Brand new at the thought of liquid titration for Ativan

I'm completely confused about all of this talk about liquid titration/weaning for Ativan. I was on a daily dose of 2.25mg that I had weaned down to until last Monday, and doing well,  when I attempted to use the Aston Method by replacing a portion of the Ativan dose with Diazepam. It's been a week from hell with horrific withdrawal symptoms. My practitioner says that I'm clearly very sensitive to changes in doses. I've had to use rescue doses just to keep me from having an all out panic attack (also okay'd by my practitioner). I'm trying to make my way back to the 2.25 mg/day divided as before: 1 mg in the a.m.; .25 mg mid-day and 1 mg at bedtime. I've thought about trying to eliminate the mid-day after I stabilize for awhile again. I want to do that by cutting it in half for at least a month before I would attempt to eliminate the other half. Problem is that I'm terrified of the potential sx. I feel shell-shocked right now and my brain is a fuzzy mess! Please help.

I'm completely confused about all of this talk about liquid titration/weaning for Ativan. Please help.

 

It's really pretty simple.

 

If you have .5mg tablets, and could cut them into quarters, then the smallest dose cuts you could make would be .125mg  (.5/4=.125)

 

But if you have your ativan as a liquid (diluted to .1mg=1ml), you can easily make dose changes as small as .01 (1/100th) of a mg. And you can then make tiny reductions each day, instead of bigger cuts every week or 2.  Smaller cuts, more often, is always more tolerable.

 

If you have a cooperative doc, there is an Rx liquid lorazepam, or you can easily make your own liquid from your tablets with a tiny amount of vodka or propylene glycol.

Titration only sounds scary. It's easy and quick once you wrap your head around it. I've done much better with DLMT.

 

 

Titration only sounds scary. It's easy and quick once you wrap your head around it. I've done much better with DLMT.

 

:thumbsup:

If I am making .01 cuts daily and I am now at  25.6 ml tomorrow would be 25.5 ml  can I continue this rate ? Or near the end should I slow down . This seems to be really slow already . Some days if I go without sleeping I have to not cut till the next day .

Any suggestions ?

Thanks Lisa

 

 

If I am making .01 cuts daily and I am now at  25.6 ml tomorrow would be 25.5 ml  can I continue this rate ? Or near the end should I slow down . This seems to be really slow already . Some days if I go without sleeping I have to not cut till the next day .

Any suggestions ?

Thanks Lisa

 

Sxs, if any, will emerge gradually when doing a DLMT.  If sxs do begin to emerge, thehn it might be time to adjust your taper rate.

 

Based on the info you are posting, you're at about 6%/14 days.  That was the level where I would begin to feel sxs.  Once you know the safe percentage cut rate that works for you, you need to try to stay around that rate.

Builder . What percentage would it be if I cut every other day ?

Builder . What percentage would it be if I cut every other day ?

 

...about 3%/14 days.

 

Sxs, if any, will emerge gradually when doing a DLMT.  If sxs do begin to emerge, then it might be time to adjust your taper rate.

 

Based on the info you are posting, you're at about 6%/14 days.  That was the level where I would begin to feel sxs.  Once you know the safe percentage cut rate that works for you, you need to try to stay around that rate.

 

Builder, in reading your signature which details your taper I see that you went at a pace that was comfortable to you and minimized SXS. 

 

At one point I was tapering at .02ml a day using liquid valium mixed with water at the 9 to one ratio that you recommend.

 

Then I got to a point where I decided to start tapering at .04 ml a day.  Over a two week period I wound up tapering a total of 15%--going down from 3.88 mg of valium to 3.32 mg by doing daily micro-cuts of .04 mg a day.  I faced increased SXS and then held, but it still kept getting worse for a while nbefore it got better.

 

My question is, now that I am down to 3.3 mg a day, might I need to reduce my daily cuts to from .02 ml to ,02 ml because as I get lower the daily cuts represent a greater percentage of my total dose?

 

thanks

 

 

 

 

 

Sxs, if any, will emerge gradually when doing a DLMT.  If sxs do begin to emerge, then it might be time to adjust your taper rate.

 

Based on the info you are posting, you're at about 6%/14 days.  That was the level where I would begin to feel sxs.  Once you know the safe percentage cut rate that works for you, you need to try to stay around that rate.

 

Builder, in reading your signature which details your taper I see that you went at a pace that was comfortable to you and minimized SXS. 

 

At one point I was tapering at .02ml a day using liquid valium mixed with water at the 9 to one ratio that you recommend.

 

Then I got to a point where I decided to start tapering at .04 ml a day.  Over a two week period I wound up tapering a total of 15%--going down from 3.88 mg of valium to 3.32 mg by doing daily micro-cuts of .04 mg a day.  I faced increased SXS and then held, but it still kept getting worse for a while nbefore it got better.

 

My question is, now that I am down to 3.3 mg a day, might I need to reduce my daily cuts to from .02 ml to ,02 ml because as I get lower the daily cuts represent a greater percentage of my total dose?

 

thanks

 

Yes.  You need to keep your percentage cut rate at a tolerable level.  Over the course of my taper, I think I lowered by cut rate (in mgs) 3 times.  I started at 2.5mg /14 days,  and eventually was as slow as 1mg/14 days.  I learned that I had to keep my percentage cut rate below 6%/14 days.

Yes.  You need to keep your percentage cut rate at a tolerable level.  Over the course of my taper, I think I lowered by cut rate (in mgs) 3 times.  I started at 2.5mg /14 days,  and eventually was as slow as 1mg/14 days.  I learned that I had to keep my percentage cut rate below 6%/14 days.

 

Thanks, Builder.

 

Do you mean that you lowered by MLs per 14 days as opposed to the MGs that you listed?

 

In looking at some of the numbers from your taper as listed in your signature, I did not see any place where you did 1mg per 14 days.  Thanks!

 

below are the samples for the numbers that I am talking about from your signature:  Thanks again!

 

10/23/13  3.5

1/10/14 3.0

3/8/14  2.5

5/6/14 2.0

7/4/14  1.5

8/29/14  1.0  3 week hold for travel

9/29/14  .8

10/8/14  .6

10/14/14 .5...jumped

quote confusedreader

 

"My question is, now that I am down to 3.3 mg a day, might I need to reduce my daily cuts to from .02 ml to ,02 ml because as I get lower the daily cuts represent a greater percentage of my total dose?"

 

Hi CU,

 

Did you mean to ask if you should slow your reductions from .02 to .01? I keep reading the above paragraph, and that's all I can come up with.

 

If that is the case, when you are having sxs, slowing down the taper (or reducing by a smaller percentage often works. So, it wouldn't likely hurt to try cutting .01 versus .02.

 

Most users are listing reductions in the signature by mg, since that would be the same person to person (but not benzo to benzo). A few do put their ml deductions, but it would be important to know the mix ratio.

Yes.  You need to keep your percentage cut rate at a tolerable level.  Over the course of my taper, I think I lowered by cut rate (in mgs) 3 times.  I started at 2.5mg /14 days,  and eventually was as slow as 1mg/14 days.  I learned that I had to keep my percentage cut rate below 6%/14 days.

 

Thanks, Builder.

 

Do you mean that you lowered by MLs per 14 days as opposed to the MGs that you listed?

 

In looking at some of the numbers from your taper as listed in your signature, I did not see any place where you did 1mg per 14 days.  Thanks!

 

below are the samples for the numbers that I am talking about from your signature:  Thanks again!

 

10/23/13  3.5

1/10/14 3.0

3/8/14  2.5

5/6/14 2.0

7/4/14  1.5

8/29/14  1.0  3 week hold for travel

9/29/14  .8

10/8/14  .6

10/14/14 .5...jumped

 

There is always a ratio between mgs and mls.  So no matter which scale (mgs or mls) your looking at, they both change in the same proportion. 

 

EXAMPLE:

 

I usually used a .1mg=1ml solution.  So assume that at 5mg, my taper rate was  .2mg/14 days, or approx .015mgs /day.

ls

That would mean I was cutting 2 mls/14 days, or approx  .15 mls per day.

 

And that would be 4%/14 days, whether you measure it in mgs or mls.

 

Many folks here say, "Oh, I can't do a percentage taper"  or "i can't do percentage cuts".  When you make any change to your dosage, up or down, mgs or mls, liquid or weight, etc, that amount IS a percentage, even if you didn't calculate it as a percentage.

Thanks, Builder.  I always appreciate your posts and the time and thought that you put into them.  I think I misread one of your posts in a way that suggested to me that you were tapering at a much higher rate than you were.

 

Hi CU,

 

Did you mean to ask if you should slow your reductions from .02 to .01? I keep reading the above paragraph, and that's all I can come up with.

 

If that is the case, when you are having sxs, slowing down the taper (or reducing by a smaller percentage often works. So, it wouldn't likely hurt to try cutting .01 versus .02.

 

Lilyann, you are right.  I meant from change my tapering .02 ML a day to .01 ml a day. 

 

I am using the same liquid valium/diazepam that Builder used, and I am following Builder's model of mixing 1 part liquid valium to 9 parts water.  So I have the same 1ml of the mix = .1mg valium

 

At one point I was tapering at .02 ml a day, then I increased it to .04 ml a day and ran into problems--because it turned out that I had reduced my total dosage by 15% over a 2 week period.

 

Now that I am down to 3.3 mgs of valium a day I can see where sticking to reducing by .02 ml would soon get me reducing by too high of a percentage.  I have no problems calculating percentages. 

 

Before I was spoiled because I simply reduced by .02 ml/.02 mg a day simply because that was the smallest mark on the 10 ml syringe.  But as I get to a lower total dosage, the .02 ,l will represent a larger percentage of my total daily amount, and this I will have to reduce my daily taper amount.

 

thanks

Yes.  You need to keep your percentage cut rate at a tolerable level.  Over the course of my taper, I think I lowered by cut rate (in mgs) 3 times.  I started at 2.5mg /14 days,  and eventually was as slow as 1mg/14 days.  I learned that I had to keep my percentage cut rate below 6%/14 days.

 

Thanks, Builder.

 

Do you mean that you lowered by MLs per 14 days as opposed to the MGs that you listed?

 

In looking at some of the numbers from your taper as listed in your signature, I did not see any place where you did 1mg per 14 days.  Thanks!

 

below are the samples for the numbers that I am talking about from your signature:  Thanks again!

 

10/23/13  3.5

1/10/14 3.0

3/8/14  2.5

5/6/14 2.0

7/4/14  1.5

8/29/14  1.0  3 week hold for travel

9/29/14  .8

10/8/14  .6

10/14/14 .5...jumped

 

I started at 2.5mg /14 days,  and eventually was as slow as 1mg/14

 

should be .25mg/14 days and .1mg/14 days

 

 

I started at 2.5mg /14 days,  and eventually was as slow as 1mg/14

 

should be .25mg/14 days and .1mg/14 days

 

Thanks, Builder.  Your corrected numbers are exactly what I was looking for.  I don't have a problem looking at my current dose and figuring out what percentage I want to drop over 2 weeks and then arriving at a daily amount that will need to taper to reach it.  What I am not sure of now is what percent will be comfortable for me, since before I was just tapering by .02 ml/.02 mg a day.  Since I am at 3.3mg a day, if I go back to tapering at .02mg and continue day it for 14 days it will be the equivalent of and about an 8.4% reduction.  That may be a bit too much.  So I will probably go with a lower daily reduction just to keep my taper going, as opposed to trying to reduce by too much and having to hold because the SXS become too intense.

 

thanks again!  I would not be able to have this smooth and comfortable taper if it were not for you.

Your experience is the only thing that will determine is the "right" rate.  5%/14 days is a pretty conservative place to start.  Folks rarelyt have issues at that level, and most folks can actually goo faster.  But again, your experience should be your guide.  All tapers should be symptom-based tapers.

 

With a microtaper, you will not get slammed with sxs if you're going too fast; sxs will emerge gradually, and you can take corrective action before they become significant.  And even in the worst case, there is never any "permanent" damage.  If you do become symptomatic, go back to a safe dose and you will quickly recover.