Ativan Taper Advice

[[Ja...]]

Hi there,

I am new here and so grateful for all I’ve read so far. I didn’t even know my symptoms were from withdrawal and felt like I was going crazy.

I started taking Ativan about 10 weeks ago after a few nights of insomnia/panic after some tough family news. I took 1mg a day for about a week and settled at .50mg a day. Initially that was divided into .25mg in the morning and .25mg at night. I was able to drop the morning dose without too many symptoms (or I just assumed that they were panic/perimenopause). 
 

The last month has been consistently.25mg at bedtime and the occasional .25mg in the middle of the night if I woke up with panic (which was happening a lot, prob from withdrawal I didn’t know I was having). 
 

My dr told me to stop taking it and said I’d have no issues coming off of at a “low dose” and I didn’t sleep for 2 days. Went to a new dr who advised tapering. 
 

So I’m on day 4 of .25 at night. I have pretty aggressive trembling, difficulty concentrating, blurry vision, some dry heaving, and general malaise. I did go to urgent care for the vision and shakes and they did an Ct scan and all was well. Never suggested it could be withdrawal. And boughts of sadness that are newer for me. I did one day of half a .25 (before I figured out what was going on) and it was panic all day. Went back to .25 and it was more manageable.

Looking for advice on where to go from here? How long do I stay at .25 and do I cut that in half or is that too drastic? I never thought I would have these withdrawals at a lower dose, it’s mind boggling.

Thank you so much for any advice/guidance. 

[[Bu...]]

Hello @[Ja...],

Welcome to BenzoBuddies.  I'm sorry for everything that you're dealing with.  Many of us didn't know what was happening to us until we found this site, as most doctors are, unfortunately, uneducated about benzo withdrawal.  To hopefully put your mind at ease somewhat, the symptoms you are experiencing are very common during withdrawal.

I am glad that you found a doctor who suggested a taper.  If you feel that you can manage your current symptoms, then I would suggest that you stay at your current dose for a while until things settle down.  If your symptoms are more that you can deal with right now, which happens sometimes, then up-dosing to settle things down is also an option.  

A slow, symptom-lead taper of no more than a 5-10% reduction in the current dose every 2-3 weeks seems to work best to mitigate withdrawal symptoms. 

We're really glad you found us and we'll do our best to help you with this.

[[Ja...]]

@[Bu...] Thank you very much, I really appreciate the support and the guidance.  Today my body felt pretty good, definitely less symptoms, so I’ll stick with this dose and then try a 10% taper in a week or so.

 

thanks again  

[[Bu...]]

@[Ja...],

You're welcome.   I'm glad you felt better today.  Let us know how it goes and if we can help in any other way.

 

[[Ja...]]

@[Bu...] Can I ask one more question please? When we taper at 10%, do we still expect major withdrawal symptoms? Are they just reduced? Is there an approx time length? My only documented taper was half and although I got through it,  it was a really tough week (I didn’t even know they were withdrawal symptoms of course, it was before I found this site and talked to a better dr). 
 

I'm a single mom, so any info is appreciated so that I can plan for some extra support for my son when I do each taper. 
 

Thank you. 

[[Bu...]]

Hi @[Ja...],

We recommend the 5-10% reduction because it is good for minimizing symptoms for most people so that they can keep up with their regular responsibilities.  That said, we don't know exactly what will happen until you start the taper, as everyone is different.  We also really stress the symptom-lead aspect to guide the speed and amount of each cut.  Being flexible is really helpful during this process.  Sometimes people can speed up a cut or cut a higher amount and other times they have to slow it down or cut a smaller amount.  If you have a doctor who is willing to work with you and let you do this at a pace that is comfortable for you, there really is no need to rush.

I am very much a planner, so getting some extra help lined up should you need it, just sounds like a good idea to me.    

Also, are you familliar with The Ashton Manual or the Maudsley Deprescribing Guidlines?  Both are great resources for you and for your doctor, if they are open to suggestions.  

Also, feel free to start a thread in "taper strategies" to get some recommendations on how exactly to structure your taper.  I didn't do the best one (and probably caused myself unnecessary difficulty), so I am not the best person to help with the specifics on that.

Please ask any other questions that you think of; it's what we're here for.

Blessings!

 

[[Sa...]]

7 hours ago, [[B...] said:

Hi @[Ja...],

We recommend the 5-10% reduction because it is good for minimizing symptoms for most people so that they can keep up with their regular responsibilities.  That said, we don't know exactly what will happen until you start the taper, as everyone is different.  We also really stress the symptom-lead aspect to guide the speed and amount of each cut.  Being flexible is really helpful during this process.  Sometimes people can speed up a cut or cut a higher amount and other times they have to slow it down or cut a smaller amount.  If you have a doctor who is willing to work with you and let you do this at a pace that is comfortable for you, there really is no need to rush.

I am very much a planner, so getting some extra help lined up should you need it, just sounds like a good idea to me.    

Also, are you familliar with The Ashton Manual or the Maudsley Deprescribing Guidlines?  Both are great resources for you and for your doctor, if they are open to suggestions.  

Also, feel free to start a thread in "taper strategies" to get some recommendations on how exactly to structure your taper.  I didn't do the best one (and probably caused myself unnecessary difficulty), so I am not the best person to help with the specifics on that.

Please ask any other questions that you think of; it's what we're here for.

Blessings!

The Ashton manual states the cuts should be 10-20% every one or two weeks, but in this forum it is often recommended 5-10% over linger periods of time. It is very confusing. 

[[Ja...]]

15 hours ago, [[B...] said:

Hi @[Ja...],

We recommend the 5-10% reduction because it is good for minimizing symptoms for most people so that they can keep up with their regular responsibilities.  That said, we don't know exactly what will happen until you start the taper, as everyone is different.  We also really stress the symptom-lead aspect to guide the speed and amount of each cut.  Being flexible is really helpful during this process.  Sometimes people can speed up a cut or cut a higher amount and other times they have to slow it down or cut a smaller amount.  If you have a doctor who is willing to work with you and let you do this at a pace that is comfortable for you, there really is no need to rush.

I am very much a planner, so getting some extra help lined up should you need it, just sounds like a good idea to me.    

Also, are you familliar with The Ashton Manual or the Maudsley Deprescribing Guidlines?  Both are great resources for you and for your doctor, if they are open to suggestions.  

Also, feel free to start a thread in "taper strategies" to get some recommendations on how exactly to structure your taper.  I didn't do the best one (and probably caused myself unnecessary difficulty), so I am not the best person to help with the specifics on that.

Please ask any other questions that you think of; it's what we're here for.

Blessings!

@[Bu...]

Thank you again, that all makes perfect sense. I have been reading through some of the old posts and did my first taper last night. I can feel it but it’s way more manageable than last time. 
 

One last question please. When people are talking about “jump off” weights, and using mg, are they referring to the amount of drug or weight of pill? I know both are used on this site and I read that a recommended jump off for Ativan is .05mg but not sure if that’s dose or weight of pill. I know everyone is different but just to use as a guideline.

i downloaded the Ashton Manuel so will read through it this week.

Thank you again. 

[[Bu...]]

@[Ja...],

I'm sorry, I don't know the answer to that one.   When I jumped off I didn't know there was a difference between the two.  I've learned a lot since then, but things having to do with tapers and weights vs. mgs are still my weak spots.  I would suggest that you start a thread with this question specifically in "taper strategies".  There are a lot of folks there who will be able to answer this for you.

[[Ma...]]

Jumpdose is about the mgai (mg Active Ingredient). Horowitz mentions somewhere between 0,05mg (quicker taper) and 0,02mg (slower taper).

[[Ja...]]

44 minutes ago, [[M...] said:

Jumpdose is about the mgai (mg Active Ingredient). Horowitz mentions somewhere between 0,05mg (quicker taper) and 0,02mg (slower taper).

@[Ma...] Thank you. Are those numbers the weight of the pill or the dose of the pill. That’s where I’m getting confused. 

[[Ma...]]

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

@[Ma...] Thank you. Are those numbers the weight of the pill or the dose of the pill. That’s where I’m getting confused. 

It’s the dose of the pill. The real amount of medicine you’re taking before jumping.

[[Ja...]]

20 hours ago, [[M...] said:

It’s the dose of the pill. The real amount of medicine you’re taking before jumping.

@[Ma...] Got it. Thank you very much.