Urgent advice please- friend stuck on Ativan and Librium

Helping a friend who is stuck between two benzos Librium and Ativan (original prescribed May/June ‘22 to replace Fioricet she had been on since 2020- it’s a barbiturate).

They switched her over to Ativan and she struggled with interdose withdrawal and I’m sure coming off the other med to substitute. They tried Valium which was not good and so went back to Ativan and subbed in Librium for the Valium. Her genetics from Genesite test show the comment ‘a higher serum level so a lower dose may be required’ for Ativan, Librium as well as Val  (this comment means slower metabolizing of the drugs correct?).

She made some decreases over the last few months of the 20mg total Librium now split in two doses, but has been very sick. She held since early Nov and then tried to make a decrease on her night Ativan with microtaper. She is scared on trying to get back to all Ativan bc like us all we don’t know how any switching is going to go once things become unstable.

This week she is having severe akathisia and uncontrollable crying and feeling out of her mind wondering if she’s having interdose Ativan withdrawal (should Librium be helping bridge that though?). She’s made very small microtaper change and all hell has broken loose for her. She’s very lost.

Current doses-

.7 mg Ativan 8am (liquid compound switched from pills in Sept, down from.75mg in Oct)

9mg Librium at 12pm

9mg Librium at 4pm(changed from 1pm in Dec)- she feels very sick after Librium doses

.985mg (microtaper from 1mg the last 2 weeks) Ativan 8pm

Please any advice is much appreciated bc she feels so stuck and has no clue how to proceed, where to start. She has been in and out of ER given steroid bc her adrenals crashed so that’s a complicating issue as well.

Her story summary-

I was put on Ativan in June 2022 (1mg x twice a day) to replace my Fioricet which I was taking since 2020.

I quickly started experiencing interdose withdrawal and doctors added another 1 mg at noon.

It didn’t go well (I think it was too much), so doctors suggested to cut it to 0.5mg x 6 times a day.

It didn’t go well, so doctors suggested switching to Valium.

Valium didn’t go well at all with me, and noon dose was replaced with 25 mg Librium: better reaction than Valium, but still worse than Ativan.

Then I tried to add a second 25mg dose of Librium and it didn’t go well.

So I went back to Ativan + Librium + Ativan

Chiming in again….. it has been suggested by benzo coach for her to do a rapid taper since she’s stuck on two and having what seems to be paradoxical reaction to her day doses. Her evening one does ok.

Any thoughts. She’s terrified, suffering from lots of severe akathisia and unsure what step to make now. I know no one knows bc we are all different but any stories of previous people being in this type of predicament? I have had the severe akathisia but it became more manageable after holding. I think the switches she’s made since June have complicated this and not sure holding will help?!

Thanks for any guidance from moderators or people who have seen a story similar.