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Hit a brick wall finishing Lorazepam taper-substitute w/Valium?


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I've been on Lorazepam now for 28 months with a dose as high as 2 1/2 mg to now at 3/8 mg (3 x a day) in a gradual taper over 6 months, but I've hit a wall. I have had intra-dosing withdrawal right along except at the highest levels and when I was on a 5x a day regimen further along in the taper (which was a huge pain as I work full time). With advice from my PCP and psych dr, I just tried cold turkey and it was TERRIBLE! I am very sensitive to any drug at all. So I meet w/my psych again on Jan 3rd and I'm going to ask about Valium substitution, but I don't want to go direct even at my low level of Loraz. I want to gradually wean off Loraz and then taper off the Valium. Any suggestions on a Lorazepam/Valium "bridge" taper schedule?
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Hello-

 

So you are @ 1 1/8 mg of lorazapam! That would be the equivalent to 11.25 mg of Valium

 

https://www.benzo.org.uk/bzequiv.htm

 

How much Valium do you plan on taking with the lorazapam? This info is needed tohelp figure out an optimal "bridge" taper plan.

 

btw, 1 1/8mg of Lorazapam is not really "a low level" of benzo. That is more than likely why you felt so "terrible" 

 

 

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Hi-I need to clarify. When I tried cold turkey I was on 3/8 total meaning 1/8 mg 3 times a day. Since I had terrible symptoms and our two sons and their families were coming for the holiday, I ended up going up to 1/2 mg three times a day for a total of 1.5 mg. I’ve been doing this for 12 days. Went to my psych yesterday and showed him the Ashton method and while he gave me a script for Diazepam, he really didn’t have a schedule suggestion for me and felt her Diaz levels were too high. So I stopped and had a consult with our young pharmacist who has excellent creds. He suggested I start today with 2 mg Diaz in the morning, 1/2 Lorazepam midday, and 2 mgs Diaz at dinner. I am very sensitive to any drug, so that’s why he went with 2 mgs Diaz. I felt ok this morning but then before and after the dinner 2 mg Diaz, I had w-drawal symptoms. Now at 11 p.m. I feel ok. The pharmacist suggested I do this for a week, then cut the noon dose of Loraz to 1/4 for another week; then the next week cut the noon Loraz to 1/8 and the week after end up with a morning dose of 2 mg Diaz and evening of 2 mg Diaz. My issue: isn’t this too

quick on the Loraz reduction? I’ve read a lot and wonder if I should just introduce the Diaz for 1 of the daily 3 doses each week. I’m also not sure if 2 mg Diaz is enough when .5 Loraz=5 Diaz. Can you please advise because of all your experience?

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Hi-I need to clarify. When I tried cold turkey I was on 3/8 total meaning 1/8 mg 3 times a day. Since I had terrible symptoms and our two sons and their families were coming for the holiday, I ended up going up to 1/2 mg three times a day for a total of 1.5 mg. I’ve been doing this for 12 days. Went to my psych yesterday and showed him the Ashton method and while he gave me a script for Diazepam, he really didn’t have a schedule suggestion for me and felt her Diaz levels were too high. So I stopped and had a consult with our young pharmacist who has excellent creds. He suggested I start today with 2 mg Diaz in the morning, 1/2 Lorazepam midday, and 2 mgs Diaz at dinner. I am very sensitive to any drug, so that’s why he went with 2 mgs Diaz. I felt ok this morning but then before and after the dinner 2 mg Diaz, I had w-drawal symptoms. Now at 11 p.m. I feel ok. The pharmacist suggested I do this for a week, then cut the noon dose of Loraz to 1/4 for another week; then the next week cut the noon Loraz to 1/8 and the week after end up with a morning dose of 2 mg Diaz and evening of 2 mg Diaz. My issue: isn’t this too

quick on the Loraz reduction? I’ve read a lot and wonder if I should just introduce the Diaz for 1 of the daily 3 doses each week. I’m also not sure if 2 mg Diaz is enough when .5 Loraz=5 Diaz. Can you please advise because of all your experience?

 

ok, got it...so you started out @ 3/8mg lorazapam total, went up to 1 1/2mg total for 12 days then started crossover 2mg Valium am + 1/2mg Lorazapam noon + 2mg Valium pm

 

I see a couple of issues for you to consider:

 

1) Cold turkey then re-instate then going up then down then up & down (yoyo) has the potential to cause the inter dose condition you describe. Try not to do this anymore. It could cause kindling issues as well.

 

2) 1mg Lorazapam=10mg Valium. The 4mg of Valium does not even cover the .5mg of lorazapam.

 

I would suggest try adding 2mg of Valium to the .5mg noon dose of Lorazapam. Wait 2 weeks or until you feel stable. After you stabilize & feel comfortable with the crossover, then start reducing the lorazapam @ the suggested rate of 5% to 10% every 10-14 days. Doing a methodical, symptom based taper will make this whole process a smooth transition. 10% is 1/10 not 1/4. Too fast =  symptoms. Once off the lorazapam then start reducing the Valium at the suggested rate of 5% or 10% every 10-14 days  :thumbsup:

 

Good luck!

 

Wishing you a smooth & quick recovery!

 

 

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You are the best! I was so hoping to hear from you soon and I did. So let me get this right. Caveat-this morning I increased the morning dose of Valium to 2.5 mg because I felt it was too low.

 

So do I hear you suggesting the following if I keep this 2.5 of Valium:

 

2.5 Valium in the morning; 1/2 Lorazepam + 2.5 Valium noon; and 2.5 Valium in the evening. Keep on this until I feel stable?

 

Am I ok going from that 1.5 Lorazepam for two weeks down to 1/2 Lorazepam because I had reduced to a total of 3/8 Lorazepam for quite a while before-like a month.

 

And btw, what is kindling-other than small pieces of wood for a fire?

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You are the best! I was so hoping to hear from you soon and I did. So let me get this right. Caveat-this morning I increased the morning dose of Valium to 2.5 mg because I felt it was too low.

 

So do I hear you suggesting the following if I keep this 2.5 of Valium:

 

2.5 Valium in the morning; 1/2 Lorazepam + 2.5 Valium noon; and 2.5 Valium in the evening. Keep on this until I feel stable?

 

Am I ok going from that 1.5 Lorazepam for two weeks down to 1/2 Lorazepam because I had reduced to a total of 3/8 Lorazepam for quite a while before-like a month.

 

And btw, what is kindling-other than small pieces of wood for a fire?

 

:laugh:

 

"Kindling due to substance withdrawal refers to the neurological condition which results from repeated withdrawal episodes from sedative–hypnotic drugs such as alcohol and benzodiazepines. Each withdrawal leads to more severe withdrawal symptoms than the previous withdrawal syndrome. Individuals who have had more withdrawal episodes are at an increased risk of very severe withdrawal symptoms, up to and including seizures, and death. Withdrawal from GABAergic-acting sedative–hypnotic drugs causes acute GABA underactivity as well as glutamate overactivity, which can lead to sensitization and hyper-excitability of the central nervous system, excito-neurotoxicity, and increasingly profound neuroadaptions."

 

https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hypnotic_withdrawal)

 

"2.5 Valium in the morning; 1/2 Lorazepam + 2.5 Valium noon; and 2.5 Valium in the evening. Keep on this until I feel stable?"

 

:thumbsup: this looks good!

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Yes, exactly what Bella Amis said. Going from 2.5mg Lorazepam a day to 1.125mg Lorazepam a day is a huge dose reduction It is more thatn a 50% cut, so no wonder you hit a wall. Lorazepam is a particularly nasty benzo to stop taking because it hits the brain receptors pretty hard and leaves very fast. It causes an array of very bizarre withdrawal effects. I think that there are a couple of benzos that may be worse than Lorazepam, but Lorazepam doesn't have a horrible reputation outside of these circles, and many have suffered greatly from it, being convinced that it is one of the safer benzodiazepines out there. Ironically, it is one of the most dangerous.

 

Oh, and you want to be really careful with that last .5mg of Lorazepam, because the last part is by far the hardest of them all.....

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I have ciguatera which is toxic fish poisoning. About 50,000 people get it a year though it is under-reported. I've had it for 9 years with 3-4 outbreaks which cause lots of itching and pins and needles. I was on Ativan as needed for about 2 years before and after our middle son died of Brain cancer in 2007 but I just stopped taking it as it wasn't regular. In August of 2015, I had a relapse with lots of itching and pins and needles. My regular doc was on vacation so another doc in the practice prescribed Lorazepam to tamp down the ciguatera symptoms. Long story short since then I started with 1/2 mg a day and am now up to 2 1/4 mg a day. My energy is low and I have painful chest tightness and back pain and I swear the Lorazepam causes itching which I'm taking it to get rid of. I want to get off because I've read it can exacerbate dementia. I am now finishing one week of every other day reducing by 1/8th but I still think I'm getting more muscle aches when I exercise (but ciguatera can cause that too), though not insomnia thank God. I do go to a psychologist and he's not gung ho on me getting off. Would I better off asking him to guide me in the Ashton method or just stick with the slow reduction?

 

And this is all related to sedative-hypnotic kindling and repeated withdrawals. The occasional use in 2007 might not have been too bad, but due to how Lorazepam works, if the doses are not taken far apart (a month or two between the 2 doses), it can cause problems (happened to me). Also, a repeated exposure in 2015 may have worsened things because the body has remembered the first exposure to Lorazepam. It may have not been significant, but it can make things worse the 2nd time around.

 

My history with Lorazepam was as needed dosing with short amounts of time of daily doses followed by not taking it and more occasional doses and then daily doses, and then trying to come off of it for good and not being able to and settling on a maintenance weekly dosing, which resulted in daily use, which resulted in having to stabilize on 2.5mg Lorazepam a day. However, I tried to get off of it quickly, was greeted with tremors and electric shocks, scared myself silly and found myself in a very unstable taper. So, I would suggest going down smoothly and not trying to take any shortcuts. Our bodies cannot take this med as needed anymore like we used to, and it is a completely different situation now. I never knew what being controlled by a substance really meant until I met Lorazepam.....

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Actually I had spent 6 months going from 2 1/2 mgs of Lorazepam a day all the way down to 3/8 mg total a day in early Dec. However, I hit a brick wall then. Christmas was around the corner-my children and grandchildren were all coming from afar for 10 days, so my PCP suggested I go cold turkey. Not good! Tried to go back up to 3/8 but no success, then 1 and finally 1.5 Loraz for 12 days. Yesterday, based on my pharmacist consult because my Psych wasn’t much help yesterday, I went to 2 mg Valium a.m. 1/2 Loraz at noon and 2 mgs Valium at 6 p.m. However, I am now listening to Bella Amis and today I Have taken 2.5 Val a.m., 1/2 Loraz noon with 2.5 Val, and then 2.5 Val at dinner. I have to stop the “yo-yo” as Bella said. I’m going to stick to this regimen for 2 weeks or longer until I am stable. “Maybe” because I got down so low on Loraz in the 6 months and just has 12 days at 1 1/2 total Loraz a day, my body will settle down. I know that reducing that noon 1/2 mg of Loraz will take time and tiration. However, getting over to Valium is the first order of business. Then I’ll spend as long as it takes to SLOWLY decrease Valium. Thanks for your thoughts. It is soooo helpful hearing from others.
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Hi Bella-I do feel a bit better today and it’s just the first day. I have a sense that it’s the Valium sort of beating back the Lorazepam withdrawal. I still have itching and chest pressure mid-morning and a couple of hours before the 6:00 dose. Had to take an antihistamine and 400 Advil which together help the itching. I have the itching now at 10:40 p.m. Sometimes just the Advil will do it.  I’ve read that it takes a while for the Valium to get into your system-is that your thinking? And while I will NEVER go up on the Loraz, I wonder if the 7.5 total I’m taking now of the Valium is enough. I certainly do not want to feel sedated and I don’t right now and I want to stay active and work. And I bet it’s too soon to tell if indeed it takes a while for the Valium to penetrate the B.B. Also, I want to be aware of doing things step-by-step and not yo-yo. Last night I had to take 15mg of Melatonin and 400 mgs of ibuprofen to tamp everything down to sleep, but that’s not new as it was on and off during my Loraz 6 month taper when I was dosing 5 x a day, then reduced the number of times and then the dose itself in the next round and so on. It was very rigid and planned out and I kept a printed schedule taped to my bathroom mirror. But then I didn’t dare switch to Valium when I got to 3/8 total Loraz a day and went up to that 1.5 for 12 days and here we are. But you have been so much help. Btw, when I come to it down the long road, do you recommend tiration for the tiny doses and is there a “kit” for that. Any other suggestions at this stage for me?
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Hi gcal-

 

The rule of thumb on "enough" is that if whatever symptoms you are experiencing are tolerable, then you have reached the ideal level.

 

You probably would not want to add any more to your taper than absolutely necessary.

 

There are different options for titration. Read through the posts on the forum in the different support groups to help you figure out what method sounds best for you. Being well informed will help make this process go smoother.

 

Good luck with your taper!

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Yes, I would be careful about adding 15mg Melatonin to sleep. Diazepam is a hypnotic and should help sleep, so if 15mg Melatonin is needed, it is possible that Lorazepam is leaving the body much more quickly than Diazepam is building up. This could result in some profound insomnia for a while until stable. Too much melatonin may worsen depression, also....
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Having a terrible time trying the recommended 2.5 Valium a.m.; 1/2 Lorazepam + 2.5 Valium noon; 2.5 Valium p.m. Been trying for 5 days:terrible  itching, stomach upset, headaches, pins and needles causing plenty of antihistamines and ibuprofen to counteract the symptoms.

 

Should I power through to get stable or go back up to 1/4 Lorazepam 5x a day to get stable and then reduce gradually over weeks and months? My history showed I did that over 6 months last year but went too fast for the last 3/8 of Lorazepam? Or should I take on the Ashton method where I am at this stage which would have me taking 1/4mg Loraz w/ 2.5 Valium morning, noon, and night and then follow her schedule from there ? HELP!

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Hello cgal...

 

It can be so difficult to try to give sound advice to anyone who is struggling with those awful symptoms

because what may have worked for me may not necessarily work for you.  :-\

 

If it was me I would go up to a dose where I get relief. Once/if I experience relief, I would then begin a slow methodical taper paying close attention to how I feel before moving forward with taper. I can only tell you what I would do because I am not a doctor. Sad to say, there is a possibility that you wont get much if any relief. You can only try.

 

I am so sorry that you are struggling. Try to stay positive & keep yourself distracted from awful symptoms anyway you can.

 

:smitten:

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  • 1 month later...

As of 3-5-18 I am off Lorazepam. How did I do it? By finding a really good doc-a psycho-pharmacologist who specializes in just benzo, opioid, and alcohol withdrawal. Recommended by one of my brothers whose daughter has been fighting opioid addiction and this doc is the first to really help her. Only two of these kinds of docs within 100 miles of where I live and they are both private pay and worth every penny.

 

I started on 1-19-18 with three doses-7 a.m., 2 p.m. and 9 p.m. .25mg Lorazepam with 3mg Diazepam and gradually followed his reduction plan. And I was able to sleep at night because of the Diazepam throughout the whole time. So March 5th was my first day with no Lorazepam.

 

It's March 6th now and I'm just on 3mg Diazepam three times a day for this week. I am having some w/d symptoms like chest pressure and a little bit of insomnia as my body is saying "What? Where is that .125 (1/8th a day of Lorazepam?" but I expected that. I'm just going to stabilize on the 9mgs daily of Diazepam this week and if I feel ok, try the .05 cut of the midday dose of Diazepam starting next week. My doc says dose cuts should start with the midday one, then morning, and finally night. But he also says take your time so if it takes more than a week to stabilize, so be it. I have also upped my physical activity. I already walked about 10 miles a week and golfed on weekends with my husband. I have added yoga a couple of times a week and that has been great.

 

I had a 1 1/2 hour office visit with him on 1-18-18, then since we are away for two months, a 30 min video con on Feb 15 and another 30 min video con coming up Mar 19 and finally, when we are back home, an office visit on April 6th. It is so comforting to have such professional guidance.

 

This still is not easy by any means, but I am making progress!

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As of 3-5-18 I am off Lorazepam. How did I do it? By finding a really good doc-a psycho-pharmacologist who specializes in just benzo, opioid, and alcohol withdrawal. Recommended by one of my brothers whose daughter has been fighting opioid addiction and this doc is the first to really help her. Only two of these kinds of docs within 100 miles of where I live and they are both private pay and worth every penny.

 

I started on 1-19-18 with three doses-7 a.m., 2 p.m. and 9 p.m. .25mg Lorazepam with 3mg Diazepam and gradually followed his reduction plan. And I was able to sleep at night because of the Diazepam throughout the whole time. So March 5th was my first day with no Lorazepam.

 

It's March 6th now and I'm just on 3mg Diazepam three times a day for this week. I am having some w/d symptoms like chest pressure and a little bit of insomnia as my body is saying "What? Where is that .125 (1/8th a day of Lorazepam?" but I expected that. I'm just going to stabilize on the 9mgs daily of Diazepam this week and if I feel ok, try the .05 cut of the midday dose of Diazepam starting next week. My doc says dose cuts should start with the midday one, then morning, and finally night. But he also says take your time so if it takes more than a week to stabilize, so be it. I have also upped my physical activity. I already walked about 10 miles a week and golfed on weekends with my husband. I have added yoga a couple of times a week and that has been great.

 

I had a 1 1/2 hour office visit with him on 1-18-18, then since we are away for two months, a 30 min video con on Feb 15 and another 30 min video con coming up Mar 19 and finally, when we are back home, an office visit on April 6th. It is so comforting to have such professional guidance.

 

This still is not easy by any means, but I am making progress!

 

Hey gcal!

 

CONGRATS on being off the lorazapam! :yippee:

 

Sounds like you have a GREAT start with your crossover /taper! I am glad you found a doctor to help you with your taper. Remember to be mindful to how you feel & do symptom based cuts accordingly. Due to the long half life of Valium the cut symptoms can creep up on one weeks after a cut. So it really is important to pay attention to how you feel prior to cutting  :thumbsup:

 

Keep up the good work! :smitten:

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Thanks for the tip about the delayed w/d symptoms of Valium cuts. Very good to know and will mention to my doc.

 

I’ll keep posting at intervals and always, always look for your views because man oh man after so many years on a high dose of Valium, you have a lot of insight and a lot of courage IMHO.

 

Right now I’ve only been on the Valium for a bit less than 2 months so hopefully things won’t be too bad. I expect a definite body reaction when I’m off the Valium and “Benzo free”. Benzo free is probably a bit of a misnomer since I know my body will take some real time to adjust, plus I still have Ciguatera and it’s expected flare ups.

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Thanks for the tip about the delayed w/d symptoms of Valium cuts. Very good to know and will mention to my doc.

 

I’ll keep posting at intervals and always, always look for your views because man oh man after so many years on a high dose of Valium, you have a lot of insight and a lot of courage IMHO.

 

Right now I’ve only been on the Valium for a bit less than 2 months so hopefully things won’t be too bad. I expect a definite body reaction when I’m off the Valium and “Benzo free”. Benzo free is probably a bit of a misnomer since I know my body will take some real time to adjust, plus I still have Ciguatera and it’s expected flare ups.

 

Keep us updated gcal  :thumbsup:  :smitten:

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