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Need help with taper plan for 2 mg Ativan (1 mg twice a day & 10 mg Ambien)


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I need help a taper schedule for Ativan & Ambien....which should go first?  I began a taper on 10/5/16 of 1 mg noon dose of Ativan down to .75.  Am taking 1 mg Ativan at 9 pm and 10 mg of Ambien at 11 pm.  Currently have awful shakes and anxiety all day.  Is there any way to dry taper & avoid having to fool with a gram scale, tweezers and a razor blade for a 10% taper?  The math seems really complicated and I would like to avoid that, if possible.  I started Ativan and Ambien on 8/30/16 and was on 5 mg Valium 6/1/16-8/29/16. Anxiety & rapid pulse is almost unbearable. I don't know if it's from the Ambien or the initial Ativan taper.  Very depersonalized and foggy.
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I have no experience with Ambien but if you want to avoid fooling around with cutting your Ativan tablets you can ask your doctor to send prescriptions for dose reductions to a compounding pharmacy...that is, if you have a compounding pharmacy in your area.  Also, as you probably know, Ativan has a short half-life and in most cases is therapeutic only for about six hours.  If you take it just twice a day rather than three or four times a day, you are more likely to experience inter-dose withdrawal.  This may account for some of your anxiety symptoms.
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Thanks for the kind response, PhotoBugSF.  Are the three decimal numbers on your log the dosage cut each time?  How did you arrive at these numbers?  And, did your doctor call in the dose reduction prescriptions to your compounding pharmacy?  My doctor seems to want me to only cut each pill in half for each reduction and that's just way too fast a taper.  She might cooperate if I gave her a specific taper schedule mapped out for her.  If I'm on 1.75 mg divided dose per day, what kind of taper schedule would you suggest?  I'm new at this and have no idea what I'm doing, so need specific instructions on the math.  Thanks!
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Hi Gardenlady, sorry I didn't get back sooner (bad dental issues etc...) As I said before, I would taper off the Ambien first. You should be able to taper off that fairly quickly, in fact you would probably be just fine doing a cold-turkey on it, but a 2 week taper would be totally reasonable. Your sleep might be a bit rough for a few days, but should smooth out pretty quickly with the Ativan backup. The hardest part after that is avoiding "rescue doses"--many have gotten rid of any leftover pills to avoid that, as it will mess you up.

 

After things have settled down from the Ambien taper, you can tackle the Ativan. If you prefer to do dry cuts, I would suggest getting a very accurate scale. You can use a nail file to get the pill size down to what you need. The other option is to do titration--either with a pre-made liquid formulation, or make your own liquid. Your doctor doesn't even need to know that you are making smaller cuts, as long as you get off the drug in a timely manner, and have the prescription you need. Oftentimes, the cuts they suggest are far too big, but most will support you tapering off.

 

Try checking out the Ativan support thread for more info about tapering, weighing and titration.

http://www.benzobuddies.org/forum/index.php?topic=44903.0

 

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Thanks, meowie, for the helpful info.  I read that the gram scales available aren't accurate enough for the smaller .5 mg Ativan pills and when the 1 mg pills are shaved below .5.  So, that leaves me with titration....I think I'll use the Ativan Rx solution which can be diluted.  Apparently Ativan is insoluble in water. 
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Thanks for the kind response, PhotoBugSF.  Are the three decimal numbers on your log the dosage cut each time?  How did you arrive at these numbers?  And, did your doctor call in the dose reduction prescriptions to your compounding pharmacy?  My doctor seems to want me to only cut each pill in half for each reduction and that's just way too fast a taper.  She might cooperate if I gave her a specific taper schedule mapped out for her.  If I'm on 1.75 mg divided dose per day, what kind of taper schedule would you suggest?  I'm new at this and have no idea what I'm doing, so need specific instructions on the math.  Thanks!

Gardenlady, the three decimal numbers on the log in my signature is the total daily amount.  For example, I am now at a total daily amount of .050 mg.  I take five capsules in each 24 hour period.  Each capsule contains .010 mg of Lorazepam.  It would be impossible to dry cut these extremely small doses.  Yes, my doctor calls in the prescriptions to the compounding pharmacy.  As a starting point I would recommend that you try cutting 10% of your remaining dose every 10 to 14 days and that you split your daily consumption into 4 separate doses due to the short half-life of Lorazepam.  When you get down to a daily consumption of around .150 mg, you can stop using cutting by 10% of your remaining dose and start cutting at something like .020 mg's every 10 to 14 days until you are off.  This plan has worked for me, but as many have said here, everyone is different.  If you feel that this is too slow for you, try being a little more aggressive and see how you feel.  All the best!

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