Tapering off ativan
November 19, 2016 5:36 PM   Subscribe

How to taper off ativan

I have been on ativan for about 6 months, increasing (prescribed by doctor) up to 1mg 3x a day for about the last 3 months of those 6 months. I really want to taper down but am very anxious about what I've read online. Can someone recommend a tapering schedule? The horror stories online are making me feel way worse and scared, but I'm trying to remind myself that most of those cases are people who took them for years. Help/hope me?
posted by DeltaForce to Health & Fitness (17 answers total)
edited: yanmd
posted by DeltaForce at 5:42 PM on November 19, 2016

Is there a reason you can't go to the doctor who prescribed it and ask this question? That would be the safest approach.
posted by zachlipton at 5:47 PM on November 19, 2016 [1 favorite]

there is a reason that i would prefer to not go into
posted by DeltaForce at 5:50 PM on November 19, 2016

Could you ask a pharmacist?
posted by chesty_a_arthur at 6:16 PM on November 19, 2016

Call the pharmacy where this prescription is filled and ask to speak to the pharmacist. No stranger on the Internet can safely or ethically recommend a tapering schedule.
posted by pecanpies at 6:26 PM on November 19, 2016 [10 favorites]

Unfortunately I don't remember the tapering plan I followed, but I can tell you that it was pretty easy, not at all like the stories I read online. After a few weeks I was off them with very little discomfort and haven't taken any since.
posted by soakimbo at 6:26 PM on November 19, 2016 [3 favorites]

Hi there. I am sorry that you are feeling so anxious. I successfully tapered off of this med by myself, but I do not know if my situation and your situation are similar at all. I felt comfortable going down a little bit at a time (like, using 3/4 of the tablet instead of the whole tablet) and then going down again when I felt subjectively ready to do so. That did not seem to me to be dangerous in any way. However, I am not you!

You will probably have to see a psychiatrist regularly anyway if you are getting this medication. I do not want to tell you to do something that is impossible, but I suggest trying to discuss this with a different psychiatrist (or even discussing this with an internist; they are often relatively familiar with benzodiazapenes like ativan because they are an old, common med).
posted by Rock 'em Sock 'em at 6:26 PM on November 19, 2016 [1 favorite]

And like the answer above, when I was tapering off it was fine. I went at a pace that worked for me and did not experience any real side effects.
posted by Rock 'em Sock 'em at 6:27 PM on November 19, 2016 [2 favorites]

This was klonopin and don't necessarily recommend this but I quit cold turkey and would just take a little bit whenever the withdrawal symptoms got out of hand.

I was shaky and felt off for a couple weeks but while unpleasant it was NOTHING like the horror stories I read online. But YMMV of course.
posted by wilywabbit at 8:06 PM on November 19, 2016

Just wanted to say that I quit Ativan and Klonopin (notoriously worse than Ativan) and didn't have terrible problems like everyone said online. That said, it sounds like you are on a moderately high dosage, so you probably want to go pretty slow. Maybe make your incremental changes over two week periods at a time since you take it multiple times a day. I can't remember my schedule, sorry, so I too recommend talking to a pharmacist.

But just to offer you a little peace of mind, 6 months isn't that long, as you know, to get your system really dependent on it. Remember that people tend to post only the worst experiences online; people who are fine with meds and related situations don't bother to post generally, so you're getting really skewed information. If you buy into all the fear, your anxiety will worsen and you may even mistake it for endogenous anxiety when it's just stuff whipped up by internet-driven fear.

You can do it; we're in your corner. Go YOU!
posted by GospelofWesleyWillis at 8:51 PM on November 19, 2016 [1 favorite]

I am not your medical professional, but I am a medical professional. I was not going to respond to this ask me until people showed up talking about cold turkeying Klonopin. Please do not do this. Any drug that primarily works on your nervous system *really* needs a step down period. The danger here is less unpleasant side effects and more seizure. Having said this, you are not on a huge dose. Substantial, yes; huge, no. If it were me and I had one mg tabs, I would start by halving my lunchtime dose for a week, followed by halving my breakfast dose for a week. Then I would do this again (down to .25 at lunch and a week later .25 at breakfast). Slow and patient, continue on this way until you are at the dose you feel comfortable with. Keep a record of what you are taking and when, don't wing it. A low dose of Ativan as needed is not an uncommon prescription, but if you stay on a smaller maintenance dose, keep your bedtime administration.
posted by letemilytryagain at 10:24 PM on November 19, 2016 [7 favorites]

I am not any kind of medical professional, but I have helped some people get off of various drugs. To underline l.e.t.a. above: most people who quit, say, Ativan or Klonopin by immediate cessation don't die.


There's no reason whatsoever to risk dying by choking on your own tongue. Nor to survive cold-turkeying any benzo, but in a coma. Or with brain damage. Tapering off just requires some patience, a touch of arithmetic, and a pill cutter. I am told that tapering off of Ativan while switching over to Valium, and then tapering off of Valium by itself, is easier and less dangerous, but I know literally nothing about that.

Have you seen this? It seems, ah, legit.
posted by BrunoLatourFanclub at 10:53 PM on November 19, 2016

I tried to quit klonopin cold turkey (4mg a day). I got very sick and when I called my Dr asking him about my vomiting, muscle jerking, sweating and anxiety, he got really pissed off that I was trying to do this on my own. He immediately told me to take 4mg and come in to see him to discuss what the hell was going on. I did detox off very slowly.

If you are not comfortable talking with the prescribing physician can you see your PCP for help or another medical professional? I would not recommend you take advice from strangers on the internet.
posted by cairnoflore at 12:06 AM on November 20, 2016

The stories you see online or in forums dedicated to this are usually from the small percentage of people who react very, very poorly, for whatever reason, and have been on higher doses for longer periods of time, and they are still a subset of people who get off of benzos. Nobody goes online to talk about how easy it was, or that it was a mild discomfort that lasted a few months.

Do not go cold turkey.

Talk to another doctor or your pharmacist about a tapering schedule. If you want to be extra cautious, or if you notice the effects of the first cut, you can see if you can get it in liquid form which you can then dilute for a slower taper.

The suggestion above seems reasonable. Follow that and you will most probably be ok. Just make sure you have someone to call if you're not.
posted by schadenfrau at 4:57 AM on November 20, 2016


I was taken off of numerous meds at once. I was on a daily benzo too (Xanax).

The doctor went off of the half lives of the meds and when they would be out of my system.

I now know about protracted withdrawal syndrome. Months later I started getting crying panic attacks out of nowhere and lost months of my life to this terror.

I would go super slow. IF you doctor doesn't have a plan that you are comfortable with, find another DR!!!
posted by kbbbo at 8:42 AM on November 20, 2016 [1 favorite]

Agree that you need to talk with a pharmacist who knows the other drugs you're on, or the doctor who prescribes this medication for you. There is no one-size-fits-all way to taper a benzo. You can probably get taper instructions over the phone or email if you don't want to go in person, but they have to come from someone who knows what they are doing, and what you are doing. Trust me, your doc won't be offended if you go to them -- this is why you and your insurance company pay them.

The one thing you definitely should NOT do is stop cold turkey. I've taken care of people who have had seizures (no prior seizure history) after running out of or abruptly stopping their benzo. Please don't become one of them.
posted by basalganglia at 10:11 AM on November 20, 2016 [2 favorites]

I quit Klonopin after being on it for 20 years. Taper slowly! It can be extremely difficult (understatement for me), especially because many (most) doctors and psychiatrists do not understand Benzo withdrawal. So, educate yourself; go slow; and get a support system in place before you begin.

Some resources:

The Ashton Manual (A must read; includes tapering schedules, based on decades of experience with patients).

Benzo Buddies. Support network for people going through withdrawal. Great resource, wide variety of experiences are shared, wonderful support; also provides way to keep track of your withdrawal. When going through withdrawal you may experience weird symptoms. Everyone has a different experience, but you'll find people here that have also had that maddening ringing behind their left ear, or whatever.

Beauty in the Breakdown, by Matt Samet. A hard core rock climber kicks his addiction to benzos. I found the article inspiring, and if you connect with it, I also recommend his book, Death Grip.

After writing all this, I should say that I believe that my struggle to get off Klonopin (which continues, 15 months after I took my last pill) has most likely because I had been on it for so long, and in increasing doses, and that from what I've read those on it for a relatively short period of time usually have it easier. However, when it comes to benzo withdrawal, slow and cautious is a good strategy.

No need to be scared — preparation helps a lot! And Benzo Buddies can be a great resource even before you begin tapering. Hope this helps, and good luck!
posted by young_simba at 4:26 PM on November 20, 2016 [1 favorite]

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