Scared, Please help

Are you interested in dry or liquid titration and are you going to wait until you hear back from RAAM before proceeding with your taper?

Thank you!! I will start typing after stable. I don't know how long I will wait for the appointment

Hi, Pamster

I forgot to mention that I am also taking zopiclone in the past 3 months. From BB

I have realized that this drug is also very addictive. Since I only took short term, not every day

Can I slowly typing it. But my first priority is to typing Ativan,

Do you know anyone who took ativan even had interdose withdrawal, they still didn't

Switch to another benzo and successful typing? I really don't want to switch to another

One to make things more complicated.

  Thank you!

Oh dear, I’m sorry to hear about the Zopiclone but I”m glad you know it needs to go too.  Yes, many members are successfully tapering Ativan but it really doesn’t matter which you taper first, it might be better to tackle the shorting acting medication, the Zopiclone. 

  Thank you for replying. Since I only take zopiclone for short time, not every day, can I do quick typing?

I am planning to cut a quarter for each week, and stop. I don't know if it's ok?

  Regarding Ativan, could you please tell me what is the difference between interdose withdrawal and tolerance?Since I changed my dose 3 times per day for 4 days. I just feel a little better. If I am still unstable on currently Dose, but don't want increase anymore, what options  can I have? Can I still do typing?

.Please give me some advice. Thank you!!

It might work to taper the Zopiclone now since you’ve only been on it for a short time, you could start by reducing a quarter to see how it goes.  Tapering is an experiment that you have to perform on yourself and once you find the key, something will change and you’ll have to make an adjustment, its a difficult process. 

 

It would help if you kept a journal of your reductions and symptoms, this will help you make decisions on when to reduce and by how much.

 

I’m glad to hear you feel a bit more stable, it appears dosing ore often is helping but it does look like you’re still tolerant to your dose.  This is a definition of tolerance. https://www.benzoinfo.com/tolerance/

Thank you Pamster for your continued support.!

Hi, Pamster

  I need help from you. I have taken ativan 0.25mg ×3 for 2 weeks, but my condition

Is still unstable. The Dr increased my sertraline dose for 2weeks now, but still not feeling well.

  I really want to get rid the Ativan because I don't feel much effective as before . I don't want to increase the dose. My doctor want me to directly switch to xanx without typering in order to let me getting better. But I don't want to change to another short half life drug. I also consulted another doctor in KAAM, but not much help.

 

    For your experience, how to distinguish my symptoms is from tolerance or interdose

Withdrawal? I don't know if I have both. What is the next step for people have both ?

 

Thank you very much!

Can you describe your symptoms and also any you may have noticed from the Sertaline?

Thank you very much for your reply. I have taken sertraline 50 mg more than 3 months. After 2 months taking

Sertraline, I was feeling much better .all physical symptoms gone. During that period (1 week) , I didn't take Ativan, because my doctor said when you feel better, you can just stop. After that, I started to have papitation, chest pain and shortness breath. I did EKG, it's normal. I did have those symptoms before, but not that sereve. I know sertraline is working, my mood is stable.before I only took 0.25mg as needed, but now 3time per day still struggling.

Even now I  increase sertraline dose, still not help. I am afraid that if all symptoms caused by ativan tolerance or interdose withdrawal, just increased the sertraline dose can make worse. But Drs thought that I am on low dose for short term, can stop anytime without withdrawal symptoms. All my symptoms are caused by anxiety. But I know it's different. 

Currently I just want to get better and starting typing. I am afraid  that I stay on Ativan too long .

 

Do you know anyone liquided sublingual ativan by themselves and successful typing without switch to another drug?

  Thank you!

 

I’m sorry your doctor doesn’t understand what you’re facing, not everyone will have as much difficulty as we do so many will discount our difficulty.

 

Stopping the Ativan cold turkey is what is making you feel so poorly, it can take awhile for our body to get back to our baseline and sometimes its not possible and a dose increase is indicated, would your doctor allow this?

 

While medications can help ease symptoms for some, it won’t take them away because they are different classes of drugs, one cannot take the place of another.  In addition to this, we don’t react to other medications the way we might normally because our central nervous system is highly sensitized, adding, subtracting or increasing can be risky.

 

I know of many members who have successfully tapered off of Ativan but before we discuss your taper, I’d like to know if you can perform your daily tasks, this is one of the parameters we use to describe being stable.

 

 

I am currently not working. I only can do some simple house work. I have those symptoms

almost all the time. I am very sensitive to medications, I will never do CT. I am thinking to switch

My sublingual to normal tablets, If normal tablets work for me, I will do liquid typering in future.

Do you know anyone directly typering off Ativan sublingual?

Thank you!

I know we’ve had members who have used the sublingual but I can’t speak to their success, I’m sorry.  If you use these search methods you’ll have better luck than with the forum search and you can perhaps find some posts. http://www.benzobuddies.org/forum/index.php?topic=251991.0

 

It might be more straightforward to switch to regular tablets but if you do, don’t reduce right away, allow your body time to get accustomed to the new formulation.

 

If you can do simple housework, you’re probably stable enough to begin your taper, being stable doesn’t mean feeling good, it means functional.

Thank you, I will ask my doctor to switch sublingual to normal tablets.

Hi, Pamster and Libertas

  Please give me some advice!  I decided to try compounding pharmacy to make

liquid ativan. But I am also very nervous  to change the form of Ativan since I am

Taking Sublingual Ativan. But I am going to try if I can tolerate or not.

  From another post, you asked" For us to help you we'll just need to know the formulation

for the liquid you're getting from the compounding pharmacist (is it stability-tested, what are

the ingredients, and most important ... what is the concentration)."

  I will give you some information the pharmacist give to me.

The company is PCAB accepted pharmacy. I will request 0.1mg/ml.

The ingredients are ativan tablets, base C- polyethylene glycol, propylene glycol, USP

Flavor peppermint oil.

  I don't understand What's the stability-tested?

 

Could you please check this for me? 

    Thank you very much!

Hopefully Libertas will stop by to take a look at your compounded medication since she's experienced.  I do want to say I think this is a great decision on your part but try not to be nervous about it because that increases stress and that's not the best way to go about this.  Having confidence in your method is key so I hope you can come around to this thinking. 

 

I also remember Libertas mentioning that when you begin the medication its a good idea not to reduce your dose until you see how the liquid is going to affect you.  Anytime we make a change, we should allow time for our body to acclimate to it. 

Sorry, I also want to know if I can use the compounding capsules  to typering. Because

the liquid ativan expired every 14 days. I may need to go back home for some family emergency

, the liquid form is not easy to keep when traveling. If the pharmacy can make capsules,

How many mg per capsule is good for typering?

thanks!

Tip of the hat for finding a PCAB accredited compounding pharmacy, Sherry li.

 

Stability testing is used to detect changes in the properties, purity, and potency of a formulated drug product over time.  You will need to ask your compounding pharmacist if the formulation they are using has been stability tested.  I suggest you also ask them to confirm what they are using as the source of the Active Pharmaceutical Tablet (API).  Given the ingredients in the formulation you shared, it’s possible they are using bulk power (i.e. the pure active drug substance) instead of regular tablets.

 

You will also need to ask your compounding pharmacist about the possibility of making capsules.  They may or may not have the capability to do this.  Also, your prescriber would have to write a different prescription for these.  Again, I’d ask the compounding pharmacy for advice about this … they may have suggestions on how to minimize the number of different prescriptions your prescriber would need to write as your dose changes.

 

Pamster has made an very important point — when you switch to the liquid do NOT make a reduction in dose at the same time.  Switch over at your current dose (or even a little higher).  Then hold at that dose for several days to evaluate how you respond to the liquid.  Members who switch from regular tablets to liquid sometimes report a shorter onset and duration of action.  You may or may not experience this given that you have been taking the Ativan sublingually.  Indeed, if you take the liquid and feel that the onset of action is uncomfortably longer than with the sublingual, I’ve read that some members hold the liquid in their mouths or under their tongues for a bit before swallowing it.

 

Did the compounding pharmacist give you a supply of oral syringes and a bottle adapter plus teach you how to use these devices to measure your dose(s)?  If not,  they should.

 

 

Thank you very much for your reply. Pamster!

I just consulted the pharmacist. actually the compounding pharmacy made things very simple.They just requested normal prescription which my psychiatrist only wrote SL ativan tablets then they can compound to liquid or capsules as I requested.

Since I only can get the normal prescription,  I think I just do liquid typering. I

can use the 0.1mg/ml liquid to typing until end by using 1ml syringe.

Thank you two very much!

You’re welcome.  Using a liquid is easy once you get the hang of it.

Hi, Libertas

  Today I called the compounding pharmacist regarding the stability test, he told me

for my liquid ativan which does not need stability test.  He also told me that they have

2 types liquid, oil and water.  I prefer water.  Because I saw someone on BB had

bad reaction to the oil. How do you think?

  Does Compounding pharmacy  make solution or suspension? What is the difference?

 

  Thank you very much for your advice!

Building and maintaining a strong relationship with your compounding pharmacist is very important.  I encourage you to contact your pharmacist with your questions and concerns.

Yes, I will. Thank you very much for replying!

You’re welcome. Good for you for reaching out to the compounding pharmacist — compounding pharmacists can be a valuable allies during benzodiazepine cessation.

Hi, Bob

  I just received compounding liquid ativan, currently my dose

Is morning 0.21mg, afternoon 0.125mg, night 0.21mg. total

Daily dose is 0.545mg.

I will  take some time to transfer from tablets to liquid. Currently I have already

transferred morning and afternoon dose to liquid, the dose in night

I will keep on tablet until I am use to the liquid form. If everything is

going well, I am going to typer next week. Since I am using ativan in

short term and low dose, I don't want do very slow typering  ( but I

will adjust by my symptoms).

  I am planning reducing my dose 10% every week or 10 days. I am

very interested in daily micro cut method, but I don't know how to

Do it. Also I would like to compare it with cut and hold method ( titrations)

Could you please give me some advice and help me to make a plan?

I also confused what is the difference of direct cut and titration?

 

Thank you very much!