Lorazepam to valium or straight taper

[[Da...]]

Hello again,

I'm at .4 mg lorazepam, 1.5 ml valium.  Here are two alternatives.  Which is better. I'm not sure if my body "likes" valium.  Ill with tolerance withdrawal.

 

Can a taper be started when one isn't stable?  Do I updose?

 

Straight taper via capsules--less flexibility than liquid but more convenient, also more expensive:

 

Starting with 10% cuts on daily dose, 2% cuts on 1/5 (20%) dose...

 

.4 mg start, 5 x .08 mg caps day 1 thru day 14

.360mg, 5 x .072 mg caps day 15 thru day 28

.325 mg, 5 x .065 mg .. day 29 thru 42

.295 mg, 5 x .059 mg

.265 mg, 5 x .053 mg

.240 mg, 5 x .048 mg

.215 mg, 5 x .043 mg .. first .02 mg cut

.195 mg, 5 x .038 mg

.175 mg, 5 x .035 mg

.155 mg, 5 x .031 mg

.135 mg, 5 x .027 mg

.115 mg, 5 x .023 mg

.105 mg, 5 x .021 mg

.095 mg, 5 x .019 mg

.075 mg, 5 x .015 mg .. first .015 mg cut

.060 mg, 5 x .012 mg

.045 mg, 5 x .009 mg

.030 mg, 5 x .006 mg

.015 mg, 5 x .003 mg.

 

 

Here's a chart based on Ashton for a crossover.

 

Don's Calculations:

Based on Ashton chart for 3 mg/day Ativan beginning dose.  BUT HOW DO I MEASURE THE LORAZEPAM FRACTIONS IN LIQUID CONCENTRATE?

 

Based on Ashton chart for 3 mg/day Ativan beginning dose

Columns edited for 2/3 PM dose + 1/3 AM dose Ativan

Withdrawal from lorazepam (Ativan) 3/8 mg daily with

diazepam (Valium) substitution. (1mg lorazepam

is approximately equivalent to 10mg diazepam)

Lorazepam (PM) Lorazepam (AM) Diazepam PM

(Current dosage) lorazepam .25mg lorazepam .125mg (none)

Stage 1

(1 week) lorazepam .208mg lorazepam .104mg diazepam .625mg (Substitution begins)

Stage 2

(1 week) lorazepam .167mg lorazepam .083mg diazepam 1.25mg

Stage 3

(1 week) lorazepam .125mg lorazepam .063mg diazepam 1.88mg

Stage 4

(1 week) lorazepam .083mg lorazepam .042mg diazepam 2.5mg

Stage 5

(1 week) lorazepam .042mg lorazepam .021mg diazepam 3.13mg

Stage 6

(1 week) Stop lorazepam diazepam 3.75mg Fully converted to diazepam

Stage 7

(1-2 weeks) diazepam 3.5mg Diazepam taper begins

Stage 8

(1-2 weeks) diazepam 3.25mg

Stage 9

(1-2 weeks) diazepam 3mg

Stage 10

(1-2 weeks) diazepam 2.75mg

Stage 11

(1-2 weeks) diazepam 2.5mg

Stage 12

(1-2 weeks) diazepam 2.25mg

Stage 13

(1-2 weeks) diazepam  mg

Stage 14

(1-2 weeks) diazepam 1.88mg Taper rate is reduced

Stage 15

(1-2 weeks) diazepam 1.75mg

Stage 16

(1-2 weeks) diazepam 1.63mg

Stage 17

(1-2 weeks) diazepam 1.5mg

Stage 18

(1-2 weeks) diazepam 1.38mg

Stage 19

(1-2 weeks) diazepam 1.25 mg

Continue reducing diazepam by .125mg every 1-2 weeks

 

 

 

 

 

 

 

 

 

[[...]]

Danielle,

 

Your story and mine are almost identical.  I took .5 - 1 mg Ativan daily for two months and tried to stop cold turkey when I realized they were making me sick (hit tolerance).  You aren't the only person out there so sensitive to these.  I ended up in the ER twice within a week of stopping the Ativan.

 

I switched over to 6mg of Valium, which I took for about 6 days until I no longer left like death.  I then took 5.5mg for about 5 days, and have gone down to 5, where I now have been for about a week.  I think I moved too quickly, and bad withdrawal symptoms are coming back. 

 

Judging from my own experience, perhaps your more gradual taper is a better approach than mine...

[[Da...]]

So sorry for your distress.  I wish I could report that I'm doing better but I'm not. At least not yet.

 

I not only hit tolerance after two months of use but have been in active withdrawal and going downhill since September.  My psychiatrist prescribed all sorts of meds-Zoloft, Paxil, citroprolam, Buspar--using the benzo as an "anchor," so the tolerance/withdrawal has continued and worsened to the point that I took a medical leave. His suggestion was to cut 1/4 of the pill replacing each time with valium, but that's all he had to offer. 

 

I just saw him yesterday and will see him again late this afternoon. There have been a number of stepdown charts done for me by my cousin's husband, and one by another psychiatrist that would take a chem lab to follow (infinitesimal amounts--many seem to have done it on this forum, but I don't have the skills and I'm so brain fogged I just couldn't do it).  The only one that seems like it's possible for me to follow is a liquid lorazepam crossover to valium and then taper.  I don't have much confidence this will work, because I am pretty overcome by anxiety and other physical symptoms--shaky and trembling this morning, for example

 

I am facing retirement and a move in the middle of all of this. Feeling isolated--my sister's in another state and has done her best to commute to help, but I'm alone here most of the time.  Med leave's only 5 1/2 months, and I'm so debilitated I can't seem to get myself together to do purge my condo in preparation for the sale, even with help.  I'm overwhelmed.  Fearing the worst.