Tapering off Ativan Support Thread

[[Al...]]

Mairin33

 

I know how you feel and a lot of what you say is very true. I had read what you quoted from Colin and it is very true.

 

Mountainman has been on Ativan for 5 months and today that is considered long term. Newer guidelines for prescribing this drug I believe is 2 weeks.

 

At any rate, what you said is really the bottom line, taper at a rate your body can handle. But for me I could not find any dose under .7 mgs. that I could handle so I had to cross over to Valium even though my Doc was not keen on it.

 

I am currently at  2.3 mgs. and finding the reductions I make, though slower than my Doc wanted, are much more easy on me than the Ativan was.

 

I also wanted to say to you 1 mg. is not a high dose. There are people on here at 4-6 mgs.

 

Try not to become disheartened, just continue to reduce and know that with every passing day and with every passing cut, you are on the road to recovery. one day we will look back at these years and they will seem like a bad dream.

 

keep your chin up! 

[[mo...]]

Reinstated last night .5  at 10 pm slept really well. Going to try .25 twice during the day and .5 at night. Try to get stable again then start a regimented taper plan . Not sure what is best for me direct or substitution ? Have to see the VA doc next week on the twelfth . Got to just chill out right now

[[Ma...]]

Hi Mountain Man,

 

Yeah getting stable is pretty important.  IT is hard to cut when you are not stable.  I know what you mean by the term being not stable.  I was not stable for about 6 months.

 

But I had a very steep drop from a high dose. 

 

I would not recommend switching to valium at first, I would try cutting small increments of ativan first.  Because you don't know how you will react to the valium.  In All Tied Up's case it worked and was the best course of action, but it is not always.  The problem with it is you really don't know how your body will accept the valium.  Sometimes people really just can't accept valium, adn then you have a botched crossover on top of your taper and feeling bad.

 

The time to crossover to valium is when you feel it impossible to get down further on ativan.

 

What I am doing is cutting small increments from four doses a day in a round robin fashion.  I have not found it impossible and it is working fine.

 

It is hard to find a doc to agree to valium crossovers as well.  You say VA hospital, well, I hope you have a doctor who understands benzo withdrawal.  You may find all kinds of resistance to doing it the way you want.  It is often not about what is best for the patient, its about, the doc looking out for his own ass, not yours.

 

Anyway, try going down on the ativan first, as many people have done here.  Valium should be a last resort.

[[mo...]]

Thanks Mairin  Chill out and start over. Little cuts and no rush make a plan and get plenty of support. Thank you

[[Ma...]]

Hey Mountain Man,

 

We are on the same dose now.  Wow it is amazing to me to be on the same dose as someone else because I was in the stratusphere where not many people ever get to.

 

It will be good to have a buddy to go down with from here

 

I figure this is going to take me about 6 more months.  So I will be around.

 

I cut yesterday, .125 to take me to 1 finally.  I may switch to cutting to .0625 using compounded pills.  I have a script for that but I have yet to pick them up.  My doc wants me to start going down by .0625 now.    He is not the doc that put me on the high does, he is a rather special guy who was really a godsend.  The problem is he does not take ins., so this is costing me a fortune.  But I am still glad to have found a doc like this.  When I first went to him he pulled me down very steeply, and I was a complete wreck and it was hard for me to trust what he was doing.  The initial drop was so bad I had a hard time trusting him but I stuck with him because I was on such a high dose and in such bad shape and it is so hard to find a good doc.  He did pull me down too much, but at the same time I was way way way too high in dose, that when I look back on it, I reckon any doctor worth his salt would have seen how terribly high that was and want to do that same.

 

So I suffered for the better part of the year for that.  But I kept going down, gradually regained stability, and started to realize he really was on my side and was doing the best he could with a bad situation.  And he has grown to respect me and my determination to go down, and also gotten to know me better as my personality came back.  When I walked into his office I was in akasthsia, my anxiety was through the roof, I could barely speak.  lol  So that is what he had to work with.  So I have to look at it from his perspective too.

 

The drop was terrible, but something had to be done.  I was in terrible shape already.  Thank God Almighty I am not where I was then.  I was simply overdrugged.  I had to be pulled off or really I could have died at that crazy drug level.

 

I started this journey by entering acute withdrawal.  It has gotten better for me, but it is still not over.  But I am not in acute, I am going slow.  That gives me hope that the brain can heal, because it certainly has over the past year.

[[aw...]]

Mairin:

I feel the same as you regarding adding Valium to an Ativan taper, or crossing over unless you have to, meaning you just can't do it on Ativan, even tho' you used a nice, slow taper with small, frequent cuts and appropriate holds. I started at 6 mg Ativan/day single dose, so I know about IW sx.

I'm very interested in your round robin idea. Do you toss the entire day's cut from the initial daily dose, then the next day from the second daily dose, etc? My daily cut is 12.5 mcg/day (yeah, micrograms/day); what is yours?

 

BTW, the half life of a drug (T1/2) and its duration of action (DoA) are not identical and not linearly related. For example, the T1/2 of Ativan is roughly 12 h in a healthy adult; its DoA is more like 6 to 8 h. This would explain IW sx at q8h dosing, which is exactly what I'm experiencing. 

 

Good luck,

 

Aweigh

[[Ma...]]

Hi Aweigh,

 

I am not cutting daily, I do cut and hold.  I have been cutting every two weeks for more than a year now.  I really cannot believe I ever got to such a high dose.  I was on 1 to 2.5 mgs of Ativan for about 10 years and I never asked for more.  Then a truly crazy doctor quintupled my dose in a 5 month period of time.  All of this is the fallout of that.  I guess it makes me angry that I have to do this for such a long period of time.  I am noticing most of the people that were here when I got here are gone, and I am still here and watching people come in who were only put on the drug when I was already tapering.  I feel like an ancient elder of some sort.  lol

 

Well the round robin thing. It is just the fact that I take four doses a day, and I cut from one dose at a time each time I cut.

 

Right now I am on: .25, .25, .25, .25.

 

Next time I cut, if I cut by .125 again, which is am not sure I will, but just as an example, it would look like this:

 

.25, .25, .125, .25

 

then the next cut two weeks later would be:

 

.125, .25, .125, .25  then

 

.125, .25, .125, .125 then

 

.125, .125, .125, .125 so that I arrive back at even doses.  this is the order I cut, and I have a reason for cutting those doses in that order.

 

This has worked well up to this point.  I am not sure how things are going to go as I get further down.  Will I reach tolerance, will I adjust just fine, will it get so hard I have to switch to valium?  I do not know.  I hope for the best.

 

I do think waiting two weeks between cuts is a really good idea because it gives your body some time to adjust to the lower dose, even though Ativan probably clears out of your system in 3 or 4 days.  You just need some rest from the cut.  But I realize this is a daily thing for you.  But I am doing cut and hold.

 

 

[[On...]]

Can anyone tell me if my taper plan looks too fast? I've been having terrible symptoms all the way down and they are getting worse. I'm holding longer but man I've ceased to feel even remotely right.

 

Maybe a valium switchover is in order?

[[...]]

Based on your increasing symptoms, your taper is too fast for you. I would go back a ways to where you felt better and take things slower.

[[Ma...]]

One Day,

 

Personally I think your cuts are too big and you are going too fast.  I was on 3 in January.  It has taken me 8 months to lose 2 mgs.

 

Ashton recommends 10% cuts, but a lot of people find that too much.  It seems to me cuts need to be kept lower than that, around 5% of your previous dose.

 

The brain cannot handle large cuts when you have been on a long time and when you are dependent on the drug.

 

However, you state your goal is to switch to Valium.  Is that your goal or is your goal to get off?

 

  My doctor is adamantly against valium because it has far more metabolites than ativan.  Ativan is actually a 'cleaner" benzo, the body does not have to work as hard to process it as it does for valium.

 

You seem to have a very strong desire to get on valium.  Maybe that would actually help you psychologically to deal with this withdrawal better.

 

For all that is said about valium, and how it helps tapering and is recommended by Ashton and so on, it also has its downsides that you should look into.  I remember reading that ativan actually has a longer duration of action than valium does.  Yes valium stays in your body longer, but the strange fact is, it's duration of action is not as long.  You can look that up.  It is hard to understand, I know.  I can barely understand that but it is true.

 

It seems the biggest benefit of valium is simply that it is less potent and comes in pills that are easier to cut.  But at your current does of ativan, you would need about 23 mgs of valium.  Each cut of ativan will leave your body in approximately 4 days, but each cut of valium will take about 3 to 4 weeks to actually leave your body. 

[[On...]]

hi Mairin,

 

I really don't know what to say at this point. Ativan acts longer? I thought Valium did. Okay. Thanks for the info. I suppose I should look into more.

 

One of the things I heard that I liked about Valium is that it is less potent/not so harsh, like you mentioned. And my idea was having something more gentle to taper from might help me a lot because I feel I've always been more sensitive to things. Also, when I get lower, It will be easier to cut like you mentioned again.

 

So what you're saying is it's just harder to metabolize, rather than truly being active for longer periods of time?

 

Thank you much for the personalized advice,

Oneday

 

 

 

ps. my goal is to get off, if not I'd have quit by now. In some relation I feel like a Samurai who goes into battle ready for the unknown. It's almost like I have an ear-wig clamped onto my brainstem that won't let me stop. Anyway, sorry, I think I'm just having trouble with the right words these days. I do think you are right my use of the word goal was wrong. Goal is a strong word and should have been left for 'getting off' rather than 'switching to Valium'. I don't know, I should quiet my perspectives because I can't decipher them anymore. Sorry for the ramble

[[On...]]

Also you say Valium leaves your body in 3-4 weeks. Is this beneficial in some way or not?

[[...]]

Actually, Valium takes much longer than 3-4 weeks to completely leave your body. Serum levels are no longer detectable after that time due to measurement limits. This probably does not matter though, as any clinical effects will be long gone before the last molecule leaves us.

[[Ma...]]

Hi OneDay,

 

Don't worry about quieting your perspectives   I truly know the confusion that you get when you are dealing with withdrawal and how that makes it so hard to think and figure things out.

 

Yes, I stumbled upon the information about ativan somehow lasting longer than valium.  I will try to look that up for you if you want.  I was surprised to read that.  The way it was explained is that, in a hospital, if someone is a seizure patient and they have to be transferred, they would be given ativan instead of valium for the trip, because ativan's duration of action is actually longer and it would keep the patient safer from seizure during a long transit.  I know that is surprising, it was to me, after reading about Ashton's valium method and the well, assumption that valium is a longer acting drug. 

 

Really I am not a doctor and I don't fully understand that.  I have learned to trust and respect my doctor.  He is very resistant to valium and I asked him why.  He said its the metabolites.  He said it has very many metabolites.  One of the metabolites of valium is actually klonopin, believe it or not.  He is a psychiatrist and a neurologist.  There has to be a reason he is against valium.  His main focus in his practice is to get people off drugs and help them holistically.  He is very well aware of the damage that psych drugs cause.

 

Yes valium has a half life of approx. 200 hours.  That is an extremely long half life.  That means that  if you took 1 mg of valium, after 8 days, 50% of that 1 mg would still be in your body.  After 16 days, 25% would still be in your body, after 24 days, 12.5% would still be in your body.  I think the focus Ashton had was to use that long half life with the assumption that since the drug stays in your body for such a long time, it would mitigate withdrawal symptoms.  It would "let you down easy".  Is that true?  I don't really know.  People seem to struggle pretty bad with valium at the lower doses, from what I have read on here.

 

Ativan on the other hand, has I think one non-active metabolite.  It also has a half life of about 20 hours max.  So you take 1 mg Ativan, after 20 hours, 50% is left, after 40 hours, 25% is left.  I usually feel some withdrawal hit about  3 days after I make a cut.  I think that is when the ativan reaches a point where the body registers that the drug is missing.  But, in my experience, it hits quickly and then I get over it.  Then I give my body an extra week and a half to calm down from that.

 

But with valium, people get hit with symptoms at varying times during that two week period, and really, to cut again after two weeks, the last dose is really not out of their system, but yet they make another cut on top of the last cut.  The UK folks came out and said that really three weeks is a better wait, probably based on valium cuts.

 

Ok, this is all stuff I have gleaned from just reading on here and other places during the last year and a half.  I could be wrong about some of this.  This is just my opinion formed from what I hear people say on here and reading about the drugs themselves.

 

I just think people jump to valium too fast sometimes.  I think it is called for in some cases, and that is exactly how Ashton used it, to help people who could not get off the drug they were on.  But all of Ashton's patients had had extreme difficulty and failed tapers before coming to her.

 

 

[[Ma...]]

Here is something from Reg Peart's site:

 

The combined half-life of diazepam and its active metabolites is over 200 hours and this produces an accumulation of 5-7 times the therapeutic action of diazepam. It takes up to eight weeks for most of the accumulated drugs to be eliminated from the body.

 

____________________________________

 

Valium has 3 major metabolites that are active, but those are not the only ones.  It has more than three.

[[Ma...]]

and this is from wikipedia, regarding the duration of action of lorazepam vs. diazepam

 

Clinical example: Diazepam has long been a drug of choice for status epilepticus; its high lipid solubility means it gets absorbed with equal speed whether given orally, or rectally (nonintravenous routes are convenient in outside hospital settings), but diazepam's high lipid solubility also means it does not remain in the vascular space, but soon redistributes into other body tissues. So, it may be necessary to repeat diazepam doses to maintain peak anticonvulsant effects, resulting in excess body accumulation. Lorazepam is a different case; its low lipid solubility makes it relatively slowly absorbed by any route other than intravenously, but once injected, it will not get significantly redistributed beyond the vascular space. Therefore, lorazepam's anticonvulsant effects are more durable, thus reducing the need for repeated doses. If a patient is known to usually stop convulsing after only one or two diazepam doses, it may be preferable because sedative after effects will be less than if a single dose of lorazepam is given (diazepam anticonvulsant/sedative effects wear off after 15–30 minutes, but lorazepam effects last 12–24 hours).[78] The prolonged sedation from lorazepam may, however, be an acceptable trade-off for its reliable duration of effects, particularly if the patient needs to be transferred to another facility. Although lorazepam is not necessarily better than diazepam at initially terminating seizures,[79] lorazepam is, nevertheless, replacing diazepam as the intravenous agent of choice in status epilepticus.

[[On...]]

But in the context of tapering wouldn't it not be the gentler drug best to come off of? Obviously I'm no doctor, but tapering is the act of going down and decreasing tolerance gradually and gently if possible. A lighter drug seems it would, like you said, let you off gentler. Instead of rougher with a more potent drug?

Correct me if I'm wrong, because I really don't know. It just seems to make sense to me.

[[Ma...]]

Yes that is the theory behind the valium switch, that the metabolites stay longer in the body and "let you down" easier.

 

It obviously works for a lot of people.  All Tied up, who posted above us, is one of them.  He had a real hard time getting past .7 ativan and switched to valium.

 

I am not against that method, I just look and observe what people are going through.  There are lots of people on here that have switched to Valium and feel it was the right thing to do.  There are also some people that switched and could not tolerate valium.  So, it is just such a crap shoot.

 

I know a woman who switched to valium at something like 80 mgs.  She is still struggling to get off it, has to go very very slowly, it has just wrecked her life.  She lost all kinds of weight, can't have sex, which is affecting her marriage very negatively, I mean, just a really bad scene for her.  I am well past where she is now on my way down with far less problems.  But, 80 mgs is just an extreme amount of valium.  I do think switching at say 30 mgs or less is a lot more doable, from what I have seen.

 

It is very hard to judge what will be best sometimes because all of us have different constitutions and ways that our body's handle the different drugs.

 

Who knows?  I may go to valium still.  But I just think you should try to taper the drug your body is used to first.

[[Bi...]]

Yes that is the theory behind the valium switch, that the metabolites stay longer in the body and "let you down" easier.

 

It obviously works for a lot of people.  All Tied up, who posted above us, is one of them.  He had a real hard time getting past .7 ativan and switched to valium.

 

I am not against that method, I just look and observe what people are going through.  There are lots of people on here that have switched to Valium and feel it was the right thing to do.  There are also some people that switched and could not tolerate valium.  So, it is just such a crap shoot.

 

I know a woman who switched to valium at something like 80 mgs.  She is still struggling to get off it, has to go very very slowly, it has just wrecked her life.  She lost all kinds of weight, can't have sex, which is affecting her marriage very negatively, I mean, just a really bad scene for her.  I am well past where she is now on my way down with far less problems.  But, 80 mgs is just an extreme amount of valium.  I do think switching at say 30 mgs or less is a lot more doable, from what I have seen.

 

It is very hard to judge what will be best sometimes because all of us have different constitutions and ways that our body's handle the different drugs.

 

Who knows?  I may go to valium still.  But I just think you should try to taper the drug your body is used to first.

 

Hi Mairin,  I think your right. Valium is good for the last leg but people should switch as low as possible.  I may not go to valium until I am down to .2mg Ativan so I'd jump to 2mg valium and then do a long taper down from there.  I can already feel that the lower you get the slower you have to go.  It's like landing a jet.  You can go from 35,000 feet to 1000 feet in 5 minutes but the last 1000 feet may also take another 5 minutes of extra slow descending or we may hit the pavement too hard and crash.

[[Ma...]]

You can go from 35,000 feet to 1000 feet in 5 minutes but the last 1000 feet may also take another 5 minutes of extra slow descending or we may hit the pavement too hard and crash.

 

^^ Wow!  Profound man! lol

 

[[Bi...]]

You can go from 35,000 feet to 1000 feet in 5 minutes but the last 1000 feet may also take another 5 minutes of extra slow descending or we may hit the pavement too hard and crash.

 

^^ Wow!  Profound man! lol

[[ir...]]

Hi everyone,

I lost the thread and just found it so I am back again! I decided to just continue taking nothing. I definitely did not want to try the neurontin after what you guys said. I have been okay with the exception of two really bad nights where I didn't sleep at all due to muscle spasms and jerking and twitching. My doc sent me to a neurologist and I had an emg done but of course all was fine. I fired my psychiatrist. She put me on the ativan initially because of having trouble sleeping after childbirth that continued.

 

So basically now the jerking and twitching muscles keep me awake some nights. And I notice the twitching during the day but its more the muscle weakness and fatigue are what is bothering me

Most during the daytime. And at night the jerks will prevent me from falling asleep.

 

No doctor will even admit that this is even remotely possible from withdrawal. I am now three weeks since I tapered and two weeks since that one time dose I took that initiated all this twitching. I hope to god that it goes away by itself. I feel like I am going to be stuck here and this is what I am like now.

[[bo...]]

I have only been dosing twice a day.  This is actually up from once a day. 10 PM and around 12 noon.  At once I was getting what I thought were ID withdrawal pretty consistently.  Now, after a few weeks, I typically feel awful in the morning and start to feel better as the day goes on regardless of when I take my second, smaller dose. Unless I get overstressed by something.  Recently, when I take the smaller dose I actually feel sleepy but it doesn't really last.

 

First question, if I can handle these symptoms and they are sort of irregular as far as whether they come and when they come, am I screwing myself up only dosing twice daily?  I might be able to get three, I can't see getting four with the cutting quipment I have,.  It is hard for me to even get the pills halved accurately.

 

and

 

How do people get the tiny doses accurately?  Are you all doing liquid? I'm around .25mg plus a crumb.  I have no idea whether the med is spread evenly in these pills I get, or the weight of that crumb.

 

I really wanted to cross to valium but my doc will only do to klonopin.  I'm not sure if that would be wise because that would be an even smaller pill to cut I think.  If I was at a higher dose I would be more anxiosu to switch, but unfortuately I was really sure where I even started and I got some bad advice at first from my doc that got a big cut and ended up where I am.  People keep saying not to updose too much and not sure my doc would help me out with that if I even wanted to.

[[Ma...]]

Iren,

 

I am very glad you did not take the Neurontin.  I think you will be glad you did not in the long run.  This is just an endless repeating cycle of slapping one drug on top of another.  Then you wind up polydrugged and in very very deep doo doo.

 

I really do hope you go and get some magnesium tablets.  They do help with muscle problems.  I would say, just let your body deal with this, forget other drugs.  Especially the freaky ones like Nerontin.  I have two unused bottles of that in my cabinet and thank God almighty I never took it.  I am so much better without it.  That should only be used when people are freaking out severely for a long time, like akathesia type of stuff.  If you are just twitching, please don't even think about that.  Magnesium will help and your body will probably heal itself in a matter of time.  All drugs throw the body out of homeostasis, all of them.  You don't want that.  I've even heard of someone rubbing magnesium on a twitch and it went away, and never came back.  I think it was an eye twitch.

 

Bobo,  well ativan lasts about 6 hours, the during of action, meaning that is the length of time you will actually feel the effects of it.  It does last about 20 hours in the body though.  Three times a day would probably make you feel better than two times a day, four is ideal but I hear what you are saying about that and cutting the pills.  I just got a script for compounded pills that will be made into doses of .0625.  A doctor could easily prescribe that for you.

 

You are so low in dose, you would only need 2.5 mgs V a day.  Perhaps that would really help you.  I really can't say, I have not been on V.  For some it works, for some it doesn't.  It is a gamble, because you don't know how your body will react to it, but 2.5 mgs is a pretty small dose of that.  And many people say it takes away the whole I/D withdrawal problem.  Just realize it is a different drug, with a very long half life, and your body will have to adjust to it.

 

Personally, I think dry is the way to go.  That is just my humble opinion.  Compounded pills, or a professionally made liquid.  You know, most of us are not chemists.  Why should we have to do that if there are pharmacists out there that can do it for us.  Yes that is how people get the accurate smaller doses.  But I am going to go with compounded pills in .0625 quantity.  I am thankful I have a doc that is not fighting me on this.

 

Klonopin is a rough drug.  This is also my opinion but I just think K is just....ugh.  Terribly strong.  I have been on it.  I don't like it, it messed me up real good.  Ask your doc if he has taken klonopin.  You know, they are good at prescribing but they have no freaking idea what these drugs feel like.  Give me ativan anyday, I will never take K again, ever!  At least with valium, it is weak and it is easy to cut the pills.  K is just a very very potent drug.

 

 

 

 

 

 

[[ir...]]

Thanks so much for the support! Is there a specific type of magnesium to try? Or like a certain dosage? I asked my general doc about taking magnesium but he was like I don't think you should take anything else at all in your current state. I tried taking zyrtec and had a horrible reAction to it. I was shaking and felt like I had ten cups of coffee. I have taken that years ago for sleep and it always worked fine. And I tried unisom the night after and was fine falling asleep but woke up hearing that loud bang that isn't there again and then was jerking awake all night long. So didn't do much for me. I have taken nothing since because I was too scared. Even on nights when I was jerking and couldn't fall asleep I just laid there.

 

It gets tough though in the night because I lay there and literally think I am going crazy while everyone else is sleeping and I am lying awake jerking every time I feel like I could fall to sleep. Fortunately this week it has only been two nights but those two nights I got zero sleep. The neuro thinks that my twitching and jerking is from sleep deprivation. But I know that can't be true. The jerking and twitching literally started with that last dose of ativan I took after tapering and hasn't stopped. I flushed the rest of my script down the toilet and that was the end of it after that night.