Lorazepam taper schedule

[[ze...]]

I've been taking 0.5 mg lorazepam twice a day for almost three years and I will soon be ready to start tapering (I am at the end of my healing from almost two years of antidepressant withdrawal). I am able to get the liquid form from the pharmacy. What type of schedule do people typically use to taper? 5% decrease of the most recent dose every four weeks? 10% of the most recent dose every two weeks? Something else? Thank you

[[Cr...]]

Generally it is recommended to do 5% to 10% cuts about every 2 weeks.

Since you will be doing your very first cut you could try 5% just to test the waters. However, many times it is easier to do bigger cuts in the beginning of a taper, so if your focus is to test the highest amount you can tolerate, for the sake of quicker taper, starting out with 10% may be better. Since lorazepam has a short half-life you should be able to tell how it affects you pretty soon after the cut.

Just remember that the suggested rates and holds are general guidelines. You can +/- your cut % according to what you find tolerable. You can also hold longer after some cuts if you feel it necessary.

 

[[ze...]]

Thank you. Is that 5-10 percent of the most recent dose? So the decreases become smaller and smaller?

 

[[Cr...]]

Yes. So if you did 10% cuts your first reduction would be .20 mgs, leaving you with 1.8 mgs for 2 weeks then next cut would be .18 mgs. 

 

 

[[ze...]]

okay, thank you

[[Pa...]]

Hi @[ze...], are you currently using tablets, have you started the liquid yet?  I've heard other members mention its good to test the liquid by taking your normal dose for a little while before reducing, some have reported a slight difference in how it makes them feel.  Its best to get a baseline of how you'll react to the new formulation before reducing. 

[[ze...]]

I haven't started the liquid yet. Thanks for the tip!

[[Pa...]]

3 minutes ago, [[z...] said:

I haven't started the liquid yet. Thanks for the tip!

Do you know the strength of the liquid you'll be taking, some have to dilute it with distilled water because its too potent.  Is this liquid from the manufacturer or is your pharmacy going to compound it for you? 

[[ze...]]

I've only briefly spoken with the pharmacist. We are going to make an appointment to meet and discuss it further. Unfortunately, she wants my psychiatrist involved and I don't trust my psychiatrist AT ALL. 

[[Pa...]]

I'm encouraged your pharmacist is taking this seriously, @[ze...] but its unfortunate you don't trust your psychiatrist, this is more common than we like to see.  I'm going to alert @[Li...] to this thread, she has a list of questions that will ensure you get the correct formulation you can have confidence in.  Hopefully, she'll see this before you have your meeting.  

[[ze...]]

Thank you so much. I really appreciate that. 

 

[[ze...]]

Have there been any people who taper slowly enough that they don't experience any symptoms? 

[[Li...]]

Hello @[ze...].  @[Pa...] asked me to stop by.

Are you planning to use the commercially manufactured oral lorazepam concentrate to taper or a compounded liquid?

If the former, here’s a link to the FDA Drug Label for the commercial liquid from one of the manufacturers:

DailyMed - LORAZEPAM solution, concentrate

We’ve had members who’ve used this to taper.  Because it’s concentrated (2mg/mL), they typically dilute it with water to achieve a lower concentration liquid (e.g. 0.1mg/mL).  The diluted liquid allows them to make smaller reductions in dose.

If you are planning to use a compounded liquid and need suggestions on questions to raise with the compounding pharmacist, let me know.

 

[[ze...]]

I'm not sure what the pharmacist has planned. Thank you for the information. I'll get back to you as soon as I know. 

[[Li...]]

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

I'm not sure what the pharmacist has planned. Thank you for the information. I'll get back to you as soon as I know. 

You’re welcome. Is the pharmacist a regular pharmacist (e.g. at CVS, Walmart) or a compounding pharmacist?

[[ze...]]

I'm not sure. It's the Veterans Health Administration.

[[Li...]]

If you are on other meds, the pharmacist may want to do a medication review with the psychiatrist.  Let us know what you find out — we’ll be here.  

 

[[Ju...]]

I had no choice but to be without about 4 yrs ago on Christmas to boot. I ran out, didn't get them anymore. I basically had the sweats and some irritation for a week.  Wasn't fun but nothing like opiates were.  If you have no kids and not working, I think it would be easier to deal with. I'm 52 with a 12 yr old still at home, at that time he was 8 and I work 3rd shift.  So mainly irritable and sweating. Before I knew it, it was over.  You'll be fine on a taper I'm sure 

[[ze...]]

On 13/07/2024 at 20:05, [[L...] said:

If you are on other meds, the pharmacist may want to do a medication review with the psychiatrist.  Let us know what you find out — we’ll be here.  

yes, i also take risperidone and hydroxyzine. what's a medication review? thanks