c/o from .5 Ativan to 5mg Valium

Hi everyone,

 

I have a question about c/o from Ativan, which I've been on since mid-February.  Initially I took it "as needed" (1-1.5 mg) but by early March started taking .5 morning and .5 evening regularly.  I hate the feeling it gives me and want to get rid of it as soon as possible.  My Pdoc told me that since I've been on A for a short time, I can just stop taking it.  I definitely can't.  Anxiety and akathesia are there immediately.  This month I was able to make a drop from 1 mg to .5 mg in one week  but I am definitely feeling withdrawal symptoms --- with akathesia being the worst one.  I could REALLY use good advice now.  I am taking .25A in the morning and .25A at bedtime and not feeling stable at all.  Each day I am highly agitated and restless.  Do you recommend a crossover to Valium?  If yes, how should I do it? Can I make the switch to 5 mg in a few days?  PLEASE send your thoughts and ideas.  I am now at a loss and the pdoc is completely useless.   

 

 

How long has it been since you cut your dose in half, zazenlion?  It's possible you are feeling the effects of that 50% cut and holding where you are for another week or two might alleviate them.  There are pros and cons to a Valium substitution and many members think it's the best way to get off a short acting benzo such as Ativan.  I tapered directly by dry cutting and while I had plenty of symptoms, they were manageable.  You might want to consider the titration.  It has the advantages of not having to get a doctor to prescribe both benzos -many won't- or possibly having a bad reaction to Valium, which does sometimes happen.

I was feeling terrible terrible with each cut of Ativan and am making a 6 week crossover to Valium.  I was very worried because I know that some people have bad reactions to Valium and I always get the rarest side effect to anything I take.  Well, making this crossover is the best decision I've made.  I am successful I believe because of my slow Ashton-style crossover.  Valium feels much, much more steady to me than Ativan ever did and I'm no longer living constantly on edge.  I do get drowsy my first few days after a cross, and some minor withdrawal symptoms one week after a cross.  However, by day 10 after a cross I can feel that the Valium has built up for me and I'm ready to do another. 

 

Just my experience - I know what you mean about not feeling good on Ativan.  I'm eating more and am more functional now that I have over 1/2 my benzo dose as Valium.  As soon as I'm crossed I plan to do a daily liquid taper.

 

Hope this helps! Btw - when I made too big of a cut down off ativan (.25 off my total dose of 1.5mg) after only being on it 2 weeks, I did have to updose to function.  Just a little bit, not the whole .25. 

Beeper, I made the drop from 1 to .5 during the first ten days of April.  Then updosed to about .7 for a few days and again dropped to .5 three days ago.  I am slowly stabilizing but really worried about how to deal with next taper since dry cutting is so difficult and imprecise.  What do you think is better in my case -- titration or c/o?  How long would you give the taper from this point on?

 

Kiki, your description makes c/o sound like the way to go but I really don't want to add another 6 weeks of exposure to the drugs.  Do you think it's possible  to c/o in one week or could that really throw me off?

I know what you mean.  I guess for me I had such a horrible experience trying to taper a little just 2 weeks after taking Ativan that I already knew the damage had been done.  If that is not the case for you, then I agree you shouldn't try to extend everything by crossing over.  If, however, you are in a really really bad state like I was (despite my short use of Ativan which is infuriating by the way), it is a nice option for you! 

 

My body has just told me that I can't switch over any faster because my body just doesn't want to let go of the Ativan.  It seems like a lot of the people that have trouble crossing over do it really quickly, have a bad reaction, and assume that they can't tolerate Valium when it is actually the Ativan withdrawal that they are experiencing.  Not EVERYONE, but in some cases. 

My experience with Ativan has been really bad and I am open to anything to try to climb out of this hole.  For the past two nights I've been waking up at 1 am and can't go back to sleep.  I've been feeling like a total mess since the taper but I am afraid to updose though it seems that the dose is not enough at all.  I really need all the advice you can offer. 

 

Here is a bit of a background: I got off Paxil  last fall (after 16 years) and had a nightmarish withdrawal that got so out of control by winter that I had to return back on the drug.  The pdoc prescribed Ativan to help with the symptoms of akathesia, anxiety, and insomnia while I reinstated Paxil. It's been two months and my main goal is to try to stabalize and get back my life.  I know that Ativan won't help me with stability but each time I try to get rid of it, I fall apart.

 

Could you PLEASE help me decide on the right dose on which to c/o and a schedule.  Should I try to updose to .75 before crossing over? 

That sounds similar to my story.  I was put on it for a bad reaction to steroids for allergies last December.  Then couldn't cut without falling apart. 

 

I am no doctor, so all I can say is what I did.  I updosed to a point on Ativan where I was sleeping some and eating a little.  I was not functional though - i.e. couldn't work or take care of my kids.  I started the cross and each cross has made me more functional. 

 

You could updose to .75.  Spread it out so that you are taking .25 + .25 + .25 through the day to minimize interdose withdrawals.  Then start swapping out by starting with your night dose of .25A to 2.5mgV.  Hold for 10 -14 days.  Then do the afternoon dose etc.  My benzowise Dr. told me that I shouldn't be afraid of small updoses when it comes to Valium because the taper is not even in the same realm of misery as tapering Ativan.  I guess we'll see when I start the taper, but I trust him. 

 

Does that help? 

Beeper, I made the drop from 1 to .5 during the first ten days of April.  Then updosed to about .7 for a few days and again dropped to .5 three days ago.  I am slowly stabilizing but really worried about how to deal with next taper since dry cutting is so difficult and imprecise.  What do you think is better in my case -- titration or c/o?  How long would you give the taper from this point on?

 

Kiki, your description makes c/o sound like the way to go but I really don't want to add another 6 weeks of exposure to the drugs.  Do you think it's possible  to c/o in one week or could that really throw me off?

 

As I said, there are pros and cons to the substitution method.  The only con I know about the titration method is you have to mix up a solution every day or two.  I'm glad you are stabilizing.  I'd probably wait several days to a week after stabilizing to either make the next reduction or start the substitution.  Do you know whether your doctor would be willing to prescribe the Valium along with the Ativan?  If he/she won't ( mine didn't), that will make the decision for you. 

Kiki, thanks so much for the schedule.  I will now try to find out from my doc about prescribing both meds. 

 

Beeper, what are the cons of the substitution method?  Do you think I can do the switch faster because I only took the drug for 2 months?

 

I am stabilizing yet.  Just had to updose to .65 because anxiety is so unbearably high. 

I see the cons as: you have to get your doctor to prescribe it along with your current benzo; you are on benzos longer because of the added crossover period; and not e eryone tolerates Valium well.  We have had members cross back to their original benzo because they felt worse on Valium.  It isn't common but it does happen.  I don't think you should go faster; you still want to allow enough time for the Valium to build up before making the next substitution, regardless of the length of time you've been on Ativan.  Of course, that's just my opinion. 

Day 4 update.  The crossover has been much harder than I expected.  I take 2.5 V at bedtime and .25A twice during the day.  Now I get more sleep but then awake with terrible shakes  The .25 A in the morning doesn't stop them.  I also now feel more confused and dazed and have more cognitive issues.  Is it still possible to go back to full dose of Ativan, stabilize at .75 and then do the taper?  At least I could think on Ativan. 

 

Beeper, the shaking (akathesia) originally started during the 5 months withdrawal from Paxil.  Initially, it was more restlessness and terrible pacing.  Now it's uncontrollable shaking of my legs and at times arms. 

Just wanted to add that the confusion is getting worse each day... I speak 3 times slower and and having problems remembering some words.  I think I would like to give the c/o a rest for now.  Do you agree?

I know what you are saying - by day 10 I stabilize, but each cross is like something of an Ativan cut.  Some people can have their worst symptoms days 4-6 and then feel better.  This most recent cross of mine has kept me in bed yesterday (day 5).  But hopefully it will pass like all of the previous symptoms have as the valium builds up. 

Kiki, so you mean that this state might just be Ativan WD?  I'd like to believe that but I was taking .5 A before the cross-over and now I still do (already took .5 A today) yet there is a real worsening of symptoms.  Do you know if going back to Ativan might create new issues?  I am just not in any position to experiment so much with my meds.  I'd rather titter.  I haven't stopped shaking all day. 

That is really tough.  I'm just wondering if is the interaction of the 2 drugs making things weird for you.  For example, when I make a switch, that switch might be in the evening, yet when I take my morning ativan dose, I get knocked out and need to sleep.  That was never the case before introducing Valium.  With time, this goes away, but I think your body is just trying to figure out how to deal with the new drug and might be overreacting to the Ativan in a way.  Does this make sense?  Just a hypothesis based on my own experience!  My journal noted weird reaction to Ativan at the start of Valium. 

 

No expert here. But I crossed over successfully to valium, 40mg equivalant(including 5mg ambien).

Went dose by dose, usually about 2 weeks, now at 35mg valium, doing well, actually feel better. Will take next drop this week...

 

Ativan is a nasty little....My guess is that you're at such a low dose, that's when things get rough with any benzo(rougher)

You may be at tolerance too. Mine were horrible, didn't really know it was tolerance. It worked against me, while it worked for me.

 

Paxil(I was on a short period long ago) is a black box warning drug is it not? Could that still be affecting you?? I guess you know about that.

 

I'm surprised Valium isn't covering the ativan issue. Again it could be the low dose. Not to updose ativan, but if dr. could up dose

Valium, even 2 1/2mg or a full 10. Still easier than ativan to titrate. There Is an answer for you out there.

 

I wish you well and peace and dr. insight and support.

 

Infoshar.

Just realized from finding this thread that some people do not have a good reaction to diazepam. I made a rapid crossover because my ativan dose was so low, .25 mg 1-2x day. I would have liked to just jump from there but my sx were screamingly horrible during the hours the ativan was not in my system.

 

Diazepam certainly evened out my wd sx, so that helped immensely, but my gastro issues have been MUCH WORSE on the diazepam than ativan. Is this common? I'm down to 79 pounds now and scared. I eat every few hours so it is not from lack of eating!  My first cut went well as far as the other sx, but my gastro swelling and pain is horrendous. I just did my second cut last night and today and not only are my gastro sx even worse, but all the other sx are bad too.

 

Is this to be expected? Do I just try harder to ignore my terrible pain and tell myself I will not die and the sx will be better tomorrow (or eventually)? 

 

 

Sorry to hear your suffering OneLove

 

Not sure you'r dosage of diaz. 10mg total? Hopefully it's truly equivalent. Because I have lyme, I was already taking probitics 2x a day, rotating thru 4 brands at each dosage. That is tremendously helpful for tummy issues. I also use digestive enzymes with my 2 biggest meas of the day. You could try niacin 100mg tab several times a day. Try l tryptophan for calm or even cheap old homeopathics for nerves,

pain, etc. no magic, but they may help some.

 

We have 2 brains. One is the gut. Lots of receptor sites there. Don't know the size of your cuts, don't go over 10% of your total dosage.

 

Actually, at your low ativan dose, your diaz. must be pretty low. My detox dr. will put me on liquid taper around 5mg total, perhaps 7mg..

Maybe that is the issue. People have a difficult time on the low dosages of diaz. in spite of Dr. Ashton's fairy tale sounding "jump offs".

They don't seem to apply to anyone here. Micro taper liquid is the way to go at those low doses, you must be at. Can you get the liquid? And you don't have to go fast. Slow and low.

 

Peace and hope for you.

infoshar.

My grandma had an akathesial reaction to lorazepam and when we tried valium to cross over, she got much worse.

I just wanted to mention this, not to scare you, but as a caution to be aware of.

My mom crossed over from lorazepam to valium with success and is tapering.

Some people are very sensitive.

 

 

One Love - am I reading this correctly in your signature that within the last week you have cut 2mgs of Valium?  If so, that is WAYYYY too fast.  You should be aiming to cut MAYBE .25 -.5 a month at such a low dosage.  I would be vomiting everything if I were to cut aggressively.