Valium, the brand name for  Diazepam, is a long-acting benzodiazepine prescribed for various conditions, including anxiety, insomnia, muscle spasms, and panic disorders. In this post, I’ll discuss the challenges of Valium withdrawal,  strategies for success, and unique aspects of withdrawal/BIND (Benzodiazepine-induced neurological disorder). BIND is what we call the symptoms after we have withdrawn from the drug, i.e., it is no longer in our system. BIND symptoms can last for weeks, months, and for some, years. Symptoms are caused by neuroadaptation (brain changes) to the drug.

The Challenge of Tapering Valium

In the 1980s, Dr. Heather Ashton ran benzo withdrawal clinics in the UK. Dr. Ashton crossed her benzo patients over to Diazepam to taper. (In the Ashton Manual, it is suggested that everyone cross over.). This recommendation might give the false assumption that tapering off Diazepam will be easier than other benzos. Diazepam’s long action and small doses might make it mechanically easier to taper from, but the benefits end there. A crossover does not necessarily mean fewer or easier symptoms. There are challenges to tapering off Diazepam.

Histamine Issues

Valium inhibits the body’s ability to produce Diamine Oxidase (DAO), an enzyme crucial for breaking down histamine. High levels of histamine in the body can lead to symptoms of histamine intolerance, such as flushing, headaches, itching, and digestive issues, among others. No other benzodiazepine appears to affect the DAO. Many feel that they have developed histamine issues during their taper and beyond, and is should be noted that not all were on Valium. Histamine-like issues are fairly common in benzo withdrawal, but Valium is the worst offender.

Sedation/Depression/Anhedonia

All benzodiazepines can cause the same withdrawal/BIND symptoms. However, some have a “corner market” on specific symptoms. Valium has the unique property of being more sedating than other benzos. The reason behind this sedating effect lies in its metabolism. Upon ingestion, Valium is metabolized into three active metabolites: Desmethyldiazepam, Temazepam, and Oxazepam. (These are benzodiazepines.) These metabolites contribute to the long half-life of Valium, extending its effects for much longer periods than other drugs in its class. They are thought to contribute to the deep depression that a Valium taper can cause.  Many people experience anhedonia (the lack of ability to experience pleasure) while tapering off Valium. All benzos can cause these symptoms; however, they are usually far more pronounced when one is tapering off Valium.

Tapering Options: Water Titration, Weighing, and Compounding 

There are several methods for tapering off Valium, and two popular options are water tapering and using a scale. Water tapering involves crushing a tablet and adding it to a known volume of water and gradually reducing the amount of liquid consumed daily  Benzodiazepines are not water soluble, so this method is less accurate than using a scale, but it requires little math and is easy for most to do  One can reduce the amount daily, known as a daily micro taper (DMT), or reduce it every few weeks, which is known as the cut-and-hold method.

Using a scale involves weighing the tablets and reducing the dose by removing small portions of the tablet based on weight. One can use a sharp knife or an emery board to file down the pill. This method is reasonably accurate, but it requires a high-precision scale. A lot of math is needed if doing a daily micro taper. To avoid complex math, one can do a cut-and-hold taper.

Both methods have pros and cons, depending on personal preference. There are videos on YouTube with detailed instructions on the various tapering methods. The best tapering method for you is the one you are most comfortable implementing.

Another tapering option is to ask your doctor to write a script for reduced doses and get them compounded by a pharmacy. This is the most accurate way to taper; however, many doctors don’t like to write scripts for compounding, and it can be expensive as some insurance companies won’t cover them.

The least effective method for tapering off any benzodiazepine is “eyeballing” your dose and using a pill cutter or knife. It is almost impossible to taper accurately by simply looking at the pill’s size and guessing how much you take.

The general rule of thumb for tapering off a benzo is to reduce no more than ten percent of your current dose in two to four weeks.

Liquid Valium

I’ve heard many complaints about liquid Valium. People changing their Valium or Diazepam pills for liquid often report feeling much worse, even though the dose remained the same. I’m not aware of what causes this issue; however, it has been reported so frequently that it is worth mentioning.

Tips for Coping with Valium Withdrawal/BIND

Dealing with Valium withdrawal/BIND can be challenging, but there are several strategies to help cope with the process:

• Consult with a benzo-wise healthcare professional if you can find one.
• Educate yourself about benzo withdrawal/BIND, so you are your best advocate. Most healthcare professionals are not educated about benzos. You must be.
• Develop a support system: Having friends, family, or support groups who understand your situation and can provide support is helpful.
• Practice stress reduction techniques: Engaging in techniques such as mindfulness, meditation, deep breathing exercises, and progressive muscle relaxation can be helpful.
• Embrace the four cornerstones of well-being:  Eat right (whole-food, plant-based diet), move enough, stress less, and love well.
• Be patient and kind to yourself: Recovery from Valium withdrawal/BIND can be a lengthy process, and it is essential to be patient with yourself and acknowledge your progress.
• Join a positive, solution-focused group for education, encouragement, and support.
• Work with a benzo-wise therapist or coach.
• Hot or cold packs can help with the pain.
• Gentle exercise helps to metabolize stress hormones.
• Avoid baths with Epson Salts as the magnesium may rev up symptoms.

  Should You Cross Over to Valium? 

  There are pros and cons to crossing over to Valium. Crossing over has been a Godsend to some of my clients and a disaster for others. There is no way to know who will do well and who won’t. As with many things in the benzo world, we have to test and learn.

  Pros:

  • Diazepam is long-acting.
  • Diazepam comes in small doses, making cutting and tapering easier.

  Cons:

  • Some people will feel withdrawal symptoms more intensely during the crossover or afterward.
  • Not everyone can make the switch to Diazepam.
  • Diazepam is more sedating. It is metabolized into three benzodiazpines: menordiazepam, temazepam, and oxazepam.
  • Depression can be more of a problem when tapering from Diazepam.
  • Diazepam blocks the body’s ability to make DAO so that histamine issues may arise.
  • Some doctors villainize Diazepam, thinking it is the only “addictive” benzo, and won’t prescribe it.

Conclusion

Although mechanically, Valium may be easier to taper mechanically, the withdrawal/BIND symptoms can be challenging due to sedation, depression, and anhedonia, among other symptoms. Coping strategies such as seeking benzo-wise professional guidance, developing a support system, and embracing the four cornerstones of well-being can be valuable in navigating the withdrawal and healing process. We do recover in time.

Add Your Voice

Have you experienced Valium or Diazepam withdrawal? What were your experiences? We’d love to hear your thoughts and ideas.