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

[[Hu...]]

Looks very expensive. I just use this scale from amazon and it is pretty precise. You need to callibrate it often, but then you will be assured it is good.

[[Dr...]]

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

Looks very expensive. I just use this scale from amazon and it is pretty precise. You need to callibrate it often, but then you will be assured it is good.

Thanks @[Hu...]. I'll look into it. It's just that I also saw it mentioned somewhere that an accuracy of 0.0001mg might be best for a microtaper? I already know I'm quite sensitive, so might need to go real slow and make tiny cuts?

[[Hu...]]

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

Thanks @[Hu...]. I'll look into it. It's just that I also saw it mentioned somewhere that an accuracy of 0.0001mg might be best for a microtaper? I already know I'm quite sensitive, so might need to go real slow and make tiny cuts?

I doubt that you can even cut 0.0001. 

0.001 is already very good.

Another option is to water taper. Take out a milliliter extra of water every couple of days. That maybe even more precise than dry cutting. Especially when you get in the lower doses. 

Edited June 19 by [Hu...]

[[Li...]]

@[Dr...]

I have a medical appointment this morning so must be brief.

I’m sorry you are experiencing issues after your rapid change in dosing schedule.  You’ve now learned one of the keys to success in tapering — when making adjustments in a taper, make small changes gradually.  

My hunch (and it’s just a hunch) is that you may need to return to a dose of at least 2mg to stabilize.  You were at that dose a tad over 4 weeks ago and indicated you were doing ok.  So, one option for you to consider is:

0.5mg morning
0.5mg afternoon
1mg evening

If you decide the try the above schedule, we can then discuss the pros/cons of reducing the evening dose from 1mg to 0.5mg to achieve 3 equal-size doses.  We also can discuss techniques you could use to make the necessary reductions.  

I encourage you to engage with @[El...] regarding your scale-related questions … she has expertise in this subject. She is also tapering the same benzodiazepines as you (lorazepam).

[[Dr...]]

@[Li...], I see you're online. I'm about to take an afternoon dose. I don't know whether you're able to read everything and advise that quick but would it help if I take 0.25 in the afternoon and 0.75 in the evening? Would that make the transition from 0 in the afternoon and 1mg in the evening more gradual? 

[[Dr...]]

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

@[Dr...]

I have a medical appointment this morning so must be brief.

I’m sorry you are experiencing issues after your rapid change in dosing schedule.  You’ve now learned one of the keys to success in tapering — when making adjustments in a taper, make small changes gradually.  

My hunch (and it’s just a hunch) is that you may need to return to a dose of at least 2mg to stabilize.  You were at that dose a tad over 4 weeks ago and indicated you were doing ok.  So, one option for you to consider is:

0.5mg morning
0.5mg afternoon
1mg evening

If you decide the try the above schedule, we can then discuss the pros/cons of reducing the evening dose from 1mg to 0.5mg to achieve 3 equal-size doses.  We also can discuss techniques you could use to make the necessary reductions.  

I encourage you to engage with @[El...] regarding your scale-related questions … she has expertise in this subject. She is also tapering the same benzodiazepines as you (lorazepam).

@[Li...], okay. Willing to try that. I'll do 0.5 now (afternoon), 1mg tonight. This morning I took 0.4 but will change that to 0.5 tomorrow morning. It feels like I'm thrown back a lot but on the other hand I want to survive this. Thanks for the support and good luck on your medical appointment 

[[Dr...]]

Hi @[Li...] and @[El...]

My experience thus far since making a change yesterday:

Yesterday afternoon and evening were just really nice after taking 0.5 mg (probably more like 0.4 as the pill was not evenly cut). Finally feeling relaxed, less pain (pelvis, bladder) and no wave at all. Bit anxious before sleeping but mainly because I was worrying about having made too drastic a change. 

At night I took 0.5 (or probably more like 0.6) before bed. I didn't sleep much but was quite relaxed and comfortable. 

In the morning I took 0.4mg at 06.00 but then started to feel restless. This has lasted most of the day. I'm also having pelvic pain and a very dry mouth. Lots of stress. And just now a wave (16.30 in afternoon). 

All the hope I felt yesterday at finally having a good afternoon and evening, is gone again. 

I took 0.5 in the afternoon and will take 1mg at night and then 0.5 in the morning. This means I'm going from recently being on 1.3 mg total to 1.4mg since Monday, and 2mg as per today. And from having 2 doses to 3 doses as per yesterday. I hope this is soon enough of a change to recuperate from only taking more or less half of my evening dose last night. 

And I hope my body and brain can handle all the changes I made this week. 

Is it okay to stay on 0.5 - 0.5 - 1 for the moment??? 

[[El...]]

I would agree with @[Li...] suggestion of dosing 0.5, 0.5, 1 mg for now and looking at ways to reduce later, once stabilized. One big thing I have learned during my taper is that anytime you make changes (and you have made a couple in the space of just a few days) it will take time for your body to adjust to those changes. Unfortunately there does not seem to be any quick or easy fix. So you have to remain patient. Your body will adjust in its own time. It might take 1 or 2 or 3 or 4 weeks to adjust to your new dosing schedule.  Waiting can be frustrating as I know you feel like you “are not getting anywhere”. But in reality you CNS is “very busy” adjusting. So, please give yourself the time needed.

My only suggestion would be that you might try to get enough 0.5 mg pills from your provider to see you through this adjustment. Unless you are weighing your pills, merely cutting them with a pill splitter (unless they are scored) is not a very accurate process.

Hope you are improving!

 

[[Dr...]]

Thanks @[El...] and @[Li...] for your support! I'm having a bit of a discussion here though with my partner (who has been hugely supportive) who believes it would be better to do

0.4 - 0.4 - 1mg

What he has witnessed over the past couple of weeks is that my morning dose of 0.3 was getting me through to about 3 in the afternoon. Then the majority of the complaints and waves would start. We had now upped my morning dose to 0.4 and yesterday with not having cut the pill very evenly it was more or less 0.4 what I took in the afternoon and that got me through the afternoon and evening. He is therefore of the opinion that 0.4 - 0.4 - 1mg would get me stable. I can understand his reasoning. He also says we can always up the dose if needed but it would be more difficult to taper down. Which I also agree with.

I have new tapering pills coming in that are for 0.45mg a day (for 28 days). They come in 0.05 mg pills. This means I would have enough pills for a little more than 15 days to make two doses of 0.4mg. I do have quite a few other pills of 0.05, but also 0.1 and 0.2 so I could puzzle around and have enough stock for probably 20 days or so. That would buy me time to buy a precision scale ( @[El...], recommendations are very welcome for a scale I could use in Europe with the right adapter) and get instructed how to cut from 0.5mg pills to 0.4mg. And only when I am stable for a long while, I will then look at tapering again and could then definitely use your advise on how to do that (evening dose down to 0.4mg to have equal doses, or differently).

Would it be okay to do 0.4 - 0.4 - 1mg?

[[El...]]

@[Dr...] I think you are the only person who can decide at what dosage you wish to begin stabilization. What stands out to me is that you state, your doses “got me through”.   If that is a level of functionality that is satisfactory for you, than you will probably be fine at 0.4, 0.4, and 1 mg doses. The aim in my recommendation was for you to reach a state of stability and functionality such that you eventually feel able to successfully start tapering and/or make all your doses equivalent.  I would just urge you to make a decision and stick with it. Each “tweak” you make may be another “jolt” to your system.

As far as selecting a scale, again, only you can decide how much you are willing to spend and the accuracy you desire. When selecting a scale, you should look at the “Spec” sheet. If none is available, chances are the manufacturer is not going to guarantee any more than +/- 0.01 gram accuracy for a 0.001 gram scale. Of course, you may purchase a 0.001 gram scale that fortunately does have +/- 0.001 gram accuracy. And I know that is the experience of many on this forum. It is just not guarenteed. If you are willing to spend more, you will be guaranteed greater accuracy. I have posted one that is available on eBay in Europe. If you look at the “Spec” sheet it has a Linearity of 0.2 mg (0.0002 grams). That means that when you are weighing something, the weight will be within 0.0002 grams of its actual weight (or we could loosely say it has +/-0.0002 grams accuracy). It also has a repeatability of +/- 0.2 mg. This means that upon repeated weighing of the same substance, each weighing will be within +/- 0.2 mg of each other. So, as long as you are using the scale appropriately, if you weigh something it should be within +/- 0.2 mg of its true weight and will not vary more than +/- 0.2 mg if you do repeat weighings. Of course you can spend thousands of dollars for even greater accuracy. This was sort of a “middle-of-the-road compromise for me because I knew I wanted (needed) greater accuracy but, sadly, do not have the funds for a truly high end scale.

https://www.ebay.nl/itm/234792807695?itmmeta=01J0RCTPADS9S7M0JGBCCSXCPM&hash=item36aabded0f:g:Hr4AAOSw-7lia3s9&itmprp=enc%3AAQAJAAAA4AzOvNYiO4HD11uZnPOiqnCE2DpNGtr3favqgmY8RPlr5JoIxW1iFOsyiBJGEukt9fxSq4uMkqIk%2F7vXSSN1H6wyysYfJYUtSAd0RT3CKzyKNp2qbc8jJEpvs5OD%2BwjJ65xqao65dYain3aNXKqyvt6fyxmQqnieEuT%2BeadljXGhnkDs2%2FoWDfdX%2FSa%2BRXvBGS0lohV0XyWctQKPHVgj4DnyxPJqJgZ2lr5Rerf4rBW%2BPa31G7JjPq6ZibqRAGUma6vfB3B5n89z07lYElgKQDX6%2FBNEC0i6ca6bvfsVYQao|tkp%3ABFBMrOXqjIZk

Hope this is helpful and you are feeling better!

 

 

[[Dr...]]

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

@[Dr...] I think you are the only person who can decide at what dosage you wish to begin stabilization. What stands out to me is that you state, your doses “got me through”.   If that is a level of functionality that is satisfactory for you, than you will probably be fine at 0.4, 0.4, and 1 mg doses. The aim in my recommendation was for you to reach a state of stability and functionality such that you eventually feel able to successfully start tapering and/or make all your doses equivalent.  I would just urge you to make a decision and stick with it. Each “tweak” you make may be another “jolt” to your system.

As far as selecting a scale, again, only you can decide how much you are willing to spend and the accuracy you desire. When selecting a scale, you should look at the “Spec” sheet. If none is available, chances are the manufacturer is not going to guarantee any more than +/- 0.01 gram accuracy for a 0.001 gram scale. Of course, you may purchase a 0.001 gram scale that fortunately does have +/- 0.001 gram accuracy. And I know that is the experience of many on this forum. It is just not guarenteed. If you are willing to spend more, you will be guaranteed greater accuracy. I have posted one that is available on eBay in Europe. If you look at the “Spec” sheet it has a Linearity of 0.2 mg (0.0002 grams). That means that when you are weighing something, the weight will be within 0.0002 grams of its actual weight (or we could loosely say it has +/-0.0002 grams accuracy). It also has a repeatability of +/- 0.2 mg. This means that upon repeated weighing of the same substance, each weighing will be within +/- 0.2 mg of each other. So, as long as you are using the scale appropriately, if you weigh something it should be within +/- 0.2 mg of its true weight and will not vary more than +/- 0.2 mg if you do repeat weighings. Of course you can spend thousands of dollars for even greater accuracy. This was sort of a “middle-of-the-road compromise for me because I knew I wanted (needed) greater accuracy but, sadly, do not have the funds for a truly high end scale.

https://www.ebay.nl/itm/234792807695?itmmeta=01J0RCTPADS9S7M0JGBCCSXCPM&hash=item36aabded0f:g:Hr4AAOSw-7lia3s9&itmprp=enc%3AAQAJAAAA4AzOvNYiO4HD11uZnPOiqnCE2DpNGtr3favqgmY8RPlr5JoIxW1iFOsyiBJGEukt9fxSq4uMkqIk%2F7vXSSN1H6wyysYfJYUtSAd0RT3CKzyKNp2qbc8jJEpvs5OD%2BwjJ65xqao65dYain3aNXKqyvt6fyxmQqnieEuT%2BeadljXGhnkDs2%2FoWDfdX%2FSa%2BRXvBGS0lohV0XyWctQKPHVgj4DnyxPJqJgZ2lr5Rerf4rBW%2BPa31G7JjPq6ZibqRAGUma6vfB3B5n89z07lYElgKQDX6%2FBNEC0i6ca6bvfsVYQao|tkp%3ABFBMrOXqjIZk

Hope this is helpful and you are feeling better!

Thanks so much @[El...]! With 0.4 - 0.4 - 1mg I will have upped my total daily dosage from 1.3mg this weekend to 1.8mg now, which is a 0.5mg increase. I'm really hoping that this will make enough of a difference. And you are absolutely right in that I will now need to stick with it for a while to see how my body will handle it. I will make no further changes until I'm absolutely ready for it. 

Tonight sadly again no sleep for me and just restlessness. Very restless legs and pelvic pain kept me from sleeping or even resting at all. 

Recently I was taking Promethazine for 1 week, then had a short break and then used Quetiapine for 4 days. Maybe this has messed things up and it will take some time to return to 'normal'. It's not that I was getting much sleep before, but at least most nights I was getting some hours. Now none at all. 

Not sleeping is not even the problem for me. It's the restlessness and not being able to relax for even half an hour. 

Hoping things will improve as I'm not sure how much I can handle. 

On the positive side:

- I only had a small wave yesterday (despite feeling restless most of the day) 

- I felt much clearer in my head. No longer a zombie

- My nose is finally open enough that I don't need to use any salt spray anymore and I can breath better at night

- No coughing fit or itchy throat this night

Wishing you a lovely day and I'll check out the scale. Thanks again for everything

[[Dr...]]

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

@[Dr...] I think you are the only person who can decide at what dosage you wish to begin stabilization. What stands out to me is that you state, your doses “got me through”.   If that is a level of functionality that is satisfactory for you, than you will probably be fine at 0.4, 0.4, and 1 mg doses. The aim in my recommendation was for you to reach a state of stability and functionality such that you eventually feel able to successfully start tapering and/or make all your doses equivalent.  I would just urge you to make a decision and stick with it. Each “tweak” you make may be another “jolt” to your system.

As far as selecting a scale, again, only you can decide how much you are willing to spend and the accuracy you desire. When selecting a scale, you should look at the “Spec” sheet. If none is available, chances are the manufacturer is not going to guarantee any more than +/- 0.01 gram accuracy for a 0.001 gram scale. Of course, you may purchase a 0.001 gram scale that fortunately does have +/- 0.001 gram accuracy. And I know that is the experience of many on this forum. It is just not guarenteed. If you are willing to spend more, you will be guaranteed greater accuracy. I have posted one that is available on eBay in Europe. If you look at the “Spec” sheet it has a Linearity of 0.2 mg (0.0002 grams). That means that when you are weighing something, the weight will be within 0.0002 grams of its actual weight (or we could loosely say it has +/-0.0002 grams accuracy). It also has a repeatability of +/- 0.2 mg. This means that upon repeated weighing of the same substance, each weighing will be within +/- 0.2 mg of each other. So, as long as you are using the scale appropriately, if you weigh something it should be within +/- 0.2 mg of its true weight and will not vary more than +/- 0.2 mg if you do repeat weighings. Of course you can spend thousands of dollars for even greater accuracy. This was sort of a “middle-of-the-road compromise for me because I knew I wanted (needed) greater accuracy but, sadly, do not have the funds for a truly high end scale.

https://www.ebay.nl/itm/234792807695?itmmeta=01J0RCTPADS9S7M0JGBCCSXCPM&hash=item36aabded0f:g:Hr4AAOSw-7lia3s9&itmprp=enc%3AAQAJAAAA4AzOvNYiO4HD11uZnPOiqnCE2DpNGtr3favqgmY8RPlr5JoIxW1iFOsyiBJGEukt9fxSq4uMkqIk%2F7vXSSN1H6wyysYfJYUtSAd0RT3CKzyKNp2qbc8jJEpvs5OD%2BwjJ65xqao65dYain3aNXKqyvt6fyxmQqnieEuT%2BeadljXGhnkDs2%2FoWDfdX%2FSa%2BRXvBGS0lohV0XyWctQKPHVgj4DnyxPJqJgZ2lr5Rerf4rBW%2BPa31G7JjPq6ZibqRAGUma6vfB3B5n89z07lYElgKQDX6%2FBNEC0i6ca6bvfsVYQao|tkp%3ABFBMrOXqjIZk

Hope this is helpful and you are feeling better!

With regards to the scale: when I click on your link it shows me a scale that has 6 different models to choose from (FA1004 through to FA2204N). I'm really not understanding much about all the specs, so I'd like to follow your advice as not to give me any more stress. Which model should I choose?

Thanks again for all your help!!! 

[[Dr...]]

@[El...], so you think it would be okay to use Melatonin tonight? I'm not sleeping at all at the moment. But maybe I just need to go through that and not add anything else to the mix?

[[El...]]

@[Dr...] If given a choice, I would select model FA1004 (as you do not need a greater weighing capacity).

When I originally viewed the scale, I did not page down to the second "Spec" sheet.  This sheet says the Linearity is +/- 0.3 mg.  It is still accurate down to +/- 0.0003  grams (which is very good for this quality scale).  But, I did want to point out the difference. Also, it looks like a "US" plug.  You will need an adaptor for the Netherlands, I believe.

Again, taking Melatonin has to be your choice.  I personally stay away from other "medications" and aids.  There are varying reports of their effectiveness.  Unfortunately, insomnia is a common dilemma  for those tapering.  I suffer from it as well.  Sleep comes in windows and waves.  I try not to focus on it  (while in a wave) as it seems to snowball into increased stress, rumination and even less sleep.  You will assuredly sleep again...it just may take time.

Hope you are feeling well today!

[[Dr...]]

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

@[Dr...] If given a choice, I would select model FA1004 (as you do not need a greater weighing capacity).

When I originally viewed the scale, I did not page down to the second "Spec" sheet.  This sheet says the Linearity is +/- 0.3 mg.  It is still accurate down to +/- 0.0003  grams (which is very good for this quality scale).  But, I did want to point out the difference. Also, it looks like a "US" plug.  You will need an adaptor for the Netherlands, I believe.

Again, taking Melatonin has to be your choice.  I personally stay away from other "medications" and aids.  There are varying reports of their effectiveness.  Unfortunately, insomnia is a common dilemma  for those tapering.  I suffer from it as well.  Sleep comes in windows and waves.  I try not to focus on it  (while in a wave) as it seems to snowball into increased stress, rumination and even less sleep.  You will assuredly sleep again...it just may take time.

Hope you are feeling well today!

Thanks @[El...] for your reply. Unfortunately now I'm still not sure what to do with the scale as I would need to have an adapter for the Netherlands. I'm not well enough right now to do any research, I'm afraid. Would you know of any similar scale that I can order within Europe? So sorry to bother you about this. I like to be prepared and order a scale but am limited with respect to being able to do research myself. Usually it's no problem for me but I'm terribly tired right now and can't focus

Could this be something: https://www.conrad.nl/nl/p/kern-pcd-250-3-precisie-weegschaal-weegbereik-max-250-g-resolutie-0-001-g-werkt-op-het-lichtnet-werkt-op-batterijen-755970.html

Or this: https://www.conrad.nl/nl/p/kern-pcb-200-3-precisie-weegschaal-weegbereik-max-200-g-resolutie-0-001-g-wit-zwart-zilver-2758365.html#modal-productTechDataOffCanvasFlyout

Or this:

https://www.carlroth.com/nl/nl/standaardweegschalen/precisieweegschaal-pcb-serie/p/hk92.1

Edited June 20 by [Dr...]

[[Dr...]]

My day so far (it's now 4 in the afternoon):

No sleep last night due to pelvic pain and restlessness 

Difficult start to the morning but then a couple of hours with more energy, more clarity and less restlessness 

Around half past 1 in the afternoon (half hour before newly introduced afternoon dose) I start to feel worse: difficulty breathing and talking, general weakness, fatigue, brainfog (although not as bad as it used to get the last couple of weeks). 

From 2.30 I start getting pelvic pain again and get restless. That's basically where I'm still at. The half past 1 wave is now more or less done but the pelvic pain, tiredness and a dry mouth (had that most of the day) remain.

Worried about another sleepless and restless night. I know I should not worry and just let things be and accept what is, but that's currently very difficult. The pelvic pain is a huge trigger. 

[[Dr...]]

@[El...] and @[Li...], my mind is going crazy and going from left to right with questions. I've never ever been stable on Lorazepam, not even when I started taking it. What if I'm in tolerance withdrawal instead of interdosis withdrawal and now not tapering anymore. I have now upped my dose considerably. How would I know the difference?

I'm so confused about everything and can't understand what is happening to me and what to do. I'm committed to stay on 3 doses for now and can understand that I need to stick with a plan now. But what if I'm doing the absolute wrong thing? 

The will to continue living is fading fast. It did feel like my waves have become less dramatic since adding the afternoon dose and this morning was much better than yesterday morning but I'm questioning everything constantly. How do I know whether I'm now on the right path? 

I guess I need some reassurance. Sorry to be asking so many questions!!! 

[[Li...]]

 

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

It did feel like my waves have become less dramatic since adding the afternoon dose and this morning was much better than yesterday morning

@[Dr...]

Do you best to focus on the positive not the negative or the ‘what if’s’.  For example, your observation above is positive news.

Also, please keep in mind that your nervous system has been through multiple ‘upsetting’ changes and it will take a while for it to settle down.  The more you aggravate it by questioning and worrying about your situation, the longer it will take.

I strongly encourage you to find and use distractions to help you get through this rough patch.  Here’s a list to get you started:

Distractions | The Withdrawal Project
https://withdrawal.theinnercompass.org/coping/distractions

It also sounds like you would benefit from developing some coping techniques.  Here’s another list to get you started:

 

Coping Techniques A to Z | The Withdrawal Project
https://withdrawal.theinnercompass.org/page/coping-techniques-z

 

 

[[El...]]

I am sorry you seem to be having difficulty today.  I would agree with @[Li...] that focusing on positive results and finding distractions can be very helpful.   Fortunately, I am able to enjoy exercise so I walk or swim daily for 1 - 2 hours.  I also enjoy reading which keeps my mind occupied away from my symptoms.  I know, for some, these activities are not possible, however.  But, I am sure you can find something that will help you through this period of adjustment.

I am also sorry you are experiencing pelvic pain. I assume you have had this checked by a doctor. I also periodically experience pelvic pain. I have experienced it for years. Mine seems to be directly related to stress and anxiety. If I am facing a stressful situation, I feel it. But it generally diminishes once out of the stressful event.

Once again, regarding the scale, only you can determine the level of accuracy you need or want and how much you are willing to pay.

Let me give you an example. Sparing you the details (which you can, if you wish, view below*), my current scale gives a margin of error between 0.9 - 1% from the weight I needed today for my afternoon dose. The first two scales you list would give you a margin of error between 13 -15% for that same dose. (The third listing did not give specifications.)

So, only you can decide what is acceptable for you.

You can buy a Tessan International adaptor on Amazon for about $15 which would work for the first scale we discussed.

Hope you can relax and continue to feel better!

(*My current scale has a Linearity of +/- 0.0002 grams. My afternoon dose today needed to weigh 0.0202 grams (equivalent to active ingredient weight of 0.1671 mg). So, with my scale I have a potential variability of between 0.0204 and 0.0200 grams (corresponding to an active ingredient weight variability between 0.1687 to 0.1654 mg). This is within a margin or error of 0.9 - 1%.

The first two of the scales you listed have a Linearity of +/- 0.003 grams. If I were using those scales, I would have a potential variability between 0.023 and 0.017 grams (corresponding to a variability in active ingredient weight between 0.190 to 0.140 mg). This margin of error is between 13 -15%.)

 

 

[[Dr...]]

@[El...] and @[Li...], thank you so much for taking the time to comfort and support me. I so much appreciate that.

I've already had a quick look at the distraction and coping tools and can see that I've already used some of them (screaming, stomping, dancing, EFT, petting an animal, etc.) but I think I've only been using those when I'm not in a too bad state. When a terrible wave hits, I tend to panic and withdraw. I'll try to use distractions or coping tools more often when in this state. 

Most difficult currently is the restlessness at night (and the pelvic pain).  I keep on trying to find peace but sometimes it doesn't come. I then don't want to get up and do something else because then it feels like my chance for some peace and quiet is over... 

Yes, the pelvic pain was checked and nothing medical was found. It is for sure linked to hyperglutamat and yes, that also means stress. 

Mentally, I know what to do and that I need to find a way to stay calm and cope and somehow even after all these months I haven't managed to accept and let go... 

[[Dr...]]

@[El...], I bought the scale you recommended. My partner is quite handy and technical so I'm sure he'll know how to get an adapter or might already have one. I'm not going to ask him just now as he did not want me to buy a scale... He needs some time to get used to the idea that we will have to be weighing and cutting the medication ourselves. Up to now we had the tapering strips. The lowest amount there is 0.05 mg though.

If and when I'm stable, I'll check in about a new tapering plan and maybe initially we could still use the tapering strips. But that's something I can't even think of right now. 

Thanks again for all the amazing support!!! 

[[Dr...]]

Dear @[El...] and @[Li...], it seems like I'm slowly getting back to 'life' again. I had hard and rough days on Wednesday, Thursday and Friday. Saturday morning was also a bit tough but the afternoon and evening were not too bad. Sunday was a bit rougher again, but not as intense as earlier in the week. Monday did not bring any huge waves, nor did yesterday. Yay!!!

I have not slept at all unfortunately but have no illusion that this will change anytime soon and that's something I already experienced before taking Lorazepam. 

Last night was tough and weird but I had a treatment for Lyme yesterday (also the 2 Tuesdays before, but the way) and also my B12 infection, so that probably caused some extra stress to the system. 

Today so far also no wave (it's nearly 15.00 in the afternoon) so finally I'm seeing some relief. 

I'm slowly getting a bit more hopeful that bringing back the afternoon dose and updosing was what was required. 

I'm definitely not in a state yet to start tapering, but I'm aware that my tapering medication will run out someday next week, so I would very soon need to look at how to make cuts myself. I ordered a precision weighing scale and am hoping it will arrive in time... 

Could you share with me how to make cuts and how to go from here? What could be my next steps?

I will definitely wait for at least another week or week and a half before I dare to say I'm really doing better and ready to make cuts. But it would be good to be prepared... 

Sending you lots of love from Holland 

[[Li...]]

Thank you for sharing your encouraging news with us @[Dr...].  It sounds like you are beginning to stabilize on your new dose and dosing schedule.

I do not have experience with either lorazepam or the ‘shave and weigh’ technique for achieving the ‘small enough’ doses required for a gradual, symptom-guided taper.  Happily, @[El...] does so I hope she is able to respond.   She will need to know:

• The amount of active drug substance in the tablets you will use, expressed in milligrams
• The average weight of 10 tablets, expressed in either grams or milligrams
• The initial taper rate you wish to trial (given your history, I suggest you consider a conservative rate of 5-10%.   It would also be very helpful to know what taper rate you were using with the Tapering Strips.
• The taper interval you wish to trial (e.g. do you wish to make reductions every day, every other day, every week, every other week, once a month).

[[Dr...]]

3 hours ago, [[L...] said:

Thank you for sharing your encouraging news with us @[Dr...].  It sounds like you are beginning to stabilize on your new dose and dosing schedule.

I do not have experience with either lorazepam or the ‘shave and weigh’ technique for achieving the ‘small enough’ doses required for a gradual, symptom-guided taper.  Happily, @[El...] does so I hope she is able to respond.   She will need to know:

• The amount of active drug substance in the tablets you will use, expressed in milligrams
• The average weight of 10 tablets, expressed in either grams or milligrams
• The initial taper rate you wish to trial (given your history, I suggest you consider a conservative rate of 5-10%.   It would also be very helpful to know what taper rate you were using with the Tapering Strips.
• The taper interval you wish to trial (e.g. do you wish to make reductions every day, every other day, every week, every other week, once a month).

Thanks for your reply, @[Li...]! Hoping @[El...] can support as well, when she has the time.

I'll look into the question you asked and will answer them soon. I have documents from the tapering strip so will upload these tomorrow when I'm near my computer. 

One of the main questions for when I go forward though, is whether I should start tapering the evening dose or all 3 doses at the same time. 

I'm currently on 0.4 morning, 0.4 afternoon and 1mg in the evening. 

I'm not sleeping at all, so it's not that my evening dose is helping with that. Should I try to reduce the evening first so that I can work towards equal doses? Or is that not advisable? 

I do notice some sedative effect from the evening dose, just not enough to put me to sleep. 

[[El...]]

@[Dr...] Thanks for the positive update!  I would be very happy to help you prepare for your taper.  The information that @[Li...] suggested is exactly what I will need to help you.

It is probably best for you to decide if you want to reduce the evening dose first.  Lowering your evening dose would be my first option, but only you can determine what is best for you given your symptoms throughout the day and evening.  Lowering your day doses, at this point, may increase your day symptoms.  Lowering your evening dose may decrease the sedative effect.

Just let me know and we can work on a plan.  Hope you are having a good day!