Tapering off Ativan Support Thread

[[Ma...]]

JuJuBi - so happy to hear you’re doing well! Painting sounds amazing... and I have been told that using your hands in this recovery process is huge in healing the brain. I have ordered a cross stitch kit... let’s see how I do!

 

Tech, you’re so close... hoping you are finding peace in this final stretch!

[[kr...]]

Hello all-

today i am 2 weeks off and things are much better..  my worst symptoms continue to be Tinnitus and ear pressure..  if I did not have that then I would be feeling great..  I still have good and not so good days but nowhere near where I was even a month ago..  looking back I was in pretty tough shape..  My 9 week taper was a success..  the best thing I did was when I got to .25 cut down to .01 at a time until the end..  My counselor and doctor would have been fine if I jumped at .25.. but I knew better because of all you wonderful people..  I can say that week 2 is a lot better than week 1 and I hope things just keep getting better..  use me as hope..  we will all heal

[[Ma...]]

Kry!!! So good to hear an update.... keep them coming, they are such an encouragement. Healing is happening, it's what our bodies were designed to do... keep visiting us!

[Guest [ba...]]

We can definitely help with the liquid taper calculations.  All I need to know is how the liquid formulation that the pharmacist made for you was prepared.  There should be a concentration indicated somewhere on the label.  From that, it's simple to calculate dilutions for a taper.

 

[[Gi...]]

Hello all-

today i am 2 weeks off and things are much better..  my worst symptoms continue to be Tinnitus and ear pressure..  if I did not have that then I would be feeling great..  I still have good and not so good days but nowhere near where I was even a month ago..  looking back I was in pretty tough shape..  My 9 week taper was a success..  the best thing I did was when I got to .25 cut down to .01 at a time until the end..  My counselor and doctor would have been fine if I jumped at .25.. but I knew better because of all you wonderful people..  I can say that week 2 is a lot better than week 1 and I hope things just keep getting better..  use me as hope..  we will all heal

 

Kry,

 

Such wonderful news and gives me hope. Congratulations on a huge accomplishment and freedom from benzos.  G

[[Bi...]]

Hi All,

 

I’m so thankful for this supportive group. For the love and support and compassion for all of us here. And for the wonderful check ins from those on the other side!

 

After a few days of reflecting I am not confident in plan to dry cut to the end. I’m also not feeling great about switching to liquid Ativan at this point. Maybe at .25 mg I should consider water titration you the end.

 

Can anyone explain how to water titrate from .25mg to zero? My benzo brain is having a hard time figuring it out.

 

Thank you and love to all!

Bibs Jo

[[Ju...]]

Bibsjo

 

I found this on the thread from Luey.  This may help.

 

JuJuBi

 

http://www.benzobuddies.org/forum/index.php?topic=44903.msg3096989#msg3096989

[[be...]]

Hi Bibs,

  As you know, I switched to water taper once my pills got too small to reliably cut. I am so glad that I did. I used a different method than the others which I think would only serve to confuse everyone if I tried to explain it.

 

  So, I think the easiest and most effective method at your dose is to dissolve an entire pill (I’m assuming you have .5mg strength pills) into 49mL of water and 1mL of 80 proof vodka. You’ll also need to purchase a pack of 10mL syringes and 1mL syringes for measuring. I got mine on amazon along with cute little 10oz jars. You start by putting the 1mL vodka on the pill inside of a jar or any container that has a lid, and then you add the 49mL water once the pill is mostly dissolved. Shake, shake, shake it up. Don’t swirl it, as it can spin the pill frags to the side of the jar...you want to shake for as even a suspension as possible. This will leave you 50mL of solution and every mL will hold .01mg of pill.

 

  Since you’re starting at .25mg, you’ll need to discard half of your solution (or save it in a separate container for the next day). Again, this is assuming that you’re working with .5mg pills. If you have 1mg pills, let us know so we/I can adjust the calculations.

 

  Now, you have your one jar of 25mL Ativan-water...each mL holds .01mg of med. You will divide this jar into the number of doses you take. If it’s two, 12.5mL per dose. If it’s three, 8.33 mL per dose. Use your syringes to measure these. I also liked to keep a cup of plain water on the side, and I’d pull a full syringe of plain water and drop it in equal parts into my doses so that any pill remnants in the syringes would make their way into my doses.

 

  Your doses are now prepared for your day, and you just drink them on down at the appropriate times. Once I drank a dose, I’d fill the jar again with plain water and drink that. I didn’t want to lose any precious remnants! Ha! I’d even sometimes lick the lid to the jar...ugh, benzos.

 

  So, all of THAT ^^^ is how to make your doses. The next thing you need to decide is how to cut your dose. Some people pull out a mL a day...a reduction of .01mg daily. Others find they need to hold longer and pull every second or third day. Still others decide that .01mg is too much at a time, and they choose to dilute the suspension further to allow for smaller cuts. It’s all about listening to your body. So, assuming you pull 1mL, this will leave you with 24mL to divide into equal doses. The next cut, 23mL into equal doses. Next, 22mL... all the way on down to whatever dose you choose to jump from.

 

  I know the directions for this method can feel overwhelming. I stayed away for months, because my mind just couldn’t wrap around it...and I was convinced I’d mess it up. Ultimately, it was much easier for me than dry cutting had become, and I’m thankful I switched. If you decide to switch, please remember to cross over at your exact same dose (no cutting while switching), and I would plan to hold for a few days or even a week before attempting to cut. Some people have no adjustment time to switching, but others say that switching to liquid feels like a 5-10% cut. For me, it felt a bit like a cut, so I held for about a week.

 

I sure hope that all makes sense! I always hesitate to post liquid taper instructions, because I know they can be a lot for the benzo brain to take on. Please keep asking questions, and I apologize in advance if anything of this is confusing.

 

Best wishes,

Beauty

[[Bi...]]

Beauty and JujuBi,

 

Thank you so much for the detailed info and explanations. This is extremely helpful. I stayed away from liquid titration because it looked so overwhelming, but this seems very clear.  I'm digesting this info now and will definitely ask if I need more clarification.

 

And yes, I am using .5mg tablets.

 

Thank you so much again!

Bibs Jo

[[te...]]

Perfectly explained beauty , that’s exactly how I have made it this far .

Best Lisa

[[Ha...]]

Thank you for that great explanation, Beauty.  If only our doctors were as knowledgeable and helpful as we are to each other on here!

 

Sunshine, I'm glad you found your way in here.  This board has literally changed my life. 

 

I'm about a week away now (hopefully) from being all the way down to my new dose of .312.  I have been heading there very gradually from .375, gradually increasing the number of days I take the lower dose, and am now taking the lower dose every other day.  This week I plan to do 2 days lower dose, 1 day higher dose and then if things aren't too awful, go full time at .312 next week.  Then I plan to hold there for at least two weeks.  It hasn't been easy but I have had a few nights of pretty good sleep.  The other night I had a bad cough (hopefully just a cold???) and took Nyquil and slept a divided NINE hours.  I felt almost rested when I woke up the last time.  I know we are not really supposed to take other meds while tapering, but boy that felt good.

 

Haimona

[[Bi...]]

Beauty, Tech, JuJuBi, Haimona and All,

 

I've read through all of this info, went out and was able to find almost all the supplies I needed at Target (U.S.). One more question. Is there any other way to dissolve the pill other than using vodka? I am a recovered alcoholic. I don't think 1 ml of vodka would be a problem, but I would prefer to use something else.

 

Thanks,

Bibs Jo

[[Ha...]]

Bibsjo,  I know I've seen some posts about using something other than alcohol -- milk, maybe? I'd have to do a search, but I know there was another option.  A lot of people, alcohol problem or not, don't like to use alcohol as some feel it messes with our benzo recovery.  Which really makes sense to me. 

 

Haimona

[[be...]]

Great question, bibs. It was recommended to me to use straight water if I was uncomfortable with the alcohol. I only needed one drop (remember my method was different), so I just went ahead and used the vodka. The person who told me said that it may just take longer to dissolve, and I’d really have to shake a lot. Let’s all do some more research on this and see what we can find. We definitely want to support your recovery!

 

Beauty

[Guest [ba...]]

Beauty, Tech, JuJuBi, Haimona and All,

 

I've read through all of this info, went out and was able to find almost all the supplies I needed at Target (U.S.). One more question. Is there any other way to dissolve the pill other than using vodka? I am a recovered alcoholic. I don't think 1 ml of vodka would be a problem, but I would prefer to use something else.

 

Thanks,

Bibs Jo

 

You can use propylene glycol in place of alcohol.

[[...]]

Hey Friends,

 

Just stopping by to say hi and read the last few posts.  Remember Ativan is NOT water soluble.  (You can easily find this info. on the internet). You need to use a solvent like alcohol when making your own solution, just as it's used in a variety of medications.  You wouldn't have any control over the amount you're taking if you just used water.  I've never heard of milk being used with Ativan although I've read about it being used with other benzos here on BBs.

 

The best source I've seen for describing micro-tapering is in the READMEFIRST sections of a computer app., developed by Jim Hawk, a formerly active member of BB.  He discusses the options and pros and cons of different solvents for liquid tapering.

 

http://benzo.alwaysdata.net/

 

You can also play around with the app. by plugging some numbers in.  I preferred doing my own calculations and would be happy to share a simple formula here if requested. (You might need to send me a pm first as I'm not checking in very often post-taper).

 

I'm happy to see so much good moral support on this thread.  I hope good taper info. will continue to be shared on BB as people come and go.

 

Keep up the good work everyone, Wishing ease to all,

 

Luey

 

 

[[su...]]

 

It's heartening to see those who are post benzo still come back to check in and offer advice as it shows the support and importance of a network like this. I am very thankful to have stumbled upon it. 

 

It's still been a lot to take in, and the not feeling well while having your brain messed with surely isn't helping things, but one moment at a time.  I've had some "better" moments in the last couple days, including A LOT of emotions/crying yesterday.  I went with it like Marwegs suggested and kept telling myself it was healing happening.  Sleep was adequate for a few nights even if I kept waking between 4-4:20 like clockwork, but this morning there was no going back to sleep.  Managed about 4 hours total and woke to intense dizziness/nausea again and that damn tremor/shaking.  It isn't like the nightmare of last week so again I am trying to convince myself that it's just a very slow stabilization. My muscles feel weak, including my leg muscles as I attempted a small walk with husband and little one yesterday to just GET OUT and my once strong runner's legs from a month and a half ago feel like jelly.

 

I'm having doubts determining whether to updose as there never really was a time that I felt really good while taking a benzo, even that very first week the Dr had me on it before I tried to initially stop.  It wasn't until I began the taper that I did have those glimmers of me again, but because I was tapering so quickly every 3 days, I'm not sure what dose in that timeline would be a safe bet.  So, I'm going to continue to hold for now at least.  The dry cutting at this low dose is just extremely frustrating as the scale is never giving me consistency even after multiple calibrations.  Yesterday I worked on cutting today's dose for almost an hour and  half which just led to anxiety over not getting these doses consistent and even.  I eventually had to walk away and just went with it.  So, with that, I am wanting to get my ducks in a row for the potentiality that I decide to switch to the liquid Ativan that I have--but do not have any dosing understanding/calculations/info from the prescriber.  I need help here.

 

So, this is what I have: The box says "Lorazepam Intensol Oral Concentrate USP" and it says "each mL contains 2 mg lorazepam USP"  (there is a 30 mL bottle and oral syringe inside the box).  Since last weekend, I have been cutting pills to approximately a total weight of .021 (trying to evenly spread out the 3 doses each day, so approximately .07/.06/.08 or some days I "think" I am getting .07/.07/.07--the scale is just giving me anxiety with the inaccuracy).  With the help of Badsocref, I understand now that my actual dose right now is roughly .175 based on pill weights (.021 / 0.060 x 0.5). 

 

If I decide to make the leap to the liquid Ativan to finish off my taper, where do I start & how do I do it with what I have?  Additionally, how do you all figure out the drop percentage?  Are you taking the percentage off the weight of the pills or the actual dose?  My brain wants to understand the microdosing of dropping .01 as taking it off the weight of the pills, but I'm not sure.  My hope is to stabilize and then begin dropping that .01 each day so things go much slower--and hopefully smoother. 

 

Take care everyone.  I hope your day is a good one, or at least a functioning day.

 

Sunshine

[[su...]]

Hello, sunshine75.

 

Can you tell us the manufacturer/distributor of the lorazepam Intensol you have? Is it West-Ward?

 

Can you also describe the measuring device that should have been included with the liquid?  Is it a calibrated oral syringe or a dropper?

 

Another member and I are working on a “how to” sheet for you.  It will take us a few days so it’s good that you are holding.

 

It will be important for us to know your total daily dose expressed in milligrams of active drug substance (not pill weight).  I will ask badsocref to stop by to confirm this with you.

 

Also, am I correct you are taking three equal doses a day?  Do you wish to continue this dosing pattern?

 

Libertas,

 

Admittedly tears came again.  Thank you.  Thank you.  Thank you. 

 

Yes, it is West-Ward Pharmaceuticals Corp (I opened box and looked at the medication guide sheet). 

It looks to be a calibrated oral syringe.  And I am taking three doses per day (every 8 hours), and I would think it best to continue that dosing pattern as when the original taper schedule had me drop amount and down to two doses, that’s when things went south in the taper (and likely just the cumulative speed of taper caught up then too). 

 

Best,

 

Sunshine

 

[[Li...]]

Thank you for the fast response, sunshine75.

 

This is good news ... the Intensol manufactured by West-Ward comes with a calibrated syringe with graduations at 0.05 mL. 

 

Are you currently taking 0.175mg a day of lorazepam, divided into 3 doses?

[[...]]

Hi Sunshine,

 

Nice to meet you.  I haven't read your other posts so forgive me if I'm being redundant or lacking info. about your situation to give a good reply.  First of all, I'm so sorry to hear about your difficult symptoms. I also had intense nausea for many months and it's a terrible and debilitating symptom. Slowing down did seem to help me eventually.  I've also heard many people talk about the muscular symptoms.  This damn drug! I agree with you to get out even on little walks as much as you're able.  I feel like I walked myself back to health.  It took me quite a while to build back my strength.

 

If it was me I think I would try holding rather than updosing unless it was a one time thing for intolerable symptoms especially since you never felt good at any level.  You sound like one of those people who has a very adverse reaction to benzos. It sounds like you just might need to slow down. You are very low so that's a good thing I believe- you don't have very far to go.  It just sounds like your body needs time to recover as you go down.  Everyone's pace is different.  I tapered .03mg for a long time.

 

It's good you getting organized to start liquid tapering. I did the same thing while holding.  Once you get the hang of it I believe you'll find it's so much more accurate and easier than dry cutting especially at the lower amount you're on.  JuJuBi is the person here who is using the Intensol.  Hopefully she can help.  I made my own solution using vodka.

 

The percentages are based on your actual dose, not on the weight of a tablet.  (With liquid you will convert mgs. to mls).  Again I hope JuJuBi will share the amount she is diluting the Intensol and help you get started.  I suggest you have someone of confidence then double check your process in the beginning.  I asked science/math oriented friends to double check for me and it made me much more secure. I think your idea to micro-taper starting with a small amount each day is very prudent, also using holds as needed.  .01mgs. would be the smallest reduction you can make.

 

Again so sorry about you've been feeling so poorly.  If it's benzo withdrawal causing your symptoms (which it sounds like it is) and not an underlying condition, I feel certain you will recover. 

 

Best wishes,

 

Luey

 

 

 

 

 

 

[[su...]]

Thank you for the fast response, sunshine75.

 

This is good news ... the Intensol manufactured by West-Ward comes with a calibrated syringe with graduations at 0.05 mL. 

 

Are you currently taking 0.175mg a day of lorazepam, divided into 3 doses?

 

Libertas,

 

Glad there is good news there--I'll take what I can get of that.

 

Badsocref helped last week with me figuring out dose vs. pill weight as I was unsure.  The weight of the .5 pills I had left (9) was .539 (.539/9 = .0598), so individual weight of the .5 pills was .060 rounded up.  He said the few 1 mg pills I had left were double weight of the .5 pills so I didn't have to change the calculations. 

 

My average weighing right now of the three pill shards I cut per day is coming in at .021 so he gave me calculation of  0.021/0.060 x 0.5 = 0.175, so my dose I guess is 0.175 right now. 

 

Thank you!

 

Sunshine

[[su...]]

Thank you for the fast response, sunshine75.

 

This is good news ... the Intensol manufactured by West-Ward comes with a calibrated syringe with graduations at 0.05 mL. 

 

Are you currently taking 0.175mg a day of lorazepam, divided into 3 doses?

 

Libertas,

 

Glad there is good news there--I'll take what I can get of that.

 

Badsocref helped last week with me figuring out dose vs. pill weight as I was unsure.  The weight of the .5 pills I had left (9) was .539 (.539/9 = .0598), so individual weight of the .5 pills was .060 rounded up.  He said the few 1 mg pills I had left were double weight of the .5 pills so I didn't have to change the calculations. 

 

My average weighing right now of the three pill shards I cut per day is coming in at .021 so he gave me calculation of  0.021/0.060 x 0.5 = 0.175, so my dose I guess is 0.175 right now divided into 3 doses. 

 

Thank you!

 

Sunshine

[[su...]]

Hi Sunshine,

 

Nice to meet you.  I haven't read your other posts so forgive me if I'm being redundant or lacking info. about your situation to give a good reply.  First of all, I'm so sorry to hear about your difficult symptoms. I also had intense nausea for many months and it's a terrible and debilitating symptom. Slowing down did seem to help me eventually.  I've also heard many people talk about the muscular symptoms.  This damn drug! I agree with you to get out even on little walks as much as you're able.  I feel like I walked myself back to health.  It took me quite a while to build back my strength.

 

If it was me I think I would try holding rather than updosing unless it was a one time thing for intolerable symptoms especially since you never felt good at any level.  You sound like one of those people who has a very adverse reaction to benzos. It sounds like you just might need to slow down. You are very low so that's a good thing I believe- you don't have very far to go.  It just sounds like your body needs time to recover as you go down.  Everyone's pace is different.  I tapered .03mg for a long time.

 

It's good you getting organized to start liquid tapering. I did the same thing while holding.  Once you get the hang of it I believe you'll find it's so much more accurate and easier than dry cutting especially at the lower amount you're on.  JuJuBi is the person here who is using the Intensol.  Hopefully she can help.  I made my own solution using vodka.

 

The percentages are based on your actual dose, not on the weight of a tablet.  (With liquid you will convert mgs. to mls).  Again I hope JuJuBi will share the amount she is diluting the Intensol and help you get started.  I suggest you have someone of confidence then double check your process in the beginning.  I asked science/math oriented friends to double check for me and it made me much more secure. I think your idea to micro-taper starting with a small amount each day is very prudent, also using holds as needed.  .01mgs. would be the smallest reduction you can make.

 

Again so sorry about you've been feeling so poorly.  If it's benzo withdrawal causing your symptoms (which it sounds like it is) and not an underlying condition, I feel certain you will recover. 

 

Best wishes,

 

Luey

 

Nice to meet you as well, Luey.  Thank you for that.  Yes, this has been a train wreck, one ride I am kicking myself for getting on.  Long story short, I listened to my Dr. who assured me it was safe and to continue when I stopped after only three days and ended up sick--saying it was my anxiety that was coming out.  An ER visit happened the 2nd time I tried to stop and again told to continue taking even when I was sure what I was experiencing was withdrawals/interdose withdrawal. Finally my cardiologist agreed with me that I shouldn't be on but his taper was really fast.  Found a psychiatrist who supposedly helped with benzo tapers--evidently too fast as well.  So, only 2 1/2 weeks of usage and then began a 3 week taper.  I was doing well at beginning of the taper with very manageable withdrawal symptoms, but 2 1/2 weeks in things went BAD.  The moments I have some clarity and can take in the gravity of things, I am furious at how this could have happened, and not just to me, but to an even a larger population of people who are suffering unnecessarily and not listened too.  It's absolutely unconscionable.

 

I appreciate the insights and am definitely fighting my way back.  Went for a drive with my husband today to run a few errands.  Made myself go inside at one point and even though it was was horrible and excruciating, I know deep down it's needed, that I have to reclaim my body and brain.  I'm still scared as hell of these feelings and the horrible bodily sensations and withdrawals, afraid it won't end, afraid that the damage has already been done, but hearing the convos on this thread and getting support from others who know what this hell is like is beyond helpful.  So, thank you for reaching out and providing some hope. 

 

Best,

 

Sunshine

[[Li...]]

Thank you for the confirm, sunshine75.  More good news is that you now have 60mg of lorazepam (30 mL of the 2mg/mL Intensol = 60mg) in a formulation that will enable you to make accurate (as in the dose you measure is the dose you get), right-sized (as in small enough for you), and right-timed (as in whatever interval works for you) reductions in your dose. 

 

 

[Guest [ba...]]

<snip>

If I decide to make the leap to the liquid Ativan to finish off my taper, where do I start & how do I do it with what I have?  Additionally, how do you all figure out the drop percentage?  Are you taking the percentage off the weight of the pills or the actual dose?  My brain wants to understand the microdosing of dropping .01 as taking it off the weight of the pills, but I'm not sure.  My hope is to stabilize and then begin dropping that .01 each day so things go much slower--and hopefully smoother. 

<snip>

 

There are plenty of ways to do this.  One way would be to combine 1.0 ml of your liquid ativan with 199 ml of water.  Mix well.  The diluted ativan solution will have a concentration of 0.01 mg Ativan per ml.  If you want to take 0.175 mg, you would measure and drink 17.5 ml of that diluted ativan solution.  If you decide that you want to do a slight up-dose when switching from solid to liquid, you could (for example) take 20 ml which would be 0.200 mg of ativan. 

 

The math is really simple.  17.5 ml = 0.175 mg;  20.0 ml = 0.200 mg;  12.7 ml = 0.127 mg;  1.3 ml = 0.013 mg

 

That will make enough for at least 3-4 days.  You can make a bigger stock if you wish.  Keep the unused solution in the fridge.  Mix well each time before using. 

 

So you'd need a container with a 200 ml mark.  200 ml is the same as 6 3/4 ounces in case you want to make your own '200 ml' container out of a canning jar or something like that.  If you want to get fancy, you can purchase a 250 ml graduated cylinder.  If you want to get insanely accurate, you can purchase a class-A, 200 ml volumetric flask (but I wouldn't).  You can use a syringe to measure the dosage you wish to take.  I'd think a 10 ml syringe would work well.  You'd have to fill it twice, but that's an easy thing.  Wash it out well after each use.

 

The surface of new, untreated glass can bind things like ativan, so I'd find a glass container that's been used a few times.

 

I hope all of this makes sense.