Tapering off Ativan Support Thread

[[pe...]]

Thanks guys

 

Your right i wasnt stable on it, and i read somewhere else going to liquid is like a cut. So i have cut once yesterday to 1.92 mg..4 times a day. Feels like im going on and off speed with this med. I'm thinking of going 5 times a day. Is this advisable? As my symptoms flare up really quickly. Bad way going on it and after 3 hours a feel the withdrawals.

 

Thanks a lot for support.

[[Ki...]]

Pete - changing the number of times you dose can also feel like a cut. What you are feeling is likely just withdrawal. There is no easy to way to get through this. I would err on the side of caution making any more changes. It's normal to feel up and down throughout the day. You can do this 

[[Om...]]

So today was pretty rough. Some pretty intense anxiety, tinnitus, and lots of vomiting, but I'm going to do my best to write down my method so that it may possibly help people, and to give my mind something constructive to do.

 

DISCLAIMER-This should not be attempted by anyone without first consulting your doctor. I am not responsible for any injury or mishaps that may occur. Having said that, I ran this method by my doctor and she approved. This however does not mean it will be ok for you. Please exercise caution and know your facts before you try to taper any medication.

 

Taper Method: Liquid Titration (I am specifically tapering off Ativan)

 

Things you will need.

---Pen and Notebook to keep track of your daily progress

---10ML oral syringes. (These can be received for free at your local pharmacy most likely.)

--- 6 oz baby food jars (I got these at Walmart, youll want 1 for every dose you intend to take throughout a 24 hour period. So if your going to be taking 3 doses a day, get 3 jars. You might want more in case one accidently breaks)

---100ML graduated cylinder with 5ML increments (These can be bought at Amazon.com rather cheaply. About $12 per cylinder)

---Glass stirring rod (I bought a pack of 3 from Amazon for around $10. You could use a spoon or knife or any other utensil if you so choose)

---3 ML graduated pipettes (You can buy these in bulk very cheaply, again, I got mine from Amazon)

---80 proof vodka (No, we are NOT becoming alcoholics! This is used in very small amounts to swiftly dissolve the pills)

---Optional---100ML oral syringe with 5 or 10 ML increments (This is for making your life a bit easier when you start cutting 20ML of fluid or more. These are also available at...you guessed it, Amazon!)

---NOTE--- Don't be afraid to buy more equipment than you need! Theres always a chance of something breaking or being misplaced. Its good to have some back ups stored in a safe location, this way if something happens you have some spares without being up creek without a paddle, and will save you a lot of worry)

 

Process:

---Get all of your equipment together. Make sure everything is clean and washed before starting.

---Take your daily dose (the total amount of pills you would take in a 24 hour period) (I take 3    0.5 mgs Ativan and start with it because my total daily dose is 1.5mg) and add them to an empty 6 oz baby food jar.

---Take your 3 ML pipette and fill it with vodka. Add it to the jar with the pills. Fill it again, but this time to 2 ML. Add this to the jar (Resulting in 5ML vodka in the jar with the pills.)

---You should notice the pills starting to dissolve in a few minutes.(This is the reason we use vodka, as Ativan would take FOREVER to dissolve in water. Also note that Ativan IS NOT water soluble, which means you will not get a true solution, but a suspension of the medicine) Sometimes the process starts instantly, sometimes it takes 5-15 minutes, depending on the brand and age of Ativan. Don't panic, be patient. Gently swirl the jar around until the pills are dissolved. ( you will notice very small clumps of the pill, as it will not dissolve completely. This is perfectly normal. Just make sure you've given the pills the appropriate amount of time to break down as far as they can go)

---Take your 100 ML graduated cylinder and fill it with 95 ML of water.

---Add this water to the jar with 5 ML vodka and your pills. This will equal to 100ML of fluid in your jar (make sure your pills are dissolved before you do this)

---Now for the fun part. Grab your stirring instrument (and have your 10ML oral syringe nearby) and stir vigorously. You need to have the suspension agitated as much as possible before making your daily cut, because if you don't, the Ativan will try and settle on bottom)

---After stirring vigorously, take your 10ML or 100 ML oral syringe and make your cut. (My advice is to try and do a daily cut of 1 ML a day. This equals to 1% of your total daily dose. So in my case 1% of the total of 1.5 mgs Im taking is .015MG)

---NOTE--- You need to decide if you want to make a cut every day or if you want to cut a certain amount and hold at that dosage for an amount of time before you cut again.

---Throw whatever amount you cut down the drain. Get rid of that poison!

---Wash the inside and outside of your oral syringe as there would be residue left on it.

---Fill one of your empty 6 oz jars with pure water

---Whatever ML cut you made, add that amount of pure water back to the suspension. So if you cut 13ML and put it down the drain, Draw 13ML of pure water and add it to the jar with the dissolved pills. So you should start with a 100 ML suspension, make your cut, and add pure water back to the suspension to reach 100ML of fluid again

---Empty out the jar with the PURE water, NOT the jar with the medicine

---Determine how many doses you want to divide this into. I take 3 doses daily, so I use the oral syringe and add 33ML to one jar, 33ML to another jar, leaving me with ABOUT 33ML in my starting jar.(Make SURE you stir vigorously before dividing the doses. Every time you add medicine to one of your jars, you should stir the suspension thoroughly before adding more medicine to another jar) If you want to dose 4 times a day, add 25ML to 3 different jars, this will leave you with your starting jar containing 25 ML, thus have 4 jars total with 25ML in each.

---Screw the caps on your jars and put them in the refrigerator. The freezer will be too cold, and I don't recommend leaving them at room temperature, although it may not hurt, but why take chances?

---Write the date in your journal, followed by how many ML you cut and how many MG of medicine you cut. This will help you keep track 

 

NOTES--- I wouldn't advise keeping these doses over 48 hours. Also, try and space your doses out evenly throughout a 24 hour period.

----Listen to your body. Only you know how fast you can taper. If you start getting bad s/x try and slow it down. Chances are your taper wont be s/x free, but by controlling your cuts and listening to your body, you can help make it more bearable.

---Wash all of your equipment after use

---If you need to go anywhere and you think youll be out for a while, you can take your doses with you. Just grab a small insulated lunchbox and put your medicine and some ice packs in it. This will keep it cool and it can be left in the car, even on hot days. Just don't let the jars tip over as they may leak!

[[Ki...]]

Thank you for this Omni.

As everyone knows, none of us are doctors and any advice or suggestions is merely what worked for one buddie and passing the info onto another. You should always refer to your doctor when making any change to your medication.

 

 

[[Sa...]]

Omni, I'm sorry you're not feeling well, take good care of yourself...but thanks so much for the detailed instructions for making the liquid using the tablets, great job 

 

 

Pete, sorry I missed your post...I would also caution you against moving to 5 times a day dosing when you're already feeling unstable. Changing the doses generally feels like another cut for most people. I'd like to see you stabilize with your first cut. There is a lot of up and down during the day, Kiddo is right, I just believe you've changed and dropped your dose before you had stability. Hope things even out for you soon.

 

[[...]]

I have a strange question:  do any of you have thoughts on using a compounded gabapentin cream for a neuropathic itch--the itch is much worse at night.

 

Background here:  I had a basketball injury about 10 years ago (way before my "Crazy-Town"), and jammed my wrists--got weird itching around my wrists/arms a few months later that came and went--mostly wasn't there at all--thought it was a stress thing. Didn't think much of it. 

 

Started lamictal 2+years ago and my forearms started itching--I thought it was the old b-ball thing popping up.

 

Dermatologist says it is from a pinched nerve and is called a neuropathic itch.  Never heard of such a thing but there you have it.  There is no cure and now I use Sarna at night which helps for a little while and then I am up putting more on. 

 

My first drop in ativan is making the itch really bad, and is compromising what little sleep I do get. I know now that there is definitely a correlation with lamictal and the pinched nerve idea, b/c every drop on lamictal I made last year amplified the itch.

 

So......I was thinking if I compounded neurontin into a cream (just for night) it would help with the itch and sleep.  I know they use oral gabapentin for peripheral neuropathies--the tingling etc.

 

It seems like most buddies are against neurontin (or at least feel that it is something to get off of too b/c it hinders healing of the GABA receptors) so I was hoping for feedback.

 

Anyone itch? That sounds funny....

 

Thanks!

[[...]]

Sorry for the non-sequitur.  I found some information about the cream somewhere else around here--a post from last year.

 

No need to reply unless you want to/have info.

 

Thank you everyone!

[[...]]

Having a really rough day. I made myself go to a restorative yoga class and when I closed my eyes I started panicking. I'm nearing the anniversary of the nervous breakdown that put me here (on meds, on ativan - I still remember that first 1 mg pill they gave me which enabled me to sleep for the first time in weeks) (then I stopped ... then I started it up again) and feeling terrified. More terror lately. I wonder if I should go up in the ativan again or if it's something else. So hard to be human and alive. Thinking I might need to hospitalize again though I don't want to be medicated again. Need support as much as possible. Handholding.

[[Sa...]]

Hi NYC,

 

Listen, I know you're really having a hard time with this. I was remembering your first posts and the start up meds you were dealing with. Your last post you said you felt suicidal a lot of the time. It scares me a little to be honest. Maybe this is not the time to be trying to reduce the Ativan? Just a thought from me. I'm not exactly sure if you're having issue with the other meds, or just really having these due to the drops you've already made.

 

I would, however, caution you about going up and down. Right now you need to find some stability. If you go back up, I'd stay there and hold a good long time until you either find stability with the other meds or the Ativan. It just sounds like you have a lot going on, and maybe this is not the best time to reduce. As I recall your drop the first time was rather large, this could still be fallout from the large reduction. Either way, I'm concerned. Do whatever you need to do to keep safe, if that means finding a therapist to talk with or going to the hospital, please do so. I'm very concerned for your well being.

 

Saga

[[Ki...]]

We will hold your hand, NYC.

 

I want you to actually hear what I have to say.....what you are feeling is normal for withdrawal. It's normal. It's sucks, and it hurts and it's scary and you feel like you are losing your mind but it's the benzo's. They are lying to you.

 

In my opinion you have dropped the Ativan way too quickly. I believe that's why you are having such a difficult time right now. Understand that if you go to the hospital you will very likely be medicated. Some people need to be, and that's ok, there is no shame in that.

 

If you are not at risk in harming yourself, I would try an updose to 1mg and make no more changes to the Ativan for a minimum of two weeks. When I cut too fast in the beginning I ended up having to hold for a month to stabilize and then was able to start tapering at 5% a week. There is no easy way to do this and you will have symptoms throughout your taper. The sooner you accept that and find healthy ways to cope, the better off you will be. Once you are completely off Ativan you will need these skills to get through the rest of your life drug free.

 

You can do this. I am proof. I've had awful symptoms and had so many ups and downs but I assure you that it gets easier. I started at 2mg, 8 months ago, and I'm currently at .50mg - I've continued to work, parent, and function. It isn't always pretty, far from it, but it's possible.

 

Another option for you may be to cross over to Valium. Many say it saved their life....apparently it's a little smoother for those who can tolerate the cross over. There is a thread dedicated to This topic that you may benefit from reading.

 

Keep posting, we will do everything in our power to help you 

[[...]]

OK, yes, maybe I did drop too fast, I didn't even really taper from 1 mg to 0.75, just some irregular times in late August until somehow I got to 0.75 by Sept 5 and after that (and yes, other meds in the mix too - Prozac and Lamictal started up) there's been panic galore and unclear thinking, loose in the head feeling. Which sort of started in August, maybe when on other meds too. Damn it all. If I go back into hospital I guess I will carry my meds with me and tell them immediately about the ativan because I don't want to be cold turkeyed. I'm scared. I have people here who will get me to hospital. I don't want to go. But I'm white knuckling. If this is normal, I don't know how anyone gets through it. Especially when my own doc has told me he gets people off a "low dose like yours in 3 days in a hospital." He has no sympathy for the withdrawal part, he says it's probably "psychological" that I'm anxious about it. People don't believe you. OK, gotta relax somehow without panicking. Thanks for your support everyone I will try to keep in touch. Very scared.

[[Ki...]]

NYC, you doctor is wrong. There is no two ways about it. You need to be very admit that you are not to be cold turkeyed off these drugs. You need to have it stated on your medical chart. Please advocate for yourself and have someone responsible go with you to the hospital to make sure all the appropriate information is on your chart. I know your scared, and you are probably right, they will likely not believe you. We are the (very large) minority who struggle coming off these drugs. We are very large in numbers but the amount this medication is prescribed is substantially larger.

 

I believe what you are feeling is both start up anxiety from the Lactimal and Prozac and a too fast taper from Ativan. You need to stabilize, even if that means going up to your full dose of Ativan and holding for a month. At this point what does it matter? You are already physically dependant. You will know if it works in 3-5 days if an updose works....then you can hold until everything calms down.

 

A slow taper will have you feeling so much better. You will not feel like this once you stabilize and taper slowly. Again, there are so many of us that are proof of that.

 

Please let us know what you decide. We'll be thinking about you.

 

Hang on. You WILL get better. I wish you could see it.

[[La...]]

NYC, I second kiddo's comment on your doctor. The statements he made that you relayed to us above are a clear demonstration he doesn't know much about this subject and even worse, could be a danger to you if you follow his advice.

 

I know what you mean by white knuckling it. I used those same exact words about ativan in the beginning to describe my experience. Fortunately it isn't that bad the whole time. There are ups and downs through the process of tapering. You wont be white knuckling it the whole way down. A cold turkey could set you up for a bad ride. Go take a look at the ct board and read their stories. You'll be back on the taper shortly thereafter.

 

Good luck, hospital or not. You'll make it but must fight for your freedom.

[[...]]

NYC4

 

My opinion:  I think this is way bigger than ativan withdrawal:  you've got recent (?) prozac and recent  lamictal:  and your biochemistry is still reeling over this past year with stints on zyprexa and lexapro?

 

If the hospital will keep you alive, go.  If you can stay with your friend, go.

 

We can't know if it's the prozac or the lamictal, but we do know They Aren't Helping!!!

 

Stabilizing is all that matters now--no agenda, just stabilizing...........

 

I hate offering advice and I am so biased in the lithium direction but nothing smoothed out my obsessive anxious thinking until I got that--then I could get rid of the other meds. that had made things worse......

 

I am so sorry your have to endure this pain. It is awful and you will survive.

[[...]]

You're all trying to help so much and yes a lot is going on. Many mixed meds this past year. And still I obsess about the taper, I'm all for it. Each day I've been trying to stick to this schedule: 0.125 mg at 7 AM, 11, 2 PM, 5PM, 9PM, 1 AM. But sometimes I'm off by an hour or more - like last night I went to bed at 11, managed to sleep straight through until 5 AM, and then took a dose then to "make up for " missing the 1 AM. I think I should do these doses differently. Then I took my morning (7AM) dose at about 8. And have been sleeping, unwilling to move or get out of bed. My schedule seems maybe too complicated.

 

I know, one change at a time. Now that I'm in it, I don't know what to do.Need a safe place. Need people but also am overwhelmed by them. NYC is too noisy, too much an assault on my senses. And I'm unemployed, alone, don't have a plan for the future, I'm 52 and unclear. So it's more than meds going on here but the meds aren't helping much. Except in the case of ativan to dull me completely. And the other meds... maybe ramping me up too much. I don't know what stabilizing means now. Stay on these meds and see what happens? Get a new opinion, if I can figure that one out?

 

I'm sorry; trying to figure it all out on my own is feeling like too much and it's really hard to get a new doc when I'm on medicaid insurance. I know I have to try to dig deep if I can, to stay alive. At least to stay sane. Hearing that w/d can make you feel really crazy is sort of reassuring. I feel like I'm just using up air-time here without a plan.

[[Ki...]]

NYC  - use all the air time you need....that's what the forum is for. Nobody should feel alone while going through this. Like June said, this is likely not just an Ativan problem. All the other meds that have been started and stopped recently are all in the equation. That's why my recommendation was to go up to your full dose of Ativan and give it time for these things to settle. Even if you hold the Ativan for a few months....does it matter?

 

In regards to your dosing, I would agree it's a bit much. Also, it's important to take your dose at the same time(s) every day. I dose 5x a day: 7am/11am/230pm/6pm/11pm.

 

I do feel like you need to come up with a plan. I would at least try to find a new doctor, even if it isn't easy. You likely need an entire med review but your current doctor may pull the benzo and that will set you up for failure.

 

 

 

 

[[...]]

Thank you Kiddo, all makes sense but hard to figure out in my current state. I see the doc tomorrow and was planning to ask him to prescribe the liquid concentrate form of ativan, even if I do go back to the 1 mg I was taking three weeks ago. Does that make sense? Otherwise I'm splitting up 0.5 mg tabs. I don't know if he'll go for it. My rx is up and needs to be renewed. I'm pretty sure he will renew it anyway.

 

I guess it doesn't matter if I hold the ativan a few months longer, though the longer I'm on it the more paranoid I feel about ever stopping it. (And scared of the down-taper ... though there are enough success stories out there). It seems that having a good support network around one is also pretty important so if I can put that into place somehow it would be good. So then I could taper off without being in a panic about it. The trouble is that I feel the ativan has been blunting me so much. Great big catch 22. I am supposed to have a med review this week with an entirely new set of docs but it's just a review for study purposes. I do need a plan. My ex-wife, mother of my kids, a decent person, is worried and thinks I should just go to hospital for a new evaluation as I said before. I know I'm scattered and need a plan. A big picture view.

 

ALSO what about switching to Valium? The Ashton manual has schedules for tapering from higher doses of Ativan than I'm on so I wouldn't know how to substitute/cross taper. Maybe better to just stick with the Ativan for now despite it being a worse drug.

 

And these out-of-nowhere moments of panic are also crazy-making. God. Is that "normal" ?

[[Om...]]

I'm praying for you NYC and everyone else as well

[[pe...]]

Hi again. I am having problems with bubbles in my suspension that i can't get out of my syringe , also im concerned about the accuracy of dose on suspension. I'm thinking of switching to solution which i asked for in the beginning.

[[...]]

I'm praying for you NYC and everyone else as well

 

Thanks Omni. I've heard it's harder to get off these things the second time around (I got off klonopin a few years ago, again a "small" dose that the doc thought was silly to worry about - but my body knew). My body/mind feels so strange now. Kind of sick, confused, random panics.

[[Sa...]]

NYC, take as much space as you need here, no limits!

 

I'm glad you have an appt. tommorrow. I think your brain is simply confused by all these med changes. That's why I believe you need some stability, either by holding where you are a long time with everything and let your brain recover, or if you go back up with the original Ativan same thing. Stay there for enough time for things to settle down. That could mean months, yes, but in the big picture does it really matter?

 

I wouldn't consider any changes to Valium right now. You've got enough going on at the moment. Plenty of time later if you decide to crossover in my opinion. For now, you need to feel stable if you can on the current meds. Good luck tommorrow.

 

 

Hi Omni, hope you're feeling better!  Pete, hope someone can help out with the bubbles...

[[La...]]

Hi again. I am having problems with bubbles in my suspension that i can't get out of my syringe , also im concerned about the accuracy of dose on suspension. I'm thinking of switching to solution which i asked for in the beginning.

 

Hi pete:

 

I had the same concerns about my ativan suspension. I load 1000s of syringes with drug in my career, sometimes thick drug suspensions, so I can tell you how to eliminate this problem from experience.

 

First off, it depends how viscous your suspension is; the more viscous, the longer/harder it will be for bubbles to rise to the surface. If they rise reasonably fast, you can just invert your syringe after drawing up the suspension. With the tip facing upward, slowly draw the plunger back (down) sucking up air into the tip of the barrel. With the tip still facing up, there will be a column of air on top of your suspension. Still holding it with the tip up, flick the barrel forecefully with your fingers in a snapping motion. Each time you do this you should see mroe and more bubbles liberated from the susupension and will rise to join the column of air. When all the major bubbles are gone, push the plunger upward so that the drug column rises. Stop pushing when the drug reaches the tip of the barrel and is just about to be ejected. This is a standard technique for removing bubbles in an injectate.

 

My suspension was SUPER thick and this technique worked perfectly for me. One additional thing you can do to prevent bubbles is to SWIRL your suspension in its container before drawing it up into the syringe. Dont rapidly shake it up and down, that will introduce air bubbles. Swirl it, roll it around, this will ensure homogenous drug distribution without adding air bubbles.

 

You dont really need a new prep. Just focus on good technique and you will be fine, dosing accurately. 

 

laser

[[...]]

NYC, take as much space as you need here, no limits!

 

I'm glad you have an appt. tommorrow. I think your brain is simply confused by all these med changes. That's why I believe you need some stability, either by holding where you are a long time with everything and let your brain recover, or if you go back up with the original Ativan same thing. Stay there for enough time for things to settle down. That could mean months, yes, but in the big picture does it really matter?

 

I wouldn't consider any changes to Valium right now. You've got enough going on at the moment. Plenty of time later if you decide to crossover in my opinion. For now, you need to feel stable if you can on the current meds. Good luck tommorrow.

 

In terms of various med changes, I see the doc tomorrow and wonder if in the long run it's better to be on the liquid prescription for Ativan. Any thoughts on that? Should I push for it?

 

And if I go back up to 1 mg from the 0.75 I've been at for 2-3 weeks, what will happen?

 

I guess it's obvious I'm running on depression and a bit manic (never diagnosed bipolar though) right here. Stumbling around for a solution and someone medical I can trust.

 

God, been indoors all day and done little but obsess and panic and worry. And write these notes. This life feels so weird and upsetting and I feel blocked from everyone and everything. Dizzy now.

[[pe...]]

NYC

 

I went to liquid a week ago and became manic and agitated although its settling down somewhat. Its just the drug shocking the system i believe as I am hypersensitve.

[[pe...]]

Laser thanks.

 

But i can't see the tip of the syringe as its in the tip of bottle. Also the suspension in the uk is £230 a month. The solution is 40% cheaper and as i am unable to work i can afford to pay £230 a month- also puts me under pressure to cut which increases the whole anxiety state im in. Hopefully now I am on a liquid version the solution woulnd't be to much of a problem to cross over.

 

Best

p