Advice needed - stay on ativan or switch to Clonazipam? Very time sensitive

Hello, I already have ME/CFS and so life was hard but I was functioning. Got the first P vax and had an absolutely horrible reaction - three trips to the ER, bedridden everyday. A revolving range of excruciating symptoms: headaches, huge asthma attack (them terrible reaction to prednisone), shakes, nausea, muscle weakness, dizziness, etc. Some of these were clearing up when the panic attacks started. I'm not sure if they were related to damage dome by the vaccine, the bad prednisone reaction, or the trauma of being in hospitals immune compromised and unvaccinated. I've gone from independent to basically bedbound and I'm devastated and very sick. I have huge anxiety at this point, basically chest pains and constant panic attacks, belly drops every time I try to sleep.

So my GP put me on Ativan so I can start Zoloft. He then goes on holiday for two weeks and cancels our next appointment. I have a terrible reaction to the Zoloft and stay on the Ativan while I'm waiting for my GP and psych referral. I varied from 1mg/day to 2.5, not knowing anything about how it can mess you up so badly.

I saw my psych last week. 30 min appointment, very rushed, seems almost like a one-off. Says he's too scared to try a new SSRI for my panic disorder because I'm already so physically weak from the vaccine and reacting to everything. (I don't know if it's true but I suspect possible MCAS because of the vaccine reaction and my multiple chemical sensitivities.) He says he wants to put me on clonazipam 1mg/day indefinitely.

I finally googled and was horrified by what I saw. I held off on starting the clonazipam and tried to take a little less ativan. I seem to be stuck at 1.75 a day and feel like absolute hell. I tried to do 1.5 last night and slept one hour and had constant panic and worse trembling.

Still massive anxiety all the time but added awfulness: nausea, poor sleep, trembling/clenching legs. I email the psych and ask if he can put me on something easier to get off, he says that's not his job, dealing with anxiety is his job.

I see my GP tomorrow. I have no idea what to do: try to ask the GP for more ativan and attempt a taper (he's unlikely to want to see me on benzos any longer and will probably hate the psych's recommendation as it is), or switch to the clonazipam and try to taper that. The psych only gave four months and said no follow up to be scheduled. Terrifying situation that keeps getting worse and worse seemingly. I'm out of ativan in five days. I have the clonazipam tablets ready. But this world is new to me and I'm too tired to research more. My body is so weak. Looking to see others expriences and learn from them. But this is very time sensitive - I have to act tomorrow.

Hi Montreal87,

I'm so sorry to hear how much you've been suffering. Your situation sounds complicated, especially as the care you're receiving from both of your medical providers seems to be of a very poor quality and consistency. I am sorry that they are not more committed to helping you heal.

A "life long" prescription to clonazepam isn't a death sentence; IMO it's a sign of an uninformed psyche doctor but it's easier to taper an endless supply of pills than a limited supply, so I see this part of your situation as a benefit not a disadvantage. I don't know if your GP will go along with the psyche's decision, but I would hope that the psyche's office would keep refilling your clonazepam prescription.

I suggest considering clonazepam as a superior medication to lorazepam, both for stabilizing your neurology and for tapering due to it's long half-life. Clonazepam is not as great for tapering as diazepam which has a crazy long half-life and less potent pills commonly available, but I think it is much easier to cross from lorazepam to clonazepam than to diazepam. Also, you have the script for the clonazepam, which makes things pretty simple to start.

The major downside I see to clonazepam is that at least in the US, a commercially manufactured solution of clonazepam is not available. If you're in Montreal, I'm not sure what is available but this site might help you:

https://go.drugbank.com/drugs/DB01068#products-header

There are at least a few lorazepam liquids being manufactured in the US, and this can make tapering easier and cheaper for lorazepam, but again, the short half-life of lorazepam can be very challenging for taperers. Clonazepam can be made into a solution or a suspension liquid form by a compounding pharmacist, or various at-home methods. Also there are supposedly orally dissolving clonazepam tablets that go down to 0.125mg in the US and elsewhere, I just haven't seen them yet myself.

Clonazepam is about twice as strong as lorazepam milligram for milligram according to Dr. Ashton. That means if you're stable on 1.75mg of lorazepam, an equivalent clonazepam dose to try would be 0.875mg (this is 1.75 of the 0.5mg clonazepam tablets) or if this is too difficult to dose at this time (1mg pill size or larger, lack of a good splitter, etc) you could updose to 1mg clonazepam and start your taper from there.

Clonazepam has a half-life that I think is about 3x that of lorazepam. This is great for stability and easy of dosing, but will make crossing over a little uncomfortable. Basically for 0.875mg of clonazepam to equal 1.75mg of lorazepam, this will take ~5-9 days of regular dosing, while the lorazepam will be eliminated in maybe ~3-5 days. This lapse in blood serum levels is notoriously uncomfortable but also temporary. If you know this about the medicine, the knowledge might go a long way to reassuring yourself about the nature of this switch and not getting confusing thinking the clonazepam doesn't work or your tolerant to it or paradoxical. It's normal if it feels insufficient at first and then you should recover, likely within a week or so; I expect you'll feel more stable on clonazepam than lorazepam once you've successfully crossed.

I have been on lorazepam before and the doses never seemed to last long enough. I have been tapering clonazepam for seven or eight months now (started at 2mg/day), I dose twice a day, and I'm high functioning. Your situation is different, so I trust you'll make the best decision for yourself.

Let us know if you need more information, or if there's another way we can help. 

Thank you. Do you think it makes sense to try to do a gentle cross over or should I just jump over like my doctor says?

I have enough ativan to possibly do 0.75 c + 0.5 a for a week or two.

Hi Montreal87,

Your doctor is like many other doctors, unfortunately. I think a two-step transition like you are describing would be much better than a sudden cross; it's two steps because the first is when you substitute about half the lorazepam with clonazepam and the second step is when you cross totally to clonazepam. I think a week or two between steps is a good time-frame for a lorazepam to clonazepam cross. Please keep in mind that this same week or two adjustment period is also necessary after the second step as well, but this time won't require any lorazepam tablets.

Dr. Ashton considers 1mg lorazepam = 0.5mg clonazepam. So if you started taking 0.75mg clonazepam and 0.5mg lorazepam for your first step it would build up to being something like 2mg lorazepam. Is this the daily dose of lorazepam that you need now to feel stable? If not, could you clarify what dosage of lorazepam you need currently?

If you tell us the size of tablets that you have for each medicine (ex. 0.5mg, 1mg), and how small you can reliably split them (ex. 1/2s, 1/4s), we can better help you to plan a simple step-wise crossover. Also, it might help to know exactly how many lorazepam tablets you'll have left over tomorrow, and what size clonazepam script (total milligrams per day) you were given from the psyche doctor. 

I have 1mg c tablets.

I have 20 0.5mg ativan left.

I don't feel particularly stable in that I feel like hell. I have terrible anxiety and don't sleep well at all. I also feel a lot of terrible nausea and tinnitus.

Because of the vaccine reaction and my panic disorder, it's hard to tell what's coming from where.

' Please keep in mind that this same week or two adjustment period is also necessary after the second step as well, but this time won't require any lorazepam tablets.' - what does this mean?

Please someone reply to advise so I know what I want to do ina couple of hours.

I should say I can't begin the taper immediately i don't think. I am in very rough shape.

Waves of bad nausea all day, near constant panic, and leg muscles clenching constantly. Hour to hour is rough right now. I can't tell what is my panic disorder and my anxiety and what is from meds. It's a horrible situation, but i don't thnk i can bare things much worse than they are.

Hi Montreal87,

I understand you are currently feeling unstable. I understand you feel anxious about your upcoming doctors appointment. I suspect that you are experiencing significant withdrawal from your recent reduction in lorazepam dosage. While I think this was a meaningful exploration for you to learn about your body's sensitivity to these drugs, I share your concerns about beginning a crossover while overwhelmed with withdrawal symptoms.

The ideal sequence of events, in my mind, would start with stabilizing on lorazepam; even taking an updose to your previous stable dose if you need to. You may need to spread your dose out during the day to get more regular blood serum levels; we haven't touched on your dosing schedule yet. Then doing a step-wise cross to clonazepam, ideally with as many steps as you can manage.

My thought tonight is that it might be best to discuss with your doctor the obvious symptomatic effects of your reduction in lorazepam dosage and your psyche doctors suggestion of an ongoing benzodiazepine prescription. Just like that.

If I was in a situation like you describe I would not mention the clonazepam script or my intention to use it. I would not discuss benzo tapering at all with my GP. I would not discuss benzodiazepine withdrawal syndrome or pursue a Zoloft prescription. I would ask for an ongoing prescription of lorazepam at my necessary dosage (2mg/day is what I suspect you're needing). If I could get it, I would use the ongoing lorazepam script to stabilize at my previously stable dose, maybe aided by dividing my daily dose up more throughout the day.

As soon as I was stable enough I would then follow up with the psyche doctor's office for a clonazepam prescription and make a step-wise crossover between the two drugs, going as slowly in the crossover as possible with the tablets on hand. And then I'd taper from there. Maybe catch my GP up on my psyche doctors prescription once I'd crossed, like it was a new development. Maybe in Canada you can't do this kind of stuff. I'm just illustrating how I would try to protect myself from a dosage shortage or a rushed crossover.

I'm sorry I can't offer a solution for your exact situation as I do not know how your relationship with your doctor is going to pan out and it's hard to stabilize or crossover without enough medicine. If you need to crossover now, without any more lorazepam tablets than the ones you have, we can help you plot that course!

A number of my earlier questions went unanswered. I'm still wondering what your last stable dose of lorazepam was, what your psyche doctor prescribed as your daily dose for clonazepam, whether you have the tools and ability to divide your pills and to what degree (1/2s or 1/4s?).

Here is a pamphlet I suggest reading, so that you can assess what your doctor is telling you tomorrow:

https://benzoreform.org/wp-content/uploads/2020/11/Pamphlet-3-BZRA-Discontinuation-1-Getting-Started-v1.2.pdf

Your doctor may not have a clue about how to taper the medicine they are giving you. I would be very very careful accepting any future psyche med prescriptions from a doctor who lacks this basic knowledge. I don't want to frighten you, but you may need to protect yourself from reckless medical treatments.

Please let us know how your situation evolves and how we can help. 

Thanks for this. Unfortunately I didn't see your message in time before bed.

I took 0.5mg clonazepam and 1mg Ativan last night. My initial Ativan prescription was 2mg (though see below, I have not been taking this in a stable daily dose)

I fell asleep ok (easier than previous night) but woke up at 2am with my brain and torso vibrating, leg muscles clenching with nausea and feelings of doom and panic. I also felt drugged and very drowsy and i think I recall acid reflux. I don't know what's happening and, yes, I'm really very scared.

At first I thought it might be an adverse reaction to the C that I was having - but reading your post, I am starting to wonder if given that Clonazepam is long-acting  (I am assuming this also means that it releases or is processed more slowly in the body), the symptoms I am having right now could be withdrawal symptoms from not having the same amount of whatever it is that the benzos do in the body. Because Ativan which releases faster has been replaced (or partly replaced) with Clonazepam which releases slower. But to be honest, even before this - I was getting brain trembles/vibrations even before with the Ativan. Just not as bad as it is now - and this feels different.

I guess my questions are:

(1) Could I be experiencing an adverse Clonazepam reaction

(2) or is it possibly withdrawal that I am experiencing - if so are my symptoms 'normal' as far as withdrawal symptoms go.

My GP already knows about my psych's Clonazepam prescription - however he gave little advice about crossing over the medication - saying to take the full dose of Clonazepam and try a gentle taper from the Ativan - he also  said 'take it and take two if you need to' (of the C)!

I have today been back in touch with my psych (via email) and he has now prescribed me more Ativan "since you weren't able to tolerate the clonazepam." No indication about dosage or anything.

I am at a real loss about what to do and would appreciate any help or guidance, both in general but in particularly with regards to tonight. If I should go back to my initial Ativan dose (or a more stable one) and just drop the C

HISTORY

19 - 30 August

Panic attacks started

Ativan 1mg night

31 August

1mg Ativan day

2mg Ativan might

1 Sept

Ativan: 0.5mg daytime

1.5 night

2 Sept

Zoloft 25mg

Morning feels worse than yesterday, super exhausted and groggy. Poss Zoloft?

Occasionally twinge in throat am (no idea)

Panicky in eve

Ativan day: 0.5

Ativan night: 1.5

3 Sept

25 Zoloft am 

Nausea most of day

Stomach ache am

Zoned out

Some tenseness/trembling in legs about an hour a

Ativan day: 0.5

Ativan night: 1.5

4 Sept

25 Zoloft

V groggy for few hours after Zoloft

Milder nausea

Stomach

ache

Headache most of day

Zoned out feeling

Some trembling in legs

Still struggling to walk more than few meters

Ativan day: 0.5

Ativan night: 2

5 Sept

Slept broken but bit better

25 Zoloft at 10am

Groggy

Dizzy

Bit less anxious

Weak, as usual

Ativan day: 0

Ativan night: 1.5

6 Sept

25 Zoloft

Groggy after Zoloft

Very weak dizzy tired

Bad anxiety and nausea, especially in evening

Ativan day: 0

Ativan night: 1.5

7 Sept

25 Zoloft 10

Bad anxiety, nausea

Hard to eat but managing to

Very tired, weak, dizzy, some jaw clenching

Tinnitus

Swollen throat, harder to swallow, can feel oesophagus at all times, feels like being gently choked

Ativan day: .25

Ativan night: 2

8 Sept

Stopped Zoloft

Some shakes

Low appetite

Swollen eyelids in am

Throat still a little swollen

Weak dizzy tired

Heavy chest since mid day

Ativan day 0

Ativan night 1.5

9 Sept

Extreme fatigue, hard to walk, talk at times

Shakes

Eating hard

Headache

Extreme anxiety

Ativan day .5

Ativan night 2

10 Sept

Extreme fatigue, anxiety

Heavy chest since waking up

Coughing eve

Nausea

Ativan day .5

Ativan night 2

11 Sept

Extreme fatigue, anxiety

Heavy chest since waking up

Nausea eve

Ativan day .5

Ativan night 2

12 September

Anxiety bad in morning, better in afternoon, bad again at night

Asthma symptoms better than yesterday

Small cough feeling eve

Cetirizine 10mg

Ativan day 0

Ativan night 2

13 September

Didn’t sleep night before

Near constant brain shivers through night, probably worst yet

Brain shivers continue on and off in morning

Tinnitus

Anxiety

Exhausted

Ativan day 0.25

Ativan night 2

14 September

Brain shivers still there but Ativan drowned out?

Nausea all day, vomited am

Googled Ativan got anxious in the day

Ativan day 0

Ativan night 1.75

15 September

Last night Slept but waking every hour

Trembling through body last night

Headache all day

Weak and exhausted as usual

Bad nausea

Ativan day 0

Ativan night 1.75

16 September

Weak and exhausted as usual

No appetite

Ativan day 0

Ativan night 1.75

17 September

Usual symptoms but bit more energy than some days

Bad nausea esp at nigh

Ativan night 1.75

18 September

Hard to fall asleep and woke early.

Exhausted, v congested, headache, tinnitus

Hard to do anything big crash

Very bad nausea and appetite

Feel very weak, muscles faded esp in legs

Feeling depressed. Lack of interest in things

Anxiety quite bad evening

Ativan night 1.75

19 September

Some depression

Managed to sit on a balcony for 5

Trembling most of day

Nausea esp at night

Vomited after dinner. Could be Ativan withdrawal? Could be anxiety?

Nausea at night and waking up

Ativan night 1.675

September 20

Severe nausea in morning Ativan 0.125 to calm

Took quarter Ativan before dinner and ate

Ativan before dinner: 0.125

Ativan night: 1.5 (day total 1.75)

September 21

Headaches and tinnitus all day

Bad stomachs middle day

Trembling

Nausea before/during dinner

Ativan night: 1.75

September 22

Legs trembling and clenching hard all day

Bad nausea am and threw up late morning

Extreme anxiety / malaise during day

Totally wired

Tinnitus and headache

Ativan night: 1.75

September 23

Tinnitus and headache

Some nausea in morning, worse from early pm

Muscle clenching all pm

Wired and very tired

Belly ache pm

Leg clenching from sept 21 most of day

C 0.5 9pm

A 1 10pm

Hi Montreal87,

1) Yes, what you describe experiencing during last night sounds like a very typical reaction on a short-to-long benzo crossover. The clonazepam isn't likely to feel sufficient for at least a few days; during this time, it's normal to feel uncomfortable and have symptoms of an over-active nervous system. I know it's not easy what you are going through but I think it's going to be worth it.

Also, yes, it makes sense that you have been experiencing interdose withdrawal symptoms from your previous lorazepam dosing schedule. Lorazepam was only effective for me for 4 hours max. Dosing only twice a day would not have been possible for me. It wasn't even possible for me to dose twice a day with clonazepam initially (I had 4 doses including a 2am dose, ugh), but we're all different. Since I got down to 1mg clonazepam/day I've dosed twice a day and it's been sufficient for my neurological stability. And oh how I treasure my uninterrupted sleep!

2) Yes, everything you're describing sound like common benzo withdrawal symptoms. Nothing about them sounds paradoxical or indicative of a problem with the clonazepam, especially given that you have been dosing irregularly and recently took a significant reduction and then began a crossover to a longer-acting benzo. I suggest considering that the clonazepam may be working longer than you're used to, but at a lower potency for the next 5-9 days than lorazepam which it's replacing.

Thank you for these details about your dosing experience. I suspect you have a tapering journal or another record system for dosing; this is a very valuable tool IME! I suggest also recording on each day any withdrawal symptoms and their intensity, such as you shared for Sept 20th.

I suggest that since you've started a cross, to hold at your 0.5mg K and 1mg A dosages for 7-10 days; I think you have just enough pills to make it this far before needing to take the next step in the crossover and go entirely to clonazepam. This is the gentlest crossover that I can envision with your limited lorazepam supply.

I do not suggest following your GPs advice to take both drugs concurrently without a substitution. If this worked reliably I believe it would be a part of Dr. Ashton's manual; her singular tapering method usually started with a rather significant short-acting to long-acting benzo crossover and steps were always made by substitution or reductions.

At least your GP isn't being stingy about the clonazepam! I consider that a boon! I wouldn't take his advice on doubling your dose, but hopefully this attitude means you won't ever have a pill shortage. Almost nothing makes a taper harder in my opinion than a pill shortage.

So, in brief, I'm sorry your suffering so much but for what you've been through everything sounds normal for benzo withdrawal. I believe you will stabilize on clonazepam with consistent dosing; and hopefully you will even begin to see benefits during the next 7-10 days as you stabilize on the first step of your cross. I think the longer half-life of clonazepam will go a long way to treating interdose symptoms that you may not have realized were caused by the lorazepam.

Please keep us posted and let us know if we can offer any more help. 

Thanks so much for all this. It's reassuring. I really appreciate your time in answering all of my questions.

I feel like I have never 'been stable' since the panic started six weeks ago - so I don't even know what that would look like. I have near constant, I think (it's hard to tell) worsening panic and doom, and the nausea keeps getting worse (I'm already way too underweight). I was worried because I didn't have nightmares on Ativan but I had my fist nightmare last night on C. I usually need 8 hours sleep to feel ok and for my asthma to be controlled. I have had nights with one or two regularly lately. It feels like my body and mind can't get worse - I don't do daily activities (I do have CFS and am in recovery already but...), I'm in bed all day feeling waves of the worst mental and physical discomfort of my life. All day.

Also, I had edited my last message before realizing that you had answered and so I'm not sure if you saw the new info I added:

Is it normal to be feeling like my brain and torso are vibrating in the night? When I woke from the first attempt at c + a, I was vibrating for a few hours.

Also, the psychiatrist responded and sent in a prescription to the pharmacy for more ativan "since you weren't able to tolerate the clonazepam." so I'm assuming that means he has put a stop on the clonazepam prescription for the time being although I at least have my first month's prescription on hand. Hopefully I can get it all sorted out with the GP (who apparently is buddies with the psychiatrist). but for now all I have is an ativan prescription and a month of c 1mg. (UPDATE: just received the new ativan prescription: 75 x 1mg pills, 1 refill available, so 150mg total to work with for a crossover).

Now I have more ativan, should I 'go back' and do more ativan and less c in the mix? I don't know how accurate my pill cutter is but that's all I have right now. I have no idea how to make this work. I can't do many more days like today. I'm leaning toward switching back to the ativan to try and stabilize. My plan is to do 1.5mg at bedtime since I'm having a lot of insomnia and this is feeding into my anxiety, 0.25mg when I inevitably wake up in the night, and 0.25mg at supper time since this is a high anxiety / high nausea time of day for me. I know that's not ideal in terms of the short half life and leaving me in a withdrawal state for a chunk of the day, but I'd really like to try to not go over 2mg per day if I can manage it. Does this seem like an ok plan for now?

I feel like I'm trying to stay out f hospital basically, so thank you so so much for your advice. I really need a path forward from this.

I ended up taking 1.75mg at bedtime (remembered that 1.5mg has not worked for me when I've tried going that low). But I wasn't falling asleep so I took another 0.25mg. I'm so, so tired but I just can't sleep. I feel hot, and the muscles in my legs are clenching and my heart rate is high (100 bpm -- which is not entirely unusual for me at rest but usually when I'm getting sleepy it drops to around 80). I do feel calmer than I did all day today but the knowledge that the ativan will wear off soon is causing my anxiety to start to creep back up.

I was really wanting to try and not go over 2mg per day but this is not making a dent in my insomnia and I really need to sleep. Is it better to spread the doses out evenly throughout the day so that I don't have to overcome all the anxiety my body has built up at bedtime? Should I increase the dose a bit more? I know I read something about a kindling effect if you go down and then back up. Could this be that? Or is that more like after an extended period of time of having gone to a lower dose?

Hi Montreal87,

It's common to have trouble sleeping when neurologically unstable from these drugs. Is also common to have vibrations and other muscular or sensory disturbances.

From what I understand GABA is our "calming down" neurotransmitter, responsible for slowing down nerve impulses and encouraging relaxation and restoration in the body. I think GABA is the most abundant neurotransmitter in the body, and when we are physically dependent on GABA agonists and reduce either the dosage or efficacy of them, the whole body can get an over-stimulation sickness.

From what I've heard kindling is poorly understood in relation to benzodiazepine usage. Some people swear they have it, and some cases are so severe that it seems to really make sense to consider, not that it changes anything. As far as I know it's not the sort of thing that is easy to recognize or diagnose, which unfortunately leaves many frightened and anxious buddies worrying about it.

I suggest dosing steadily and reducing as slowly as is reasonable, prioritizing stability and functionality, thereby minimizing the need to updose and eliminating any need to consider kindling. And updosing is not the end of the world either; I think the general idea is that it's risky to keep updosing and changing dosage usage patterns. "Slow and steady" has been an approach that has worked well for my recovery.

If you get a chance, putting your dosage history and current doses in your forum signature makes it easier for buddies to understand your situation. You can see my signature just under this post as an example. You can change yours by hovering over the word "Profile" in the menu near the of the page and clicking "Forum Profile" from the drop-down menu; just remember to click "Save" once you're done typing your signature.

I think you will continue to see improvements if you can be patient. I think now is a good time to practice self-soothing techniques; tapering and life beyond benzos seems to really require a strong skill-set of non-medication methods for calming down through life's inevitable stressors. I think you have plenty of stressors now, and plenty of motivation to calm down; I suggest spending time working on these skills.

Thank you so much for your reply Slowandsteady. I know that you are going through your own withdrawal, so really appreciate you taking the time to consider things so carefully and respond so clearly and thoughtfully. I can see from reading your blog that you have been through so much yourself. 

This, and the anxiety/panic disorder is still very new to me and I have been struggling to navigate and make sense of it all - whilst feeling shot to pieces at the same time.

It just feels that the intensity has increased so much, it is hard to work out what is going on....

So, I am thinking of trying to get a stable dose of Ativan first, to try to calm things down and have come up with the following plan/schedule - If you have time, I would very much appreciate your advice on it:

0.25mg every 4 hours or so (3x during the day)

1.5mg at bedtime and 0.25mg when I wake up in the night for a total of 2.5mg per 24-hour period.

I have prioritised a larger dose at night (my thinking is that I need to maximise sleep as not sleeping worsens my ME and really increases the fear/anxiety/tremor/brain  symptoms I am having).

Spacing out the doses has really helped with the nausea and extreme anxiety (though the anxiety is still there) and generally reduced the tremors. Last night I did wake up at 3am vibrating though and I wonder if this is because I'm not dosing at the same interval during the night. I know you had mentioned that you had to take a scheduled dose in the middle of the night and I wonder if this is something that I'll need to do as well. What do you think?

PS. Just a note that I've also posted a new topic with my question about my Ativan dosing schedule - "Attempting to stabilize on Ativan before switching to Klonopin - Advice Needed". I figure that the current thread's subject line doesn't reflect the current questions I have about stabilising on Ativan. Please feel free to reply to either thread (if you are able to), and thank you again for your replies and the valuable advice shared.

Hi Montreal87,

I am grateful that my own struggles and transitions can be of some help to you amidst yours! Two quick responses are all I have time for right now.

The first is that how you distribute your daily doses is entirely up to you. If you need more support at night, I understand your reasoning. Personally I like to keep my doses spread as evenly as possible, but I understand that other buddies have dosed at times and quantities based on their needs and sometimes this has really worked out best for them. I suggest trying your intended schedule and only making adjustments if it's not working for you.

The second, I cannot say exactly why you're experiencing vibrating sensations, only that as I mentioned earlier the withdrawal symptoms from GABA agonists like benzos include a wide range of muscle movements and sensations that can be quite uncomfortable. I get muscle tremors quite regularly since I began tapering, but like the headaches I originally took the clonazepam for, they're something I've learned to accept and live with.

I think that the time you spend holding on lorazepam and seeing functionality improvements will go a long way towards reassuring you. For now I understand that all the newness of this severity of anxiety and panic is overwhelming and confusing. In my opinion things have not so much gone wrong as become a challenging transition to greater understanding and health. I suggest just taking one day a time, and being open to learning from this experience.

You will definitely get the hang of this!