Need help tapering

I have been tapering from Ativan for over a year from 1 mg taken it night .. I wish I could have done it quicker .. but I just couldn’t .. in the middle of my taper I lost my Son.. but I just kept going .. I held longer till I felt I could go down .. I am down to  a little more 0.125.. I only take at bedtime .. I always did it this way.. I am wondering should I break this dose to 2 times a day?  Would it help? I am having a rough time.. I just cut down Feb 13 and having all kinds of GI issues and anxiety and all kinds of things .. does it get worse when you get down lower? Thank you for any help

Hi BlueMisty.

 

First let me say how sorry I am for the loss of your son. This is a parent’s worst nightmare.  I can’t imagine tapering during such intense grief.

 

Yes, the end of a taper is usually the touchiest. If you’ve always only taken it at bedtime, I think I’d stick to that schedule. Honestly, as low as you’ve gotten on this, I think I’d finish the taper and let my body heal. I jumped at the dose you’re on and it didn’t bring on any more misery than I was already feeling.  If you can break the tablet in half, that might be a better option for now. No sense in pushing it too hard now that you’re almost done.

 

Take care... 

 

Challis

Thank you so much for your reply.. it’s been hard loosing my Son .. his Birthday is Tomorrow he be 33

It has been intense grief and still is... 

This has been really hard trying to get off this ..  I was worry if I jump now it be worse I am holding now cause I am having issues.. I really want to get off this stuff.. a few years ago I was on it and came off in 2 months .. this time it’s been so much harder.. I never knew this stuff was so bad for you .. until my GYN doctor told me it was..  all the other Doctors I have seen have never told me anything about it..I can home look it up and found this group and started tapering .. thank you again for all your help

Hi Bluemisty,

 

Tomorrow is going to especially tough, birthdays are never easy, please allow me to tell you how sorry I am for your loss. 

 

I'm glad you have at least one Dr who knows how awful these drugs are, I'm grateful you've taken your time and if you feel you're not quite ready, then perhaps you can do as Challis recommended and taper a little lower.

 

Many members report having difficulty getting off of the drug after a previous cessation or multiple cessations, there is a theory about that called kindling. 

 

Pamster

Thank you so much Pamster .. it’s just indescribable how much the loss of my son.. it’s truly devastating:( 

Thank you for your response .. I am so thankful for this Doctor that open my eyes to this.. so I finally went to my family Doctor and told him and he agree and I found out they wanting to get all their patients off these meds and they don’t give these anymore .. but they are still giving them to patients that need to taper .. I never knew how awful this stuff was..  yeah this time is much different .. I be so glad to be done with this ..

Bluemisty 5.

Condolences on your loss. Anniversaries of events and birthdays tend to be tough times. Please take a moment to appreciate how hard you've held on to get here through all this adversity. You're a champion, even if right now, it doesn't feel that way.

 

Its tricky between the dosage and the residual left due to half-life.  1 mg Ativan= 10mg of Valium; 0.125mg Ativan= 1.25mg Valium. Ativan 1/2 life is 10-20hrs. https://www.benzo.org.uk/bzequiv.htm  Since the Ativan numbers are tiny, I used Valium equivalent. I hope I've done the maths correctly. Please Lord, someone check me.

 

Once a day:  If you use 1.25V number, then at 10 hours, equivalent of about 0.62mg V or 50% is present, and at 20 hours it's 0.31mg V or 25%. *By 24 hours, you'll take another dose so it's 1.25mg+<0.31mg=<1.55mg initially as there's a little overlap for a short while.     

http://www.drugsdb.com/resources/drug-half-life-calculator/

 

Twice a day: If you instead did 0.62mg x2 doses, then first day, your 10 hour level would be 0.31mg; at 12 hours, add second dose 0.62mg+<0.31mg 1st =0.93mg. At 24 hours take 3rd dose so <0.15 1st (25%)+ <0.31mg 2nd (50%)+ 0.6mg 3rd= about 1.16.  By your second day, at 10hrs you're at about 0.6mg- same as before. Due to next dose coming on though, <0.6mg 1st + 0.6mg= 1.2mg at beginning of the next 10 hour cycle.  That keeps your low in about 0.6mg range versus having the 0.3mg lag.  Seems this way blood levels would stay a little higher overall.

 

I hope I did it right, and it's useful. Hang in there. Come back to the forum for encouragement when you need it.

Thank you so much Hohhot ❤️ Yeah it’s a rough day .. missing My Son and the what if’s .. so hard..

 

Thank you for the information on that taper .. I bought a scale but my pills are so tiny they don’t register on it .. and I just been cutting when I can..  but I am going to look into what you posted .. thank you so much!

I've never used a scale but I've seen members say they'll weigh ten of them at once them divide by 10 to get an average. 

Thinking of you today, BlueMisty. 

Blue misty,

So sorry for your loss.  So sad.  My son is 43, and I don’t know how I’d cope.  You are strong to walk through all this.  You’ll make it.  Tapering off clonazepam myself.  Similar dose as you 1 x a day.  Getting ready to cut again.  The pills are so hard to cut, so I went to a liquid compound and get accurate small doses now.  I agree that you may as well continue your taper.  Clonazepam .125 is actually equivalent to 2.5 mgs valium.  Unsure about Ativan equivalence.    You can look that up, though.  Take good care 🙏.

Thank y’all so much ❤️ It was a hard day yesterday.. it’s tough .. it’s hard to even describe the pain from loosing him 😞

 

Thank you for all your advice.. I am really thankful for y’all information it really helps me .. and I wonder if my Doctor would give me liquid instead of pills.. they are so tiny pills

FYI ...

 

(1) In the U.S., an FDA-approved 2mg/mL concentrated oral solution of lorazepam is available.  The formulations from the different manufacturers use two solvents: propylene glycol and polyethylene glycol.

 

To learn more, enter “lorazepam” in the search box at:

 

DailyMed

https://dailymed.nlm.nih.gov

 

(2) In the Netherlands, a team of compounding pharmacists developed and tested formulations for oral lorazepam solutions suitable for pediatric patients. The final, 1mg/mL formulation used three solvents: glycerol, polyethylene glycol 400, and propylene glycol. The formulation remained stable for 12 months at 4 °C (about 39 °F) with lorazepam content remaining > 95%.

 

To learn more:

 

Vossen, A.C. & Velde, I. & Smeets, O.S.N.M. & Postma, D.J. & Eckhardt, M. & Vermes, A. & Koch, Birgit & Vulto, Arnold & Hanff, L.M.. (2017). Formulating a poorly water soluble drug into an oral solution suitable for paediatric patients; lorazepam as a model drug. European Journal of Pharmaceutical Sciences, pp. 205-210. Accessed online at: https://www.sciencedirect.com/science/article/pii/S0928098717300490

 

(3) A compounded, 1mg/mL suspension of lorazepam was developed by a team of compounding pharmacists at the University of Utah College of Pharmacy, Primary Children’s Medical Center in Salt Lake City, and Children’s Hospital of Philadelphia. The suspension remained chemically stable for up to three months when stored at 4 °C.

 

To learn more:

 

Wan-Man Ellaria Lee, Ralph A. Lugo, William J. Rusho, Mark MacKay, and John Sweeley. (2004). Chemical Stability of Extemporaneously Prepared Lorazepam Suspension at Two Temperatures. The Journal of Pediatric Pharmacology and Therapeutics: October 2004, Vol. 9, No. 4, pp. 254-258. Accessed online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469120/pdf/i1551-6776-9-4-254.pdf

 

I reply the other day .. and I look and don’t see it .. I just wanted to say thank you all for your advice and thinking of me.. his Birthday was rough... everyday is ... I just miss him so

I see your reply, it's at the top of the page, so no worries.  Have you looked into getting the liquid Lorazepam that Libertas supplied some links for?  It would certainly make your life easier, in fact I wish the drug manufacturers would provide them for all of their medications.  They provided the pills which got us here, the least they can do is provide the solution to our problem.

 

Would you do me a favor, could you put your medication history in your signature so we can see where you're at in terms of your taper?  Here are the instructions.  Add your history/signature 

Just take your time and stay at the low dose for now.  I wouldn’t move to twice daily, rather try to get used to going without it for a day.  That’s what I did and I think it helped prepare me for going off of it completely.

 

Ok, I admit I cheated a couple times and took it more often, but don’t do it because it just makes you feel worse the next day, plus you feel like you failed.  Towards the end of my taper I kept increasing the days between doses by telling myself tomorrow you can take another dose.  One day became two, then a week, then two weeks....now I’ve been off of it for three weeks.

 

You can do it...just go at your own pace.

I am down to a tiny speck of dust.. I am so scared to jump! This been so hard! Seems like every time I went down like 2 weeks later I will have symptoms and they would be different ones pop up .. right now I feel light headed .. is it ok to just jump? My husband telling me that’s just a small amount .. but I know it can still affect me!  During this taper I have lost my oldest Son to addiction and it’s been a nite mare .. but I still went on with my taper .. I just want to be done with this!

I think it's a good idea to jump because you're down to such a small dose. The biggest difference will be psychological. You might feel some nerves... fear but also excitement. It's normal. I think whether you hold on a little longer or jump now, the outcome will be the same. You're not going to be quite done when you take your last dose, although it's a huge milestone and something to be celebrated and applauded. The truth is, most of us still have some months of healing. The best way is to try to be patient. It won't make this nightmare over sooner by being impatient; it is actually far more likely to make things worse.

 

I'm so sorry for your loss and I can't imagine what you've been through. It shows great strength and courage to keep on going through that but remember what the goal is. I hope and assume that you're doing this for the sake of your good health. Take it steady and you'll get there.

Hi Bluemisty5

 

I agree, that you can seriously consider stopping at such a low low dose now.  It gets so the amount you take is not enough to make a difference anyway.  Yes, you may feel it somewhat, but that is normal  It probably won't be any more than what you have already been through.  And my guess is, it won't be as bad as you think. 

 

I stopped clonazepam at a very tiny dose.  I have been benzo free over 2 months now.  I have some mild waves each couple of weeks.  They don't last more than a few hours and they are much milder than withdrawal was. 

 

You are a strong person.  Be proud of this accomplishment.