Tapering 1 dose per day Ativan

[[Mt...]]

Has anyone tapered Ativan (or any short acting Benzo) at a single per day dosage? Most of the user accounts I've read have been tapers that involve multiple doses per day. I'm currently on 0.5mg of Ativan per day and plan to taper soon once I stabilize more. My taper would be a single dose per day as I don't experience interdose withdrawal or the likes. 

[[Mt...]]

Anyone? 

[[El...]]

@[Mt...] It seems likely that the reason you have not received replies is because it is fairly "unusual" to be stable on one dose per day of Ativan! 

Correct me if I am wrong...but you have been holding your 0.5 mg dose since early July after updosing?  What are your current symptoms?  Are your symptoms fairly "stable" throughout the day and night?  If they are, I would suppose a taper would follow normal guidelines...no more than 5%-10% every few weeks and adjusting your taper rate according to your symptoms.  But, since you did experience difficulties earlier in the summer by tapering too much or too fast, you might be wise to start with a more conservative and lower percentage cut to begin.  You can always go faster if your symptoms allow..  But as you have discovered, it is often difficult to recover from an aggressive cut.  Perhaps you could start in the region of 2%-2.5% (or even lower)?

Let us know how we can help!

[[Mt...]]

Hey @[El...] - as always, thanks for the response. I suppose you're right. Why is it that one could not be stable on simply one dose? I understand Ativan has a short half life but I'm not sure why I would be an anomoly.

Thanks for the taper advice. I will certainly take this into consideration. I am working with a doctor now who will taper with. ( Dr. G) she will prescribe a liquid version and I'll micro taper from there

Yes you're right. I'm still recovering from the rapid taper. I was only on for 3 weeks! 

Again, thanks for the response and for all your help here throughout the community. 

PS yes I'm still on the 0.5 but in also still recovering from AD withdrawal and reinstatement. It was only intended for short term use as I knew the risks. I was unlucky in that I got dependant on the Ativan so quickly. 

 

. 

 

 

 

 

 

 

 

Edited September 6 by [Mt...]

[[El...]]

@[Mt...] I think the differences in dosing needs is probably due to differences in people's metabolism and body chemistry.

Anyway, if you are planning to transition to the liquid, I would caution you to plan for it to be, indeed, a transition.  I started transitioning to the liquid on August 25.  I was holding my dose constant and transitioning slowly using both pills and the liquid.  The first 4-5 days went very well.  Midway into day 5, I began to experience some discomfort.  And it was fairly uncomfortable until about mid-day yesterday.  I am now seeing continued improvement, but I am still holding my dose for a few more days.  Hopefully, you will have a seamless transition!  Are you planning to dilute the liquid for your microtaper?

[[Mt...]]

Thanks @[El...] - glad to hear about your transition to Liquid. I know you were cutting pills this whole time. I guess you've gotten to a small enough dose in which the liquid works best?

Yes I plan to transition for sure. How long is your transition for? 

[[El...]]

@[Mt...] I began my transition on August 25.  I first introduced the liquid for my afternoon dose, keeping pills for the morning and evening.  On the third day, I used the liquid for both the afternoon and evening.  Then, prematurely, I started the liquid for all 3 doses on the fifth day.  I should have waited longer, as I was beginning to feel unwell.  It will be 13 days, today, that I have held my dose.  I am tentatively planning for a small reduction perhaps on Monday?

For my microtaper, I was doing 0.3%-0.35% consecutive daily reductions for about 7 days, then holding for 2-3 days.  But, even with my 0.0001 gram scale, it became impossible to make that size reduction consistently.  Hence a change to the liquid.  

I am wishing you all the best with your transition and taper to come!

[[Mt...]]

Hi @[El...] - just curious how your liquid transition is going? 

[[El...]]

@[Mt...] Thank you for asking! I held through September 8 (15 days). Even though I continue to feel somewhat “drugged and spacey”, I have made 5 small, daily percentage reductions since then. If my symptoms do not increase in any other way, I will probably continue with small percentage reductions for another 5-7 days (?),  then hold for a few days. This is all trial (and I hope not too much error!) as I continue to adjust to this new method.

Hoping things are going well for you.

 

[[Cw...]]

I’m late in replying but I just wanted to say I am in a similar boat to you @[Mt...]. I too was stabilized on a 0.5mg dose once a day (at night). A previous rapid taper had not gone well for me so I had to take a lot of time back on 0.5 to just cool my brain down from that. Then I did a direct switch over to the liquid with no problems then started tapering with that back in August. 

[[Mt...]]

Hi @[El...] - when you had the liquid solution made from the compunder, did you have them use the same manufacturer tablets or powder to make the solution? Or do you think that matters much? 

[[El...]]

@[Mt...] Sorry, I am not using a compounded liquid...so not sure about the effect of tablets or powder.  I am using the manufacturer's liquid which comes as 2 mg/ml and I dilute it in water to a useable concentration.

[[Mt...]]

Gotcha! Have you found yourself stable on this liquid transition yet? 

[[El...]]

@[Mt...] You are so kind to ask!  Still feeling slightly "drugged".  It is not debilitating...just annoying.  I don't know if I am still just adjusting, or this is just some new symptom.  But hoping it will pass.  When do you start your transition?

[[Mt...]]

Hey @[El...] so problems with the compounding pharmacy has led me to begin tapering with the ativan Intersol solution as you are. Curious to see how your transition went or is still going? 

I'll begin tomorrow. 

[[Mt...]]

Question: what was your transition dosing regimen from pill to Liquid? 

[[El...]]

@[Mt...] Good to hear from you!

Since I am dosing 3 times per day, I first introduced the liquid for my afternoon dose, keeping the pill form for the morning and evening. After a couple of days, I used the liquid for both my afternoon and evening dose, still using the pills in the morning. Finally, I fully transitioned to the liquid for all 3 doses. I did not reduce my dose during the transition. It took me 15 days to fully transition (with holding after fully transitioning to the liquid) until I felt stable enough to do a small reduction. But, even after slightly more than a month, I still feel slightly “drugged”, particularly right after I take a dose

If you are now going to use the manufacturer’s liquid, do you have at least a 0.5 ml syringe? The smallest increment you can measure with the eye dropper they provide is 0.25 ml or 0.5 mg. I actually purchased 0.5 ml insulin syringes as I could not seem to remove all the bubbles from a 0.5 ml oral syringe. I am also diluting the liquid in water as I found it difficult to actually dose the concentrate below 0.1 ml.

I hope the transition goes well for you. Let me know if you have any other questions or I can help in any way.

 

[[Mt...]]

Thanks @[El...]... Yes I have 0.5ml oral syringes... Interesting about the bubbles. I'll have to experiment.