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Ativan and Ambien


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Moving my post from the Z group here and hoping for some help! Post script (or pre) I havent had Ativan in 24 hours and i feel such anxiety an fatigue but I am trying not to take it so i can just deal with the Ambien!! 

 

Hi,

 

I am hoping to get some help from this group. I am pretty lost right now. I have been taking about 40-50mg of Ambien (working my way up from 2mg at the beginning) for about 15 years. I clearly reached tolerance years ago and would wake up in the middle of the night sweating and thought it was perimenopause. I have taken other benzos along the way but nothing consistent. Valium here and there for anxiety and some of the others but very sporadically. I liked valium the most because i got NO side fx when it went out of my system. Last spring I switched from Celexa to Prozac as it had stopped working. Prozac worked but I didn't like how numb it made me feel. I was switched to Zoloft on Sept 14th and it gave me insane anxiety and nausea. After 2 weeks of it not getting better I was switched to 5mg of Lexapro. It was hellish too but is now better. My doc gave me .5 ativan to help with the SSRI induced anxiety and i realized after being on it for 3 weeks that my body has become addicted to it. In the last 3 nights i have tapered down on Ambien and as of last night i took 20mg of Ambien 1mg of Ativan and 5mg of Diazepam and did ok. I woke up with anxiety and help off til 10am til i took .5 of Ativan and have been fine all day except for the morning nausea and anxiety.

It is now evening and i am thinking of repeating the same tonight. What i would like to do is actually skip the Ativan and see if the 20mg of Ambien and 5mg of valium does the trick.

Sorry this is so long and all over the place, but i would love to just take ativan out of the equation since it hasn't been that long and just deal with the Ambien using Diazepam and switch over and eventually taper off Diazepam slowly. I know this may be me being naive and i am so mad that i added Ativan in a few weeks ago because I feel like it has changed the game. I would love any advice you have. A schedule for tapering, order of drug tapering, etc. Also i have heard so much conflicting info on if i even need to switch to Diazepam or if i should just try to cut down Ambien on it's own. Any help is so so appreciated.

 

Thank you!

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Hi Missfrida,

 

I see you've been getting some suggestions on the z-drug support group thread, would you still like input on your situation here?

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Hi,

 

I would be so grateful to get some help with a plan. This is long so hopefully you will read through it!

 

I have gone up from 2.5mg of Ambien a night to 30-40mg a night after 15 years of usage (i went up to this higher amount about 2 years ago). I didn't really have any day time problems from this (or not that i thought though when i look back now I can see that it caused anxiety and pain issues I didn't attribute to it). Overall I was functional, even though i was (am) absolutely addicted and was always in interdose withdrawal. I have used Diazepam sporadically over the last 5-6 years with NO withdrawals between doses. I've also very sporadically used other benzos over the years but never really felt any withdrawals. The only real withdrawals i had felt up until 2 weeks ago were interdose Ambien withdrawals, which led me to need to wake up in the middel of the night (now exactly 2 hours after going to sleep) and having to take more (totaling the 40mg).

 

A moth ago my SSRI was switched from Prozac to Zoloft, which gave me crazy anxiety and nausea. I stayed on it for 13 days before switching to a low dose of Lexapro. Same symptoms. About 4 weeks ago my Psychiatrist put me on Ativan as needed to deal with the SSRI transition. UGH. i took it for about 2.5 week (.50 2x a day) and didn't think much of it as it really helped...until i stopped taking it. I went into FULL WITHDRAWAL. At first i thought it was still side effects from the SSRI but it's not (although I'm sure that doesn't help). My blood sugar tanked, my POTS raged, shaking, vomiting and nausea and total inability to eat. I am sure the Ambien with the Ativan is what made this all so much worse. I was SO resistant to reinstate because i just wanted to deal with coming off the Ambien and now...this. My doc is currently reading the Ashton manual and is on board to help me but she doesn't really know what she's doing so I am looking here for help with a tapering plan. I have been trying to pretend the Ativan isn't an issue for the last week and just taking it once a day and taking less Ambien at night and diazepam before bed. This erratic approach has left me feeling horrible and dysfunctional. I know i need to go back to stabilizing at .5 Ativan 3x a day and 30 mg of Ambien at night to start and THEN go into a tapering plan so i can start out functional. I HAVE to work. If I can't work I cannot live and i have a high stress job (and a completely blown CNS system). How would you approach this taper? What would you taper first? I know i need to go from Ativan to Diazepam but right now Diazepam makes me so tired its hard to believe i will be able to function on it. When i used to take it as needed (about 2mg) it didn't effect me too badly and i could live with it easily. When i take it now it has a totally different effect. It's like it has intesified from all of this and exhausts me, now. That really scares me. Oh man I wish Ativan didn't get into this mix (it happened so quickly!!) but I can't turn back time. I want off of all of this but need to do it right (while being able to work). Any advice on how to approach this would be insanely appreciated. TY!!

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I believe you're right when you say you need to stabilize on the Ativan and Ambien, I'm not sure what that dose would be so unfortunately you'll need to experiment.  A cross to Valium would be the wise choice because you're on two short acting drugs but if you're already hesitant to go this route I'm not sure its the wise choice.  Crossing over is a huge commitment that as you know isn't without challenge so before we go down this path, I ask you to really look at this and make a decision.

 

If you choose the Valium, lets work on that, if you decide you want to taper the Ativan and Ambien, lets work on that.  :thumbsup:

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Hi Pamster,

 

I missed this reply. No, the help i was getting in the Z group wasn't helpful so I posted both here and in the tapering group (last night) in hopes of getting some more guidance. I wasn't sure where the poly group was and if I should post there.

 

Any advice would be much appreciated!

 

Best,

Sherri

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Thanks Pamster! You are the warmest!

 

I am trying to decide what to do about tapering both and if i should switch. Is it even possible to taper 2 short acting drugs? Feeling confused and defeated...

 

MF

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I've merged your two threads together so we can avoid confusion.

 

Its absolutely possible to taper two short acting drugs, if you decide this is the route you want to go then having confidence in your decision will go a long way to ensure your success.  When we doubt ourselves is when we get into trouble because we're constantly second guessing and that leads to increased symptoms. 

 

If you decide to go with tapering from your current medications, I would suggest ridding yourself of the Ambien first.  I used to think the Ambien could aid in the benzo withdrawal because it could help with sleep but I've since changed my thinking.  You're only getting a couple of hours out of it and I feel it's contributing to your overall misery.

 

Whatever you decide to do its important you get on a steady dose taken at the same times every day, first things first.

 

 

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Thanks.

 

I am working on steadying right now by taking .5 Ativan 3x a day. I wait to take the Ambien til bed and take 20mg when I go to sleep and then 10 in the middle of the night when I wake up. Hoping this will stabilize me. How do i define being stable? Is it no side effects?  I feel like my stomach is wrecked and my heart rate is out of control. I need to drink water with elecrtrolytes and salt all day or i will collapse. Been trying to eat but it is still so hard. Hoping those clear up as part of stabilization?

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We define stable as able to perform your daily tasks, or your symptoms have stopped changing drastically and have settled into a kind of expected routine, it doesn't mean we feel good. 

 

Your symptoms are common so try not to fear them because fear is a huge symptom which can cause the others to be more pronounced. 

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Ok thanks. If anyone has any advice on tapering plan for these or if you think i am better served going on Diazepam please chime in. I would SO appreciate the support!

 

 

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I'm really not good at these but I think if it were me  I would try to taper the Ambien first. I say this because we usually advise tapering the short acting drug first. Also, I have no idea how to do a crossover and substitute for two drug simultaneously. But maybe there are some other different options from others?
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Hi!

 

Just bumping this here. I am doing .5mg Ativan 3x a day (I need the first two doses, less so at night) and have cut Ambien down to 20mg. As long as i take these meds I appear to be stable now and am eating and functioning like a human. I am still tired from the meds but otherwise ok (for now). I would love help with a tapering plan for Ativan as i do think it should come before Ambien and i have only been on it for a month as opposed to 15 years for the Ambien.

I want to avoid going on Diazepam if possible. I am not great at cutting pills and would love anyones advice on a taper plan. I have a psychiatrist who will work with me and has read the Ashton Plan but she doesn't know much more about it than I do and will listen to me (and my body) when I tell her what I think we should do. Any help would be appreciated!

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I had missed your note, Pamster. I would love to try to taper directly off Ativan if possible since it's only been 4 weeks (having said that i can tell you that my body is fully dependant!) as opposed to going on Diazepam.

 

Thanks!

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I agree.  What are your current doses of Ativan and Ambien and how long have you been taking these doses, also what size are your pills of each?  Also, when was the last time you took Valium?
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Hi Pamster,

 

My current doses are .5 mg of Ativan 3x a day and 30mg of Ambien a night although last night I took 20mg and slept through the night. Usually i take 20mg and need another 10 in the middle of the night. I will try to keep it to 20 but that may fluctuate. The last time i had valium was 2 days ago and I'm not sure i feel any withdrawl from it. I never have before but who knows with this cocktail i am on!!

 

I have been on the Ativan on and off for the last month (though now i am consistent with the 3 doses in order to stabilize) and I've been on the Ambien at this dose for about 5 years. Before that i was lower then hit tolerance.

 

For the Ambien i have 10mg tablets and for the Ativan I have 1mg and 5mg tabs but can ask my doctor to prescribe differently if needed.

 

Thank you for your help!!

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I'm a little worried about the Valium, it takes awhile to leave and you may have symptoms show up, I wonder if you should wait a couple more days before making any changes to your routine.  Maybe take your normal amount of Ativan and Ambien but no Valium. 
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Yep makes total sense.

 

I just spoke to a new psychiatrist who is familiar with Ashton and willing to work with me. She is really worried about the Ambien part and thinks that will be hardest of all to quit and worries too that there is no specific protocol for tapering that...:(

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I'll tell you my story, I took Ambien for about 7 months and quit it cold turkey and while I had insomnia for a few days, I didn't get the horrific symptoms I got when I quit Klonopin cold turkey, and I've seen other members report this as well.  I'm not advocating a cold turkey, most of our members will use the 10% rule but I'm telling you this because just like everything else around here, no two of us react the same.

 

 

 

 

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Hi Pamster,

 

Ok i decided to go down the transition to Diazepam route. I cannot tolerate Ativan. Even at .5 3x a day it makes my heart race and just makes me feel bad. There is no way I can taper down on this. The past few nights i have been following Ashton on crossing from 1.5 mg to Ativan 15mg Diazepam (schedule 8 but modified for half). It's just the night dose right now but already I feel a little better and stable and my sleep was better last night. I wonder if you were right about there being a bit of dependence still in my system from starting and stopping the diazepam sporadically in the recent past. I am still taking 20mg of Ambien when i go to sleep and 10mg in the middle of the night. I need to figure out how to taper that while all the rest is happening. I am seeing a new addiction Pdoc today so hoping she will have some insight (she is aware of Ashton). Any thoughts/help appreciated.

 

Thanks,

S

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I'm happy to hear you've seeing some improvement since starting the Diazepam, and I hope your new doctor will listen to your needs.  Are you planning to cross the Ambien to Diazepam as well?
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I wasn't planning to. I don't want to be on that much Diazepam. I was hoping to slowly taper it while I am crossing over from Ativan to Diazepam. Ugh. Such a mess.
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