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Ativan and Ambien


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I understand, but I'm not sure tapering it while crossing is a good idea but this is your taper and you should be able to determine your path.
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Hi Pamster,

 

I don't disagree with you. What would you suggest as an alternative path? The diazepam does make me tired, which is good, but I guess i need to worry about the actual withdrawl from high dose Ambien. I haven't really worried about that before as I have always felt more emotionally dependent on it than physically and thought withdrawls would just be lack of sleep (which diazepam helps with) but that may be naive. Would love any and all input on a path as you all know so much more about this than me.

 

thanks,

S

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You could very well be like me, I didn't experience withdrawal symptoms when I quit Ambien cold turkey, I actually felt better except for the insomnia and that resolved in a matter of days.  However the big difference between our situations is I'd been Klonopin free for 14 months so we're apples to oranges here.

 

You may be onto something though, if the Valium is helping you to feel tired it might be the right time to reduce your dose of Ambien.  I guess the only thing you can do is experiment, it would be great if you could get off of it and only have to worry about the Ativan cross.

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Hi Pamster,

 

Even if I can get the Ambien down to half in the next few weeks I feel like that would be a victory. The biggest concern is not knowing how that dropping down will effect me as i cross over to diazepam. But honestly at full dose of Ambien and .5 Ativan 3x a day i feel like absolute shit,. Shaky, tired/wired, major hypoglycemia and intense anxiety. The one symptom i am thankfully over (for now) is nausea and vomiting, I went on a PPI and that seems to have stopped that in its tracks.

 

S

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The fact that you're familiar with Diazepam is on your side, some who don't have experience with it have a difficult time adjusting, just because it's such a different feeling.  I wish I knew how this will go for you but I can see you're looking to make a change so I guess the only thing to do is to give it a shot.  I wonder what your doctor will say?
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I will let you know!  Yes i am familiar with Diazepam and way way prefer it to any of the short acting crap. The worst part is now that that Ativan is in my system it makes the diazepam act completely differently. It doesn't feel at all like it did when i would take 2mg here and there. Such a bummer.
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Hi Pamster,

 

So I saw the 'Ashton plan wise' doctor and we talked through everything for a good long while and I showed her the crossover guide I was using from 1.5mg Ativan daily to Diazepam and we talked about the Ambien and her strong suggestion was to stop Ativan and go directly to the 15 mg of diazepam a day--20 if needed and to also stop the Ambien. She said the Diazepam should cover me through any withdrawls and that she didn't feel comfortable with me on 3 drugs cause it was too much short/long/short acting meds for my brain. She said it may be uncomfortable for a few days as my body got used to Diazepam but that i would be ok and to work through it. I love this in theory but it goes against everything i have read on here and in the Ashton manual (I told her that). If I try this am I setting myself up for disaster? I would love to give it a go but don't want to make things worse for myself down the line if issues arise. What do you think?

 

thanks,

S

 

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Hi Missfrida,

 

Its not a good idea to abruptly stop the Ativan, you'll be leaving yourself open for severe symptoms if the Valium hasn't had time to build up in your system before you stop the Ativan.  I feel a two step cross would be better.  She's on the high end of her suggestion to cross to 15-20 mgs but I guess that's to incorporate the Ambien dose in there?  https://clincalc.com/benzodiazepine/default.aspx

 

I'd sure think about doing the crossover in stages rather than all at once because you can gauge your dose better that way.  If in the initial step of crossing over you feel fairly good then you can add in only what Diazepam you need at that point which may be less than 15-20 mgs, everything counts when you're looking at months to taper off of the amount you end up on.

 

Do you have enough Ativan to cross a little slower?  And about the Ambien, if you feel you'd rather eliminate that directly instead of converting to Valium, I'm all for it.  I'm much more afraid of benzo's than I am z-drugs but my experience informed my fear.

 

I know you sought this doctor for her expertise but this is still your body and your taper and I believe it should be your decision on how to proceed.

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Hi Pamster,

 

I completely agree with you on all counts. Yes she is covering for the Ambien assuming i would need 15mg to sleep at night and 5 for the day but that is if i go straight switch. I think i should follow taper schedule 8 (3mg ativan to diazepam) but for half the amount and maybe make the changes every few days instead of once a week. Heather actually says that's ok to do it quicker if you are crossing to diazepam and feel ok. I have enough diazepam and ativan to see me through and also my other psych doc i saw who is willing to follow the schedule is seeing me (if needed) next week and she can prescribe, but i should be ok for the next month and if i do the ativan taper right it may not take me longer than that. I just really want off that drug. It's interesting that i haven't taken my afternoon dose yet (i usually do it around 3pm and its now 5pm) and I feel ok actually. I think it's the diazepam still in my system from last night even though it was such a small dose. I am gonna continue to cross to the diazepam the way I was going to following schedule 8 (but a bit faster) and see how i do cutting down on the ambien as i go. Any thoughts? I'm all ears and fears!

 

One other quick question. I know everyone is different and everyones bodies are different but do you ever see anyone go through the stage i am now at and continue to work? I would really love to be able to function and continue my work life even if i have to rest evenings and on weekends etc. I know you may not be able to answer that but thought i would ask.

 

Thank you!!!

S.

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I like how you're approaching this, you're listening to suggestions but you're also listening to yourself because you know yourself better than any of us. 

 

Its interesting to know the Diazepam is already doing its job of giving you better coverage than the Ativan, it may allow you to eliminate the Ambien which would be wonderful.  I know you feel okay now but please do your best to stick to your schedule, you don't want to tempt fate and hit a wall of symptoms.

 

I worked all but the first three weeks of my cold turkey and while it was rough, I'm grateful I was able to do it.  It was a good distraction, I can't imagine what it would have been like if I would have had to stay home every day with only my symptoms for company.  I needed work so much that I started dreading weekends.  Sometimes when I couldn't sleep, I'd just get up and go into the office, why not?  So what I'm thinking is, if you do a nice slow taper, one that hopefully keeps you functional that you'll be able to live your life and do what you need to do while ridding yourself of the drug.

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Pamster,

 

Thank you so much for your guidance. I just took my .5 ativan so i didn't skip a dose. You are right!

 

My job is SO high stress (I produce tv commercials and have to travel and be on set, etc that I don't know if that will wreck me or save me!!).  I guess the next few weeks will be telling.

 

I don't think i won't use this new doctor unless she agrees to let me go through the next 5-6 at my own pace. I need to figure that out. I'm a little pissed that she said she follows the Ashton Protocol but was willing to have me jump from Ativan to Valium without crossing, saying my dose was low, i hadn't been on it long and she didn't feel comfortable prescribing me both. She said she does this shift to all diazepam from ativan all the time with no issues. Given what I've read here I honestly don't see how that is possible. Ugh.

 

Thanks,

S

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Thats the problem with some doctors, they think we're all alike and whatever method they've had success with other patients will work for all, it doesn't work like that.  And I agree with you that she if advertises she follows the Ashton protocol but doesn't follow a critical part of it then she's not being honest.  I can't tell you how many members have been sent into horrible symptoms from trying to eliminate their current benzo before the Diazepam has had time to reach full strength.

 

Your job does sound stressful, traveling can be rough so you may not be able to do what I did but will your employer work with you, allow you to pick and choose when and where you'd like to work?

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I'm freelance so i can can pretty much set my own schedule. I told my current employer that I may have to drop out before the end of the job (I started last Monday and the job goes through mid Jan) due to medical reasons so they know that might happen but i am trying to stay on as long as possible so I can make the $$ while I can still work. I would say my single biggest symptom right now not even in 'withdrawal' is low blood sugar and POTS (which i had before this). They are the things that make it so hard for me to work. That and anxiety and fear about this whole situation!!
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You're smart to work as long as you can and I know the fear, its one of our worst symptoms but educating yourself like you are is the best defense against it. 

 

It sounds like you've got some other health issues going on, that complicates things but won't prevent you from tapering, recovering and living happily ever after.  :)

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Hi,

 

I have an update. I stabilized (well not stabilized but as good as i could do without going up on dose and I was functional) on the .5 3x a day Ativan. I wanted to do a crossover to Diazepam to make this tapering easier and i have used Diazepam before for anxiety and found it to be 'fine' (that was before Ativan which completely changed how it behaves in my body). I started (per the Ashton Manual) with my evening dose and lowered my Ativan from .5 to .25 and added in 2.5 Diazepam. This worked pretty well for that evening dose so after about 6 days i did the same substitution with the morning dose. I got SO nauseous, weak, dizzy and depressed when i changed out that morning dose. I'm not sure if it was too much Diazepam or not enough Ativan but after 3 days i couldn't do it anymore so pulled up stakes and went back to just the Ativan 3x a day at .5. I really have no idea how I will taper down on Ativan given the short half life so i am considering trying the Diazepam crossover again only slower (so i do the evening dose for say 10 days then try morning, etc). My new doctor thinks i should crossover that evening dose for a few days then try pulling the Ativan out and keeping the day doses and just going with diazepam at night and eventually doing that with the day doses. I feel like that will be really hard as i will feel that loss of Ativan at night. Any advice on re-trying the crossover? Could the issue be that i tried the morning crossover too soon? I am leaving Zolpidem where it is right now. I can't tackle both at once. Any advice would be greatly appreciated. I will also post this in the Valium group.

 

Thanks,

Sherri

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Oh dear, I'm so sorry to hear it didn't work out with the Valium but its good to hear your doctor is supportive of your struggles.  How are you feeling now, have you stabilized?

 

I wish I could tell you what to do but I don't have experience with tapering or Valium, so I think asking this question on the Valium support thread would be smart.

 

I just want to let you know that if the Valium doesn't work out, many members have been successful tapering directly from Ativan.

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Hi Pamster,

 

Yes i have stabilized in as much as I am functioning and can do all my daily takss and am still working. I would love to taper from the Ativan but I just do not feel good on this medication and i cannot see staying on long term. Also i have no idea how to titrate down and cutting pills is not for me. The evening dose of valium works fine it's when i went to the morning one that all hell broke loose. I am also trying to continue to work though this so the gentler on my system the better. Do you think someone will answer in the Valium thread? Is there anywhere else you suggest I put it?

 

Thanks,

Sherri

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Ativan comes in liquid form from the manufacturer if you're interested in going that route.  https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=LORAZEPAM

 

Lets give it another day on the Valium thread for someone to respond, if no one does, I'll try reaching out to someone on your behalf.  In the meantime, are you considering going back to your evening dose of Valium?

 

 

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Hi Pamster,

 

I started the crossover last night and it was fine (it always is at night). It doesn't help me sleep but the next morning I can go longer without my Ativan morning dose. I just feel a little more relaxed, but then when i go to that morning valium crossover dose a week later. OOF. 

 

Thanks for the support, P!

 

Sherri

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Pamster,

 

I am going to start a new topic and retell my story so i can hopefully get some advice as i am really struggling right now.

 

Any advice on where i should put it so it gets seen by people who can help me either move over to valium or taper ativan. Also wondering if i need to updose before tapering as i am still unstable.

 

thanks,

Sherri

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Hi P,

 

I am not sure about updosing yet. I feel awful again instead of stable. I can't tell if that's from cutting the evening dose of ativan in half and the valium not covering it or if it's just the whole thing. I think her advice of holding longer on the crossover for each dose makes sense and i will do that. I just worry that I feel so sh*tty and I haven't even started tapering yet. That is what is scaring the hell out of me right now, but we know there is so much at play here including the Ambien. I just don't know what to do :(.

 

Sherri

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Hi Pamster,

 

I am feeling a little better. It changes day to day and even hour to hour. Work is always a good distraction.I am doing the evening Valium 2.5 crossover and it's been going ok but my sleep is really bad. I actually took a low dose (25mg) Trazadone last night and it helped me cut down on Ambien by 5mg and I also slept better (I think). Being on A, V and A it's hard to know what is causing what. I still wish I didn't have to add Valium to the mix but I don't see how i can cut down on Ativan given I'm so unsteady on it. I also think the Ambien is messing everything up cause I'm on a long acting benzo and 2 short acting ones. How can that not be messy? Oh I also started Propranalol (10 mg) and that helps with some of the heart racing (my Pots is terrible). I am seeing my Pdoc tomorrow and will see what he says. He will follow(ish) Ashton with me but doesn't really believe I can't taper in a quicker fashion. Sigh...

 

Sherri

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I'm glad you checked in, I can see how difficult it is to know what is causing what, I'd sure like to see you get off of the Ambien, it really did a number on me.  The internal trembling, dark thoughts and anxiety it caused for me was horrific. 

 

I'm worried about your appointment, if your doctor doesn't fully understand this process and you don't have a clear idea of what you'd like to do I'm afraid you're going to be sent down a path that isn't the best for you.

 

I'm glad you got on the Propranolol and I know many members do okay with Trazadone, but understand how symptoms come and go and vary in intensity. 

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