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Ativan taper (low dose)--valium switch-over or titration?


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I was prescribed .5mg Ativan for anxiety-related insomnia.  Took it for two months (mixed success in terms of sleep) then began to taper (as recommended) by cutting by 1/4 of the dose every two weeks (i.e., two weeks at 3/4, two at 1/2, two at 1/4).  When the first cut was made to 3/4 I began to experience muscle spasms and odd feeling of shakiness..  Not one of the doctors I saw, including the prescriber of the med, connected it with the Ativan, and none suggested I was experiencing withdrawal symptoms.  But after reading the posts here, I realized that's exactly what it is.


My question: Titration or valium substitution?


I began to try titration last night.  If I go this route, I could theoretically achieve the ten percent reduction every ten days by decreasing the dosage by one ml per day.  HOWEVER, this means I am always in a state of continuous micro-reduction.  Is this wise or is it better to do a larger decrease (say 10 percent) and "sit" at that amount for ten days, then make another ten percent cut?    What are people's experience?


Alternatively is it possible to do a valium switch-over at such a small dosage level, and if so, what would that look like?  I take the Ativan in one dose at night (because it was intended  for sleep).  How would the valium switch-over work if I am currently at .375 mg of the Ativan (3/4 of 5 mg).


I would really appreciate any and all suggestions from those with experience at water titrating Ativan  and  from those who could comment on how a valium switch over would work in my scenario.


Thank you.

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Yep, the muscle tightness and shakiness are very common withdrawal symptoms.


I did a very fast change from Ativan to Valium and it was uneventful. I was at .75 mg Ativan, and changed over to 7.5 mg Valium in four days. I just sort of gradually increased the V and decreased the A over those few days and did not have a problem.


But other people do need to do this more slowly and carefully, as for some it can be more challenging to make the changeover. So hopefully others who have changed from Ativan to Valium will chime in with their experiences too.


As for equivalencies, it's not precise, but the general rule is 1mg Ativan = 10 mg Valium, 0.5 mg Ativan = 5 mg Valium, etc.


Some people also like to updose a bit on Valium when they make the change, to cover any w/d fuss that might kick up as the Ativan leaves your system.


And don't start cutting right away. Give yourself some time to fully stabilize and get adjusted to the Valium - possibly a couple of weeks - before you begin to taper.


Good luck! You're on a low dose - it might be easy peasy to taper down nicely and step off. Just take your time.

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Hi Danielle,


Members can respond best if they know your medication history. Please take a moment to create a signature line, listing your medication, dose and any relevant history.

Go to the top of the page and select Profile, then choose Forum Profile, insert drug history/timelines into the text box and click Change Profile.


You have gotten some good advice from solitudeseeker. The only thing I would add is that you have been on only two months, so I think a direct taper or a titration taper would be the best approach for you. It might be uncomfortable but limiting your overall exposure to benzos is a good idea. Crossing to valium can be very helpful but it does take a while to get settled on the new benzo and some people find it more sedating/depressing. It is a good backup plan, but my hope for short term users is that they can get out before the drugs really take hold.




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Good advice. It will take longer overall to change to a new benzo. And though I got along alright with Valium, I know it made some people feel like crap and they wished they'd stayed with their first benzo for tapering.
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  • 1 month later...

Solitude seeker,


I too am on .75 Ativan, taking one dose at night.  The intradose withdrawls are killing me, and I'd like to switch to Ativan before I'm tempted to jump back up to 1 mg Ativan.  It looks like you switched over your one dose for a single dose of Valium per day.  Do you take a night only?  Can you give me an idea of the steps you took over the four-day period?




NW Guy

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