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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by cache-monkey on March 26, 2005, at 13:45:54
Hey all,
So, I've been trying to go the benzo route lately, upon a strong recommendation from my therapist. Xanax works the best for me at about 1-1.25 mg per day. Problem is the inter-dose rebound anxiety and the difficulty with eventual discontinuation.
The XR version of Xanax didn't work for me. Maybe my digestive system rips through all the layering too quickly, but it was like 3 hours of intense sedation, another 3 hours of anxiolysis, then nothing.
Klonopin also didn't work: excessive sedation relative to anxiolysis, and some sexual dysfunction.
I'm now trying Valium and was pleased by my first 2 mg dose. Problem is, I'm not sure what amount of Valium equates to 1-1.25 mg of Xanax.
According to Dr. Bob's tips [1], 1 mg of alprazolam should be ~ 10 mg of diazepam. I've seen this also at the on-line Family Practice Notebook [2], and in an article in the American Family Physician on discontinuation/withdrawal [3].
But, C. Heather Ashton, who has written an extensive manual on benzos and discontinuation, claims that 1 mg of alprazolam should be ~ *20* mg of diazepam [4].
What gives? Maybe it's because Ashton's equivalence chart is geared toward cross-tapering to diazepam for discontinuation. I.e. just to make the transition smoother (since not all benzos are perfectly interchangeable), she inflates the diazepam equivalent?
Anyway, if anyone, from personal experience, might be able to tell me what amount of Valium they found to equate to a workable Xanax dose, I would be much obliged.
Thank,
cache-monkey[1] http://www.dr-bob.org/tips/bzd.html
[2] http://www.fpnotebook.com/PSY163.htm
[3] http://www.aafp.org/afp/980700ap/miller.html
[4] http://www.benzo.org.uk/bzequiv.htm
Posted by Larry Hoover on March 26, 2005, at 13:57:42
In reply to Xanax to Valium Conversion.. Ashton's #s too high?, posted by cache-monkey on March 26, 2005, at 13:45:54
> I'm now trying Valium and was pleased by my first 2 mg dose. Problem is, I'm not sure what amount of Valium equates to 1-1.25 mg of Xanax.
If I may be so bold, I think you are placing too much emphasis on secondary sources, and not enough emphasis on the primary, i.e. your own experience.
The literature guides must inherently rely on a number of assumptions, any of which may or may not be true for you.
In the end, you must do your own titration, to calibrate the scale for your unique self.
Instead of thinking in absolute terms, i.e. 1 mg X is equal to 10 mg Y, substitute the concept of "about", or "may be around".
I think you're overthinking a little.
Best,
Lar
Posted by ed_uk on March 26, 2005, at 13:58:44
In reply to Xanax to Valium Conversion.. Ashton's #s too high?, posted by cache-monkey on March 26, 2005, at 13:45:54
Hello!
>Problem is, I'm not sure what amount of Valium is equivalent..............
1mg Xanax = Xmg Valium
X is a different number for everyone. Since alprazolam and diazepam are different drugs, there is no exact equivalent dose. Although the equivalence charts are a useful guide, I'm afraid you'll have to do a bit of trial and error to find your own person value of X. At least you know that it'll probably be between 10mg and 20mg, it might not be though!
Best of luck :-)
Ed.
Posted by cache-monkey on March 26, 2005, at 15:23:22
In reply to Re: Xanax to Valium Conversion.. Ashton's #s too high? » cache-monkey, posted by Larry Hoover on March 26, 2005, at 13:57:42
Good points, Larry.
And, I am definitely overthinking this. When I'm not feeling (mentally) well, that's what I do. I had my Lithium pulled out from me a couple of days ago and that's kind of knocked me down a hole.
Hopefully things are gonna get better.
cache-monkey
> > I'm now trying Valium and was pleased by my first 2 mg dose. Problem is, I'm not sure what amount of Valium equates to 1-1.25 mg of Xanax.
>
> If I may be so bold, I think you are placing too much emphasis on secondary sources, and not enough emphasis on the primary, i.e. your own experience.
>
> The literature guides must inherently rely on a number of assumptions, any of which may or may not be true for you.
>
> In the end, you must do your own titration, to calibrate the scale for your unique self.
>
> Instead of thinking in absolute terms, i.e. 1 mg X is equal to 10 mg Y, substitute the concept of "about", or "may be around".
>
> I think you're overthinking a little.
>
> Best,
> Lar
Posted by Phillipa on March 26, 2005, at 19:07:13
In reply to Re: Xanax to Valium Conversion.. Ashton's #s too high? » Larry Hoover, posted by cache-monkey on March 26, 2005, at 15:23:22
I just went through the same thing. The charts totally confused me. I found as ED and Scott advise go by how you feel. I found that 5mg of valium was as effective for me as lmg of klonopin or .5 of xanax. It just doesn't make me tired or feel stupid. Fondly. Phillipa
Posted by Buckeye Fan on March 28, 2005, at 6:56:13
In reply to Xanax to Valium Conversion.. Ashton's #s too high?, posted by cache-monkey on March 26, 2005, at 13:45:54
Having just had a dental procedure last week...in which I was prescribed ( and took) 25 millligrams of Valium for the first time in my life....
I can say I felt about as relaxed as 2-3mg's of Xanax..which I take daily.
I was curious about Valium since even though its a different med, it is in the same family as alprazalom ( xanax).
Now I am glad I am on Xanax instead since to ME it is more relaxing all things being equal.
The only advatage I would give Valium is that it is a bit more relaxing to the muscularskeletal system...which does agree with the medical litature concering its muscle-spasm relief effectivness.BF
This is the end of the thread.
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