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Starting Taper from Ativan - Once Daily - need direction


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Hi all!

 

So I am starting my Ativan taper after taking it since late November to help with a 5 day run of insomnia.

 

My PCP who originally prescribed it knew I didn’t want it and I was worried the cure would be worse than the problem. She has been monitoring me and agreed to start the taper today (I’ve been having weakness in my legs and so on so I’m worried it was the Benzo and don’t want this in my system anymore). She had suggested a 1/4 pill reduction and I said that seemed to aggressive but she felt confident given the “low dose”, single daily usage and overall time frame I’ve been on the meds. I pushed back thanks to the knowledge I learned here and from Dr. Ashton and other Benzo Coalitions.

 

Question to those who’ve tapered (hopefully some off of Ativan and a shorter usage time like mine (5-6 weeks) is should I be ok with a cut from 1mg to .875mg? Will I feel anything? How long before I would notice if something was wrong (not just me making things up/psychosomatic)? If .875 is too much, do I go back up to 1mg?

 

My doctor is totally open to going as slow as I need and supporting me through the process. I had mentioned compounding pharmacies and she said we can certainly do that especially as the cuts and doses get smaller. She also has an addiction specialist in her clinic that she is going to consult with and stay in contact with as we do this.

 

At this rate, with my usage should I be more concerned with time on the drug or the percentage of reduction? If I taper slowly won’t that increase the time on the drug thereby increasing the potential damage to my brain chemistry and function? If I stabilize at a larger reduction is that a good sign my brain is recovering fast enough to continue larger reductions or should I still try and stick with the smaller taper percentage? At this rate if I did that, a 1mg 6 week use would put me son 6-8 months worth of tapering if I’m thinking this through correct.

 

Looking forward to hearing back from any in the community and thanks in advance for your help!!

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I didn’t taper but I’ve watched many members work through the process so I hope i can reassure you a bit.  Your doctor sounds great, so glad she’s on board with your needs.

 

Ativan is fairly fast acting so you’ll probably know fairly soon how this is going to affect you but fearing it will likely cause you stress and stress can make us feel worse so I hope you can approach this from a place of acceptance.

 

There are many who can get off these drugs with little to no problem, you may be one of them.  Have you experienced any interdose withdrawal, or any symptoms you attribute to the drug?

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Hi Pamster!

Since I dropped the one time daily dose on Friday night from 1mg to .875mg I have felt symptoms of withdrawal. Some fatigue (although I also have COVID, 6 days in and getting better), uneasiness in my body, some headache/tingling in my head, and a little anxiety. Again not sure how much of this is COVID or the reduction but I know the reduction is doing something. When I was on the single dose I don’t recall ever really feeling an issues in between doses except one time a week and a half ago when I took a .5mg at 3 pm and then another at 9:30p. The next day I was waiting to take my regular 1/day 1mg dose and around 4-5p I took a nap and woke up with a headache and then by 7:15p I could feel some intense symptoms so I took a .5mg around 7:45p and then my other .5mg at 10p. Next night I got to 8:30p for the .5mg and then to 10p for the other and then next night I got to my full single dose again at 10p. I didn’t have any crazy symptoms in between to single dose on those days as I climbed back to my normal dosing time.

 

I am wondering if I should split my doses even though I’ve been taking only for sleep at night once a day. Would this be best? How many doses? 2? Say 9am and 9pm?

 

Just wondering.

 

I bought a scale and I can weigh the pills to make it more accurate as cutting pieces can be challenging.

 

Thanks again for the help, I hope my shorter term use means this is a successful and relatively painless healing  process!

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  • 3 weeks later...

Hey all,

Anyone lend some advice on splitting Ativan doses. You can see in my signature that I’m only taking once a day. I have symptoms, mostly leg weakness and fatigue. I wonder if splitting my dose up in two would help. I am dry tapering and weighing my doses. Cutting every 7 days at this rate (I’ve felt good enough to do so each Friday night).

 

Just curious if I could smooth the road by multiple doses. Any advice would help. Please see the above replies already for more details. Thanks a bunch!

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I’m sorry I missed your last post, but yes, most Ativan users will split their dose and take it at least twice but typically three times a day.  It’s important to take your doses on schedule to keep your blood serum levels constant.

 

 

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Thank you again for you reply. Is it easier to take a smaller dose in the AM and then the larger portion at night? Do you take it evenly? I originally took it for sleep.

 

If you take the smaller one as you get closer to the end I imagine you could just drop the AM dose completely as it gets too small to measure properly? I am weighing with a scale and I’m currently at .742mg.

 

Just wondering again what the best way to do it would be. I am guessing you say to take the dose on time so your CNS doesn’t bounce around from the fluctuations in serum levels?

 

Thanks in advance for the advice!

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You can arrange your doses to fit your needs, if you’ve typically used it for sleep then you’d leave that dose heavy. What you gain in a steady concentration of the drug during the day will most likely affect your sleep if it hasn’t already. 

 

It’s best to stick to a schedule because your body expects it but you can eliminate the drug from wherever you need to, you can take a little off the morning then you can take some off the nighttime dose but really, you can taper however you need to.  There aren’t many things we can control about this process but this is one we can.

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You can arrange your doses to fit your needs, if you’ve typically used it for sleep then you’d leave that dose heavy. What you gain in a steady concentration of the drug during the day will most likely affect your sleep if it hasn’t already. 

 

So I notice sleep issues (harder to fall asleep) the first few days after a cut, then it gets progressively better. I’m wondering what you mean it will most likely affect your sleep… do you mean negatively by splitting doses or positively by splitting them?

 

Just curious. I’d assume positive because my CNS won’t be going through the serum level swings it’s  going through now.

 

Thanks again for all your help, love the support this community brings!

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I’m glad to know your sleep improves the further away you get from a reduction, that’s a positive development.  I meant it could affect your sleep negatively, most of us suffer with insomnia while we’re withdrawing and during recovery.  But hopefully a relatively steady state of the medication in your blood stream will give you less ups and downs during the day.
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Ok thanks for that. Just wondering if I go to the two doses and I don’t improve the symptoms (weakness and so on) then am I stuck staying with two doses? Would that set me back?
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Anytime we make a change to our schedule it can have an effect so there is some short term risk to switching it up.  I guess the same would apply if you decided its not beneficial.  I don’t know if you would call it a setback, you might have to hold your dose for a few days until things settle. 

 

Honestly, most members on short acting drugs like Ativan need the multiple doses during the day but we’re all different of course.

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  • 3 weeks later...

Hi CNote12,

I am also dry cut tapering from Lorazepam (Ativan) and before I started tapering I was having a lot of symptoms from interdose withdrawal.  I now take my doses 4x/day (one of those doses is when I wake up during the night, usually around 1:30am).  Everyone's different, but it really helped me to split up my doses.  I was having extreme anxiety as well as some weird lip quivering. 

Good luck,

BWarrior

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  • 2 weeks later...

Hi Bwarrior,

 

Asking for a friend… how did you split into 4 doses? Did you gradually do this or make change all at once? This friend is taking .5mg at afternoon and 2mg at night and is having pretty tough symptoms so thinks she might be having interdose wd and wants to maybe split doses but not sure how to make that transition. Anyone else have suggestions on how splitting up if already very symptomatic?

 

Thanks and best wishes to everyone!!

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Hi Boges11,

I was on 1.5mg and I did it all at once.  I didn't have any adverse reactions.  In fact, I remember feeling like it helped right away.  But like Pamster said, we're all different.  As you know Ativan has a short half-life so like you said, there's a good chance your friend is experiencing interdose withdrawal.  If it were me, I might try taking, say, .5mg out of the 2mg night dose & take that .5mg in the morning to see if it would help the symptoms.

I hope this is helpful,

BWarrior

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Boges11--To clarify how I made my dose change: I switched from taking 3 doses to 4 doses and I basically just made the change one day & stuck with it.  It helped me noticeably. 

BWarrior

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  • 2 weeks later...
This is similiar to my question. I was taking only 0.5mg once around 6pm.  I cut the does to .25mg becaus they are tablets and figured half was good. But I am having terrible withdrawl.  Do you think it wise to take the 0.5mg I was taking and split to .25mg in the am and .25mg in the evening and get leveled out. Once I feel leveled then start to cut a little off each dose at a time?
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  • 2 weeks later...
Yes things are better splitting. I am currently down to .125mg am, .062mg afternoon, .125mg evening. Having small waves but feeing mostly functional. I tried to cut too much the other day and really felt it. I have to keep reminding myself slow and steady!
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