Help! Liquid tapering of Ativan under .25ml / .50mg

[[Ne...]]

Hi all,

I have a compounded 2mg solution of Ativan that I am planning to taper from; however, I’m confused on how to dose from this in tiny amounts (I’m currently taking .75mg/day spread out in 3x .25mg doses). The dropper it comes with is a 1ml dropper with lowest marking at .25ml / .50mg.  How am I supposed to measure amounts below this?  

[[Li...]]

Hello @[Ne...].

You may need to obtain a syringe with more graduations. Members who use a concentrated lorazepam liquid, typically dilute it.

But first:

(1) Do you plan to use a combination of regular tablets and liquid to taper?  Or liquid alone?

(2) What taper rate do you wish to trial?  

It would be very helpful if you would add your medication use History to your profile.  This will enable members to view your history at a glance instead of having to read through your past posts (many members do not have the time or capacity to do this). 

[[Ne...]]

@[Li...] I was thinking just liquid?  Not sure what is best.  I want to try to taper as quickly as possible…it will probably be 5-10% every 2 weeks? I haven’t been able to find a dropper online with more graduations…syringes seem to have different measurements from the dropper? I’m currently extremely dizzy and struggling to function (I’ve been spaced out / slow / cognitively impacted since August).  I was starting to feel worse just taking the pills alone.  You can see my medication history in my profile now.

 

 

Edited April 21 by [Ne...]

[[Li...]]

Great job on your medication history, @[Ne...].  This is very helpful.

Given the merry-go-round of meds you’ve been on and off, it’s no wonder you aren’t feeling well.  Indeed, it’s possible you’re starting to feel worse on the lorazepam pills because your nervous system and body are dysregulated from the other med changes.  Given that you’ve been taking the lorazepam since November, dependence and tolerance are also possibilities.

I hear you about wanting to taper as quickly as possible but given your history and current condition I’m concerned this might put you at risk for severe withdrawal symptoms.  

My initial inclination is to suggest a slow, symptom-based taper.  However, I want to think about this some more plus ask other members to review your history and provide input. 

Do you have access to both pills and the liquid at this point?  

Re: finding appropriate syringes … we can make suggestions and provide links to suitable products on Amazon. 

 

[[Ne...]]

@[Li...] yes I have both the pills and liquid.  I’ve done liquid the last 2 days and still stuck on the lexapro. My biggest issue right now is the dizziness / disorientation and shallow breathing.  I can barely walk / leave my house and have to be able to function.  Is there anything you could suggest that I do?  I try meditation etc. and barely get any relief.  I have plenty of other symptoms (frequent bowels, acid, severe weight loss, poor appetite, chest tightness, mouth ulcers, insomnia, acne, etc.) I’m a 37F, marriage hanging by a thread and barely any contact left with friends and family. I truly feel I will not make it much longer if I can’t figure out some way to make this manageable…

[[Li...]]

Hello again @[Ne...].  I’m sorry you’re having such a difficult time.

My inclination is to suggest that you set an initial goal of getting more stable on the lorazepam.  How did you feel when you were taking a total daily dose of 1.5mg (0.5mg 3x a day)?  How did you feel when you reduced your total daily dose to 1.25mg?  (That’s a reduction of almost 17% — we typically suggest reductions in the range of 5-10%.)

Given that it’s only been two days since you started using the liquid, I also suggest you give yourself adequate time to adjust to the change in dosage form.  The bioavailability of liquid dosage forms can be slightly different from that of solid forms; some individuals are sensitive to this.

Your case is complex so I continue to hope we’ll hear from other members.  (If you aren’t already aware of it, everyone on the team is a volunteer plus live in multiple time zones so it can take a while to get responses.)

[[Ne...]]

@[Li...] Quite honestly, I stopped feeling genuine relief from the Ativan back in January.  Even when the dosage was raised to 1.5mg / day, I felt pretty uncomfortable, delirious, and spaced out, and started to experience inter-dose withdrawal (burning skin sensations, rebound anxiety, head pressure / confusion, processing issues). I started feeling nerve / muscle pain and trembling when I cut the dose down to 1mg, then to .50mg and quickly raised it to .75mg/day.  I’ve been sitting at approx .75mg/day for about a month and have “windows” here and there of feeling ok, but am still feeling most of the symptoms I described above.  Not sure what else to do to try to stabilize and am getting more and more frightened staying on this poison at this level.

Are there other people from the team I should maybe tag in for input?  Totally understand the lag in responses…just appreciate any and all help that you / they can provide.  Thank you ❤️