Tapering off Ativan Support Thread

[[La...]]

I have been following cedartree's taper to a T so far . It seems that the lower I get the better I feel, knock on wood . So far at the lower doses my wd sx are fairly mild .

 

For me as well, the lower I go the better I am feeling (with the exception of a single 0.1mg drop midway into my taper). wd sxs are much milder and it really feels like this poison is loosening its grip on me. But this may have more to do with the fact that my taper rate is slower at these lower doses (doing 0.05mg drops per week) as opposed to earlier in my taper where I was doing 0.25mg drop at the beginning then 0.1 mg drops midway into the taper.

 

I keep waiting for the other shoe to drop but in the past 2 weeks it fortunately hasn't, though to be fair, I have had two days total where wd symptoms were moderate (though manageable). The remaining time in these last 2 weeks wd sxs have been minor and my sleep is incrementally improving! Time spent in REM and dreaming is increasing as is the total length of sleep and sleep onset latency is gradually decreasing. I'd really like to believe this whole pattern will continue. I've examined cedartree's schedule and would like to follow it to a t but it is a bit more agressive than mine and am a bit scared that upping my taper rate to cedartrees will rock the boat that seems to be on course. If I continue 0.05mg weekly drops, that would equate to some pretty hefty cuts expressed as I % as I approach 0.1mg and beyond. Ski season is rapidly approaching and the last thing I want to do is jeapordize my planned first trip up in Dec. Thank you all for your support and comments.

[[ak...]]

I am down to .25mg in the am and..225 in the pm.  I can't figure out titration (or whatever it is called in liquid).  How far down do most people go before they completely quit?    And does anyone have easy liquid prep suggestions? I am NOT good at math and figuring out percentages.

Thanks in advance for ANY and ALL replies and suggestions

Emily

[[ak...]]

I am down to .25mg in the am and..225 in the pm.  I can't figure out titration (or whatever it is called in liquid).  How far down do most people go before they completely quit?    And does anyone have easy liquid prep suggestions? I am NOT good at math and figuring out percentages.

Thanks in advance for ANY and ALL replies and suggestions

Emily

 

Also, I found a post from Colin about titration support from Oct 2007. It states that you can give your dosage and someone will supply you with a table of liquid measurements to take. Anyone know if that help is still available now?

Thanks again!

[[Ma...]]

AKK,

 

Probably the best thing to do would be to get a liquid compound.  You would still have to learn to reduce by tiny amounts of the liquid and figure out how much the liquid has of the drug.  YOu can get that at the compounding pharmacy, if your doctor will agree.

 

You can also do this by making your own liquid titration in water.  There are lots of thread on how to do that.  Basically, you drop your pill in the water, dissolve it,  and remove a bit each time you cut.

 

I saw a video of a woman who just simply took a glass of water, dissolved her pill, and took out a teaspoon each week.  She wasn't worried about the math, but she had the concept down.  One week she took out 1 teaspoon, the next two teaspoons, etc. 

 

Simplicity is genius!

[[ak...]]

AKK,

 

Probably the best thing to do would be to get a liquid compound.  You would still have to learn to reduce by tiny amounts of the liquid and figure out how much the liquid has of the drug.  YOu can get that at the compounding pharmacy, if your doctor will agree.

 

You can also do this by making your own liquid titration in water.  There are lots of thread on how to do that.  Basically, you drop your pill in the water, dissolve it,  and remove a bit each time you cut.

 

I saw a video of a woman who just simply took a glass of water, dissolved her pill, and took out a teaspoon each week.  She wasn't worried about the math, but she had the concept down.  One week she took out 1 teaspoon, the next two teaspoons, etc.

 

Thanks Mairin! That video sounds awesome! I will try to search for some on youtube.  Do you know how far to go down...until you have no more teaspoons to remove?

[[El...]]

Hi Cedartree

Please tell me where on BB I can go to see your Ativan taper plan. Thank you.

Elizabeth1996

[[aw...]]

Howdy, folks:

 

I'm changing over from 3X/day Ativan dosing to 4X/day. The IW symptoms are getting a little too noticable and it seems like a fairly standard thing to do in the neverending quest to taper directly from A without going to V. The real motivator is that the docs who write my Rxx are very leery of Valium; they think Klonopin is the way to go for a changeover taper from Ativan  Lord help us all!

 

Anyway, I've posted the method I'm using to change over on my buddy blog, which is linked at the end of this post. Maybe someone can use it. Please let me know how it works for you if you try it.

 

Aweigh

[[ch...]]

Im feeling awful. I feel like I will have a seizure. my BP last night was so so low at 83/50 and I kept waking up feeling terrible.

 

Today bp is back to normal, unless I lie down, then it plummets again.

 

I feel like my head is numb. I have severe tightness in my throat and chest and like theres a lump In my throat. My eyes are blurry and my heart keeps speeding up, slowing down and am getting palps.

 

The pressure in my head is immense

 

Wil I have a seizure? Im liquid titrating from 0.75mgs and am at 0.69mgs at the mo I think. Ive done this over 10 days after going into tolerance I think.....

 

Am stuck and scared

 

Charlotte

[[An...]]

Oooh, I am so sorry Charlotte, that is just terrible ..

Why not try to hold for awhile ..Give tapering a rest so that your system can begin to calm and start to heal. You may find that you will start to feel a bit better.

Then when you stabilize, you can resume tapering in a slow manner.

Please consider holding.

Thinking of you, and sending you loving thoughts of well being.

Love, Anu

[[ce...]]

Hi Cedartree

Please tell me where on BB I can go to see your Ativan taper plan. Thank you.

Elizabeth1996

Hi Elizabeth.  This is for you. 

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 6 a.m.  12 p.m.  6 p.m. and 12 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!

 

[[ak...]]

Hi Cedartree

Please tell me where on BB I can go to see your Ativan taper plan. Thank you.

Elizabeth1996

Hi Elizabeth.  This is for you. 

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 6 a.m.  12 p.m.  6 p.m. and 12 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!

 

Cedartree,

I hope you don't mind I might be able to use this info for myself also. I am in the beginning two weeks of my taper and am considering titrating. Do you know how much of a reduction each step down is? I don't really know how to figure out the math. When you say go slower, does that mean stay on the amount for a while - or not reduce by as much of an amount? (does that question even make sense?)

Thanks for any other help you can offer.

Emily

[[La...]]

Aweigh:

 

I wanted to respond to a comment you made about spreading out doses with regard to IDW. I cant remember if you made that comment on this or another thread, but you stated that by limiting my dose to once nightly, I was setting myself up for failure.  I would like to lay out my rationale for this decision and I am also open to suggestion/specific comment. Can you please consider my thinking below and offer comment (or anyone else who so feels inclined)?

 

------------

I was first prescribed lorazepam for severe insomnia that went from acute to chronic. The insomnia was so severe it mentally and physically debilitated me to near complete loss of function (several days zero sleep). Accordingly the ER DR and my GP prescribed it once at night. Within 3 weeks the lorazepam lost its sedative effect, though I have been taking 50 mg trazodone at night and fortunately, the traz has not lost its moderate sedative properties. My sleep has been gradually and slowly improving with the limited and erratic confounding contribution of rebound insomnia from the lorazepam taper. So, the boat is slowly making it to shore, with a few big waves along the way, but i am just so hesitant to do ANYTHING that might derail my gradually improving nightly sleep.

 

Which gets me to the issue of spreading out my dose. Even though lorazepam does not induce sedation anymore, it still does have a calming effect and my CNS has been conditioned to receive its daily dose of this poison at 11pm. I fear that by spreading out my dose, I will be reducing my nightly dose which plays some unknown, but real role in facilitating sleep. Even if it doesn't facilitate sleep, I fear dropping the night dose could induce more rebound insomnia. since my sleep is gradually imporving, I have been pushing through the IDW which really isnt that bad and it doesn't seem to be getting worse. However, if I could reduce/eliminate IDW WITHOUT impacting my recovery from insomnia I would do it. I guess I could try it one or two nights to see what would happen, but since I have come such a long way in recovery from crippling insomnia, I am just so hesistant to rock the boat.  And my recovery seems so fragile, as if the slightest breeze could push me off course. The other, though minor, aspect of spreading out doses regards practicality, e.g. dosing during the work day. But since my IDW starts at ~5-6 pm, perhaps I could spread my dose out from a 100% at 11pm to 30% at 6 pm (when I get home) and 70% at 11pm. Maybe this would be a conservative step in the right direction to manage IDW?

 

I just dont want to do anything to move the slightest bit backwards in my healing from insomnia. Thanks for your help and insight.

[[Ma...]]

Laser,

 

Sure you could try your 70/30 plan.  It's hard for me to judge your situation because I am not sure how long you were on Ativan.  I don't think people should split the doses unless they have been on for a significant amount of time.  Not everyone gets severe interdose withdrawal.  I think I/D is more of a problem for people who have been on the drug for years and are physically dependent.

 

The longer you have been on, the more likely I/D w/d is apt to be a problem.  I really think it depends on how bad I/D withdrawal is for you.

 

I think if people are truly dependent and are going to be on a very long taper, like I was, 3 or 4 times a day will help in the long run.  But, really, it is not always necessary to do that.  You are getting through this and functioning, and it looks like you will be off very soon.  The 70/30 idea sounds like a good one.  But this will all be over for you in the next month or two, it seems.  You only started ativan in August?  Really I am surprised you had trouble getting off at all.

[[Ju...]]

Hi LaserJet --- Even though I tapered Xanax, which has a somewhat similar, though shorter half-life than Ativan, I continued dosing 1X per day during my entire taper off.  I was always advised to break up my dose by many of my buddies.  However, I had only dosed at night for 25-years and did not suffer from interdose withdrawal.  So even though the rationale to break up doses made sense to some, it didn't make any sense for me.  I went with my gut level feeling and continued my PM only dosing.  I'm very glad I continued my regular dosing schedule.  Crippling insomnia was why I took Xanax too.  When I jumped I was probably back to 80% of my old self and all I've done is continued to feel better and better.

 

If I had suffered from IDW I would have broken up my dose, no questions asked.  But I simply did not.

 

I slept well during my taper.  However, the night I jumped the insomnia returned.  I struggled with it 'on and off' for about 3 or 4 months post taper.  Then it suddenly resolved.  I sleep well most nights now.  There's hope for we insomniacs being able to sleep again being benzo free.   

[[An...]]

All of you above, are light, encouragement, and hope for me. Juliea, Mairin, Laser.

 

I hope to be able to swim the uncharted waters of psychiatric drug WD, as you have done .. It takes incredible courage to face the dragons of the deep.

 

I  switched to dosing 5 times a day,  even though there was no ID WD.

 

I think my problem may be TW, which has me grounded. I have great difficulty cutting. The last tiny cut of 0.625 mgs hit me like a train, and has me holding for over 6 weeks now, with many debilitating symptoms, that cycle in, cycle out. :'(

 

I feel hopeless, and do not know how to proceed from here ..taper a tiny bit, or hold longer.

Also, I fear that a CT at a Detox facility in January of this year, may be complicating matters further, even though I feel that it has dissipated to a large extend.

 

What to do? What to do? My BP has gotten unstable since this long hold, my breathing is labored. :'(

Any thoughts, I would be grateful for.

Thinking of you all, and holding you in my thoughts and prayers.

Love, Anu

[[La...]]

Thank you Mairin, Julea, and Anoushka for your words of encouragement. I was only on Ativan for five weeks before I began tapering. But by that time I developed a severe physical addiction as was evidenced when I either skipped a day or cut and held. This has been no walk in the park for me. It is the most difficult thing I have ever done and the suffering up until 2 weeks ago was severe. Now my wd sxs vary from minimal to moderate and a slow taper to 0.03mg will take me a minimum of 2 more months, notwithstanding any complications. I could not have gotten this far without BB. Thank you all!

[[El...]]

Dear Cedartree,

Thank you! Thank you for your lorazepam taper schedule. I am tapered to 1.5 mg, from 3.0 mg. I make my cuts every 2 weeks. Can a compounding pharmacy go all the way down to .0312 mg?  I found a compounding pharmacy about 50 miles from me. Did you have to get the tablets put into .125, . 0625, and .0312?  Or cut the .0312, and then use multiple tablet to reach correct dose?  The compounding pharmacy said I had to get a prescription from my dr, they couldn't just take my prescription and then compound it. That won't be a problem. Is this how you had had to do it with your compounding pharmacy.

 

You give me hope that I can get off Lorazepam. Thank you, Cedartree.

 

With gratitude,

Elizabeth1996

[[ce...]]

Hi Elizabeth.  Yes, you can get a script for any dose from your doctor and then take it to any compouding pharmacy to fill.  Its too bad you have to go 50 miles to get there though.  I found it was worth it to do it this way because I was just too sick to do all of the measuring and to figure out how to titrate.  If I had been well enough I would have liked to do the titration method which many people here talk about and have great success with.  But, this way worked for me.

 

You can cut the compounded doses if you want to, but its not as accurate because they make them into capsules, so you're left cutting the powder and trying to make it even.  I think its just as easy to get a script.  But, whatever works for you.

 

I really hope this helps you.  Well done getting down to 1.5 mgs from 3 mgs!  I know how hard this is.  Just know you're halfway there and you'll be free of this before you know it.

 

Much love,

Cedar 

[[je...]]

Just left the Dr. And she switched me from Ativan to Xanax. I currently take 1mg of Ativan in the morning and .50 in the afternoon and bedtime. So I will take .50 Xanax in the morning and then .25 later, sound about right? Anybody have experience with this crossover? Assuming it goes ok, how long do I wait to taper the Xanax? She didnt want to give me anything longer acting. So in theory, since my body isn't used to the Xanax yet it may be easier to wean.

[[aw...]]

Hi, JL:

Personally, I would not switch from Ativan to Xanax without a clear reason for doing so, and I can't imagine one at the moment. Why does she want to do this? I don't want to undermine a good relationship, if that is what you have with your Dr., but I've been reading this site for > a year and I don't remember anyone switching from A to X for a taper.

 

Aweigh

[[je...]]

I was on Xanax before and didnt have a problem stopping it, so in theory maybe it will be easier to wean.

[[aw...]]

Could you make a signature so I and others can see your drug history? There are links for this in the intorductory sections.

Are you having problems tapering directly from Ativan?

 

Aweigh

[[je...]]

Sure. Every time I try to reduce Ativan I turn into an emotional wreck! I cry and cry uncontrolably.

[[aw...]]

jennylynn: You know what? I'd bet money that I've cried a bathtub full of tears so far this year. I wonder if this is a "feature" of Ativan.

People most commonly do c/o to a longer acting (duration of action, not half life) benzo if they're going to switch drugs for the taper. It was mandatory in the early days of Dr. Ashton's work. Why does your doctor not want you on a long-acting benzo for the taper?

 

Aweigh

[[Ma...]]

Hi Jenny

 

I've never been on X, but I've heard it is a hard hitting drug, that is why it is used for panic attacks.  By hard hitting I mean it works fast and leaves fast, or so I've been told.

 

I haven't seen anyone split their dose up for Xanax.  I think it is very short acting, even shorter than Ativan.  But lots of people have tapered Xanax.  You might try the Xanax board.  I have noticed, it seems Xanax people have *what seems to me* an easier time getting off.  But, I am not sure about that.  It seems to me, Klonopin people have the worst time of it.

 

Interesting that you say ativan makes you cry.  When I was on a high dose I cried a lot.  But I didn't seem to have that problem until I got to a real high dose.