Ativan Taper Help Please

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Hi all ! I started Ativan .5 every night roughly 8 months ago. I’ve cut my dose down very uncomfortably then made the switch to Valium - again I’m super uncomfortable. Headache, tremor, fast heart rate, insomnia you name it.  So I’m going to hold here until I’m stable then I started doing the math and at 5% I came up that it would take me approx 44 weeks to get off of it.  It’s almost as long as I’ve been on benzodiazepine.  Can someone help me - my head hurts, it seems wrong ? 😟

2.5 - two weeks start 7/15 

 

5% = .125 

2.38 - two weeks 

 

5% = .119 

2.25 - two weeks 

 

5% = .113

2.14 = two weeks 

 

5% = .107

2.03 = two weeks 

 

5% = .102

1.93 = two weeks 

 

5% = .097

1.83 =a two weeks 

 

5% = .092

1.74 = two weeks 

 

5% = .087

1.65 = two weeks 

 

5% = .083

1.58 = Two weeks 

 

5% = .079

1.50 = Two weeks 

 

5% = .075

1.43 = Two weeks 

 

5% = .072

1.36 = Two weeks 

 

5% = .068

1.29 = Two weeks 

 

5% = .084

1.26 = Two weeks 

 

5% = .063

1.20 = Two weeks 

 

5% = .06

1.14 = Two weeks 

 

5% = .057

1.08 = Two weeks 

 

5% = .054

1.03 = Two weeks 

 

5% = .052

.98 = Two weeks 

 

5% = .049

.93= Two weeks 

 

5% = .045

.89 = Two weeks 

 

 

…. 

 

44 weeks ? and that’s not even down to .5 

 

Did I do this right ? 
 

thank you friends I’m lost right now and this is consuming me. 

 

[[Fa...]]

@[...]

I have a spreadsheet calculator.  I have punched in 2.5mg with a 5% hyperbolic taper rate.  

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4 minutes ago, [[F...] said:

@[...]

I have a spreadsheet calculator.  I have punched in 2.5mg with a 5% hyperbolic taper rate.  

@[Fa...] thank you so much. Wow this is a long road ahead.

 And I should expect to have the worst withdrawals after the last dose is that the idea ? 

[[Fa...]]

@[...]  NO!  That is not the idea.  You should expect to heal on your way down.  That will be your mind-set.  It can happen, and it does happen.  There are no guarantees, but move forward expecting to improve as you go, and you may even be able to increase your percentage down the road.  Also, you may get to a stage where your symptoms are very manageable that even being on a taper still, you are able to live a productive and enjoyable life.  Those are the expectations we want!  If there is any space to be toxic positive, this is it!  You're on a very lose dose, @[...].

I can't count how many times I have been given this pep talk by a fellow BB.

Edited July 18 by [Fa...]

[[Fa...]]

@[...]  There is one more thing that is important.  I posted a very similar post just last week.  I did what you did.  I worked out the time it would take for me to get to the jumping point dosage.  However, as @[Al...] pointed out to me, there is a point where you do begin to taper linear because otherwise it will take forever using the hyperbolic calculations.  Jump off dose is .5mg according to the Ashton Manual for Diazepam.

Edited July 18 by [Fa...]

[[...]]

26 minutes ago, [[F...] said:

@[...]  There is one more thing that is important.  I posted a very similar post just last week.  I did what you did.  I worked out the time it would take for me to get to the jumping point dosage.  However, as @[Al...] pointed out to me, there is a point where you do begin to taper linear because otherwise it will take forever using the hyperbolic calculations.  Jump off dose is .5mg according to the Ashton Manual for Diazepam.

@[Fa...] thank you for the encouraging words.  Right now I’m barely keeping it together - I want to be positive, I truly do.  Can you explain the linear concept to me ? I’m not sure I fully understand it.  If I were to jump off at .5 I’d be past week 27 , I’d be getting off as long as I’d been on - Ashton seems so much faster but it’s so scary I won’t do that quick. 

[[Fa...]]

@[...]  I understand.  Just know that many people improve as they taper.  There are positive stories, too.  They are not all terrible.

Linear is calculating at your starting dose rather than your current dose.  So, if you started a linear taper at 1mg, each cut would be calculated from the 1mg.

Try not to have any preconceived ideas about the timeline.  One cut at a time.

[[...]]

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

@[...]  I understand.  Just know that many people improve as they taper.  There are positive stories, too.  They are not all terrible.

Linear is calculating at your starting dose rather than your current dose.  So, if you started a linear taper at 1mg, each cut would be calculated from the 1mg.

Try not to have any preconceived ideas about the timeline.  One cut at a time.

@[Fa...] thank you I think the thing I’m most scared about is that I’ll be able to live a normal life while I taper because right now I’m really not between the insomnia and the morning panic. It’s very hard to function. I can’t believe I’m in this mess

[[...]]

On 13/07/2024 at 16:10, [[E...] said:

@[...] So sorry you are being "forced" to switch to Valium.  Please don't fret too much. Many, many people have succesfully tapered from Valium without developing additional "dependencies" or difficulties.

I was wondering if your doctor would be willing to prescribe the liquid formulation of Valium?  It is my understanding that it comes in a concentration of 5 mg/5 ml (1mg/ml).  This might be easier to dispense your dose as, I believe, the smallest pills available are 2 mg.  2 mg pills might be difficult to cut accurately at your low dose and as you taper to smaller doses.

Please keep us informed how you are getting along!

Hi @[El...] my doctor said she would prescribe the liquid when we get to that point.  I’m wondering if you are thinking I should do the hyperbolic or Ashton - I believe folks here are in favor of hyperbolic, at this point I want to do whatever will not create a dependency and cause the withdrawal effects right now the insomnia and anxiety are tough - considering i take my dose at night I can believe it doesn’t actually let me sleep the night through but I am down from .5 on 7/5 on Ativan to 2.5 now on Valium.   Let me know which you think is a safer option - liquid Valium is intimidating to me.  

[[El...]]

@[...] So, it is my understanding that you started on 1.25 mg Valium. But then increased to 2.5 mg?  And you are still suffering from the same symtoms as when you were when taking Ativan?  Hopefully as you hold longer your symptoms will settle and you adjust to your new dose as well as to the Valium.  But do bear in mind that you have made three major cuts of 50%, then switched to Valium, then increased your dose of Valium - all within the last 2-3 weeks.  I would imagine you nervous system is really feeling "confused" and unsettled.

So, I guess if I were you, I would take my time to first allow my system to settle.  Then, based on your history of difficulties with rapid tapering (if it were me), I would be following Dr. Horowitz's guidelines, at least for the foreseeable next weeks.  You can always speed up a taper, but once you have gone too fast, it often takes more time to recover then if you had just proceeded more slowly.  I am certainly not an expert, but I really don't think you need to worry about developing a further dependency.  So, please don't worry!  Just be kind to yourself during this settling period.  Try not to focus on the calender.  Your body will recover and then you can take as much (or as little) time as you need to "gently" move through your taper.

If I may ask, why are you intimitated by liquid Valium?  Please don't worry unduly.  Many, many people have made the transition successfully.

Please let me know how you are getting along!

[[...]]

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

@[...] So, it is my understanding that you started on 1.25 mg Valium. But then increased to 2.5 mg?  And you are still suffering from the same symtoms as when you were when taking Ativan?  Hopefully as you hold longer your symptoms will settle and you adjust to your new dose as well as to the Valium.  But do bear in mind that you have made three major cuts of 50%, then switched to Valium, then increased your dose of Valium - all within the last 2-3 weeks.  I would imagine you nervous system is really feeling "confused" and unsettled.

So, I guess if I were you, I would take my time to first allow my system to settle.  Then, based on your history of difficulties with rapid tapering (if it were me), I would be following Dr. Horowitz's guidelines, at least for the foreseeable next weeks.  You can always speed up a taper, but once you have gone too fast, it often takes more time to recover then if you had just proceeded more slowly.  I am certainly not an expert, but I really don't think you need to worry about developing a further dependency.  So, please don't worry!  Just be kind to yourself during this settling period.  Try not to focus on the calender.  Your body will recover and then you can take as much (or as little) time as you need to "gently" move through your taper.

If I may ask, why are you intimitated by liquid Valium?  Please don't worry unduly.  Many, many people have made the transition successfully.

Please let me know how you are getting along!

@[El...]thank you for your reply and encouraging words! I went from .5 of Ativan at a day for a year (I recently called the pharmacy and asked them for my records) to  .25 to .125 in a very short time frame, then I found a psychiatrist who could help me taper and she wanted me to go on .5 Valium to start but I stubbornly went on 1.25 for a few days and then went up to 2.5 because my anxiety was really bad along with heart raising - those are my biggest symptoms. I don’t have the depression I had when I was on Ativan. I just have a lot of anxiety and racing heart in the morning and throughout the middle of the day, it eases up around four or 5 o’clock in the afternoon, but I have no appetite all day which I’ve had for months on Ativan, I never knew why and had every test under the sun to figure it out, but of course found nothing.  I guess m liquid intimidates me because I’m afraid of measuring it wrong but I’m not there yet.  I plan to hold here until I can say I feel good enough to taper and I agree I think the hyperbolic taper will suit my system better even if that means being on it longer.  I foolishly thought I could do this in a month I guess reality is setting it that it will be more like 4 months.  I’m praying it’s not for months of feeling like this. 
 

thank you again for responding with your advice !

[[...]]

Hi @[Fa...] and @[Li...] after days and days of looking through the site I think you may be just the folks to help.  I am on a taper from .5 Ativan but now at 2.5 Valium and holding because I’m very uncomfortable and severely depressed.  I am interested in micro tapering and my doctor is willing to perscribe liquid Valium.  I don’t think I’ll be ready to start anytime soon - I need to level and not have such depressive symptoms and heart palpitations.  

I have read over and over posts about hyperbolic tapers and I don’t understand them at all.  Is there a resource you would suggest where I can learn more? I’d been taking .5 mg of Ativan for 11 months I realized it had been causing me to be very sick.  I worry that the micro taper will be as long as the time I was taking it and may wreak further havoc on my CNS and prolong this agony.  

Also another question With liquid Valium do you just take it right from the bottle or do you have to dilute it? Is it stronger ? Dangerous ? 

Can you explain the concept to me or steer me in the right direction? 
 

Also I’m having depressive thoughts in the last few days and have booked a consultation with Nicole Lamberson for August.  She thinks that I should consider going up to 5.0 of Valium since I halved my dose this month before I found this forum.  I have read members get worse when they do this.  She said it may not help or it may  - im In a paralyzed state.  If I do that it will take me a year to taper … what do you all think ?

 

Here is my taper history: 

7/3 .5 
7/4 .5

 

7/5 .25
7/6 .25 

7/7  .125
7/8 .125 
7/9 missed 
7/10 .125 
7/11 .125 
7/12 .125
7/13.125

7/14 1.25 Valium 
7/15 2.5 Valium 
HOLD

 

thank you in advance. 
 

 

 

[[Fa...]]

Hi, @[...].  Sorry this is my first time reading through your taper thread, but I see you have received some good feedback to this point.  

I would like to first note that I am no 'expert' or 'medical professional' and am only speaking from my own personal experience and associated research.  I agree with your assessment - that you need to hold and stabilize on a daily dose of diazepam before proceeding with a taper.

I would assume taking .5mg of ativan once daily at night for 11 months was causing you to experience interdose withdrawal symptoms due to the shorter half-life of ativan, resulting in a sensitized nervous system.  Then proceeding with a rapid taper off of the ativan has only sensitized your nervous system more.

The good news is that your brain knows how to stabilize itself when it's given a proper chance - at least that is my belief and experience.  Many members, including myself, have been in this exact same situation, have stabilized, and been able to proceed with a taper.

You are now on diazepam which should allow for your once daily dosing schedule without causing further issues; however, it could take a few weeks to months for the diazepam to build up in you system and also allow time for your nervous system to settle down and stabilize.  If it were me in your shoes, and since you have already been holding at 2.5mg diazepam for over a week, I would continue to hold there until your consultation with Nicole Lamberson.

If you are approaching one month of holding at the time of your consultation, and not feeling any better, improving or 'stabilizing' at 2.5mg - I would then consider trying an updose to 4mg diazepam (your .5mg ativan dose equated to an approximate diazepam dose of 3.8mg according to clincalc.com).  I would only attempt increasing to 5mg diazepam if you are still suffering and do not feel an improvement at 4mg diazepam after at least a 1 month hold.  I would not go any higher than this though as your long-term goal is to go the opposite direction - to 0.   

As hard as it sounds, try to trust and believe that you will stabilize.  I can almost say with certainty that you already have and/or are experiencing the worst of it currently - remember this.  It can be a slow process to stabilization, but it almost always occurs (though do not expect to feel great - just better, functional and an overall consistency to your symptoms though they should be manageable).  

Also, are you taking any other medications or supplements at this time?

[[...]]

32 minutes ago, [[F...] said:

Hi, @[...].  Sorry this is my first time reading through your taper thread, but I see you have received some good feedback to this point.  

I would like to first note that I am no 'expert' or 'medical professional' and am only speaking from my own personal experience and associated research.  I agree with your assessment - that you need to hold and stabilize on a daily dose of diazepam before proceeding with a taper.

I would assume taking .5mg of ativan once daily at night for 11 months was causing you to experience interdose withdrawal symptoms due to the shorter half-life of ativan, resulting in a sensitized nervous system.  Then proceeding with a rapid taper off of the ativan has only sensitized your nervous system more.

The good news is that your brain knows how to stabilize itself when it's given a proper chance - at least that is my belief and experience.  Many members, including myself, have been in this exact same situation, have stabilized, and been able to proceed with a taper.

You are now on diazepam which should allow for your once daily dosing schedule without causing further issues; however, it could take a few weeks to months for the diazepam to build up in you system and also allow time for your nervous system to settle down and stabilize.  If it were me in your shoes, and since you have already been holding at 2.5mg diazepam for over a week, I would continue to hold there until your consultation with Nicole Lamberson.

If you are approaching one month of holding at the time of your consultation, and not feeling any better, improving or 'stabilizing' at 2.5mg - I would then consider trying an updose to 4mg diazepam (your .5mg ativan dose equated to an approximate diazepam dose of 3.8mg according to clincalc.com).  I would only attempt increasing to 5mg diazepam if you are still suffering and do not feel an improvement at 4mg diazepam after at least a 1 month hold.  I would not go any higher than this though as your long-term goal is to go the opposite direction - to 0.   

As hard as it sounds, try to trust and believe that you will stabilize.  I can almost say with certainty that you already have and/or are experiencing the worst of it currently - remember this.  It can be a slow process to stabilization, but it almost always occurs (though do not expect to feel great - just better, functional and an overall consistency to your symptoms though they should be manageable).  

Also, are you taking any other medications or supplements at this time?

@[Fa...] thank you so much for taking the time to read through my history and provide some thoughtful advice.  I know you are going through your own journey, are a busy father and work - your stability through all of this inspires me.  I will take the advice and stay the course, that’s what I’m inclined to do.  I pray this is the worst of it - I can’t imagine going on if it gets worse.  I only take metformin 500 ER at dinner.  Also a probiotic but I stopped all other supplements including magnesium and curcumin.  

[[vo...]]

[[Li...]]

[[...]]

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

@[...] Hi Wren I've read several times on here about people trying it so I was going to try it, but I don't want to if it might be a waste of money. Can I ask why you stopped the magnesium?

@[vo...] I stopped it because I read it can be harmful and I didn’t want to chance it.  

[[vo...]]

[[...]]

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

The Maudsley Deprescribing Guidelines (Horowitz & Taylor, 2024)

Some members use the manufacturer’s liquid as is, others dilute it.  It all depends on what size reductions you are able to tolerate and what taper strategy works for you.

Many members report increased depression when taking Valium.  However, many members also report that this lessens over time.  If I’m understanding your taper history, you have only been taking the Valium for 10 days. I’d give it more time.

You are in good hands with Nicole.  What date is your appointment with her in August?  Early in the month or later?

Valium takes a while to build up in your system so I agree with @[Fa...] about holding.  But if your symptoms are not trending in the right direction (i.e. lessening or at least stabilizing as in not changing), then an updose to 5mg would be something to consider.

Two other questions:

1. Is this the first time you have taken and tried to stop a benzodiazepine or z-drug?  
2. Do you have a history of taking and stopping any other psychotropic medications (e.g. antidepressants, stimulants)?

 

@[Li...] thank you for getting back to me, after a severe life threatening uterine hemorrhage in 2020 I briefly was given Ativan which I stopped abruptly, I don’t remember the extent to which I took it or when I stopped it, I’ve asked Walgreens for my prescription history and waiting to hear from them.  However for 9 months after that was a series of medical mysteries, tinnitus, tachycardia, cardiac arrhythmia, leg and calf pain, weight loss, hair loss, anxiety and I was told I had PTSD.  Then one day after 9 months of hell it all seemed to stop.  I never found out what caused it, but it feels similar to what is happening to me now.  I used Ambien and Klonopin 20 years ago after a period of stress but had no issues because I hated them and didn’t take them for a long time.   
 

I forgot to mention to you and @[Fa...] am on 15mg of Lexapro and have been for 12 years.  

[[Li...]]

You’re welcome @[...].  Thank you for sharing your medication history with us.  This is very important information.  You’ll want to share it with Nicole and your prescriber as well.

Per The Maudsley Deprescribing Guidelines (Horowitz & Taylor, 2024), a history of repeated cycles of benzodiazepine — or other psychiatric medications — use and cessation is one of the high risk characteristics for withdrawal. These cycles are thought to lead to sensitization, a phenomenon sometimes referred to as kindling (pp. 352). 

If a patient presents with this characteristic, Horowitz and Taylor suggest starting the taper with a 5% (or less) trial dose reduction.  If no difficulties are encountered, the taper rate can be increased.