyldiazepam, can a direct transition be made from
    > Klonopin to Valium without untoward reactions? It would appear from
    > the numbers that the Valium would need to accumulate in the plasma to
    > fully replace the Klonopin. Would it be wise just to simply switch
    > directly to the Valium, or should the Valium be stepped in to replace
    > the Klonopin gradually?
    >
    > It was the doctor's impression that 0.5 mg of Klonopin was equal to 5
    > mg of Valium, and that by prescribing a double dose he'd be erroring
    > on the side of caution just in case he was mistaken. He's also under
    > the impression that the two may be interchanged without incident.
    >
    > My concern is not temporary rebound or anxiety, but rather
    > hypertension (I have severe controlled hypertension), and perhaps, the
    > risk of seizure. I can manage anxiety/panic, but have to be careful in
    > regards to blood pressure.
    >
    > If anyone could shed some light on this, I would greatly appreciate
    > it. Perhaps someone in the group has switched from Klonopin to Valium?
    > Here, I've had the prescription for almost a week and have been very
    > apprehensive about trying it.
    >
    > Sincerely,
    >
    > Bill


    You'll build a tolerance much faster with the vailum - personal
    experience tells me that a 2 klonopin has a very similar effect as a
    10mg Valium. Theres more information on benzodiazapams at my blog -
    http://[email protected] -- Good Luck

  4. #4
    [email protected] Guest

    Default Re: Transitioning from Klonopin to Valium...

    On May 25, 9:05*pm, Death To X Humans X <sm...@mac.com> wrote:

    > *You'll build a tolerance much faster with the vailum - *personal
    > experience tells me that a 2 klonopin has a very similar effect as a
    > 10mg Valium. Theres more information on benzodiazapams at my blog -
    > http://www.suboxo...@blogspot.com *-- Good Luck- Hide quoted text -
    >
    > - Show quoted text -


    Doubtful, but then again, it doesn't really matter.

    If it were Ativan, Serax or Xanax, tolerance could potentially be an
    issue. However, I've no intentions on taking any of those agents. The
    response to any agent is highly individualized. I've tried both Ativan
    and Xanax p.r.n. without benefit. Both were prescribed as adjuncts to
    my standing Klonopin dosage.

    30 milligrams of Valium (in my case) has proven to be ineffective thus
    far in comparison to the 1.5 milligrams of Klonopin that I had been
    taking. I've never "felt" anything from taking a Benzodiazepine, and
    Valium is no exception. No ataxia, no sedation, and (most important to
    me), no "anti-panic" effect from the Valium. I will give the Valium
    one full week before reaching my final conclusion, but as of now, it
    has been ineffective for me. This was readily apparent today while
    driving on the interstate - having to pull over due to
    hyperventilation and tetany of the hands.

    If the Valium proves ineffective after one week, I have no good
    options left. The only agent that has ever helped me regain quality of
    life is Klonopin, however, it will need to be discontinued due to
    recurring Thrombocytopenia.

    As far as 2 mg of Klonopin equating to 10 mg of Valium - it would seem
    highly unlikely from a panic perspective. I think perhaps you're
    confusing sedation with anxiolysis (the two are discrete).

    Bill








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