Need advice on switch from Lorazepam (Ativan) do Diazepam (Valium)

[[Dr...]]

Hi all,

Hope this message finds you as well as possible.

I am currently doing very unwell and wondering whether I should change strategies and try to switch from Lorazepam to Diazepam. I'll add my history below for you all to see.

I was tapering Lorazepam via taperingstrips and per dose. The original plan (as per the advice of the tapering expert in The Netherlands) was to taper each dose over 2 months, then pause for 2 weeks and start with the next dose. Total of 7 months, but could be changed anytime depending on withdrawal symptoms. So I started with the afternoon dose and succesfully tapered that dose over a period of 2 months. It wasn't a walk in the park, but still it was manageable. After 2 weeks of stabilising I started with the morning dose and that went pretty okay up to 0.25mg. Then things got too tough and I had to stabilise at 0.35mg. Then was stable and tapered to 0.3mg. I never managed more than that, which was on May 13th.

I have been feeling worse and worse. Terrible insomnia (I'm usually okay with not sleeping or not sleeping much, but now it meant not being able to get through the day and not being able to get through the night), exhaustion, extremely dry mouth, brain fog, feeling numb and like a zombie, restlessness, etc. When I'm in a wave it feels like I will never get out of it and even after all these months I still don't know how to calm down.

Things have gotten so bad, that I don't see how I will ever get out of this hell and will ever feel better again. I started thinking about death and dying more and more, wanted to get admitted to a clinic but apparently we don't have the kind that I was looking for here in The Netherlands. The clinics we have are for the mentally very disturbed people, like people with psychosis, schyzofrenia, etc. That was not the safe and peaceful place I was looking for... So I ended up with the mental health crisis service again last Friday, as I just wanted to die but still wanted to live as well. Does that make any sense? I have such a strong wish for all of this to be over and just die, but still there is a big part of me clinging to life and wanting to get better.

Two weeks ago my GP prescribed me with Promethazine to help me sleep. I reacted quite strongly and it only helped me sleep a little, but made me feel like a zombie the day after and made me even more numb and feeling depressed. So I quit taking that after a week. Then the mental health crisis service prescribed me with Quetiapine last Friday, just 12.5mg. Three times a day if needed and I could up to 3x25mg if needed. I tried it 3 nights, in different amounts and it only helped me sleep twice but it was a weird kind of sleep and not very restful. The other night it did nothing for my sleep but at least I was lying in bed peacefully. I also tried it Saturday during the day as they said it could also help with my restlessness and stress. It did not work at all for that, it gave me a severe dry mouth, now dry eyes as well and did not lessen the waves. It gave me itchy feet and heart palpitations... And I now feel like a zombie again during the day. To be honest, I might feel like a zombie without the Quetiapine but I will only find that out when I stop taking it. I think I will take a break from it tonight.

I have no clue why I went downhill so fast since Mid-May. I did get a bronchitis around that time and all the coughing, itchy throat, blocked nose etc. wasn't helping me sleep, which wasn't helping to heal the bronchitis, etc. So 4 weeks later I still have a blocked nose and itchy throat. Have had a hoarse voice now for weeks...

In the meantime a couple of people around me started mentioning B12 deficiency. I know of two people that nearly died due to a B12 deficiency and they got alarmed because of my medical issues so far (not just from the last year by the way). I am now getting B12 injections twice a week. They could also cause symptoms to worsen over a certain period of time... I have been getting the injections for the past 2 weeks.

Anyway, I do notice now (not always, just the pas couple of weeks) that my waves usually start around 15.00 in the afternoon. I wouldn't say i always had interdosis withdrawal and often I have had some more energy again at night. But recently I have been thinking that maybe I am experiencing interdosis withdrawal. It didn't seem like an issue at first, but maybe now it is?

I am thinking that maybe it would be wise to switch to Diazepam? I tried that once but just one day was enough to make me switch right back. But that was because the psychiatrist thought I could make the switch in 1 day and use the equivalent of 5mg diazepam to 1mg lorazepam... I left it at that 1 day and then switched back to lorazepam...

The pharmacist is a strong believer that it's best to stick with the medication you're body is used to. In my case lorazepam. He is also not in favor of re-introducing an afternoon dose. I used to trust him completely, as he is the expert here in The Netherlands, but right now I'm not sure anymore whether it is in my best interest to follow his advise.

So I'm wondering whether it would be better to switch to Diazepam?

What would that look like??? Maybe something like the below:

Week 1
Morning: Lora 0.4mg
Evening: Lora 0.5mg and Dia 5mg

Week 2
Morning: Lora 0.2mg and Dia 2mg
Evening: Lora 0.5mg and Dia 5mg

Week 3
Morning: Lora - and Dia 4 mg
Evening: Lora - and Dia 10mg

Any advice is welcome! Thanks so much in advance!!!

Wishing you all the vey best <3

 

Pregabaline/Lyrica: 2x 75mg per day for 3 weeks in October 2023

-> upon advice doctor, I went down to 1x 75mg per day for 1 week and then should have taken it every other day. Didn't manage to do that though because of severe withdrawal symptoms from November 6th onwards

Lorazepam

From Mid-November 2023:
Morning: 1mg
Afternoon: 1 mg
Evening: 1mg

From January 23rd till March 18th:
Morning: 1mg
Afternoon: succesfully tapered from 1mg to 0mg
Evening: 1mg

From March 19th till March 31st:
Morning: 1mg
Evening: 1mg

From April 1st till April 28th:
Morning: tapering from 1mg to 0.25mg via taperingstrips
Evening: 1mg

From April 29th I had to stabilise on 0.35mg morning dose because of increased withdrawal symptoms
On May 13th I was stable enough to taper to 0.3mg morning dose

Since May 13th I have been on 0.3mg morning and 1mg evening and am getting worse and worse

June 17th, after consultation with pharmacist increased morning dose to 0.4mg to see whether I can get stable

 

[[Li...]]

8 hours ago, [[D...] said:

I have no clue why I went downhill so fast since Mid-May.

I’m sorry for your troubles, @[Dr...].

You made a 33% reduction in a lorazepam over a 6 1/2 week period followed by a 37.5% reduction over a 4 week period.  These large, relatively rapid reductions may have caught up with you.  

You’ve also experienced two other potentially destabilizing events.  First, a change in dosing schedule from 3 to 2 times a day (many individuals find it necessary to dose lorazepam 3 - 4 times a day to keep blood serum levels steady and avoid interdose withdrawal).  Second, the rapid taper and severe withdrawal from the Lyrica/pregabalin you experienced back in November 2023.

In your shoes, I would respectfully agree with the ‘expert’ about staying on your current benzodiazepine but respectfully disagree about returning to dosing the lorazepam 3 times a day in equal amounts.  This would require some experimentation on your part to find a total daily dose (TDD) that would keep your withdrawal symptoms in the tolerable range and allow you to stabilize (e.g. you may need to increase your TDD). 

If a return to your original dosing schedule and (possibly) a dose increase don’t work, then I would consider crossing over to diazepam.

Have you had a blood test to verify a vitamin B12 deficiency?  If not, you might want to get one.  If you don’t have a deficiency, there’s no need to complicate an already complicated situation.  

Are you still taking the Lyrica/pregabalin?  If so, what is your daily dosing schedule?  Might you be experiencing adverse effects from it?

Lastly, if you have not already done so, please do your research about quetiapine/ Seroquel.  It has some nasty adverse effects and several members have reported harms from taking it.

[[El...]]

I would respectfully agree with @[Li...]. I cannot speak to your concerns about other medications and B-12...I would defer to Libertas suggestions.  But, I am tapering Ativan. To avoid interdose withdrawal, I have found that it is very important that I dose 3x per day (some people are OK with 2 doses; others need 4). I also take evenly weighted doses. Ativan only has a half life of about 12 hours. So, if you have eliminated your afternoon dose and now more than halved your morning dose, I would suspect you are experiencing peaks and valleys in your blood serum levels. It would seem that your current level of withdrawal symptoms are a result of this uneven dosing coupled with your rather large reductions over the past 11-12 weeks (which have now probably now “caught up with you”).

I am certainly not a medical doctor.  But, after much trial and error, I have found that if I dose 3x per day (evenly spaced - 6am, 2pm,and 10pm) with three evenly weighted doses, I am very functional.  While withdrawal symptoms are certainly not completely absent, I can complete daily tasks, exercise, eat appropriately, and enjoy family activities.

So sorry for your present difficulties, but wishing you the best!

 

[[Dr...]]

@[Li...] and @[El...], thank you so much for taking the time to reply to me.

I'm not sure yet how I would get to 3 equal doses. The evening medication (1mg) comes through my GP, but the morning dose comes via tapering strips. I have never done any cuts myself, so wouldnt know how to reduce the evening dose. 

I'm sure I can't just go to 3x 0.5mg in one go, right? Would probably need to do that gradually? 

I'm not taking any Lyrica. Only had that for 3 weeks. 

[[Dr...]]

@[Li...] I could probably convince my GP to prescribe me 0.5mg tablets instead of the 1mg for the night. But it would mean no gradual transition from 0 in the afternoon and 1mg at night to 0.5mg in the afternoon and 0.5mg at night. Would that screw me up even more? No idea how to do this gradually at the moment.

Would it already help me when I would now take 0.4 in the morning, 0.5 in the morning and 0.5 at night? 

I don't want to screw things up even further but at the same time I don't think I can take my current situation much longer, that's why I ended up with the crisis services as my death wish was so high. 

Thanks again for your much appreciated support! 

[[Li...]]

On 17/06/2024 at 06:23, [[D...] said:

From March 19th till March 31st:
Morning: 1mg
Evening: 1mg

How did you feel when you were taking the above total daily dose of 2mg?*  Were you experiencing any withdrawal symptoms?  Were your symptoms stable?  (i.e. not changing in number or nature)

Were you experiencing interdose withdrawal?  

*A 33% reduction in dose from your starting dose of 3mg over ~6 1/2 weeks.

[[Dr...]]

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

How did you feel when you were taking the above total daily dose of 2mg?*  Were you experiencing any withdrawal symptoms?  Were your symptoms stable?  (i.e. not changing in number or nature)

Were you experiencing interdose withdrawal?  

*A 33% reduction in dose from your starting dose of 3mg over ~6 1/2 weeks.

 @[Li...] At that point I was doing reasonably well. Same as the weeks and months before: some days were better than others but overall it was manageable and I was still able to work. I'm not sure whether at that stage I felt interdosis withdrawal or whether the symptoms were at random times. I'll check and come back to you about that

[[Dr...]]

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

How did you feel when you were taking the above total daily dose of 2mg?*  Were you experiencing any withdrawal symptoms?  Were your symptoms stable?  (i.e. not changing in number or nature)

Were you experiencing interdose withdrawal?  

*A 33% reduction in dose from your starting dose of 3mg over ~6 1/2 weeks.

This is how I rated that period (Numbers are from 1 to 10, so rating my day with an overall figure of 7 would be pretty good but a rating of 7 for brainfog would not be good. So my numbers (not the ratings of my day but the other numbers) were usually around a 2, 3, 4 or 5. So in the lower ranges. Right now I would be rating much, much higher.

 

Date	Rating of the day	Sleep in hrs	Pelvic pain	Brainfog	Tiredness	Emotions	Restless	Lorazepam in mg
19-3-2024	7	5,5	4	3	4	5	4	2
20-3-2024	7	4	4	3	4	3	3	2
21-3-2024	7	4	4	4	4	3	3	2
22-3-2024	7	3,5	4	3	4	3	3	2
23-3-2024	6	2,5	4	4	6	4	4	2
24-3-2024	6,5	3,5	4	3	5	5	4	2
25-3-2024	7	4	3	4	5	5	4	2
26-3-2024	6,5	4	4	4	4	4	4	2
27-3-2024	7	4,5	4	4	5	3	4	2
28-3-2024	7	5	3	3	4	5	3	2
29-3-2024	7,5	5	3	2	2	2	2	2
30-3-2024	8	6	2	2	2	3	3	2
31-3-2024	6,5	4,5	5	3	3	7	3	2

[[Dr...]]

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

How did you feel when you were taking the above total daily dose of 2mg?*  Were you experiencing any withdrawal symptoms?  Were your symptoms stable?  (i.e. not changing in number or nature)

Were you experiencing interdose withdrawal?  

*A 33% reduction in dose from your starting dose of 3mg over ~6 1/2 weeks.

@[Li...] I checked my reports for those days and can see that I sometimes mention that I feel more symptoms in the afternoon than during the morning. But I can also see (and remember) that often I would get a bit more energy again towards the evening. I do remember occassionally wondering whether I was experiencing interdosis withdrawal, but I didn't have that feeling every day and as I mentioned I also often felt a little bit more energy in the evenings.

The past few weeks though it's been a different matter. I feel exhausted the whole day, but the waves are usually coming around 15.00 to 16.00 in the afternoon and there are hardly any breaks or more energy at night.

[[Dr...]]

These were my numbers from a morning dose of 0.5mg onwards. I stopped reporting early June when things got too bad and I didn't want to be behind my computer anymore

 

Date	Rating of the day	Sleep in hrs	Pelvic pain	Brainfog	Tiredness	Emotions	Restless	Lorazepam in mg
17-4-2024	6	2,5	4	4	4	4	4	1,5
18-4-2024	5	4,5	3	4	4	6	4	1,5
19-4-2024	7	4,5	2	2	3	3	3	1,5
20-4-2024	7,5	5	2	2	3	3	2	1,45
21-4-2024	6	2	4	5	6	3	4	1,45
22-4-2024	7	3,5	3	3	4	3	3	1,4
23-4-2024	7	4,5	4	4	4	4	4	1,4
24-4-2024	5	6,5	4	4	4	4	4	1,35
25-4-2024	7	6	3	3	3	4	3	1,35
26-4-2024	6,5	6	3	2	3	5	3	1,3
27-4-2024	5	4	4	4	4	5	5	1,3
28-4-2024	5,5	4	5	3	4	4	5	1,25
29-4-2024	4,5	0	6	5	7	0	7	1,35
30-4-2024	5	5	6	6	6	0	5	1,35
1-5-2024	6	0	3	4	5	0	4	1,35
2-5-2024	6,5	5,5	3	3	3	3	4	1,35
3-5-2024	5	5	5	6	5	0	4	1,35
4-5-2024	6	4,5	3	4	4	3	4	1,35
5-5-2024	6,5	4,5	2	4	3	3	3	1,35
6-5-2024	7,5	4,5	2	3	4	2	2	1,35
7-5-2024	6,5	5,5	3	3	3	2	4	1,35
8-5-2024	5,5	4,5	4	4	4	3	4	1,35
9-5-2024	6	0	4	5	5	0	4	1,35
10-5-2024	7,5	1	2	3	4	2	3	1,35
11-5-2024	6,5	5,5	3	4	4	2	3	1,35
12-5-2024	7,5	0	2	3	4	2	3	1,35
13-5-2024	7	6	3	3	5	5	3	1,3
14-5-2024	6	3,5	3	3	6	3	4	1,3
15-5-2024	7	5,5	2	2	3	2	4	1,3
16-5-2024	5,5	0	3	5	6	2	5	1,3
17-5-2024	5	4,5	3	6	7	0	4	1,3
18-5-2024	6,5	4,5	4	4	5	6	4	1,3
19-5-2024	7	6	3	3	4	6	3	1,3
20-5-2024	7	4,5	2	4	5	4	3	1,3
21-5-2024	5	4	3	4	7	1	4	1,3
22-5-2024	5,5	1	2	4	5	0	5	1,3
23-5-2024	6	0	3	4	4	0	5	1,3
24-5-2024	5	4,5	2	4	5	0	4	1,3
25-5-2024	6	0	1	4	5	0	5	1,3
26-5-2024	6,5	3	1	3	5	3	3	1,3
27-5-2024	5,5	2	4	4	5	0	5	1,3
28-5-2024	6	2,5	2	4	5	0	4	1,3
29-5-2024	6	1,5	2	4	6	0	5	1,3
30-5-2024	4	1,5	2	5	7	0	5	1,3
31-5-2024	4	0	3	5	8	0	5	1,3
1-6-2024	5	4	3	5	5	0	4	1,3
2-6-2024	6	2	3	4	5	0	5	1,3

[[Rh...]]

Hi!  I would have to second all that @[Li...] said as well.  You made some very large cuts and took out a whole dose and almost halved your afternoon dose.

I have heard mixed reviews with the tapering strips and although I think the idea of them is a good one, they usually don’t seem to lend the individual tapering enough control of the percent of cuts and other useful tools.  I do think your experiencing possibly several issues and the first is interdose withdrawal because you have eliminated your morning dose so your evening dose isn’t long enough to cover all the way until you dose in the afternoon and secondly you made too large of cuts in your initial phases and that has also caught up with you.  Thirdly, you have added other psych meds into the mix (which is no fault of your own and when we are desperate we try anything), but your central nervous system is already very sensitive and adding and taking away anything that could further disrupt it best to be avoided.  And lastly having B12 injections without knowing if they are necessary could also complicate things as well.  Many in the withdrawal community find that they are unable to tolerate any supplements, alcohol, marijuana, and even foods. More notably many find that the B vitamins are especially Intolerable.  So unless you are experiencing a deficiency then I would suggest foregoing anymore injections.  Of course, if you are in face deficient, they you must correct this.

As for a remedy to your predicament, I would consider all that @[Li...] said and to find a way to divide your total dose up again into 3 doses (you might need a new script altogether or make your own liquid or ask about a compound) and stabilize for a good amount of time before attempting a MICH slower taper using the Ashton Manuel guides.  You also could go back to whatever dose you last felt stable at, hold there for awhile and then proceed with your taper but go slowly and keep your doses divided up into 3 times a day.

If all else fails a switch to valium could help, but you were doing so well up until these disastrous mistakes which isn’t necessarily because of the lorazepam, but more because of your tapering methods.

Best of luck!!!

Edited June 18 by [Rh...]
Spelling

[[Dr...]]

Thanks @[Rh...] for your reply and for the advice. Going back to 3 doses does actually sound like the right thing to do.

Practically, for now that would result in:

Morning: 0.4mg

Afternoon: 0.5mg

Evening: 0.5mg

I still have a tapering strip for the morning dose and can either cut the 1mg pill in half for the time being or ask my GP to prescribe me with 0.5mg pills. 

Right now the aim is to get stable, survive and find back the will to live. Only then will I consider tapering again... And I will sure ask for advice again then, because I guess I will need to learn how to make cuts myself and will need advice on how to do that, how much, how long and all the doses at the same time or differently. 

I was supplementing B12 with pills over the past few months so unfortunately blood results are now useless. They were on the very low side, but influenced by the supplements. The B12 specialist diagnosed me clinically. There were already suspicions of B12 deficiency 10 years ago. From what the doctor said (as well as 2 of my friends that both nearly died because of B12 deficiency) you can't overdose on B12. Not the injections. Don't know how that is with the pills. If I'm not deficient, it wouldn't really do much and wouldn't cause issues. If I am deficient then it can temporarily worsen my issues, which is a sign of deficiency. That's what I have been told anyway. This doctor is well aware that I'm suicidal and knows I can't handle much more. 

With regards to the Promethazine and the Quetiapine, you're absolutely right. They're not doing me any good and only add more difficulties to the mix. Unfortunately I was faced with a team of 3 people at the mental health crisis services that were really doing a good job of convincing me that I wasn't willing to cooperate and would I rather die then try Quetiapine?! I was in a very bad shape so I gave it a go. But I'm done with it now after 4 nights. 

Thanks again for the support and have a lovely day! 

[[Hu...]]

Yes Dragon. Keeping balance with 3 doses is so much better than to taper a specific am/noon/pm dose. Then you'll get interdose withdrawal because there is a gap. Keeping balance is key. Then you can taper xanax, ativan whatever. 

Crossing to a different benzo can be very difficult. It may help a lot, but it can also cause great distress. Diazepam is a tricky med not every person can metabolize well. 

[[Rh...]]

22 minutes ago, [[D...] said:

Thanks @[Rh...] for your reply and for the advice. Going back to 3 doses does actually sound like the right thing to do.

Practically, for now that would result in:

Morning: 0.4mg

Afternoon: 0.5mg

Evening: 0.5mg

I still have a tapering strip for the morning dose and can either cut the 1mg pill in half for the time being or ask my GP to prescribe me with 0.5mg pills. 

Right now the aim is to get stable, survive and find back the will to live. Only then will I consider tapering again... And I will sure ask for advice again then, because I guess I will need to learn how to make cuts myself and will need advice on how to do that, how much, how long and all the doses at the same time or differently. 

I was supplementing B12 with pills over the past few months so unfortunately blood results are now useless. They were on the very low side, but influenced by the supplements. The B12 specialist diagnosed me clinically. There were already suspicions of B12 deficiency 10 years ago. From what the doctor said (as well as 2 of my friends that both nearly died because of B12 deficiency) you can't overdose on B12. Not the injections. Don't know how that is with the pills. If I'm not deficient, it wouldn't really do much and wouldn't cause issues. If I am deficient then it can temporarily worsen my issues, which is a sign of deficiency. That's what I have been told anyway. This doctor is well aware that I'm suicidal and knows I can't handle much more. 

With regards to the Promethazine and the Quetiapine, you're absolutely right. They're not doing me any good and only add more difficulties to the mix. Unfortunately I was faced with a team of 3 people at the mental health crisis services that were really doing a good job of convincing me that I wasn't willing to cooperate and would I rather die then try Quetiapine?! I was in a very bad shape so I gave it a go. But I'm done with it now after 4 nights. 

Thanks again for the support and have a lovely day! 

Oh I completely sympathize with all you’ve said and been through.  The mental heal crisis teams and any type of rehab/clinics (here in the US) make you feel like your uncooperative and not willing to be a advocate for your health unless you take more meds…they are unaware of WD and all that can happen because of it.  Their only answers are more meds!  Please don’t blame yourself for any of what happened in your worst of times and then the aftermath of the mental health crisis team.

As for the B12, if you were clinically diagnosed and needed it, then that is another story all together!  B12 deficiency is no joke and addressing it is an utmost priority.  I’m glad your dr is aware of your mental health and taking that into consideration.

Once you are stable again you’ll have s whole new lot on life and the SI (suicidal ideation/thoughts) will lessen and possibly go away.  I find that it isn’t so much that I want to die, it’s that I want this suffering to end and the only way you think that can happen is by death.  So it’s not that I want to die, but more escape the, what feels like, never ending torture.  There is a clear difference between the two…is that how you would describe yours?

On a positive note, it seems you’ve come up with a good plan for now and I’m hopeful stabilization will take place and you can resume your more “normal” life again and then when your ready, think about tapering again! 
 

 

[[Hu...]]

Btw, I never asked this question but I'm curious. Is ativan even water-solubale (able to water taper)

Can somebody with experience with this or a mod or Colin answer this, please?

[[Dr...]]

40 minutes ago, [[H...] said:

Yes Dragon. Keeping balance with 3 doses is so much better than to taper a specific am/noon/pm dose. Then you'll get interdose withdrawal because there is a gap. Keeping balance is key. Then you can taper xanax, ativan whatever. 

Crossing to a different benzo can be very difficult. It may help a lot, but it can also cause great distress. Diazepam is a tricky med not every person can metabolize well. 

Thanks for the confirmation @[Hu...]. It's getting clear to me now that interdosis withdrawal might be the issue. I have mentioned it many times to the pharmacist but he dismissed it every time. If this really is the clue, then you guys may be saving my life 🙏

[[Hu...]]

Oh, you're not alone. I had a mental nurse (somebody I should trust) look at me crazy because I told her I tapered with a 0,00 mg scale and took of 0,01 a couple of times a week or so. She thought that was very strange and obsessive.

"just decrease a quarter of a milligram" Trough the phone. 

These people don't know what benzo withdrawal really is. Ashton manual, didn't know that also. Doesn't mean you have to agree with it. But it is a solid work you should at least know as a mental nurse dealing with these kind of medications. 

 

Edited June 18 by [Hu...]

[[Dr...]]

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

Oh I completely sympathize with all you’ve said and been through.  The mental heal crisis teams and any type of rehab/clinics (here in the US) make you feel like your uncooperative and not willing to be a advocate for your health unless you take more meds…they are unaware of WD and all that can happen because of it.  Their only answers are more meds!  Please don’t blame yourself for any of what happened in your worst of times and then the aftermath of the mental health crisis team.

As for the B12, if you were clinically diagnosed and needed it, then that is another story all together!  B12 deficiency is no joke and addressing it is an utmost priority.  I’m glad your dr is aware of your mental health and taking that into consideration.

Once you are stable again you’ll have s whole new lot on life and the SI (suicidal ideation/thoughts) will lessen and possibly go away.  I find that it isn’t so much that I want to die, it’s that I want this suffering to end and the only way you think that can happen is by death.  So it’s not that I want to die, but more escape the, what feels like, never ending torture.  There is a clear difference between the two…is that how you would describe yours?

On a positive note, it seems you’ve come up with a good plan for now and I’m hopeful stabilization will take place and you can resume your more “normal” life again and then when your ready, think about tapering again! 
 

@[Rh...], thank you for the very kind words. They touched me and made me cry, which is wonderful because I was unable to express any emotion for a long time. To be honest I cut my 1mg evening dose in 2 already and took half this afternoon. It is likely way too soon to reach any conclusions, but afterwards I felt something lift and now I feel more like myself than I have in the past few weeks. And no wave so far (it's half past 6 in the evening here). I'm praying that dividing my 1,4mg into 3 doses is the answer to get the much needed relieve.

And yes, you're spot on. It's not necessarily that I want to die as wanting to let the suffering come to an end. It all seemed so hopeless. No quality of life at all. 

The mental health crisis people mean well but have no clue what kind of hell they're putting people in. No awareness with regards to WD. At least the B12 doctor acknowledged that Lorazepam is extremely difficult to taper. He understood. 

Thanks again for all the support. It is so much appreciated and so welcome. I have felt so horribly lonely (do have a very supportive partner and also lots of support from my parents) as no one understands what we are going through in withdrawal. 

[[Dr...]]

10 minutes ago, [[H...] said:

Oh, you're not alone. I had a mental nurse (somebody I should trust) look at me crazy because I told her I tapered with a 0,00 mg scale and took of 0,01 a couple of times a week or so. She thought that was very strange and obsessive.

"just decrease a quarter of a milligram" Trough the phone. 

These people don't know what benzo withdrawal really is. Ashton manual, didn't know that also. Doesn't mean you have to agree with it. But it is a solid work you should at least know as a mental nurse dealing with these kind of medications. 

I'm sorry you had a similar experience! I also asked 4 people at the mental health service whether they knew about the Ashton manual. They blinked a few times and had no clue what I was talking about. I even brought the manual yesterday to an appointment and they couldn't care less. They were happy that I upped my dose however (from 0.3 to 0.4 in the morning). They could agree with that... But when I mentioned interdosis withdrawal, they went blank again... 

At least my GP supports me in everything, so whatever prescription I need, she'll take care of it. She's not a fan of medication, which I can appreciate in a medical doctor! 

[[Hu...]]

Well, at least you have a prescriber who doesn't cut you off. I had one who just changed the 1.0mg tablets to 0.5 That felt like somebody put a gun to my head.

I also had great problems with tapering in the lower regions (0,7) because I only took one dose a day. I just couldn't push it lower or I didn't sleep at all and I was all tensed up.

[[Dr...]]

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

Well, at least you have a prescriber who doesn't cut you off. I had one who just changed the 1.0mg tablets to 0.5 That felt like somebody put a gun to my head.

I also had great problems with tapering in the lower regions (0,7) because I only took one dose a day. I just couldn't push it lower or I didn't sleep at all and I was all tensed up.

Oh, that's a horrible experience. I'm lucky to have several doctors doing their very best to support me (but not knowing how, really). I really do feel supported by my GP. And even the psychiatrist at the mental health service did whatever I asked of him. He didn't understand that I wanted to taper, had no clue that tapering strips existed, but at least he put his signature on every paper I prepared for him. 

Were you on Lorazepam? I hope you'll find a way to taper and maintain a quality of life

[[El...]]

@[Dr...] I sincerely hope that your splitting of your evening dose is successful. Since you are dealing with an already very sensitive central nervous system, I would have cautioned you to perhaps go a bit slower to make this transition. But, if it is working and you are determined to keep this dosing schedule, you will most certainly need to give yourself a good, long chance to stabilize.

May I ask at what times you are dosing? Are the times now 8 hours apart? Additionally, do you have a scale? When you are stable at these dosing weights and this schedule, you will more than likely need to go at a much slower reduction pace. That will involve cutting, shaving and weighing pills. I would be willing, as I am sure are many others on this forum, to help you figure this out.

In the meantime, I hope you are feeling well!

 

[[Dr...]]

2 minutes ago, [[E...] said:

@[Dr...] I sincerely hope that your splitting of your evening dose is successful. Since you are dealing with an already very sensitive central nervous system, I would have cautioned you to perhaps go a bit slower to make this transition. But, if it is working and you are determined to keep this dosing schedule, you will most certainly need to give yourself a good, long chance to stabilize.

May I ask at what times you are dosing? Are the times now 8 hours apart? Additionally, do you have a scale? When you are stable at these dosing weights and this schedule, you will more than likely need to go at a much slower reduction pace. That will involve cutting, shaving and weighing pills. I would be willing, as I am sure are many others on this forum, to help you figure this out.

In the meantime, I hope you are feeling well!

Thanks, @[El...]. I felt like I needed to do something today and since I have no clue about cutting and shaving yet I didn't see another option then to cut the evening dose. So far I have not had a wave today and I laughed, cried and danced for the first time in weeks. My nervous system is indeed fragile, so I'm hoping I'm not screwing things up. But I was desperate.

I was taking a dose at 22.00 at night and at 08.00 in the morning. Will now change to 06.00, 14.00 and 22.00 as per your advice

[[Dr...]]

14 hours ago, [[E...] said:

@[Dr...] I sincerely hope that your splitting of your evening dose is successful. Since you are dealing with an already very sensitive central nervous system, I would have cautioned you to perhaps go a bit slower to make this transition. But, if it is working and you are determined to keep this dosing schedule, you will most certainly need to give yourself a good, long chance to stabilize.

May I ask at what times you are dosing? Are the times now 8 hours apart? Additionally, do you have a scale? When you are stable at these dosing weights and this schedule, you will more than likely need to go at a much slower reduction pace. That will involve cutting, shaving and weighing pills. I would be willing, as I am sure are many others on this forum, to help you figure this out.

In the meantime, I hope you are feeling well!

@[El...] or @[Li...]I would need your advise please.

My afternoon and evening were actually quite nice yesterday, for the first time in weeks. I went to bed with a mixture of relaxation and a little tension whether I hadnt screwed things up. Didn't sleep much, but that also had to do with a coughing fit and blocked nose in the middle of the night. I did feel calm though and could peacefully ly in bed.

This morning I took 0.4mg at 06.00 in the morning and had hoped to just ly in bed for a bit more. But now I'm starting to feel a bit restless and am starting to get a dry mouth. I think I'm also too much in my head now, worrying whether my sudden change yesterday (from 2x dose to 3x dose) will catch up with me. So I'm hyper focusing on every single sensation... 

Can/will this catch up with me and how should I go about that? Should I still try to make changes in the doses to make a more gradual transition? How do I do that? What would the 3 doses then look like? And how to do it, without actually having the right equipment to cut and weigh? 

Needing a bit of reassurance I guess... 

So my situation was:

Morning dose: 0.4mg (only increased that dose on Monday, I came from 0.3mg)
Evening dose: 1mg

Yesterday I took 0.4mg in the morning and cut the 1mg more or less in half with a pill cutter. I think it was more like 0.4 in the afternoon and 0.6 in the evening

How can I make the transition more gradual with the limited tools I have? I do actually have some 0.05mg pills left from my tapering strip so I could use these for the afternoon and evening dose to come up with more exact numbers. I can't do that for may days unfortunately.

What amount should I take in the afternoon and evening and for what numbers of days untill I reach more evenly distributed doses during the day?

Thanks in advance for your support! Since there is a time difference, I do hope you or someone else would read this message in time for my afternoon dose

Edited June 19 by [Dr...]

[[Dr...]]

@[El...]: I saw you mentioning a good scale in another thread but since I'm in Europe (Netherlands), I don't think I can use that one because of the adapter? You mentioned this one:

https://www.ebay.com/itm/404982267351?_trkparms=amclksrc%3DITM%26aid%3D1110006%26algo%3DHOMESPLICE.SIM%26ao%3D1%26asc%3D264183%26meid%3Db179af616ce94aecb9e8b33c33ae6fc5%26pid%3D101875%26rk%3D1%26rkt%3D12%26sd%3D135072991408%26itm%3D404982267351%26pmt%3D1%26noa%3D0%26pg%3D2332490%26algv%3DSimplAMLv11WebTrimmedV3MskuWithLambda85KnnRecallV1V2V4ItemNrtInQueryAndCassiniVisualRankerAndBertRecallWithVMEV3CPCAutoWithCassiniEmbRecall%26brand%3DU.S.%2BSolid&_trksid=p2332490.c101875.m1851&itmprp=cksum%3A404982267351b179af616ce94aecb9e8b33c33ae6fc5|enc%3AAQAJAAABcLC2%2Ba5TgOFYgIvLQSBIYkURSzHvc7cCccVTU14STgixqt2LHVH3DQgpuMCV11vSwIPgiyFOwqAlvyaCYV%2F3KC%2BV%2Bw2hITE7xTLMc%2FUAdPVM74mBrClyfys6h0qSntiKTtamp%2FwRG%2FuVgTYA%2FQ9W3Ox1vA0GraSb4JMRxeVcTuw%2FbvfsO7mDS6tzWet1HTCrTYRbeb2tHmAHHAup62wQ1bhEouCGCcrjno6DbPNsyKPcjxzwU77ReA5wfcqPzMfgpfTYeGvabrLSfnLm%2FJHFCT5Z%2F1w4mcZYcOYyQ4050QW5QnMEL%2BbSE5hfwM6r%2FF1HVcvvaNag5pjv04%2BG4TRzG5ijPR4OkWNUUZXv4D2%2FIssEroIme1cVrxOf26aSF6B4CzW9MGDJulrZoavWea%2Bd2CCUhnb%2FLaDIqAuoxBW8cemhdTbFp3yNg1YKUMsKXbXEoOPgN1U6ipoWgkhK6KsdndxyaZUWM10MAvrFb4Kw6tFq|ampid%3APL_CLK|clp%3A2332490&itmmeta=01J0BW5WW7SY0MVQ6JTJ9ZWTXG

Is there something similar that can be used in The Netherlands?

Your help and advice are hugely appreciated!

Edited June 19 by [Dr...]