Help with Ativan taper

[[st...]]

 

I was hospitalized after some scary heart rate issues (they think it may be POTs) and while I was in the hospital they put me on Ativan/Lorazepam since I hadn't been sleeping. They started it at 4 am and I had no clue what Ativan was that is a strong, addictive drug that causes severe withdrawals. I had no informed consent. They pumped me with this for two days (every six hours 1 mg). When I left, they prescribed it for me as needed (suggested every six hours). I ended up taking 1 mg per day at night for the next week or so until I googled and figured out quickly I cannot be on this drug long term. I have tapered down the last 11 days to somewhere around .20-.25 using my scale. I have had so many weird symptoms during this time like numbness in my feet, heart palpitations, headaches, brain zaps, jaw pain, intense neck and back pain, neck popping, muscle tenseness, shivering. I don't know if it's the POTs/underlying issues or withdrawal. My GP told me to start skipping days now to taper off, but I know from this sub and Benzo buddies that is NOT something to do. She also wants me to continue for another 2 weeks, but I feel like that will prolong it. I am scared and pretty sick. Any advice on how long to taper/what dose to reduce to?

Two days (nov 6-7) - upwards of 3-5 mg Lorazepam but cannot be sure

Ten days (nov 8-18) 1 mg at night

Three days (nov 19-21) .5 mg at night

Seven days (nov 22-28) between .25 and .5 - couldn't really tell until I got my scale

One day (nov 29) - .22 mg on the scale I purchased and just received. 

Not a single doctor, including neurologists and other specialists I've been seeing, have any advice for tapering. I even had one doctor tell me to go up to 1.5 mg a day until I get a diagnosis. Do the long Ashton tapers apply to my situation? Any guidance is helpful. Thanks!

 

[[Br...]]

Hello @[st...] - welcome to BenzoBuddies.  What an ordeal you've been through.  While we often suggest a slow taper to members if they've been on benzos for a substantial period of time we suggest a very different approach when use of the benzo has been short term as it has been for you.  So no, the long Ashton tapers are most likely not the best way to go for you.  Your doctor seems to be supporting a rapid taper and again, this is very likely the best route for you in my opinion

I have the impression that this was the first time you took a benzo.  is that the case or do you have a history of taking and discontinuing benzodiazepines (or other psychoactive drugs)?  

You're correct that we don't suggest skipping doses to reduce.  

With a rapid taper off lorazepam I think it's likely you will have withdrawal symptoms.  However, the alternative is worse; if you prolong taking the benzo you risk developing tolerance withdrawal and going through many months or even years of symptoms.

Going forward  I think you could take half your current dose for a day or two and then jump from there.  If I were in your position I wouldn't drag this out for more than a couple more days.  Again It will not be easy but I think it is your best alternative. I believe your chances of full recovery are excellent.

Please ask questions and reach out for support.We're glad you found us!

Brighterday

 

[[Ha...]]

My opinion and it's just that, is Brighterday is absolutely correct. Jump soon.

[[ou...]]

I concur with @[Br...]. Only difference is I don't think you need to rush this much. If you've been on .22mg for a just a day you could stay there for a couple more days. Likewise you could half that dose for another 3 days and then jump, assuming symptoms haven't gotten much worse. Good luck!

[[st...]]

Thank you @[Br...], @[Ha...] and @[ou...]. That's my feeling too - try to taper as quick as possible if I can tolerate it. I am having some nerve pain, numbness, tingling, and other weird sensations. My heart rate is also elevated more than usual when I walk/climb stairs. Could that really be caused by the taper/withdrawal in such a short period? It may be the underlying issues. 

[[Br...]]

@[st...] - the symptoms you describe sound like common withdrawal symptoms.  Here's a link to The Ashton Manual chapter on symptoms: https://www.benzoinfo.com/ashtonmanual/chapter3/  It's a pretty comprehensive list but doesn't include all symptoms.  I found it very comforting to see my symptoms listed.  It's very hard to cope with them and they can overwhelm you at times.  The fear center of the brain is highly sensitized during withdrawal so it's hard for us to assess symptoms when our brain is alarmed by everything. I'm guessing most of us worry in withdrawal about underlying issues.  I know I did.   If you were cleared by your doctors during your hospitalization I hope that gives you some reassurance.  You know yourself best; if you're worried it may be reassuring to check in with your doctor.

We know that individuals can develop dependence on benzos in a surprisingly short time.  I think it's important to remind yourself that your symptom will likely be hard at first but they are temporary.

[[st...]]

Thank you @[Br...]. I need to read through this to become familiar. They did an MRI, chest X ray, CT scan (on head and abdomen), EMG, holter, echo, all within a matter of two weeks and they all came back clear, but my symptoms mimic those of MS (last night my entire left leg was numb and burning pain). Still more tests to run I suppose to rule out POTs/neuropathy/rare disease. But even typing this out makes me look crazy.  Since I have tapered the last three nights have been the best sleep I've had versus on the 1 mg. My body is very sensitive to medicine I think so I wonder if the Ativan was causing some the symptoms and more now in withdrawal. So many weird things happening to my body (sores in my mouth, green veins in my hands, my foot goes numb, burning pain in my neck, heart beat in head). Hoping/praying it was anxiety before and now just the Ativan and will fade with time. 

Thanks for the encouragement. 

[[Br...]]

Here's what The Ashton Manual say about sensations like those you describe.  Please note where she says 3 patients in her research were diagnosed with MS and when they were through with withdrawal, the diagnosis and symptoms vanished.  Again, you have to do what's right for you and gives you peace of mind.  (Peace of mind is pretty rare during benzo withdrawal!):

 

Bodily Sensations

All sorts of strange tinglings, pins and needles, patches of numbness, feelings of electric shocks, sensations of hot and cold, itching, and deep burning pain are not uncommon during benzodiazepine withdrawal. It is difficult to give an exact explanation for these sensations but, like motor nerves, the sensory nerves, along with their connections in the spinal cord and brain, become hyperexcitable during withdrawal. It is possible that sensory receptors in skin and muscle, and in the tissue sheaths around bones, may fire off impulses chaotically in response to stimuli that do not normally affect them.

In my clinic, nerve conduction studies in patients with such symptoms revealed nothing abnormal – for example, there was no evidence of peripheral neuritis. However, the symptoms were sometimes enough to puzzle neurologists. Three patients with a combination of numbness, muscle spasms and double vision were diagnosed as having multiple sclerosis. This diagnosis, and all the symptoms, disappeared soon after the patients stopped their benzodiazepines.

Thus these sensory symptoms, though disconcerting, are usually nothing to worry about. Very occasionally, they may persist (see section on protracted symptoms). Meanwhile, the same measures suggested under muscle symptoms (above) can do much to alleviate them, and they usually disappear after withdrawal.