Tapering off Ativan Support Thread

[[Ma...]]

Well, yes, "going liquid" gives you more control over cuts and you can make them infinitesimal.  I am just saying, for the non-mad scientists here, at some point we are going to get out of the range of 10% on the low end of things.

 

At some point though, everyone is going to make a 100% cut.  Unless you get lost in the 7th dimension of eternal taperers.  I suppose you could get 5% of .0000001 with an electron microscope and a holographic pipette. 

[[Co...]]

So glad to find this thread...at the near end of my taper..but stuck stuck...so good to read other 's experiences....thank you for starting this ..sure I will be frequent visitor..

[[cl...]]

If anyone would recommend a benzo wise doctor in Ohio please PM me. Need someone that will help wife with Ativan Ashton taper.

 

Talked to a psychiatrist who recommended we search for a psychopharmocologist. Comments?

 

 

 

Edit: removed personal information

~Juliea

[[Ma...]]

Hi clawspeak,

 

Seems like what you are trying to do is extend the time she takes the ativan.  Personally, I don't think that works.  Ativan has a duration of action of 6 hours.

 

My opinion is, it would be better to work out a four dose a day schedule, and gradually subtract more and more of the pill from each dose, but in a very slow fashion, 2 weeks probably, and in small increments, such as .125.

 

You really do not need a doc to tell you what to do.  Read ashton. It is extremely hard to find a doc to agree to this.  You are better off just getting the refills, and doing it yourself.  Many people are doing this without doctor "supervision."  Doctors often do not understand how to get patients off benzos safety.  It is far easier to put someone on this drug, than to take them off.

[[cl...]]

Since I posted the note below, I did not realize there was an Ativan Taper thread. Looking for anyones comments ... note: motivation for using a time taper instead of cutting the doses is I believe I have far more control over the size of the cut using space between dose ... see below.

 

 

My wife started Ativan nearly 4 years ago. She started with 2-1mg doses daily (1mg every 12 hours). after about a year, increased to 3-1mg doses (1mg every 8 hours). It is only earlier this year when she went to 4-1mg doses daily (1mg every 6 hours), did she start having the paradoxical effect. Since the half life of Ativan is between 6 and 8 hours, the level of the drug may been building in her system.

 

My plan is to walk backwards gradually. Not by cutting pills but by slowly spread out the time between doses. Here is the plan to get from 4mg daily to 2mg daily. We are now on the first cut.

 

You can see cuts start between 5% and 10% and with each cut the percentage decreases. We stay at each step for two weeks. This is a very slow and gentle taper.

 

Time Taper Calculations (cut planned every 14 days)

 

1mg every 6.0hrs = 4.0mg daily (4mg every 24hrs) (highest does and starting point)

 

1mg every 6.5hrs = 3.69230769230768mg daily  (current step)

(4mg every 26hrs - 7.692307692308% cut)

 

1mg every 7.0hrs = 3.42857142857144mg daily

(4mg every 28hrs - 7.142857142857% cut)

 

1mg every 7.5hrs = 3.2mg daily

(4mg every 30hrs - 6.666666666667% cut)

 

1mg every 8.0hrs = 3.0mg daily

(3mg every 24hrs - 6.25% cut)

 

1mg every 8.5hrs = 2.82352941176472mg daily

(3mg every 25.5hrs - 5.882352941176% cut)

 

1mg every 9.0hrs = 2.66666666666667mg daily

(3mg every 27hrs - 5.555555555556% cut)

 

1mg every 9.5hrs = 2.52631578947367mg daily

(3mg every 28.5hrs - 5.263157894737% daily)

 

1mg every 10.0hrs = 2.4mg daily

(3mg every 30hrs - 4.999999999999% cut)

 

1mg every 10.5hrs = 2.28571428571428mg daily

(3mg every 31.5hrs – 4.761904761905% cut)

 

1mg every 11.0hrs = 2.18181818181819mg daily

(3mg every 33hrs - 4.545454545454% cut)

 

1mg every 11.5hrs = 2.08695652173912mg daily

(3mg every 34.5hrs - 4.347826086957% cut)

 

1mg every 12.0hrs = 2mg daily

(2mg every 24hrs – 4.166666666666% cut)

 

My wife is reporting a lowering of her anxiety but but still can get worked up if she does not distract herself from being obsessive.

 

Has anyone else done this? Any thoughts?

 

[[Ma...]]

Hi claw,

 

Well I have never run into this type of taper before.  I did read something recently that was kind of like your taper, using time.  Not sure where I saw that, it was on BB though.

 

The problem I see with this is that ativan's duration of action is 6 hours.  I really can't see extending the time between doses as something that will work.  Right now she is waiting 6.5 hours, that is not much difference, but you said she is still having to distract.  I think once you get the doses further apart, well, you are just going against the way the drug works, it is going to stop working after 6 hours adn she is going to be suffering more and more as the doses get further apart.  Of course this is all my opinion based on what I personally have experienced and also read.  I have never seen anyone purport this method on this board.

 

Knowing what I know, I do not think this plan will work well.

[[cl...]]

Mairin33, at 3mg she was fine, as soon as she went to 4mg she started having trouble. I believe she hit her tolerance level and instead of helping she had the paradoxical effect. She is feeling a bit better with the first taper.

 

 

[[ce...]]

Since I posted the note below, I did not realize there was an Ativan Taper thread. Looking for anyones comments ... note: motivation for using a time taper instead of cutting the doses is I believe I have far more control over the size of the cut using space between dose ... see below.

 

 

My wife started Ativan nearly 4 years ago. She started with 2-1mg doses daily (1mg every 12 hours). after about a year, increased to 3-1mg doses (1mg every 8 hours). It is only earlier this year when she went to 4-1mg doses daily (1mg every 6 hours), did she start having the paradoxical effect. Since the half life of Ativan is between 6 and 8 hours, the level of the drug may been building in her system.

 

My plan is to walk backwards gradually. Not by cutting pills but by slowly spread out the time between doses. Here is the plan to get from 4mg daily to 2mg daily. We are now on the first cut.

 

You can see cuts start between 5% and 10% and with each cut the percentage decreases. We stay at each step for two weeks. This is a very slow and gentle taper.

 

Time Taper Calculations (cut planned every 14 days)

 

1mg every 6.0hrs = 4.0mg daily (4mg every 24hrs) (highest does and starting point)

 

1mg every 6.5hrs = 3.69230769230768mg daily  (current step)

(4mg every 26hrs - 7.692307692308% cut)

 

1mg every 7.0hrs = 3.42857142857144mg daily

(4mg every 28hrs - 7.142857142857% cut)

 

1mg every 7.5hrs = 3.2mg daily

(4mg every 30hrs - 6.666666666667% cut)

 

1mg every 8.0hrs = 3.0mg daily

(3mg every 24hrs - 6.25% cut)

 

1mg every 8.5hrs = 2.82352941176472mg daily

(3mg every 25.5hrs - 5.882352941176% cut)

 

1mg every 9.0hrs = 2.66666666666667mg daily

(3mg every 27hrs - 5.555555555556% cut)

 

1mg every 9.5hrs = 2.52631578947367mg daily

(3mg every 28.5hrs - 5.263157894737% daily)

 

1mg every 10.0hrs = 2.4mg daily

(3mg every 30hrs - 4.999999999999% cut)

 

1mg every 10.5hrs = 2.28571428571428mg daily

(3mg every 31.5hrs – 4.761904761905% cut)

 

1mg every 11.0hrs = 2.18181818181819mg daily

(3mg every 33hrs - 4.545454545454% cut)

 

1mg every 11.5hrs = 2.08695652173912mg daily

(3mg every 34.5hrs - 4.347826086957% cut)

 

1mg every 12.0hrs = 2mg daily

(2mg every 24hrs – 4.166666666666% cut)

 

My wife is reporting a lowering of her anxiety but but still can get worked up if she does not distract herself from being obsessive.

 

Has anyone else done this? Any thoughts?

Oh no!  I would not have been able to handle this aggressive type taper. I would not call it slow or gentle.  The first problem with this taper is that Ativan has a half life of 5-6 hours.  The effectiveness wears off after about 5 hours, so waiting for another dose until 7-12 hours is going to be terrible.  She will actually begin to go into wd from not dosing correctly through the day because the body is going to think you're not giving it any more Ativan. 

 

Most people tapering from Ativan have to dose 3-4 times a day and just take a portion of their daily dose from one of those times a day.  I don't see how this is going to work out at all.

[[aw...]]

Clawspeak:

I took Ativan 6 mg once a day for 9 years, and I was a real mess.  I used a gradual method to change from 1Xday dosing to 3Xday (every 8 hours) and as my doses got closer together I could watch my symptoms improve--it was rather dramatic, and everyone who knows me remarked on the change. If I need to, I'll go to 4Xday w/o hesitation.

 

Increasing your dosing interval = increasing your symptoms. No way!

 

Aweigh

[[cl...]]

aweigh,

 

Thanks for your input. My wife started at 2 1mg per day, followed by 3 1mg then four.

 

6mg is a very high does. Would like to get my wife down to 3 1mg per day as she was doing much better at that level.

 

Hoping at smaller doses that the spread of doses will help. I am a little worried about cutting as it appears to leave lots of room for error.

 

Will share with everyone what we learn.

[[aw...]]

clawspeak:

You're welcome. Yes, I also think your wife would be much better at 1 mg every 8 hours. $50 will get you a Gemini jeweler's scale from Amazon, they weigh accurately down to about 0.04 mg. A 0.5 mg Ativan tab weighs about 45 mg, so you can measure 1/10 of a tablet accurately = 0.05 mg of Ativan. That's a lot better than you can get blind cutting.

 

aweigh

[[On...]]

hi again Aweigh,

 

I had a question about your titration method. Is it better for me to wait till I'm at a lower dose before I  titrate? I was worried about mixing even a little alcohol with lorazepam. Didn't you mention it was a end of taper solution?

[[aw...]]

Hi, One day:

In this method, the amount of alcohol ingested is not clinically significant, about 1-3 mL as pure ethanol. It depends on how dilute you want to make the solution and where you are in the taper. 2 mL of pure ethanol is 1/10 of a standard drink.

 

I think it has some special advantages for the end of the taper (I'm not there yet), but I didn't design it for that purpose. I designed it so I could measure small doses accurately for tiny cuts. It may make end of taper dosing more accurate, but that's no reason not to start it at any point. Nobody wants to change over to a new method, but I'd say if you think you're going to be using it, change over when it's convenient, i.e. a low stress period. Sooner may be easier, I don't know.

 

Aweigh

[[cl...]]

Question : My wife did 3-1mg Ativan for 2 years and was stable. Earlier this year she went to 3.5mg Ativan a day then 4mg Ativan each day. Shortly after increasing here dose is when she begin to feel badly and begin having paradoxical effects (panic attacks, high anxiety etc.).

 

Our goal is to get back to 3-1mg (3 mg daily) with the hope she will once again stabilize. Currently we are at 1mg every 6.5 hours. The next step is 1 mg every 7 hours, then 1 mg every 7.5mg and finally 1m every 8 hours.

 

We were planning at staying at each taper for 2 weeks. The issue is, my wife feels her worst after taking her dose. Her hands sweat, her heart races and she sometimes shakes. Instead of wanting the clock to speed up so she can take her next dose, she wants time to slow down so she doesn't have to take her next dose.

 

Question is, should we drop down to the next level (1mg every 7 hours). We have been at 1mg every 6.5 hours for 5 days but given her symptoms was wondering if we should drop sooner (1 mg every 7 hours) than two weeks.

 

Thoughts anyone?

[[On...]]

hi clawspeak,

 

What prompted her to increase her dose? Was it not having the same effect?

 

I'm not the most educated one here but her reactions sound like she may have reached tolerance and is experiencing tolerance w/d. Or maybe 4mg is too much for her and is now having 'paradoxical' effect like you mentioned. You say she reacts this way to the Ativan now which sounds more like a paradoxical effect to me.

 

I don't really understand your taper method. You are trying to get back down to 3mg right? That would require reductions in the amount she is taking over a period of time to get to 3mg. Someone on this board can devise you a taper plan if you ask around. Check out the taper boards. You can get more information from there.

 

Typically, one would reduce between 5-10% of the dose every 2 weeks. Some people need to go even slower and cut less than that.

 

 

If she really is in tolerance w/d or the Ativan is no longer working for her, she may have to taper from the Ativan entirely. There are so many smart and helpful people on this site, just ask around for the information on how to plan a safe taper and someone will help. But be sure to listen.

 

Good luck to you and your wife, I hope everything works out alright

 

Oneday

 

 

 

Update: Whoops, I just saw your comment. Never heard of a time taper and reduction but interesting. But if she's in tolerance w/d you might need to dose 4x daily eventually as she gets lower, dosing every 6 hours to avoid interdose withdrawal if they become applicable to her.

[[Ma...]]

Claw,

 

This case is very hard for me to understand.  I do understand paradoxical.  Going on a high dose of klonopin caused paradoxical reactions for me too.  Not sure why that happens, but it does.  Instead of sleeping I was up all night.  Never had that problem with ativan.

 

That's why its called paradoxical I guess.  It creates the opposite of what it is supposed to, and makes no sense.

 

This sounds complicated, because, why did she raise her dose?  Was the ativan not working at the previous level?

 

Still, this method does not make sense to me, because you are not taking into account the duration of action of ativan.

 

Just sounds very complicated, perhaps she is in tolerance and neither going up or down is really going to provide relief.  But spacing it out further and further, just does not sound like it is going to work.  Cutting is really the only way to eliminate the drug.

 

Or perhaps in this case, switching to another drug like valium.  I almost never recommend doing that, but it sounds like ativan is very problematic for her.  Switching from klonopin back to ativan, while it wsa very difficult, was better for me in the long run.

[[mo...]]

Mairin , I was just wondering how are you doing on your current dose of .75 ? I'm riding out these waves that come and go. Kinda felt anxious and detached yesterday. That was day 4 on a cut.  Trying to get some things done when I get some windows . Gets kinda unnerving at times .  Today is a good day . Weather is turning into fall now . Hiking is really nice in the mountains . Helps put things in perspective .

[[Ma...]]

Hi MM

 

I am doing really well on this cut.   Anxiety is not a problem for me anymore.  My gaba system seems to be back online, compared to when I first started this.

 

I think I just get normal anxiety.  It is very hot where I live and that makes me anxious, but not the chemically induced kind of anxious that I used to get in acute withdrawal.

 

I did notice I got 'spacy" the last few days, that detached feeling.  It was also days 1-4 after the cut, but not real bad.  I am feeling a lot better recently, and I think it is because it is cooling off a bit here.

 

I envy you, the nice crisp mountain air   Really, that should help you very much, just keep doing that, it is very good for you.

 

Hugs

 

[[ce...]]

Question : My wife did 3-1mg Ativan for 2 years and was stable. Earlier this year she went to 3.5mg Ativan a day then 4mg Ativan each day. Shortly after increasing here dose is when she begin to feel badly and begin having paradoxical effects (panic attacks, high anxiety etc.).

 

Our goal is to get back to 3-1mg (3 mg daily) with the hope she will once again stabilize. Currently we are at 1mg every 6.5 hours. The next step is 1 mg every 7 hours, then 1 mg every 7.5mg and finally 1m every 8 hours.

 

We were planning at staying at each taper for 2 weeks. The issue is, my wife feels her worst after taking her dose. Her hands sweat, her heart races and she sometimes shakes. Instead of wanting the clock to speed up so she can take her next dose, she wants time to slow down so she doesn't have to take her next dose.

 

Question is, should we drop down to the next level (1mg every 7 hours). We have been at 1mg every 6.5 hours for 5 days but given her symptoms was wondering if we should drop sooner (1 mg every 7 hours) than two weeks.

 

Thoughts anyone?

I get this particular statement.  But I can tell you from living through this myself that going without a dose is worse.  Its a double edged sword there's no doubt about it. 

 

I think this taper plan of making the times between doses longer and longer is a dangerous one (because wd sets in when the drug wears off which can actually cause worse symptoms).  Obviously you both are going to do what you think is the best course of action, but I personally disagree with this idea and really hope she's going to be okay.  Tapering faster than two weeks is also really rough.  If you decide to do this be very careful. Acute wd symptoms can occur 3-5 days after you do a major change (tapering too fast or doing a cold turkey). I did this myself and I've seen others cold turkey or rush it and say claim that they are doing so well and think they're home free, then BAM!  the real wd begins.  Its a hard lesson of trial and error.

 

Wishing you and your wife well.  Its so good of you to help her like this.  My husband helped me come up with my taper plan, and without that I would not be where I am today.

 

[[cl...]]

Thx to both of your responses. Here is some additional detail.

 

My wife lived fully functional on 3-1mg doses daily for a couple of years. She hit a crisis with an issue with our daughter and thus asked the doctor is she could go to 4 doses. She said she wasn't craving any more but was distraught.

 

Early this year she went to 3.5mg per day then 4 mg per day. Once she increased she begin to feel worse. Within a short time she was not able to sleep at started having anxiety attacks and finally was in ER with panic attacks.

 

She reports feeling worse in the few hours after taking her dose and feeling better before her next dose. We dropped to 7 hours today and she stopped shaking and her hands stopped sweating and her heart no longer races. We will see if she sleeps any better this evening.

 

I am thinking that her body was unable to handle the 4mg and she ended up with the paradoxical symptoms. Is it unreasonable to think she will stabilize once she is back to 3 mg daily?

 

I have heard enough for each of you that I won't go beyond 8 hours between doses. From here we will cut doses and remain at 8 hour intervals.

[[cl...]]

Reviewed the Ashton Manual for Ativan half life. It is 10 to 20 hours. Since my wife is nearly 60 I suspect Ativan is closer to 20 hours and not 10 for her metabolism. This should make 8 hour doses very possible. Thoughts?

[[ce...]]

Reviewed the Ashton Manual for Ativan half life. It is 10 to 20 hours. Since my wife is nearly 60 I suspect Ativan is closer to 20 hours and not 10 for her metabolism. This should make 8 hour doses very possible. Thoughts?

My doctor himself has been prescribing for over 30 years and knows that Ativan's half life is 5-6 hours.  10-20 hours is a joke. The effectiveness wore off for me after this time.  7 hours was even a stretch.  All I can tell you is that she can certainly try going that long without a dose, but it may or may not work out for her. 

I personally do not believe that age and metabolism have anything to do with it, but that's just my opinion.  I've seen anyone from teens to their 80's be brought to their knees by this drugs, so its not descriminating.

 

All you can do is try it and see how it goes, but I do not agree that Ativan's half life is 10-20 hours.  I don't care what ashton says.  I know from experience this is balony.

[[cl...]]

Cedartree, we will let you know how it goes. Going slowly. From what I have read the biggest mistake made is going to fast.

[[cl...]]

What size doses can one purchase for Ativan. My wife is using 1mg. Can you purchase .5mg and .25mg tables? Are there other sizes? Using smaller doses certainly would help when cutting doses.

[Guest [no...]]

Hi,

I was on Ativan before klonopin many years ago.  I had tapered from 4mg. to 1/2 mg. on my own and was having no problems.  Then I found out I was pregnant and stopped the ativan immediately.  I went into a bad withdrawal which lasted about 6 months.  After that I felt fairly normal except for anxiety over the pregnancy.  Unfortunately after my son was born I went back on benzos because I was very stressed out.  I have to say that the ativan withdrawal was not nearly as bad as the klonopin. It was more mental than physical as I remember.  That may be because I had tapered, and with the klonopin it was cold turkey.  I wish I had stayed off of it and I wouldn't be going through this hell now.  Good luck to you!