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How should I taper off 2mg of Ativan?
  1. #1
    crescentelite is offline New Member
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    Post How should I taper off 2mg of Ativan?

    Hello everyone. I've been taking lorazepam for almost 5 months now for panic disorder. My dose during that time has varied from 3mg a day in the beginning, to now 1.75mg a day. I was prescribed these after a one year binge of vodka landed me in the ER. So I was already messing with my GABA receptors long before my first panic attack. I quit alcohol cold turkey, but unfortunately can't do the same with lorazepam.

    Originally, lorazepam worked wonders for me, but now I want off due to the ever increasing cognitive impairment I'm experiencing. What should my taper look like and how long can I expect to experience withdrawal effects?

    Switching to Valium is unfortunately out of the question because I have a paradoxical reaction to it. I also can't handle SSRI's so that's not an option either. I believe the best method here is just slowly and directly tapering off of Ativan.

    Is tapering .25mg every week too fast? Also how should I handle the interdose withdrawal? I've been experiencing severe brain fog and spaciness. I've felt really out of it ever since I cut below 2mg a day. Also, should I expect a large increase in panic attacks? I know how to handle these if they happen (thanks to CBT), but I'm really not looking forward to it.

  2. #2
    Ricky71 is offline Advanced Member
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    Quote Originally Posted by crescentelite View Post
    Hello everyone. I've been taking lorazepam for almost 5 months now for panic disorder. My dose during that time has varied from 3mg a day in the beginning, to now 1.75mg a day. I was prescribed these after a one year binge of vodka landed me in the ER. So I was already messing with my GABA receptors long before my first panic attack. I quit alcohol cold turkey, but unfortunately can't do the same with lorazepam.

    Originally, lorazepam worked wonders for me, but now I want off due to the ever increasing cognitive impairment I'm experiencing. What should my taper look like and how long can I expect to experience withdrawal effects?

    Switching to Valium is unfortunately out of the question because I have a paradoxical reaction to it. I also can't handle SSRI's so that's not an option either. I believe the best method here is just slowly and directly tapering off of Ativan.

    Is tapering .25mg every week too fast? Also how should I handle the interdose withdrawal? I've been experiencing severe brain fog and spaciness. I've felt really out of it ever since I cut below 2mg a day. Also, should I expect a large increase in panic attacks? I know how to handle these if they happen (thanks to CBT), but I'm really not looking forward to it.
    Hello and welcome to the forum. You are right, quitting benzos cold turkey is not the way, it is dangerous and complete misery! The slower the taper the better, especially with benzos. Slow and steady wins the race, the point is to have very little to no withdrawal getting off the Ativan! A taper of 5-10% taper every 5-7 days is ideal and should work well for you, you can adjust the dosage and frequency up or down depending how you feel? Keep us updated? You'll be fine just take it slow! Good luck... God bless us all!

    PS
    What is your exact dosing schedule now?

  3. #3
    crescentelite is offline New Member
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    Right now I dose .5mg when I wake up at about 11am. .5mg at 6pm. And .5mg around midnight. I throw the extra .25mg in if I wake up at like 6am or something

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by crescentelite View Post
    Right now I dose .5mg when I wake up at about 11am. .5mg at 6pm. And .5mg around midnight. I throw the extra .25mg in if I wake up at like 6am or something
    Well, you have to keep the same dosing schedule first and foremost! Take your benzo at the same times everyday to keep a level amount as possible in your system! So for example if you dose .25mg 4x/day = 1mg/day. 5-10% reduction would be .23mg 4x/day = .91mg/day... You want to have equal doses, you can do the math for your current dose?

    This involves shaving the pills, do a goggle search for 'The easiest way to taper Xanax, or any other benzo" This site does not allow us to put up links that lead to outside sites so you have to search in google, use the exact search phrase I gave you and it should come right up? I hope this helps? I'll be out for a few hours but I'll check in on you later this evening? Hopefully some others will chime in also with their thoughts and suggestions?
    Last edited by Anonymous; 07-27-2016 at 07:30 PM.

  5. #5
    crescentelite is offline New Member
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    "People who don't have generic but severe anxiety, etc. during the taper are usually still ill. It's sort of like stopping taking an antibiotic while you're still suffering from a bacterial infection and wondering why you are getting sick again. Don't do that."

    So I still have panic disorder. Is it just a bad idea to even quit? I mean I'm pretty certain the only reason I'm still having anxiety is due to interdose withdrawal. If I let my addiction take over I'd start dosing back at 3mg a day. It's probably better to be off this entirely and let my body stabilize eventually.

    Also, these pills are beyond crumbly. How can I cut them that accurately? Or measure them properly? It's a round .5mg pill.

  6. #6
    Ricky71 is offline Advanced Member
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    Quote Originally Posted by crescentelite View Post
    "People who don't have generic but severe anxiety, etc. during the taper are usually still ill. It's sort of like stopping taking an antibiotic while you're still suffering from a bacterial infection and wondering why you are getting sick again. Don't do that."

    So I still have panic disorder. Is it just a bad idea to even quit? I mean I'm pretty certain the only reason I'm still having anxiety is due to interdose withdrawal. If I let my addiction take over I'd start dosing back at 3mg a day. It's probably better to be off this entirely and let my body stabilize eventually.

    Also, these pills are beyond crumbly. How can I cut them that accurately? Or measure them properly? It's a round .5mg pill.
    In that case there is another method to accurately (actually more accurate) than cutting or shaving down the pills, Water Titration!

    What is Titration?

    Titration is merely mixing your pill with water to allow you to precisely measure your dose. Then you slowly reduce your dose every day, instead of cutting pills every two weeks. This method allows your body to adjust to the reductions in a very subtle and gentle way and allows you to have greater control over the rate of your taper.

    Why use the Water Titration Method?

    Taper rates are dictated by the brain’s ability to adjust to the absence of the drug. This rate varies from individual to individual depending on their health, dosage, duration they have been on benzodiazepines, and other factors. Tapering in as small an increment as possible is the safest method, and titration provides the ability to control the taper by minute amounts. Benzos are powerful drugs. A controlled titration minimizes withdrawal symptoms.

    Using the water titration method you can… obtain smaller daily cuts, taper from any benzodiazepine, and adjust your taper rate to suit your individual tolerance.

    Google search "Water Titration - Benzodiazepine Withdrawal Support". There is a lot of information on it as well as videos, check it out? I've recommended a book to quite a few people here in the forums that have depression and/or anxiety. I suggest that you get a copy, it may help you? You can read the reviews on Amazon, the book is called - Nutrient Power: Heal Your Biochemistry and Heal Your Brain by William J. Walsh

    Also look up Rebound anxiety?

    "Rebound symptoms are common during withdrawal from Ativan. Rebound symptoms are the temporary, enhanced return of the symptoms, like anxiety or insomnia, that led the person to take Ativan in the first place.
    Rebound anxiety and/or rebound insomnia usually occur one to four days after the last dose is taken. Rebound symptoms are often the result of abruptly quitting the drug or reducing the dosage too quickly. Tapering off of Ativan can help manage rebound symptoms until an alternative treatment is determined."

    Keep us updated? Take care... God bless us all!

  7. #7
    Thisweekforsure is offline Advanced Member
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    Quote Originally Posted by crescentelite View Post

    I mean I'm pretty certain the only reason I'm still having anxiety is due to interdose withdrawal. If I let my addiction take over I'd start dosing back at 3mg a day. It's probably better to be off this entirely and let my body stabilize eventually.

    Yes, yes, yes! Interdose withdrawal or simply becoming tolerant to a benzo will make anxiety disorders worse in the long run.

    If you are feeling very badly and desperate right now, the rule is to go back up to the last dose at which you were stable. Remain there until you get stable again, and stay there for 3-4 days. Then make a cut no more than 5-10% as Ricky says, and wait as long as it takes to restabilize. Usually 4-7 days will do it. ( If you were on 2 mg and cutting .25 is giving you severe symptoms then you may need to cut by only .1 mg or 5%.) The goal is to NEVER feel severe withdrawal symptoms, but you WILL feel mild to moderate symptoms. That is okay, as long as they are tolerable. It's your brain readjusting and they will improve in a few days. Once you feel stable for a few days then make the next cut. Rinse, repeat.

    Yes you will need to work out how to get the pill into the tiny amounts. Grind into a powder and separate into piles, or go to liquid titration. I used water titration once I got down to small doses and it worked great. I ground it into a fine powder and mixed with a measured amount of water, then kept in a capped bottle in the refrigerator. You must shake it up before you draw a dose because it doesn't really dissolve in water, it remains suspended and can precipitate out. You need to do the math carefully and have a syringe that will measure milliliters. Calculate how many milligrams of drug you mix with whatever amount of water and figure how many milligrams per milliliter is your mix, then you can draw the dose with the syringe and just dose yourself like you would a dog or a baby.

    One really great thing about liquid titration: You are sensitive to interdose withdrawals. With the liquid method you can divide doses into many more small ones throughout the day and achieve smoother blood levels. With lorazepam you really should only need to dose twice per day but individuals vary and you may be someone who needs to dose more often.

    Best of luck, you can do this. But be patient, don't be afraid to take your time, it can take several months to get off a dose of Ativan at your level. 2 mg does not sound like a lot but for that particular drug, that's a pretty good sized dose.

  8. #8
    crescentelite is offline New Member
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    Yep, I'm actually stable at 1.75mg. I had a full blown panic attack yesterday so that was a fun 4 hours of my life XD. Anyway I've been on this dose for a week or so now. I might stay here for a few more days and try 1.5mg. If I get down to that successfully, I'll feel somewhat accomplished. I go back to college this semester though, so hopefully that doesn't mess with my taper. College is stressful enough without mind altering drug addictions haha. Oh and by some miracle I fixed the brain fog and spaciness by taking a vitamin b6 supplement. I still feel a little off, but this is way more manageable.
    Last edited by Anonymous; 08-01-2016 at 11:29 PM.
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  9. #9
    Thisweekforsure is offline Advanced Member
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    I'm going to try your B6 trick.

  10. #10
    crescentelite is offline New Member
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    Hopefully that works for you haha.

  11. #11
    RE Express is offline New Member
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    Hi,
    I know the dilemma that you described very well after having been mis-diagnosed with a panic attack because my leg was shivering! None of the doctors or phychiatrist knew anything about tapers, dosing, time periods between cutting down, etc. I finally found a medical group that had an addictive drug program which included Benzodiazapines like Lorazapam that I was taking. Here is the program that I used: I was taking the 0.5mg Lorazapam tabs & cutting them in half. I took 1/2 tab (4) times per day each six hours. For each taper period of a minimum of 14 days, I used a half of a 100mg. cap of Gabapentin, which is 50mg., to replace each of the four Lorazapam tabs. When I had replaced all four doses of the Lorazapam, I started to taper off of the Gabapentin taking 14 days between eliminating another dose. This taper program was quite effective and I did not experience any harsh withdrawal symptoms like I did by trying to taper off of Lorazapam without any replacements. It took me 4 months and I was successful in getting the monkey off of my back. When you are finally off of the Lorazapam, you must stay as stress free as possible by staying away from people or situations that cause stress - if at all possible. Eat well. Try to knock out your meat consumption - I did and just eat broiled fish, chicken, steamed vegetables with some kind of a starch. Exercise on a regular basis and stay occupied with whatever you like to do. If you take any kind of blood pressure meds and you have a spike in blood pressure, try hydroclorithiasad for a short period until the BP gets back to normal. Do not use Clonidine, which is used for BP and is VERY ADDICTIVE and is more difficult for some to get off of than Lorazapam! I wish you good luck in your efforts. I hope this 1st hand report will be of help to you in eliminating Lorazapam from your life - forever!!!!!!! Cheers, Peter

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