Can someone please help me wean off 8 mg of lorazepam

I please need help in weaning off 8mg of lorazepam.

What help are you looking for?

I want to get off lorazepam.

Have you had a look at the Ashton Manual yet?  Have you determined how you want to do your taper yet (solid, liquid, cut & hold, daily micro-taper)?  Are you thinking of crossing over to a longer-acting benzo (e.g. valium)?

I want to do the cut and hold method.I can’t switch to valium because I don’t do to well on it..

Hi susana

 

While I'm willing to assist you, I realized that you made the same request more than 6 years ago. Does that mean that during all this time you have received no effective help from buddies? Or could you please share why they all failed? Thanks.

 

Hi Jim Hawk.Oh yes I have received effective help from buddies. I have been able to wean off successfully from lorazepam,with the help of the buddies. I have gone back to it because of high anxiety level of pain from two bulging in my lower back,two bulging disc in my neck and arthritis on my neck.

Hi susana

 

This second taper taking place years after the first one will probably turn things more complex. For some reasons with a new successive taper the old dose that used to work might not work anymore. In many cases buddies now find that it's much more difficult to taper because of persistent rough symptoms they likened to "hit a wall". The phenomenon is known under the name of kindling.

 

Nevertheless we can try. Would you like to provide a few information please?

1. What are the reasons why you want to taper?

2. Any withdrawal symptoms you are experiencing?

3. How do you take the current 8mg of lorazepam? How many doses a day? At what time?

4. What is the size of the tablet?

5. Have you started to cut?

6. What was the last successful taper based on? Dry Cut? Liquid Taper? Taper pace (% or mg every number of days)?

7. Any expectations for the new taper duration?

8. How high is the chance that you will have to use again the drug after the (successful) second taper?

 

Thank you.

Hi Jim Hawk.Jim the reason I want to taper is because of the withdrawal symptoms.The withdrawals symptoms I’ve been having are chest pains that scared me,heart palpitations,shakiness,fatigue,anxious,jittery,irrability,forgetful,not much appetite. I take the dosages at 5:00am,11:00pm,5:00pm and at 11:00pm.The size of the tablet is 2mg.No I haven’t started to cut yet.The last successful taper was dry cut.The chance of me using this med.is 0 because this med.has put me and my family through a lot.

Hi susana

 

It appears to me that those withdrawal symptoms occur as your doses of Lorazepam become no longer effective after long years of regular use. It actually lost much of its efficacy although you continue to take your regular doses day after day. Those symptoms suffered by many long-term users are known to be a combination of adverse (side) effects of the drug and withdrawal effects due to "insufficient doses" or called differently "tolerance".

 

When you taper you decrease the daily dose. By decreasing the daily dose you just further contribute to tolerance. Is it reasonable then to expect improvements of symptoms? From a "tolerance" view point it is unlikely that symptoms will diminish with the cuts, they would increase instead. But we have witnessed buddies who tapered while in tolerance withdrawal and for some reasons their symptoms considerably lower along with the taper until they even disappear. There's perhaps something else.

 

Benzo certainly brings its share of therapeutic effects against convulsion, anxiety, insomnia, epilepsy, spasms... Along with those it also brings its fair share of side effects. While we may be hesitant to establish which particular symptoms are withdrawal related and which are side effects, actually not few people find aspects of tolerance to be a positive experience, because various noticeable adverse effects of a drug also diminish in parallele. For example, as the dose decreases they experience less somnolence when taking benzodiazepines, or less insomnia commonly caused by stimulants. The key is therefore to find a taper dose that lowers benzo in a way that withdrawal symptoms still remain manageable while benefiting from reduced adverse effects following reduced drug in your blood stream.

 

Before trying to prepare a taper plan, please provide some information about your last Dry Cut techniques.

1. Did you do a daily micro taper where you cut a tiny quantity of drug on a daily basis? If not, please explain.

2. Did you use a gram scale to weigh out your doses?

3. What was your taper pace? (percent or quantity reduction per period of days)

 

Hi Jim Hawk. I would take a 1mg tablet off lorazepam and cut it in quarters,i would start taking off 1/4 from the morning dosage and stay there in that dosage for one month,then after one month I will take off 1/4 from the afternoon dosage and stay in that dosage for one month,i will continue to do this pattern until i was done with the 1/4 of the evening dosage.

Hi susana

 

By cutting 1/4 of a tablet over 4 tablets per day and holding for one month, the taper pace is 6.25% reduction every month. It is a nice slow taper that is lower than the general recommendations to reduce between 5-10% every 10-14 days. You can in all evidence continue to taper that way.

 

Some points to consider:

- By reducing a fixed quantity (1/4 a tablet) all along the taper process, the lower you go down with your doses, the higher will become the reduction percent. For instance when you are half way off with 2 tablets (4 x 1/2) a day, the same cut will correspond to 12.5 %/month. This is why going forward numerous buddies suffered withdrawal due to fast taper towards the end.

- The 6 hours between 2 successive doses (5:00am, 11:00am, 5:00pm, 11:00pm) can shield you from the inter-dose withdrawal as Lorazepam is known as having short half-life elimination (12 hours) with peak concentration in plasma approximately 2 hours following administration. When after some months you arrive to 4 x 1/4 mg/day and you cut 1/4, one dose will be removed and at some moment the time between two doses will be 12 hours. Higher will be the risk for inter-dose withdrawal. Before that moment arrives, consider to taper the 4 doses altogether by cutting a smaller quantity for each dose so they can extinguish altogether. As you can't split a tablet to 8 equal parts, you may need to do a micro taper with a gram scale or liquid taper.

 

The only point that remains would be to see if the same cut now will provide the same effect as with the first taper. An indicator could be to monitor the symptoms following the cuts. If they remain unchanged after a few days then it is an excellent sign.

 

Wish you a smooth journey towards a full recovery.

 

Hi Jim.Thank you Jim for all the information you have given me,much appreciated.Jim i will like to do the 5-10 percent every 10-14 days,instead of one month,can you please tell me how should i do it with the dosage that I’m taking.Jim the hours between the doses,are they to far apart,if so,can you please give me a schedule off hours to take the doses.Thank you Jim for your good wishes in my journey towards a fully recovery.

Hi Jim Jim can you please help me with this.

Hi susana

 

To be efficient I need to introduce a new complexity in the process. I will try to keep it simple.

 

So far in your taper you have been dry cutting and your reductions deeply depend on your ability to split a 2 mg tablet to 4 equal parts. When you cut a quarter at the beginning it is usually a reasonable cut. The more you advance in the process the more the same quarter assumes an increasingly threatening dimension: it gradually becomes 1/16, 1/8, 1/4, 1/2 of your daily dose. In terms of percent the cut climbs to 6.25%, 12.5%, 25%, 50% of the daily dose. While 6.25%, 12.5% might still be acceptable, 25%, 50% are not as they may be source of rough withdrawal symptoms. What should we do? We micro cut.

 

There a two ways to micro cut (cut tiny quantity) I know of.

1. By reducing a number of tablets to fine powder and weigh out the needed quantity by means of a precision gram scale

2. By transforming tablets to liquid and draw up the volume of solution containing tiny quantity of benzo by means of a syringe. This is also known as Liquid Taper.

 

The first method seems to attract a lot of people because it looks like dry cutting only in smaller proportions. The dark side is that you must buy a gram scale and hope that it works. Actually a number of buddies after having spent about 20 USD on Amazon to buy one  (resolution 0.001 g) had to throw away the device as the displayed digits kept on jumping up and down and never stabilized. Nevertheless many others have successfully completed their taper with the same device.

 

The liquid taper consists of dissolving a number of tablets in solvent to obtain benzo liquid. The final solution will be obtained by adding flat water in controlled quantity to that benzo liquid. By using one or more syringes of different sizes (Ex: 10 ml and 1 ml) taperers draw up each day the needed quantity and swallow it like with any cough syrup. When the solution is finished, another batch must be prepared. It could be prepared for more days (Ex: one week use) to save work. There is nothing like discarded unused solution.

 

As water is not suitable as solvent for its poor dissolution capability, many buddies found difficult to decide what kind of solvent to use. Although alcohol is amongst the most used solvents in the pharmaceutical industries, when buddies hear about alcohol their first reaction would be "is milk ok?". The fat in milk is known to dissolve benzo. When fatty milk transits in the gastrointestinal tract, it will traverse first the acidic stomach environment where it is treated as food in all aspects. Mechanical and chemical work will step in to prepare it before it can go to the small intestine where benzo is targeted to be absorbed. Following those actions in the stomach, when it arrives to the small intestine, benzo has lost an amount knowledgeable people estimate to 5-10% of the initial dose. In worst cases withdrawal would kick in and taperers got the feeling of a cold turkey stop. For some others milk works just fine.

 

In case you want to read more about micro dry cut: http://bzo.spes-lavaux.ch/direct/directHelp.htm?help=Help or Liquid Taper: http://bzo.spes-lavaux.ch/titration/titrationHelp.htm?help=Help

 

I let you decide which one best suits your needs. Based on it we will pass to the scheduling phase.

 

Hi Jim.Jim I wouldn’t want to do the dissolvent solution because I have fatty liver.

Hi susana

 

The taper method I'm going to discuss here is based on a daily micro reduction. You will no longer "Cut and Hold". You are now called to cut a minuscule quantity each day. For that you will need a precision gram scale. One example: https://www.amazon.com/American-Weigh-GEMINI-20-Portable-MilliGram/dp/B0012TDNAM . It must cost you about USD 20.

 

At home, place the scale in a place shielded from air flow, vibrations, temperatures variations. Possibly letave it in the same position throughout the entire taper period. Calibrate it before use with the 2 weights shipped together. You may repeat the same calibration operation every now and then to compensate fluctuations due to environment variations. Do not lean on the table while operating the scale.

 

While we know the quantity of benzo in one tablet (Ex: 2 mg) we do not know how much one tablet exactly weighs. Actually due to manufacturing process, the weight of a tablet varies and is never the same although they may come from a same bottle. This value is needed as we calculate and weigh out the right quantity we will use. We can obtain a fairly accurate value by weighing not one but 10 of them altogether. By dividing then by 10 we obtain an average value that will be accurate enough for our taper. This value can be used until a new bottle is needed.

 

To avoid inter-dose withdrawal, we will try to taper the 4 doses altogether.

 

To smooth out the last 1/3 of the road before jump, where taperers are more sensitive to cuts, the "attenuated ending" parameter adjusts the reduction to 1/3 the initial cut value.

 

Go here: http://benzo.alwaysdata.net/ , select "Direct Taper" and Submit

 

Then enter the folowing parameters:

 

The planning will look like this:

 

where the blue column is the (rounded) quantity measurable by the gram scale that you will weigh out from a bunch of tablets previously reduced to powder, and drink day after day. The grey column next to it is the value before rounding and is for information only. When you see more days with the same blue value, take the same dose again and consider the thing as a hold.

 

Hope you find it useful. If not please ask.

 

Hi Jim.Jim thank you for the taper schedule plan you prepared for me,much appreciated.Jim i need to buy a mortar and pestle to crush the pills,I’m going to order it today. I already have the gemini scale.Jim can you please tell me what are the hours that I’m going to take the doses?

Hi susana 

 

i need to buy a mortar and pestle to crush the pills

It's a facility but not imperative. Some buddies use the back of a spoon on a hard surface and it works too. Keep the powder in a closed dry place.

 

what are the hours that I’m going to take the doses?

The same as now. 4 times a day to minimize inter-dose withdrawal.

 

 

 

 

 

Ok,thank you Jim.

Hi Jim.Jim how long this taper is going to take me?

Hi susana

 

I you generate the report and scroll down to the end you can see the expected date when your taper would complete.

 

I realized that taking the doses like you do now (5:00 AM, 11:00 AM, 5:00 PM, 11:00 PM) is somehow burdensome, especially for the first morning dose. Do you have symptoms during the night that force you to take this early dose?

 

Unless when insomnia, in a number of cases buddies feel that during the night while they sleep symptoms are little felt compared to the daily symptoms. I wonder if it can be your case. If it is then we can perhaps postpone the 5:00 AM to 7:00 AM with little risk of inter-dose withdrawal. The new timing could be for instance: 7:00 AM, 12:00 PM, 5:00 PM, 11:00 PM . It is possible that the 12:00 PM dose collides with lunch. Take the dose 5-10 minutes before lunch to minimize loss of effects.

 

Hi Jim. I think that’s a good timing Jim.Thank you.

Hi Jim.Jim how many pills I’m going to have to crush.

Hi susana

 

As you use 4 tablets per day, the minimum number of tablets to reduce to powder is 4. You can keep on doing it day after day if the operation does not bother you. If it does then you might think to crush 12 tablets for 3 days. Possibly don't prepare more for the preservation would be better when tablets are entire. Keep the powder in a clean small closed jar away from direct sunlight.

 

As you proceed, you will pick up less medication each day. Slowly you will see that the rest in the bottle increases each time. Do not discard.