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How do i come my pills: slow withdrawal HOW DO I COME MY PILLS: SLOW WITHDRAWAL
Many people withdraw very successfully at home. If your doctor has agreed that you should reduce, but has not given you a withdrawal regime, here are some suggestions:
The Open University course called 'Anxiety and Benzodiazepines (Tranquillizers)' recommends a dose reduction of 1\8 th of the daily dose per 2-4 weeks. Some people feel that this regime prolongs the agony and prefer to tolerate symptoms of a more rapid withdrawal. The course also recommends that where a short-acting drug (e.g. Ativan) is being taken, a long-acting drug (e.g. Valium) be substituted. This can be done when the lowest possible dose of the short-acting drug is reached. Alternatively the recommendation for Diazepam (Valium) substitution from the Drugs Newsletter, No. 31, April, 1985, of the Regional Drug Information Service, Newcastle upon Tyne, can be used.
The benzodiazepine in use should be replaced in increments of one dose per day by the equivalent dose of diazepam [see Appendix]. This substitution can usually be accomplished within a week, although the duration of this period should be varied to suit individual patients. For example, a regime for a patient taking Lorazepam lmg morning, midday and evening is to replace the evening dose with l0 mg Diazepam for two days, then add replacement of the midday dose for two days, and finally replace the morning dose. The patient is then taking a daily dose of 30 mg Diazepam, which is approximately equivalent to 3 mg Lorazepam. Some patients feel better when Lorazepam or other relatively short-acting benzodiazepines are replaced by Diazepam in this manner. Some, however, require slightly more than the approximately equivalent dose of Diazepam given in the table to replace the benzodiazepine they are used to. A minority of patients experience real difficulties in changing from one benzodiazepine to another. In these cases, the changeover needs to be carried out more gradually.
It is generally agreed that the short-acting drugs cause most problems during withdrawal.
Many people have found the short-term or intermittent use of Propranolol (Inderal) useful. It helps the panic attacks, palpitations, sweating, and is a mild sedative.
It is extremely important to check with your doctor before you reduce any drugs.
Do not compare the numbers of milligrammes—1 mg of one drug cannot be substituted for 1 mg of another drug. 5 mg of Ativan does not equal 5 mg of Valium or 5 mg of Mogadon.
*8\49\8*
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