Recommended lorazepam jump dose?

[[bi...]]

Hello. I am currently taking 0.5 mg of lorazepam three times a day. I take my first dose at 9 AM my second dose at 3 PM and my third dose at 9 PM at night. I originally was prescribed this medication in January 2023 at 0.5 mg three times a day by the time March came around my Dr. had me up to 6 mg a day, 2 mg three times a day. Now I’m finally back to my starting dose. Just curious at what dose is safe to jump off at? My next cut will be my afternoon dose then after a week or two my morning dose then afterwords my night dose until I’m down to 0.25 for all three doses. Just curious what a safe dose to jump off of lorazepam is recommended? I don’t want to drag this out longer than I have to but I still want to be safe! At some point should I go down to only two doses a day? Like 12 hours apart? Then once a day? I know I hear a lot of people say slow and steady wins the race but I definitely don’t want to drag this out longer than I need to. Any advice anyone can give would be greatly appreciated
 

0.5 - 0.25 - 0.5 (stay for a while)

0.25 - 0.25 - 0.5 ( stay for a while)

0.25 - 0.25 - 0.25 (stay for a while)

[[je...]]

Hi @[bi...]

I know exactly how you feel. Everyone of us who started tapering just wanted to get it over and done with. Unfortunately getting off the drug is just the first step, once you're off you are very likely to still have withdrawal symptoms for quite some time after that. It can take anything from 12-24 months after jumping to fully recover. 

If you are functional and your taper is manageable then you also have a better chance that your recovery after jumping will be functional and you won't be suffering. 

The plan you've proposed look very risky to me. It's a linear taper meaning with each 0.25mg reduction your percentages keep increasing. We usually recommend cuts of no more than 5-10% of each new total daily dose every two weeks.

You can do it fast and suffer tremendously or you can do it slowly and have some level of quality in your life. I unintentionally had too big cuts and I suffered at the start. I became bedridden and couldn't function at all. I wouldn't wish that on anyone. But once I knew how bad it could get, I understood why it was important to take it slow. I really don't want to see you go through what I went through. 

[[bi...]]

Thank you for replying @[je...]. If I could measure out exactly a 10% cut, which I don’t know how to do I would do that as the Ashton manual recommends. I don’t know how to cut the pills up to odd mg dosages

[[bi...]]

@[je...] For example, if I did a 10% cut on my current dosage, which is 0.5 three times a day, my dosages would have to be 0.45 and I don’t know how to make that dosage   

[[je...]]

 

Most people use a jewelers scale to weigh their pills and then shave off 10%. Jewelers scale can be bought on Amazon and are around $20-30 if I'm not mistaken. Then you use a nail file or something similar to shave it. There are videos on YouTube that shows you how to do it. 

How it works is, you would weigh ten of your 0.5mg pills and get the average weight for a 0.5mg pill. Then you multiply the average weight by 3 (because you take 3 pills a day). You are now going to work in grams because you work with the weight of the pill, not the weight of the active ingredient (how much Lorazepam is contained in the pill which is measured in mg). Deducting 10% of the weight of the pill is the same as if you're deducting 10% of the active ingredient. (Please let me know if you're not understanding the difference between pill weight and active ingredient weight).

If you want to deduct 10% then you multiply the total weight of your daily dose by 90%. 

Because different benzo's have different weights (I was on Clonazepam and I don't know how much yours weigh), I'm going to include this great example from another member with actual numbers, so you have a better understanding of how to calculate the maths:

 

On 26/08/2023 at 19:52, [[W...] said:

 

If one of my 2mg valium tabs weighs an average of 0.172grams, then 5 1/2 tablets (11mg) weighs 0.946grams. I did that in my head, but your tablets may weigh slightly different weight, so you would simply weigh 5 1/2 tablets on the jewellers scale for the total weight. Keep in mind that doing it this way you are no longer calculating in terms of API (active pharmaceutical ingredient), but simply calculating percentages based on weight of the tablets. 

If you want to calculate 5% of that 0.946grams, you would simply multiply… 0.946 x 95% using the calculator on your phone = 0.8987 (forget about the 7 as it’s an inconsequential weight with Valium and only complicates the equation with benzo brain). So, the reduction will be 0.048…. 0.946g down to 0.898.g

So, you would simply shave or file 0.048g from one of your tablets, or even the half (1mg) tablet which would have a total weight of 0.086g, half of 0.172g. If you discard 0.048g from that 0.086g half (1mg) tab, it leaves you with 0.038g to add to your other 5 x 2mg tablets, a tottal daily dose of 0.898. You have reduced by 5%. 

You would simply recalculate that 5% again before each new reduction from your remaining total daily dose to get your new total daily dose.

‘If you wanted to reduce by 10% rather than 5%, then you would multiply total weight of your dose (at the moment 0.946) by 90%.… 0.946 x 90% = 0.8514(drop the 4…inconsequential), so you would simply shave or file your dose down by 0.095 from 0.946g to 0.851g.

 

 

[[bi...]]

Thank you very much @[je...] for your replies, and your help. I’m going to purchase a scale

I did want to ask you a question or anyone else here who may see this. I started my prescription of lorazepam in January of this year and at my fifth and a half month I started my taper at one point I was up to 6 mg a day (prescribed 2mg 3x’s a day). Now I’m currently down to 0.5 mg three times a day. My question is, would it even make sense to switch over to valium right now, or just continue on with only lorazepam since I’ve gotten this far???

[[je...]]

When you started your taper, from what dose did you start reducing?

[[bi...]]

40 minutes ago, [[j...] said:

When you started your taper, from what dose did you start reducing?

 

@[je...]

(Jan was 0.5mg pills) (Feb was 1mg pills)

It averaged out to be about 6mg a day (March April may June), my prescription was for 2 mg pills three times a day. Maybe one less pill on certain days or one extra pill on other days.

But to answer your question 6 mg 

I learned the hard way that I was physically dependent. I was never on an official schedule “until” I started my taper. Every time I picked up my refill, I always had some pills left over. I would just take it as needed, which ended up being every day though. I just remember one morning the room was spinning. I had vertigo pretty bad. First thing I thought about was the Ativan pills because I hadn’t taken any in a few days. I thought to myself I wonder if this is from the ativan. 
 

My pharmacist said that it’s not a guarantee if I cut these 0.5 mg pills in half that it will be an even 0.25 since they aren’t scored. I do have 1 mg pills that are scored and also 2 mg pills that are scored.

 

[[je...]]

What symptoms did you have when you tapered down to 0.5mg? Apologies for all these questions, but you tapered down from a fairly high dose in a short amount of time, so I'm just trying to understand how your body is reacting to your cuts.

[[bi...]]

1 hour ago, [[j...] said:

What symptoms did you have when you tapered down to 0.5mg? Apologies for all these questions, but you tapered down from a fairly high dose in a short amount of time, so I'm just trying to understand how your body is reacting to your cuts.

Hi @[je...]

I’ve had headaches and head pressure and feeling blah. I feel better when I cut out the refined carbs and sugars and I exercise. I don’t mind you asking any questions at all  I just don’t want to prolong this taper if it doesn’t have to be I understand that the lower the better and even to zero if I can, but I’m just wondering what a safe dose would be to jump off. I know I’m far from jumping off, I’m just wondering what doses people have jumped off of lorazepam at  

 

[[je...]]

@[bi...], if you've managed to reduce this much in about three months and you're functional, you might be able to go a bit faster in your taper. 

There is no hard or fast rule for jumping - it really depends on the individual. Most people (who don't want to taper down to zero) seem to follow Prof Heather Ashton's guidelines. She said people can jump between 0.5mg-1mg of Valium. According to this conversation calculator 0.05mg Lorazepam equals 0.5mg Valium. I jumped from Clonazepam at the the Valium equivalent of 0.5mg.

[[he...]]

Hey @[bi...], I would agree with jelly baby that you can probably go faster than the recommended guidelines with as quickly as you’ve tapered already and as well as you’ve tolerated it. I’m actually having a headache and head pressure today at 16 weeks off clonazepam. 

[[bi...]]

It’s so frustrating to want to stop these pills so badly but knowing I can’t just stop them cold turkey sucks. I swear at this lower dose they are effecting the left side of my “jaw” to the point that it feels like my back bottom crowned molar needs work but I’ve been into the dentist twice and my teeth are fine. So frustrating and uncomfortable discomfort  

[[Br...]]

Jaw pain is a common withdrawal symptom.  The Ashton Manual, Chapter III. https://www.benzoinfo.com/ashtonmanual/chapter3/  talks about how benzos are effective muscle relaxers. When we stop benzos, our muscles have to readjust which can create all kinds of symptoms including jaw pain. Remember, it's temporary and will ease up as you heal.

[[je...]]

You could attempt your original taper plan and cut every 2 weeks as Lorazepam has a fairly short half-life so you should be able to determine pretty early on, if it's too fast. We would not generally recommend it, but I didn't understand you tapered down from 6mg to 1.5mg in such a short time. I thought you were only taking 6mg occassionally. At the last step, we can re-evaluate how you're feeling. I wouldn't jump there.

On 30/08/2023 at 04:58, [[b...] said:

0.5 - 0.25 - 0.5 (stay for a while)

0.25 - 0.25 - 0.5 ( stay for a while)

0.25 - 0.25 - 0.25 (stay for a while)