Taper plan

[[Mo...]]

I have been taking  Ativan 2 MG. daily for 5 months. I need a taper plan.

[[Mo...]]

I probably need to add a few things to my request. 

I have been on klonopin before and was able to use a jewelry scale to successfully taper. That was several years ago. I am taking Ativan .5 tablets. 1 morning, 1 afternoon and 2 at night, which is 2mgs. I don't know if I can use a jewelry scale since this is a different type of benzo. Maybe cut and hold? Just not sure. Any suggestions will be appreciated. (I tried the Ashton method at first with the Klonopin. Can't take the diazepam.)

[[Bu...]]

Hello @[Mo...],

Welcome to BenzoBuddies.

Congrats on getting off Klonopin before.  That's quite an accomplishment and it means that you are familiar with the process.  While tapering is not my strength, we have many caring, knowledgeable members who I am sure will be a long soon to help you set up a good plan. 

I am so glad you found us and we'll do our best to help you.

[[Mo...]]

Thank you so much. I am looking forward to suggestions as I am in tolerance withdrawal now.

[[En...]]

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

I have been taking  Ativan 2 MG. daily for 5 months. I need a taper plan.

I was on Ativan at first and developed tolerance withdrawal. My Dr switched me over to Clonazepam because it is a longer acting benzo.

I have been tapering that just like you did your first time. I have seen other members who have tapered off Ativan reduce their dosages by no more than 10% a dose. You run the risk of interdose withdrawal when you taper from a shorter acting benzo that's the reason I was switched to clonazepam. 

[[Mo...]]

I was hoping I didn't have to do that, but looks like I might have to.  I'm experiencing some pretty bad tolerance WD now. It's been several years since the Clonazepam taper, so don't remember exactly how I did it. Also, since I've been on 2 mgs. of ativan, not sure what amt of Clonazepam to replace it with. 

[[El...]]

I am tapering Ativan.   I was originally on Xanax.  Late April 2023, my new provider switched me to 3 mg Ativan and I began my taper.  After much trial and error, I began a micro taper in September 2023.  I am now at 0.53 mg.  I dose 3x per day (6am, 2pm, 10 pm) with 3 equal doses.  I use a scale (to weigh each dose accurately...after cutting and filing my pills).  I reduce about 0.3% for 10-12 days consecutively, followed by a 2-3 day hold.  So far, I have not experienced any interdose withdrawal (but I am very careful to dose 3x day).  I am, of course, not completely symptom free, but I am very functional (can carry out daily tasks, exercise and enjoy family activities). Many have said it is difficult to taper Ativan.  So far I have found it very doable.  Hopefully, I can complete my taper without resorting to a switch to a longer acting benzo.

I do not know much about Clonazepam.  But I think the ratio is 2 mg Ativan = 1 mg Clonazepam.

Wishing you well!

[[Mo...]]

I still have a jewelry scale, but would like to learn again how to micro taper off the 2 mg Ativan.  Not sure exactly how to weigh them. I'm sure it won't be so hard once I get started, just need to know how to begin.

Thanks so much!

[[El...]]

I would be glad to help if you would like me to (and you if I can!).  But first, I need to know whether you are using 1 mg or 0.5 mg pills,  the average weight of your pills (you need to weigh 10 pills, then divide by 10 to get the average weight), how often you dose, and the percentage reduction you would like to start with.

Looking forward to hearing from you.

[[Mo...]]

OK great, I would appreciate your help.

Right now I am taking 0.5 pills. The first one at 7am, the 2nd at 3pm and two at 11pm. I'm thinking maybe 10% reduction.

[[Mo...]]

I wonder if I should start just reducing the 11pm pills since I am taking 2 or each dose.

[[El...]]

Reducing your 11pm dose is certainly an option. This would enable you to eventually reach 3 even doses. You could then start reducing all doses simultaneously. Are you taking a higher dose at night to help you sleep? I only ask because if it is for sleep, if you make a 10% cut to only that dose, it might affect your sleep quality or quantity. If that is what you choose to do, I guess if it were me, I would start with a smaller reduction (say 5%) and see how you feel and sleep in the next few days. You can always make an additional 5% reduction if your symptoms are manageable. But once you have made that 10% cut, if it is too much, you may be in for a rough couple of days-weeks.

To make that cut (regardless of size) you will still need to get the average weight of 10 pills. For example, my 0.5 mg pills generally weigh in the ballpark of 0.060 grams. And for this example, lets assume they do weigh 0.060 grams. 2 pills would weigh 0.120 grams. So a 10% reduction would be 0.120 × 0.9 = 0.108 grams. So, you would need to shave one pill, but weigh them both together, until you reach 0.108 grams. A 5% reduction would be 0.120 × 0.95 = 0.114 grams. You would shave one pill until the 2 pills together weighed 0.114 grams.

Hope this is helpful.

 

[[Mo...]]

OK, 5% would probably be a safer bet.  Thank you so much - I will try this and let you know how it's going!

[[El...]]

@[Mo...] I failed to make one last comment. If you wish to make a 5%-10% cut followed by a time of holding…this is really a “cut and hold” method. But you stated earlier that you might be interested, alternatively, with a micro taper. To do this, you would make much smaller cuts for a period of days, followed by, usually, a short hold to make sure your central nervous system is keeping up. For example (assuming 2 pills weigh 0.120 grams and given the 3 decimal place limitation of your scale), you could make 6 successive 0.001 gram cuts of resulting in approximately 0.8ish% for each reduction.

1st cut: 0.120 - 0.001= 0.119 grams 0.83%

2nd cut: 0.119 - 0.001 = 0.118 grams 0.84%

3rd cut: 0.118 - 0.001 = 0.117 grams 0.85%

4th cut: 0.117 - 0.001= 0.116 grams 0.85%

5th cut: 0.116 - 0.001 = 0.115 grams 0.86%

6th cut: 0.115 – 0.001 = 0.114 grams 0.87%

Hold

Some people find it easier to sort of “creep up” to a certain percentage. For me, I do not seem to experience the highs and very lows of making an extreme 5% cut all at once.

I just wanted to mention this as a option.

 

Edited June 3 by [El...]

[[Mo...]]

I think I'm going to go with your previous instructions, but thanks for the info!

[[Mo...]]

I shaved off the 5% from the 2 night time pills last night and don't know if that's too much or if I just need to get used to it for a few days but I feel horrible today.  Of course I've been feeling badly for the last week because of tolerance withdrawal. Maybe I should try the micro taper but don't understand the chart with the 6 cuts and how to do that.

I understand that any taper isn't easy, but just hoping to have one that is bearable.

Any more suggestions on the micro taper or anything else I mentioned would be appreciated.

Thanks so much for all the work you've done on this so far!

[[Mo...]]

On 02/06/2024 at 09:15, [[E...] said:

I was on Ativan at first and developed tolerance withdrawal. My Dr switched me over to Clonazepam because it is a longer acting benzo.

I have been tapering that just like you did your first time. I have seen other members who have tapered off Ativan reduce their dosages by no more than 10% a dose. You run the risk of interdose withdrawal when you taper from a shorter acting benzo that's the reason I was switched to clonazepam. 

I'm thinking about those interdose withdrawals with ativan because I'm feeling really sick the last few days. Did it make a big difference in the way you felt physically when you switched from ativan to Clonazepam? And since I've been taking 2mgs ativan for 5 months, how much Clonazepam would I be taking to start a taper? 

[[Mo...]]

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

I'm thinking about those interdose withdrawals with ativan because I'm feeling really sick the last few days. Did it make a big difference in the way you felt physically when you switched from ativan to Clonazepam? And since I've been taking 2mgs ativan for 5 months, how much Clonazepam would I be taking to start a taper? 

I think I was tapering off of 1.5 Clonazepam at 5% reduction

[[El...]]

@[Mo...] I suspected you would not feel too well with that initial cut, particularly since you were feeling unwell to start.  You could do a couple of things from this point.  You could ride it out for the next days-weeks.  You will eventually adjust, but it may take some time.  I also suffered greatly from larger cuts and it was taking me a lengthy time to recover (really long holds) after each cut.  That is when I started to micro taper.

So, your other option is to begin a micro taper.  Tomorrow, instead of holding at your present weight, you could cut 0.001 grams from what was your original dose. See how you feel on that for a day or so.  Then cut another 0.001 grams.  Hopefully within a week or so with successive reductions, you will reach your originally planned whole 5% reduction.  You have reached your goal, just taken it in smaller steps and hopefully not felt so unwell doing so.

Or you could switch to a longer acting benzo.  But that will take time and adjustment as well.

Please let me know how you are doing.

[[Mo...]]

Just now, [[E...] said:

@[Mo...] I suspected you would not feel too well with that initial cut, particularly since you were feeling unwell to start.  You could do a couple of things from this point.  You could ride it out for the next days-weeks.  You will eventually adjust, but it may take some time.  I also suffered greatly from larger cuts and it was taking me a lengthy time to recover (really long holds) after each cut.  That is when I started to micro taper.

So, your other option is to begin a micro taper.  Tomorrow, instead of holding at your present weight, you could cut 0.001 grams from what was your original dose. See how you feel on that for a day or so.  Then cut another 0.001 grams.  Hopefully within a week or so with successive reductions, you will reach your originally planned whole 5% reduction.  You have reached your goal, just taken it in smaller steps and hopefully not felt so unwell doing so.

Or you could switch to a longer acting benzo.  But that will take time and adjustment as well.

Please let me know how you are doing.

I read your May 27 post about being symptom free. I would take the time to shave if I could get it correct. How do I weigh the 0.001 grams? Do you hold when you get to the 5%? And then continue shaving on all 3 of my doses?

[[Mo...]]

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

I read your May 27 post about being symptom free. I would take the time to shave if I could get it correct. How do I weigh the 0.001 grams? Do you hold when you get to the 5%? And then continue shaving on all 3 of my doses?

So I think you mean 0.001 grams from the 2 mgs. (All of the 4 .5 tablets)?

[[Mo...]]

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

So I think you mean 0.001 grams from the 2 mgs. (All of the 4 .5 tablets)?

Or do you mean from the 5% I cut last night. So sorry for so many questions but my brain is very foggy!

[[Mo...]]

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

Or do you mean from the 5% I cut last night. So sorry for so many questions but my brain is very foggy!

FYI- on my jewelry scale, 10 pills weighs 0.515, 2 pills 0.98 and 1 pill 0.46

Maybe you can help me micro taper knowing those weights

[[El...]]

@[Mo...] Please never apologize for “brain fog”! We have all been there.

But, to begin to answer a few of your questions, are you still planning to reduce your pm dose to 0.5 mg before reducing your other doses? If so and you plan a micro taper, you would incrementally reduce only your pm dose (in your case each time by 0.001 grams) until your pm dose reaches 0.5 mg (or 1 pill).

I am a little confused about the weights you gave. Do you mean 2 pills weigh 0.98 grams or 0.098 grams? 1 pill weighs 0.46 grams or 0.046 grams? If the average weight of 10 of your pills is 0.515 grams, then the average weight of 1 pill is 0.0515 grams. 2 pills would then average 0.103 grams. So I am slightly unclear how you got 0.98 grams and 0.46 grams. Perhaps you need to reweigh 10 pills and take the average again? If you do so, I would gladly help you figure out how much to weigh for your next dose.

But moving on, after you have finally reduced your pm dose to 0.5 mg (1 pill), then you would begin to reduce all your doses by no more than a total of 0.001 grams. For example, you could first reduce your am dose by 0.001 grams (holding the afternoon and pm constant). Then holding the am and pm dose constant, you would reduce the afternoon dose by 0.001 grams. Finally holding the am and afternoon dose constant, you would reduce the pm dose by 0.001 grams. Now all 3 doses are again the same weight. Then you would start the rotation again.

The way I handle my taper is by reducing 10-12 days consecutively, then I hold for 2-4 days…regardless, even if I am feeling well. This gives my system a chance to “catch up” to my cuts. I also keep a strict log of my symptoms. If any one symptom even creeps up a fraction, I hold immediately for 2-3 days. I keep my taper strictly to no more than 6%-7% every 4 weeks. That percentage will probably get lower as I get lower. I should note that I use a 0.0001 gram scale (not a jeweler’s scale) so I can make smaller reductions than 0.001 grams. Remember, this is only the way I currently taper. Through trial and error, everyone has to find their own comfort zone. For me, it just takes constant monitoring of my symptoms and mid-course adjustments.

So, what do you plan to do tomorrow? Hold or go back up to 0.001 grams from your original dose? Just let me know (as well as the average weight of your 10 pills again) and I am glad to help!

 

[[Mo...]]

If you think it would be the best to reduce the bedtime dose first, then I'll do that.

I weighed correctly this time (I think)- 10 pills 0.515, 2 pills 0.100 and 1 pill 0.050.

I would love to start asap! Thanks again for all your time spent on this!