My doctor has stopped my diazepam!

[decca]

So are we saying that it's OK to take low doses of Diazepam indefinitely ?

Decca.

[Oceanblue]

So are we saying that it's OK to take low doses of Diazepam indefinitely ?

Decca.

Hi Decca,


Not quite sure who you are referring to. I wouldn't agree that taking low doses of Diazepam indefinitely is a good idea, more so because it would be totally unnecessary. I believe it should only be given to a patient for short term use only, whatever the dosage.

I find it insane, that Confusedbylife's doc had repetitively repeated his prescription for 5yrs ! Seem's very strange and most definately wrong I would say, doesn't sound very professional to me.

[decca]

Thanks Katie,
Yes I agree - It's just that I couldn't quite understand what you were saying in your last post.

Cheers
Decca.

[Oceanblue]

No worries Decca , I'm certainly not the best at explaining things.

[decca]

I'm the same - It's all down to anxiety hun, mind you I am a doddery old twit as well, lol.

Decca.

[Mikke]

Hi there decca.

I think you could ask any doctor if he preferred his patient coming off diazepam or oxazepam and he would say oxazepam, regardless of half life there is time of absorbtion in the blood which is just as important.
Diazepam acts within 15-30 minutes beacuse of ity's very specific chemical structure, and in that matter it doesn't differ much from most illegal drugs, oxazepam on the other hand acts within about 2 hours, that's why drug dealers don't earn a lot of money selling them on the streets either.

When it comes to withdrawal it's more than one factor to be considered. Half life is one thing, acting time another.

[decca]

Yes I agree with the pharmacokinetics but when it comes to Benzo tolerance and withdrawal it's always easier to withdraw from the longer half life drug.
This is why patients are always crossed over to an equivalent dose of diazepam before starting a withdrawal plan - see The Ashton manual or any of the reports in The Journal of clinical Psychiatry by Profs. Bernik,Lader or Gorenstein.

Decca.

[Mikke]

Comparison of diazepam and oxazepam:
preference, liking and extent of abuse
by
Griffiths RR, McLeod DR, Bigelow GE,
Liebson IA, Roache JD, Nowowieski P.
J Pharmacol Exp Ther 1984 May;229(2):501-8

ABSTRACT

In a residential hospital research ward setting, the effects of and preference for placebo, oxazepam (480 mg) and diazepam (40, 80 and 160 mg) were studied in human volunteers with histories of sedative drug abuse. Doses p.o. were administered every 3rd day under double-blind conditions. After an initial exposure to the letter-coded test drugs, a series of choice days was scheduled on which subjects chose between two available drug alternatives. Compared with oxazepam, diazepam produced greater liking (area under the time-action curve), peak liking and euphoria and was judged to be of greater monetary street value. Diazepam was categorized as producing barbiturate-like subjective effects more frequently than was oxazepam (54 vs. 21%), whereas oxazepam was identified as placebo more often than diazepam (32 vs. 4%). Diazepam was associated with a more rapid onset of effect than was oxazepam, and this rapid onset was repeatedly cited by subjects in poststudy written comments as being a desirable feature of the drug effect. In choice tests, 80 and 160 mg of diazepam were preferred to 480 mg of oxazepam on 62.5 and 91.7% of the choice tests, respectively. In choice tests between placebo and drug, placebo was never preferred to diazepam; however, placebo was preferred to oxazepam on 21.4% of choice tests.

Overall, these results extend previous experimental observations suggesting that diazepam has a higher abuse liability than oxazepam. The results are also compatible with an analysis of epidemiological data showing that diazepam abuse uniformly exceeds oxazepam abuse on seven epidemiological measures of drug abuse.

[Mikke]

Decca,

It's not my intetion to argue, both medications are fairly potent - but it's just flat out wrong to suggest that diazepam is a drug easier to get off than oxazepam, which is just "Valium-light".

However - yout are perfectly right in saying that it would be a better idea to be put on a lower dose, bt as I understand it that was not an option for the threadstarter.

[decca]

Hi Mikke,
Yea I understand what you're saying but all the different reports by various experts seem to disagree with each other which leave us - the end user even more confused - I guess we can only be guided by our own Doctor's who hopefully have made an informed decision on the correct way to administer these drugs, this obviously didn't happen with the poster.
It's nothing new tho' as in the sixty's I was left on 30mg per day Phenobarbitone for 15 years and had to wean off of it myself.

Cheers
Decca.