Sandfield: How to taper off Ativan .75mg a day

[Sandfield]

Moderator note - link to Sandfield's benzo thread - Sandfield: Try to taper off Ativan

 

My name is Sandfield.

 

I am on Cipralex and Ativan. I have been on Cipralex 10 mg for 6 months. Prior to that I was on 5 mg of Cipralex for 2 years.

 

i was on clonzepam for 2 months May and June 2017 and tapered down to .375 mg at the end of June. The doctor then put me on Ativan .5mg twice daily and I was able to taper and get off 3 weeks ago for 2 days however the withdrawal was so bad I am now on .5  to .75 daily.  My doctor is having me taper off the Cipralex by reducing fro 10mg to 7.5 mg and then to 5mg and then to .25 mg.

 

i am experiencing interdose withdrawal from the Ativan, burning sensation, muscle spasm and tightness in the shoulders and neck and anxiety.

 

Would appreciate any advice on how to handle the withdrawal or if anyone knows of a good doctor in Toronto who may be able to help

Edited October 14, 2017 by Shep
white space (baroquep), moderator note (Shep)

[baroquep]

Hi Sandfield,

 

Welcome to Surviving Antidepressants (SA).  I am glad that you found the site before going any further in your taper.  While the plan your doctor has set out for you is a lot more conservative that most doctors advise, in my opinion, each reduction he has suggested is far too large a decrease and you will likely run into trouble trying to reduce the Lexapro this way.  Lexapro is one of the strongest antidepressants on the market today and can be very difficult to discontinue.  As well, because you are taking a benzodiazepine as well as an antidepressant, you will definitely need to be even more cautious.  While I can't be 100% sure until I see your withdrawal history signature, I have a feeling that you may be experiencing withdrawal syndrome from discontinuing Lexapro and/or rebound anxiety from the Ativan.  

 

A few questions:

When did you discontinue Lexapro 5mg?

When did you start experiencing withdrawal symptoms?

Why did you start taking Klonopin? at what dose?

When did you start Lexapro 10mg?

 

I would encourage you to post an introduction topic in the Members only Benzo Forum to get specific advice regarding the possible Ativan inter-dose withdrawal.  We work closely with the moderators in this forum when a person is planning to taper from an antidepressant as well as a benzo.  Unfortunately in our experience, many doctors will add a benzodiazepine when a patient comes to them complaining of withdrawal symptoms from an antidepressant and oftentimes ends up becoming dependant on the benzodiazepine as well.  I'm not sure if you are aware but you can become addicted to this type of drug in as little as two weeks of continued use. 

 

Members Only Benzo Forum

 

Before being able to provide you with any specific information with respect to your current situation, we would ask that you summarize your withdrawal/drug history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months in particular?  We ask all members to provide their drug history as a signature.  This will be a permanent part of your introduction and It helps moderators to be able to see all of your details at a glance.  You can find the information on how to complete your signature at the link below:
 
Instructions:  Withdrawal History Signature
 
    •    Please leave out symptoms and diagnoses.
    •    A list is easier to understand than one or multiple paragraphs. 
    •    Any drugs prior to 24 months ago can just be listed with start and stop years.
    •    Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
    •    Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.

 

SA recommends tapering by no more than 10% of your current dose followed by a hold of about 4 weeks to allow the brain to adapt to the changes in the central nervous system (CNS).  When changes are made too quickly, doses are alternated/skipped or the drug is discontinued abruptly, the brain is unable to adapt to the changes and this results in uncomfortable withdrawal symptoms.  I am attaching a few links so that you can familiarize yourself with the recommendations made by Surviving Antidepressants and encourage you to become familiar with the recommendations made her so that you can discontinue these drugs in the safest way known at this time.  

 

What is Withdrawal Syndrome?
Before you begin tapering what you need to know
Taking Multiple Psych Drugs - Which to Taper First
Why taper by 10% of my dosage?

Tips for Tapering Off Lexapro / Escitalopram

 

Please feel free to connect with other members of the Surviving Antidepressants community by posting in their introduction topic, they are a supportive group, know what you are dealing with and are here to help.

 

I realize that I have given you a lot of information to digest, but feel that an informed decision is the best decision when it comes to our health and well-being.  If you have any questions, or need clarification on any of the information I have provided, please to do hesitate to post back here in your introduction topic and a moderator with stop by to help.

[Sandfield]

lexapro history April 2011 to June 2012 10 mg,    July 2012 to June 2013 - 5 mg.   July 2013 to July 2014 10 mg. 

                            August 2014 to May 2017 - 5 mg.     May 2017 to October 7 2017 10 mg  now tapering at  7.5 mg

 

ativan April 2017 to mid May 2017. .5mg to 1 mg a day

klonopin mid May 2017 to July 5 2017  .75 mg a day but tapered to .375 mg

ativan Jul  6 2017 to current date .50 to .75 mg a day however Tapered in September to none for a couple of days but had to reinstate

i have had withdrawal symptons from the klonopin taper and currently I am experiencing withdrawal symptons from the Ativan.

The dose I am on never helped the anxiety.

 

 

[baroquep]

A reduction of the Lexapro from 10mg to 7.5mg is far too high a percentage all at once.  We would have recommended that you reduce by 10% of your current dose 10mg x 10% = 1mg  and have a feeling that you are experiencing increased anxiety because of this reduction (among other things).  I would suggest that you stay at 7.5mg of Lexapro for the time being, at least another month, until your central nervous system has a chance to re-stabilize before making any other changes.  

 

Have you been taking the Ativan consistently?  what doses and what time of the day?

Are you still taking the Klonopin .375mg or did you discontinue that in July?

 

It would be appreciated it if you could complete your withdrawal history signature so that we are able to see your history at a glance and would then be better able to offer suggestions as to what might help you get off of these drugs.  It would also be a good idea if you created an introduction in the Benzo Forum as the Ativan (Klonopin?) are interrelated with the Lexapro and it is important that you keep those dose(s) steady until we can work out a solution for you.  It is recommended that you taper only one drug at a time and it is often recommended that you taper the antidepressant first (see link above regarding tapering multiple drugs).  Until we have a little more information regarding your history, it is difficult to advise you on what the best course of action is.  These drugs are very powerful, even in small doses, and you'll want to taper carefully and cautiously so that you are successful in eliminating these drugs.  You can find the information on how to complete your signature below as well as a link to the Benzo Forum:

Members Only Benzo Forum

Instructions:  Withdrawal History Signature
 
    •    Please leave out symptoms and diagnoses.
    •    A list is easier to understand than one or multiple paragraphs. 
    •    Any drugs prior to 24 months ago can just be listed with start and stop years.
    •    Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
    •    Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.

 

 

Edited October 13, 2017 by baroquep

[Sandfield]

The klonopin was stopped in July. I was on Ativan .5 mg twice a day for a couple of weeks and then tapered to .5 mg and .25 mg twice a day. Aug 22 I started the taper of Ativan .25 in the morning at 9:00 and .25 in the evening at 9:30 until Sep 4. Then morning dose dropped and only the night dose .25, Sep 11 dropped the night dose however I had to reinstate a couple off days later as anxiety was so bad.

Intially took .25 when needed usually twice a day. I am now taking approximately .25 or .50 twice a day ( total .75 mg) . No set time just when I really feel the withdrawal symptons. It is also very difficult to cut the .5 mg pills. I was wondering if I should have the doctor switch me to Valium or just take . 5 mg twice a day for now

 

 

[baroquep]

Okay, that's good to know about the Klonopin and the reason I'm encouraging you to fill out your withdrawal signature history ... we need to know exactly what has been going on with you at glance and not have to search through your posts to find the information.  Many of the moderators are also going through withdrawal from these drugs and it can be difficult to assist without all of the relevant information to pinpoint where things took a turn for the worse.  

 

I'm going to alert one of the moderators on the Benzo Forum as I have no experience with these drugs but from what I understand, it is best to take the same dose at the same time of the day, everyday as this will help you to avoid the rebound anxiety caused by these types of drugs.  

Please take the time to complete your withdrawal history signature and post an intro in the Benzo Forum so that we can help you get back on track.  It is possible to discontinue these drugs with minimal withdrawal discomfort.