New Here- need HELP taper

[[ur...]]

I'm currently on .25 Ativan every other day for at least 8 weeks for sure. I've written dates down. Prior to that sporadic soaring but never more than .25. Up until about 10 days ago it would give me two days of relief form anxiety.  I've been having a lot of physical symptoms I attributed to health issues. Numb and tingling in feet and hands, sore tense muscles.  All of which are much worse. I know I'm in inter dose dependence and in withdrawal.  I have a physical dependency. I've ordered a scale from Amazon and am ready. I sleep very little due to being so uncomfortable. I've had insomnia for 4 months.  I don't drink and am not on any other meds.  Please help me with a plan.

[[Co...]]

Hello @[ur...]. Welcome to BenzoBuddies.

Are the tingling and numb feet and hands due to benzodiazeoine withdrawal, or an underlying condition? And, how do you know?

Yours is low dose, and your more sporadic use (especially after 8 weeks of use) makes dependency less likely, but not impossible I would suggest.

Have you taken benzodiazepines before?

[[ur...]]

Thank you for your reply.  I've seen numerous Drs and had many tests. All good.  The ativan helped with anxiety until about 10 days ago. A lot less benefit.  Now, it hardly helps at all.  Was taking one dose .25 once a day but as of yesterday I'm taking half of that at 6 am and the other have at 6 pm.  Have terrible heart palpatations, no sleep to speak of. Restless legs but worse. Sore muscles now and nerve like pain in arms, legs, shoulders. All over muscle tension. Feels like someone else's head. Pressure and stuffy sinus. Brain fog. Since I was taking every other day and that was fine, but now that day off with nothing is pretty horrible. Should I start taking .25 every day to get an even dose in my body.  Dr said last week I could just stop but my symptoms weren't as bad as they are now. Everything turned all of a sudden. I had two scripts of 30 pills .5mg each since July and I still have a few left.  So basically I've used about 55 pills in 6 months. This tolerance I believe has been going on for at least 3 or 4 months. That's when the insomnia started and some of the side effects.  I also take a low dose of metoprolol which I've had to increase due to worsening high BP and palpitations this past week.  I'm so scared and feel so desperate at the moment.  Ive never experienced anything like this. 

[[ur...]]

I took a few ativan about 10 years ago, short term as I was concerned as my mother had dementia. Just quit taking them. No other benzos. Was using them this time trying to onboard an antidepressant- tried several but I had too many side effects. Tried paxil, zoloft, prozac, busbar. Had to get off after a few days on each. I'm very sensitive to medication.

[[Co...]]

@[ur...] Can you describe your use from the past few weeks in more detail. How often you take it, and at what dose. I am not sure I fully understand.

[[ur...]]

Looking at my notebook for the month of December, I have taken one .25 mg ativan every other day. There was one time when I took a .25 dose three days in a row. One dose of .25 every other day.

[[ur...]]

It was originally prescribed for panic attacks and heart palpitations/anxiety July 2022. A bottle of 30 .5mgs would last me several months.  Have I over stimulated my Gaba receptors by trying several SSRI'S?  Had a terrible reaction to one dose of Zoloft a month ago. 

[[ur...]]

Please, can anyone help me with safe taper schedule? My pill is .5.  Currently on .25 once daily. I'm alone and very afraid. Brain and body won't allow sleep. I have a scale from Amazon arriving today.

[[Co...]]

Hello @[ur...]

It seems that you are already taking the smallest dose available in Ativan (0.5mg). The majority of people to taper off by quartering these pills. The majority of our members would take Ativan every day, but if your usage is generally every other day, in your shoes, I would stick to this regimen (unless you are experiencing intolerable interdose withdrawal effects).

The general approach would be to proceed by reducing your by 0.125mg (a quarter of a pill). After a week or two of taking thee-quarters of a pill (or as a soon as you feel reasonable recovered from the previous cut and ready), you would reduce your dose again to half a pill (0.25mg). You would proceed similarly from there down through a quarter pill (0.125mg), and then to zero.

If you find that you cannot tolerate these reductions, there are methods to allow you to make smaller cuts. If you begin to experience intolerable withdrawal effects (that is, they begin to affect you a day or so after your previous dose), you then might move to daily dosing. But I suggest avoiding doing this if possible, especially if it is nearly two days before interdose withdrawal effects become significant. (Others here might take a different view).

You are the best person to know how you should proceed. We can only provide you with perspectives based upon our personal experiences or what the average member tends to report here. There is, however, great variability - you do what you feel is right for you.

One way or another, you should be able to get off. Keep us informed of your progress and we will try to help you through any problems.

[[ur...]]

Thank you. I currently take .25 one time every other day. Ive started a taper today of .22, divided into two doses 12 hours apart.  Today is normally the day I don't take anything but was having fairly uncomfortable interdose effects so I took one dose today of .0135.  Thought it may be better to avoid high and low amounts in my body. Hopefully I won't need a second dose today. At what dose would you recommend that I jump?  Thank you for your reply, Colin. My husband and I survived cancer diagnoses this past year and I'm anxious to put this behind me.

[[Co...]]

Hi @[ur...]

How are you achieving does of 0.22mg and 0.11mg? You also mentions a dose 0.0135mg - did you mean to type 0.135mg?

[[ur...]]

Thank you for your reply. Please check my calculations. I weighed 10  .5mg ativan pills.  Avg weight of total pill is .060.  One half pill weight is .030

.030-.003=.027  (took 10%)off

I want to split this dose into 2, 12 hours apart, which is.0135 twice daily. This is my first cut of 10%. Yesterday was my day that I normally didn't take anything. Had some unpleasant effects but did not take any dose. Thank you Colin for checking my calculations. My measurements are in grams.

[[Co...]]

You are welcome, @[ur...].

Your figures look correct to me.

If you would, please write your weights like this: 0.0135g. When you write your weights without the leading zero (.0135), this can cause confusion. I know it is a big no-no amongst medical professionals for this reason.

[[Li...]]

On 19/01/2024 at 07:14, [[u...] said:

My measurements are in grams.

Hello, @[ur...].  Just double-checking … is the average weight of your 0.5mg Ativan tablets 0.060 grams (or 60 milligrams)?  If so, Ativan tablets must be very small!  US members here have reported that 0.5mg clonazepam tablets weigh around 0.170g (170 mg). 

[[Co...]]

29 minutes ago, [[L...] said:

Hello, @[ur...].  Just double-checking … is the average weight of your 0.5mg Ativan tablets 0.060 grams (or 60 milligrams)?  If so, Ativan tablets must be very small!  US members here have reported that 0.5mg clonazepam tablets weigh around 0.170g (170 mg). 

I expect that you are correct, @[Li...]. I was switching between the two when reading through @[ur...] post, and have corrected my use of 'mg' to 'g'.

[[ur...]]

What is the benefit of tapering off of the average pill weight vs the actual mg size of the dose I take. I did my first taper of 10% off the pill weight, but feel I'm not getting very far. Thanks for the help. Really struggling as I am starting with tolerance withdrawal symptoms.

[[Co...]]

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

What is the benefit of tapering off of the average pill weight vs the actual mg size of the dose I take. I did my first taper of 10% off the pill weight, but feel I'm not getting very far. Thanks for the help. Really struggling as I am starting with tolerance withdrawal symptoms.

When we talk about pill weight (as opposed the weight of the dose), we are usually referring to grinding the pill into a powder and reducing the dose by 10% (or whatever the desired amount). Reduction of a whole pill (without crushing into a powder) by 10% (some such figure) is next to impossible. Yes, we can use the score lines on the pill (if they exist) to divide the pill in two (or even sometimes quarters), or use a pill-splitter for a similar result. But beyond halving and quartering of whole pills, crushing into a powder is the only practical method for making smaller reductions to dose.

The better method is to weigh the crushed pill powder, but some manage smaller reductions than halves or quarters by eye-balling the powder.

I should add, that although most benzodiazepines are suitable for crushing, eXtended Release (XR) types will lose their extended release properties. Further, there may be some localised brands which are just plain unsuitable for crushing at all (gel capsules, for example - I'm guessing).

[[Pa...]]

On 25/01/2024 at 06:59, [[C...] said:

When we talk about pill weight (as opposed the weight of the dose), we are usually referring to grinding the pill into a powder and reducing the dose by 10% (or whatever the desired amount). Reduction of a whole pill (without crushing into a powder) by 10% (some such figure) is next to impossible. Yes, we can use the score lines on the pill (if they exist) to divide the pill in two (or even sometimes quarters), or use a pill-splitter for a similar result. But beyond halving and quartering of whole pills, crushing into a powder is the only practical method for making smaller reductions to dose.

The better method is to weigh the crushed pill powder, but some manage smaller reductions than halves or quarters by eye-balling the powder.

I should add, that although most benzodiazepines are suitable for crushing, eXtended Release (XR) types will lose their extended release properties. Further, there may be some localised brands which are just plain unsuitable for crushing at all (gel capsules, for example - I'm guessing).

Is crushing better than filing small amounts off of the pill because beyond halving (with scores) there is an uneven amount of med dispersed through the pill? 

I have been tapering my .5mg K (weighs .170g) by reducing .001 every two weeks or so, on average, using Gemini scale. I shave the amount off of the pill, I don’t crush it. This has worked ok until I reached .096g. Which is slightly more than half a pill scored. Now I’m getting hit much harder with symptoms. 

I am wondering if this uptick is because I’ve just reached a point in my taper where I’m going to start to feel things more? Or is this because I’m getting uneven dosing due to cutting instead of crushing, and the piece beyond the scored amount is so small (how to know if it’s mostly filler)? I would think if it was the latter, I’d be feeling this lousy throughout my whole taper. But maybe not. 🤷🏻‍♀️

The increase in WD symptoms has also coincided with having to change a brand in another medication(Pregabalin) - twice in last 4 months due to discontinuations🤦🏻‍♀️ - and this could be part of the culprit too.

Finally, I’m just wondering when one crushes the pills do you just crush one pill at a time? And does crushing the pill alter their metabolism and absorption in the body? I’m so ridiculously sensitive to the most minor changes. I’ve been afraid to try crushing for this reason.  TIA!

 

 

 

 

Edited February 24 by [Pa...]
Typo

[[or...]]

12 minutes ago, [[P...] said:

Is crushing better than filing small amounts off of the pill because beyond halving (with scores) there is an uneven amount of med dispersed through the pill? 
I have been tapering my .5mg K (weighs .170g) by reducing .001 every two weeks or so, on average. This has worked ok until I reached .096. Now I’m getting hit much harder with symptoms. 
I am wondering if this is because I’ve just had a point in my reduction where I’m going to start to feel things more? Or is this because I’m getting uneven dosing? I would think if it was the ladder I’d be feeling this throughout my whole taper. But maybe not. The increase in WD symptoms has also coincided with having to change a brand and another medication and this could be part of the culprit too.my symptoms has also coincided with having to change a brand and another medication and this could be part of the culprit too.
I’m just wondering when one crushes the pills do you just crush one pill at a time also, does crushing the pills alter their metabolism and absorption in the body? TIA!

 

 

 

 

I had to find what worked for me.  I chose shaving off a tablet simply because it seemed easiest, and my little scale works very well for me.  It's really what works for you.  I started, before BB, just breaking the tablets, and that, I found out here, was not accurate in the least.  I'm OCD enough that I couldn't go on like that.  I'm almost a year into a DMT, slow, dry micro taper and doing so well after using a 1 mg a day Clonazepam tablet for 35 years.

But again, everyone, that is lucky enough to still have a 'script needs to read, try, and decide on their way.  I read a long time ago even pharmacist-grade scales can't be totally accurate, so I stopped worrying if I was a small percentage off, and can't get "perfect" reading on my scale.  It's never that I recall, been more than .001 g of weight off my dose weight I need it to be.  I get tired of trying though, and will just take the .094 g instead of my .095 g which is what I really want.

My way won't fly with some, but I'm doing so well limiting wd sxs that I don't care what anyone thinks, it's working for me oregonlady

Edited February 24 by [or...]

[[Pa...]]

4 minutes ago, [[o...] said:

I had to find what worked for me.  I chose shaving off a tablet simply because it seemed easiest, and my little scale works very well for me.  It's really what works for you.  I started, before BB, just breaking the tablets, and that, I found out here, was not accurate in the least.  I'm OCD enough that I couldn't go on like that.  I'm almost a year into a DMT, slow, dry micro taper and doing so well after using a 1 mg a day Clonazepam tablet for 35 years.

But again, everyone, that is lucky enough to still have a 'script needs to read, try, and decide on their way.  I read a long time ago even pharmacist-grade scales can't be totally accurate, I so I stopped worrying if I was a small percentage off, and can't get "perfect" reading on my scale.  It's never that I recall, been more than .001 g of weight off my dose weight I need it to be.  I get tired of trying though, and will just take the .094 g instead of my .095 g which is what I really want.

My way won't fly with some, but I'm doing so well limiting wd sxs that I don't care what anyone thinks, it's working for me oregonlady

Oregonlady,

Thanks for your feedback. Yes, it’s worked ok for me too this way.  I’ve been slowly tapering for a few years. Things just got very bad, very fast. I’m guessing the brand changes in my other meds could be culprit. 

Wishing you well with your taper, you’ve done great getting a good ways off your dosage, after being on so many years! 

[[or...]]

Yes, I've heard different brands, different weights and dosages.

I  have the same sort of scale and it turned out to be the best of 3 or 4 I bought and returned to Amazon, and least expensive too!!  Btw, I'm at .095g and I held the last .096 g about 2 weeks as well!! Only person I've run into doing their taper just like mine

If you look at my "history" you'll see I was wavering quite a bit, but did keep as steady as I could, oregonlady

Edited February 24 by [or...]

[[Co...]]

46 minutes ago, [[P...] said:

Is crushing better than filing small amounts off of the pill because beyond halving (with scores) there is an uneven amount of med dispersed through the pill?

That's my take on it. As I understand it, there is no guarantee that the active ingredient is evenly distributed throughout the pill, except where it crosses score lines. Further, I expect the coating will have some effect too. It might well be minor, but I cannot say this for certain.

46 minutes ago, [[P...] said:

I have been tapering my .5mg K (weighs .170g) by reducing .001 every two weeks or so, on average, using Gemini scale. I shave the amount off of the pill, I don’t crush it. This has worked ok until I reached .096g. Which is slightly more than half a pill scored. Now I’m getting hit much harder with symptoms.

There is no way for us to know for certain. It must be possible (given the lack of guarantee about even distribution of the active ingredient) that the active ingredient is in higher proportion in the middle of the pill. So, reductions in this area might have a greater affect upon the dose. Others here disagree with me, but for reasons of uncertainty, I generally recommend crushing and grinding the pill into a fine powder.

On the other hand, it could be that your overall taper rate is too high and the accumulated reductions are catching up with you. You might try crushing and grinding your pill and see if this improves the situation for you. Or, you might have hit a tougher patch for some other indeterminate reason.

46 minutes ago, [[P...] said:

I am wondering if this uptick is because I’ve just reached a point in my taper where I’m going to start to feel things more? Or is this because I’m getting uneven dosing due to cutting instead of crushing, and the piece beyond the scored amount is so small (how to know if it’s mostly filler)? I would think if it was the latter, I’d be feeling this lousy throughout my whole taper. But maybe not. 🤷🏻‍♀️

Again, there is no way for us to know for certain. You might instead crush your pill; if there is improvement, then this is suggestive of variability in distribution of the active ingredient. Or, again, you just hit a rough patch for some more random reason.

46 minutes ago, [[P...] said:

The increase in WD symptoms has also coincided with having to change a brand in another medication(Pregabalin) - twice in last 4 months due to discontinuations🤦🏻‍♀️ - and this could be part of the culprit too.

Possibly. And I cannot even speculate without trying look into how pregabalin might affect benzodiazepine metabolisation.

46 minutes ago, [[P...] said:

Finally, I’m just wondering when one crushes the pills do you just crush one pill at a time? And does crushing the pill alter their metabolism and absorption in the body? I’m so ridiculously sensitive to the most minor changes. I’ve been afraid to try crushing for this reason.  TIA!

I would suggest crushing one pill at a time. Although there is some utility in crushing up batches (this would average out variability of dose between pills, and saves some time), we cannot know for certain what effects this might have on the active ingredients (exposure to air, moisture, contaminants, etc.). Further, if you experience a mishap, this could result in you losing a large proportion of your pills. I strongly recommend crushing a single pill at a time. And if you take multiple doses across the day, only crush only as many pills as you need to achieve your individual doses. You can mix and match powder and whole pills.

[[Co...]]

39 minutes ago, [[o...] said:

I had to find what worked for me.  I chose shaving off a tablet simply because it seemed easiest, and my little scale works very well for me.  It's really what works for you.  I started, before BB, just breaking the tablets, and that, I found out here, was not accurate in the least.  I'm OCD enough that I couldn't go on like that.  I'm almost a year into a DMT, slow, dry micro taper and doing so well after using a 1 mg a day Clonazepam tablet for 35 years.

But again, everyone, that is lucky enough to still have a 'script needs to read, try, and decide on their way.  I read a long time ago even pharmacist-grade scales can't be totally accurate, so I stopped worrying if I was a small percentage off, and can't get "perfect" reading on my scale.  It's never that I recall, been more than .001 g of weight off my dose weight I need it to be.  I get tired of trying though, and will just take the .094 g instead of my .095 g which is what I really want.

My way won't fly with some, but I'm doing so well limiting wd sxs that I don't care what anyone thinks, it's working for me oregonlady

There is lot to be said for accepting that we cannot achieve perfect. And even if we could achieve 'perfect' in our dosing, the chances are that it would not deliver appreciably improved results. After all, our blood levels dip by substantial amounts between doses, even for longer half-life benzodiazepines. It is simply not possible for blood levels to remain constant unless the benzodiazepine is being drip fed to us 24 hours a day. Aim for good enough. (Of course, good enough will vary between individuals.)

[[or...]]

That was interesting @[Co...] about the possibility of the accumulation of the actual drug being near the center.  It does seem like things went a lot smoother for me until getting very near the halfway point

My C is not scored at all, but after I got to BB and learned about shaving off to taper, I didn't care, or at least I didn't look into getting "scored" tablets.  I will be asking for .5 C tablets and scored as well, when I reach mid-way though oregonlady

PS not sure right now how my TEVA brand comes in .5, scored or not yet. I so hope I don't get changed on brand for any reason, probably get paranoid it that happened.

pss on the crushing, I am just too clumsy, and also sneeze a lot so that wouldn't work for me

Edited February 24 by [or...]

[[Co...]]

3 minutes ago, [[o...] said:

pss on the crushing, I am just too clumsy, and also sneeze a lot so that wouldn't work for me

Do whatever works best for you. There is no perfect method - anyone who suggests they have the answer, does not appreciate the extent of the unknowns and uncertainties.