Would like some opinions...

[[sh...]]

I fired my psychiatrist and saw a CNS on Monday.  He wants me to hold at 1mg ativan/day for a few months to give my brain time to catch up with all of the changes.  He also said that he would be fine with me staying at this dose forever if that's what I want, which is an option I never even considered.  But he said that if I did want to go off ativan, I should take 0.25 mg cuts, which I've tried and can't tolerate.  I do however think he's more open minded than my psychiatrist was, and I think I could talk him into a slow taper if I brought in some pages from the Ashton manual.  Any opinions on this situation?  I am stable at 1mg/day right now but I'm worried about tolerance withdrawal if I hold for too long.

[Guest [ba...]]

Cutting by 0.25 is a pretty standard doctor response.  It works for a lot of people, but not everybody.  10% cuts (instead of 25% cuts) is a reasonable idea.  You'll probably need to purchase a milligram balance to do it unless you want to switch to doing a liquid titration.  A lot of people buy a Gemini-20 from Amazon (around $20).  It works pretty well for what you want to do.

 

If you've been stable for a while, there's probably no sense holding much longer.

[[so...]]

I dont see how you could stay at 1mg forever. That doesn't sound right. Holding for a few months is fine then try smaller curts.

[[me...]]

That's great that you have a new doctor, that is willing to support you in tapering with some flexibility! I don't think you will find very many here who would agree that staying at 1 mg. "forever" is a good idea. I think you have seen by now that that is not going to work very well, and the long-term consequences can be very bad.

 

Agree that the reduction he is suggesting is quite steep and hasn't worked well for you before, so a much slower reduction is the way to go. perhaps even a micro-taper? The lower you go on your dosage, the more you need to keep it on the slower side, as reductions have a much stronger effect.

[[sh...]]

Thank you for your responses, I appreciate them.  I want to do a slow taper, but I think I'm going to have some difficulty convincing him of the need for one.  On the other hand, as long as he prescribes my meds I can do a liquid titration taper without him even knowing I'm doing it.  It would just be so much easier if he would prescribe liquid ativan that I can dilute easily.  I suppose I could say I'm doing this regardless and you can help me or not, up to you.

[[...]]

I've tried tapering from ativan (not using liquid, just dry cuts) and I couldn't tolerate it. Cross-tapering to valium, holding for a bit and doing small cuts with 5mg pills has been more successful.

[[sh...]]

Crossing to diazepam is going to be a hard sell to anyone around here.  I can tell him about the Ashton manual, bring in a few pages from it, but I don't think there's a doctor in my area who is going to sign off on me starting another benzo.  I have heard that a direct ativan taper can be difficult, but I've basically resigned myself to it.

[[...]]

Crossing to diazepam is going to be a hard sell to anyone around here.  I can tell him about the Ashton manual, bring in a few pages from it, but I don't think there's a doctor in my area who is going to sign off on me starting another benzo.  I have heard that a direct ativan taper can be difficult, but I've basically resigned myself to it.

 

If you can muster to the resolve, I'd say try to broach the subject. For me, it's meant a big difference in pain and difficulty. Some people don't do well on valium at all, yet another wonderful aspect to these meds is that you never know from person to person, but try to do everything you can set yourself up for success. I wish you the best of luck.

[[sh...]]

Thank you mrn.

[[Na...]]

Your a long time user so IMO a much slower taper would work in your favor. I wouldn't say a word about it to him and do your own controlled taper. After all, he said you can stay on it forever, so you can go at whatever pace you want. Ativan is a tuffy for making very small cuts but micro scale is ideal and some fine emery cloth for sanding and weighing if a LT is not an option.

[[be...]]

I used a scale to get rid of my klonopin tho my pdoc was happy to do a partial ℅ to Valium for me. I'm doing C/H with that but will do liquid once I get lower in my dose. And I agree, 25% for a long time user is not such a good idea.

 

Betsy 

[[sh...]]

Thank you for your responses. I think I'm going to try a liquid titration taper and just not even mention it to him, just take control of it on my own.  Are there any drawbacks to holding for a few months?  Is it safe?  Does it make it harder to taper later?

[[bu...]]

Thank you for your responses. I think I'm going to try a liquid titration taper and just not even mention it to him, just take control of it on my own.  Are there any drawbacks to holding for a few months?  Is it safe?  Does it make it harder to taper later?

 

:thumbsup: