need help with Lorazepam taper

Need help in tapering from 0.75 mg Lorazepam

Took 7.5 zopiclone from April to May for various health conditions.

End of May had weird food reactions, took 0.5 mg lorazepam to bring down high HR

Dr. moved me to Temazepam in June, took only for 6 days, didn't want to become dependent.

Went back to zopiclone, but had to use 0.25 - 0.5 lorazepam to get to sleep.

Early July moved to Trazadone, used 1 mg lorazepam to get on it.

Successfully got down to 0.5 mg lorazepam by mid Aug. (probably only 4 weeks)

Didn't notice any symptoms, as they were similar to ones I've been dealing with all along (food reactions, high HR, breathing issues)

I was in the midst of being investigated and diagnosed with POTS/Dysautonomia and Mast Cell Activation Syndrome

By third week of Sept. started getting mind blowing migraine like headaches, like someone has taken a razor to my head.

Finally realized what may have happened. I had no idea this could happen, as I've taken lorazepam and clonazepam both for 4 weeks a year apart, 14 years ago and CT them no problem. No doctor had ever told me this was a problem.

I reinstated 0.25 mg of lorazepam in the morning to see if that would solve the migraines - it didn't.

So no I need help with a taper from 0.75 mg lorazepam.

Currently, I take 0.25 mg at 9 am and 0.5 mg at 9 pm.

Do I taper down the evening dose to match the morning dose or taper off the morning dose first?

I have a scale and have been cutting and filing my morning dose.

I don't know how I going to accomplish any of this as these migraines are debilitating and occur everyday now, and I don't feel stable.

Thanks!

Only since last Friday, before that I was at 0.5 mg at night only.

I had to come off some allergy medicine for skin prick tests and all hell broke loose with my anxiety.

tried to add in the morning dose of 0.25 mg to stabilize - didn't work.

not sure what to do?

I feel you would benefit from holding .75 for a little while longer, it's a good idea to be somewhat stable when you start your taper.  Your medication history is fairly erratic and I can see you're suffering with migraines so why not hold a little while to give yourself some relief?

The thing about tapering is, we shouldn't rush to get off the drug, that only increases our pain on the way down.  There is still healing to be done after you're done with your taper so why not make the taper tolerable so you can function?

I added your medication history to your signature, could you check it to make sure I got the information correct, I had to pare it down a bit for space.

Yes, I agree, I will hold here for a while.

The meds are very erratic - dr's were trying to get me sleeping, as I was sick.

They also didn't know what they are doing, told me that it would be no problem etc.

I was stable in July, albeit still sick with lots of allergies and headaches from them.

But then I made the mistake of moving down way tooo quickly.

once I feel I might be stable, how should I taper?

Most members who take Ativan will dose 3 times a day due to it's short half life, are you doing okay on 2 doses?  I've also seen members leave the nighttime dose heavier than the others to aid in sleep, it all depends on your needs.  Some will taper each dose equally, others will select the dose to taper according to their lifestyle.

I'd sure take it slow though, since you've had so much trouble already.  I'm glad to see you have a scale, this should help you make small reductions.  What about a 5% reduction for the first cut when you're ready?

I have no idea if I need three doses a day?

Dr is useless? He's the one that got me into this mess by switching my meds so many times...I'm so angry - mostly at myself - I had no idea.

He just gave me Cambia for my migraines, but I have no idea if that's safe etc.

I'm just so lost....still working, but barely, just trying to hold it all together.

If I dose 3 times, then how would I start to taper down?

Let me first say that how many times you dose a day needs to be determined by your symptoms, this isn't a requirement just because you take Lorazepam.  Lets talk about how you're feeling as your nighttime dose approaches, are you experiencing an increase of intolerable symptoms?  If not then your two doses are serving you well, but if you feel you'd be more comfortable taking it three times a day then you might consider it.  Of course, there is a downside to this action, you'll be getting less of your other doses as a result so while it may help your blood levels stay more consistent, you'll feel the loss in other places.  Eventually though, they'll all have to go.

I know you're angry and frustrated but its important to settle in to this process and accept that it's going to take awhile and you'll be uncomfortable but this is fixable and you're taking your first steps to do just that.

We have some time before you're going to begin so lets take this time to get you more comfortable with the process, one of the best ways of doing that is by educating yourself and gathering the tools you're going to need to get through this through posts around the forum.  Can you let your family know what you're facing to help them understand why you may be out of commission at times?  Do you have a therapist you trust to talk to? 

I worked full time except for the first three weeks during my recovery from my cold turkey and even though it was difficult, it was a good distraction from my symptoms and helped pass the time, so I hope you can hold on to yours.

I did a search on the forum for Cambia but didn't find any discussions about it so if it helps with your migraines, I'd say it's a necessary part of your recovery for now.

Thanks so much!

So now that I've been able to be back on my allergy meds, I'm a lot more stable in the morning, I didn't need to take the morning lorazepam dose. So pissed that I had to add it for a few days just for stupid allergy tests etc. But I also realize that by mid-afternoon, I was struggling with these headaches etc.

I'm going to see how I do taking it at midday etc.

Family has been amazing, and been taking care of me since April since I got sick from who knows what?

The one thing I can't figure out is why my head feels like it's burning and even the tops of my ears?

Are these migraines, I've never had this feeling before, so it's crazy!

It's like razors through my head and ears. Have you ever heard of this before?

I do find if that I try to remain calmer, it helps. But it's so crazy painful, I have been freaking out a little bit.

Part of my problem is that one of my, as of yet undiagnosed, medical conditions, is POTS/Dysautonomia, which means that my body is stuck in fight or flight mode, which produces a lot of anxiety, not from the brain, but from the body, physiological not psychological etc.

It creates a lot of adrenaline surges too, so that's why I had been using the lorazepam - to calm down those crazy HR's etc.

Since I'm still able to mostly work and understand things, just with a heightened level of anxiety, I'm taking this as a good sign that I may be ok, after I get this drug out of my body and heal etc.

I don't have a therapist, but will have to try and find one. I don't have a lot of coverage, but at least a few visits would help.

I'll stay at this level for at least a while, until I get some form of control back. I had been good up until a few weeks ago, as I had got past the crazy early withdrawal symptoms (didn't even know that's what was going on).

How did you get past the Brain zapping and burning feeling if you had it, that's what I'm struggling with the most.

thanks again, for all your help!

I'm glad to hear you're going to hold and that your family is supportive, you're lucky in that respect.  Your brain zaps and burning are very common, Professor Ashton described them in chapter 3, doing your best to remain calm is one of the tools you need to apply with this whole process, so I'm glad you've found this out for yourself.  The other tool is distraction, anything to temporarily take your mind off of your symptoms helps.  You might start a thread in  Withdrawal Support (during your taper) for suggestions for how to deal with your worst symptoms.

https://www.benzo.org.uk/manual/bzcha03.htm

Bodily sensations. All sorts of strange tinglings, pins and needles, patches of numbness, feelings of electric shocks, sensations of hot and cold, itching, and deep burning pain are not uncommon during benzodiazepine withdrawal. It is difficult to give an exact explanation for these sensations but, like motor nerves, the sensory nerves, along with their connections in the spinal cord and brain, become hyperexcitable during withdrawal. It is possible that sensory receptors in skin and muscle, and in the tissue sheaths around bones, may fire off impulses chaotically in response to stimuli that do not normally affect them.

In my clinic, nerve conduction studies in patients with such symptoms revealed nothing abnormal - for example, there was no evidence of peripheral neuritis. However, the symptoms were sometimes enough to puzzle neurologists. Three patients with a combination of numbness, muscle spasms and double vision were diagnosed as having multiple sclerosis. This diagnosis, and all the symptoms, disappeared soon after the patients stopped their benzodiazepines.

Thus these sensory symptoms, though disconcerting, are usually nothing to worry about. Very occasionally, they may persist (see section on protracted symptoms). Meanwhile, the same measures suggested under muscle symptoms (above) can do much to alleviate them, and they usually disappear after withdrawal.

I'm disturbed to hear that your as yet undiagnosed medical condition has the same symptoms as benzo tolerance and withdrawal.  If you'd have been on the drug for longer than you have, I'd feel fairly confident in saying your issue is with the benzo but you say you had these issues before being put on the Zopiclone and benzo's?

I had been dealing with some of these weird symptoms going back to Jan after an infection from the dentist, way before I took any sleeping pills etc.

POTS/Dysautonomia can surface after an infection etc. Also, I've always had a whacky HR very low on sitting and way too high upon standing, just never had any symptoms before, as I was in such good shape.

The symptoms got really worse after I took antibiotics - likely all the histamine that was released in the body. It was after the antibiotics that I took the sleeping pills.

I think the zopiclone and lorazepam definitely made my symptoms worse, I just never put two and two together before.

So what I blaming on the illnesses may have been in fact some aspect of the drugs - who knows.

This can also explain, why I haven't been getting better.

I wish I'd been able to not have to got back to 0.75 mg, but there wasn't much I could do, I was a mess.

So I took the 0.25 mg at noon today and was out of it for hours had to lie down, so that's not going to work for me, as I have to work.

I have no idea where to put in it now?

I might have to go back to putting it in at night?

I really don't want to switch to Valium or Clonazepam either, if I can help it etc.

Thanks so much!

It sounds like the drugs have exacerbated your condition, hopefully when the trauma of the infection, antibiotics, z-drug and benzo use are resolved, you can get back to normal, but wow, what a confluence of events that has pulled your life apart. 

It sounds like you'll need to put the morning dose back in place, I don't think it's a good idea to take all the Lorazepam at night, that won't serve you well as you begin your taper, once a day won't be enough.  But, if the noon dose of .25 was too much, do you need the whole .25?  Would taking a smaller dose work for you?

Thanks,

yes, it was the perfect storm that hit - it actually all came to ahead in March, when I had another weird infection. Same week as covid shut down everything?

Yes I'll put the morning dose back in.

I've never needed a mid day dose before, so I'll try to make due without it and do my night dose around 8pm

Have you ever heard of having a different reaction to the teva version of lorazepam, instead of the sublingual?

I got the teva version, as they are easier to cut, but man they seem to be whipping me out.

I just can't seem to win.

There is a support group who discusses Teva Clonazepam, here is the link:  http://www.benzobuddies.org/forum/index.php?topic=204645.0

I've seen many members discuss how they react to different brands and generics, we're so sensitive during this process that I absolutely believe it can effect you.