Tapering off Ativan Support Thread

[[ce...]]

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

Here it is again for you Jackie.  Just an FYI.  I had been on 4 mgs K which a great deal more than 4 mgs Ativan when I started this whole process.  She may be able to make some larger reductions in her Ativan in the beginning and then taper slower once she gets down to 2 mgs or less.  Anyway, these is just a rough outline of what I did.  Hope it helps.

 

1. If you can take doses 4 times a day (rather than 2 or 3) it's better, as to avoid interdose withdrawals.

 

2. I suggest taking your largest dose at bedtime for sleep.

 

3. A Compounding Pharmacy can be your best friend.  Every city has a compounding pharmacy, so just ask your doctor about where the nearest one is, or google your city name and compounding pharmacy.

 

4. Spread your doses out evenly.  For instance 7 a.m.  12 p.m.  5 p.m. and 10 p.m.  (OR)  7 a.m. 1 p.m.  6 p.m. and 11 p.m.  This is important so as to avoid interdose withdrawals.

 

Note: if you choose to taper Ativan you'll have to watch the clock closely everyday to make sure you take your dose on time.

 

5. Get a calendar and map out your taper plan.  This was so helpful to me to know how much to take at what time of day. Otherwise it's too easy to forget what it was that you are doing.  There's enough pain and confusion with withdrawal anyhow.

 

Here's what a "possible" Ativan taper can look like.  You may choose to slow it down or speed it up depending on what your symptoms are.  Many people find that the lower you get on the doses the harder it is, so make it slower as you get to those low doses.  Try to make the cuts every 10-14 days for the best results:

 

Possible Ativan taper:

 

.50          .50        .50        .50                  Total:  2 mgs

.25          .50        .50        .50                  Total:  1.75

.25          .25          .50        .50                  Total:  1.50

.25          .25          .25        .50                  Total:  1.25

.25          .125        .25        .50                  Total:  1.125

.25          .125        .125      .50                  Total:  1

.25          .125        .125      .375                Total:  .875

.25          .125        .125      .25                  Total:  .75

.125        .125        .125      .25                  Total:  .625

.125        .125        .125      .125                Total:  .50

.125        .0625      .125      .125                Total:  .4375

.125        .0625      .0625    .125                Total:  .375

.0625      .0625      .0625    .125                Total:    .3125

.0625      .0625      .0625    .0625              Total:    .25

.0625      .0312      .0625    .0625              Total:    .2187

.0625      .0312      .0312    .0625              Total:    .1874

.0312      .0312      .0312    .0625              Total:    .1561

.0312      .0312      .0312    .0312              Total:    .1248

                .0312      .0312    .0312            Total:    .0936

                                .0312    .0312            Total:    .0625

                                            .0312            Total:    .0312

                                                                  Off!

 

 

[[ja...]]

Thank Cedar, so she would be doing 1 mg 4x a day, then cut .25mg off the morning or how do you suggest? I can write it out once I know how much we are cutting. Maybe cut pills until she gets lower. Any thoughts on that 2 would be appreciated. She really wants my helpand I really want to help her.

 

Love Jackie

PS I guess I'm not sure how she takes that 4 mg, I mean how she divides it, but you think its best in 4 doses no matter what?

[[mo...]]

Thanks Mairin , Its good to have someone to bounce this stuff off of . Because of my PTSD and underlining anxiety I'm going to do my last cut mid-day too, its the hardest time for me. So I just started .125 .125 0.0625 .125 . I am supplied 0.0625 capsules .Take  2-2-1-2 pills total 7  = .4375 if my math is right.  Beats pill splitting . If I stick to cedar's tapering plan I  have 110 days left if I my schedule is in 10 day increments . Jump December 30 at .0312 . Of course leave room for holding more. I am sitting here this morning hoping the compound pharmacy got the dosage right .

[[Ma...]]

 

I hope they got the dosage right too MM.

 

See I am taking a mix of the regular tablets and the compounded ones.  I will be adding the compounded ones in more over time though.  I had a little fear about that too, is the dose right?  It really does seem ok to me though.

 

It is hard to trust when we have been put on these pills to begin with.  But life still demands we take leaps of faith sometimes.

 

Hugs

[[ce...]]

Thank Cedar, so she would be doing 1 mg 4x a day, then cut .25mg off the morning or how do you suggest? I can write it out once I know how much we are cutting. Maybe cut pills until she gets lower. Any thoughts on that 2 would be appreciated. She really wants my helpand I really want to help her.

 

Love Jackie

PS I guess I'm not sure how she takes that 4 mg, I mean how she divides it, but you think its best in 4 doses no matter what?

You know, I'm thinking about all of this and tapering from 4 mgs Ativan is going to be considerably time consuming.  Have you talked to her about switching to a longer acting benzo such as Valium?  I often say that if I had this to do over again I probably would have insisted on a switch because dosing 4 times a day is much harder than dosing one time a day. For this reason most people prefer to take Valium when tapering.  I never took it, so I cannot advise on that, but there are many people here who can.  I know that if she has no alternative but to taper from Ativan it can be done, but it is a lot of work and when you forget doses its very unpleasant. 

 

Anyway, I just wanted to suggest that to you before you begin implementing an Ativan taper plan with her.  Maybe talk to her and research a little more.

[[mo...]]

Gezzzzzzz Forget a dose very unpleasant . Cedar even at the lower doses too ? Well got to keep on keeping on .  I just keep on telling myself I can do this . 

[[ce...]]

Gezzzzzzz Forget a dose very unpleasant . Cedar even at the lower doses too ? Well got to keep on keeping on .  I just keep on telling myself I can do this . 

Yeah, don't forget a dose even at the lower doses. Yikes.    And you're right, you can do this because you are doing this. 

[[Ma...]]

 

 

I would not recommend switching to valium.  Valium is rougher on the body, liver and metabolites.  I think switching can really mess people up.

 

It is no big deal to dose four times a day.  Takes 10 seconds to swallow the dose.

 

I would never point people to valium, unless they are really having a difficult time with the ativan first.  She hasn't even tried it yet.

 

I have just know too many people that switched to valium, only to regret it.  One woman in particular moved to it at high dose and it just wrecked her life.  I am way past her on the way down and she started before I did.

 

It takes three weeks for a dose of valium to get out of your body.  So all that time, the body is working to process it.  Seems to take a lot of body energy.  Ativan is gone in about 4 days.  I still wait two weeks but my body has time to rest.

 

I only think people should switch after they have determined they can't do ativan.

[[ce...]]

That's interesting Mairin.  I never tried it personally.  That's good to know. 

[[aw...]]

Hey, Mairin:

Thanks for a very supportive post. I hope to taper directly from A without changing benzos and quite possibly without having to go to 4X day dosing, 'tho I will if I get serious IW sx. However, everyone is different and I have a long way to go. I certainly won't consider Valium until I'm convinced I can't taper from Ativan. Actually, I already take 5 mg of V/day for a musculoskeletal condition and plan to taper off the A with the 5 mg of V in place, then deal with that when I'm Ativan-free. Not a bad plan. "A pre-emptive partial crossover"? Maybe it's the long Valium duration of action (not 1/2 life) that's letting me dose Ativan 3 X/day.

 

Aweigh

 

[[Ma...]]

Yes Aweigh, it very well could be the valium supporting you though interdose feelings.

 

I actually thought about that too, adding in a little dose of valium, a small dose, like you are taking.  But really, I/D has not been a problem for me.

 

And also, my doc is really against valium.  I asked him why and he did explain all the metabolites in it.  Klon is actually one of its metabolites.  Ativan is probably the most metabolite free of all the benzos.  It has one inactive metabolite.

 

However, valium has many metabolites and they are active metabolites. 

 

I think people have more success with valium when they switch at lower doses.  It seems to me, 20 mg and under is ok, but above that, many times people have a lot of trouble.  It just seems like the body cannot handle high doses of valium very well.  This poor woman I know, she switched over to 70 mg V.  And she has been just a wreck ever since.

 

I just don't think valium was ever meant to be taken in such high amounts.  That may have been partly why klon, ativan and xanax were developed, so people could take more benzo without the deleterious effects of valium?  I am not sure, but would make sense.

[[mo...]]

I switched from my 0.5 mg pill of lorazepam ( VA pharmacy medication white tablet pill 321 /M )  yesterday. I was dosing 0.125 4 times a day .50 mg . Cutting the pill in quarters.

Yesterday I started my 0.0625 compound pills  ( capsule ) from a civilian pharmacy . Made a 10 day cut to .4375 . 2-2-1-2 of the 0.0625 = 7 pills.

Late yesterday afternoon I felt like I up-dosed. I felt very sedated . I guess this could be from pill cutting . I know you can't accurately cut

4 quarters . Also you may loose some of the drug ( small pieces & dust ) when cutting . Of course my underlining anxiety and wd are playing tricks with my mind . Just looking for some assurance . Thanks MM

 

[[ce...]]

Hey, Mairin:

Thanks for a very supportive post. I hope to taper directly from A without changing benzos and quite possibly without having to go to 4X day dosing, 'tho I will if I get serious IW sx. However, everyone is different and I have a long way to go. I certainly won't consider Valium until I'm convinced I can't taper from Ativan. Actually, I already take 5 mg of V/day for a musculoskeletal condition and plan to taper off the A with the 5 mg of V in place, then deal with that when I'm Ativan-free. Not a bad plan. "A pre-emptive partial crossover"? Maybe it's the long Valium duration of action (not 1/2 life) that's letting me dose Ativan 3 X/day.

 

Aweigh

I'm so confused by this post.  You won't consider Valium, and yet you're taking 5 mg's of Valium a day?  I cannot for the life of me understand why you're doctor is prescribing you 2 benzo's at the same time.  Why not take only one and taper from that.  Tapering off of your Ativan and then your Valium doesn't make any sense at all.  Its going to take you years to get free of this. 

[[Ma...]]

Hi MM,

 

Ok well, it is quite possible you are getting a different amount of ativan than you were taking.  LIke you said, the crumbly pill cuts.

 

This is what my doc told me.  He said the drug is not evenly distributed throughout the pill, the tablets that we have been cutting, I mean.  If you take a .5 pill whole, you will get .5 ativan.  But if you cut up the pill, there is no real guarantee that you will get say, .25 in a half a pill, because the pill has "swirls" of the drug in it.  Anyway, this is what he said.

 

So that may be what you are experiencing, that you are really getting the full dose, or it is possible that the pharmacist made them a little stronger as well.

 

But, no matter how we do this, we are not going to be getting the exact dose.  Because even with the manufactured pills, the dosage is allowed to be slightly off.

 

Personally, I don't think it means a whole lot in the grand scheme.  What you are doing is gradually reducing.

 

LIke I said, I am using a combo of the compounded pills and my regular pills, it is just cheaper that way.  So I have just added in one compounded pill to the mix, and tonight I will add in another.  That way I am not taking the whole dose in the compounded pill form.

 

The pills vary from manufacturer to manufacturer as well.  I have often seen people report noticing changes when switching brands of pills. 

 

The doses we take, when we are tapering, are probably not going to be the exact dose we are trying to get, no matter HOW we do it.  Compounded, titration, cutting,  all the different things people do, there is going to be more error than just taking whole pills.  But the thing to keep in mind is that the dose is going down when we eliminate, and it is probably accurate enough for our purpose.

[[mo...]]

Mairin , Your support is  very much appreciated . Thank you for being there it means a lot . How has your heart rate been doing ? I answered your post in another thread . I have been retired for 3 years and have been walking 2-3 miles everyday since. I have a resting heart rate of 56. It is the one most single important things I do for my physical and mental health . Insomnia , depression,  anxiety , PTSD, and WD SX. Bart has an excellent thread on exercising while withdrawing . I had debilitating depression  when I first started to taper. I know that stabilizing played a major key . But along with hiking/walking everyday my depression is 90% better ! Hugs MM Semper Fi

[[mo...]]

I have learned so much from the short time I have been on this site from everybody. I am truly thankful for everybody's help . I have recuperated from a 50 % cut I did in the beginning reinstated and have stabilized . I am using just compound doses of 0.0625 of lorazepam . I understand the desired rate of a cut is  5 to 10 % . Based on my schedule at what rate am I reducing . Sorry I am no math wiz . Thanks MM

 

 

.25          .125        .125      .25                   Total:  .75

.125        .125        .125      .25                   Total:  .625

.125        .125        .125      .125                 Total:  .50

.125        .0625      .125      .125                 Total:   .4375

.125        .0625      .0625    .125                 Total:   .375

.0625      .0625      .0625    .125                 Total:    .3125

.0625      .0625      .0625    .0625               Total:    .25

.0625      .0312      .0625    .0625               Total:    .2187

.0625      .0312      .0312    .0625               Total:    .1874

.0312      .0312      .0312    .0625               Total:     .1561

.0312      .0312      .0312     .0312              Total:     .1248

                .0312      .0312     .0312             Total:     .0936

                                .0312    .0312             Total:     .0625

                                             .0312             Total:     .0312

                                                                   Off!

 

[[Ma...]]

MM,

 

The formula is this:  .0625    n

                              ––––    –––

                              .4375  100

 

 

So. .0625 x 100 =  6.25/.4375 = 14.28 %

 

 

 

 

[[Ma...]]

I have learned so much from the short time I have been on this site from everybody. I am truly thankful for everybody's help . I have recuperated from a 50 % cut I did in the beginning reinstated and have stabilized . I am using just compound doses of 0.0625 of lorazepam . I understand the desired rate of a cut is  5 to 10 % . Based on my schedule at what rate am I reducing . Sorry I am no math wiz . Thanks MM

 

 

.25          .125        .125      .25                  Total:  .75

.125        .125        .125      .25                  Total:  .625

.125        .125        .125      .125                Total:  .50

.125        .0625      .125      .125                Total:  .4375  = 14.28 %

.125        .0625      .0625    .125                Total:  .375    = 16.66 %

.0625      .0625      .0625    .125                Total:    .3125 = 20%

.0625      .0625      .0625    .0625              Total:    .25    = 25%

.0625      .0312      .0625    .0625              Total:    .2187 = 14.2 %

.0625      .0312      .0312    .0625              Total:    .1874  = 16.64 %

.0312      .0312      .0312    .0625              Total:    .1561  = 20%

.0312      .0312      .0312    .0312              Total:    .1248  = 25%

                .0312      .0312    .0312            Total:    .0936  = 33.3 %

                                .0312    .0312            Total:    .0625  = 50%

                                            .0312            Total:    .0312  =100%

 

 

These are percentage of the present amount you are taking, not percentages of your original dose.

                                                                  Off!

[[Ma...]]

The formula for percentage of your original dose would be:

 

      .0625    n

      -------    -----

          1        100

 

 

.0625 x 100 = 6.25/1 = 6.25%

 

So what ever cut you make (.125, .0625 or .0312) from your original 1 mg. would be about 10% or less.  If you go down from 1 mg in 10 steps, each step would be 10% of the original dose.  But I think most people think in terms of the previous amount taken, not the original.

 

But, towards the end, it is harder and harder to get 10% cuts from the previous dose.

 

The 10% idea was made by Ashton.  It was a good starting point.  I don't think Ashton intended for people to keep doing that all the way off.  It was a guide to start with.  It is completely impossible to keep that up until the very end when you get into the low ranges, because the doses become too small and everyone is going to have to make a 100% cut at some point.

 

Even Bart lol.

 

 

 

 

[[mo...]]

  So I just dropped 0.0625 mg of of my .50 mg dose and that gives me a 14.28 % cut I just made ? I have 10 cuts left according to my taper.  I guessing they will not all be the same ?        gezzzzzzz LOL  God I feel like an idiot LOL 

[[Ma...]]

There is no reason to feel like an idiot.  Why do you feel like that?

 

Look I was on the equivalent of 12 mg A to start with.  My first cut was in effect 30%, taking me down to 8.  That was horrible and put me in a bad state for a year.  But it was a very high dose.

 

If I would have continued making 10% cuts from my original dose, I would have been cutting too much.  In fact, 10% of 8 is .8, which says I should jump off now, but something tells me that would not be a good idea.

 

The idea of Ashton is simply this: a slow steady decline in blood levels of the drug.

 

Percentages are a good guide from high levels and for most of a taper.  But nowhere is this carved in stone.  I took a 14% cut too recently.  The thing to really pay attention to, is how you feel.  Go down in reasonably small amounts that your body can tolerate. 

 

Not everyone is going to tolerate the same cut amounts.  Some people can cut more, some have to cut less.  5-10% is a good guide, but at some point, EVERYONE is going to have to taper more than that.

 

Listen to your body.  If this cut was too much for you, start cutting by the smaller amount, .0312.

 

Check out Phoenix2's threads.  She got down mostly by .0625 all the way.

[[mo...]]

Thanks Mairin , You right listen to your body . I have been doing fairly well on this taper. If it works don't mess with it . I have adjusted to the compound doses too. I see what you mean when I checked out Phoenix2's taper. She came off at 0.0625 dose. I'll see how I feel when it comes time to go back to the pharmacy to pick up my 0.0312 doses . Many thanks MM 

 

[[Wi...]]

Hello,

 

Was on a small dosage of Ativan 0.5. for two years because of a terrible accident t-boned drivers side struck @ 45 mph, in fact today is the anniversary. Have not jumped to a higher dosage for these two years.

 

Started my titration on 8/1/13 in a 100ml bottle (free from my pharmacist) then pouring the Ativan (shaked for 1 minute) into a small baby food bottle. Easy using the plastic syringe.

 

Was all over the map some days with w/d I would tapper some days 5ml and then felt terrible but would not cheat during the day. I would then go back to a 2 or 3ml per day taper. Once I was at 1/2 of the 0.50 then only used 50ml of water (much easier while using a plastic syringe, less to take out while always stirring the water so Ativan does not fall to the bottle og the baby food bottle.Tonight I will go very slowly for the next 25 days to the end (1ml per night). Hopefully will be done in these next 25 days. We shall see?...so far (Thank God) it has been working.

You must do your own thing because your body and your mind will surely be talking to you.

 

My W/D symptoms so far, headaches and muscle tightness, especially in my legs, insomnia a first.

 

You must not chat period...it is a mind over matter. Easy to say hard to do, I realize. It is not a race and some days I was proud to do 5ml but in retrospect it was really silly to think...we all just want to get it done, right?!

 

One good thing my dreams are amazing!

 

God Bless!

 

 

[[mo...]]

Welcome Winter , There are some great folks here that will be very supportive . Being informed about what this drug does is half the battle . I went back and read through most of the posts on this thread .  Go slow MM

[[aw...]]

Mairin:

 

..."5-10% is a good guide, but at some point, EVERYONE is going to have to taper more than that."

 

I beg to differ. I have never cut anywhere close to 5%, I doubt I ever will, and I think I'll get to zero OK. Different tools for different fools    I thought the whole point of going liquid is that you can make tiny cuts.

 

aweigh