Switching from Ativan to Clonazepam for taper

[[vi...]]

I have been on Ativan 1 mg a day for two weeks and then went up to 2 mg for two weeks. Tried to taper but only got to the first taper .5 mg & 1 mg before I went back to 2 mg due to feeling withdrawal between doses. My pcp decided to switch me to Clonazepam .5 twice a day for a week and then start to taper from there since Clonazepam has a longer half life. I wanted to know before switching if it is safe to just stop the Ativan and go straight to Clonazepam to start my taper?

[[je...]]

Hi @[vi...]

Welcome to BenzoBuddies!

I’m sorry to hear you’re struggling. I just want to clarify a few things. How long in total have you been on Ativan? Have you used benzos before? When you made the first reduction, did you cut 0.5mg from your dose?

Thanks! We’re so glad you’re here and happy to help you. 

[[vi...]]

1 minute ago, [[j...] said:

Hi @[vi...]

Welcome to BenzoBuddies!

I’m sorry to hear you’re struggling. I just want to clarify a few things. How long in total have you been on Ativan? Have you used benzos before? When you made the first reduction, did you cut 0.5mg from your dose?

Thanks! We’re so glad you’re here and happy to help you. 

I have only been on the ativan for a total of 1 month and 1 week of trying to taper. Never been on benzos before. When i made the first reduction I did cut .5 mg from my dose yes.

[[je...]]

Thanks. I apologise I have one more question. Prior to making that cut, did you feel withdrawal symptoms between your doses?

[[vi...]]

1 minute ago, [[j...] said:

Thanks. I apologise I have one more question. Prior to making that cut, did you feel withdrawal symptoms between your doses?

no, i did not. a little history, before i tried the taper my pcp tried to have me cold turkey being that it was only 3 weeks I had been on it and I ended up with all kind of symptoms and ended up going to the ER where they put me on the taper. It was just yesterday my pcp switch to clonazepam for the taper after I explained what I have been going through but I have not yet made the switch because everything I have read saying to switch dose by dose instead of just stopping the Ativan and then switching. Im not sure if that is only for long time users though. Im just confused and really need some clarity.

[[je...]]

I gather these symptoms you experienced were unmanageable if you ended up in the ER right? 

[[vi...]]

Yes. I had a bad tremor, very dizzy and was very sensitive to light. As I said this is my first time dealing with anything like this so I went to the ER out of fear. I had no clue what being on benzos really meant as my previous pcp didnt really explain the dangers when she first prescribed.

[[Cr...]]

Welcome to Benzo Buddies vidia!

Just wanted to say that an ER visit is what also brought my attention to the harsh potential difficulty of stopping benzodiazpines.

While 1 month is not a long time generally speaking, it is enough time for physical dependence to occur. The question now is just how dependent your body got and whether it would be better to get off clonazepam faster than a standard Ashton Manual-based taper. Sometimes a long slow taper is unnecessary for short-term users as it just extends the length of time spent on benzos and thus can cause the body to become even more physically dependent.

[[je...]]

Usually benzos should only be prescribed 2-4 weeks and you are right in that range. But many people have developed dependency within a couple of days. It’s not unheard of. 

I think what has happened is that the cut you made caused your symptoms. I’m not convinced you’re experiencing interdose withdrawal. Usually we would not recommend switching to another benzo unless you are really struggling with interdose withdrawal. We always recommend tapering the drug you are on unless there is a compelling reason to switch because crossing over always contains risks.

The fact that you didn’t experience withdrawal symptoms prior to cutting your dose is suggesting to me that you don’t need a longer acting drug. If you did, you would’ve experienced interdose withdrawal prior to making the cut. 

It remains your decision whether you want to cross over or not, but I wouldn’t recommend it. As @[Cr...] mentioned you also have to weigh your short term use and decide whether prolonged use will deepen your dependency and potentially create more symptoms. Only you know how severe these symptoms are and only you can make the decision. 

We are here to support you whatever you decide.

[[vi...]]

28 minutes ago, [[C...] said:

Welcome to Benzo Buddies vidia!

Just wanted to say that an ER visit is what also brought my attention to the harsh potential difficulty of stopping benzodiazpines.

While 1 month is not a long time generally speaking, it is enough time for physical dependence to occur. The question now is just how dependent your body got and whether it would be better to get off clonazepam faster than a standard Ashton Manual-based taper. Sometimes a long slow taper is unnecessary for short-term users as it just extends the length of time spent on benzos and thus can cause the body to become even more physically dependent.

Thats the thing he didn’t prescribe anymore ativan for a ashton manual based taper, he only switched to clonazepam so it would just be switching to that and then tapering

[[vi...]]

24 minutes ago, [[j...] said:

Usually benzos should only be prescribed 2-4 weeks and you are right in that range. But many people have developed dependency within a couple of days. It’s not unheard of. 

I think what has happened is that the cut you made caused your symptoms. I’m not convinced you’re experiencing interdose withdrawal. Usually we would not recommend switching to another benzo unless you are really struggling with interdose withdrawal. We always recommend tapering the drug you are on unless there is a compelling reason to switch because crossing over always contains risks.

The fact that you didn’t experience withdrawal symptoms prior to cutting your dose is suggesting to me that you don’t need a longer acting drug. If you did, you would’ve experienced interdose withdrawal prior to making the cut. 

It remains your decision whether you want to cross over or not, but I wouldn’t recommend it. As @[Cr...] mentioned you also have to weigh your short term use and decide whether prolonged use will deepen your dependency and potentially create more symptoms. Only you know how severe these symptoms are and only you can make the decision. 

We are here to support you whatever you decide.

That actually makes alot of sense. Im just at a loss being that I have never been on benzos before. Im wondering if I should just call him to prescribe enough ativan to continue that taper. I only have 2 more ativan but a full prescription of the clonazepam I just didnt know if i would go into complete withdrawal from the ativan by just switching. This is the taper plan he provided for the clonazepam to be done over the next 4 weeks.

[[Cr...]]

23 minutes ago, [[v...] said:

Thats the thing he didn’t prescribe anymore ativan for a ashton manual based taper, he only switched to clonazepam so it would just be switching to that and then tapering

As in he believes it is better to taper from clonazepam than from lorazepam? Technically it could be easier since clonazepam has a longer half-life than ativan, however you were not experiencing interdose withdrawals so the low half-life was not really a factor for you. Of course over time it may have became a factor. But since he wants you off in 4 weeks, tapering from Ativan should have still been a choice offered by your doctor.

Do you notice any worse feelings on clonazepam vs ativan? If not, you probably don't need to worry about not having slowly crossed over to clonazepam. Gradual crossovers are mostly needed when long term users are changing to another benzo. Although there are complications for short-term people as well but usually not to the same degree.

That taper plan may be viable, physically, since you have not been on benzos for too long. You can probably tell after the first week how tolerable that rate is for you. If things become increasingly too difficult, be sure to let your doctor know and hopefully he will allow you to slow it down.

[[Cr...]]

Sorry, i misread your earlier post. I thought you had already just started clonazepam.

[[vi...]]

@[Cr...] I think that is exactly what happened. On the 4th week exactly is when i started feeling withdrawal between dosages and that was last week. I just now started the first taper this week and ended up going back up to my regular dosaging. Thats when he decided to switch to clonazepam and do a 4 week taper off of that. Im not sure how the clonazepam feels yet as I was trying to get some clarity as to whether Im going down the right road before i made the switch. All in all i just want to be off of all meds as I have never been on anything in my life other than allergy medicine everyday. It was prescribed in the first place because my first primary believed I had a chronic anxiety disorder but it turns out after a study from a cardiologist my “anxiety” symptoms may be symptoms of pots onset from a miscarriage I had last month. So now i just want to be off of it all 

[[vi...]]

Overall this has been a crazy month. I have lost 15 pounds because i have very little appetite. I’ve experienced muscle cramps/spams, headaches/numbness on only one side, tremors, chills, cannot tolerate heat at all so much to the point i have to take cold showers on the days that i am not too dizzy to shower. My body is definitely physically dependent but my mind is only on getting off of these drugs in the safest way possible. I am terrified of seizure after I have read all the horror storries about benzos and I just am really confused about it all.

[[Cr...]]

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

I am terrified of seizure after I have read all the horror storries about benzos and I just am really confused about it all.

People have cold turkeyed from doses far higher than yours and did not get seizures. Unless you have a history of seizures or a condition that makes you susceptible to them, I would not worry about them. While the taper rates doctors give patients are often too fast in regards to preventing general withdrawal symptoms, they are generally medically safe and devised primarily to help avoid seizures.

Since you said interdose withdrawals have started recently, perhaps the doctor switching you to clonazepam will work in your favor. The only other way to help prevent interdose withdrawal while staying on Ativan would be by splitting the dose up to 2 or 3 times a day.

Try not to let horror stories sow confusion and anxiety. Site's like this will naturally be skewed towards those that suffer far more than others. Right now just keep your focus on the immediate goal (stablizing on clonazepam if you have accepted that route, starting taper). 

[[vi...]]

@[Cr...] @[je...] thank you both so much for clarity! you two have truly given me all the answers and info i was searching desperately for. I think I am going to ask my doctor if we could stay the course with ativan for taper and if not i will probably just try the clonazepam then taper. thank you again!

[[je...]]

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

@[Cr...] @[je...] thank you both so much for clarity! you two have truly given me all the answers and info i was searching desperately for. I think I am going to ask my doctor if we could stay the course with ativan for taper and if not i will probably just try the clonazepam then taper. thank you again!

This sounds like a feasible plan. If you do find the Ativan problematic down the road, then you can always consider a longer acting benzo later. But if your doctor refuses and you don’t have a choice then we can help you with Clonazepam. 

[[vi...]]

Thank you. I have left a message to speak with him. fingers crossed! 

[[vi...]]

Well he refused the Ativan so here we are! Now my question is, I took .5 of Ativan today around 12:30 when is it safe to take my first dose of Clonazepam?

[[Cr...]]

27 minutes ago, [[v...] said:

Well he refused the Ativan so here we are! Now my question is, I took .5 of Ativan today around 12:30 when is it safe to take my first dose of Clonazepam?

What is your total current daily dose? Weren't you back at 2mg of Ativan a day (1mg two times daily) and preparing to switch to 1mg Clonazepam (.5mg two times daily) So why did you take .5 ativan today?

[[vi...]]

I was trying to save my last two pills until he gave me an answer as to if he would refill the ativan for the taper 

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

What is your total current daily dose? Weren't you back at 2mg of Ativan a day (1mg two times daily) and preparing to switch to 1mg Clonazepam (.5mg two times daily) So why did you take .5 ativan today?

 

[[Cr...]]

Ok. So how much Ativan in total will you be taking today? If you take 1mg of Ativan today you may want to take your first .5 mg Klonopin tonight so your total daily benzo dose stays at the same amount before you start your taper.

So if you took another dose this morning, today should have looked like this

Morning .5 A, Noon .5 A, Night .5 K

Then tomorrow will be:

Morning .5 K, Night .5 K

[[vi...]]

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

Ok. So how much Ativan in total will you be taking today? If you take 1mg of Ativan today you may want to take your first .5 mg Klonopin tonight so your total daily benzo dose stays at the same amount before you start your taper.

So if you took another dose this morning, today should have looked like this

Morning .5 A, Noon .5 A, Night .5 K

Then tomorrow will be:

Morning .5 K, Night .5 K

yes i took .5 this morning & .5 at 12:30 so around what time should i take the .5 K?

[[Cr...]]

It shouldn't matter too much as Ativan is quickly metabolized. Even if it wasn't, the total amount for the day is still going to the same.

I would take it at a time that will make it exactly 12 hours apart. So it is your call. Any time between 6pm and 9pm is probably fine, just take the morning dose 12 hours later.

You could also choose the morning time you prefer first and take the dose tonight according to what time you prefer for morning.