Valium (Diazepam)



Diazepam is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic.



In acute alcohol withdrawal, diazepam may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis.



As an adjunct prior to endoscopic procedures if apprehension, anxiety or acute stress reactions are present, and to diminish the patient's recall of the procedures (see WARNINGS).



Diazepam is a useful adjunct for the relief of skeletal muscle spasm due to reflex spasm to local pathology (such as inflammation of the muscles or joints, or secondary to trauma); spasticity caused by upper motor neuron disorders (such as cerebral palsy and paraplegia); athetosis; stiff-man syndrome; and tetanus.



Injectable diazepam is a useful adjunct in status epilepticus and severe recurrent convulsive seizures.



Diazepam is a useful premedication (for injectable solution only, the IM route is preferred) for relief of anxiety and tension in patients who are to undergo surgical procedures. Intravenously, prior to cardioversion for the relief of anxiety and tension and to diminish the patient's recall of the procedure.





WARNINGS



When used intravenously, the following procedures should be undertaken to reduce the possibility of venous thrombosis, phlebitis, local irritation, swelling, and, rarely, vascular impairment: diazepam should be injected slowly, taking at least one minute for each 5 mg (1 ml) given; do not use small veins, such as those on the dorsum of the hand or wrist; extreme care should be taken to avoid intra-arterial administration or extravasation (see CLINICAL PHARMACOLOGY).



Do not mix or dilute diazepam with other solutions or drugs in syringe or infusion container. If it is not feasible to administer diazepam directly IV, it may be injected slowly through the infusion tubing as close as possible to the vein insertion.



Extreme care must be used in administering injectable diazepam by the IV route to the elderly, to very ill patients and to those with limited pulmonary reserve because of the possibility that apnea and/or cardiac arrest may occur. Concomitant use of barbiturates, alcohol or other central nervous system depressants increases depression with increased risk of apnea. Resuscitative equipment including that necessary to support respiration should be readily available.



When diazepam is used with a narcotic analgesic, the dosage of the narcotic should be reduced by at least one-third and administered in small increments. In some cases the use of a narcotic may not be necessary.



Diazepam should not be administered to patients in shock, coma, or in acute alcoholic intoxication with depression of vital sins. As is true of most CNS-acting drugs, patients receiving diazepam should be cautioned against engaging in hazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle.



Tonic status epilepticus has been precipitated in patients treated with IV diazepam for petit mal status or petit mal variant status.



Use in Pregnancy: An increased risk of congenital malformations associated with the use of minor tranquilizers (diazepam, meprobamate and chlordiazepoxide) during the first trimester of pregnancy has been suggested in several studies. Because use of these drugs is rarely a matter of urgency, their use during this period should almost always be avoided. The possibility that a woman of childbearing potential may become pregnant at the time of institution of therapy should be considered. Patients should be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physicians about the desirability of discontinuing the drug.



In humans, measurable amounts of diazepam were found in maternal and cord blood, indicating placental transfer of the drug. Until additional information is available, diazepam injectable forms are not recommended for obstetrical use.



Pediatric Use: Efficacy and safety of parenteral diazepam has not been established in the neonate (30 days or less of age).



Prolonged central nervous system depression has been observed in neonates, apparently due to inability to biotransform diazepam into inactive metabolites.



In pediatric use, in order to obtain maximum clinical effect with the minimum amount of drug and thus to reduce the risk of hazardous side effects, such as apnea or prolonged periods of somnolence, it is recommended that the drug be given slowly over a three minute period in a dosage not to exceed 0.25 mg/kg. After an interval of 15 to 30 minutes the initial dosage can be safely repeated. If, however, relief of symptoms is not obtained after a third administration, adjunctive therapy appropriate to the condition being treated is recommended.



Withdrawal symptoms of the barbiturate type have occurred after the discontinuation of benzodiazepines (see drug ABUSE AND DEPENDENCE).



Additional Information for Injectable Emulsion: STRICT ASEPTIC TECHNIQUE MUST ALWAYS BE MAINTAINED DURING HANDLING. DIAZEPAM INJECTABLE EMULSION IS A SINGLE-USE PARENTERAL PRODUCT, CONTAINS NO ANTIMICROBIAL PRESERVATIVES, AND CAN SUPPORT RAPID GROWTH OF MICROORGANISMS. ALWAYS DISCARD UNUSED PORTION (SEE DOSAGE AND ADMINISTRATION, ASEPTIC GUIDELINES FOR PARENTERAL USE). THERE HAVE BEEN REPORTS IN WHICH FAILURE TO USE ASEPTIC TECHNIQUE WHEN HANDLING OTHER PARENTERAL PRODUCTS (CONTAINING THE SAME VEHICLE) WAS ASSOCIATED WITH MICROBIAL CONTAMINATION OF THE PRODUCT AND WITH FEVER, INFECTION/SEPSIS, OTHER LIFE THREATENING ILLNESSES, AND/OR DEATH. DO NOT USE IF CONTAMINATION IS SUSPECTED.





PRECAUTIONS



Although seizures may be brought under control promptly, a significant proportion of patients experience a return to seizure activity, presumably due to the short-lived effect of diazepam after I.V. administration. The physician should be prepared to readminister the drug. However, diazepam is not recommended for maintenance, and once seizures are brought under control, consideration should be given to the administration of agents useful in longer term control of seizures.



If diazepam is to be combined with other psychotropic agents or anticonvulsant drugs, careful consideration should be given to the pharmacology of the agents to be employed¾particularly with known compounds which may potentiate the action of diazepam, such as phenothiazines, narcotics, barbiturates, MAO inhibitors and other antidepressants. In highly anxious patients with evidence of accompanying depression, particularly those who may have suicidal tendencies, protective measures may be necessary. The usual precautions in treating patients with impaired hepatic function should be observed. Metabolites of diazepam are excreted by the kidney; to avoid their excess accumulation, caution should be exercised in the administration to patients with compromised kidney function.



Since an increase in cough reflex and laryngospasm may occur with peroral endoscopic procedures, the use of a topical anesthetic agent and the availability of necessary countermeasures are recommended. Injectable forms of diazepam have produced hypotension or muscular weakness in some patients, particularly when used with narcotics, barbiturates or alcohol.



For Injectable Solution Only: Until additional information is available, injectable diazepam in not recommended for obstretical use.



Lower doses (usually 2 mg to 5 mg) should be used for elderly and debilitated patients.



The clearance of diazepam and certain other benzodiazepines can be delayed in association with cimetidine (Tagamet) administration. The clinical significance of this is unclear.



Labor and Delivery: For Injectable Emulsion Only: In humans, measurable amounts of diazepam were found in maternal and cord blood. indicating placental transfer of the drug. Until additional information is available, injectable diazepam is not recommended for obsterical use.





OVERDOSE



Management of Overdosage: Manifestations of diazepam overdosage include somnolence, confusion, coma, and diminished reflexes. Respiration, pulse and blood pressure should be monitored, as in all cases of drug overdosage, although, in general, these effects have been minimal following overdosage. General supportive measures should be employed, along with intravenous fluids, and an adequate airway maintained. Hypotension may be combated by the use of levarterenol (for injectable solution), norepinephrine (for injectable emulsion), or metaraminol (for either form). Dialysis is of limited value.



Additional Information for Injectable Solution: Flumazenil, a specific benzodiazepine-receptor antagonist, is indicated for the complete or partial reversal of the sedative effects of benzodiazepines and may be used in situations when an overdose with benzodiazepine is known or suspected. Prior to the administration of flumazenil, necessary measures should be instituted to secure airway, ventilation and intravenous access. Flumazenil is intended as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. Patients treated with flumazenil should be monitored for resedation, respiratory depression and other residual benzodiazepine effects for an appropriate period after treatment. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. The complete flumazenil monograph, including



CONTRAINDICATIONS

, WARNINGS, and PRECAUTIONS should be consulted prior to use.





CONTRAINDICATIONS



Diazepam is contraindicated in patients with a known hypersensitivity to this drug; acute narrow angle glaucoma; and open angle glaucoma unless patients are receiving appropriate therapy. Injectable Emulsion Only: Because the diazepam emulsion vehicle contains soybean oil, diazepam injectable emulsion should not be used in patients with known hypersensitivity to soy protein.

Melody,

Can you tell me how long valium stays in your sytstem ??

Well, I'm not Melody, but I think I can answer your question for you.

Firstly, the half life for valium is about 12 - 18 hours, meaning half of the drug will be out of your system in that time. But, the thing with half lives, if you remember from chemistry, then the process starts all over again for the remainder. Meaning half of what remains will be out in another 15 hours or so, and so on.

So, it takes a lot longer than two half lives to eliminate a drug from your system.

It takes about seven half lives to totally eliminate any drug from your system. So, doing the math and assuming an average of 15 hour half live, it would take about 4 1/3 days (105 hours) to eliminate the drug totally.

Now, keep in mind however, this does not mean that Valium is effective for 4 days. The level required for therapeutic dose of most drugs is generally at most one half life, and even shorter if you’ve used the drug for a while and developed a tolerance to it.

According to the Clinical Handbook of Psychotropic Drugs, the half-life of Diazepam 5 mg is 30 to 200 hours. Check this site:

http://www.dr-bob.org/tips/bzd.html

Great example of why you should read a book or scientific/medical article for that data, as I have seen people on boards saying "15-50", "average is 40!" etc. etc. bullshit.

nycalt,
Your post is accurate and informative. Much of the on-line "literature" is total BS when it comes to half-lives. Some people quote the half-life of valium as 200 hours. If that were the case, and someone took 15 mg/day, they would be a total zombie in a week or so.

The half-life of any drug is independent of the initial amount. Whether it's 1 mg or 1 gram, the half-life is the same. And your 200 hour half-life for valium is exactly what I was talking about in my last post. It cannot be accurate.

Anyone heard of Terapia brand Valium it is 10mg from romania is it any good?

It is a perfect brand.

What do you mean by perfect? Have you tried them and compared them to regular U,S, Valium.

Perfect generic Valium from Romania? Hmmmm. Don't think so. The real deal Roche from U.S or Int'l works best for me.

Will

Yes, I have compared them with the blue Roche. As far as I know, the Terapia generic should be a production licensed by Roche.
But I may be wrong, so correct me if you have any other information.

Blue Roche, licensed for manufacture in many countries is always a good bet. US Barr labs also has a good product. I have found Indian diazepam to be a bit weak.

The romanian (terapia) are a little stronger than the Roche blue 10mg pills. Ive tried both, and terapia is better for the $

What is this half-life?.....I am new to taking valium once a day for sleep so I am lost to the lingo....thanks.
I hope that I will not have to take it long, seems I have re-developed a bit of OCD about locking doors and such and it prevents me from sleeping.....I had this when I was a teen and it has resurfaced years later.....not sure why I went so long symptom free?(I used to take trazadone as a teen...that stuff knocked my butt COLD in 15 minutes back then)

Kammi

It's one of the longest lived benzos. Literature values for the half life are around 90 hours, which I find hard to believe, but it is much longer lived than xanax.

Half life of valium ?

I used to take 10 mg in the morning for muscle relaxation.

Late in the afternoon/early in the evening most of the effect had worn off, and I had to take another 10 mg.

Take those stores of the half-life of valium being tens to 100's of hours with a grain of salt.

Of course, this varies from person to person.

Not true. The blood level of some drugs will affect their rate of metabolism. Codeine is a good example. Swamping the enzyme system puts a ceiling on its conversion to nor-morphine. Many other drugs affect the CYP system and their blood levels can either speed up or slow down their metabolism.

Metabolic halflife is not ruled by the laws of physics as is the case for radioactive decay. Metabolism of a drug in a living organism can be subject to complex interactions of enzyme systems affected by drug blood level or which can be overloaded as is the case for codeine.

You are correct about the published halflives of diazepam being much longer than its effective halflife.

Trampy, you never cease to amaze me. I wish I had your knowledge, brain power, and time to research and learn all this stuff about just about everything. I think we all know if we have a serious question or concern about any matter discussed on the board, we can come to you and get logical, reasonable, and honest answers. Thanks for what you do for all of us.

What you say is more or less true, but largely irrelevant. You are confusing the rate of chemical reaction with the half-life. These are two totally different concepts, both of which are entirely dependent on the laws of chemistry, which are totally derivable from physics. Most metabolic reactions will display pseudo first order behavior in the recommended dosage range , because the substance being metabolized is present in very small amounts, and everything else is more or less constant over the timescale of the reaction. I can write the differential equations for you, if you are interested. Indeed, without a linear response it would be just about impossible to ever get dosages correct.

I was going order from my ROP during my re-consult soon and also ask these questions, but did not want too look too dumb. I take Lortab for my pain for fibro, bulging discs and other pain. I am also in the need for a muscle relaxant and had read that Soma is a good one and was also going to request that. Further I have been having severe anxiety for all of this pain trouble sleeping and other things going on in my life right now. I was going to ask for Valium (Diazepam) too but didn't know enough about meds to know what class they are in, types they are, and if all would be filled for me. Could someone with knowledge in this subject let me know before I make a complete fool of myself. I also hope I am able to get all of these or feel I may loose my mind from the pain I deal with everyday. I am also going to see someone and hopefully that will also help.

I was going order from my ROP during my re-consult soon and also ask these questions, but did not want too look too dumb. I take Lortab for my pain for fibro, bulging discs and other pain. I am also in the need for a muscle relaxant and had read that Soma is a good one and was also going to request that. Further I have been having severe anxiety for all of this pain trouble sleeping and other things going on in my life right now. I was going to ask for Valium (Diazepam) too but didn't know enough about meds to know what class they are in, types they are, and if all would be filled for me. Could someone with knowledge in this subject let me know before I make a complete fool of myself. I also hope I am able to get all of these or feel I may loose my mind from the pain I deal with everyday. I am also going to see someone and hopefully that will also help.

Just a thought for you~ There is a medication called amytriptolin that is supposed to work wonders for Fibro pain, at least for some people. You might want to Google that and see what you can find. For some people, the traditional medications don't touch Fibro pain. Have you visited any forums for Fibro patients? I get a lot of good info at some of them.

Good Luck. Fibro stinks!

I am in the process of checking out the sites and hope to find something helpful. I also have contacted a couple of people with fibro and am waiting for them to get back to me. I also tried amytriptolin for migraines(sp?) about 6 months ago before I was diagnosed and had very bad reactions to it. It made me pulse and heart race and made me very dizzy, I couldn't stand up straight. Thanks for the advise though.

How much Lorezepam is too much to say OD. I know that about 1mg of L equates to about 5mg of Diazepam but I just started with the Lorezepams and they seem not to do anything when I take them as oppose to valium. I just want to be safe but cured at the same time.

I have not taken Lorezapam, but I have researched it for my anxiety.

I am not sure about when it becomes toxic but I wouldnt recommend taking more than about 2-3mg at a time for anxiety/panic treatment. I would say 1mg of L = 5mg of Val but I am not sure if 3mg of L = 15mg of V if you know what I mean. Also different people may need different doses or bemore resistant to one drug or another so if 1 mg of L doesnt work you could try 2 and then 3 but I would also increase gradually, not all at once. If I find more info I will post it.

Hope that helps.

Well I know of people that take 40mg of valium daily that are older. That would equal like 8mg of L?

Recommended dosage for Lorezapam

Here is what the PDR has to say about it:


ADULTS


--------------------------------------------------------------------------------

The usual recommended dosage is a total of 2 to 6 milligrams per day divided into smaller doses. The largest dose should be taken at bedtime. The daily dose may vary from 1 to 10 milligrams.

Anxiety

The usual starting dose is a total of 2 to 3 milligrams per day taken in 2 or 3 smaller doses.

Insomnia Due to Anxiety

A single daily dose of 2 to 4 milligrams may be taken, usually at bedtime.

CHILDREN


--------------------------------------------------------------------------------

The safety and effectiveness of Ativan have not been established in children under 12 years of age.

OLDER ADULTS


--------------------------------------------------------------------------------

The usual starting dosage for older adults and those in a weakened condition should not exceed a total of 1 to 2 milligrams per day, divided into smaller doses, to avoid oversedation. This dose can be adjusted by your doctor as needed.


--------------------------------------------------------------------------------

Overdosage


Any medication taken in excess can have serious consequences. An overdose of Ativan can be fatal, though this is rare. If you suspect an overdose, seek medical attention immediately.


The symptoms of Ativan overdose may include:
Coma, confusion, drowsiness, hypnotic state, lack of coordination, low blood pressure, sluggishness

Oh, and other benzos (Valium and xanax, etc) will intensify the effect so those numbers are if you are only taking Lorezapam / Ativan.

Be careful and conservitive and consult with your doctor before increasing your dosage significantly esp if on other benzos.

Hope I helped

I have currently went of to 8mg and seem to still feel really quite normal. Maybe it is just a dirrent body reaction. Thanks for your help.

8mg sounds like alot, esp to have no effect. i dont know where it came from but if it isnt from a primary care dr or a reputible pharmacy (so you know the meds are fresh and potent), it may not be the right drug for you.

Good Luck!

I know this is going off topic now. But, I've taken lorazepam before as well. It didn't do much if anything for me. I think doctor's start you off on it because its weaker and less likely to be abused. I know the charts say that a mg of lorazepam is equal to 5mg of valium or whatever, but thats really not true in my opinion. Valium is much stronger. I have recently been switched to clonazepam(klonopin) to help me relax in the evening, get to sleep and have less daytime anxiety. So far, two days, its worked much better than ativan. I barely noticed any effect from 1mg of ativan.

Has anyone had any experience with the Wyeth sublingual 2mg lorezapam? I've been curious to know if it is effective, and if it works faster than say Xanax for sudden panic.

In my opinion ativan sucks.....but I don't know your anxiety situation. If you've got genuine full on panic, I don't think ativan is strong enough. I don't recommend xanax either, just saying from my experience with ativan in general.

Sublingual Ativan is usually prescribed for the most extreme anxiety conditions - it is for extreme panic.

http://home.intekom.com/pharm/akromed/ativansl.html

FWIW. Ativan (lorazepam), out of myriad benzos, is the only one that made me dizzy and nauseous. Got the spins and had to sit, then lie down, or I would have done the Rainbow Yawn.
Not an overdose, either.
Go and figure. And I could eat Valium like Pez (not that I do).
One person's experience. YMMV.

I found Lorazepam to be "smoother" and not as strong as xanax or valium. I found xanax can quickly kill my anxiety and is the strongest of the three (it can knock me off my you know what), but is very short acting. Valium seems to be in the middle. It is not as strong as xanax, but works fairly well and lasts a bit longer. Note: all my experiences are based on 2mg Lorazepam vs. 2 mg xanax vs. 10 mg valium.

I can't comment on Wyeth sublingual 2mg lorezapam, but I've had regular Wyeth 2mg lorezapam and found them to be so weak they were useless for me.

My insurance will no longer cover Brand Name meds. I can only get generic meds or I have to pay full retail price for brand name meds.

I've been taking Valium for 14 years and have always gotten brand name "Roche" but now (unless I want to pay full retail) I have to get generics.

I would like to hear from those who have tried generic Valium and what the best brand of generic Valium is?

Any information regarding the best generic brand of Valium would be greatly appreciated.

Thanks in advance,
Paul

the barr marked ones worked for me watsons were good also

FWIW - I take 2mg Lorazepam thru the day and it has become my benzo of choice when it comes to functioning at a peak level altho they're not enough to put me out. The Alprazolam never fails at nite

My Dr. prescribed both valium and hydro for me (I was involved in a horrible accident recently). He said it was ok to take them simultaneously, but I haven't done it yet. I usually wait a few hours to take one if I have already taken the other. Does anyone have any experience with taking both of these meds at the same time? I have never taken valium before, but it doesn't make me sleepy, drowsy or "out of it." I'm not driving due to my injuries, so that's not an issue. I was just wondering if taken together, what typically happens? I have small children and don't want to get "loopy." I know everyone is different, but has anyone here had any interaction issues? I would really appreciate as much feedback as possible. Thank you,
Alyssa

Do you think anyone on this board knows better than your doctor? If so, I would find another doctor.

I typically enjoy your sarcasm and wit, but it rubbed me the wrong way this time. I specifically stated that the Dr. said it was ok to take them together (if you bothered to read that part), I was simply seeking personal experiences from others. BTW, he is an excellent Dr. who is extremely bright, well educated about pain management, and actually listens to me. Anyone else with helpful experiences?????

Taken together, they make my sleepy. Hydro, by itself or combined with say Flexeril, makes me hyper. Valium, by itself, makes me groggy, but won't "put me down". Hydro+Valium, taken simultaneously= nap time. Many Dr.'s used to use these in combo, as their drugs of choice, for back and neck pain.

In my experience, they rarely still do, but it is safe. Just don't take more then what was prescribed.

Thank you, Pillar, for your helpful feedback....I appreciate it. For anyone who missed any part of my post, I wasn't asking if it is ok to take them together, I am asking people who have done so how it made them feel. Anyone else?????

In my opinion, they go together as well as peanut butter and jelly. Be very careful as they do act "together" and can be very intoxicating. Do not drive a car etc. until you know how they effect you.

DO NOT DRINK ALCOHOL while taking these medications together!

Sometimes, Hydro disrupts my sleep and leaves me very edgy in the morning. If I take 5mg of Valium, I sleep very well and don't get the "uptightness" that Hydro alone sometimes causes.

I am not a Dr., but have been using this combination to treat my back pain for years. For me it is the perfect combination.

one last comment: Another poster (I think Nephro...who seems very wise) mentioned that Valium can cause extreme drowsiness long after your dose. I have experienced this. I took valium one night and slept great. Woke up bright eyed and bushy-tailed, grabbed some coffee and took off on my sales route. While driving, about 16 hours after taking the Valium, I got VERY drowsy. I was forced to pull my car to the side of the road and sleep. Remember this is like 15-16 hours after taking 10 mgs of Valium and 8-9 hours of solid sleep. No other drugs or alcohol had been used.

Hope that helps.

~ Swizzel

Thanks, Swizzel, it helps a lot. Thanks for the feedback. Guess what my favorite sandwich has been since I was a toddler? You guessed it, PB&J!!!

Yes diazepam is biphasic due to its active metabolite. Diazepam itself is relatively short-acting, but because of the metabolism by the body of it into another active drug, a second period of drowsiness can occur, making the drug plus its metabolite long-acting.

Trivially, diazepam can be found naturally in trace amounts in certain plants.

Sorry, drowsiness, then after you get used to it, it evens out. Be careful driving. Just my experience with hydro and any benzo.

Thanks, OldandWorn, I didn't mean to be a [censored], I have been overly sensitive recently because of what has happened. I have been affected both physically and cognitively....it hasn't been real fun being me. Anyway, I always enjoy reading your posts...they usually put a smile on my face. It will be quite a while before I can get behind the wheel, so driving is not an issue at this point.

Yes. I do. And it has been okay'd by my GP and Cardiologist both.

It can tend to make me drowsy but I never take more than 1/4 to a 1/2 at a time (valium)during the day and then one at night to help me sleep. During the day I need it sometimes to help with my rapid heartbeats, but when taking the hydro along with...I do tend to get a little drowsy a few hours after.

The only problem I dont like about Valium is that it stays in your system too much longer..

Yes, it is because my doctor prescribed hydro and valium. Then Then I was switch to Xanax. So both are ok to take at the same time. My mother is taking deremol and xanax and takes together all the time too. I hope this helps.

Yes. Hydro & Valium are O.K. together.
Another question to answer. Valium half-life is 200 hrs ( the longest of all Benzo's).
Still non-chronic user's should be clear in a week.

Thank you for all of your replies, I apppreciate you taking the time to post. My Dr. prescribed them both for me, so I knew it was ok to take them together. I think my original question got lost somewhere, although a few of you have given great information. I have been hesitant to take them too close together for fear of feeling "out of it" or "loopy." I have been spacing them apart but my muscle spasms have been pretty bad lately and I think I will have to start taking them together. I was hoping for feedback from people who have, or are currently taking those meds together and how it effects them. Thanx again for your responses.

Well , Valium is for the muscle spasms (specifically).
Good Luck

Thanks, Amenestelle. When I left the hospital, they gave me a prescription of the valium and specifically said it was the best medication for my soft tissue injuries (muscle spasms)and it will help with the anxiety associated with what happened to me. I know it doesn't help much with the pain from the fractures (that's why I was also prescribed hydro). Anyway, thanks for taking the time. This is all new to me, so I suppose I am just a little bit insecure with everything going on. Before the "incident," the strongest med I took for anything was 800mg Ibuprofin and Tramadol.

Just watch out. Valium addiction has plagued my life.
My stomach can't tolerate hydro, Ultram, etc.., but Valium grabbed me like The Devil came straight from Hell and bought my soul.
Just be careful.

You know, it's funny, I have heard about the dangers of valium addiction and how "good" it can make you feel from many people. I have absolutely no sensations or different feelings when I take them. I don't even really feel much of a "calmness" when I take them, but my husband and other people in my family seem to think I am not as anxious and controlling (for lack of a better word) when I do. It definitely helps with the muscle spasms and resulting headaches, but otherwise I wouldn't even bother taking them at all. I have never taken a benzo of any sort and I weigh 102 lbs., so I know it isn't a tolerance issue. These are the 10 mg. tablets I'm talking about. Well, I guess it just goes to show you how different our body chemistry is. I could honestly take it or leave it, and I can't fathom becoming addicted to it. Perhaps if I take them long term, I could develop a physical dependance on them, but otherwise they don't make me feel "good" as so many have described. This is probably a good thing.......

Alyssa, I absolutely feel the same way about valium.. Lorazepam has a better calming effect..

I add:

Valium-Diazepam form:

Tablets: 2 mg, 5 mg, 10 mg

Which Valium would you suggest: apaurin-diazepam 10mg ,krka/roche EU - blue valium OR
valium-diazepam 10mg, Galenika AD & Habitpharm?? Please give me you opinions one way or another! I'm leaning towards the 1st one..
Thanks,
Tia would you use (this is Serbian, I think)

For me, valium/diazapam is like booze in a pill. 20 mgs and I am stumbling around, slurring words, acting drunk.

klonopin, totally different, calms my anxiety, but no bad effects.

My sub doc rx's one 10mg valium at nite to sleep, and I notice a nice warm-fuzzy feeling from it for like 15 min. before I fall asleep.

since I'm on sub, this is the only warm-fuzzy I get. I look forward to that 15 minutes.

Is there another benzo that provides even more of a warm-fuzzy? I know it sounds like a recreational-type question, but I do use it for sleep only, and can't sleep at all without it.

You're better sticking with diazepam. It's one of the most rapid-acting benzodiazepines there is, but also easier to withdraw from than shorter-acting ones. If you ended up on alprazolam, for example, you may end up with an addiction that there is no equivalent of Suboxone to help you, and a risk of death from sudden cessation.

could 10mg of valium once a night actually cause an addiction? I have no craving for benzos or even think about them, but am dependent on that 1 valium to sleep.

to me, this situation shows the difference between dependance and addiction.

Scruf, I think you are fine on that level of valium/10mg each night. Since you do not crave it, abuse it (taking more and more) and are prescribed it, I would not lose any sleep over it!

I guess if you were really concerned about it, maybe you would just cut some of the 10 mgs in half and try 5 mg/night for a couple of weeks.

Really, I think you are fine the way your dose is now.

It's no major problem needing 10mg diazepam to sleep, as long as you don't start increasing the dose if it loses effectiveness. If tolerance creeps up (either suddenly or slowly), it's best to lower the dose and make yourself tired in other ways. Not easy, I know!

No matter what your intentions are (recreational vs legit)
Benzos are meant to be taken for no more than two weeks period.I do not mean to sound like a jerk or anything but if you as you said " look forward to that 15 minutes" to me that sounds like the early stages of dependence.Trust me when I say you DO NOT want to go through benzo withdrawls
if you have been on it for longer than two weeks it would be time to quit.Ask you doctor to give you something else to sleep.Plus if you are on sub like me and you just started it is expected that you might have trouble sleeping.

if benzo's are meant to be taken for "two weeks period", I'm afraid a lot of us are breaking your Rules I'm afraid.

I've been taking sub for 2 months and valium once at nite for a year, and am definitely dependent on them for sleep at night. If I were 'addicted', I would think that I'd crave them at other times. I don't. my sub doc knows I depend on it to get to sleep. she now rx'es the valium for me too, since I have a visit every month anyhow.

occasionally, I will try an ambien, melatonin, benadryl or muscle relaxer instead. ambien makes me groggy into the next day, and I can't fall asleep with the others.

actually, I sleep better on sub than I did before when I would wake up after 5 or 6 hrs in sweaty withdrawals. I just can't GET to sleep without help.

I am sorry you begrudge my 15 min warm-fuzzy before I fall asleep. do you not need to take a sleep aid at all? you are lucky, and probably a male. I think women have a harder time that way.

I appreciate your concern but don't think I will ever have to worry about physical benzo addiction or withdrawal using 1 10mg a day. I couldn't use it any other time. they make me too sleepy. I have always wondered how anyone could take them or any benzo all day long and function.

Crveni is referring to the Rules which are set out by medical authorities with the intention that doctors follow them. Of course, not all do, and there are many patients out there on long-term benzodiazepines.

This is from the Committee on Safety of Medicines:



The indications for diazepam are:



I would guess that the withdrawal symptoms of suddenly stopping 10mg diazepam each night would be an exaggeration of the original problem, ie. insomnia. After long-term use, some tapering would be required.

What I find worrying is the number of times I read on here about a doctor suddenly stopping the prescribing of such drugs, or the doctor leaving town and another one less generous taking over.

I'm from the medical field myself. And having worked with a Psychiatrist I know for a fact that Benzos can be Rx'd for more long term use.

They can be given out like candy if the doctor wants. But it doesn't make it good medical practise.

Neph, depends and what you're using, why, and the dosage.

well they give out the serotonin drugs like candy!
I am addicted to celexa and did not even know it till I tried to quit last month.

Dizziness, disassociation with reality, stumbling and limited motor coordination, crying spells, confusion, and, oh, did I mention dizziness?

My head feels like it may just topple from my body. Seriously.

I am three weeks off it and I am just going to get back on the train. Not what I expected.

I guess 7 years on a potent psychotropic comes with a price.

what a racket.

uh-oh. my doc just rx'ed celexa. I am on sub and valium for sleep. (I have taken 5 days worth). shall I quit now while I can?

sub doc did not want to rx antidepressants until I stablized on sub so she could see what my "baseline" is. asked me a bunch of 'test' questions and decided my baseline is "depressed".

I know it takes awhile for ssri's to kick in, but still imagine I feel a little better after 5 days. now I don't know what to do.

I don't like the idea of taking sub, valium, and antidepressants all at once. all addictive. how could anyone survive 3 different med withdrawals? what a mess. just wish I could be free of this pill stuff altogether.

antidepressants are not addictive in the classic sense. a good doctor would know what to do. if you want to be free of it, why are you adding more?

What, people here have taken benzos, of all types for YEARS and they aren't dependent or addicted!

and what, in your opinion, would that be? I consider my doc to be a very good doctor.

I do not want to be depressed.
I do not want to deal with the misery and danger of withdrawals at my age.
I do want to sleep.

my doctor is addressing these issues with me.
surely you wouldn't mind sharing your magic cure-all with us?

Well, I do know that Celexa has helped my depression. If you are really depressed, for me this is the one ssri that worked (and works) well for me. And it will help you sleep!

So, in your situation Scruf it is a tough call. Only you can decide

I am going to start back on it because I cannot continue to feel this way. 20mg though, which was half my usual dose and I will see if that brings me into normal range.

Good things about celexa: It's unscheduled, cheap (off patent) so you will get generic "citalopram," Easy to get (Friendly carries it) and you will not develop an increasing tolerance to it where you find yourself taking absurd quantities of the drug.

Bad things: Your body will develop an affinity to it. Long term (like me, seven years) it is (as I am now discovering) absolutely a BEACH to get off!

I am getting back on the train. Life is too short. At 46, it really does not matter to me.

The antidepressants do have a withdrawal syndrome associated with them, but are not considered addictive because there are no reinforcing properties. You don't take one AD pill and think, "That was nice; I'd love another". But benzodiazepines and opioids can produce this effect.

exactly.

I wish Nephro or any guru could develop an "inverse addiction equation," in which certain drugs, like ssris, although they will not cause an "addiction profile," nevertheless hook the user, provided that the initial response to the drug is positive, leading to continued use.

Like me and celaxa.

I mean, I have never taken more than the 40 mgs/day, ever, accept maybe 2 to 3 times if I "forgot." I was rewarded with a headache.

So there is no positive reinforcement to take more. No way.

However, I am still taking it.

Why?

My brain is hard wired for it now.

Now, take a benzo, in my case, klonopin, I have "taken more" than the suggested dose of 3mg/day. I get woozy, spacey, then tired and then sleep.

Next day, I skip all dosages of klonopin to achieve equilibrium.

hooked?

yes, but not like the celexa.

so the question is which is more addictive, and which would be harder to come away from? That is an experiment I do not want to be a part of!

yes, from reading the pdf prescriber's guide from roche on diazepam, the diazepam is converted into desmethyldiazepam (sp?) which has an even longer half life than the diazepam. the desmethyldiazepam is then metabolized into temazepam (active benzo) and oxazepam (active benzo). so taking diazepam is like taking up to four benzos, each with different half lives, over a period of time depending on your metabolism.

nephro please correct me if i misinterpreted the info, thanks!

I know it's just semantics but I'd say you're not "addicted" to Celexa since addiction is characterised more as a mental issue (i.e. craving for the drug), whereas you're physically habituated to it which is why you've got a withdrawal syndrome.

I would get those complaints checked out. There is a protocol for stopping SSRIs and other like medications.

Half life is misused as a measurement. It is about how it makes you feel, not blood plasma measurements.

Yep, for this reason, diazepam is generally used as a taper to get off benzo addiction. The 50-200 hour half life is something that cant really be disputed, as blood levels are tested periodically in clinical settings, and the above metabolites can be traced...well, up to 200 hours later.

Also, for those saying they have been taking valium for years with no addiction symptoms, it generally takes a week or so to feel the withdrawl
effects. Even at prolonged theraputic use, quitting cold turkey can potentially kill you, much like booze (both substances acting on the GABA areas of the brain). There are quite a few tapering schedules on the web, all of which suggest diazepam, and most of which take 7 to 8 weeks.

Sorry to ramble, i just enjoy knowing about the substances I need. I could go on and on about about the long term GABA chemical tomfoolery benzos inflict.

Yes again, but this long-action appears when used regularly, as the active metabolites have an additive effect and build up. Taking diazepam on a PRN basis won't have this effect. Of course, when tapering, regular doses are taken, and it means that the daily dose may be taken all at night in some cases.

This would be characterized as dependence versus addiction. These side effects are common with this type of medication when stopped cold turkey. All meds need to be tapered off of when used for a long period of time. I've seen heart attacks from people who abruptly discontinued hypertension and cardiac meds. I had the same symptoms as you years ago when I quit taking zoloft abruptly.

If used on a regular basis, my guess is that all types of people here ARE either dependent or addicted depending on their circumstance and the years they've been taking them. Anyone taking a benzo for years, or months even, is probably physically dependent on the med, not much way to get around that with regular use of the drug.

Nephro, you quote the CSM, I'll quote a different source-Most docs say 4-8 weeks MAX, especially if taken in conjunction with other psychotropics, basically to off set negative side effects. Unfortunately, most docs aren't as vigilant as they should be, and then wonder why patient 'X" is showing up and requesting an increase in dosage. I don't have a scanner, and am quoting from a pharm text copyright 2007 "Drugs and Behavior" by Mckim. Will provide more adequate references if you don't take my word for it Not trying to quarrelous , just to lend (yet) another time frame-further proof that no "absolutes" exist in medicine.

Well whether it's 2-4 weeks or 4-8 weeks, either is preferable to several years. Patients do vary, and if a doctor (and the patient) wants to stick with a particular antidepressant, despite initial symptoms of anxiety, I see no harm in going slightly beyond whichever guidelines they are issued with. As long as a tapering plan is carried out properly, of course.

A Doctor can over rule that as he sees fit. Every situation is different and also from person to person things can be quite different.

Just recieved Karnel Vals and was curious if others have an opinion of them. Its the first type of val I have taken and it works well for me but I have no benzo tolerance now.

I like the Karnels just fine. No problems.

Karnel? Never heard of them..
Are they generic or an IOP option?
I had heard mentioned that the Watson's were quite
effective as a generic.
Good thread.
Thank you Nephro,Private Realm and Scruff.
IMO you learn so much from reading an entire thread
such as this and this is a great example. IMHO

Well after trying my first karnel 10mg V I am very pleased. Quality seems to match that of any other I've had before. Thanks for the feedback!

I have had about 5 different kinds of valium, and most are ok, but the roche brand, with the hole in the middle, are by far the best IMO.
I am getting the same effect from 15mg of brand, as I did from 30-40mg generic.
I've had blues, whites, some say roche, some say diazepam.

Brand valium are far better then any other generic equivalent.

they are a large manufacturer in SA.

(and from what i read, known for having quality medications)

onetime, are you getting the v-cut roche from your local pharm/doc or by other means? as i never see the v-cuts round here. always a solid generic at the local pharms.

I don't know where you got your medical license but your diagnosis is inaccurate.I don't believe you can cure anxiety attacks in 2 weeks.I don't believe it can be cured at all just medicated to slow the episodes.I have been taking Valium,Xanax and Ativan for over 35 years. Not all at one time.Every couple years the doctor tapers me off one and starts me on another.We then start low and taper back up for a couple more years.I am now back on Valium and I have no problem tapering down and quitting without getting addicted.I do believe a person could get addicted using without being under a doctors supervision but if Benzo's are used under medical supervision they are a good medicine for anxiety. FYI . B.D.

Why does he start you on a different one after tapering the previous one?

from my doc.
she forgot to write DAW, so i went back and they changed them to brand.
From CVS

Over a period of time the med loses it's potency and doesn't work as well.Along with the addiction factor.All I know is that it works so I don't complain. FYI. B.D.

That just makes no sense.

Benzos have cross-tolerance, so the tolerance thing would be the same whether you tapered up or down, and stayed on the same med or switched to a different benzo of an equivalent dose. Changing the med, unless the dose were increased, would not mojorly change your tolerance.

Also, addiction happens quite often with prescribed meds just the same as it does with recreational use of meds. The fact that they are prescribed does not majically stop a person from becoming addicted.

Dependence on the other hand is definately an issue with prolonged use of any medication, prescribed or not.

That's why I asked; I could see no sense in it. If the doctor tapered the patient off one benzodiazepine, he might as well re-start the patient on the same one rather than swap.

But, as BD says, he's happy so wants to keep going with it, the doctor seems happy doing it, so might as well carry on!