Anxiety - Properly tapering off Ativan?

Question

Hi everyone

So glad to have found this place. I have suffered from severe anxiety, panic attacks, OCD, stress-intolerance, Agoraphobia and a few other anxiety-related disorders for about 12 years now. I've also been taking Ativan (1mg) for the last 4 years and was splitting my pills in half. At first, I was only taking one pill as needed whenever I had a panic attack or encountered a particularly stressful situation but later, I began just taking a half pill three times a day (when I woke up, at 4:00PM and just before bedtime). This went on for several years. I never took more than this because I didn't want to become too addicted or give in to the tolerance by increasing my dosage over time.

Recently, my doctor has been increasingly resistant to prescribing these pills and even getting visibly angry when I ask for them. During the last visit I was really put throught the wringer and he ended up only giving me half of what he normally prescribes after a stern lecture and a threat to cut me off completely. He also put me on an anti-depressant which I've already told him twice I had a bad reaction to.

Knowing that I risked being cut off and that being forced to go off of the pills abruptly could cause severe withdrawals, I decided to begin tapering on my own just in case and to prepare myself for the day when I wouldn't have them around anymore.

For the last 5 days, I have dropped my daily dosage from a half 1mg pill 3 times each day to just a 1/4 of a pill 3 times a day. It has been one tough ride so far and I never realized that I had become THIS dependant on them until now. The first day was the worst and then that night I had some really wild dreams and woke up wishing I could just stay in bed for a hundred years. I felt like a zombie. Like my brain had been sucked out of my head. Zero motivation. Zero emotion. Like a robot.

The next day I felt about the same way although I felt only slightly better that evening but then the increased anxiety, fears and paranoia set in. I began to have all sorts of obsessions about being spied on and tracked by government agents. I was ID'd at the pharmacy for the first time and that sent me into a paranoid frenzy. I took my dog to the vet and they took a picture of him which I thought was just a "ploy" to get a picture of me. I went outside and at the same time, my neighbor came out to sit on his porch and looked over at me which lead me to believe he was spying on me. I would also get what I believe are myclonic jerks (where a muscle suddenly "fires" and your arm jumps or twitches a little bit, etc). Over the next few days other little things happened which made me suspicious and paranoid and I began magnifying every event in my mind to the point where it got completely out of control.

I began looking up my symptoms and it sounded like schizophrenia and that terrified me. I read about psychosis and that made me even more afraid. I thought I was losing my mind. Then I began reading about benzo withdrawal and how it can mimic the symptoms of schizophrenia and make people very paranoid and cause lots of the other symptoms I have been experiencing lately. The shame is that at a time when I am under increased stress and anxiety, I am having to taper off of the same medication that is used to treat my anxiety and that makes the whole situation even worse.

Anyway, having given some background here, I guess what I'm wondering is...

1) Does it sound like I tapering correctly or should I not have cut my daily dose in half like I did?.

2) Is there anything I can take to lessen the severity of the withdrawal symptoms?.

3) Do any of these withdrawal symptoms sound normal for my situation... are they typical?.

4) I have read in many places that Valium is the best benzo to use for tapering but after I've tapered off Ativan do I then stop using it altogether and switch to Valium -or- is it safe to start the Valium WHILE at the same time I'm taking the tapered doses of Ativan?.

Thanks for any input on thse things and again, so glad to be here!.

- Jaybird

Answer

You must get to the point where your tapering leads to NO Ativan daily.Sounds like you need a doctor&rsquo;s monitoring.

Answer

Staying on benzodiazepines long term? They are only meant to be used for 4-6 weeks because of the long term side effects... besides addiction.
Benzodiazepines have been linked to the development of dementia and other brain disorders, memory loss, seizures, depression, sexual dysfunction, aggression, sleep disorders, psychosis, exacerbated anxiety, IBS, depersonalization, disturbances to immune and endocrine function, suicide ideation, pneumonia, and a possible increased risk of cancer.
Way too risky for me... I decided on pursuing traditional treatments and hung in with them until they became therapeutic. Glad I muddled through and proud of it.

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Jaybird, how did your taper go? I am on my third month of 0.5 mg lorazepam and want to get off it. I am also withdrawing from another benz, so my sleep is precious. I&rsquo;ve been trying to cut out 1/4 of the tablet for the past 2 week and want to cut out another 1/4 tablet for another 2 weeks until I can get down to 0.25 mg and jump off. Since I&rsquo;ve only been in this medicine a short time, does this sound reasonable? I don&rsquo;t have time or energy to go through another protracted withdrawal.

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I have been on Ativan for 30 years for sleep anxiety. I only took 0.5 mg at night. I recently moved to a new state and got a lot of flack from my new PCPthat he would not prescribe them and he sent me to a sleep clinic. I was very upset for what was going on, however, I met the doctor from the sleep clinic who actually Was extremely disappointed with my PCP because she believed that start being the drug after 30 years was very very unsafe. Was extremely disappointed with my PCP because she believed that start being that drug after 30 years was very very unsafe We are in the process of doing some sleep studies to see why I have sleep anxiety but at the same time she told me that we would have to do a very long taper so that The benefits of tapering would outweigh the side effects . She started me at 0.25 mg at night and I am on that dose for probably to months.

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Depending on the sleep studies we will go from there as far as how to help my sleeping but she said that once we all feel good about decreasing the Ativan dose again we will only go down to a half of 0.25 mg tablet for another 1 to 2 months. Depending on the sleep studies we will go from there as far as how to help my sleeping but she says that once we all feel good about decreasing the Ativan dose again we will only go down to a half of 0.25 mg tablet for another 1 to 2 months even though these are very low doses and I started off at low-dose is the fact that I was on it for 30 years is the biggest problem . I actually would like to just stop them but she told me that if I just stop them the tape rain with a successfu I actually would like to just stop them but she told me that if I just stop them it would likely be unsuccessful. She is a really really good doctor with great human compassion and like my PCP that I fired. She is a really really good doctor with great human compassion unlike my PCP that I fired Whatever you do know that a slow taper is probably the very best that you can do to yourself as long as you have a doctor that believes the same thing . In talking to people I was told that most regular doctors believe that if you are only on a 0,5 mg At night, at night It is a low-dose and you would not have to taper but that is not true because is the length of time that you’ve been on it that they need to look at and that the amount. It is a low-dose and you would not have to taper but that is not true because is the length of time that you’ve been on it that they need to look at and that the amount. Good luck to you and me both.

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I'm also wondering, since I'm new to this medication, can you still smoke cigarettes with it?

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Hello, bluejay47, I'm new to this medication and just started taking 1mg as needed. They gave me one at the hospital at 9am this morning and now at 5pm I started to take another one because just for that moment I felt my attacks coming back, but I hope it doesn't remain hard for you to ween off.

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Hey everyone I hope all is well and everyone is feeling good and at peace. I've had experience with Ativan on and off for the past few years. I take other meds for bipolar disorder as well. As a result of unfortunate circumstances I started having panic attacks again after going a few years without them. I keep a script of .5mg prn, but I wouldn't take any unless i desperately needed to because again I'm on other meds that's suppose to keep the anxiety low. So, again I had to go back on Ativan daily .5mg once a day. After I told my doctor that the panic attacks were daily, she wanted to increase the dosage to 1mg, but I refuse to increase my dosage and now I'm actually going to try a slow taper off by going down to .25mg once per day. I like the idea of tying Benadryl. We'll see how it works. I understand that everyone is different, but I'm not too keen on this medication Ativan. I wish you all well, let us keep each other lifted in prayer.

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I took Ativan 3 mg a day for 3 years. When I tried to detox I was fine until 2 days after I had been ativan free for 2 days WRONG! Tried to tough it out dizzy, involuntary shakes, eye problems, could not sleep etc. After 7 days could not handle anymore went to a detox specialist put me back on 1mg ativan for a month which worked then 3/4 of a mg for a month 1/2 mg for a month 1/4 for a month then 1/4 mg every other day for a week.. I was DONE no problem at ALL after that... must be done SLOW!

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Hello I hope you are doing better and were successful in your attempt to get off of Ativan. I have been on 1mg for over 10 years. I was prescribed one 1mg every 8 hours. Thank goodness I didn't start taking more as it no longer worked for me. I did not know about the withdrawal so a couple of years ago I stopped taking it. Well in a day or two into stopping I could not function and went to see the doctor and was then told my symptoms were from stopping the Ativan. I started taking it again with no real advice from the doctor. I take one 1 mg at bedtime. I'd like to know the best way to taper off. I've read the longer your on it it's more difficult Thank you

Answer

I tried tapering off ativan by switching from ativan to valium (diazepam) but I found I could not do it. I found diazapam did not act quickly enough and I felt quite ill on it. Diazepam takes 1-2 hrs to work whereas lorazepam only takes about 15-30mins. Probably why I could not do it.

I am now trying to taper by splitting my 1mg of lorazepam into 4 x 1/4 mg doses spread at equal times of the day, 8-9am, 12-1 pm, 4-5.pm and 8-9 pm. Finding it a bit difficult. Had two panic attacks yesterday and wonder if it was because the 1/4 mg dose is too weak.

Anybody else had this problem?

Answer

Try taking diphenhydramine ( generic name  Benadryl) for withdrawal. It works - see clinical trial:  Evaluation of inhibitory effect of diphenhydramine (Benadryl) on benzodiazepine dependence in rats.  Result of clinical trial: It may be concluded that diphenhydramine (Benadryl) exerts a protective effects on benzodiazepine withdrawal syndrome.   https://www.ncbi.nlm.nih.gov/pubmed/10225031   I tried it - it works - especially when taken with paracetomol.

Answer

Hi... this is a new reply to an old post but I thought I'd reply for those that are struggling with tapering off Ativan. I was on a 3x a day dose for about 3 mths. 0.5mg in evening and 0.25mg in am and afternoon due to severe anxiety. I stabilized my anxiety with an SSRI (5mg of Lexapro daily) and have been tapering down off Ativan for the past 7 months. Yes. It takes that long. I have another month to go. The taper is micro-taper every week. I basically decrease my dosage a tiny bit every 5-7 days using lorazepam powder in an oral suspension. I first had a 0.5mg per 1ml oral suspension from a local compounding pharmacy. I developed a detailed taper schedule and shared with my doctor who approved and wrote the prescription for the local compounding pharmacy. I used a 1ml oral syringe that the pharmacy gave to me. I have to keep the oral medicine in the refrigerator.

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I recently changed to a weaker formulation of 0.1mg per 1ml formulation to be able to get down to very small and accurate doses during my last 2 mths of taper. I recently removed the day and afternoon dosages and now only take in the evening with good results. I have about 4 weeks left. So excited to be off.

I have very slight withdrawal at times but mostly I have no withdrawal with this method. Small calculated decreases. It takes a long time but it is worth it. I had terrible withdrawal when I tried to go fast. All of the horrible things you read about. Doing it this way greatly mitigated my withdrawal. I could live a normal life as I withdrew using a taper method.

Amazing at the dependency this drug causes. Only 3 months of taking it and 8 months of tapering off.

If I can do it, you can do it. Take it slow. Tell your family and friends that this is what you are doing. Get support and get a good doctor and a good compounding pharmacy so understands what you are trying to do and supports you.

Votes: +2

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I have been on 2mg of Ativan per day for the last 4 years or so and I recently started tapering off of it. I have found that they key to successful tapering is to go SLOW AND STEADY. Hopefully your doctor is working with you (and not against you) and will assist with a slow taper. I started by cutting my 1mg daytime dose to 0.75mg and taking the night time dose as usual. I did this for about a month before going down another 0.25mg. I would alternate between my daytime and nighttime dose for the cuts every month so that my body eventually got used to it throughout the day. Although it has been a slow ride (there definitely have been a few hiccups) I am currently on 0.12mg in the morning and 0.5mg at night (I cut my 0.5mg tablets in quarters with a pill cutter - its not super accurate but I try not to think about it too much because it is getting the job done).

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With this taper method I do experience withdrawal symptoms (and the list is long) but they are mild in nature. The first week of the new dose is usually where I will experience the most discomfort. This includes insomnia, depression, lack of motivation/energy, low mood, rebound anxiety, stiff neck, irritability, difficulty concentrating, feeling scatterbrained and overwhelmed and a general feeling of dread. After the first week these feelings usually subside and things become more tolerable. The rest of the weeks are still a challenge but I try to focus on the fact that I will soon be Ativan-free.

Personally, I chose not to taper off Ativan with the assistance of another drug. I didn't want to have any negative side effects from the new drug and have to eventually taper off that too. But I understand that everyone is different and you should do what works for you.

Its also really important that the people who are close to you know what you are doing and have a general understanding of what you are going through. In my situation, my partner is pretty unaware of my daily struggles with anxiety and withdrawal. When I let him know I'm about to cut my dose its almost as if he acknowledges it and then immediately forgets and does not realize that his words and actions can exacerbate the symptoms. This has been the most challenging part of my withdrawal. Living with someone who has to be continuously reminded that I am going through something extremely challenging can be exhausting and makes me feel pretty crappy.

Other than that, I think you are definitely doing the right thing but need to slow down your taper. I couldn't imagine being forced to drop my dosage down that quickly. Is it possible for you to get a new doctor? He sounds pretty insensitive. I know how hard it is to find someone new though, so I definitely empathize with how stressful it can be.

But yeah, keep it up. Do it slow and steady and make sure the people around you are supportive and aware!

Votes: +1

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I have been on Ativan for 35 years 1 mg twice a day last week I cut to 1 in morning and for 2 days I had chills hot flashes 3rd day was fine after 35 years I thought it would be harder then that I hope to stop and get off to none.

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I took Xanax for 9 years and in August of 2015 my Dr. said he was going to take me off of it because new studies came up that showed early Alzheimers in people that take Xanax for long periods of time. I originally got them from my OB just by asking. What a mistake!! My family Dr. started the prescription for me about 5 years ago. He substituted the Xanax with Ativan. Seemed like they were working pretty good but he is really funny about the prescriptions and wants me to come in every 6 months. I am just tired of it and have been weaning off slowly in the past 3 months. As of today I have not taken any in 3 days. I am swimmy in my head but seems alright, like something I can handle. Just hope it doesn't last that long. Sad part about my story is that I really never had anxiety to begin with until AFTER I started taking the Benzos. I had a heart attack on December 6, 2015 and had to quit smoking.

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That is the ONLY reason I continued as I was almost off of them when that happened. I have some left in a bottle and I will keep them with me just for the sake of it but I am done with these things. Hope you get some relief!!

Anxiety - Properly tapering off Ativan?

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