Tapering off Ativan Support Thread

[[mo...]]

I'm in agreement with you there Mairin . My private family Doctor was a least open-minded at least to consider my plan . He told me he was going to keep my taper plan for future use. The VA on the other hand the folks that are still treating us veterans with benzo's was a different story. There answer for my dependency was a 4 day detox inpatient hospital stay . I feel I was lucky enough to at least get enough medication for my taper. I best keep quiet about the VA fro the obvious reasons. I am very fortunate enough to find BB. It has been a godsend .

[[ja...]]

Ok BB, my neighbour is on Ativan and other meds. She wants off the Ativan and she goes to my Doctor. He will help her if she figures up the plan, same as me. I would like to give her a slow taper plan due to other health issues that she has. She is on 4 mg Ativan, I was thinking the slower the better. Can someone help me with a plan from 4 mg for her.

 

Thanks so much

Love Jackie

[[Ma...]]

 

It's hard to say Jackie.  I got down from 8 mgs to 6 by cutting .5 at a time.  Then I got from 6 to 3 by cutting .25 at a time.  At three, I started going down by .125, until I got to 1.  Now I am going down by .0625.

 

Its so hard to say.  Can she start with .25?  Probably, but for how long I don't know.  It all depends on how she in particular handles it.

 

It would probably be better if she used .125 cuts all the way down to about 1 or so.  Doing it that way takes about 4 months per mg.  She is looking at about a 16 month taper, at least, that way.  But that is better than not even trying to get off and spending the next 16 months on the 4 mgs.

 

The best thing would be if your doc would just give her the 4 mgs in .5 dose pills.  Just very simple to cut that way.  The dosage of the pills really comes into play when you are cutting.  That was such a big part of Ashton's reasoning for valium, because the pills come in low dosages.  It is a significant aspect of tapering, what strength the pills are.

 

Tell her she does not really need to cross to valium, unless she is having lot of difficulty.  It is doable to get get down on Ativan.

[[ja...]]

Thanks Mairin, a couple ? for you. Time is not a issue for her because she stays home due to an accident she had and hurt her back about 8 years ago. She was painting up high in her hallway and fell off the ladder and hit the oak banister with her back.

 

She is on Tramadol, Hydrocodone, Ativan, Trazadone, and some others drugs, talk about Polly drugged, Very sad. Now correct me if I'm wrong are Ativan pretty small? How would she cut .125 mg? Also what would she cut at 1 mg?

 

Thank you for all your help

Love Jackie

 

[[ce...]]

Jackie, I hope its okay if I jump in here.  There's not good way to cut .125 mgs of Ativan, even with a pill cutter. They are just too small and crumble into tiny peices.  The best thing to do is have the doctor prescribe smaller doses and then take the script to a "Compounding Pharmacy".  This is how I tapered off of the smallest doses and it worked.  Every city has a compounding pharmacy.  You can look it up on the internet, or ask your doctor where the nearest one is. 

 

Reading that list of drugs she's taking was heartbreaking. No one would feel "good" on that cocktail.  Shame on doctors for doing this to people.  Its criminal.

[[Ma...]]

 

Well, I will just respectfully disagree with Cedar.  I think you can cut the pills just fine.  Up to a certain limit.  I do have .0625 compounded pills now.  But really, I didn't need them to get down to 1 mg.

 

A one mg pill can be cut in quarters pretty easily with a decent pill cutter.  I got mine at the pharmacy, about 7 dollars.  Been using it all along.  The one mg pills and the .5's cut into quarters pretty well.  It is cutting beyond a quarter that is hard with ativan pills.

 

If she has all that time, I think she should just cut by .125 for a long time.  She will not be going over 5% for a very long time, doing it that way.  I think she will hit 5% at 2.5?  And really, you can cut higher than 5%, up to 10%.  And ten percent is just suggested to start really.  I think Juliea was talking about that, that Aston didn't even really follow ten percent religiously.

 

I have just found it helpful to stay under 10%, and she does not even have to worry about that for about a year if she just sticks to .125 cuts.

 

I did, recently, ask my doc to give me the whole dose I am taking in .0625 compounded pills.  But he said, well it is expensive and you don't really need that just yet.  Compounded is costing me 40 dollars for a script as opposed to 7 dollars for the regular pills.

 

A quarter of a .5 pill is .125.  It is pretty simple.  It really would help her to have .5's instead of 1mgs.

[[ce...]]

I think you misunderstood me Mairin.  I said it was hard to cut a .125 mg peice of Ativan in half or into a smaller peice.  .125 mgs is a quarter peice of a .50 mg Ativan.  Cutting a quarter peice of Ativan in half is very difficult.  Its simply too small to make an accurate cut. Anyway, I hope this makes sense since .50 mg pills of Ativan are the smalles doses sold without a compounding pharmacy.

[[ja...]]

Hi Mairin and Cedar, thank you both for helping me to help someone else. If I'm not mistaken I think she has 1 mg pills I'm pretty sure she told me that. So 1/2 of 1 mg is .05 and 1/2 of .05 is .125? Is that doable with Ativan?

 

We do have a compounding pharmacy also. I need to come up with a taper plan from 4 mg. Im sure she can get .05 pills also if she needs them.

 

Thanks again

Love Jackie

[[On...]]

Can someone review this and tell me if I'm doing okay with titration? I'm not quite sure if this method I'm trying works. I'll just post my question that I had somewhere else:

 

I mixed finely powdered .5 mg of lorazepam in half a liter of milk, stirred well, and poured 105 ml in cup which should be .105mg which I drank along with my regular .5mg tab (night dose).  I removed .02mg. Does this sound right?

 

Is this too much milk to use to get accurate dosing?

 

 

I want to mention I got a headache and blurry vision afterward which I don't understand. I wonder if it means the solution wasn't equal and I got too much?

[[On...]]

Given my symptoms tonight I don't think my solution attempts worked, I'm crying terribly and other sx. Maybe the loraz became innactive, idk ..

[[Ma...]]

Hi Mairin and Cedar, thank you both for helping me to help someone else. If I'm not mistaken I think she has 1 mg pills I'm pretty sure she told me that. So 1/2 of 1 mg is .05 and 1/2 of .05 is .125? Is that doable with Ativan?

 

We do have a compounding pharmacy also. I need to come up with a taper plan from 4 mg. Im sure she can get .05 pills also if she needs them.

 

Thanks again

Love Jackie

 

Um, 1/2 of 1 is .5 mg, and 1/2 of .5 is .25.  A quarter of a .5 pill is .125.  That is doable.

 

Cutting FURTHER than .125 was difficult for me.  I agree with Cedar that to get below .125, it is better to have it compounded.

 

OneDay, wish I could help but I have never done titration.

[[An...]]

Hi One,

I am saddened that you are having troubles with your titrating ..

I am concerned that Ativan does not desolve in milk ..

I had the symptoms you are describing while on Compounded liquid ..I think it was the solvents in it that made me ill ..

Maybe aweigh can help, since he is familiar with Ativan and tapering it ..

I hope you will find a solution to this, and start to feel better.

Thinking of you, and sending you hugs ..

Anu

 

[[ja...]]

Thanks Mairin, have a great day!!!!

 

Love Jackie

[[ce...]]

Hi Mairin and Cedar, thank you both for helping me to help someone else. If I'm not mistaken I think she has 1 mg pills I'm pretty sure she told me that. So 1/2 of 1 mg is .05 and 1/2 of .05 is .125? Is that doable with Ativan?

 

We do have a compounding pharmacy also. I need to come up with a taper plan from 4 mg. Im sure she can get .05 pills also if she needs them.

 

Thanks again

Love Jackie

 

Um, 1/2 of 1 is .5 mg, and 1/2 of .5 is .25.  A quarter of a .5 pill is .125.  That is doable.

 

Cutting FURTHER than .125 was difficult for me.  I agree with Cedar that to get below .125, it is better to have it compounded.

 

OneDay, wish I could help but I have never done titration.

Oops, must have been tired.  I meant .5 mgs, not .05 mgs.  HUGE difference. 

 

Compounding works very well. 

[[ja...]]

Thanks Cedar, I might try and write up something like your taper when she gets a little lower. She is at 4 mg now. I cant remember where you started. Ill go back and look it over again.

 

Love Jackie

[[...]]

Hello Tina,

I have been tapering off .05 ativan. I started taking it about 3 months ago and though it works great for anxiety I really just want to get bak to me. I take 1/2 in the morning and 1/4 in the afternoon. Changed the taper a little yesterday and boy I payed for that. I did 1/4 morning 1/4 noon and  1/4 evening. Been getting brain zaps all day . Don't know how long to hold my present taper before cutting. Can anyone help with this information.

[[Br...]]

Hi, hope it is ok to hop in here.

 

Cut in paste of my intro post here, hope that's ok, takes me log time to write. I hope you can cypher my info. I really can't make out how you all are posting your taper schedule in your signature. Can someone direct me to a post that explains this? I'm sure mine is confusion, but hopefully you can get an idea.

 

Anyways, here is my intro.

 

Howdy,

I was seeking out a tapering program when I found this great site.

I have been on 3 mg day of Ativan since Brain surgery in July 2011.

 

I had tumors around my pituitary and up into my hypothalamus, which were removed. My brain went a little crazy over the tampering by the neurosurgeon . My main symptom, besides pain, was anxiety and a "zapping" feeling, like little electrical shocks( fun). I also had a surgical complication, I developed a CSF leak. So my brain was getting bruised evertime I moved suddenly, or just stood up. So the Ativan helped with keeping the stimulus down.

 

Now I'm cured , been in recovery mode since December last year. I started the Ativan tapering program from the UK professor at this link..http://www.benzo.org.uk/manual/bzsched.htm#s8

But after only 6 days I cannot handle even the small dose of 5mg of the diazepam.

 

So I would like to try to taper off without a cross taper. I have tried to taper once before but the doc tapered me way too fast (4 weeks). We are in no hurry, but I will not be able to work until I'm off this stuff. I do have memory issues, hopefully due to the Ativan and not the brain surgery. I won't know till I get off this stuff.

 

Anyways, any input would be greatly appreciated.

 

Some quick thing to help give me advice:

*I'm on 150mg XL of Wellbutrin ( started 6 weeks ago)

*I take 1 or 2 Norco a week for extreme head pain( getting better everyday)

*Was on Ambien 10mg nightly since surgery, stopped cold turkey in may/June.

 

Sorry so long winded, thanks for any advice.

 

 

 

 

[[Br...]]

Sorry, forgot to add that I'm undergoing a series of occipital/frontal nerve blocks and cervical diagnostic procedures, almost weekly, started about two months ago. I'm under conscience anesthesia to do some of this ( 3 times so far).

[[Ma...]]

I just have to say, Holy Guacamole! Brokenbrain!  Wow you have been through the wringer.

 

I am shocked your doc tried to take you off it so fast, especially after all you have been through with brain surgery.  You would think a brain surgeon might know better?  He's a brain surgeon!  This IS brain surgery!  lol  omg

 

You can try going slow with this.  I have found success with reducing the dose by .125 every two weeks.

 

That would be, one quarter of a .5 pill.  Can you get the ativan in the .5 dose size?  This will help a lot.

 

Your situation is definitely far more complicated that most people on here.  It kind of scares me to give advice in your situation.  Because, I absolutely do not want to steer you wrong in any way after all you have been through.

 

But, getting off fast is pretty definitely not the way to get off this drug for most people.  Slow tapers are better.

 

Look at my signature.  I was on a very high dose, 8 mg Ativan.  It has taken me a long time, as you can see.  Personally, I believe it is best to cut small amounts every two weeks or so, depending how you feel.

 

Big hugs to you.

 

 

 

 

 

[[mo...]]

Hey Mairin , I know we have had this conversation before about what dose to eliminate first and so on . I found this post by nickiheat . Started to make me think . I am wondering now if it may better in the long run . Thinking about when jumping off ? I curious to see if cedartree has any comments about this ? I'm following cedar's tapering plan. Anyway I'm starting my next cut tomorrow using my compound doses 0.0625 . Right now I'm on even dose x 4 across the board . I seem to have more good days than bad right now. MM

 

 

A quote from the Journal of the Royal College of General Practitioners, April 1989

 

"Where the drug is being taken three or four times daily it will

be important to establish which dose to cut first. To reduce the

impact of diurnal fluctuations and psychological dependence

on the drug during the day, it may be useful to reduce the lunchtime

dose first, then the morning dose followed by the evening

dose, repeating this format until withdrawal is complete. The

evening dose should be cut last as sleep disturbance is often one

of the least tolerable symptoms."

 

[[Br...]]

Thank you for your replies

 

Yes, my latest neurologist was very alarmed how long I'd been on Ativan and wanted me off ASAP. Luckily, I have a very cool psychologist who is willing to let me set the pace of my taper, try new stuff, etc. I have a Pain doc who is working to block my nerves so less pain meds are needed, and i just started to see a new counselor who will help me regain some lost coping skills and I'm sure I'm suffering from PTSD too! I also am in Aqua therapy( I highly recommend!).

 

I gave you bare bones of my "Saga" . My brain surgeon dropped me like a hot potato after sugery cause he'd never seen what he found before . Never saw him again. He is considered one of the top Neurosurgeons in Texas, so maybe a lesser doc would of messed me up more..? But my case was a bit unusual, even the top pathologists in the country disagree on what I have/had. So we are in a holding pattern to see if the tumors come back, which will exonerate some and disprove others...sound crazy?  So I've been through a lot of docs, some playing "hot potato", some using me like an interesting guinea pig to try new drugs on . I now seem to have a good team, though getting them to communicate with each other is near impossible.

John Hopkins ( Baltimore) and Cedar Sinai (LA)  saved my life.

Anyways, for a year between surgeries, one brain and one to fix my CSF leak, I needed to avoid all stimulus. This included light, sound, movement, even smells bothered me. But some cool thing, now that I'm cured, have come out of this. I have a super super sense of smell and taste. I can tell you all spices in a dish, and smell a forest fire before it even catches fire .

Sorry I babble...

 

I like the reduction of .25 plan, I think I'll see if my doc will let me do this every 2 weeks, that gives me 6 months to get off.

I also think it is good point about not to touch my night dose just yet, as I have issues even before starting the taper.

So

1mg      0 .75    1 mg    (2weeks)

0.75      0.75      1mg    (2weeks)

0.75      0.75      0.75    (2weeks)

0.75      0.5        0.75    (2weeks)

0.5        0.5        0.75    (2weeks)

0.5        0.5        0.5      (2weeks)

0.5        0.25      0.5      (2weeks)

0.25      0.25      0.5      (2weeks)

0.25      0.25        0.25      (2weeks)

0.25      0          0.25    (2weeks)

0            0          0.25    (2weeks)

0            0          0.0      Hooray!

 

 

Sound good?

[[Ma...]]

Hi MM

 

Well yes a lot of people recommend keeping the night dose.  I understand that.  But I think the worst psychological dependence is on the night dose for most people.

 

I would rather supplement with hydroxyzine to sleep if I need to.  I am not sure if you are aware of hydroxyzine?  It's an antihistamine.  My doc has no problem prescribing that for me.  It helps with sleep.  I don't take it often really. 

 

Sleep is an issue for you, I know.  Personally, I find the midday dose to be most important for me, everything seems to revolve around that dose.  Because, I need to function most at that time.  But on top of that, I also don't want to keep depending on ativan to sleep.  I cut the night dose third, so I do keep it to almost last, but the psychological dependence, as mentioned in that quote, is much bigger than the dependence on the midday dose in my opinion.

 

We are going to have to get off the night dose completely at some point.  And for both of us, sometime in the next 6 months right?  We have to be psychologically ready to live without ativan at any time of day.

 

I used to take ativan only once a day.  And I would take it at night.  This is when I was on 1 mg.  I would take that pill, and say, "Oh wonderful, I am going to just fall asleep!"  I never really had huge issues with falling asleep.  But it was so wonderful, to take it and know I was going to sleep very fast.  There is something terribly wrong with that.  It is not the reason I got on the drug in the first place.

[[Ma...]]

 

BrokenBrain,

 

I am totally blown away by your situation.  I know your plan probably seems highly reasonable to you, but this drug is a real bear.  That is why there is this huge forum dedicated to just this particular drug.  "This ain't no Mudd Club, no CBGB's this ain't no foolin' around." 

 

The other drugs you are on, which seem to be all aimed at pain, may ameliorate things for you to some extent. 

 

But really, knowing what I know about benzos, I would err WAY ON THE SIDE OF CAUTION in your case.

 

I personally think .25 cuts are too aggressive.  If that plan seems reasonable to you, I guess try it and see what happens, knowing you can always slow down or change it.

 

You said you were already reduced too fast, how did you feel then?  Obviously, you pinpointed the ativan as a problem and realize it is not that easy to get off it.

 

Ok, this is my theory.  I believe the brain is a slow healer.  The brain is not like other body organs or systems.  (This is really interesting because you have actually had your brain physically manipulated).  The brain, is encased in the skull, and it is the only organ in the body that comes in its own private "lock box" so to speak.  I guess, the brain functions on two levels.  The physical brain, and the chemical brain system.  The chemical and electrical stuff is not as easy to fix as the physical.  Dose this make any sense to you?

 

It seems the brain can adjust to small changes over a long period of time, better than fast changes, such as fast reduction of this drug.  It is not like a boo boo on the skin, which heals very quickly.  The brain heals slowly.  We need to give it lots of time.

 

I've used the analogy of getting down from a high building.  If you jump off 5 stories to the ground, you are gonna been in pretty bad shape.  Body can't handle that.  If you jump down one floor at a time, you are still gonna be hurtin', body can't handle that.  But if you take the stairs, your body CAN handle that.

[[Br...]]

Hmm, the cadets logic is sound. I first worked up a schedule that took a year and thought, that's crazy! But much of what you say rings true.

 

I'm on my way to get some needles jammed in my head and spine fun. So you may not hear from me for a day or two, but as soon the anesthesia clears, i will do more research and try to work up another taper schedule.

Thanks for the great input.

BB

[[An...]]

Dear broken,

I am so very sorry for all that you have endured ..

You are so very brave, with an inspiring attitude ..!!

Please, when you start tapering, please go slower than the schedule you put up ..

It sounds too quick ..Perhaps do 0.625 mgs every two weeks, and hold as long as you need until you feel better, to do another cut ..

Your system is delicate now, and sensitive, and needs outmost care ..

I tried tapering Ativan by .125 mgs, and failed ..I held for 4 weeks ..

Please take care of you ..

You are in thought, and heart ..

Love, Anu