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5mg daily Ativan taper question


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Hello,

My husband is currently on 5mg Ativan daily (3 mg during the day, 2 mg for sleep). He is trying to taper and is 10 days in at 4.75 mg. He currently is splitting a 1mg pill to take .75 mg for one of his doses. My question is should he try to lower each of his doses evenly or is lowering the one dose by .25 ok? Does it make a difference in the withdrawal symptoms either way?

He is down from a high of 7mg daily which was done in hospital but with horrible symptoms.

Thanks in advance  :)

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His own biosystem will give him a far more meaningful answer then you're going to find here.

 

But...as a generalization, Ativan is fairly short-acting, short half-life benzo, typically Rx for 3X-4X/day dosing.  So he will likely find he needs to maintain some dose-to-dose uniformity.

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The general guidelines of tapering are no more than a 10% cut every 1-2 weeks maximum. Good to keep it low as you're doing. When taking more than one dose per day, you may want to "spread" the decreases among doses. Why? Because depending on the drug's half-life, if you only drop a PM dose then you can create a deficit for the hours between it until the AM dose. If you alternate the cuts between the AM and PM dose, then the drops are spread out over the 24 hours. This provides a more consistent blood level. Ativan has a half-life approximately 10-12 hours.

 

Other considerations:Is he taking the AM amount prior to work or other challenges? If so, he may want to weight the drops so that it's a little bigger dose before the event.  Bear in mind that you're still creating an "up and down" effect if you do this, but some trial and error can help

decide how to handle it. Using other things simultaneously with the Ativan can cushion the drop dose.

 

Dealing with Ativan myself from the hospital.  Find that OTC Dramamine helps all symptoms, especially the vertigo. Caution that it causes drowsiness. Dosing should be body weight/symptom guided.  Natural helpers are buffered vitamin C (1000 mgs) and niacin for all symptoms. Ashwaganda helps to relax without drowsiness.  Taurine helps tremors. Take with food as it drops blood sugar. Try some of these helpers to get through the bad times of day.  On all these except the Vit C, start at lowest dose and move up to find what is therapeutic for him.

 

Thanks for being a supportive spouse. It means everything to the person going through the problem as often others (friends and family) have no idea how horrific the symptoms can be.  I find myself enduring 2nd withdrawal in 3 years after another surgery. Couldn't have made it without my husband's help.

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I started out shaving some off  the midday dose, then the morning dose, then the evening dose. Rinse and repeat. When I got around 1 mg a day or something like that I did it all into liquid and divided that liquid every day into thirds.  I'm not the one to ask about how to do that--just look into daily liquid microtapering.
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