Tapering off Ativan Support Thread

[[cl...]]

Has anyone heard of or tried[nobbc] http://www.pointofreturn.com/withdrawal_program.html[/nobbc]

 

 

 

 

Edit: deactivated commercial link

[[ce...]]

Has anyone heard of or tried[nobbc] http://www.pointofreturn.com/withdrawal_program.html[/nobbc]

I have heard of this.  Its a way to sell their supplements to sick desperate people.  I can tell you for free that all you need is a good and safe taper plan, a doctor who will prescribe you what you need to taper, healthy whole foods as often as you can, mild exercise stretching, etc. if able, a comfortable room to rest, things to distract you like movies and books, etc., a supportive husband helps more than anything  and a desire to be free of benzo's and get healthy.  You don't need supplements, expensive therapies, etc.  You need to follow a safe plan and stay safe and healthy while doing it.  Thats it.  Thats all.  Your home is going to be the most comfortable hospital there is.  Once she's off benzo's the real healing is going to take place.

 

 

 

 

Edit: deactivated commercial link in quote  

[[mr...]]

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.

You are absolutely right that the drug does not descriminate and the half life is far less.

When my mom reinstated at the hospital to lorazepam, she couldn't hold out for the next dose 4 hours after her dosing. Things were far better once she was on valium instead.

Also, her acute withdrawal from lorazepam last year lasted 3 months and her symptoms started improving dramatically, so metabolism doesn't seem to matter much according to age.

 

[[mo...]]

Question about half life . I dose at 7am 12 pm 5 pm and 10 pm . So between 10pm and 7am is 9 hours. I don't seem to have too much of a problem with inter-dose withdraw in the morning . I guess it could be because of very body's metabolism is different ? And or other medications that I take . I wondering about in particular about a delayed RX release  Protein Pump Inhibitor I take twice a day. It may slow the absorption rate of the Ativan . I know it blocks it if I take it at the same time because I have had WD SX . If it is works I'm not going to mess with anything thats for sure . But it would seem that I would have some inter-dose withdraw after 9 hours .

[[ce...]]

Mountainman, its cool that you can go 9 hours at night without it, not everyone can.  Mornings for me were hell on earth (worst part of the day) probably because it was the longest duration between doses.  I often went to bed around 11 p.m. and took my next dose at 5-6 a.m. which was 6-7 hours between doses and that was too long for me to go without it.  It was terrible because I was sick when I took it, but sicker when I didn't take it.  I could never make sense of it other than to say it was a double edged sword.  Damned if I did, damned if I didn't.  That's why I knew I simply had to keep tapering for safety, so as to allow my body to heal properly after I stopped taking it. In the end, it did work since I'm fully healed now.

 

Its all trial and error.  You can't just read one thing on the internet and call it gospel.  Your body will tell you pretty quickly if waiting 10-20 hours between doses of Ativan is going to work. My body began screaming at 6 hours that I needed another dose.

 

Just keep tapering and you'll all get there.  One day at a time. 

 

 

[[Ma...]]

 

 

Just to say, there is a difference between duration of action and half life.

 

Ativan's half life, is 10-20 hours yes.  But its duration of action is 6 hours.

 

The duration of action is the time in which the blood levels are high enough as to cause the effect that is wanted from the drug.  After this, blood levels drop so that the drug loses effectiveness.  But the drug is still in your body and will be eliminated at the half life rate.

 

Oddly, even though ativan has a very short half life comparitively, its duration of action is actually longer than diazepam.  Weird, I know.

 

MM, I also have more time between my night dose and morning dose.  This does seem to effect me as mornings are more difficult to me.  Not horrible, but I don't feel exactly good when I wake up.  It's livable though, and I don't set my alarm for 5 am.

 

 

[[Ma...]]

Claw,

 

I know you are trying your best to make sense of this, but there are factors involved here that you are not really aware of at this point.  Lots of people come on BB after having tapered in a way they were told by a doctor, or thought they could just cut out the pills fast.  Then, they learned.  But a lot of times people have to learn the hard way, which is unfortunate.

 

I think what may be happening, is that your wife is in tolerance.  She takes the pill, and gets shakey, and associates the shakiness with taking the pill.  But that may not be what is really happening.  What I think is happening, is that, she takes the pill, and then she goes  into interdose withdrawal.  Because, after you swallow the pill, it takes between an hour to two hours for the pill to take effect.  So, it may not be taking the pill that is causing it, it is the low blood levels of the drug that are causing that shakiness.  Then after an hour or two, when the drug levels rise to therapeutic levels, she feels better.  It may be the lack of the drug that is causing that feeling.

 

If she has tolerance and is metabolizing this drug faster than 6 hours, that could account for this.  So stretching out the time is going to worsen this.  It would seem to me the best course of action, would be to spread the dose out evenly 4 times a day, and gradually reduce it.  Otherwise, this is going to go on and on forever.  Once the drug stops working effectively, there is not a whole lot you can do about that.  You can't "fix" it and make it work again.  Getting off and letting the body heal is the only way to stop the problems.

[[cl...]]

Mairin33,

 

Thx for your input. She is at 1 mg every 7 hours. Today was a rough day. She seems to be resting easier this evening.

 

Her worst symptoms are psychological. She does have, off and on, sweaty hands, shakes, upset stomach, dizziness, an occasional zap. Her psychological symptoms are fear of dying, germ phobia, light agoraphobia, OCD regarding her physical symptoms.. She is convinced taking the pill is killing her.

 

After reading the postings regarding how to manage your symptoms I was able to help my wife. I assured here that we are going to do a slow tapper. That her symptoms are a sign of healing. That symptoms are uncomfortable but will eventually pass. Her body will heal given enough time.

 

It appears to help. However, she has not yet made the decision to manage her symptoms ... but I believe she is getting closer.

 

We will not go any longer than every 8 hours. If she can manage an 8 hour interval we will begin to cut her doses. If not, we will cut the dose and go 4 times per day.

 

Do anyone know if Ativan comes in .5mg  and .25mg pills?

[[ce...]]

Ativan does come in .5 mg pills, but not .25 mgs. That's why I suggest having your doctor prescribe the doses you need for the taper and then take the script to a Compounding Pharmacy where they can make up the doses you need.  Dry cutting is very tricky business. The pills are small and break apart into uneven peices.  So compounding or titrating using liquid is often a better solution for tapering Ativan. 

[[ce...]]

Just to say, there is a difference between duration of action and half life.

 

Ativan's half life, is 10-20 hours yes.  But its duration of action is 6 hours.

 

The duration of action is the time in which the blood levels are high enough as to cause the effect that is wanted from the drug.  After this, blood levels drop so that the drug loses effectiveness.  But the drug is still in your body and will be eliminated at the half life rate.

 

Oddly, even though ativan has a very short half life comparitively, its duration of action is actually longer than diazepam.  Weird, I know.

 

MM, I also have more time between my night dose and morning dose.  This does seem to effect me as mornings are more difficult to me.  Not horrible, but I don't feel exactly good when I wake up.  It's livable though, and I don't set my alarm for 5 am.

Thank you for this Mairin.  I think what I've been caling a half life is the "duration of action" as you have stated.  My husband and I were talking about this again today and he reminded me earlier of the difference. 

 

Mairin, I never had to set an alarm because I had extreme insomnia and wasn't sleeping anyway.  I was always looking at the clock for my next dose.  Man am I glad those days are over.  It was brutal.

[[Ma...]]

 

I know Cedar, it is brutal.  It is over for you.  I know the memory of it can still be painful.  I am sure this causes PTSD.  I am not in acute anymore, but the memory of it and how long it lasted is difficult sometimes to deal with.

 

I can understand why people leave BB.  However, I think there is something about revisiting the scene of the battle so to speak, that somehow helps you.  Maybe it helps you some to come here and help others.  Either way its a win/win thing

 

Hugs.

[[aw...]]

Mairin:

 

Your explanation of the mechanics of IW and the difference between T_1/2 and DoA to Clawspeak was as lucid and complete as could be wanted. I worked in a pharmacokinetics lab, which is all about studying the parameters you describe: T_1/2, DoA, V_d, transporter/enzyme interactions, dose-matrix effects, generic equivalency. Most of our $ came from NIH, only some from BigPharma. Whoopie!

 

Also, Ativan's T_1/2 is given as 3 different values [ranges, actualy] in the 3 reference books I have handy. Not hugely different, but different enough to make a difference, as it were. Our bodies are all different anyway.

 

Aweigh

[[cl...]]

cedartree, how does one find a compounding pharmacy? Cutting now will be manageable but I can see it being a problem at the lower doses.

 

[[cl...]]

Regarding number of doses of Ativan, I noticed a range of doses taken daily from 1 dose to 4 or 5 doses daily. It appears that the number of doses required depends on the person and his or her reaction to the taper.

 

I can see the benefit of more frequent doses if inter-dose withdrawal is to much to bear. Right now we won't be changing anything given she is at 1 mg every 7 hours until she stabilizes. She is uncomfortable but managing. She appears to be more stressed out about having to take her next dose instead of craving her next dose. Her psychological symptoms are causing her more distress then her physical symptoms.

 

One thing that I have learned here and from Ashton is the biggest mistake made by those that taper is to go to fast. Long slow tapers are the path to success.

 

I am watching and learning. This is all so new to us.

[[mo...]]

Thank you Mairin and Cedar , When I first started a little over a month ago I thought I was going to be admitted in a VA detox ward . I am doing so well now I actually have days where I am wd symptom free and it feels great . Your knowledge is invaluable and I hope you keep helping members . Go slow and come off low my motto .  Hugs MM   

[[ce...]]

cedartree, how does one find a compounding pharmacy? Cutting now will be manageable but I can see it being a problem at the lower doses.

You can google the name of your "city/state" and then "compounding pharmacy".  Or, you can ask your doctor where the nearst compounding pharmacy is and he can tell you.  Compouding pharmacies are very useful and do not cost more than buying pills that are already made at your local pharmacy.  Sometimes they are actually cheaper this way.

[[Ma...]]

Thanks Aweigh.  I have a BS in Science.  I had to take a gabillion classes in chemistry, physics and math, and I've spent 100's of hours in labs.  I guess that comes in handy sometimes  .  I'd rather be birding

[[cl...]]

Mairin33 you are doing so well on your taper. I quote your taper to my wife. She got as high as 4mg daily and is now at 3.4mg. She is fearful presently and believes her CNS is dying. She is always afraid of taking her next dose.

 

I assure her that her CNS is not shutting down and that her symptoms are a sign of healing.  She wants me to keep talking to her and it appears to help but she is feeling such despair and keeps saying she can't do this.

 

We take walks and car rides and I make her smoothies (soy milk, almonds, amla powder (Indian Gooseberries), a few broccoli spears, some spinach, 8 dates, and blueberries, raspberries, blackberries and flax seed). So far she has had 3 smoothies today (12 ounces each). So I know she is getting good nutrition and exercise. Trying to do all I can to distract her.

 

We set goals. Most days she can obtain them then some. Today not so much.

 

I know we have months and months ahead of us. Hoping she will stabilize soon. She was OK yesterday evening. Hoping her windows come more often and stay longer. Once she is stable we will go oh so slowly.

 

 

[[On...]]

Mairin33 you are doing so well on your taper. I quote your taper to my wife. She got as high as 4mg daily and is now at 3.4mg. She is fearful presently and believes her CNS is dying. She is always afraid of taking her next dose.

 

I assure her that her CNS is not shutting down and that her symptoms are a sign of healing.  She wants me to keep talking to her and it appears to help but she is feeling such despair and keeps saying she can't do this.

 

We take walks and car rides and I make her smoothies (soy milk, almonds, amla powder (Indian Gooseberries), a few broccoli spears, some spinach, 8 dates, and blueberries, raspberries, blackberries and flax seed). So far she has had 3 smoothies today (12 ounces each). So I know she is getting good nutrition and exercise. Trying to do all I can to distract her.

 

We set goals. Most days she can obtain them then some. Today not so much.

 

I know we have months and months ahead of us. Hoping she will stabilize soon. She was OK yesterday evening. Hoping her windows come more often and stay longer. Once she is stable we will go oh so slowly.

 

http://www.drgangemi.com/healthtopics/msg/

 

Hi Clawspeak. I feel pretty much like your wife. My CNS has certainly undergone changes. I'm pretty sensitive to medications of any kind, but I know so many people taking and withdrawing from benzos that are NOT having near the problems I am, so I've had to start doing a lot of research lately. And what I have learned has brought about changes in my diet and habits. And those changes are starting to help me. Basically, we now have impaired or deficient calming GABA receptors and a much higher ratio of excitatory glutamate neural receptors that are everywhere in the body. When withdrawing, the glutamate receptors get overwhelmed no matter what we eat. But when we load our bodies with high levels of extra glutamates, we get completely overwhelmed with glutamate storms. Much information and research in the medical field does say that TOO much glutamate neural toxicity does cause CNS disorders and diseases. It DOES damage the CNS. It be hooves us to do everything we can while withdrawing to avoid glutamate storms.

 

This is a very elementary article but a good beginning. Read all the way to the end where it mentions soy milk. If you want more in depth explanation after that, google and you will find much! I have more links to more articles that give other information besides the glutamate angle as far as soy milk is concerned too. Also, there are many  comprehensive lists available on line that show all the different names used these days to get msg into our food supply without calling it msg. Some of that is intential and some is not. Many foods convert the healthier glutamine to glutamates or glutamic acid when the are highly processed or heat treated. For instance, milk that is pasteurized but not ultra pasteurized maintains its healthy glutamine form. Ultra pastuerized and homogenized, by nature of f the super high-heat processing, is high in free form glutamates which contribute to the storms on our glutamate CNS receptors.

 

Give your wife my best, and I hope this in some way helps. Oh, and concentrated  whey protein is super high in glutamic acid. It's listed on the amino acid breakdown on the label; its by FAR the most predominate amino acid in whey. I used to do whey protein shakes like you're doing your soy shakes. I nearly died. Glad I got it figured out. But of course, the docs, nutritionists, and naturopaths were all telling me to drink up, drink up. They just don't know diddly squat about benzo biochemistry.

[[Ma...]]

Hello Clawspeak,

 

I can see you are very concerned for your wife and are doing what you think is best for her.

 

But the problem that I see with this is, that you are doing what you think is best for her.

 

What you think is best for her and what is best for her are two different things.

 

I can understand why you think these things you have come up with are good, but I think you are also not really listening to what is being said here.  I hesitate to comment anymore because I perceive a resistance to advice and an insistence on doing it your way.

 

I understand you are under very great stress and you are trying very hard of your own volition to think of what can help.  But I think it would help if you would listen a little harder to what is being said on these boards.

 

I do think taking your wife for walks and drives is very good.  But I personally don't think spreading her doses wider and wider is going to help, I think it is going to hurt.  Also, getting nutrition into her is good, but there is a lot of trouble with what you are giving her.  Please do read OneLove's link.  OneLove is right on the money with that.  It would be better to ply her with high protein foods and stay away from sugars.  Eggs, meat, stew.  Sugar and msg can be highly detrimental in this situation.

[[Ma...]]

OneLove,  I totally agree with your post.  So many foods are so damaging and unhealthy nowadays.  Soy milk is not milk in any sense of the word.  It is processed soy.  Apparently they can turn soy into absolutely anything, which is amazing.  And profitable.  Soy is just so bizarre.

 

Soy turkey for crying out loud. lol  Can't we just eat turkey?

 

And yes our CNS is impaired, but it can heal, thank God.  You are totally right about the glutamate.  That is the big problem in benzo withdrawal.

 

 

 

 

[[On...]]

Mairin, thanks. I'm guessing that you're being so aware of glutamates in foods and eating to avoid the neurotoxicity is a BIG part I'd why you have been able to taper so successfully. Maybe you should write a manual for others on this concept. So much of what I'm finding in the research on this is geared toward glutamate avoidance for autism, or Multiple Sclerosis, or Amylateral Sclerosis, etc. They all are specific about the glutamate/ GABA dynamic and it is the same thing with benzo wd only we KNOW for a certainty that we are pulling the GABA back by X amount every cut and leaving glutamate receptors in the majority. More info geared toward benzos so people would get "hits" when they google benzos and glutamates would be nice. It could be almost like a companion to the Ashton Manual.  . 

[[Ma...]]

 

 

Haha wow OneLove.  Write a manual?    Yeah, me and Ashton be hangin'   I need to invite her over for tea.  Actually I would love to meet her

 

Well, perhaps we could get some of the old timers to come up with some sort of helpful hints thread.  I have noticed people come on here and they miss information because it is kind of scattered around the site.  Then people move on and information gets buried.

 

But I agree, the whole glutamate/gaba thing is pretty essential information to this journey.  Avoiding msg is extremely helpful.  And boy it is mighty hard to do, it is in so much stuff.  I remember reading years ago that it is best to just stick to the perimeter of the grocery store, because that is where the fresh meat, dairy and vegetables are, so I have been doing that for a long time now.

 

Maybe a sticky called "Things That are Useful To Know about Benzo Withdrawal"?  Would have to run that by Colin and the moderators.  But thanks for the vote of confidence

[[mo...]]

I like the tip about sticking to the perimeter of the grocery store to shop . I have been trying to eat and shop more healthy since I started tapering . I'm a single guy and do not cook much . There should be a sticky or thread  for some of us guys on how to shop healthy . I have a fast metabolism and never gain weight plus I daily exercise .  The bad stuff that we do eat how fast is that processed from our system in regards to tapering ? Does daily exercise  and plenty of water speed up that process ?

[[cl...]]

Mairin,

 

You are right. I have come to understand, even though my wife fears taking her next dose that she is experiencing withdrawal. I am holding her dose now until she stabilizes. Then we will cut. I am also coaching her to understand what she is feeling are symptoms. At a slow taper the symptoms may make her feel beyond miserable, beyond hopeless and helpless (beyond words) but they are part of the healing process and will pass without permanent harm as stated by Heather Ashton. Her toughest symptoms are emotional and not physical. She has periods where she truly believes the next pill will kill her. I am seeing signs where that might be starting to pass.

 

She seems to do better in the evening than morning. She has times when she is able to function and is the least uncomfortable when you gets started on a task. She is able to complete what she starts. Her worst periods are when she is inactive and becomes OCD on her "dying body".

 

My nutrition information comes from Dr Michael Mcgregor at nutritionfacts.org. Her food is very high in antioxidants which help her body protect itself and heal at the same time. I have since added almonds because of the melatonin and high magnesium content (from what I learned here).

 

Dr Heather Ashton calls for more research on diet as not much is understood. Dr Michael Mcgregor reads all the prominent research annually in the field of nutrition and post it to his web site in videos he makes three time per week. I haven't seen any source better or that I trust more.

 

Sorry for being a slow learner. Appreciate your input. Please continue.