MD prescribed taper plan - lorazepam -> diazepam

Hi Everybody!

Hope you guys are doing well and thank you so much for this amazing support community!

I'm really fortunate my new doctor recognizes the harm benzos do and gave me a taper plan yesterday.  I just started it last night, and definitely feel more groggy this morning than usual, moving from lorazepam to diazepam.  Other than that, I am cautiously hopeful. 

I've been taking 1mg lorazepam at bedtime, for 4 months, without any big issues, but know that's too long from all the research I've done (and read on BB).  So I must begin tapering & stop any benzos entirely.  You guys are an invaluable resource for which I am so grateful!

I want to share my doctor's taper plan with everybody, in hope's it can provide another baseline for those of you unsupported by the medical community.  This is a faster pace than the Ashton Method.  I know we're all different and your mileage may vary, but at least this is a starting point from someone in the medical community who's supportive.  My next appointment is in a month, for us to check progress and readjust if necessary.  He also encouraged me to call his office if I have any problems. 

Here's his prescribed taper plan, moving me directly onto diazepam to get off the lorazepam: 

10mg diazepam nightly for 1 week ->

8mg diazepam nightly for 1 week ->

6mg diazepam nightly for 1 week ->

5mg diazepam nightly for 1 week ->

4mg diazepam nightly for 1 week ->

3mg diazepam nightly for 1 week ->

2.5mg diazepam nightly for 2 weeks ->

2mg diazepam nightly for 2 weeks ->

1mg diazepam nightly for 2 weeks ->

.5mg diazepam nightly for 2 weeks ->

stop.

xo,

sierra7

I think this taper schedule might be a bit too fast too. An example is when you cut 2 mg at once.

Definitely listen to your body and the amount of side effects you're dealing with in order to decide whether you need to slow it down a bit more.

I really appreciate the feedback that this taper plan may be too fast, PerAsperaAdAstra & Hopeforrecovery!  Thank you both for taking the time. 

Yes - I'm staying in the driver's seat and not allowing the medical community to dictate.  From my bad experience, and reading so many of yours, I do not fully trust any of them to know what's right for me.

I'm also thinking, after 2 nights of a complete transition from 1mg lorazepam to 10mg diazepam, that's too radical.  Since my 4 month history is only taking the lorazepam 1x/bedtime, without perceptible interdose withdrawal symptoms, but knowing I need to get off it, I'm kinda unsure if the transition to diazepam is worth going through a bunch of new symptoms (grogginess til noon is the main one, so far).

I may just take the current plan (extend timeframes + even them out) and recalculate the diazepam dosages into lorazepam equivalents (1mg lorazepam = 10mg diazepam).  I've just ordered a jeweler's scale (measures to .001g) to prepare for smaller doses.

Constructive feedback on this approach would be great.

Wishing you the best & thank you!

xo,

sierra7

I wish you a lot of wisdom in order to decide whether or not you will crossover to diazepam.

I always hear that tapering off a benzo with a longer half-life is easier, although several people here taper off of other benzos with a short half-life.

By the way, according to my information one mg of lorazepam equals 5 mg of diazepam. This might shorten your path to 0 mg... How did your MD come up with 10 mg?

Thank you!  I need all the wisdom the universe will grant me! 

According to Ashton, 1mg lorazepam = 10mg diazepam:  https://www.benzo.org.uk/manual/bzcha01.htm#4

Wow - if it's actually your calculation, that would totally explain the extreme sedation as I'd have been doubling the "equivalent" dose, thinking it was a taper for the last 2 days!

Love to have others chime in as to the correct conversion so I (and others reading) can get this correct.

With gratitude,

sierra7

Hold your horses! I based the conversions on the Dutch pharmacy standards. According to them 1 mg of Lora equals 5 mg of Dia.

But according to Ashton it indeed is 10 mg. So I was wrong, derp! Doesn't the extreme sedation might be caused by the fact that diazepam might be more hypnotic?

I really appreciate the feedback that this taper plan may be too fast, PerAsperaAdAstra & Hopeforrecovery!  Thank you both for taking the time. 

 

Yes - I'm staying in the driver's seat and not allowing the medical community to dictate.  From my bad experience, and reading so many of yours, I do not fully trust any of them to know what's right for me.

 

I'm also thinking, after 2 nights of a complete transition from 1mg lorazepam to 10mg diazepam, that's too radical.  Since my 4 month history is only taking the lorazepam 1x/bedtime, without perceptible interdose withdrawal symptoms, but knowing I need to get off it, I'm kinda unsure if the transition to diazepam is worth going through a bunch of new symptoms (grogginess til noon is the main one, so far).

 

I may just take the current plan (extend timeframes + even them out) and recalculate the diazepam dosages into lorazepam equivalents (1mg lorazepam = 10mg diazepam).  I've just ordered a jeweler's scale (measures to .001g) to prepare for smaller doses.

 

Constructive feedback on this approach would be great.

 

Wishing you the best & thank you!

 

xo,

sierra7

It's a reasonable schedule. Although lorazepam can be a rough drug, you haven't been on it for that long.

Transitioning to diazepam is not for everyone, some people prefer a direct taper. Whichever works. As for fast cuts, diazepam accumulates a lot so in some ways the cuts are not that fast - considering your low dose and short time on the drug.

You might want to consider slowing down a bit at the end, but that's a guess on my part.

Hi liberty -

I appreciate your validation that transitioning to a new benzo is not for everyone & that the initial plan pace is reasonable.  Thank you.  I'm going to rework my plan & incorporate your suggestion of slowing down at the end. 

From reading so many of your experiences & drawing from that wisdom, a taper plan is really general guidelines which may be individually adjusted to one' s circumstances.  It is not set in stone.  I love this approach because it keeps each of us in better control and going at a pace we can best handle.

Maybe for me, staying with 'the devil I know' (lorezepam) and not introducing a new unknown one (diazepam) may work, especially once I get that scale.

When I rework a direct taper plan (general guideline), I'll put it up on the direct taper group for review & feedback.  Wouldn't that be the correct group?

xo,

sierra7

Hi,

  I am tapering from 1mg of lorazepam (ativan) for sleep over many years. Its going well with a liquid micro taper which is so simple to do.....and I mean that! Why not try it. I had a few withdrawal symptoms initially as I dropped .25mgs  but have never slept better than I do now in years and I'm at .630 mgs now . The taper should take about 5 months in all but can be adjusted as suits.

The poster here called "builder" worked it out for me and I have slowed it down while travelling twice so far.

Wishing you all the best....you will make it for sure.

Difference is that sierra7 has been on it for a 'short' time. For some the transitioning from tablet to liquid has been rough. My suggestion is to stick with tablets if possible.

I don't know what's possible locally, if they prescribe 0.5 or 0.25 mg tablets.

I really appreciate all your responses!   

Once I get the .001g scale in a few days, I can begin calculating exact doses by weight.  That'll allow me to use the same 1mg lorazepam tablets I have to taper when I get beyond cutting accuracy. 

Weighing a tablet, then crushing it will make creating any tapering percentage possible.  This seems pretty simple to me & there's a bunch of examples in the forums.

xo,

sierra7