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This is the first time I'm having a problem with tapering a benzo.

My healthcare provider finally fixed me an appointment and I made complains about Flurazepam; (I'm taking it for too long, it's too impairing specially during the day in various ways: cognition, excessive tiredness...).

The PDOC that I saw told me the PDOC that I used to 'work' with was back and recommended to schedule an appointment and this PDOC prescribed me Lorazepam to replace the Flurazepam and suggested experiences with both but not at the same time, something like: Taking lorazepam one night and 15mg of Flurazepam the other and he was very flexible with it but not with a plan for me to follow up.

I found out that spreading some dosages of clonazepam during the day worked. 

I was feeling fine but I just went too fast on reducing and I can't talk with this PDOC or the other one and I have about a month to see my 'old' PDOC which I'll ask for a plan to get me out of this trap.

This is causing me a bunch of problems because I don't want to show up at emergency and say I'm having problems with tapering my benzos because this will not happen, not with a lot of struggle and more stress to it.

I was using clonazepam because I thought it would be easier to taper than Lorazepam, for me clonazepam isn't as sedative which I could benefit during the day and I also think if I use Lorazepam during the day, it will make harder to sleep during the night using just a bigger dosage of it.

I thought as clonazepam as a short-curt. (for reducing faster the tolerance)

I'm feeling better, strange thing, my headaches only happens when I take the Flurazepam to sleep, even on 7,5mg.

I have 2mg Lorazepam pills and 2mg Clonazepam.

If I take more than 2mg clonazepam I'll not make to next appointment and I'm worried about worsening everything using Lorazepam but I'm inclined right now to divide 0,5mg of lorazepam during the day and taking 2mg or 3mg at night and just report this to my PDOC or if my tolerance drops on Lorazepam to a level that I feel comfortable tapering I could make an exchange of 0,5mg of lorazepam to 0,5mg of clonazepam some weeks from now.

ARGH.

I don't even know if this type of thing can be discussed here.

I think I can write an e-mail to my old PDOC but I don't know what exactly how to summon up and tell what's needed besides "I'm having trouble with tapering Flurazepam".

Edited by uncomfortable thoughts
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Would be great if I got a response.

I don't know if figuring this out on my own would be the best but at least I would face the PDOC that first prescribed me the 30mg flurazepam and vanished leaving me with refills for almost a semester of a drug that after two months I clearly need to be out off.

I don't think I can make worse than keep on this 30mg a night.

What I'm observing that is getting worst by the day.

I already figured out that I have to take three divided doses of clonazepam if I don't want to get all my muscles stiff and tense but unfortunately I don't have the pills to keep it going and relaxed.

It is taking at least 2.5 mg a day and didn't get easier.

Right now it seems ideal taking 3mg. (1mg morning / 1mg afternoon / 1mg evening + Lorazepam still unknown dosage).

I have a theory that, because Flurazepam is actually absorbed really quickly but it's effects sticks for too long is why the withdrawal symptoms are worsening after more time than usual.

If I go back to Flurazepam I would get uncomfortably tired and zombie alike 20 hours after taking it and I would make an extreme effort to focus to read a paragraph... and... the headaches!

All that tiredness and incapability of doing something just got me frustrated and irritated.

I don't think the emergency psych would let me leave with a three dosages a day of long acting benzos prescriptions knowing that I'm stacked up with a bunch of short-medium to 'horse-tranqualiser' types.

 

I still rather take this treatment path than going on dopamine antagonists.

The thing just went wrong when I found myself without a pdoc for more than three months.

 

Edited by uncomfortable thoughts
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I got no response.

I think my tolerance and dependence aren't as bad as I thought.

I'm managing it with three low dosages of clonazepam and using lorazepam as sleeping pill.

I feel more awake, have better focus and I'm less frustrated and having less headache than taking 30/15 or even 7,5 mg of Flurazepam at night.

I think the best part of it is I'm sleeping and feeling well rested.

I'm still pissed about my noise neighbors but only becoming deaf would solve it.

I wish I could make the clonazpeam lasts, I don't think using lorazepam instead would benefit me since clonazpeam is holding it.

I don't know if it's too soon, but if I keep myself this way I will go to ER and say what's happening and preventing me to go backwards.

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According to the Ashton Manual, the best benzodiazepine to use for tapering off of another benzo is diazepam due to its long half-life, especially of its metabolites. However, flurazepam actually lasts longer than diazepam! So I'm not really sure that diazepam substitution would actually work in this case. It would certainly be a lot better than substituting it with lorazepam or clonazepam though (due to its longer half-life). The only other one that might be better would probably be chlordiazepoxide, but they only come in capsules in the US to my knowledge and thus cannot be split.

This link talks about how to design a withdrawal schedule. Part of that involves finding out the equivalent dose of your benzo to diazepam. Unfortunately this website just says flurazepam "15-30 mg" is equivalent to diazepam 10 mg—not very specific... lol. So here's a link to the benzo equivalency chart from Epocrates.

https://online.epocrates.com/tables/3058/Benzodiazepine-Equivalents

In case you're not able to access it, it says 15 mg flurazepam = 5 mg diazepam, so that means 30 mg flurazepam = 10 mg diazepam.

There are a bunch of example withdrawal charts on that website, many of which really probably don't apply to you since you're taking flurazepam (which I assume you're only taking at night). The withdrawal schedule from temazepam would seem to be the closest example to follow for you in your case, except your starting dosage would be flurazepam 30 mg and equivalent diazepam dosage would be 10 mg. From there you could start with flurazepam 15 mg + diazepam 5 mg = equivalent to diazepam 10 mg, and reduce the diazepam by 1 mg or 2 mg every 1 or 2 weeks until you're no longer taking diazepam, just flurazepam 15 mg, then discontinue flurazepam 15 mg and start taking diazepam 5 mg again, then repeat the same process, decreasing the diazepam dosage by 1-2 mg every 1-2 weeks.

For example, this would be how I personally would do it...

 

Night time

Equivalent diazepam dosage

Starting dosage

flurazepam 30 mg

10 mg

Stage 1 (1-2 weeks)

flurazepam 15 mg
diazepam 5 mg

10 mg

Stage 2 (1-2 weeks)

flurazepam 15 mg

diazepam 4 mg

9 mg

Stage 3 (1-2 weeks)

flurazepam 15 mg


diazepam 3 mg

8 mg

Stage 4 (1-2 weeks)

flurazepam 15 mg


diazepam 2 mg

7 mg

Stage 5 (1-2 weeks)

flurazepam 15 mg


diazepam 1 mg

6 mg

Stage 6 (1-2 weeks)

flurazepam 15 mg


stop diazepam

5 mg

Stage 7 (1-2 weeks)

stop flurazepam


diazepam 5 mg

5 mg

Stage 8 (1-2 weeks)

diazepam 4 mg

4 mg

Stage 9 (1-2 weeks)

diazepam 3 mg

3 mg

Stage 10 (1-2 weeks)

diazepam 2 mg

2 mg

Stage 11 (1-2 weeks)

diazepam 1 mg

1 mg

Stage 12 (1-2 weeks)

stop diazepam

0 mg

You could skip stage 6 and go straight to stage 7—stage 6 was included to get used to taking just flurazepam 15 mg, and stage 7 was included to get used to taking diazepam 5 mg instead of flurazepam 15 mg.

This could be accomplished with a lot of diazepam 2 mg tablets, the amount depending on whether you want to taper every week or every two weeks.

I hope this is of some help to you and doesn't overcomplicate things. Good luck to you!

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Hi, thanks for posting.

I like Diazepam for tapering, if I had I would use because for me the onset is faster than Clonazepam and easier to 'quit' and would probably last longer on the muscle relaxant thing that I'm struggling with.

I can't notice Clonazepam onset while Diazepam I feel a mild sedation, which makes Diazepam not as great for me to use during the day.

Unfortunately I have more Lorazepam pills and I'm working with what I have.

Lorazepam for me is more sedating than both (clonazepam and diazepam) and I can feel muscle relaxant properties starting on 15 to 30 minutes and feeling the onset would make it worst for me to quit it. This is my logic.

I'm also avoiding Lorazepam during the day because it start making a difference on hypnotic effects after 1 hour.

I'm using Clonazepam because it's the mildest thing I have around and again, for me it's slow absorbed (2 hours)  and I can't feel it reaching peak.

Unfortunitely in this 'scenario' Clonazepam is holding my muscles relaxed for 4-5 hours tops but has the benefit of reaching those effects without being something noticeable. That's why I'm keeping a steady three doses a day at the minimum efficient dosage.

Eventually I'll run out of Clonazepam because I've got prescribed Lorazepam instead.

Lorazepam would work faster but would also come with sedation.

That's why I'm using Lorazepam for sleep and I can notice a mild effect of lorazepam after 7 hours of sleep, so I think it's holding my muscles very relaxed all night.

 

I don't think any chart of benzo is accurate and I can prove it by one test.

Take 30mg of Flurazepam and see what happens.

Take 10mg of Diazepam and see what happens.

 

Or (Please don't do this).

Take 30mg of diazepam and 90mg of Flurazepam.

 

Anyways.

 

There are too much info to be crossed and I think it's impossible to make such a chart.

How could someone compare a thing that has a faster onset and a larger half-life with something that has a slow onset and a shot half life?

How would be 'potency' calculated?

 

90mg of Flurazepam could be dangerous for your life and 30mg of Diazepam, at least on divided doses are something normal to be prescribed.

 

Flurazepam is instructed to be only administrated once, at night, you can start wondering about those charts with this info and due to it's metabolites close to diazepam, the withdrawal symptoms are more noticeable after some days, a thing like alprazolam you can notice a withdrawal in the same day you ceased it.

 

Again, how could you cross those things?

30mg of flurazepam would make hard to keep your eyes open, that the purpose of it while, let's say, 10mg of diazepam would not do the same thing.

Edited by uncomfortable thoughts
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