Help Ativan taper

[[Ma...]]

Hi posting this here again for some help! 
Iv been on daily Ativan since June-July. 
im down to 0.21-0.22 mg dry cutting once daily. I am unsure if I’m having interdose withdrawals. I am extremely sensitive and dropping 0.01 mg is sending me in acute intolerable wirhdrawal for about 2 weeks. I feel I need to split my doses but not sure what the best way to do it is. I’m also super worried to switch to water taper. Should I do compounding pharmacy? 

[[El...]]

I am certainly not an expert.  I am also on Ativan, but much further behind you in my taper.  Do you mean you make 0.01 mg cuts all at once?  If so, that is almost a 5% cut.  Perhaps you could make smaller cuts of 0.001 mg or a 0.5% cut.  This might be easier on you CNS.  Just a thought...particuly since you are at such a low dose and each 5% cut may have much more of an impact.

Wishing you the best!

[[Ma...]]

6 minutes ago, [[E...] said:

I am certainly not an expert.  I am also on Ativan, but much further behind you in my taper.  Do you mean you make 0.01 mg cuts all at once?  If so, that is almost a 5% cut.  Perhaps you could make smaller cuts of 0.001 mg or a 0.5% cut.  This might be easier on you CNS.  Just a thought...particuly since you are at such a low dose and each 5% cut may have much more of an impact.

Wishing you the best!

If I did it like that, wouldn’t that take me literally years to come off of like four months of Ativan use? And how do I do this ? I’d need to liquid taper. Any tips on this 

Edited October 26, 2023 by [Ma...]

[[El...]]

What a quick reply!  If I were you, and again I am not an expert, I would first get stabilized on my current dose. Then, I would try a 0.5% cut and again wait to make sure I am stable.  Then, I might up it to a  0.75%, 1%,...etc.  I think, for me, it is always best to get stabilized, then start with small incremental cuts, moving back up to larger incremental cuts.

I know it is a dismal thought to prolong the agony.  But, I just try to remind myself that I would rather get most of the healing done while I can still rely on some medication to keep me stable.  And if you slow down now, you might be able to resume your current pace later.

I do not really understand your question about splitting doses.  Do you think you will feel worse?  The only way you will be able to tell, as far as I know, is to try.  Unfortunately, you are the guinea pig in this experiment!  You could split your dose in half and take each dose 12 hours apart.  Wait a week or so to see if it helps.  Your body will certainly let you know.  If the half-life is somewhere in the vicinity of 12 hours, after 12 hours you only have 0.11 mg in your system (assuming .22 mg dose).  After 24 hours, you have about 0.055 mg - approahing a non-theraputic dose. So, perhaps that is why you are experiencing interdose withdrawal.

Again, hoping all the best for you!

[[Ma...]]

5 minutes ago, [[E...] said:

What a quick reply!  If I were you, and again I am not an expert, I would first get stabilized on my current dose. Then, I would try a 0.5% cut and again wait to make sure I am stable.  Then, I might up it to a  0.75%, 1%,...etc.  I think, for me, it is always best to get stabilized, then start with small incremental cuts, moving back up to larger incremental cuts.

I know it is a dismal thought to prolong the agony.  But, I just try to remind myself that I would rather get most of the healing done while I can still rely on some medication to keep me stable.  And if you slow down now, you might be able to resume your current pace later.

I do not really understand your question about splitting doses.  Do you think you will feel worse?  The only way you will be able to tell, as far as I know, is to try.  Unfortunately, you are the guinea pig in this experiment!  You could split your dose in half and take each dose 12 hours apart.  Wait a week or so to see if it helps.  Your body will certainly let you know.  If the half-life is somewhere in the vicinity of 12 hours, after 12 hours you only have 0.11 mg in your system (assuming .22 mg dose).  After 24 hours, you have about 0.055 mg - approahing a non-theraputic dose. So, perhaps that is why you are experiencing interdose withdrawal.

Again, hoping all the best for you!

The problem is I’m not stable Iv been trying to stabilize for 6 months. My issue is a little complicated. I went on Ativan due to severe SSRI withdrawal. I am now in protracted SSRI withdrawal. And I would much rather just be in that then be stuck on a benzo because it is not helping, it is paradoxical, and I am in tolerance and updosing didn’t work. 
 

thanks for your comments! The thing with splitting is, now when I reach 12 hours later I am hitting .11 and withdrawing. If I split my dose, every 12 hours I will hit 0.055 mg instead of just once a day.. do you know what I mean? 

[[El...]]

Again, I am not an expert.  But, it seems like with one dose a day, at such a low dose, you are never achieving a steady state and I do think our bodies craves consistency.  For example (I made a chart..hope it is clear), only considering 3-half lives... (Caviot-I was a chemistry professor at a small university for 25 years and used to teach half-life.  This is really a simplistic representation of what happens.)

One dose per day.                                                                            Total dose

0 hrs.         .22 mg.                                                                            .22 mg

12 hrs.       .11 mg.                                                                              .11 mg

24 hrs.      .055 mg.          .22 mg.                                                    .275 mg

36 hrs.      .0275 mg.        .11 mg.                                                     .1375 mg

48 hrs.          ---                .055 mg.         .22 mg.                            .275 mg

60 hrs.          ---                .0275 mg.        .11 mg.                            .1375 mg

72 hrs.          ---                   ---                 .055 mg.      .22 mg.      .275 mg

So, your dose jumps from .1375 mg to .275 mg on a daily basis

If you dose 2/day..

0 hrs.              .11 mg.                                                                                               .11 mg

12 hrs.            .055 mg.         .11 mg.                                                                       .165 mg

24 hrs.           .0275 mg.        .055 mg.        .11 mg.                                                .1925 mg

36 hrs.             ---                  .0275 mg.      .055 mg.      .11 mg.                           .1925 mg

48 hrs.             ---                    ---                .0275 mg.    .055 mg.     .11 mg.       .1925 mg

Your dose reaches steady state.

Anyway, I would be inclined to try the steady state to see if you can stabilize.

So very, very sorry you are experiencing this.

Edited October 26, 2023 by [El...]

[[Ma...]]

16 hours ago, [[E...] said:

Again, I am not an expert.  But, it seems like with one dose a day, at such a low dose, you are never achieving a steady state and I do think our bodies craves consistency.  For example (I made a chart..hope it is clear), only considering 3-half lives... (Caviot-I was a chemistry professor at a small university for 25 years and used to teach half-life.  This is really a simplistic representation of what happens.)

One dose per day.                                                                            Total dose

0 hrs.         .22 mg.                                                                            .22 mg

12 hrs.       .11 mg.                                                                              .11 mg

24 hrs.      .055 mg.          .22 mg.                                                    .275 mg

36 hrs.      .0275 mg.        .11 mg.                                                     .1375 mg

48 hrs.          ---                .055 mg.         .22 mg.                            .275 mg

60 hrs.          ---                .0275 mg.        .11 mg.                            .1375 mg

72 hrs.          ---                   ---                 .055 mg.      .22 mg.      .275 mg

So, your dose jumps from .1375 mg to .275 mg on a daily basis

If you dose 2/day..

0 hrs.              .11 mg.                                                                                               .11 mg

12 hrs.            .055 mg.         .11 mg.                                                                       .165 mg

24 hrs.           .0275 mg.        .055 mg.        .11 mg.                                                .1925 mg

36 hrs.             ---                  .0275 mg.      .055 mg.      .11 mg.                           .1925 mg

48 hrs.             ---                    ---                .0275 mg.    .055 mg.     .11 mg.       .1925 mg

Your dose reaches steady state.

Anyway, I would be inclined to try the steady state to see if you can stabilize.

So very, very sorry you are experiencing this.

You are amazing!! I have been trying to get someone to explain this to me for weeks. I was asking about area under the curve yada yada it’s just very hard for me to understand. With the second example though, doesn’t it still bounce between .0275 too .1925? So technically it’s still a lower dose all and all versus once a day? It’s just the peak that’s reaching steady state but it’s constantly falling close to zero. I take Lunesta at 9 pm so I take the Ativan at 6 am, start feeeling cruddy at 6:30 and then 9pm I’m out like a light because Lunesta which is benzo like. I know I hate all these meds

 

also, are you liquid tapering by any chance? 

Edited October 27, 2023 by [Ma...]

[[El...]]

Hi

Hope you are feeling better today.

I have thought about you questions in your last post...so I did some additional calculations. Since most medications are eliminated from your body in 5.5 half lives (about 60 hours in the case of Ativan), I did more extensive calculations through 5 half lives to get a better idea of what was happening.  The numbers will be different because I have included all the available half live concentrations.  Do be aware, however, that medications can be eliminated more quickly or more slowly depending on many factors.  Some of these include: age, sex, weight, diet, hydration, interaction with other medications a person might be taking, general health, the acidity of your body chemistry, how the drug is eliminated -by lungs, kidneys or liver, etc., etc.

ONE DOSE/DAY CONCENTRATION

0 hrs.    .22 mg

12 hrs.   .11 mg

24 hrs.   .275 mg

36 hrs.   .1375 mg

Immediately before 48 hrs dose -  .06875 mg

48 hrs.    .2888 mg. This is 31% greater than you dosage for the day...essentially an up-dose.

60 hrs.    .1444 mg. Ever decreasing.

Immediately before 72 hrs dose - .06875 mg.  This is a decrease in dosage of 76% during the last 24 hours.  Near non-theraputic level.

72 hrs.     .2888.   So now you have gone from a decrease of 76% added to an increase of 31% or about a 100% change in serum levels over 24 hours.  Surely, this would cause interdose withdrawal and withdrawal symptoms.

 

TWO DOSES/DAY CONCENTRATION

0 hrs.     .11 mg

12 hrs.    .165 mg

24 hrs.    .1925 mg

36 hrs.    .2063 mg

Immediately before 48 hrs dose - .1031 mg.  1/2 of dose at 36 hours, but still only 3% less than .11 dose.

48 hrs.    .2131 mg.  Up-dose of 11% as compared to 31%.  Still only 3% difference for entire day's dosage.

Immediately before 60 hrs dose - .1035.  Same as before 48 hrs dose.

60 hrs.     .2135 mg

Immediately before 72 hrs dose - .1035 mg.  As long as your dosage for the day remains at .22 mg, you serum level will never decrease below .1035 mg.

72 hrs.     .2135 mg.  As long as your dosage for the day remains at .22 mg, your serum level will not increase above .2135 mg.

So, overall, you have a smaller fuctuation, you never approach non-theaputic serum levels and you stay in the range of each individual dose of .11 mg or your total dose for the day, .22 mg.

 

Of course at some point you will have to go to one dose due to weighing difficulties, unless you go to a liquid formulation.  After my two failed attempts with a home brew liquid titration, I bough a 0.0001 gram scale.  I am hoping it will see me through the entire taper in pill form.

Again, hope you are feeling better!  I am so very sorry you are experiencing such difficulties.

 

[[Ma...]]

2 hours ago, [[E...] said:

Hi

Hope you are feeling better today.

I have thought about you questions in your last post...so I did some additional calculations. Since most medications are eliminated from your body in 5.5 half lives (about 60 hours in the case of Ativan), I did more extensive calculations through 5 half lives to get a better idea of what was happening.  The numbers will be different because I have included all the available half live concentrations.  Do be aware, however, that medications can be eliminated more quickly or more slowly depending on many factors.  Some of these include: age, sex, weight, diet, hydration, interaction with other medications a person might be taking, general health, the acidity of your body chemistry, how the drug is eliminated -by lungs, kidneys or liver, etc., etc.

ONE DOSE/DAY CONCENTRATION

0 hrs.    .22 mg

12 hrs.   .11 mg

24 hrs.   .275 mg

36 hrs.   .1375 mg

Immediately before 48 hrs dose -  .06875 mg

48 hrs.    .2888 mg. This is 31% greater than you dosage for the day...essentially an up-dose.

60 hrs.    .1444 mg. Ever decreasing.

Immediately before 72 hrs dose - .06875 mg.  This is a decrease in dosage of 76% during the last 24 hours.  Near non-theraputic level.

72 hrs.     .2888.   So now you have gone from a decrease of 76% added to an increase of 31% or about a 100% change in serum levels over 24 hours.  Surely, this would cause interdose withdrawal and withdrawal symptoms.

TWO DOSES/DAY CONCENTRATION

0 hrs.     .11 mg

12 hrs.    .165 mg

24 hrs.    .1925 mg

36 hrs.    .2063 mg

Immediately before 48 hrs dose - .1031 mg.  1/2 of dose at 36 hours, but still only 3% less than .11 dose.

48 hrs.    .2131 mg.  Up-dose of 11% as compared to 31%.  Still only 3% difference for entire day's dosage.

Immediately before 60 hrs dose - .1035.  Same as before 48 hrs dose.

60 hrs.     .2135 mg

Immediately before 72 hrs dose - .1035 mg.  As long as your dosage for the day remains at .22 mg, you serum level will never decrease below .1035 mg.

72 hrs.     .2135 mg.  As long as your dosage for the day remains at .22 mg, your serum level will not increase above .2135 mg.

So, overall, you have a smaller fuctuation, you never approach non-theaputic serum levels and you stay in the range of each individual dose of .11 mg or your total dose for the day, .22 mg.

Of course at some point you will have to go to one dose due to weighing difficulties, unless you go to a liquid formulation.  After my two failed attempts with a home brew liquid titration, I bough a 0.0001 gram scale.  I am hoping it will see me through the entire taper in pill form.

Again, hope you are feeling better!  I am so very sorry you are experiencing such difficulties.

Wow this is incredible info ! Thank you so so much for spending this time to do this for me. I seriously appreciate this so much. If I may ask, where did you purchase this scale? And because my serum levels are so all over the place now, I wonder if splitting twice daily I will develop severe withdrawals? Or do you think because my level is going between so high and so low now, I shouldn’t notice a huge difference. I know you can’t forsee the future lol. Again, thank you SO MUCH

 

also..is there a way to learn how to do this? I’m trying to figure it out for my ssri too but I’m so confused!! I looked for a calculator online lol. I’m an np and man not good at math clearly 

Edited October 28, 2023 by [Ma...]

[[El...]]

I am glad the information was useful.  In fact, I really enjoyed doing the calculations.  I could almost hear my past students in my mind saying, "Dr. M., stop, stop, stop with the calculations!"  They loved to tease me about my "mad" calculating!  It made me realize how much I miss my students and teaching!

Anyway, if it were me, I would be inclined to try splitting the dose.  If you do, wait a week or so and see how you feel.  You will never know if it will work unless you try it.  Your body will tell you soon enough if it is not working.  Just don't try to reduce your dosage at the same time.  If you put 2 variables in there and you don't feel well, you will not know which is causing the problem.  I also would not taper the ssri while you are tapering the Ativan.  I only sleep 3-4 hours per night due to this taper.  So, you don't want to add lack of sleep on top of all your current discomfort.  Anyway, I looked up your ssri and I could easily do the calculations if you would like me to.  

I bought my scale for about $300 on eBay.  You can buy much more expensive ones, but this one has been working well for me.  I was going through a period of extreme bone, nerve and joint pain.  I really could barely walk.  I was holding for about a month when I purchased the scale.  When I first started using it, I was amazed how erratic my old jeweler's scale was compared to my new one. I was able to stabilize my dose and I started feeling better within a week or two.  But that is just me.  We are all different.  I certainly don't want to imply that you need to make an expensive purchase so that you may feel better.  We all need to decide, independently, what we think will work for us.

Keep me posted.  Hope you are improving!

[[Ma...]]

20 minutes ago, [[E...] said:

I am glad the information was useful.  In fact, I really enjoyed doing the calculations.  I could almost hear my past students in my mind saying, "Dr. M., stop, stop, stop with the calculations!"  They loved to tease me about my "mad" calculating!  It made me realize how much I miss my students and teaching!

Anyway, if it were me, I would be inclined to try splitting the dose.  If you do, wait a week or so and see how you feel.  You will never know if it will work unless you try it.  Your body will tell you soon enough if it is not working.  Just don't try to reduce your dosage at the same time.  If you put 2 variables in there and you don't feel well, you will not know which is causing the problem.  I also would not taper the ssri while you are tapering the Ativan.  I only sleep 3-4 hours per night due to this taper.  So, you don't want to add lack of sleep on top of all your current discomfort.  Anyway, I looked up your ssri and I could easily do the calculations if you would like me to.  

I bought my scale for about $300 on eBay.  You can buy much more expensive ones, but this one has been working well for me.  I was going through a period of extreme bone, nerve and joint pain.  I really could barely walk.  I was holding for about a month when I purchased the scale.  When I first started using it, I was amazed how erratic my old jeweler's scale was compared to my new one. I was able to stabilize my dose and I started feeling better within a week or two.  But that is just me.  We are all different.  I certainly don't want to imply that you need to make an expensive purchase so that you may feel better.  We all need to decide, independently, what we think will work for us.

Keep me posted.  Hope you are improving!

Oh wow. Do you mind linking me what scale you got?? Yeah I haven’t stabilized at all except for when I’m near ovulation when my estrogen levels are really high. Only time I ever can make a cut. And yeah I probably will start moving my dose 1 hour a day to get it 12 hours apart.. problem is I did that with my ssri and went into worse withdrawals which haven’t improved. I was on 20 mg viibryd daily. I split it to 10 mg twice daily. Problem is I need to take it with 400 calories and my breakfast and lunch are making me have panic/terror attacks for hours after. I really want to combine my dose again but I’m already so sensitive to the rise and fall of each dose. But it’s better than not being able to eat and essentially cold turkeying my med again. If you could do it for me for viibryd I’d be literally eternally grateful….

 

that’s how I feel with my career. I was obgyn np and had to quit becaue I’m disabled from this. I miss when my colleagues call me sometimes for advice. Makes me feel Alive again.. I’d do anything to get back to work

[[El...]]

Here is the link.  I hope it works as I am having a few problems with my computer.

https://www.ebay.com/itm/404451023985?_trkparms=amclksrc%3DITM%26aid%3D777008%26algo%3DPERSONAL.TOPIC%26ao%3D1%26asc%3D20230811123856%26meid%3D73f53d01c9e84996887bdb80d72731fe%26pid%3D101770%26rk%3D1%26rkt%3D1%26itm%3D404451023985%26pmt%3D1%26noa%3D1%26pg%3D4375194%26algv%3DRecentlyViewedItemsV2%26brand%3DUnbranded&_trksid=p4375194.c101770.m146925&_trkparms=parentrq%3A780a0fad18b0ab96cefca2e0ffff0f26|pageci%3A1c9e008d-75d3-11ee-bba9-2a488992e709|iid%3A1|vlpname%3Avlp_homepage

It seems like you have a complicated set of circumstances.  If it were me, I would concentrate on one "problem" at a time.  I think it would be hard to unravel if and when a change was working or not working if you simultaneously try to split your Ativan into 2 doses and at the same time unite your ssri into one dose.  Which case do you think is giving you the most problem-the Ativan or the ssri?  If you could decide that, that might be a good starting point (again, I am not an expert).  At any rate, I would work on one situation at a time and try to get stable with that before tackling the second situation.  I also would not be making any cuts to my Ativan until I, to some point at least, sorted myself out.

Anyway, I looked at your ssri.  It has a half life of 25 hours.  So, I am curious why you split your dose.  Assuming you are already at a steady state on your 10 mg taken 2/day, your steady state dose is 19.5 mg.  Immediately before you take your next 10 mg, you serum level would be 9.5 mg.  9.5 mg is pretty low, so perhaps that is why you feel you are in a withdrawal state.  If you were on 20 mg 1/day, you steady state serum level is 39.5 mg.  Immediately before taking your 20 mg dose, you are at 19.5 mg.  So, I can see why you would want to recombine your doses.  Have you had any input from your doctor?

I am still hoping that you are starting to feel better.  I definitely do not feel the greatest day by day and I definitely feel discouraged many times along this difficult road, but my situation is a lot more straight forward than yours.  So, I deeply sypathize with you.  Please keep me informed so I know how you are doing (and if the link worked).

Edited October 29, 2023 by [El...]

[[Ma...]]

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

Here is the link.  I hope it works as I am having a few problems with my computer.

https://www.ebay.com/itm/404451023985?_trkparms=amclksrc%3DITM%26aid%3D777008%26algo%3DPERSONAL.TOPIC%26ao%3D1%26asc%3D20230811123856%26meid%3D73f53d01c9e84996887bdb80d72731fe%26pid%3D101770%26rk%3D1%26rkt%3D1%26itm%3D404451023985%26pmt%3D1%26noa%3D1%26pg%3D4375194%26algv%3DRecentlyViewedItemsV2%26brand%3DUnbranded&_trksid=p4375194.c101770.m146925&_trkparms=parentrq%3A780a0fad18b0ab96cefca2e0ffff0f26|pageci%3A1c9e008d-75d3-11ee-bba9-2a488992e709|iid%3A1|vlpname%3Avlp_homepage

It seems like you have a complicated set of circumstances.  If it were me, I would concentrate on one "problem" at a time.  I think it would be hard to unravel if and when a change was working or not working if you simultaneously try to split your Ativan into 2 doses and at the same time unite your ssri into one dose.  Which case do you think is giving you the most problem-the Ativan or the ssri?  If you could decide that, that might be a good starting point (again, I am not an expert).  At any rate, I would work on one situation at a time and try to get stable with that before tackling the second situation.  I also would not be making any cuts to my Ativan until I, to some point at least, sorted myself out.

Anyway, I looked at your ssri.  It has a half life of 25 hours.  So, I am curious why you split your dose.  Assuming you are already at a steady state on your 10 mg taken 2/day, your steady state dose is 19.5 mg.  Immediately before you take your next 10 mg, you serum level would be 9.5 mg.  9.5 mg is pretty low, so perhaps that is why you feel you are in a withdrawal state.  If you were on 20 mg 1/day, you steady state serum level is 39.5 mg.  Immediately before taking your 20 mg dose, you are at 19.5 mg.  So, I can see why you would want to recombine your doses.  Have you had any input from your doctor?

I am still hoping that you are starting to feel better.  I definitely do not feel the greatest day by day and I definitely feel discouraged many times along this difficult road, but my situation is a lot more straight forward than yours.  So, I deeply sypathize with you.  Please keep me informed so I know how you are doing (and if the link worked).

Yeah I won’t touch both meds at once deff not. but looking at that with my viibryd holy shit. So I almost took a 50% cut in dose when I split it your saying? My psychiatrist split it because I thought I was withdrawing before my next dose. I wasn’t now that I know what was happening to me but I got much worse after I split my dose.
 

But now I’m thinking about what we were talking about with splitting the Ativan, but isn’t it same concept? Basically a 50% reduction in dose, or not really because Ativan half life is shorter. With the half life of viibryd being 25 hours he shouldnt have told me to split it. I’m so sensitive idk what to even do right now. I could work on just the viibryd moving one dose an hour a day to combine them and maybe with the higher serum levels it will help alleviate my symptoms OR the huge drop and fall could fry my brain even worse although according to what your saying it’s either going from 9.5-19.5 mg or 19.5-39.5 mg so still a 50% drop either way. My doctor has absolutely no idea and Iv tried talking to pharmacists as well.. your the only one that’s tried to make sense of this for me in the last 6 months.. 

I have no idea what step to take next. 
 

im so sorry your not feeling well. Keep your head up and keep charging forward! 🤍I’m here for you too. Why did your liquid titration fail? I was planning to switch to milk dilution taper.

Edited October 29, 2023 by [Ma...]

[[El...]]

Just a quick note, before I try my first attempt at sleep tonight.  If you think about it, at the higher dose of your ssri, even if are down a 50% drop, you still are almost at your daily dosing weight of 20 mg.  Whereas, if you dosing 2/day, you are at 1/2 of your total dosing amount for the day and never even get up to a 20mg steady state even after you take your second dose.  And you are correct, this is the difference between drugs with short half lives (like Ativan) and drugs with a longer half life. With longer half life drugs, you generally do not need to dose as often to keep an elevated serum level.  Shorter half life drugs require more frequent dosing to maintain theraputic levels.  I am not a medical doctor, but it does confuse me that your doctor split your dose on such a long acting ssri??  Anyway, if you take that route, please take it slowly and gently.  The aim is to be as comfortable and functional as possible, not to give your body another shock.

Sleep well...

[[Ma...]]

12 hours ago, [[E...] said:

Just a quick note, before I try my first attempt at sleep tonight.  If you think about it, at the higher dose of your ssri, even if are down a 50% drop, you still are almost at your daily dosing weight of 20 mg.  Whereas, if you dosing 2/day, you are at 1/2 of your total dosing amount for the day and never even get up to a 20mg steady state even after you take your second dose.  And you are correct, this is the difference between drugs with short half lives (like Ativan) and drugs with a longer half life. With longer half life drugs, you generally do not need to dose as often to keep an elevated serum level.  Shorter half life drugs require more frequent dosing to maintain theraputic levels.  I am not a medical doctor, but it does confuse me that your doctor split your dose on such a long acting ssri??  Anyway, if you take that route, please take it slowly and gently.  The aim is to be as comfortable and functional as possible, not to give your body another shock.

Sleep well...

Why did your liquid taper not work and what medium were you using? Thank you so much for your help.. I hope you sleep well and continue to get better !! 🤍🤍

Edited October 29, 2023 by [Ma...]

[[El...]]

Slept 5 hours last night!  Felt great.

I first tried a plant-based milk taper in June.  I am lactose intolerant, so I could not use milk.  But someone had said that the Ativan could be suspended in plant milk as well as dairy milk, so I used Ripple, a pea-based "milk". But, there were so many variables during this time, I suppose I cannot say it was a failure, because of all the variables.  I was still using my old scale and I was only trying to dissolve part of a pill, so even though I was very careuly measuring with a syringe, I was really not sure of my original concentration-one variable.  I absolutely detested the taste of the Ripple.  It made me literally gag-second variable.  I, foolishly tried to reduce my dose, before getting used to the initial dose in the Ripple first.  In other words, I did not try to get stable before reducing-third variable.  Since the pill is the same color as Ripple, even though I crushed the pill finely and shook the mixture reapeadedly, I was never sure I was getting an accurate dose-fourth variable.  And overall, I just felt awful-terrible leg  and joint pain, vision problems, pounding headaches, insomnia, teeth and jaw pain, tittitus, etc.  So, I went back to pill form, but I still did not stabilize.

I tried again with water in about mid-July. Because I felt so unstable I was willing to try again.  Still had the problem with the scale.  But, this time I did hold my dose (as much as the scale would allow) for 2 weeks before starting to reduce.  But by 8/8, I was in agony with terribly severe nerve, bone, and joint pain.  So, I ordered the scale.  When the scale came, I still tried to titrate with the water mixture, and even though I felt my dose was accurate, my symptoms were not improving.  I was even only doing my afternoon dose as a titration and keeping the pills in the morning and evening.  In early September, I went back to all pills.  I held for a week or so.  I got stable fairly quickly, and all my nerve, bone and joint pain just vanished.  I really haven't had any type of that pain at all since then.  I started to reduce again, I think, mid September and have been doing so at a fairly regular pace since then.  I am doing a daily microtaper, keeping my reduction at 10-12% every 4 weeks.  I am not sure how long I will be able to keep this pace.  In the last week, my tittitus, headaches, and "weepiness" have become pretty acute.  I am currently holding for a week to try to get these back under control.  Since others on this site have recommended inserting regular holds while doing this type of taper to allow your CNS  to "catch up", as soon as I am stable again and reducing I will probably introduce a short hold after every 5% reduction.

So, I don't know whether my home-brews were just not accurate or I can't tolerate the medicine in any other form?  I am scared to go to the formulated liquid because of my problems with my own liquids.  I am sure hoping I can use the scale all the way down.

Hope that long-drawn out explanation helps.  But, again, you should not make your decisions based on what happened to me.  Again, hope you are feeling better.

[[Ma...]]

25 minutes ago, [[E...] said:

Slept 5 hours last night!  Felt great.

I first tried a plant-based milk taper in June.  I am lactose intolerant, so I could not use milk.  But someone had said that the Ativan could be suspended in plant milk as well as dairy milk, so I used Ripple, a pea-based "milk". But, there were so many variables during this time, I suppose I cannot say it was a failure, because of all the variables.  I was still using my old scale and I was only trying to dissolve part of a pill, so even though I was very careuly measuring with a syringe, I was really not sure of my original concentration-one variable.  I absolutely detested the taste of the Ripple.  It made me literally gag-second variable.  I, foolishly tried to reduce my dose, before getting used to the initial dose in the Ripple first.  In other words, I did not try to get stable before reducing-third variable.  Since the pill is the same color as Ripple, even though I crushed the pill finely and shook the mixture reapeadedly, I was never sure I was getting an accurate dose-fourth variable.  And overall, I just felt awful-terrible leg  and joint pain, vision problems, pounding headaches, insomnia, teeth and jaw pain, tittitus, etc.  So, I went back to pill form, but I still did not stabilize.

I tried again with water in about mid-July. Because I felt so unstable I was willing to try again.  Still had the problem with the scale.  But, this time I did hold my dose (as much as the scale would allow) for 2 weeks before starting to reduce.  But by 8/8, I was in agony with terribly severe nerve, bone, and joint pain.  So, I ordered the scale.  When the scale came, I still tried to titrate with the water mixture, and even though I felt my dose was accurate, my symptoms were not improving.  I was even only doing my afternoon dose as a titration and keeping the pills in the morning and evening.  In early September, I went back to all pills.  I held for a week or so.  I got stable fairly quickly, and all my nerve, bone and joint pain just vanished.  I really haven't had any type of that pain at all since then.  I started to reduce again, I think, mid September and have been doing so at a fairly regular pace since then.  I am doing a daily microtaper, keeping my reduction at 10-12% every 4 weeks.  I am not sure how long I will be able to keep this pace.  In the last week, my tittitus, headaches, and "weepiness" have become pretty acute.  I am currently holding for a week to try to get these back under control.  Since others on this site have recommended inserting regular holds while doing this type of taper to allow your CNS  to "catch up", as soon as I am stable again and reducing I will probably introduce a short hold after every 5% reduction.

So, I don't know whether my home-brews were just not accurate or I can't tolerate the medicine in any other form?  I am scared to go to the formulated liquid because of my problems with my own liquids.  I am sure hoping I can use the scale all the way down.

Hope that long-drawn out explanation helps.  But, again, you should not make your decisions based on what happened to me.  Again, hope you are feeling better.

Oh man that sounds rough!! Yeah I am reading the milk needs to be homogenized and full fat. I am also lactose intolerant but I believe lactaid is whole and homogenized. The pain sounds awful! I am afraid of what you describe above with liquid, so I am likely going to purchase the same scale. I get nervous with dropping low and using the scale because the pills just break apart so easily and idk about taking straight powder. Like putting it into a capsule at that point who knows. It’s so scary this whole thing.

 

sounds like your tapering pretty quickly. I was doing 0.01 cuts twice a month and crashing so hard I feel like I almost died. But technically they were 5% cuts. I too, need to do a micro taper like 1-2% max at a time and let my CNS catch up. I also need to split my dose, which we talked about I’m incredibly nervous to destabilize more but I’m getting these crazy PM headaches that feel like a vice pulsating, jaw and neck pain and hysterical crying and fear. Sooo lol time to break it apart. 
 

im glad you slept and that you are feeling better today. Sleep is so important. How long were you on Ativan? Iv been on since June since the ssri wirhdrawal issue.