Lorazepam to Valium Crossover Trouble

[[Ch...]]

I would like to give a little info on myself before getting into why I was put on Lorazepam.  I had a heart attack in July of 16.  Certainly wasn't expected.  I exercised and stayed busy but probably didn't eat right.  I'm only 46 years old.  Had 2 stents put in and felt great after about 2 weeks.  Cardiologist put me on 7 different meds including Atenolol (Beta Blocker).  This drug didn't work for me after about 1 month of being on it.  Starting having insomnia and anxiety.  Went to my PCP and Cardiologist and both said it wasn't the Atenolol.  After doing research online I knew it was my problem.  Works for some and doesn't for others.  Little did I know this was supposed to be tapered down.  Doc told me to quit it cold turkey.  Within 2 days I was having Panic Attacks and Anxiety through the roof.  PCP(Primary Care Physican) put me on Lorazepam to help with the withdrawals from the Atenolol.  Within 4 months I was up to 4 mg a day and still having anxiety.  My PCP didn't let me know the addiction factor that can be involved with Benzos.  She just kept giving me more.  Very scary and considered up dosing.  After research on this site I was able to find the Ashton Method of getting off Ativan.  I was desperate but my PCP would not prescribed the Diazepam I was wanting to use to taper the Lorazepam. 

 

I finally found a psychiatrist that had experience with these meds.  I started my taper 2 weeks ago trying to use the Ashton Method. 

 

I have come down from 4 to 2.5 mg in 2 weeks.  Been uncomfortable most of the time with inter-dose withdrawals.  Had some really bad days and some decent manageable days.  Feel really weird most of the time.  Dizzy and no appetite at all.  Since starting Lorazepam (which never really helped) I have lost 35 lbs.

 

My problem is I don't think the Diazepam has had time to build up in my system enough to handle the crossover with minimal effects.  I have been replacing .5mg of Lorazepam with 5mg of Diazepam.

 

How long does it take for Diazepam to help with inter-dose withdrawals?  I absolutely hate Lorazepam and can't wait to get off of it.  I'll want to end up at about 30mg of Diazepam once finished with my taper.

 

Is it ok to up the Diazepam until it builds up?  Take more than the Ashton Manual suggests? 

 

Any advice would be very much appreciated.

Modify message

 

[[sn...]]

You don't say in your signature how many times per day you are taking lorazepam.  If you were taking it three times per day Ashton general recommends replacing half of one of the doses and waiting a week or two to stabilize then going to anotther of your doses and waiting another week or two to stablilize again.

 

Also, you just say you have dropped from 4 mg to 2.5 mg of lorazepam.  Did you already replace that with 15 mg of diazepam.  That is a tremendous drop in just two weeks but more info on how you are dosing and what you have replaced it with would be helpful to answer your question.

[[Ch...]]

You don't say in your signature how many times per day you are taking lorazepam.  If you were taking it three times per day Ashton general recommends replacing half of one of the doses and waiting a week or two to stabilize then going to anotther of your doses and waiting another week or two to stablilize again.

 

Also, you just say you have dropped from 4 mg to 2.5 mg of lorazepam.  Did you already replace that with 15 mg of diazepam.  That is a tremendous drop in just two weeks but more info on how you are dosing and what you have replaced it with would be helpful to answer your question.

 

Right now I am taking .5mg of L 4 times a day.  Using 20mg of Diazepam but it doesn't seem to be helping much.

 

I believe I dropped too fast and am suffering right now.  My last cut was 2/12/16 of .5 mg of L.  I had cut just .25mg just 6 days before that.  I plan to hold there until I feel better.  What kind of time frame should I expect to start feeling a little relief?

[[sn...]]

One problem is that the diazepam needs time to build in your system.  The lorazepam has such a short duration and may lose its therapeutic effect within a matter of hours.  The diazepam could take up to two weeks to build to level of the first dose you started with.

 

With that being said, it still depends if your body accepts the diazepam as a valid substitute for the lorazepam.  It works for some and not for others.

[[Ch...]]

I believe the Diazepam is working.  It does calm me down and makes me a little sleepy during the day.

 

Some people say 4 to 6 weeks for Diazepam to build up?  Is that your opinion?  According to Ashton I would end up on 40mg of Diazepam after my c/o.  But, I believe I can be at about 30mg and settle there for a month before tapering.

 

You've been a huge help and I welcome any more suggestions. 

 

My plan going forward:

Hold for at least 2 weeks to let my body catch up to the .5mg of L that I did too soon.

Then do 1/4mg cuts every 1 to 2 weeks.  My Doc will just have to understand.  He thinks I should be done with the crossover in 4 weeks.  Not a chance.

 

I guess I was in a hurry.  I was feeling horrible on the Lorazepam and wanted off as soon as possible.  I started at .5mg for about 2 weeks then just increased it from there.  Never did get stable on 4mg.  Considered up-dosing to see if I could get stable but decided that as bad as I felt I didn't want to increase the problem by taking more. 

 

Seems that dropping .5mg at a time will not be possible and I just need to step back and take my time.  It will happen.

 

Thanks for your time.

[[sn...]]

Glad I could be of some help.  I was just going by its half-life of 200 hours which is about eight days and calling it two weeks.  On the Ashton Manual they usually allow about one to two week for each substitution of a dose.  If you look at Schedule 8 on Ashton withdrawal that is someone who is taking 1mg x 3 times a day.  See how they just gradually substitute half of the diazepam by doing half of each dose one at a time?

 

If i was making a suggestion now I would stabilize where you are...then I would gradually substitute for each remaining dose of lorazepam giving each time a week or two to stabilize...then work on the taper from diazepam.

 

Show your doc a copy of that Ashton Manual and see if they will hear you out.  When they took you off Atenolol did they substitute another beta blocker or did they go to a different type of blood pressure medicine?

[[Ch...]]

Glad I could be of some help.  I was just going by its half-life of 200 hours which is about eight days and calling it two weeks.  On the Ashton Manual they usually allow about one to two week for each substitution of a dose.  If you look at Schedule 8 on Ashton withdrawal that is someone who is taking 1mg x 3 times a day.  See how they just gradually substitute half of the diazepam by doing half of each dose one at a time?

 

If i was making a suggestion now I would stabilize where you are...then I would gradually substitute for each remaining dose of lorazepam giving each time a week or two to stabilize...then work on the taper from diazepam.

 

Show your doc a copy of that Ashton Manual and see if they will hear you out.  When they took you off Atenolol did they substitute another beta blocker or did they go to a different type of blood pressure medicine?

 

Truth is I didn't need the Atenolol.  My blood pressure was fine. Averaged about 125/80.  46 years old.  I smoked for 30 years and that's why I had the heart attack.  Cholesterol was fine to but I'm taking Lipitor.    Still not sure why I'm taking it either.

 

My Heart Doc just put me on the standard group of meds that they give someone after a heart attack.  Blood thinner, baby aspirin, beta blocker and cholesterol meds.  After about 1-1/2 months the Beta Blocker was causing all kind of problems.  This went on for a while before I finally asked to get off of it and he said ok.  Problem was he said just go cold turkey instead of tapering.  By day 2 of cold turkey I thought I was heading to the ER.  But, I had already started taking the Lorazepam at that time due to the anxiety the Atenolol was causing.  So, I had .5mg and was fine within 45 minutes.  Went through a rough 3 weeks getting the Atenolol out of my system.  There are tons of forums on Beta Blockers causing what it did to me.

 

I lost faith in my GP Doc and my Heart Doc so I went to a Physiatrist that dealt with addictions.

 

My Physiatrist was aware of the Ashton Manuel but thought that since I had only been on Lorazepam for 4 month I should be able to taper quick.  That doesn't seem to be working.  So, slowing it down it what I'm going to do.  He'll be fine with it. 

[[Ch...]]

Thanks for talking with me.  I would like to keep you updated on my progress and get any advice I can along the way.

[[Ch...]]

I apparently have reduced my Lorazepam too quick and am having terrible withdrawals.  I am trying to hold at my current reduction of 1.5mg.  I started at 4mg and reduced to 2.5mg within about 2 weeks.  Been 7 days since I cut .5mg and I am having terrible withdrawals.  It's been about 2-1/2 weeks since I started my crossover. 

 

I don't want to try and reinstate any of the Lorazepam.  Should I increase my Diazepam?  Right now I am taking 20mg of Diazepam and it doesn't seem to be helping.

 

Any suggestions?

[[sn...]]

I would probably up my lorazepam dose unless you just want to grit it out.  The diazepam simply takes a lot longer to work in your system than the lorazepam does to get out of your system.

 

Look at the earlier post I made.  Are you able to locate that Schedule 8 in the Ashton Manual for slow withdrawal schedules?  They only substitute one-half of one of the doses on each portion of the crossover to give your body a chance to adjust.

 

It just feels to me like the lorazepam has worked its way out of your system before you have given the diazepam a chance to build in...based on that schedule and your four doses a day it would take at least 8 weeks or maybe more to gradually crossover doing each dose separately and half at a time.

[[Ch...]]

I would probably up my lorazepam dose unless you just want to grit it out.  The diazepam simply takes a lot longer to work in your system than the lorazepam does to get out of your system.

 

Look at the earlier post I made.  Are you able to locate that Schedule 8 in the Ashton Manual for slow withdrawal schedules?  They only substitute one-half of one of the doses on each portion of the crossover to give your body a chance to adjust.

 

It just feels to me like the lorazepam has worked its way out of your system before you have given the diazepam a chance to build in...based on that schedule and your four doses a day it would take at least 8 weeks or maybe more to gradually crossover doing each dose separately and half at a time.

 

I have read the schedule on the Ashton Method and just got in a hurry apparently.  Wanting this Lorazepam out of my system.  It has never really agreed with me.

 

How much longer would you think I would have to grit it out before getting some relief?  I am on day 6 since I cut the .5mg.  I have read it takes 8 to 14 days to feel any relief from a cut.  Keeping in mind I was going to fast.

 

Thanks for responding.

[[sn...]]

The 14 days sounds about right.  Yes, best to just go gradually as long as your have the support of your doctor to prescribe what you need.  I compare it to someone walking one mile who wants to get up to five miles at a time...he walks two miles the next day and says oh I feel fine...let's do three tomorrow...next thing you know he is so achy he can't even do one mile and has to start over again...that is kind of how it is with tapering except we are reducing not increasing.

[[Ch...]]

My Doc seems to be ok with how I want to handle it.  Which is reassuring that I don't have to fight with him.

 

Thanks

[[Ch...]]

I went too fast on my taper.  I went from 4mg to 2.5mg in 2 weeks.  My last cut was 2/12/17 of .5mg of Lorazepam.

 

I am also trying to do a crossover to Diazepam but it doesn't appear to be helping yet.

 

After the .5mg cut how long will it be before I can get any relief and make another cut?  I plan to go a lot slower now.

 

 

[[sn...]]

What time do you take your diazepam?  How much diazepam are you taking now?

[[Ch...]]

What time do you take your diazepam?  How much diazepam are you taking now?

 

I am taking 20mg total.  5mg with each dose of L.  6:00am,11:00am, 4:00pm and 11:00pm.  I am taking 2.5mg of L.  Have cut 1.5 mg.  Stated at 4mg.

 

6:00 am: .75mg of L and 5mg of D  (Cut .25 off the L on this dose)

11:00 am: .5mg of L and 5mg of D  (Cut .5 off the L on this dose) 

4:00 pm:  .75mg of L and 5mg of D (Cut .25 off the L on this dose)

11:00 pm: .5mg of L and 5mg of D  (Cut .5 off the L on this dose)

 

Basically cut 1.5mg of L from 1/29/17 to 2/12/17.

 

Up until 2/12/17 I as at .75mg for all my doses and I cut a total of .5mg of Lorazapem that day.  It was obviously too much.  Plan to to to 1/4 or 1/8 cuts moving forward.

 

My last cut was to the 11 am and 11 pm doses.  They seem to be causing me the most trouble.  Sleeping only about 3 hours.

 

I realize that I am over the Ashton recommendations already.  But, should I try to help build it up or just wait for everything to catch up?  I do not want to re-instate any Lorazepam.

[[sn...]]

Yes, I would again say stabilize then we can work on a next step going forward.  Even though you don't want to...maybe one of those lorazepam doses you could go back to .75mg at one of the times you are having trouble.

 

Also, on the diazepam if your time to sleep is at nighttime possibly you could move your 4 p.m. dose together with your 11 p.m. dose or just take it at maybe 8 p.m. to assist with your sleep.

 

just on an aside I had cut my dose as is shown in the signature but ran into some other problems so I upped mine back to 2mg for now.  I found it easier for me to cut my night dose and ran into trouble during the day.

 

I think if you can just get to a stabilization point that is your first step...i still think that fast cut might be your biggest problem...so I am thinking up one of those lorazepam doses to help you stabilize and consider moving that your 4 p.m. diazepam dose to later.

 

These are trial and error based on what works for each person...and you really do have to just be patient...I know easier said than done..

[[Ch...]]

Yes, I would again say stabilize then we can work on a next step going forward.  Even though you don't want to...maybe one of those lorazepam doses you could go back to .75mg at one of the times you are having trouble.

 

Also, on the diazepam if your time to sleep is at nighttime possibly you could move your 4 p.m. dose together with your 11 p.m. dose or just take it at maybe 8 p.m. to assist with your sleep.

 

just on an aside I had cut my dose as is shown in the signature but ran into some other problems so I upped mine back to 2mg for now.  I found it easier for me to cut my night dose and ran into trouble during the day.

 

I think if you can just get to a stabilization point that is your first step...i still think that fast cut might be your biggest problem...so I am thinking up one of those lorazepam doses to help you stabilize and consider moving that your 4 p.m. diazepam dose to later.

 

These are trial and error based on what works for each person...and you really do have to just be patient...I know easier said than done..

 

When you went back up on your L dose how did it take for you to stabilize?

 

I really hate to got back up.  I'm hoping within another week I should stabilize at the cuts I've made.  That would be around 14 days. 

 

My background on the Lorazepam is it made me feel horrible.  It did help with the anxiety but it gave me insomnia and just felt terrible all the time.  Was losing weight and couldn't sleep. 

 

When I first started my crossover I kinda got my appetite back and put back on 5 lbs really quick.  Then I screwed up and went to fast.  Now have lost that 5 lbs gained back again.  Probably some more as well.  I quit getting on the scale.  Just depressing.  I've gone from 215 to 175 lbs.  My Cardiologists wants me at about 190.  All that weight wasn't lost due to Ativan.  After my heart attack I had changed my diet and was exercising.  But, about 25 lbs of it was caused by the Ativan.

 

I'll give it a few more days and see how I feel.  I do want to know when you went back up on your L how long did it take you to stabilize?

[[sn...]]

I felt better almost immediately.  I would think that since you have not been on it so long it would SEEM easier for you to reach stability than many.  I have never abused my doses or took it for fun or a high...I may take some extra on really bad days...I know I read on here that some people can't stabilize again but for me it was almost immediately.  I think even if you updosed for two weeks you could likely go right back down from that .75mg I suggested back to you .50mg.  You will have to decide which path feels like the lesser of the evils to you.

 

All of these stresses we face...like your weight just make it that much more difficult on certain days...I can understand the weight thing as well...I've usually had problems being underweight...I also understand beta-blockers cause I am on one and if I forget to take that  my heart might start pounding like I am in a race...it is unfortunate he put you on that and then took you back off not needing it....mine was because my blood pressure increased from always feeling the anxiety/stress.

 

I guess what I am saying if you need to vent  or let your frustration out I'll be here to listen.

[[Ch...]]

I felt better almost immediately.  I would think that since you have not been on it so long it would SEEM easier for you to reach stability than many.  I have never abused my doses or took it for fun or a high...I may take some extra on really bad days...I know I read on here that some people can't stabilize again but for me it was almost immediately.  I think even if you updosed for two weeks you could likely go right back down from that .75mg I suggested back to you .50mg.  You will have to decide which path feels like the lesser of the evils to you.

 

All of these stresses we face...like your weight just make it that much more difficult on certain days...I can understand the weight thing as well...I've usually had problems being underweight...I also understand beta-blockers cause I am on one and if I forget to take that  my heart might start pounding like I am in a race...it is unfortunate he put you on that and then took you back off not needing it....mine was because my blood pressure increased from always feeling the anxiety/stress.

 

I guess what I am saying if you need to vent  or let your frustration out I'll be here to listen.

 

I really appreciate it.  I'm going to give it a few more days and see where I'm at before going back up.  Problem was I was never stable at 4mg or really at any time that I was taking it.  Might not get "stable" until I'm completely off the stuff.  I just need it to be tolerable so I can function.  Might have something to do with the fact I was an alcoholic for 15 years.  Been sober 13 years on 2/4/17.  I knew very well about addiction.  I just didn't know what I was getting into with this stuff.  Doc never told me this could happen.  Needless to say I'm never going back to her again.

 

I'll keep you posted and you please do the same.  I've got 3 young kids and have no choice but to get through this.

[[Ch...]]

I felt better almost immediately.  I would think that since you have not been on it so long it would SEEM easier for you to reach stability than many.  I have never abused my doses or took it for fun or a high...I may take some extra on really bad days...I know I read on here that some people can't stabilize again but for me it was almost immediately.  I think even if you updosed for two weeks you could likely go right back down from that .75mg I suggested back to you .50mg.  You will have to decide which path feels like the lesser of the evils to you.

 

All of these stresses we face...like your weight just make it that much more difficult on certain days...I can understand the weight thing as well...I've usually had problems being underweight...I also understand beta-blockers cause I am on one and if I forget to take that  my heart might start pounding like I am in a race...it is unfortunate he put you on that and then took you back off not needing it....mine was because my blood pressure increased from always feeling the anxiety/stress.

 

I guess what I am saying if you need to vent  or let your frustration out I'll be here to listen.

 

I felt ok yesterday afternoon and evening.  Actually slept about 5 hours last night.  Woke up feeling ok.  I ate a light breakfast and about 10:00am  I was back in bad shape.  When stabilizing does it come and go?

[[sn...]]

Yes it can come and go.  Observe to see if you get longer periods and more days of the good times...if you do you will know you are on your way.

 

Also, for many of us we feel better at certain times of day.  I am better in the evenings/nights and worse in the mornings.  You said you woke up ok though and got worse.  Cortisol levels are generally high in the early morning and lowest late at night unless your system gets out of sync on that.

[[Ch...]]

Yes it can come and go.  Observe to see if you get longer periods and more days of the good times...if you do you will know you are on your way.

 

Also, for many of us we feel better at certain times of day.  I am better in the evenings/nights and worse in the mornings.  You said you woke up ok though and got worse.  Cortisol levels are generally high in the early morning and lowest late at night unless your system gets out of sync on that.

 

Ok, thanks.  I usually feel better in the evenings.  Sleeping 5 hours hasn't happened for a month.  So, I'm hopeful.  I plan to start cutting my L by .25 once I stable out.  My question is how are you cutting such small amounts?  Your signature shows you went from 1.75 to 1.625.  How are able to accomplish that?

[[sn...]]

I am using .5mg tablets.  They are scored so I can cut in half to make .25mg...then I cut that in half again.  That second cut is usually kind of haphazard but close enough if you take your time.  I just use a regular pill splitter that costs about 5 dollars at most places...it has a razor in the center or you can just cut it with a regular razor blade.  The hardest thing for me is that when I go to take them they start sliding under my fingernails or I can't really feel them hit inside my mouth or they try to hide in your gums and teeth when you try to swallow them.

[[Ch...]]

I am using .5mg tablets.  They are scored so I can cut in half to make .25mg...then I cut that in half again.  That second cut is usually kind of haphazard but close enough if you take your time.  I just use a regular pill splitter that costs about 5 dollars at most places...it has a razor in the center or you can just cut it with a regular razor blade.  The hardest thing for me is that when I go to take them they start sliding under my fingernails or I can't really feel them hit inside my mouth or they try to hide in your gums and teeth when you try to swallow them.

 

Did you ever try a crossover to Diazepam? 

 

I had a rough most of the day.  Felt ok for a few hours this afternoon.  A lot of stress going on in my life right now and that's not helping.

 

I have been taking 20mg of Buspar for about 6 weeks and I absolutely hate it.  Doc prescribed it for anxiety but I don't feel it helps at all.  I believe that it is making me feel worse.  I take it and within 20 to 30 minutes I'm so dizzy I can hardly stand up or have a conversation.  Then within an about 1.5 hours the dizziness is gone but I feel terrible.  Last night I took it at 10:00pm to get ready for bed and by 11:00 I could hardly make it to my bed room.  I'm not sure if it's the Buspar or withdrawal effects from dropping the Lorazepam.  I'm 90% sure last night was from the Buspar.

 

Talked to Doc today and he said I could either taper off of it or drop it cold turkey.  Seems there are mixed reviews on whether to taper or go cold turkey.  According to the Doc there should be no withdrawals.  I decided to drop .25mg today and gonna hold it for a week and see what happens.  Hoping I can tell the difference between Benzo withdrawals and anything associated with tapering the Buspar.