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Overwhelmed Right Now - New 1.5mg Ativan Taper Help Needed plus misc questions


[Ap...]

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I've been learning on the forum for a couple days now and it has been amazing. I'm at the point where I need to put together my taper plan. I've having trouble finding some answers to some of my questions and I'm getting anxiety from the benzo brain not being able to get the answers. So here we go:

 

Currently taking .5mg 3x per day for 1.5mg total daily. Started taking ativan ~3 years ago just as spot treatment but then after my first panic attack a few months ago I have been taking 1-3 doses of .5mg per day consistently. I obviously just realized all of the anxiety I have been dealing with was probably from my all-over-the-place daily dosage of ativan and it was actually interdose withdrawal that was fueling the anxiety. I initially thought it was from the prozac (hence the taper below) but not thinking so now.

 

1. Would like to start Ashton's plan which is taking 1/4mg  off per day for 7-14 days. So how do I actually go about doing that? Is just one of the 3 daily doses reduced by a 1/4 or do I spread the 1/4 reduction among all 3 pill so I would need to some how take .083 off each pill?

 

2. With either answer to number 1, based on what I am reading here, I need to be very accurate. How do I very accurately cut (lets say) a 1/4 off one of the pills? There is a scribe mark to make it easy to break in half but breaking a half into another half is never accurate when I do it. What are most people doing in this situation? I've looked at milligram scales but none seem to go down low enough to read in fractions of a mg.

 

3. Based off the half life of ativan, is there an ideal amount of doses per day? IE, 4 times is better than 2, etc?

 

4. Does there seem to be a good timing through the day to take the doses that works better than others? IE wake up, mid day, bedtime?

 

5. I'm currently tapering off being on prozac for a few months as well. The last highest I was on 20mg for a couple months and I started tapering down a week ago and I'm at 8mg right now. Should I completely taper off prozac before starting the ativan taper so I'm only dealing with one thing at a time? For the record, I haven't dealt with depression at all these last few months, just the anxiety. Of course a couple sad days because I was taking sporadic ativan doses daily which wore me down but thats it.

 

6. Being that I have only been consistently taking ativan daily for 3 months, should I do a more aggressive taper than the normal Ashton/10% reduction style of taper?

 

Thank you in advance to everyone here. I'm sure I'll have more questions to come but these were the ones that I couldn't find answers for so far. BB is my only life line right now and I don't know where I'd be without it.

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You're amazingly detailed, so many of us dealing with benzo tolerance and withdrawal are cognitively impaired, you're doing great!

 

I'll give you my input, but I'm sure others will drop by with theirs, this is the great part about BenzoBuddies, you'll get lots of perspectives to choose from.

 

1.  You can reduce from different doses during your taper but with Ativan's short half life, you may have increased interdose withdrawal, so taking a little from each might be best.

 

2.  You're correct, making a cut in half is fairly easy and you're pretty much guaranteed to get an even distribution of the medication in each half, once you go smaller than that, you get less precise.  As for using scales, most people will weigh say 10 pills then take an average of the total.  You can also add a filler when you get to the really small doses, the type the pills are made with in the first place, there is a video by Bob7 which describes the process he used to make his own capsules.  You don't need to do the capsules, but his process shows you whats possible.  Bob7 Benzo Dry Taper Method 

 

3.  Whatever your body requires, it will tell you what it needs.

 

4.  Again, your body determines this, you'll get really good at paying attention to the signals it sends you, this is key.

 

5.  I mentioned on your introductory thread that it can be prudent to be on an A/D, I'd halt that taper for now.

 

6.  We hate to see anyone taper longer than they were on the drug, but again, your body will let you know what it needs.  Some people can go faster, others need to go a lot slower than Professor Ashton's time table.

 

I'd like to add one last option, a compounded liquid version of your benzo, do you have a compounding pharmacy near you and would your Dr be willing to prescribe it for you?

 

 

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Thank you very much for the kind words, Pamster! I feel like my brain is shot so it helps to know that some of it is still there, ha!

 

I'm not sure if there is a local pharmacy around here that does compounding but that would be awesome to get it in liquid form. That would solve all of the cutting into little pieces issues.

 

I'd love to hear others opinions as well so if anyone out there has any other thoughts on my questions above, please share your thoughts.

 

 

 

 

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April,

 

I did not taper using Ashton’s method so I cannot comment on that, only to say that once I got down to .25mg, I did not feel like it helped me at all and so I should have jumped sooner.  I took mine at night as I have issues falling asleep.

 

So as long as you don’t try to jump off a higher dose you should be fine.  Yes, it is tough to break up the pills, but I just got as close as possible.  Amazing that I once was nervously trying to collect every last shard from those stupid pills...

 

Stay on your antidepressant either at your current dose or reinstate.  No matter how perfect your taper is, you will have symptoms after you jump and depression is a big one...I know I had it.

 

Make sure you plan for when you jump because the first two to three weeks are hell, again, no way around that.  Be ready to have a way to address your symptoms without Ativan. 

 

On YouTube there is a woman who shared her thoughts as she was tapering and after she jumped off Ativan.  I think her channel is poweroverpills.  I found her videos to be helpful along with all the stories here.

 

One day I’m going to write a book:  “No you’re not crazy, you’re just withdrawing from Beonzos!”

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[42...]

Hi and welcome to the forum.  My thoughts below...

 

1. A lot of people buy inexpensive milligram balances to weigh pill pieces.  Amazon sells a GEM-20 for around $22.  Works reasonably well.  We use one at the lab (I own an analytical lab). 

 

2. Try to be reasonably accurate, but don't stress over it.  If you're a few percent over on one dose, you'll probably be a few percent under on another dose.  It kind of averages out over time.  The pills contain a lot of binders and inert materials so they weigh well over a milligram - most weigh over 100 mg. Easy to weigh pill fragments.

 

3. Depends on your needs.  I used Ativan for sleep, so would want to reserve enough at night to put me to sleep.  I only dosed it once a day, but did experience some interdose withdrawal (although I didn't know what it was at the time).  Didn't matter for me as daytime anxiety wasn't an issue.  If daytime anxiety is an issue, then I'd suggest 2 or 3 doses.  4 doses equally spaced cuts into sleep time and doesn't offer much additional 'coverage' compared with three.

 

4.  Again, depends on your needs.  Many people dose equally.  Some favor certain times (e.g. nighttime for sleep or mornings because mornings can be rough).  Some will taper one dose (e.g. afternoon dose) before starting on the morning or evening dose.  Many ways to do this.  Again, be mindful of your body's needs.  Take the pill consistently.  Swallow pill fragments quickly - don't let powder linger in your mouth or sublingual absorption will occur.  Sublingual absorption of power and small pieces is more efficient compared with the intact pill (due to higher surface area).  The variability in dosing due to sublingual absorption is higher than the variability due to the balance.  So wash the pieces/powder down your throat quickly and consistently.

 

5.  I can't really answer that and you'll see conflicting experiences reported.  If your current strategy has worked, maybe stick with it.

 

6.  Same as 3 and 4.  Listen to your body.  Some people can taper much faster.  Others must taper more slowly.  Problem is that nobody knows in advance how quickly or slowly they can taper.  So we advise caution at first.  Good thing about Ativan is you'll know the results of a cut within a day or two.  So if you're feeling good after 5-7 days, you can probably feel more confident about making another cut compared with somebody tapering valium where it takes 10-14 days for the new medicine dose to re-equilibrate in the body.  So I wouldn't advise larger cuts, but you may be able to cut more often.  Once again, listen to your body.  Push a little, but don't get overwhelmed.

 

Hope this helps.

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badsocref, THANK YOU. You literally just lowered my regularly scheduled late afternoon anxiety by half with your excellent suggestions.

 

I keep battling what to do with the prozac. Mentally I would love to remove it completely so I know I'm only dealing with one evil and not two. I never got a good feeling of what type of side effects are solely attributed to the 20mg because I was so sporadic with my Ativan daily that I was just a mess. I took at 1.25ml prozac (5mg equiv) this morning so in about the last 10 days I have cut from 5ml (20mg equiv) to 1.25ml (5mg equiv).

 

I went ahead and ordered the GEM-20 scale, thank you for the suggestions.

 

Called my pharmacy this morning and they notified me that there is a compound pharmacy close by so if I wanted to go the liquid ativan route I could do that. Seems like it would simply things a ton but I would be a bit scared if there would be a difference in absorption rates and if I would have any negative effects to that. So many decisions, ah!

 

 

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[42...]

Liquid is a convenient way to go, so if you can get formulations compounded, it could make things easier.  Or you can make the liquid formulations yourself.  It's pretty easy.

 

I think it's good to decide on an approach (liquid or solid) and stick with it.  A fair number of people feel that liquid doesn't deliver as much medicine.  I think it's because there's very little sublingual absorption when taking/swallowing liquids.  People often let a pill sit in their mouths several seconds before washing it down.  Drug absorbed directly from the mouth (sublingually) doesn't go thru 'first pass metabolism' which can result in more medicine in the bloodstream.  So people in the middle of a solid taper who switch to liquid often feel a significant cut in dose (and are unhappy about it).  Hope that makes sense.

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Makes total sense, pick one or the other and stick to it.

 

So just made my first call on the first cut, its a bit more agresssive than Ashton's plan but going to try it out. The next cut would be more inline with Ashton.

 

Currently - 1.5mg (3x full pills)

4/14/20 Cut - 1.25mg (1x full pill morning, 3/4 pill afternoon, 3/4 pill bedtime)

4/21/20 Cut - 1.125mg (3/4 pill morning, 3/4 pill afternoon, 3/4 pill bedtime)

4/28/20 Cut - 1mg (3/4 pill morning, 1/2 pill afternoon, 3/4 pill bedtime)

5/5/20 Cut .875mg (3/4 pill morning, 1/2 pill, afternoon, 1/2 pill bedtime)

5/12/20 Cut .75mg (1/2 pill morning, 1/2 pill, afternoon, 1/2 pill bedtime)

....etc until jump

 

I still haven't made my decision on the prozac, I'm on 5mg right now so I'm either going to just sit at this low dose or cut it totally off the next 3-5 days.

 

Everything look good cut-wise for the ativan?

 

 

 

 

 

 

 

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[42...]

It's a fine plan.  Just remember that benzo tapering plans are best made with #3 pencils (with lots of erasers around). 

 

Good luck!

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Really need some support today everyone, I'm just freaked out and I think my doctor did it. When I found BB forum on April 10th, I literally had clarity of what my enemy was (ativan) and it really relieved the major all day anxiety. I decided to pretty much follow the Ashton method and I was on my 4th day of my taper yesterday. I keep a daily journal of how I feel the last couple months and I literally ranked those first 3 days of the taper as 1 (1 best, 10 worst)...it was amazing, my anxiety was gone from just finally knowing who the enemy was, finding a support and knowledge source in BB, and then relief in committing to a plan to get off. Now I am all off track mentally and I need help.

 

Essentially I met with my psychiatrist yesterday, who I've only worked with a short time and never really clicked with but kept going because he was my only option, and had my first opportunity to tell him that I found out about the BB forum and the Ashton method. What started my anxiety is that he said he knows about Ashton and just doesn't believe in the method, he says it is way to slow and is like being an alcoholic who drinks a bottle of whiskey a day and just taking one less sip each day...it doesn't work. He told me he would support me in either method but feels like since I was only on small dose for a couple months that its crazy to be on a taper that is just as long or longer. He said what he does with all of his patients is use a more aggressive/quick taper but that uses spot treatment of a single increased dose of ativan to help through "really bad days". He said the key is to limiting the usage of this extra ativan dose to no more than once per week. This strategy logically makese sense to me but it seems like it is so polar opposite to what this forum says. Is his method here logical and should I switch over to it? I mean I have only been on ativan consistently every day for a couple months. Would the quick method be better since I haven't been on it for years like so many here?

 

Another thing he said that I keep playing in my head over and head is that you said "the taper is going to be terrible, just being honest"...him saying that made me so scared of the taper even more than I already was. I had a very rough last couple months because my ativan usage was all over the map on a daily basis and I now know I was basically in constant interdose withdrawal and it was ROUGH (like rolling around on the ground rough). I asked him if the taper would be worse than that and he said yes. That freaked me out because if it is truly worse, I don't know if I can handle "worse than that". It was so bad before, I seriously can't fathom it and now my anxiety is back because of it.

 

I am so conflicted right now and lost the confidence I had. I now realize how much the confidence I had for 3 days lowered my anxiety levels but not they are right back up.

 

So I'm sitting here right now not being able to think about anything but ativan and ativan taper withdrawals that I may encounter soon and at the same time not knowing if I should listen to my doctor or BB/Ashton.

 

I hate this.

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It sounds as if your Dr has seen some pretty horrific tapers, I wonder if it's because of the method he espouses?  Something to consider.

 

Isn't it amazing how a few words spoken by someone in authority can send us over the edge?  I agree, we don't wish to see anyone tapering the drug longer than they took it but when your body is calling the shots and you wish to remain functional, what are you to do?  Your body developed a dependence on this drug in a very short time but I've seen it happen in as little as 10 days, everyone is different.  Are we to throw everyone in the same box and say one method is the key to this, I don't see how that works.

 

We suggest tapering guidelines but stress each person is an individual and each taper must be tailored to that individual - our circumstances, our lifestyles, our health all have to be taken into consideration.  And to tell you the truth, I trust your judgement about your own body and mind when it comes to making these decisions more than faceless people on the internet and yes, even someone in authority with whom you've never really clicked.  We give you the tools to do this, but the decision to use them is yours to make.

 

I absolutely and emphatically disagree with your Dr using the analogy he did about whiskey, what does one have to do with the other?  I agree, a person cannot taper from alcohol but benzo's are a totally different animal, that comment had no place in your conversation.

 

You're likely to face more withdrawal symptoms, we just don't know but this is what happens to those of us who will suffer from benzodiazapine withdrawal syndrome.  This is a painful horrific process that fills us with fear, pain and hopelessness and the only way to make it through it is to educate yourself to increase your understanding and to lessen your fear.  I feel both you and your Dr could benefit from taking a look at this website, there is a portion of it dedicated to those medical professionals who are willing to go outside of their preconceptions to truly learn about what is happening to their patients in order to actually help them.  https://benzoreform.org/

 

Only you can make the decision as to who to follow as you proceed and we'll support you however you do this, but this forum has been around for over 12 years and we've seen thousands of members through recovery and I predict you're going to be one of them as you face this challenging time in your life.

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April:

 

My Doctor had me use a taper method that is different, and not as optimal, as Ashton’s method.  He had me take a full dose, 3/4 dose, then full dose, then you gradually work down to where you are at 3/4 dose comfortably.  Then you go 3/4, then 1/2, 3/4 then 1/2...and gradually work down to 1/2 a dose consistently.  I worked down to 1/4 dose...then went 1/4 ,skip a day, 1/4...then I went two whole days without...then finally I just kept going until I was at one week off....then I said, ok, I guess I just jumped.

 

Now this method is suboptimal because you are going up and down in dosage and so your nervous system doesn’t really adjust.  But I don’t recall it being a problem.  The hell for me started after I jumped and lasted a few weeks.

 

The one pro of the method I used was that psychologically it built my confidence because I learned that I could go for a couple of days without Ativan, then I said let’s try for three days.  I was afraid of jumping, and this way, the jump just sort of happened.  Now I knew I had to jump in winter cause my schedule is lighter and it is easier to sleep.  But it was hell anyways....I don’t want to relive those days ever!

 

I jumped from .25mg and I doubt tapering lower would have reduced my symptoms.  I did not know of this site or Ashton’s method during taper, I only found this site after I jumped and the withdrawal symptoms made me feel like I was going crazy. 

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To continue my previous post...

 

Here is what I would have done differently:  Use a smooth taper down to .25mg.  I doubt I would try to go lower, those .25mg crumbs didn’t seem like they were doing anything for me outside of providing a psychological boost.

 

Here is what I wouldn’t change:

 

Have tools and techniques to help me deal with my anxiety, depression and claustrophobia...without relying on pills.

 

Plan for my jump.  I picked a slower time of year (winter, after the holidays) as my work schedule is not as hectic and it is easier to sleep in winter.

 

I also scheduled some vacation time just in case I could not make it into work...I did not use them as it turns out.

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[42...]
I think I've mentioned this before - you might be able to get off Ativan much faster than 10% every 7-10 days.  But I think you want to see what a 10% cut feels like before you consider trying a 25% cut.
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It sounds as if your Dr has seen some pretty horrific tapers, I wonder if it's because of the method he espouses?  Something to consider.

I didn't even think about that but it make sense.

 

Isn't it amazing how a few words spoken by someone in authority can send us over the edge?  I agree, we don't wish to see anyone tapering the drug longer than they took it but when your body is calling the shots and you wish to remain functional, what are you to do?  Your body developed a dependence on this drug in a very short time but I've seen it happen in as little as 10 days, everyone is different.  Are we to throw everyone in the same box and say one method is the key to this, I don't see how that works.

 

Totally. I feel like I should be stronger mentally than to allow that to happen but when its your own doctor it makes it so much more stressful and puts you in a completely conflicted position. I just never knew that I could become dependent in such a short time and to see stories of people on here that are in exactly my position as far as length of time just astonishes me. I simply do not get how doctors are blind to all of this. My psychiatrist is the doctor I was referencing above (the one whom I have clicked with), but even my general doctor who I love and click with and trust completely was ignorant of this. When I told both of them I was worried about taking ativan regularly everyday, they both literally said "STOP, stop freaking yourself out over such a low dose, you need this now and it will help, stop worrying about getting addicted". Since I had two different doctors telling me this is why I ultimately made the decision a couple months ago to start taking it regularly. Neither of them even mentioned that the whole reason I was at the point of "needing them everyday regularly" was because of my inconsistent use throwing me into interdose withdrawal. Just astonishes me. These doctors see 100s of people a week, you think they would have seen everything and would be truly experts. 

 

We suggest tapering guidelines but stress each person is an individual and each taper must be tailored to that individual - our circumstances, our lifestyles, our health all have to be taken into consideration.  And to tell you the truth, I trust your judgement about your own body and mind when it comes to making these decisions more than faceless people on the internet and yes, even someone in authority with whom you've never really clicked.  We give you the tools to do this, but the decision to use them is yours to make.

 

I absolutely and emphatically disagree with your Dr using the analogy he did about whiskey, what does one have to do with the other?  I agree, a person cannot taper from alcohol but benzo's are a totally different animal, that comment had no place in your conversation.

 

I was hoping you would say that...I was really stuck on the whiskey analogy as it makes sense to an uneducated person (me) on the surface. Thank you for the clarification as it truly helps put me at ease.

 

You're likely to face more withdrawal symptoms, we just don't know but this is what happens to those of us who will suffer from benzodiazapine withdrawal syndrome.  This is a painful horrific process that fills us with fear, pain and hopelessness and the only way to make it through it is to educate yourself to increase your understanding and to lessen your fear.  I feel both you and your Dr could benefit from taking a look at this website, there is a portion of it dedicated to those medical professionals who are willing to go outside of their preconceptions to truly learn about what is happening to their patients in order to actually help them.  https://benzoreform.org/

 

Only you can make the decision as to who to follow as you proceed and we'll support you however you do this, but this forum has been around for over 12 years and we've seen thousands of members through recovery and I predict you're going to be one of them as you face this challenging time in your life.

 

No I hadn't found that website yet. I will probably share it with my general doc but I feel like my psychiatrist is to egotistical to let himself be impressionable with it.

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April:

 

My Doctor had me use a taper method that is different, and not as optimal, as Ashton’s method.  He had me take a full dose, 3/4 dose, then full dose, then you gradually work down to where you are at 3/4 dose comfortably.  Then you go 3/4, then 1/2, 3/4 then 1/2...and gradually work down to 1/2 a dose consistently.  I worked down to 1/4 dose...then went 1/4 ,skip a day, 1/4...then I went two whole days without...then finally I just kept going until I was at one week off....then I said, ok, I guess I just jumped.

 

Now this method is suboptimal because you are going up and down in dosage and so your nervous system doesn’t really adjust.  But I don’t recall it being a problem.  The hell for me started after I jumped and lasted a few weeks.

 

The one pro of the method I used was that psychologically it built my confidence because I learned that I could go for a couple of days without Ativan, then I said let’s try for three days.  I was afraid of jumping, and this way, the jump just sort of happened.  Now I knew I had to jump in winter cause my schedule is lighter and it is easier to sleep.  But it was hell anyways....I don’t want to relive those days ever!

 

I jumped from .25mg and I doubt tapering lower would have reduced my symptoms.  I did not know of this site or Ashton’s method during taper, I only found this site after I jumped and the withdrawal symptoms made me feel like I was going crazy.

 

Appreciate the further explanation here RShack. I totally could understand how a positive of that method would be the mental aspect of learning that you are ok for small (and growing) periods of time without the drug. I'll probably just stick with the Ashton style slow taper but with a side of a slightly faster added to it.

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Here is what I wouldn’t change:

 

Have tools and techniques to help me deal with my anxiety, depression and claustrophobia...without relying on pills.

 

Plan for my jump.  I picked a slower time of year (winter, after the holidays) as my work schedule is not as hectic and it is easier to sleep in winter.

 

I also scheduled some vacation time just in case I could not make it into work...I did not use them as it turns out.

 

What were the best tools/techniques that helped you with the anxiety and depression without relying on pills?

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I think I've mentioned this before - you might be able to get off Ativan much faster than 10% every 7-10 days.  But I think you want to see what a 10% cut feels like before you consider trying a 25% cut.

 

10-4. My first cut that I started 5 days ago with a 16.6% cut. Hopefully this will tell me a good deal based on how this goes.

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This graph represents the hell on earth/i'm losing my mind phase of this journey. It is a daily chart of my dosage of ativan. You can see at the end in green when I found BB and started my taper.

 

Just to confirm, would everyone else agree that this usage (link below to graph) is what was causing my high anxiety/losing my mind withdrawal symptoms?

 

 

qxn23GO.jpg

 

 

Edit - could someone please explain how to add images to posts? I've tried all the usual forum code methods and its not popping up. Are they disabled on BB?

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Wow April10th, you're incredibly high functioning for someone going through what you describe as "hell on earth", I can't wait to see who emerges from the ashes when you get past this!

 

Some people can take benzo's PRN for years and years with no problems, others can't, it looks like you fall into the latter category.  Your chart and your rating of your symptoms the first 3 days tells me you're on the right track now, try not to second guess yourself and the process because as you've found, it only makes you feel worse.  Making a decision and sticking to it is empowering and we desperately need this.  Make adjustments to your taper as you need to but keep the gradual elimination of the drug at the forefront.  Your brain is crying out for consistency, give it what it needs.

 

Here is a link to the Technical Support board, there are a number of topics at the top speaking to the addition of pictures plus member questions and suggestions on the various threads, I hope it helps.

 

 

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[42...]

To post an image here, you need the 'Image Address' of the image you wish to post.  It's the specific URL for the jpg - not for the entire page. 

 

I do Macs, so I just control-click over an image and select 'Copy Image Address'.  I'm sure there's a similar approach on the WinPC side if thats what you're using. 

 

That address gets pasted into the code that is inserted when you depress the 'Insert Image' icon.  You seemed to do that part correctly, but didn't use the Image Address.  I think you used the page URL instead. 

 

The image address for your graph is...  https://i.imgur.com/qxn23GO.jpg

 

I like the graph, btw.  I kept similar graphs of my progress and posted them occasionally.

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Wow April10th, you're incredibly high functioning for someone going through what you describe as "hell on earth", I can't wait to see who emerges from the ashes when you get past this!

 

Some people can take benzo's PRN for years and years with no problems, others can't, it looks like you fall into the latter category.  Your chart and your rating of your symptoms the first 3 days tells me you're on the right track now, try not to second guess yourself and the process because as you've found, it only makes you feel worse.  Making a decision and sticking to it is empowering and we desperately need this.  Make adjustments to your taper as you need to but keep the gradual elimination of the drug at the forefront.  Your brain is crying out for consistency, give it what it needs.

 

Here is a link to the Technical Support board, there are a number of topics at the top speaking to the addition of pictures plus member questions and suggestions on the various threads, I hope it helps.

 

Oh no, I wish I could take the credit. "hell on earth" phase ended on 4/13. The last 6 days have been night and day since I started on the taper. I did have one bad day 2 days ago but it has been significantly improved since hell on earth. You are right, when I was in the hell phase all I could do was roll around on the floor and pray to god that I wasn't literally losing my mind for the rest of my life. Crossing my fingers I never get back to that territory again. Hell on earth is what lead me to BB...couldn't take it anymore.

 

I PRN'd ativan for about 3 years. Never took more than 1 .5mg pill to do the trick. In the early years it was maybe one every month or two. Started out taking them just to fly or when giving a big presentation. THe last year prn was ramping up to ~10 or so pills a month which ultimately then led to the graph you see where there was daily use.

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