Serax taper to begin via Ativan crossover

[[Buddie]]

Hi Everyone,

Well, after thinking about the titration taper from 15 mg of Serax (once daily, for abou 11 years now), my doctor convinced me to do it via crosover to Ativan.  She wanted nothing to do with the Ashton Manual, which I had purchased on line and brought to her. So... ok, I'll try it her way.

She gave me a prescription for 1 mg pills, and told me to take 1/2 to 1 whole pill per day, to begin the substitutuion.  By my calculation, based on conversions in the Aston Manual, about .75 mg (1/2 plus 1/4 of a pill) is probably equal to my 15 mg Serax dosage.  Does this sound right?

My other question is, when do I try to reduce again, and by how much?

I'm really scared of this whole process. Hope I can do it successfully.  Thanks for all the support you all so generously offer in this forum. 

[[Buddie]]

Hi Everyone,

Well, after thinking about the titration taper from 15 mg of Serax (once daily, for abou 11 years now), my doctor convinced me to do it via crosover to Ativan.  She wanted nothing to do with the Ashton Manual, which I had purchased on line and brought to her. So... ok, I'll try it her way.

She gave me a prescription for 1 mg pills, and told me to take 1/2 to 1 whole pill per day, to begin the substitutuion.  By my calculation, based on conversions in the Aston Manual, about .75 mg (1/2 plus 1/4 of a pill) is probably equal to my 15 mg Serax dosage.  Does this sound right?

My other question is, when do I try to reduce again, and by how much?

I'm really scared of this whole process. Hope I can do it successfully.  Thanks for all the support you all so generously offer in this forum. 

Hi [...]!

Well, I hate to say this, but ativan is a very strange choice for a crossover. The reason for a valium cross over is it comes in lower potency tablets, which enables you to make smaller(lower strength) cuts to your dose. Also, it is long acting, making for a smoother taper.
Ativan is short acting, but it is longer acting than serax, so that is one plus of the cross over. And the  relative equivelency is ok. 1mg ativan is equal to 20mg serax, according to Ashton. Klonopin would have been a better choice though, if not valium. It's longer acting than ativan.
Having to reduce by a quarter pill is going to be rather hefty. Could she prescribe smaller dose pills? I know it comes in .5mg, and maybe even .25mg, (not sure about that)
Or you could do a titration taper, which is mixing your powdered benzo in a liquid, allowing you to make smaller reductions.

Try not to be scared. We'll help you.

[[Buddie]]

Hi again,
I would wait to begin your taper. You want your body to adjust to the crossover for a week or so.

[[Buddie]]

I thought it might be best to stay on the equal dose of the Ativan for a little while before beginning the taper.  Would a couple weeks be too long?  I had askd re: valium instead and she was not too agreeable.  I am sure I can get a lower dose when ready so it's easier to cut.  I have the supplies for titration, too, if needed but feel unsure about how to do that. Hoping for a direct taper once I've made the switch over to the Ativan...just need to know if the next cut should be by 1/8, or titration...A 1/8 cut is going to be difficult, knowing that it's a small pill to work with.  But is this is reasonable amount to cut by?

[[Buddie]]

A 1/8 cut is going to be difficult, knowing that it's a small pill to work with.  But is this is reasonable amount to cut by?

Yes, it's a reasonable amount for now, I think. That's what I did with klon. 1/8th mg cuts. I"m glad you have the titration supplies. [...] is very good at explaining it in detail, and will take care of you if and when you like to go that route.   

And yes, it's ok to hold for a couple of weeks. Good idea.

To cut by an 1/8th, you can always try crushing a 1/4 pill and splitting into two piles of powder, and just eating one.

[[Buddie]]

OK...I began the substitution with Ativan tonight. (Actually it's the generic lorazepam).  I took 3/4 of the 1 mg pill.  This is a huge step for me.  I'm so grateful for this forum.

I tend to get panic attacks if something that causes me anxiety happens late in the afternoon at work...and sometimes even if something happened earlier in the morning, the panic suddenly begin later in the day.  After reading around on this forum, it sounds like that's more a withdrawal sympton than me.  They are nearly uncontrollable these days.  There is something good in knowing it's my bodie's reaction to needing more serax.  Thanks for all your shares, everybody.

[[Buddie]]

I slept well last night on .75 of a 1 mg tablet.  Had a little dizziness today - I think this is a normal side effect of this drug.  It came and went at 2 different times during the day. Can't wait to be drug free.

Just wanted to ask a question.  My doc, when prescribing the Ativan for crossover, gave me the option of beginning the night by taking one half of a pill, and if needed to take the other half.  One half would have been too little, and taking th other half would have been too much, according to my calculations in the Ashton Manual.  She also said to only break the pills at the line that is cut in them, and not to break them elsewhere - meaning no 1/4 breaks, I think.  (Which of course, I had to do in order to get an equivalent dose of the serax, and to begin my crossover-still staying within her limits of 1 full mg).  Anyone know why she would have specified this (not doing 1/4 breaks)?  Is it dangerous?

[[Buddie]]

Hi [...],

I have not heard that Ashton doesn't recommend quartering tablets. I have been quartering my klonopin with no problems. Good to hear you're still sleeping okay.


T2

[[Buddie]]

I've crossed over to the Ativan, and since I have a long weekend due to the holiday, I'm planning to cut by 1/8 tonight.    (Currently taking 3/4 of 1mg, or .75).  Wish me luck everyone!  I'm kinda nervous. 

[[Buddie]]

Hi [...],

You'll be fine, but GOOD LUCK anyways!! 


T2