Valium versus Ativan questions

Hi! 

I want to thank this group for being here.  Here is my story (it might be a little too long, sorry about that):

I am 54 years old, and have had a problem with anxiety disorder since I was a child.  As a teenager I took librium, and then later I think I used marijuana for a similar purpose (although I have not smoked pot in about 20 years now).  However, I have been on low dosages of ativan for years now.  I started taking ativan on a semi-regular basis in 2003 when my partner suffered a massive heart and kidney failure and he was in the ICU for over six weeks.  Over the next four years my partner had numerous health issues, including dialysis, heart surgeries, and other issues as his medical condition deteriorated.  My partner finally died from complications due to a fall in March of 2007.  I had taken ativan (1 mg) before my partner's health problems began in 2003, but only rarely.  While he was unconscious in the ICU, his physicians presecribed ativan to help with my stress, so I began to take it more regulary, probably about 1 - 2 mg a day.  When my partner came home from the hospital I managed to reduce, but never eliminate, the ativan dosage.  The problem was my partner was always on massive dosages of ativan -- he was taking about 16 mg a day when he had his initial cardiac arrest in 2003, which caused great problems getting him to respond while in the ICU.  They got his ativan down some over the next four years, but it always slowly inched back up.  He was taking about 8 - 10 mg a day when he died, plus he was on lots of other psychiatric and pain meds.  As I had to deal with his daily care and his various medical issues, both crises and routine, I would occassionally borrow his aitvan to help me deal with the stress.  I usually took only 1 to 2 mg a week, and never if there was a chance of his running out first.  However, after he died, and I was left with his huge prescription of ativan just sitting there, I started taking it regularly -- 1 mg a day at first and then up to 2 mg some days.  I really feel that the ativan helped through the death and all it entails, as well as the funeral, etc.  He died in March 2007, but by July I was sick of taking the ativan (I was taking around 2 mg a day by then) so I tossed out all that was left (about 20 - 30 tablets).  I didn't have any problems that I can recall from going cold turkey like this.  Usually, when I had stopped taking the ativan before it would bother me for 3 -4 days and then I was fine, so that is how it went down last July.

In September I saw my primary care physician for my routine physical and he prescribed an anti-depressant, remeron, as he felt I was experiencing situational depression from my partner's death.  I welcomed this at the time, as I was very worried about the upcoming holidays and not being with my partner for the first time in 26 years.  The remeron really helped at first, especially through Thanksgiving, but by Christmas it wasn't doing anything at all.  On top of that, I had gained around 15 - 20 pounds from the remeron, which only made me feel worse about everything.  None of my clothes fit me and I felt just wretched.  After consulting with the doctor, we decided to discontinue the remeron and take welbutin instead.  He had me switch from one to the other overnight, but I hated the effects of the welbutin (I was really nasty to people!), so I just stopped it abruptly one day in January of this year after only taking it for a few days.  Then all hell broke lose!  My blood pressure, which had been well controlled for years on only 10 mg of lisinopril, shot up to 175 over 120;  I had severe chest pains and thought I was having a heart attack.  I went to an urgent care center and my EKG was normal, so the thought was I was having a panic attack.  I had these before, begining in 2004 on the one year anniversary of my partner's first cardiac arrest, but I had never experienced such a rise in blood pressure back then.  The physician at the urgent care center prescribed xanax, which immediately reduced my blood pressure and helped out, so it must have been a panic attack.  My doctor raised my lisinopril and added a diuretic for my blood pressure, and he decided I needed to go back on the remeron and to taper off of it more gradually.  He also prescribed ativan (1 mg) to help with the anxiety of the remeron withdrawal.  The ativan did help, and I took my last remeron (after slowly tapering down) in early March.  But of course, now I was stuck back on the ativan!  Unlike before, even last July, I seemed totally unable to get off of the ativan this time!  I would get it down to .5 mg a day, then every other day, but then I would go nuts and up it back to 1 or even 2 mg a day.  I now understand that I was experiencing tolerance withdrawal due to its fast action, based on what I have read here and on the Dr. Ashton website.  After reading about Dr. Ashton's plan, I asked my doctor to switch me over to valium so I could taper off, which he did (5 mg of valium).  I started taking maybe up to 2 valium (5 mg tablets)  a day, but got it down to a quarter tab (which should be 1.25 mg) which I took daily for about two weeks through May 1st.  Then I didn't take any till May 3 (1.25 mg), then none again till May 8th (1.25 mg), but then I had a hard time on my partner's birthday, May 11th, so I took half a tab (2.5 mg) and then again for no reason I can think of I was a mess on the 13th, and I took an entire tab (5 mg)!  I was terrified that I was going the wrong way, so I threw all the rest of my valium out, as well as some opiate pain meds that I had, and the four remaining 1 mg ativan tablets I had been keeping (I had not been taking these, but was keeping them in case of some future anxiety attack).  I did this on the 14th (my last valium was on the 13th), but now I am going nuts!  Yesterday I had severe chest pain, rib pains, aches all over, my head feels terrible, like a hangover sortof, and I am dizzy and very depressed.  I had gotten so low on my regular dose of valium (1.25 mg) that I thought it would be okay to just stop.  In ativan terms as I understand the charts, that is only 0.125 mg of ativan!  That seems like nothing to me.  I am thinking a lot of the problem has to do with how long the valium stays in your system?  I was used to the ativan that clears out much faster, but of course I understand that is what causes the withdrawal symptoms being so harsh.  Anyway, although I do feel a lot better today than the past two days, I called my doctor earler today and asked him to write a prescription for 2 mg valium tabs.  I didn't want to be going nuts over the weekend and end up in the hospital without anything.  I figured I could taper those down even further, to .5 mg a day, and then stop altogether (I hope). 

My questions to your group are:

Should I have re-filled the valium like that -- or should I have asked for ativan and tried the direct taper method instead?  I hate the way the valium makes me feel the next day, all groggy and out of it.  I also hate the way it feels like it is building up inside of me.  I much prefered the way I felt on the ativan -- when it was working right I usually felt awake and alert the next day, not groggy at all.

Why shouldn't I be able to just stop taking it all together now -- I have only been on a low dose of the benzos all along, at least compared to others I see on this board or to the amount my partner was taking.  So why can't I just stop taking it now when I could in the past?

What is the role of exercise in withdrawal from benzos?  I read on the "Road Back" website that they were not recommending starting an exercise program while tapering off, but I know exercise helps me a lot with my anxiety issues.  Also, what is the opinion of others here about the "road Back" program -- it seemed to me that they were trying to sell a lot of supplements, but if the supplements work I would certainly like to try them.

Any help anyone can give me would be greatly appreciated!  Thanks again for allowing me to share all this with you!

Hi!

Welcome to BB.

Stick with the valium. The fact that it is long acting in the body is a plus when it comes to tapering, as it leaves more smoothly. Ativan can be jarring. It's also better not to jump around from benzo to benzo. IMO, you should stay with the valium. Also, when doing a direct taper it's easier to make smaller reductions in dosage than it is with ativan.

Yes, you were on a small amount but some people do have a hard time coming straight off that amount. It would be better to taper down by .5mg every week or two.

You actually sound like you might fare ok without even restarting.

You said you have felt better the last couple of days. It's up to you. If you reinstate, it shouldn't take you much longer to taper and come off the easier way though.  

Some people seem to come off benzo quite easy the first time, only to find it very difficult subsequently.

The road back is selling supplements. And of what I have heard, they don't work. So save your money.

As for exercise, it is almost always beneficial in any case. But go by what your body tells you. Moderate exercise is great at combating anxiety, depression, and insomnia. All stuff that benzo wd causes!

Linda

Hi wangjrming,

Welcome to BenzoBuddies!! I believe what Eljay has suggested is a good plan, either reinstate or try riding it out. Valium is much easier to come off than Ativan because it is longer acting. As far as the Road Back Plan, some have stated that all the supplements they want you to buy at a great expense are not worth the benefits. Many of the ingredients are available through a health food store. Sorry to hear about your partner and the grief you have suffered. Take care.

T2

Hi,

Yes, I agree too, stick with the Valium. Quitting from 1.25mg is more than most of our members can stand - I highly recommend that you obtain 2mg Valium tablets instead. Quartering these tablets means that you can make reductions of 0.5mg - this is far more manageable.

Hi Wangjrming,

I moved you thread to this board, as it is more suitable. You are more likely to receive feedback on this board.

Thanks for your comments and support.  I did get a 2 mg valium prescription yesterday.  The problem is the doctor would only give me six pills -- I hope that will be enough to quit.  I took 3 mg last night (1 and a half pills) and tonight I am going to try and take only one 2 mg pill.  Then try and reduce it by .5 mg (quarter pill) each night.  I will keep you posted.

I have a low grade fever (under 100) -- has anyone ever seen that as a symptom of withdrawal, or do I have something else going on?  I keep have anxiety and small panic attacks, so I keep thinking there is something major wrong with me or I am going to die.  When I have had this before, even with the chest pain (no chest pain now) I ended up going to the ER, paying the huge co-pay and have lots of tests, all of which were negative, and of course they probably gave me an ativan to calm me down.  So I am convinced that there really is nothing wrong with me, but I didn't see low grade fever on the list of withdrawal symtoms so I wondered.

Thanks again!

Hi,

Six pills?? Well, that kind of is not even a worthwhile amount to prescribe you for a taper. 

But i would say, since you seem to be doing ok benzo free the last two or three days, you will probably do all right with this.

I posted somewhere else about your fever.

http://www.benzobuddies.org/forum/index.php?topic=8159.msg97012#msg97012

Hi,

You should try to obtain some more of the 2mg pills. If you have some 5mg pills left over, you can mix and match the two different dose pills so that you do not use up your 2mg pills so quickly.

Edit: Oh, I think you were down to 1.25mg anyway, so I guess you will not be able to mix and match the pills.