WHAT TO DO WHEN YOU HIT TOLERANCE ??

been on ativan for over 6 years now i very sure i hit tolerance because i am having withdrawal symptoms  almost every day now and its not intermittent withdrawal symptoms either because i dose ever 4 hours all around the clock i am at 1.625mg in  a 24 hour span my prescription is only for 1.5mg a day . i do not know what to do ??

 

i would have to go see my pcp for more and that is a tall order because of the agoraphobia i have its very bad i rarely leave the house  if i start tapering i feel like it might be a bad idea because i am not that stable i am some what stable and the long journey ahead terrifies me with all the story's i have read !!!  my symptoms right now are headaches  burning skin sensation in random places  dizziness  light headedness  and insomnia of and on  i could really use some good advice ive tapered before in 2014 under doctors supervision  it was a very fast taper i was on 1.5mg a day and he had me cutting 0.25mg every 10 days i got all they way down to the last cut 0.25mg daily but only lasted 1 day at that does because all hell broke loose

been on ativan for over 6 years now i very sure i hit tolerance because i am having withdrawal symptoms 

 

Then that is NOT "tolerance"!

 

What your describing is what BB calls tolerance withdrawal  or alternately relative withdrawal.

 

Tolerance is a normal, benign condition that is simply the body's response to the continuing presence of a substance or stimulus.  Its the declining effect of the med.  It causes no sxs, except the sxs of the original condition may return.

 

And FWIW, there doesn't seem to be any published research or info on "tolerance withdrawal" anywhere except on BB, or similar message board.

Builder

 

Can you expand on your withdrawl you went through. It looks like you went really fast. How tolerable was it?  I am so scared and would love to hear more success stories.

Builder

 

Can you expand on your withdrawl you went through. It looks like you went really fast. How tolerable was it?  I am so scared and would love to hear more success stories.

 

2 years to taper off of 9mgs is fast?? 

 

I wasn't scared of coming off of benzos, I was afraid of staying on benzos!

 

When you are benzo- dependent, and you begin to take less, your body will gradually adjust to the new dosage.  So instead of making a big cut, then holding (and suffering!) for days or weeks, you just make a tiny cut each day, so your body only has to make a tiny adjustment.

2 years is a long time. It just seems short to me because i have so much further to go. I did not mean to minimize what you went through. I know it was a struggle.

Also builder. Did you do the DLMT for your entire 9mg?

 

Thanks!

Also builder. Did you do the DLMT for your entire 9mg?

 

Thanks!

 

Yes.

 

My peak dosage was 15mg and I did a C&H starting at 15mg.  It was miserable until I got down to9, then it was intolerable.

 

Once I stared DLMT, I only had occasional, manageable sxs (sleep issues, headache, etc)  But I was always fully functional, able to work, socialize, etc.

Hi Builder,

 

I'm jumping in on the conversation above with PowerPearl about rates of withdrawal.  Of course I know it is relative to the situation of each person.  So please see this as a conversation and not wanting you to be the expert who gives a concrete answer. 

 

It seems according to what I have read here on BB that Ativan is roughly equivalent to 10 Diazepam.

You say it took two years to go off 9mgs of Diazepam.

 

I have tapered down to 3mg. of Ativan (30 Diazepam equivalency).  I would like to attempt to taper (DMLT) at a rate of .25 per 30 days.  This is a medium rate between what I tapered initially and what I have tapered in the last three months.  I have really slowed down these past three months to become more stable, more functional on a daily basis and in general feeling better.  (I am wondering if the earlier fast months of "cut and hold" caught up with me).

 

I know everyone is different and we all need to listen to our bodies and symptoms. 

 

My question for you is, based on what you have seen on these forums and your opinion if you think I could attempt DLMT @ .25 per 30 days?  This would turn out to be a 16 month taper total if I was able to be successful.  I know you can't say for sure.  Of course if I have to accept a longer taper, I will do it and wonder if it might take me longer to taper the last 1 mg.

 

My only symptoms have been much less energy than I am used to having as I have always been strong, healthy and athletic my whole life.  Now instead of climbing mountains, I have to settle for one or two hour hikes so I don't get exercise fatigue.  I usually need to rest every afternoon and evening.  And some days (although not for the past two weeks), I have had nausea and vomiting for a couple days each week which is my worst symptom.  On those days, I am pretty much house bound. 

 

Anyway,  I appreciate your opinion even though I know its a hypothetical question.  I'm not trying to put you on the spot to give me a definite answer as I know the process will tell me what I need to do.  Maybe I already know your answer.  But at least do you think its worth trying a .25 per 30 day rate?

 

I so appreciate your presence and all the help you give people here.

 

Thank you!

 

Luey

 

 

 

 

 

 

 

 

 

My question, is do 

You can start a DLMT anytime, at any dose, on any benzo.

 

A taper rate must be proportional to the current dose.  At 15mg, I could make bigger cuts (in mgs) than I could at 10mg.  Overall, I learned that about 5-6 % per 2 weeks was about all I could handle.  Even while doing C&H, my worst periods was any ttime my cut rate approached 6%/14 days.

 

So what I suggest is you need to think of your cut rate as a percentage of your current dose, NOT a fixed mg number.

 

If your at 3mg, and cut .25mg/30 days, thats sbout 8% per month.  And by almost any standard, that's a pretty conservative.  But when you get down to 2 mg. its 12.5% per month, and when you down to 1mg, it's 25% per month  This is why so many folks say it gets harder as you go down.  It really doesn't get harder, its just the relative (percentage) size of the cut has gotten much bigger.

 

And with reference to PowerPearl's situation, yes it will probably take her longer to come from 20 than it did me to come from 9, but it won't take twice as long.  If she does  a 5%/14 day plan, then she will start out at 1mg per 2 weeks.  But by the time she is down to 10mg, the will very likely have had to make adjustments to the taper rate (measured in mgs)

 

If you've ever looked at the many taper plans I post for folks here on BB, the first step is always to apply a percentage to the currrent dose, then divide that number by days to arrive at a  milligram reduction-per-day.

Thanks Builder,

 

That is very helpful about figuring out percentages per amount of time.

 

To clarify, since 1 mg. of Ativan is roughly equivalent to 10 mg. of Diazepam, do you think that would that affect the taper rate?

 

With gratitude,

 

Luey

Thanks Builder,

 

That is very helpful about figuring out percentages per amount of time.

 

To clarify, since 1 mg. of Ativan is roughly equivalent to 10 mg. of Diazepam, do you think that would that affect the taper rate?

 

With gratitude,

 

Luey

 

Not as long as you make a plan by proportion (percentage)

 

If 1mg of ativan = 10mg of diazepam, then a .1mg ativan cut would be the same as a 1mg diazepam cut.

 

3mg of ativan will equal 30mg diazepam.  So a .25mg reduction from ativan would be the same as a 2.5mg  diazepam cut.  They would both be 8%

Thanks Builder,

 

Based on what you are saying, I am going to start DLMT at a 5% rate every 14 days and see how that goes, lowering the percentage if I need to because of symptoms.  You have given me all the calculations to figure that out.  I am not a math person so your I very much appreciate your help.

 

Wishing you a good evening,

 

Luey

Builder,

 

Thank you for your input I am so sorry.  My brain is not working right.  I want to clarify what you are saying. Lets say I decide my first cut is going to be 5% and I go from 20 to 19 mg.  When I make my next cut do I change the formula and do 5% of 19mg making it 18.05? And then after that 5% of 18.05? and so on and so forth?

 

Does that make sense?

Builder,

 

Thank you for your input I am so sorry.  My brain is not working right.  I want to clarify what you are saying. Lets say I decide my first cut is going to be 5% and I go from 20 to 19 mg.  When I make my next cut do I change the formula and do 5% of 19mg making it 18.05? And then after that 5% of 18.05? and so on and so forth?

 

Does that make sense?

 

IMO, I would stay at the same cut rate (mgs) as long as it was working.  That's what I did.  I only made changes to my cut rate if I felt sxs emerging.

 

You can recalculate at specific milestones if you prefer.  For most folks, it just adds a little unnecessary complexity, and adds to the time required to finish the taper.

 

But you can it.

Thank you thank you for your guidance and positivity.  This is such a struggle to navigate and I really appreciate your input.

Luey, i , too, am on 3 mg of ativan.  well, now i am on 2.75.  having a hard time of it, i am on day 20. i am an old lady.  i also kindled myself 4 years ago, so, it's extra hard.  what does DMLT mean, please? 

    what does DMLT mean, please?

 

Daily Liquid MicroTaper

my doc won't give me liquid ativing. no way.

my doc won't give me liquid ativing. no way.

 

So make your own.  That's what most folks do anyway.

 

1mg A: 2ml vodka or propylene glycol : 8ml water.  That's a .1mg=1ml solution, and you can easily prepare in 10-12 day batches and just extract and drink the appropriate dose each day.