Low dose Ativan taper info needed please!

[[Ta...]]

Hi, I am still new here so hope I am posting in the right place. I take 1mg Ativan every night for over 10 years. I feel I have reached tolerance withdrawal, or interdose withdrawal, such a small dose 24 hours apart. New mental health nurse practitioner says switch directly to .5 mg clonazepam (generic Klonopin, I think?) starting Sunday night, so I have 4 days to make this decision.

 

Complete switch? After 10+ years use...is this wise?

 

I am reading just taper the Ativan. I'm at a steady low dose, never increased, just go slow.

 

I have a copy of the Ashton Manual. My PDoc not interested in the diazapam taper. In fact he's not giving me much info at all, that's why I went to new NP. Am leery of a complete outright switch. I understand the concept that Klonopin is slow acting, stays in your system longer, that Ativan is short acting. But jeez, a total switch? I am scared to do this, and like I said, have 4 days to decide.

 

Any help would be much appreciated.

 

Thank you.

[[Ki...]]

Hi Taylor - I personally wouldn't do it. I would only switch if you are unable to carry out an Ativan taper. Slow and steady is the way to go. I've been tapering Ativan for a year.....from 2mg and am now at .37mg so I'm proof that it's entirely possible.

 

Please keep in mind that 1mg is actually not a low dose, it's equivalent to 10mg of Valium. Don't let doctors tell you differently. If you taper slowly you will absolutely be able to taper directly from Ativan. You may have to split your dose (dosing 3-4x a day) and get a scale to weigh your dose or you can have compounded liquid made or make your own.

 

Are you experiencing interdose withdrawal?

Is your doctor willing to keep you on Ativan if you wish?

 

Here is the link for the Ativan thread....we are all tapering from Ativan there so you will have a good perspective and lots of helpful advice.

 

http://www.benzobuddies.org/forum/index.php?topic=44903.msg1637605#new

 

You can do this 

[[La...]]

you can taper directly off ativan. i did. go slow and split your dosing to several times per day to prevent interdose withdrawal. small cuts are difficult but possible using tablets, liquid soution/suspension much easier.

 

good luck. 

[[Ta...]]

Thank you for the quick responses. Yes my doctor is willing to keep me on Ativan. It was the new NP that wants the direct switch to Klonopin. I do believe after all these years, I Am starting to experience interdose withdrawal. Since I only take 1 mg at night, you suggest starting the taper broken into 2-3 doses throughout the day...just want to understand. It would make sense. Also, I might have to order a scale, because I am not good with math in my head and don't quite know how to figure those small dose cuts.

 

I feel pressured to make this decision by Sunday night. I don't really want to switch. I understand the concept, but I am scared to do it. Would just rather stay on Ativan and go from there.

 

Thank you for the Ativan link. I will go there. I am still learning how to navigate this site. It is the only time I have EVER been on a forum. Have never needed it until now!!!

 

I found an ativan taper on the internet that takes approx. 4 months. On paper, it is the only thing I have right now. Ashton doesn't give a specific for starting at 1mg.

 

Thank you again. 

[[Ki...]]

Hi Taylor - Laser is one of our resident hero's and did a direct taper off Ativan using compounded liquid. I'm using tablets and a scale.

 

4 months to get off 1mg seems very quick to me. I'm not sure that will leave you very functional BUT some people can taper that quickly and be fine. My advice would be to start slow and if it's fine then speed up. It's harder to do it the other way.

 

The general rule is to taper at 10% or less every 7-14 days. I personally cut 5% of my dose every week. When my symptoms are too much, I just hold where I am until they subside.

 

Splitting your dose is the key to tapering off Ativan as most people do experience interdose withdrawal. At 1mg you can split your doses to 4x a day at .25mg each. Then hold that pattern for a week to give your body time to stabilize to the new routine.

 

The scale most of us use is the GEMINI PRO 20 MILLIGRAM scale. You can get it on Amazon for about $25 - it's worth it.

 

Some good folks to look up that had varying speeds of tapers are: Laserjet3051, Saga23, Rriver and Cedartree.

 

Keep asking questions, you are not alone 

[[Ta...]]

Thank you Kiddo! I am SOOOO getting that scale. Will order it tonight. Well, 4 months is what the paper showed that I printed off. I'm not against going longer at all.

 

Would you happen to know, are people able to taper SLOW and still keep their jobs? One of my fears is that I will become dysfunctional and can't work! I can't lose my job! But like I said, I've been told 1mg is still sort of low, so I'm hoping I won't become some sort of basket case.

 

In case you haven't noticed, I worry a lot! And am still new to this site and tapering. The specific names you gave me, how do you find those people individually? This site seems so huge!

[[La...]]

Thank you Kiddo! I am SOOOO getting that scale. Will order it tonight. Well, 4 months is what the paper showed that I printed off. I'm not against going longer at all.

 

Would you happen to know, are people able to taper SLOW and still keep their jobs? One of my fears is that I will become dysfunctional and can't work! I can't lose my job! But like I said, I've been told 1mg is still sort of low, so I'm hoping I won't become some sort of basket case.

 

In case you haven't noticed, I worry a lot! And am still new to this site and tapering. The specific names you gave me, how do you find those people individually? This site seems so huge!

 

possible to keep job, but can be extraordinarily difficult for some. 1 mg is certainly lower than 2, 3, or 4 but in my opinion, 1 mg is not even close to low, this is a very powerful drug!

 

I got off 1mg in just under 4 months but individual mileage may vary.

[[be...]]

I am sorry you reached tolerance with Ativan. I withdrew from it one year ago, but I did came off 8 mg without a taper. Ouch. You are on a fairly large dose. I think if you try a taper at no more than 10 percent every two weeks that you can reduce your withdrawal symptoms. I personally would only cross over if you can not taper directly from the Ativan.

[[Ki...]]

Taylor - I've been able to work, Laser too, as he said. Saga23 has worked throughout. Here is a link to a support group for people who are working while tapering....

 

http://www.benzobuddies.org/forum/index.php?topic=66302.msg1637628#new

 

To search individual members: under your name you will see various icons (helpdesk, home, search) and one says "members". Click on there and put in the name you'd like to search 

 

You'll get the hang of it 

[[Ta...]]

Thank you Kiddo, Laser and nice Benzo Mediator: all positive reaffirming information. Was just talking to my husband. I don't think I'm going to do the switch. I will stay on Ativan and attempt that first. Like I said, I am getting the scale. I'll get the hang of small cuts with that. I think that people here know what's going on better than our doctors, (not knocking them, per se) because everyone here has been through it or IS going through it now. Our doctors don't seem to want to be involved. My doctor will support my taper however, he just doesn't want to substitute valium. The NP's suggestion to switch directly to Klonopin, nope, I just don't feel comfortable doing that.

 

You have all given me a lot to go on in just one evening, and I thank you for the quick responses. I am signing off for the night, but will check back tomorrow. Thank you for telling me how to find people individually. Do they mind if someone sends them a personal message, or should you somehow wait to be invited?

 

Depending on when the scale comes, I will start then. Amazon usually delivers within a week or so. So I will maintain my 1mg as usual, cut it to .25 4x/per day and start there. I will then attempt the 5-10% cuts. This sounds like a better thought out plan than my visit to the NP this morning. Thank you all for your valuable advice. 

[[Ma...]]

Hi Taylor,

 

I'm a bit late here, but I did a taper directly off 15 years of 1 mg Ativan in about 3 1/2 months and it wasn't too bad.  I still have some residual insomnia, but it turns out that is largely a hormone issue that is being treated now.

[[Cl...]]

Thank you Kiddo! I am SOOOO getting that scale. Will order it tonight. Well, 4 months is what the paper showed that I printed off. I'm not against going longer at all.

 

Would you happen to know, are people able to taper SLOW and still keep their jobs? One of my fears is that I will become dysfunctional and can't work! I can't lose my job! But like I said, I've been told 1mg is still sort of low, so I'm hoping I won't become some sort of basket case.

 

In case you haven't noticed, I worry a lot! And am still new to this site and tapering. The specific names you gave me, how do you find those people individually? This site seems so huge!

 

Hi Taylor, I work  full time while tapering, it is very difficult sometimes, but work is my best help so far!...sometimes I almost forget my symtoms while working...

 

I really think that this road would be more hellish if I were not working...and I HAVE to work anyway...

 

 

I wish you the best in your taper!

[[Ta...]]

Mariposabell: My situation is very similar to yours then, in dosage and duration. This is exactly what I'm looking for, although I know everyone's experience will differ. Can you tell me your method? Thank you for responding. Any and all information is helpful to me!

 

Clona: I have reached tolerance/interdose withdrawal as my doses are approx. 24 hours apart, in the evening only. Being busy at work actually helps my mind to NOT focus on the heightened state of anxiety that usually comes after I get home, cook dinner, take a shower and finally sit down for the evening. It is at this time when my agitation is the highest I think, when I finally have a chance to unwind. Everything comes crashing down. While it is not debilitating, it is annoying. My intent is to break my dose up into 4x a day, as I've been advised, and maybe that will help with the hours I'm at work. A few posts back I was given a link to a site for people working while tapering. Haven't had a chance to read it yet, but fully intend to. It helps knowing you're going through similar situations and to see how other people handled it.

 

Best wishes to everyone on this brand new New Year's day!

[[Cl...]]

Hi Taylor! Thank so much for you post! I was actually waiting for this kind of response. I am also suffering half an hour before my dose, after reading you, definitly I am going to split my doses.

Still scared of taking a morning dose since I never drive after taking my evening dose.

A Morning dose may help a lot while working!

 

[[Ma...]]

Taylor,

 

I dry cut down to about .4 of a 1 mg pill, and then started a suspension in water, drawing off a little more every third day down to .25 mg, and then a tiny amount every day until I was at a very small dose. I can't remember the exact amounts, but it was very small cuts. I probably cut 10% of the most recent dose each time. 

 

I had very little trouble with this, experiencing only mild symptoms most of the time. My jump was okay, too.

[[Ki...]]

Mariposa - were you very symptomatic during your dry cutting?

[[Ta...]]

Thanks, Mariposabell. Since our dosages are similar, that gives me an idea of what to look for. Not trying to copy you, but similar is very reassuring! There's one store across town that MAY have a scale, I'm going over there today. If they don't, I'll order off of Amazon and have it within a week or so. Then.....I start. (Insert Twilight Zone Theme Here)

 

Clona: At my job (in healthcare) some patients that I see are given 1mg of Ativan before certain procedures to "calm" them. From what I understand, they are only prescribed ONE pill. Just ONE, in the entire bottle. I'm glad of that, for them. But it's so funny. They come in, staggering around, some can barely talk (I'm not making fun, I swear) but I'll ask before we get started, "Did you take something?" and they'll say "I took an Ativan." And in my mind, only in my mind, I think "AN ativan. And you're like this? Dude, I can drive AND operate machinery."

 

My point is that I have been on this shit for so long it doesn't even affect my day to day stuff, like driving and work. And it's a good reminder for me to see what it can do to those who aren't used to it. I've driven a zillion times (true, though never more than my 1mg per day) and never had any trouble, but you'll have to see how it goes for YOU. Just be careful. All ativan does to me now is calm me down in the evenings when I take it. It doesn't make me loopy or sleepy. Just relaxes me, then I can sleep for 8-9 hours. It's out of my system by the time I get up in the morning, and none left in my while I'm at work. It's later in the afternoon when I can feel my anxiety start to creep up....then it jumps on me when I get home. Like a sneak attack. Although not really sneaky, because I KNOW it's coming.

 

I think I'll be ok when I start taking it 4x a day (Split doses) because I'm just used to it. Hope all goes well for you too. 

[[Ro...]]

Do you have a link to that 4 month taper you found on the internet, Taylor?  Could you post it please?

 

I too am on 1mg Ativan, but I've only been on it for a couple months.  I am tolerant to it, and I've tried cutting back myself- as it turns out- too quickly, all three times.

 

And since I also work full time...

[[Ma...]]

Ativan is a sneaky drug, for sure.

 

I started at .25 mg, and over 15 years went up to 1 mg, each night, for sleep.  I don't know if I ever reached tolerance, because I don't recall any symptomology. It worked for me, almost every night, for all of that time. It felt like my angel of mercy, allowing me to work, giving me rest.

 

Given how gentle it seemed, I was really surprised to see how bad my symptoms were when I tried to quit cold turkey it several years ago, when I was only taking .75 mg per night. I thought I would die. Missed three days of work, stumbled in twice and thought I would fall over from nausea and exhaustion, and finally reinstated after five nights of almost no sleep at all.

 

But even with all of that, I did manage to taper relatively easily two years ago and have been free now for 20 months.  During the dry cut part of my taper I had symptoms between 1.0 mg and about .6 mg, but interestingly at .5 mg I had three weeks of blissful sleep and no symptoms to speak of.  I had symptoms on and off below .4 mg, but nothing horrendous.

 

The only real problem I had after my taper was the insomnia, and that was a problem even before I started taking the Ativan. However, with the help of my ND over the last year and a half, and a newly started hormone treatment (progesterone) I now sleep between 6 and 8 hours every night. And I had problems with my cortisol levels, which also contributed to the insomnia.  Now that both of those issues are dealt with, I'm healed and looking forward to life every day.

[[Cl...]]

Thanks, Mariposabell. Since our dosages are similar, that gives me an idea of what to look for. Not trying to copy you, but similar is very reassuring! There's one store across town that MAY have a scale, I'm going over there today. If they don't, I'll order off of Amazon and have it within a week or so. Then.....I start. (Insert Twilight Zone Theme Here)

 

Clona: At my job (in healthcare) some patients that I see are given 1mg of Ativan before certain procedures to "calm" them. From what I understand, they are only prescribed ONE pill. Just ONE, in the entire bottle. I'm glad of that, for them. But it's so funny. They come in, staggering around, some can barely talk (I'm not making fun, I swear) but I'll ask before we get started, "Did you take something?" and they'll say "I took an Ativan." And in my mind, only in my mind, I think "AN ativan. And you're like this? Dude, I can drive AND operate machinery."

 

My point is that I have been on this shit for so long it doesn't even affect my day to day stuff, like driving and work. And it's a good reminder for me to see what it can do to those who aren't used to it. I've driven a zillion times (true, though never more than my 1mg per day) and never had any trouble, but you'll have to see how it goes for YOU. Just be careful. All ativan does to me now is calm me down in the evenings when I take it. It doesn't make me loopy or sleepy. Just relaxes me, then I can sleep for 8-9 hours. It's out of my system by the time I get up in the morning, and none left in my while I'm at work. It's later in the afternoon when I can feel my anxiety start to creep up....then it jumps on me when I get home. Like a sneak attack. Although not really sneaky, because I KNOW it's coming.

 

I think I'll be ok when I start taking it 4x a day (Split doses) because I'm just used to it. Hope all goes well for you too. 

 

:thumbsup:

 

Very nice post!!! You are right! I do not feel dizzy nor anything like that after my first morning dose.

Such a nice job you have! Wonderful that you are working well!, very inspiring post!, Thank you so much!

[[Ta...]]

Rockingchaircat: Crap Crap Crap! I'm typing away a good response to you and just lost the whole damn thing. I HATE it when that happens...

 

I can't find the exact link, and for some reason I can't Copy/Paste here so I will type it: (AGAIN!)

 

twitter.com/savvypharmacist/status/474343630657044480

 

It's by someone named Susan Beth Martin. The website I found it on had a more in depth article along with it, in fact the chart was the last of 10 pages, so I just printed it off at work. I might have that website on my work computer but I am at home until Monday. See if you can pull it up. It's 18 weeks, and I would imagine you could adjust the 2 week increments if you wanted to. It was the only thing I could find that gave me an idea about how to make the cuts.

 

Am ordering the Gemini scale from Amazon today. Couldn't find it in the store. In the mean time, I will try to break my 1mg into 4 pieces and take them throughout the day. It doesn't matter if they're not exact, it's still the same dose. Don't need to worry about precision until I start making the cuts. I better hit <post> before I lose this again...grrrrrrrr

[[Ro...]]

Got it, thanks.

[[su...]]

Taylor, that chart is interesting!  I couldn't get into the site...is there anywhere on there where they have success stories? . I am at the 1 mg of lorazepam, generic to Ativan myself!  We can do this! 

[[Ta...]]

Hey Sunny, let me check at work tomorrow (Monday). I've been off all week and I think the correct website for that chart is on my computer at work. I know I've got it somewhere, and yes I think it did have stories to go with it because like I said, the article was 10 pages long. It was a pretty good site so I think I saved it.

 

I am ready to make a cut in the 1mg dose I've been on for over 10 years. My scale from Amazon is supposed to be in on Thursday. Quite a few great BB's have given good ideas on a low dose taper, although I was also told 1mg is really NOT that small. I thought it was. My doctor keeps acting like 1mg is no big deal, but I'd rather prepare (for the worst, or at least Something) just in case. That's why I want the scale. I am a very anxious person, and I would just feel better with exact measurements. It's just me 

 

Oh yeah, I am on lorazepam too. Ativan is just easier to type, ha!

[[su...]]

Taylor, always a good idea to do what is necessary to ease ones mind!  My doctor acted as though 2mgs was nothing, thank god fo BB! . Keep in touch!