How to taper 2mg Lorazepam

I'm currently on 2mg (2 x 1mg) of Lorazepam (called Temesta here in Switzerland). They are fast dissolve tablets and I take them for sleep since stopping my antidepressant last year. I was wondering how to proceed to safely taper from this? Many thanks!

I see you were on Flurazepam in 2017, were you able to discontinue that and if so, how long ago?

Yes I was. I managed to stop in 2017.

However my doctor put me back on it due to insomnia linked to Lexapro. I finished my Lexapro withdrawl last year but still have some side effects (anxiety, depression and insomnia).

 

So basically now I'm stuck with 2mg of this fast dissolve Lorazepam (I take two 1mg pills for sleep) and 15mg Flurazepam. 😔

 

I know I can't stop both at once especially since I'm already not feeling well. I figured I'd stop the Lorazepam first.

How did you taper in 2017, are you looking to repeat that method?

I basically cut the pill at about 10% over many weeks but I can't remember exactly.

 

I don't know if I should try that with Lorazepam. Just cutting a very small portion of the pill but I don't know how often

What is your dosing schedule now, do you only take them at night?

 

Are you worried about cutting the pills?  Would you like to discuss titration?  Are you aware there is a liquid formulation of Lorazepam from the manufacturer?

 

We typically suggest reducing your dose by about 5-10% every week or two, but we stress allowing your symptoms to guide you so you can stay functional. 

Yes I'm taking them at night.

In Switzerland they don't have the liquid form unfortunately.

 

So should I just cut 10% of the 2mg every day and then reduce again by 10% in two weeks or maybe even a month? I want to avoid withdrawal symptoms as much as possible.

 

I am already having high anxiety and insomnia which I don't know if due to the fact that I took Lorazepam for a year or remaining side effects stopping Lexapro last year.

 

Is it better to feel emotionally stable before staring the taper?

 

What is your dosing schedule now, do you only take them at night?

 

Are you worried about cutting the pills?  Would you like to discuss titration?  Are you aware there is a liquid formulation of Lorazepam from the manufacturer?

 

We typically suggest reducing your dose by about 5-10% every week or two, but we stress allowing your symptoms to guide you so you can stay functional.

 

 

 

I've read about water dilution tapers where very small amounts are removed each day. These tapers last about 10 months depending of the dosage of the medication.

 

Will I have less withdrawl symptoms during a slower taper than the 5% every two weeks you mention?

I'm sorry the liquid form isn't available for you but most members just use their tablets so you'll do just fine.

 

I'd suggest dry cutting to begin with because its easier and it will give you a good idea of what you can and can't do.  I'd also suggest a very small drop for your first reduction to get an idea of what to expect.  The fact that you've taken and stopped benzo's in the past can add a bit of uncertainty into your situation, the body seems to remember past experiences and this can make withdrawal symptoms more intense.

 

As for symptoms, its difficult to say what will happen, the only way to do this is experimentation with you as the subject, its a painful way learn but its the only way.  This is why we suggest slow and steady with a heavy emphasis on letting your symptoms guide you so you can make adjustments as you go.

 

Feeling emotionally ready before you begin a taper is key, this is a huge commitment of time and it can be life changing while you're going through it so yes, being prepared is a good thing.

Hello, chopstyx.

 

Do you have access to a compounding pharmacy in your country? I’ve included a link to a stability-test formulation for an oral lorazepam solution.  Also, fyi, Thame Laboratories (a specialty pharmacy in the UK) makes a 1mg/mL oral solution.

 

Another option to consider is Tapering Strips from The Netherlands.  This compounding pharmacy ships to other countries and can make mini-tabs in doses as low as 0.05mg of lorazepam.  See links below.

 

Links:

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

 

Tapering Strip (general info)

https://www.taperingstrip.com/

 

Tapering Strip for Lorazepam (Temesta)

https://cdn.taperingstrip.org/presordfrm/sedatives/LRZP_bestel_GB.pdf

 

I'm sorry the liquid form isn't available for you but most members just use their tablets so you'll do just fine.

 

I'd suggest dry cutting to begin with because its easier and it will give you a good idea of what you can and can't do.  I'd also suggest a very small drop for your first reduction to get an idea of what to expect.  The fact that you've taken and stopped benzo's in the past can add a bit of uncertainty into your situation, the body seems to remember past experiences and this can make withdrawal symptoms more intense.

 

As for symptoms, its difficult to say what will happen, the only way to do this is experimentation with you as the subject, its a painful way learn but its the only way.  This is why we suggest slow and steady with a heavy emphasis on letting your symptoms guide you so you can make adjustments as you go.

 

Feeling emotionally ready before you begin a taper is key, this is a huge commitment of time and it can be life changing while you're going through it so yes, being prepared is a good thing.

 

Thank you for your kind advice. I will start slow and see how it goes. If the symptoms get too strong I can always pause and resume once they subside?

Thank you.

Unfortunately my doctor doesn't believe Lorazepam needs tapering, he always said it was a safe and a non habit forming drug so I can't count on him to provide me with prescriptions for specialised pharmacies. I will have to dry cut, I will go slow and see how my body reacts.

It sounds like your prescriber would benefit from addition information about discontinuing benzodiazepines.

 

I wonder if he would respond favorably to a deprescribing guidance document written by prescribers for prescribers?

 

The document (linked below) was developed by the Benzodiazepine Action Work Group of the Colorado Consortium for Prescription Drug Abuse Prevention. (Please note the authors were very careful to distinguish between ‘drug abuse’ and ‘drug dependence’ in the document.)  It has now been endorsed by the two major advocacy groups for improving benzodiazepine prescribing and deprescribing practices in the US (the Benzodiazepine Information Coalition and the Alliance for Benzodiazepine Best Practices).

 

The document is up-to-date, well-written, concise, and evidence-based.  Several members have shared it with their prescribers with positive results.

 

Link:

Benzodiazepine Deprescribing Guidance Document (January 2022)

https://corxconsortium.org/wp-content/uploads/Benzo-Deperscribing.pdf

 

Hi,

 

I would need help to set up a simple cutting taper for Ativan. I'm on 2mg (two 1mg pills) in the evenings since 1year.

 

I don't have a scale so I don't know it's possible to simply split the pills and how often?

 

Many thanks

What is your dosing schedule now, do you only take them at night?

 

Are you worried about cutting the pills?  Would you like to discuss titration?  Are you aware there is a liquid formulation of Lorazepam from the manufacturer?

 

We typically suggest reducing your dose by about 5-10% every week or two, but we stress allowing your symptoms to guide you so you can stay functional.

 

Do you know someone who can help me set up a taper plan for cutting the pills and how often? Thank you

Are you aware of this resource?

 

Pill-splitting taper plans

http://www.benzobuddies.org/benzodiazepine-withdrawal-methods/direct-taper/

 

Re: your question about how often to make reductions …

 

The collective wisdom of this community is ‘Let your symptoms be your guide.’ After a reduction, most individuals will experience withdrawal symptoms.  Over time, those withdrawal symptoms should begin to settle down/stabilize (as in stop changing, become tolerable — not disappear completely). When this happens, your body is signaling you that it’s ‘ready’ for the next reduction.

 

If you have not already done so, I strongly encourage you to set up and begin keeping a daily taper journal.  Examples of key data to collect include:

 

- The date

- Time(s) and amounts(s) of drug ingested

- Daily rating of your withdrawal symptoms (0 = no symptoms; 10 = intolerable symptoms)

- Daily rating of your functionality (0 = able to perform all essential daily tasks; 10 = unable to perform any essential daily tasks)