Urgently need advice regarding tapering or staying on ativan after shortterm

I desperately need help, advice.

 

Two weeks ago I stated experiencing nightmare withdrawal symptoms from tapering an SNRI Effexor XR (which I have been doing for over a year using the 10% of previous dose method)

 

The most troubling symptom was extreme anxiety. Also stomach pain, cramping and nausea, and diarrhea.

 

After a week I went to my GP and he prescribed my ativan 1mg sublingual tablets (as needed). Unfortunately I used the them irregularly and at various doses for the 10 days. The ativan helped, but I soon started experiencing even worse anxiety in between doses. I have a history of alcoholism and a few benzo withdrawals so I suspect there is kindling.

 

For the last 5 night I’ve barely slept and that coupled with the anxiety is wearing me down. I came to BB looking for advice on a raid taper. I tried to just stop 3/17 but now I am in agony. I also need advice if it would be wise to stabilize on ativan or pursue diazepam since it is helping my original condition

 

Thank you 🙏

You mentioned in another post your doctor was unwilling to prescribe more Ativan, has this changed or are you going to seek another provider? 

I am planning on trying another provider. I have 20 tabs left. I took 1mg this morning at 8am, and am much more calm but still can seem to get sleep.

I'm relieved you're feeling better, how confident are you that you can find another provider?  I want you to be able to sleep but please use what you have sparingly until you can be assured a supply.  I've read from members that Nurse Practioners can be a little more understanding about this process and may be willing to see you through it.

 

As for sleep, I hope you won't try again until bedtime.

Thank you, you have been very supportive - I appreciate it so much. Do you think that in order to avoid the chaos of using it on a irregular schedule, that I should also take 1mg today at 8pm. Also, I was unable to sleep even after taking the 1mg ativan at 8AM (I made a typo)

 

Thank you

I understood it was in the am that you took your pill but figured you were so exhausted you might try to sleep during the day, it's best to wait until tonight.  I agree that getting on a regular dosing schedule is a good idea but not sure about taking another 1 mg, that seems drastic since in the past the most you ever took was 1 mg for the entire day.  I know you're desperate for sleep but I'm hoping you'll opt for .5 instead.  Next you might want to get back on your original schedule of dosing 3 times a day since Ativan's half life is so short.  Just try to land on a dose that keeps you stable (able to take care of your daily tasks but not feeling great) without going too far up in dose.

 

Hopefully you can get busy looking for a new provider tomorrow, then we can help you figure out a taper plan.

 

Edit: 

 

I just had a thought, your body is obviously already dependent on the Ativan so getting off the drug quickly isn't an option now.  You might want to consider going back on your full dose and waiting to taper until you've finished and recovered from the Effexor taper.

 

Thank you Pamster for your continued support, much appreciated. I also had misgiving about taking 1mg yesterday morning. Yesterday did go well for me withdrawal wise and in the evening I took it again 12 later. I am thinking this is to much but I slept for the first time in week. I woke up 2 hours before my next dose with dreadful anxiety.

 

I am really needing guidance on how to institute a stable dosing schedule. I am ok with using the 0.5mg. Even though the tiny sublingual pills are hard to split; I have a scale.

 

Q: would the best be to space it out 3 times a day. (6 hours apart) Would this look like this?

10am 0.5mg

4pm 0.25mg

10pm 0.5mg

 

Also if I’m able to do a crossover sooner than later to diazepam, what do you think that would look like. Is 10mg of diazepam equivalent to 1mg of ativan? Would I need to do the

1st week of 3/4 ativan dose, 1/4 diazepam dose

2nd week 1/2 ativan dose, 1/2 diazepam dose

3rd week 1/4 ativan dose, 3/4 diazepam dose

4th week all diazepam

 

And should the diazepam also be taken 3 times a day.

 

Thank you so much

I think it's way too soon to discuss crossing over to Valium, not many doctors in the US will prescribe it (not sure where you are), they say it's a dirty drug, probably the reputation it got back in the 1970's.  Also, many are hesitant to prescribe two benzo's at the same time, they may be worried about prescribing guidelines.  I think concentrating on just the Ativan would be a good idea for now, no sense stressing over this scenario if it's not going to happen.  Also, crossing is challenging, for many it comes with sedation and depression so your motivation has to be strong to do this, like serious inter-dose withdrawal issues.  I'm told that once your body acclimates to the Valium the side effects go away but some are unable to make the transition and go back to their original benzo. 

 

As for your dosing schedule, whatever times fit your lifestyle is best, I notice you upped your dose by .25, I feel you might be better served to see how 1 mg works for you before you do this.  You may find after a few days you're stable on 1 mg.