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Help - Need Plan For 0.5mg Ativan Titration


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As the subject reads I want try titration as it might be easier for me. Can I get a plan made? Thanks in advance.

 

1 - One tablet of 0.5mg Lorazepam - split into 3 times daily - 0.2mg / 0.2mg / 0.1mg (although this is not set in stone as I'm just starting my taper.

 

2 - I want to taper fairly slow. 1% per day?

 

3 - 100ml cylinder with 1ml markings will be used.

 

 

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Having the drug in liquid form is a great advantage as it opens a new world of flexibility in dosing.  One thing it allows is for you to split your dose any way you wish.  So for example your ,5mg dose can be split exactly into thirds if you wish.

 

1% per day would be a 100 day taper.  Probably way too fast.  I'd let your body determine the rate, but start at perhaps a .002mg per day cut and see how it goes for a few weeks.  Then adjust up or down.

 

A cylinder may be useful, but what is needed are 1ml and 10ml oral syringes.

 

What liquid are you thinking of?

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Having the drug in liquid form is a great advantage as it opens a new world of flexibility in dosing.  One thing it allows is for you to split your dose any way you wish.  So for example your ,5mg dose can be split exactly into thirds if you wish.

 

1% per day would be a 100 day taper.  Probably way too fast.  I'd let your body determine the rate, but start at perhaps a .002mg per day cut and see how it goes for a few weeks.  Then adjust up or down.

 

A cylinder may be useful, but what is needed are 1ml and 10ml oral syringes.

 

What liquid are you thinking of?

 

Too fast huh? But I had a dry cut plan suggested to me that would basically take my pill and cut it into 1/8ths and then drop one of them every 10 days. Even the Ashton method of 10% every 10 days comes to 100 days (or does it mean 10% of the balance after every cut?). Does the fact that it's 0.5mg and that I was an occasional user make it a bit easier? I've seen many peoples taper schedule and I always look at the last 0.5mg of it. Lots of them were in the 3-4 month rage. Sorry this is all new to me.

 

As far as what I'm using as a liquid I have no clue. Can't seem to get a good method from the posts I read.

 

Thanks SG57

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Yeah, ativan all over the map.  I did not use it.  Some use alcohol to dissolve it.  Others use a good quality suspension agent like Ora Plus.  There is also a prescrition liquid.  I would advise staying away from water as it does not dissolve it and makes a poor quality suspension.  Although others do use it and are sometimes successful.

 

Ultimately, your own reaction will determine how long it takes, but I would careful not to jump in too high as it might make you sick then you end up correcting it.  It might only take three months.  But it might take a year.  There i just no telling until you get into it.  So I feel the best approach is to approach it from the bottom up so you don't get in too deep.

 

I've been through the mill with these drugs.  When symptoms get entrenched they can last a long time.  They are very dangerous drugs.

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Yeah, ativan all over the map.  I did not use it.  Some use alcohol to dissolve it.  Others use a good quality suspension agent like Ora Plus.  There is also a prescrition liquid.  I would advise staying away from water as it does not dissolve it and makes a poor quality suspension.  Although others do use it and are sometimes successful.

 

Ultimately, your own reaction will determine how long it takes, but I would careful not to jump in too high as it might make you sick then you end up correcting it.  It might only take three months.  But it might take a year.  There i just no telling until you get into it.  So I feel the best approach is to approach it from the bottom up so you don't get in too deep.

 

I've been through the mill with these drugs.  When symptoms get entrenched they can last a long time.  They are very dangerous drugs.

 

Thanks SG57. That's why I'm hoping to get some Ativan people with this experience. I agree with going slow but how slow? I could do 1% and then wait a week etc. How many cuts should I make before holding? I want to do this once and do it right and put this behind me. If I make a 1% cut when will I feel it? So many questions. :)

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Thanks SG57. That's why I'm hoping to get some Ativan people with this experience. I agree with going slow but how slow? I could do 1% and then wait a week etc. How many cuts should I make before holding? I want to do this once and do it right and put this behind me. If I make a 1% cut when will I feel it? So many questions. :)

 

You body is able to heal a certain amount EACH DAY.  The trick is to find this daily cut AND DON'T EXCEED IT.  This is how slow/fast to go.  It's easy to find this cut.  It's the highest cut that doesn't bring on symptoms.  It makes no sense to cut faster than your body can heal.  Follow the healing down and stay feeling good.

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Thanks SG57. That's why I'm hoping to get some Ativan people with this experience. I agree with going slow but how slow? I could do 1% and then wait a week etc. How many cuts should I make before holding? I want to do this once and do it right and put this behind me. If I make a 1% cut when will I feel it? So many questions. :)

 

You body is able to heal a certain amount EACH DAY.  The trick is to find this daily cut AND DON'T EXCEED IT.  This is how slow/fast to go.  It's easy to find this cut.  It's the highest cut that doesn't bring on symptoms.  It makes no sense to cut faster than your body can heal.  Follow the healing down and stay feeling good.

 

I think I will just cut and hold instead of daily. Seems to be easier from what I'm hearing.

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So a compound pharmacy is making me a suspension. They say they've done many before although never for 0.5mg. They say they get their Lorazepam in powder form already. So what do I get? 0.5mg/100ml? What really is the difference if it was in 50ml? Thanks.
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More volume means more measuring accuracy.  But there is a point where it gets ridiculous and unnecessary.  And I'd say you need less accuracy if you are not going to daily taper.  For daily taper I'd say a solution strength no higher than .01mg/ml would work well for ativan.  Putting .5mg into 50ml is a useful strength.  On a 1ml syringe 1/10th of it would be .001mg.
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More volume means more measuring accuracy.  But there is a point where it gets ridiculous and unnecessary.  And I'd say you need less accuracy if you are not going to daily taper.  For daily taper I'd say a solution strength no higher than .01mg/ml would work well for ativan.  Putting .5mg into 50ml is a useful strength.  On a 1ml syringe 1/10th of it would be .001mg.

 

Great info. Thanks SG!!

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So my liquid suspension will be ready on Monday. It will be 0.5mg/50ml. Now I'm just not convinced on the daily taper. If I do .002 taper per day we're looking at around 250 days. I know time shouldn't be part of the equation but that seems kind of long from where I'm starting from. But what do I know. Is that the average per day most people are doing? Comments from people with past experiences would be greatly appreciated. Thanks.
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I assume this is ativan?  .002mg per day is a great starting point to search for your best cut.

 

Here's how I would go about finding it.  Cut at .002mg for at least two weeks and assess how you feel.  If good, then nudge up to .003 and repeat.  Then .004.  Then .005.  Keep doing this until you find a cut that increases symptoms.  Then back off to the previous cut.  That is your best cut.

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I assume this is ativan?  .002mg per day is a great starting point to search for your best cut.

 

Here's how I would go about finding it.  Cut at .002mg for at least two weeks and assess how you feel.  If good, then nudge up to .003 and repeat.  Then .004.  Then .005.  Keep doing this until you find a cut that increases symptoms.  Then back off to the previous cut.  That is your best cut.

 

So no holding then. Just keep cutting and if all feels good then up it?

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Yes.  If you are at or below your healing rate there should be no increase in symptoms and you would not have a reason to hold.

 

I'd give each level at least a two week test.  And since you are at .5mg ativan I'd expect you will bump into symptoms at a fairly low cut rate because you are already near the lower doses where everyone seems to need to go slow.

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So if they give me a bottle with 5.0mg/500ml would that be the same as 0.5mg/50ml? Cuz I think that's what they did. I was expecting a months supply to be 30 x 0.5mg/50ml bottles.
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Unless I am totally missing how they mark these I would say 5mg/500ml and .5mg/50ml are the same thing.  They are both .01mg/ml solutions.

 

Just guessing, there seems to be a marking convention where they want to use 5mg as the drug amount then the liquid amount is whatever makes it the proper solution strength.  For example with valium they call it 5mg/5ml.  Or maybe they just want to stay away from decimal points if possible.  IDK really, just guessing why they do it this way.

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Well I distinctly told them I wanted 0.5mg/50ml. I was just figuring to get 30 bottles as my month supply. I guess it's the same thing. Just scares me knowing that now there are 10 pills worth  in each bottle instead of just one. It all comes from raw powder she said.

 

So I think I've got the math figured out. If I'm starting with a .002mg reduction per day.

0.50mg divided by .002mg = 250. So 50ml divided by 250 = 0.2ml. So that means on day one I drink 49.8ml and day two I drink 49.6ml and day three I drink 49.4ml and so on. I'll try that for 10-14 days and see what happens.

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I get the same thing.  You have a .01mg/ml solution so each ml contains .01mg.  To cut .002mg that would be .2ml, so day one dose is 49.8ml, day two dose is 49.6, day three 49.4...and so on.

 

Be sure to use long test periods.  Don't cut them short.  A tricky thing about benzos is lag time.  A cut might be too big and cause symptoms, but, depending on your lag time, you may not feel that cut until many days later.  Lag time bit me hard.  Mine was ten days, but I did not realize it was so long so I thought my cut was fine and moved to a bigger one.  Big mistake.  :sick:

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I get the same thing.  You have a .01mg/ml solution so each ml contains .01mg.  To cut .002mg that would be .2ml, so day one dose is 49.8ml, day two dose is 49.6, day three 49.4...and so on.

 

Be sure to use long test periods.  Don't cut them short.  A tricky thing about benzos is lag time.  A cut might be too big and cause symptoms, but, depending on your lag time, you may not feel that cut until many days later.  Lag time bit me hard.  Mine was ten days, but I did not realize it was so long so I thought my cut was fine and moved to a bigger one.  Big mistake.  :sick:

 

So I should do .002 for like 14 days?

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To be safe and cover your bases I would do at least 14 days.  This amount of time will cover just about everyone.  Your lag might be many days shorter, but it can be tricky so unless you know it cold I'd assume it is very long.  As you taper you might learn to recognize your symptoms lag.  Then you could shorten the test period.
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  • 2 weeks later...
So just to update. I switched over to the liquid on Saturday (17th). I remained at my stabilizing dose. 0.166mg x 3. That in itself was a bit of a cut because before I knew the tablet was 0.5mg so I knew I was getting that even though one of the 3 does may have been 0.167 etc. But with the liquid 0.166 x 3 = 0.498mg. I did that for 4 days. On the fourth day I felt a little off but didn't think anything of it. On day 5 (Wed) I tapered down to 0.496mg. Didn't feel great. Day 6 (Thurs) I tapered down to 0.494mg. Had trouble sleeping and then woke around 4AM with the sweats and legs and arms feeling like needles. So today I had another 0.002mg cut scheduled but I decided to hold and do another 0.494mg. Now is this what I should be feeling? I thought with this low of cuts I wouldn't get symptoms like that. Did I not give the liquid enough days to stabilize? I'm not sure what to think anymore. I just know that if I'm going to do daily cuts and have to feel like that something must be wrong. So that's where I'm at. Going to hold this for a day or so and see if I feel better.
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I'd be very surprised if what you are feeling is from that small a cut at your dose, but this is why we start low.

 

Rule #1 is never allow symptoms to increase, and yours are, so I would hold until you get this sorted out.

 

Could it be interdose?  Do you need to dose more often?

 

Could it be the liquid is just weaker or not absorbed as well and you have just started to feel it?  This often happens with a change of delivery method or product.

 

Could it be something else?

 

I'm thinking since you felt a bit off just by switching to liquid that the liquid is not as strong as the pill.  It is a different product and may not be delivering .5mg as advertised.

 

For example, if it is off by 5% to the low side you would have actually switched to .475mg.  That would have been a cut of .025mg.  Definitely enough to feel!

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I'd be very surprised if what you are feeling is from that small a cut at your dose, but this is why we start low.

 

Rule #1 is never allow symptoms to increase, and yours are, so I would hold until you get this sorted out.

 

Could it be interdose?  Do you need to dose more often?

 

Could it be the liquid is just weaker or not absorbed as well and you have just started to feel it?  This often happens with a change of delivery method or product.

 

Could it be something else?

 

I'm thinking since you felt a bit off just by switching to liquid that the liquid is not as strong as the pill.  It is a different product and may not be delivering .5mg as advertised.

 

For example, if it is off by 5% to the low side you would have actually switched to .475mg.  That would have been a cut of .025mg.  Definitely enough to feel!

 

I was thinking interdose as well but there's not a pattern where closer to dose time I'm craving it. Sometimes it's the opposite. When it's close to dose time I feel fine. Like when I woke up at 4am and felt the legs and arms needles. I did not feel that as much when I actually fully got out of bed a few hours later. I'm thinking it must be the liquid too. That would really suck. So I guess just keep holding until I feel better is what I should do.

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If it was the liquid the thing to do would be go up to the right dose and hold to give you the actual .5mg you should have gotten.  But we don't know how much it might have been off.  You could guess say a few percent maybe 3%?  IDK just a guess.  That would mean go up to .515mg.

 

Or you could just ride it out if you don't feel too bad.  Sucks to get off on the wrong foot.  This is common when changing products.

 

Good sign that you have no problem making it to dose time.  I always worry about this with ativan.  Three a day for ativan is great!

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If it was the liquid the thing to do would be go up to the right dose and hold to give you the actual .5mg you should have gotten.  But we don't know how much it might have been off.  You could guess say a few percent maybe 3%?  IDK just a guess.  That would mean go up to .515mg.

 

Or you could just ride it out if you don't feel too bad.  Sucks to get off on the wrong foot.  This is common when changing products.

 

Good sign that you have no problem making it to dose time.  I always worry about this with ativan.  Three a day for ativan is great!

 

Ya I'm not sure I want to start guessing what's going on with the liquid. I know my math and the separating of the liquid is bang on. Probably best to ride it out and hope I feel better. I just pray when I go back for next months batch its consistent.

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