Doctor switched from Xanax to Ativan - having trouble

Hi. I was being treated with 1mg of Xanax (taken 3-5x daily) for the past 3.5 years. About a month ago, my doctor (a new doc as I have moved) switched me “cold turkey” to 1mg Ativan 3-4 times a day. I’m having tremors in my legs at night, insomnia, teeth grinding that is waking my partner up, anxiety, depression, sensitivity to sound, etc.

I went  to the ER after she prescribed an SSRI that gave me bad anxiety and disturbing thoughts last month; then she tried hydroxyzine to help with the  insomnia; and now she prescribed me a drug used for RLS/Parkinson’s patients to help with tremors. I haven’t taken the last one.

I just need to taper off Xanax by using it at night and then  Ativan during the day. Eventually, I’d like to only use Ativan as maintenance.

I have an appointment with her Wednesday and I’ve been taking So much Ativan (like 8 a day) and I know she’s going to wonder WTF but tbh I had to take it and it’s cruel to cut someone cold turkey like that. Especially since i juuuust moved to my current state (I have agoraphobia, GAD, panic disorder).

What are your thoughts? Thank you

Hi Sarahawaii,

First off, I'm so sorry that you are dealing with this. This is obviously a difficult situation.

Many doctors are not very well versed in benzo withdrawal. Switching from one benzo to another is an art and requires a transition period, changing abruptly, as you know, could be very difficult.

I've had a doctor try to get me on an SSRI for the withdrawal, but I politely declined. If you have a legitimate need for an SSRI, that's one thing, but for many... an SSRI is just another difficult drug that requires a complicated tapering process. If you think you can and your doctor agrees, I highly recommend not going down the SSRI route.

Hydroxizine is an H1 histamine receptor inverse agonist, meaning, it acts in a similar way that Benadryl (diphenhydramine HCL) or Doxylamine Succinate work.

How is the hydroxizine treating you? Is it helping you with sleep? In my case, H1 histamine related drugs seem to work well without causing additonal withdrawal symptoms.

Xanax and Ativan are difficult meds due to their short half lives (meaning, higher likelyhood of interdose withdrawal).  Is your overall goal to be benzo free or is it to simply stabilize on Ativan? My thoughts on this would be to pick one, stabilize on it and then make a game plan. I also highly recommend you find a way, if that's what you want, to very slowly and carefully taper your doses down over a long period of time.

Bottom line, you'll be fine so long as you make a plan and stick to it. You will get through this!

I wish you the best of luck with your doctors appointment. If you have any questions feel free to ask.

According to an Android app I have (Benzodiazepine calculator), if you are taking 5mg Xanax daily, that is equivalent to 10mg Ativan. I was taking .5mg Xanax for only 3 months not understanding the consequences of this drug. It took 3 months to get off that; withdrawals were horrible.

You are correct IMO it really is cruel for your doctor to basically cut you off the xanax.

Every person's chemical makeup is different. I know someone that was taking clonazepam for a long time, went cold turkey and didn't have any withdrawals. My wife was on Ativan and quit it twice with no or little withdrawals.

My doctor sent me to a psychiatrist to get off clonazepam. His solution was to work me up on Zoloft to 100mg daily. After just 50mg my body rejected it and I had to stop.

Lately I've been testing L-Theanine 200mg 2x daily. It definitely has a calming effect and so far it looks promising to help me kick the benzo habit. I take it with a teaspoon or less of coconut oil to increase absorbability.

I plan to dissolve the clonazepam in whole milk and taper off that way. It is very accurate and by taking it 4x daily it helps keep a steady flow of the drug in the body. Makes sense to me anyway as I'm very sensitive to changes in medication.

Good luck.