Need help regarding Ativan

[[St...]]

Hi. My name is Steve and I think I might have a dependency issue with Ativan. It was prescribed to deal with 2 specific issues that caused me a lot of anxiety back on May 17th and I was given .5 mg to take 3X daily. I followed that schedule for the most part with a couple of occasions where I took a 4th dose when I woke up in the middle of the night and couldn't get back to sleep. Anyway, the 2 factors that have been causing me stress have been resolved and I went from last Monday evening, June 6th (I only took one that day) until yesterday without taking Ativan. What I noticed is my anxiety level seemed to increase with each passing day to the point where I ended up taking 2 yesterday. The first one didn't really seem to help but the 2nd one did. Now here I am at 10:49 AM with full-blown anxiety again. I'll include the daily amounts I took from May 17th on (I usually spaced them 5 hours apart) and get to the gist of my post, which is - can I be "hooked" this quick? If I need to taper do I go back to the 3X (1.5 mg) dose and work down or try to taper from 2 pills? I've read some horror stories of where some folks endured months of anxiety when stopping this drug incorrectly and I'm not sure I could put up with my current level of anxiety that long. Here's more info based on the introductory thread:

 

The type of benzodiazepine (or z-drug) you take or have taken: Ativan

 

For how long you have been taking benzodiazepines: Since May 17th. Starting with that day and up to the present my daily consumption in pills was: 3-3-3-2-3-0-3-3-0-0-1-3-4-3-3-0-4-0-0-2-1-0-0-0-0-0-2-none so far today

 

Your present dose: see above.

 

The size (dose) of the individual pills you use: 0.5 mg.

 

If you have started or finished your taper: I'm here to see if I need to taper, and if so, from what dose? Or do I just "tough it out" if I'm not that far into dependency.

 

And anything else you feel would be useful for those wishing to reply to your introduction: I understand I apparently have anxiety issues but they have always been specific to real scenarios. This particular bout of anxiety seems to have a mind of it's own as the "issues" I initially took them for were resolved on June 6th. That's when I quit taking Ativan (until yesterday).

 

Anyway, that's my situation. I'm not sure what I should do.

[[Pa...]]

Hi Steve, Welcome to BenzoBuddies!

 

Unfortunately it doesn't take long for our bodies to build up a dependence on the drug, I've seen it happen in as little as two weeks, in fact some manufacturers suggest only using the drug for 2 to 4 weeks due to dependence issues.

 

If you're uncomfortable, you probably should let your Dr know what you're doing so he can be on board with it, in case he needs to supply enough pills to do a safe, slow taper.  There is no reason to expect months of suffering, but it's good you've been doing some research so you'll know what can happen if you stay on this drug too long. 

 

If you're not functional, you might want to go back on a small dose to try to stabilize then taper more slowly, but this is no guarantee that you'll feel better.  I quit cold turkey, and while it was painful, I was able to recover completely. 

 

Please ask questions, we're here to help.

 

Pam

[[St...]]

Thanks for the welcome. My doctor prescribed enough Ativan that I should have enough to taper if I decide to go that route. I'm reluctant to call him about this as he seemed nonchalant about this benzo as if he was unaware of it's (or my) potential for dependence/addiction but will if I need to do a slow taper. The thing is, I'm not sure if it's the pills or me. What makes me think it's the former is my anxiety seems to be present constantly irrespective of my thoughts. Things are good right now and I shouldn't feel like this.

 

I'll keep y'all posted (pardon the pun  ) and welcome any advice from those that walked this road before.

 

[[Be...]]

The thing is, I'm not sure if it's the pills or me. What makes me think it's the former is my anxiety seems to be present constantly irrespective of my thoughts. Things are good right now and I shouldn't feel like this.

 

 

We all have the same worry when on benzos and tapering, Steve 

 

I have been benzo free now for 11 months and my anxiety has gone from an 10 to a .5 since getting off that junk.  I would hazard a guess that it's the pills making you feel that way too.

[[sh...]]

Hi Steve

 

I understand what you are saying about the anxiety.  I took Ativan and then Valium for a muscle spasm issue (not anxiety), at a much smaller dose and for a shorter duration than most people on this list,  so in my case I knew it was not anxiety returning.  When I stopped the drugs c/t, the anxiety was out of control. It felt like when you know something bad is going to happen and your body is sooooo shaky and tense inside--difficulty breathing and straight up panic that I had to constantly reassure myself was going to pass.  At first, I could not control my emotions and cried a lot, but then it was more of a body sensation.  I kept walking the neighborhood and looking for ways to distract myself.  The anxiety is getting better with time though.  I know people here will be able to offer you support.  Hang in there..

Shell

[[St...]]

Thanks shellmac, you've described my feelings of anxiety perfectly. I still haven't taken any Ativan today but my anxiety is not getting any better. I feel like a live wire right now. I'm tempted to try to taper from 2 pills instead of 3 (1 mg vs 1.5 mg) but am not sure if that's too big a jump. I'll let you all know what I decide.

 

[[...]]

Steve, Welcome!

 

I notice that you went several days without taking ativan. It's so helpful you included that info. So it would be sad to undo the work you have already done (and suffer for nuttin'). It took you two pills to settle things down because you hadn't had any for a while. This is w/d anxiety, as you know now. I WILL get better.

 

I agree with your plan to go with ativan 2x a day. That'll take advantage of gains already made, and you won't have to taper for very long. Ativan dissolves quickly in water, which is what I used to split my doses up. Sometimes it's hard to divide the pills the way you need them for tapering.

 

My doctor seemed very very surprised I was having a problem with his taper (drop half a dose every 3-5 days). His plan for two weeks actually took me eight weeks, and it was not easy. But so worth it!!

 

Good luck!

[[St...]]

Thanks for the support yram. I decided to give the 2X/day taper a shot and took my first Ativan @ 5:19 PM. I'll take the 2nd one before bed and figure out how to get this taper thing started. I'm assuming I should wait a day or two to make sure 2 pills (1 mg.) "stabilizes" me before cutting back from that, correct?

 

I'll start a thread in the 'taper' fora when I get this ball rolling because cutting doses with these small pills doesn't look easy and I could use some advice on how much & long each reduction should be.

 

 

[[St...]]

I feel much better today which makes me think it was the Ativan causing my distress. I have a question: how long should I continue to take 2 (1 mg total) pills before I start the taper? My wife thinks I should give it 2 weeks but I don't think I have to wait that long. Any thoughts?

[[Be...]]

I'm assuming I should wait a day or two to make sure 2 pills (1 mg.) "stabilizes" me before cutting back from that, correct?

 

 

I would personally wait a lot longer than two days before you begin cutting again.  It could take a couple of weeks, perhaps longer, before you stabilize.  But I would certainly wait longer than 48 hours before you begin tapering.

[[St...]]

I'm assuming I should wait a day or two to make sure 2 pills (1 mg.) "stabilizes" me before cutting back from that, correct?

 

 

I would personally wait a lot longer than two days before you begin cutting again.  It could take a couple of weeks, perhaps longer, before you stabilize.  But I would certainly wait longer than 48 hours before you begin tapering.

Thanks. I think I'm just itching to get the show on the road but don't want to get ahead of myself. I want this to work.

[[...]]

Steve,

 

Reading your story really hits home for me.  I ended up on Ativan (Lorazepam) back in January after reaching a breaking point of stress in my life.  After I resolved most of the issues that were bothering me, I still had this uncontrollable amount of anxiety for what seemed like no reason.  Thing is, there is a reason.

 

I did some research on Ativan before I started taking it and had serious reservations, but I was a mess at the time and didn't have the mental tools I have now to beat my own self induced anxiety.  Add to that, my doctor straight up told me that she wouldn't let me get addicted and that I would be fine on the dose I was on (1mg, once a day or as needed).  I'm not even sure it took me 2 full weeks before my body started building up a dependence.  At first, it was nightmares and waking up in the middle of the night for no reason.  Then it was unexplained anxiety in the middle of the day that I could not shake (tried exercising, watching movies, etc).  My body felt like it wanted to panic all the time.. and at first, I let it.

 

I can personally tell you that without a doubt, it is 100% possible to get a dependence on this drug in as little as 1-2 weeks, even on 1mg or less a day.  Don't just take my word for it though, there are thousands of other victims on this board and many other boards on the web with a similar story.  The good news is that you caught this early and you will most likely fully recover without too much pain and suffering.  I managed to taper off successfully myself and have been clean for over a month now.  I still have some lingering issues, but they may or may not be benzo w/d related.  On top of that, I feel night and day better today than I did when I was on this stuff.

 

Here are a few things I learned along the way that really helped, I hope this helps you too.

 

1. Ativan/Lorazpepam has a fairly short half-life of about 12 hours.  This means that half of the drug is out of your system after about 12 hours and just continues to leave your body at a steady pace.  Once your body becomes dependent on a certain level of this drug, it will 'cry out' for more once the drug level in your system reaches a certain point.  Any by 'cry out' I mean withdrawal symptoms (palpitations, chest pain, anxiety, etc).  Because of this, it is very important to try and maintain a stable amount of this drug in your system.  When I first started taking this drug, I only took it once a day.  After your become dependent, once a day is a roller coaster ride you don't want to ever ride.  Simply cutting my dose in half and taking one half in the morning when I got up and the other half before I went to bed made me feel MUCH better.  I would highly recommend taking this drug no less than 2X a day while you're on it as you taper off.

 

2. Withdrawal.  As you taper off, you will experience withdrawal.  As it is, you are already experiencing it now (interdose withdrawal).  Don't expect tapering to be easy as such, and go at a pace YOU can tollerate and try to work with your doctor about tapering off at a reasonable pace.  At the end of the day, you're the one that is in charge of your health.  If you don't like what your doctor is telling you, considering talking to someone else.  I think the majority of doctors out there don't have any idea how bad this stuff can be.  Also, this drug affects people differently.  One person can take this drug for several months and stop taking it cold turkey and not feel a thing (probably rare) while another person would have a full blown seizure.  Each of us are different and the symptoms we'll experience along the way will be similar, but different as well.

 

3. Personal anxiety.  It's super easy to generate anxiety about your health and other circumstances.  Do everything you possibly can to minimize this as it will only worsen your situation.  I like to use heart palpitations as my prime example.  I used to be terrified of them to the point that I would experience intense levels of anxiety.  In fact, palpitations were one of the main reasons I started taking this stuff.  In a strange twist of fate, taking this medication actually ended up making my situation much much worse, especially in the palpitation department.  There was a point in time before I started my taper where I would get palpitations days on end.  Every 4th or 5th beat I'd feel my heart skip.  I would literally get thousands of them in a single day.  Before I got on this stuff, I had maybe a couple dozen of them in the evening and got all worked up about it.  You can only imagine the anxiety I generated when I started getting them all day long.. I thought I was going to die just about sums it up.  After I started figuring things out and prevented the symptoms from freaking me out, I felt an improvement.  Simply being positive and not letting the symptoms not bother you will not be enough for them to go away, but getting really worked up about them will not serve you well, trust me on this one.

 

4. Exercise.  If you are able to, I would highly recommend getting some good cardio exercise frequently.  Not only is this good for your overall health, but it really does help combat benzo withdrawal.  I hit the gym about 4 times a week during withdrawal and did a mix of cardio and weights for about an hour and almost always felt better to some degree.

 

I could go on and on with more tips, but what I have mentioned really helped me the most.  I wish you the best of luck as you move forward.

 

-Erik

[[so...]]

excellent advice.

st

[[St...]]

I agree with softtail Erik, excellent post and one I'll keep coming back to to reread. Kudos to everyone here who has offered their support and given advice. It's nice to know I'm not alone or experiencing something unique to me.

 

The wisdom of not jumping on the taper wagon too soon became apparent this morning when I woke up with some anxiety. Thanks Bevoir   I'm going to keep my limit to 2 pills although I might take them later or maybe spread them out. Yesterday I took 1 @ 1 PM and the other @ 6 PM. (My rationale was that if I took it right before bed it would wear off 5-some hours later and I'd be tossing & turning and I obvious still have that 5-hour apart mindset that I used when taking 3X day). Anyway, that's my current status. I can't say enough about the encouragement y'all have given me. I know it'll be a battle at times but having taken the time to read some posts here I can see that my situation could have been worse. The courage of those who fight the battles and support they are given here is really inspiring. 

[[...]]

Steve,

 

I'm so glad you found my advice useful.  It took me 2-3 months of intense suffering to learn most of that stuff.  None of the doctors I went and saw along the way even considered that I could be having interdose withdrawal as a reason for many of my symptoms.

 

As far as spacing your doses out, I would advise against only spacing them out 5 hours if you're taking this drug 2X a day.  You'll probably feel pretty good in your waking hours, but will be more likely to wake up in the middle of the night with anxiety.  If I were you, I would consider spacing your doses out as evenly in the day as possible.  If you take a dose 2X a day, spread them out 12hrs apart.  If you take a dose 3X a day, spread them out 8hrs.  When I was taking this stuff once a day, I remember taking a 1mg dose at around 3 or 4pm and woke up in the middle of the night at around 4am with unexplained anxiety and shaking.

 

Look at it this way, you have X amount of this drug in your blood and your brain needs X amount in order to be happy at all times.  The better you maintain a constant level, the better off you'll be.  Sleep is also very important, which is why I opted to take my doses at 11am and 11pm.  This way, I ensured I would sleep OK.  After waking up, it would sometimes be a little hard making it to 11am, but I'd manage to pull it off most of the time and do alright for the day.  I think 3X a day was a little easier on me looking back come to think of it, but not by much.

 

Also.. when you cut these pills (if you're dry cutting), make the best possible cut you can.  I can assure you that your body won't be fooled by taking a half that isn't quite a half.

 

Good luck,

Erik

[[St...]]

...As far as spacing your doses out, I would advise against only spacing them out 5 hours if you're taking this drug 2X a day.  You'll probably feel pretty good in your waking hours, but will be more likely to wake up in the middle of the night with anxiety.  If I were you, I would consider spacing your doses out as evenly in the day as possible.  If you take a dose 2X a day, spread them out 12hrs apart.  If you take a dose 3X a day, spread them out 8hrs.  When I was taking this stuff once a day, I remember taking a 1mg dose at around 3 or 4pm and woke up in the middle of the night at around 4am with unexplained anxiety and shaking.

 

Look at it this way, you have X amount of this drug in your blood and your brain needs X amount in order to be happy at all times.  The better you maintain a constant level, the better off you'll be.  Sleep is also very important, which is why I opted to take my doses at 11am and 11pm.  This way, I ensured I would sleep OK.  After waking up, it would sometimes be a little hard making it to 11am, but I'd manage to pull it off most of the time and do alright for the day.  I think 3X a day was a little easier on me looking back come to think of it, but not by much.

 

This certainly makes sense and is what Ill do from here on out.

 

Also.. when you cut these pills (if you're dry cutting), make the best possible cut you can.  I can assure you that your body won't be fooled by taking a half that isn't quite a half.

 

Good luck,

Erik

 

Thanks again Erik for your advice/support. I'm not looking forward to pill-splitting but will try that first. I'm planning, once I'm comfortable with my current dose,  on trying to reduce by 25% every 2 weeks which would have me cutting those pills in half. I think I can handle that but if it's problematical or the .25 reduction is too steep I'll have to do the titration thing.

 

All in all I'm feeling pretty good right now. We'll see what happens when I take my doses 12 hours apart.

[[...]]

Very good, I wish you the best of luck.

 

One last tip when you're tapering.  There is some controversy on how much to taper, and how fast.  Some say 10% every 2 weeks, some say more.  Some say wait 1 week between tapering, some say 1-2 weeks, or more.  At the end of the day, you should talk to your doctor about your plans to taper and come up with a good plan.  I ended up dry cutting 0.125mg every 2 weeks myself and found success.  If you end up cutting at the same amount/rate I did, try to take the same amount at each dose.  In other words, if you're at 0.5mg and taking 0.25mg twice a day, I would consider doing 0.125mg 3X a day when you're at 0.375mg instead of taking 0.125mg on one dose and 0.25mg on another.  Remember, the name of the game is keeping the drug level from fluctuating too much.  And yes... 0.125mg more in a dose can be enough to cause some problems.

 

-Erik

[[St...]]

Very good, I wish you the best of luck.

 

You've been a lot of help and I haven't really even started, although I suppose my consistent 1 mg a day could be considered a "taper" from the 1.5 mg I was taking. The irony is, looking back, the anxiety I started experiencing after I stopped was worse than what prompted me to take the dang things in the first place! The lesson I learned, outside of how fast Lorazepam can become a problem, is that the anxiety/stress I feel doesn't need an easy crutch. Some anxiety in life is unavoidable and the way to deal with it is to analyze those feelings and determine what is natural and what is over the top. If I blow things out of proportion then it's my thinking that has got to change. Pills won't do that for me. Heck, if there's a positive to all this it's that I found "natural" anxiety to be a 'walk in the park' compared to a pharmacological-induced one and I probably was only getting a taste of what long-term users have to go through.

 

One last tip when you're tapering.  There is some controversy on how much to taper, and how fast.  Some say 10% every 2 weeks, some say more.  Some say wait 1 week between tapering, some say 1-2 weeks, or more.  At the end of the day, you should talk to your doctor about your plans to taper and come up with a good plan.  I ended up dry cutting 0.125mg every 2 weeks myself and found success.  If you end up cutting at the same amount/rate I did, try to take the same amount at each dose.  In other words, if you're at 0.5mg and taking 0.25mg twice a day, I would consider doing 0.125mg 3X a day when you're at 0.375mg instead of taking 0.125mg on one dose and 0.25mg on another.  Remember, the name of the game is keeping the drug level from fluctuating too much.  And yes... 0.125mg more in a dose can be enough to cause some problems.

 

-Erik

 

One of the reasons I decided to try a 25% reduction every 2 weeks is the short amount of time I've been taking Ativan. Today marks one month exactly since I began this odyssey and, as long as it's not debilitating, I'm prepared for some discomfort when I reduce. I'm not going to be foolish though, if 25% is too difficult I'll go the 10% route.

 

 

[[...]]

You've been a lot of help and I haven't really even started, although I suppose my consistent 1 mg a day could be considered a "taper" from the 1.5 mg I was taking. The irony is, looking back, the anxiety I started experiencing after I stopped was worse than what prompted me to take the dang things in the first place! The lesson I learned, outside of how fast Lorazepam can become a problem, is that the anxiety/stress I feel doesn't need an easy crutch. Some anxiety in life is unavoidable and the way to deal with it is to analyze those feelings and determine what is natural and what is over the top. If I blow things out of proportion then it's my thinking that has got to change. Pills won't do that for me. Heck, if there's a positive to all this it's that I found "natural" anxiety to be a 'walk in the park' compared to a pharmacological-induced one and I probably was only getting a taste of what long-term users have to go through.

You are 100% right.  Normal anxiety usually comes and goes and is more situational.  The anxiety we feel from withdrawal is constant, intense, and relentless.  If you have no real reason for the anxiety, chances are you're feeling the w/d effects of the drug.  So ironic that an anti-anxiety medication would actually make your condition worse.  Not knowing any of this made me really affraid for my life during the first couple of months of use.  Shame on our doctors for not warning us and handing this stuff out like candy.

 

I think you're going to do just fine.  Just go at a pace you can handle and hopefully get your doctor's support too.  If things get too rough, slow down.  While I don't think there is any proof of this, I think those who taper too fast or c/t have a greater chance of suffering longer once they're off.  Almost everyone on here would usually recommend a safe, slow taper... even if you've only been on the drug for a month.

 

-Erik

[[sh...]]

Hi

I was a short term user of Ativan and then Valium....and when I stopped Valium C/t at 2mg I spent the next month really suffering.  I still am not close to myself, but I am improving and feeling markedly better. I know now that c/t was a stupid thing to do, but no one told me (not even the dr that prescribed 3Xs that amount for pretty much an unlimited time)  Point here is that you cant underestimate the degree of withdrawal effects even after a short term usage.  Most people will tell you that you might have some difficulty, but even my family doc who told me I would be sick for a while thought it would be shorter.  Only by visiting this site and noting how many other short term users had withdrawal effects that were longer than they used the drugs did I find some comfort and realize that it might be longer than I expected and I just had to hold on. So take your time if you need to, keep yourself safe, and know you can do this.

 

ONe thing that helped me was having my neighbor, a hospice nurse, take my blood pressure and heart rate and listen to my lungs every few days.  It helped assure my racing mind that I was not physically ill.  If the neighbor wasnt available, I would have paid my copay and visited the doc every week just to have this done.  That was important because I had to keep reassuring myself that I was ok and just had to get through this.  Right now I am busy obsessing about my neighbors new dog that showed some aggression towards my kids....sure it is something to be worried about, but even I know I am over the top.  So a month out, the brain still has a way to go.

 

All my best to you

Shelly

 

[[An...]]

Agree.  I was on Xanax for 12 days then 12 day valium wean. Also jumped off at 2mg. This was on my psychiatrist's instruction (Priory Clinic, London - film-star rehab). Suffered badly with full-blown withdrawals.  Probably best to taper.  I don't regret way I did it as hated being on the Valium.  Good luck with the Ativan wean.

[[St...]]

Hi

I was a short term user of Ativan and then Valium....and when I stopped Valium C/t at 2mg I spent the next month really suffering.  I still am not close to myself, but I am improving and feeling markedly better. I know now that c/t was a stupid thing to do, but no one told me (not even the dr that prescribed 3Xs that amount for pretty much an unlimited time)  Point here is that you cant underestimate the degree of withdrawal effects even after a short term usage.  Most people will tell you that you might have some difficulty, but even my family doc who told me I would be sick for a while thought it would be shorter.  Only by visiting this site and noting how many other short term users had withdrawal effects that were longer than they used the drugs did I find some comfort and realize that it might be longer than I expected and I just had to hold on. So take your time if you need to, keep yourself safe, and know you can do this.

 

Thanks for your encouragement. I think I'll do fine. I got a taste of what you went through when you went c/t and admire you for hanging in there. The way I look at this is I'm going to stop. I'm hoping my 1/4 every 2 weeks works but if it doesn't I'll just adjust my taper. I know I can depend on fine people like you to give me a shoulder to lean on when I have a bad day and the experience to give me constructive advice when needed.

 

ONe thing that helped me was having my neighbor, a hospice nurse, take my blood pressure and heart rate and listen to my lungs every few days.  It helped assure my racing mind that I was not physically ill.  If the neighbor wasnt available, I would have paid my copay and visited the doc every week just to have this done.  That was important because I had to keep reassuring myself that I was ok and just had to get through this.  Right now I am busy obsessing about my neighbors new dog that showed some aggression towards my kids....sure it is something to be worried about, but even I know I am over the top.  So a month out, the brain still has a way to go.

 

Don't be so hard on your brain Shelly. Your concerns about an aggressive dog with regard to your children shows me that your brain is in the RIGHT place!

 

All my best to you

 

Ditto Shelly. 

[[St...]]

Agree.  I was on Xanax for 12 days then 12 day valium wean. Also jumped off at 2mg. This was on my psychiatrist's instruction (Priory Clinic, London - film-star rehab). Suffered badly with full-blown withdrawals.  Probably best to taper.  I don't regret way I did it as hated being on the Valium.  Good luck with the Ativan wean.

 

Thanks. Good luck to you. 

[[St...]]

Well, after 14 days of "stabilizing" on 1 mg. of Ativan (no problems during this period) I'm ready to start my taper today. Like I said earlier I'm going to cut one of my 0.5 mg pills in half and take 1½ pills (0.75 mg) daily instead of 2. I aim to do this for 2 weeks and then do the same thing with the 2nd pill, etc. I'll post in the 'taper' fora with any thoughts, concerns, questions I might have.

[[Pa...]]

It's good to hear you've stabilized, and that you've not felt bad.  Your plan sounds good, but if you feel too bad, you could cut one of your .5 mg pills in quarters and cut by .125.