Jump to content

Should I substitute?


[du...]

Recommended Posts

I am 6 mos into my Ativan taper. Have dissolved 0.5 mg in a small amount of vodka then filled to 300 ml of water. I take 1 ml per day out when not holding.

 

I am down to 0.19 mg per day of A divided into 3 doses and have hit a wall of symptoms. I have been holding for 4 days now but wondering if I should consider switching to Valium. I have had wd symptoms throughout the entire taper but tolerable.

 

Seems like many people have troubles when substituting so not sure what to do. I would like to finish this off over the next 3 months but these symptoms make it hard to work and I can see why many reinstate.

 

Pure misery.

 

 

Thanks for your help.

Link to comment
Share on other sites

I’m sorry you’ve hit a wall of symptoms, dude 66.

 

To answer your question, we need more information from you about how you’ve been tapering. The purpose of these questions is twofold: (1) to discover if there might be issues with the way you are preparing/using your do-it-yourself (DIY) liquid and (2) to discover if you might need to adjust your taper technique (e.g. decrease your taper rate, change your taper interval, add holds).

 

First, can you tell us more about how you’ve been preparing and using your DIY lorazepam liquid?  For example, how much vodka do you use?  What proof or ABV is it?  (e.g. 80 proof or 40% ABV).  Do you shake the liquid vigorously before you use it to distribute the drug/excipient particles as evenly as possible throughout the liquid? Do you measure your reductions quickly before the drug/excipient particles settle out of suspension?  Do you make a fresh batch of the DIY liquid every day?  Or do you store your liquid? If so, where and for how many days?

 

Second, can you tell us more about how you’ve been reducing your dose?  For example, have you been making a fixed amount reduction in dose on a daily basis?  Or, have you been using a taper rate to guide your reductions?  If so, what rate have you been using?  (e.g. 10% a month calcuated on previous month’s dose).  Have your symptoms ramped up before?  If so, when?  What was your total daily dose at that point?  What did you do in response? Did you hold your dose constant until your symptoms stabilized (i.e. stopped changing and became tolerable)?  How many days did you need to hold?

Link to comment
Share on other sites

Good questions and sorry I did not include previously so here goes-

 

I use 80 proof Vodka(about 5-10 ml) to dissolve over 15 minutes. I then add water to total 300 ml and shake vigorously. I use a 100 ml syringe to pull suspension out attempting to keep tip in the center of container. I do this once per day. From the remaining suspension I pour equal amounts into two other containers for a total of 3 doses. These three doses are not equal in amount usually but pretty close as I feel the overall dose ends up being the same. This may be a potential spot for error. Liquid stored in fridge.

 

I take one ml extra per day for a decrease of 0.0016667 mg per day. However I do hold when feeling lousy. I have suffered setbacks before but not this bad. I have read symptoms often get worse when getting lower so not surprised I guess. Previous waves at various times earlier in taper. I would hold for a few days and then improve.

 

New stress this past week at work may be contributing as I feel way more anxious.

 

Thanks for your help. I just am wondering if switch to liquid V or even liquid A may smooth things out cause I feel awful.

 

 

 

 

 

Link to comment
Share on other sites

Thank you for the additional information.

 

It sounds like you are aware that the do-it-youself liquid you are making is most likely a suspension (not a solution) with an unknown ‘shelf-life’ and are taking appropriate risk-minimization steps. (If you wish to take a deeper dive into the topic of the issues associated with making/using DIY liquids similar to yours, I’ve included a link below to a recent discussion on this topic.)  If you think accuracy of dosing may be an issue, then trying the oral lorazepam solution from one of the FDA-approved manufacturers is certainly worth consideration (see link below to the drug label for one of the manufacturers).

 

It also sounds like you are aware of the importance of decreasing your taper rate via holds when your symptoms begin to ramp up.  If you have not already done so, you might want to review your taper log to determine what your taper rate was when you experienced an uptick in symptoms but were able to stabilize after a brief hold.  This may give you a clue as to what ‘speed limit’ you might want to set going forward.

 

I’ll defer to other members to address your question about a Valium/diazepam substitution.

 

I’ll close with two questions:

 

Your total daily dose is low (approx 0.19mg).  Moreover, you are splitting that dose over 3 daily doses of approx 0.063mg each.  Is it possible that your drug serum concentration has reached a subtherapeutic level?

 

In addition to a general increase in symptoms, are you also experiencing interdose withdrawal?

 

Links:

http://www.benzobuddies.org/forum/index.php?topic=269733.msg3387711#msg3387711

 

DailyMed - LORAZEPAM solution, concentrate

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5ff82103-cc57-4af9-9362-82a7c686271d

Link to comment
Share on other sites

Yes, my doses may be sub therapeutic. I did not think of that.

 

Frankly, I don't feel much different an hour after a dose or 7 hours. I pretty much feel lousy all day. Mornings are the worst by far but I can still get 4-5 hrs of sleep.

 

Not sure where to go from here. I want off this poison. This has cost me a well paying job and my relationship with family is strained.

 

Appreciate your help.

Link to comment
Share on other sites

×
×
  • Create New...