Tapering question.

[[Sh...]]

Hi and thanks for any advice you can give me.

 

About 8 years ago I started 2mg of ativan. 4 years ago I decide it was time to start tapering and in the last 4 years i went from 2mg to 0.8mg of ativan which was not easy but overall I could handle it....but at 0.8mg I couldn't cut anymore it was to hard. So  5 1/2 months ago I went to a sauna detox center and within 2 months got down to 0.3mg (0.1mg 3 times a day, the ativan is compounded). It was  rough but I had some really good weeks on the way down but once I got to 0.3mg it was not good and it has been brutal for the last 3 1/2 months. It used to be that I would have 2-4 good weeks and then maybe a really bad 5-7 days but now at 0.3mg it is the opposite, I mostly have really brutal days with a few window days here or there where I feel am somewhat better. It is very scary when you feel that you will never get better and every moment of the day is scary (accept at night it breaks a bit, though waking up is the worst by far).

 

I wonder what peoples thoughts are whether i should wait at the 0.3mg till I finally get some stability or should I keep tapering slowly regardless? Or go back up for awhile? I would love your general advice on that!!

 

Thank you so much for the help!!

 

Sean

 

 

[[Be...]]

Hi, Sean.

 

I'm sorry you are finding it so difficult to kick this last little bit of Ativan.  I know for me and many others, a lot of symptoms came back strong when we were really low in dose.  It hit me at .25mg lorazepam (Ativan).  Another possibility is that you have become tolerant and are experiencing tolerance withdrawal.  Here's a write up Colin did some time ago about tolerance so you can see if it might be what's going on:

 

"A Few Notes Concerning Tolerance

We regularly come across misinformation concerning tolerance. You should understand the following:

 

'Tolerance' occurs when your GABA (benzo) receptors have down-regulated in response to the regular use of benzodiazepines. Put simply, your benzos will no longer deliver the therapeutic effects they did before you become tolerant. Only by increasing your dose might the effects of tolerance be counteracted. However, you are highly likely to become tolerant of the new dose - so begins a vicious circle of escalating benzo use. Since this is completely counter to our stated mission, in our opinion, the only sensible solution is to taper off at a sensible rate, and allow enough time for your GABA system to recover and regulate itself properly.

 

The longer you take benzodiazepines, the greater the chance that you will develop tolerance. Most people develop tolerance, and it is a gradual process. For some, this may occur and develop very rapidly, within a few weeks of their first dose. It is probably easier and wiser to taper off benzos before developing tolerance, and particularly before developing 'Tolerance Withdrawal' symptoms - we prefer the term Relative Withdrawal.

 

Relative Withdrawal refers to withdrawal effects that some people experience once they have become tolerant to their benzodiazepines. Although they are not reducing their dose, they nevertheless experience withdrawal-type symptoms. As with 'tolerance', increasing their dose might alleviate the symptoms, but they are likely to again become tolerant of the increased dose. The only good solution is to taper off at a sensible rate and allow enough time for the GABA system to recover. We should point out that only a small number of people develop Relative Withdrawal symptoms."

 

Sometimes holding in the hopes of symptoms easing simply does not work and you have to press forward.  That's what I did the last month of my taper and believe I didn't really begin to heal until I was no longer putting that stuff in my body.  That may not be the best course for you to take but I wanted to share my experience in case it helps.

 

Good luck with the rest of your taper. 

 

 

[[...]]

One thought is to continue to slowly taper and soldier on. It really is hard to sort out because confused thinking is a w/d symptom and of course our human urges are to avoid discomfort. But possibly you will have less discomfort over the long haul by pushing on.

[[Sh...]]

Thanks both of you that is great advice!

Beeper, when you were at .25mg of ativan what speed did you taper and what amount each time? Also how did you spread it out throughout the day?

 

Thanks so much

[[Be...]]

I couldn't cut my tablets smaller than quarters with any accuracy so was taking .125mg 2x/day (12 hours apart).  I usually cut every 2 weeks but when so many symptoms came on strong at the end, I held an extra few days.  I don't remember exactly but it was less than an extra week.  When I didn't feel any better, I decided just to get it over with and dropped to .125mg.  Things were neither better nor worse after that so I think I made the right decision.  I did the same thing for that last cut and, again, I didn't feel any better holding so just decided to jump.  And, again, I felt no better - but o worse - after the jump.  It was never as bad as that last month from there on out.