Ativan Water Titration

[[Bi...]]

Hello everyone. I titrated todays dose of my .375mg Ativan (1.25mg every 8 hours) for the first time.  I had held at .375mg 8 days prior to today.  I think my daily after-work wave was stronger than it has been, today- and must represent a more even dosing and maybe a real cut of sorts, because I'm pretty sure when dry cutting fourths of a .5 mg pill, I always chose the largest fourths. So I think hold here a little longer.

 

I asked for and will pick up an additional 60 .5mg tabs (I hope, that is the # I was getting prior) tomorrow; that will give me 100 tabs to taper with.  That helps with a little of my anxiety, as I dont think the 40 tabs I had was enough to taper with the sx at a reduced roar.

 

Q:  Has anyone had a compounding pharmacy take and dilute the pills somehow rather than using the liguid preparation and then diluting that?  I could not convince the Dr. to give me the liquid.  Of course, he was suggesting a two-week taper.

 

I would prefer to go the compounding pharm. route if I can get a consistent strength preparation, and just not mess with the titration.

 

Q:  Does anyone with experience with Ativan know at what total daily dose it becomes impractical to do multiple dosings/day?  I don't feel I'm there yet but want to be aware if there is a threshold.

 

Thanks very much in advance for any input.

 

Bilbo

 

 

 

[[Be...]]

Hi again, Bilbo.

 

I just have a couple of comments.  One is I want to make clear where the decimal point goes in your doses.  You wrote that your total dose was .375mg/day but were taking 1.25mg every 8 hours.  I'm pretty sure you meant .125mg 3x/day but just want to make sure.

 

You said that you titrated today but I'm not sure what that means.  Are you using a set amount of liquid and then removing a set amount from it before dividing into 3 doses?  How much are you removing and do you have a plan for how often you will reduce?  I noticed you mention you would be holding for a while which is probably a good idea given you just changed from cutting up your pills to titrating the whole .5mg tablet (I assume).

 

I didn't use a compounding pharmacy but I think that's something a doctor has to order.  You could always check with your pharmacist to see if that's possible and what it would entail.

 

I don't think there's a particular point when it's impractical to do multiple doses.  Because I was dry cutting and didn't want to try cutting my pills into 1/8s, I decide to make the cutoff at .125mg 5x/ady.  In other words, my next cut was to drop one of those 5 doses.  I'm sure if I had been titrating, I would have gone lower before dropping a dose but I can't tell you how low.  Kind of a judgment call that partially depends on the "hassle factor" of dividing that titrated dose up 3x/day I guess.

 

Hope this method works well for you.  From all I've read, it's probably the best way to get off a short acting benzo lilke Ativan. 

 

 

[[Bi...]]

Thanks, Beeper.

 

Yes, you're right, my decimal point was misplaced!  And you're also correct that I used the term titrate incorrectly, as I have not used this process to reduce the total daily dose, yet.  I just tried the process of dissolving the pill into water and withdrawing doses.  I understand that the way to reduce is to withdraw and discard the amount to be reduced, replacing it an equal amount of drug-free water, then dividing into equal doses, always keeping the total volume the same.

 

I have not yet purchased a graduated cylinder, so am using a 20 ml syringe to fill a glass food measuring cup that has a 100 ml marking.  I know there is a chance for cumulative error in doing so, but I'm watching for bubbles and measuring carefully, and don't think its so far off.  The measuring cup also will make it apparent if I lose count of syringe draws.

 

Thanks for your endorsement of this method.  Frankly, I was afraid of the next quarter-pill cut, as that would represent proportionally more of my total daily intake than was my first quarter-pill cut, which  equalled 25%, and was very hard.

 

I like the idea of trying the recommended 10% cut very much more.

 

Thanks again, Bilbo

[[Be...]]

I know you are supposed to start out with the same total liquid every before you do the withdrawing. but hadn't heard about adding back liquid to keep the total volume the same after you made the withdrawal.  I don't think it makes any difference to your benzo intake but probably would be helpful when you get down to the last few milliliters.

 

Mostly because the math is easier, I like the idea of starting with a 1% every day.  It's easy to keep track of removing 1 ml on day 1, 2ml on day 2, etc.  And no matter what very small variations there may be from day to day using the measuring cup, it's still got to be about 1000% more accurate than dry cutting.  And, if you do that, you know you will probably be done with your taper in 100 days.  Of course, as with any method, you can hold where you are when you feel the need.

[[Bi...]]

Makes sense to me Beeper.  I have a very primitive brain, even before this happened.

 

Right now, rather than cut the pill and dissolve my daily dose (.375mg), I am dissolving the whole .5mg pill in 100 ml water and calling that four doses, so the 100 ml lasts 1-1/3 days.  I have a little bottle that holds 100 ml very closely, which I think is important, to not have a bunch of surface area in the jar not in contact with the water.  So if I reduce by 1 ml/per each bottle prepared, that will be somewhat less than 1%. 

 

I'm thinking the thing to do is when my daily dose reaches .25mg, start using 1/2 pill (I can cut a pretty decent 1/2 with a pill cutter, just not quarters), and recalibrate using a smaller amount of water, bringing the cut back to the desired 1%/day.

 

See how I can complicate things?  But waste pains me, even with this foul drug!

 

Bilbo

[[Bi...]]

So if I reduce by 1 ml/per each bottle prepared, that will be somewhat less than 1% PER DAY. 

 

Bilbo