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Treatment - Can I come off of Ativan cold turkey and live?

Discussion in 'Downers addiction' started by Astal, Feb 14, 2012.

  1. Astal

    Astal Mercury Member

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    Ive been taking it on and off for 2-3 months and never had any withdrawls. I was off of it for like 4-5 days before my last bout of it. things got out of hand I found out my gf was pregnant and I was super stressed. So for about 2-3 weeks ive been using anywhere from 2-6 mg of ativan a day, some days 1-2 some days 4 before bead, some days 3. There were a lot of 4 mg days in there. Anyway

    I was off of them for like 48 hours before figuring out what was wrong, why I was hallucinating, my skin was on fire, felt like needles, I felt like I was having a heart attack chills and so much more.

    Im so scared im so so scared im sitting here with tears pouring all over my keyboard I regret this so much. My gf is pregnant and sick so she cant help me. Im afraid when I call my doctor what I did tomorrow he is just going to cut me off. What can I do.

    How long would my withdrawl last if I cut out all ativan right now?

    4days? 1 week? 2 weeks? If its anything over 1 week I dont think ill be able to survive it. I WISH I WOULD HAVE NEVER TAKEN THESE PILLS.

    Please someone help me
     
  2. Mindless

    Mindless Gold Member

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    Ativan (Lorazepam) is a short-acting benzodiazepine and has a high potential for addiction. If you are experiencing hallucinations this could indicate delerium tremens, i.e. DTs. Your other symptoms are also indicative of acute benzodiazepine withdrawals. These withdrawals are sufficiently severe to be life-threatening. Acute withdrawal often causes convulsions (which may be fatal), psychosis, and can lead to suicide. You cannot afford to waste time until you see your doctor tomorrow, you need to see a doctor, contact emergency services, or go to a hospital now.

    The risk of dying is more frightening than seeing your doctor. The most effective treatment is to stabilise you on lorazepam for the first week, gradually switch over to diazepam, which is longer acting, then taper down the diazepam. If a taper is suitably slow there may be minimal withdrawal effects. Heather Ashton's equivalency charts are often quoted, she gives an equivalency of 10mg of diazepam for 1mg of lorazepam. Diazepam is more suited to tapering as it has longer effects, and is available in small doses so that a more gradual taper can be achieved. This won't be anything like the hellish experience you are currently having.

    Source: The Ashton Manual

    There is an excellent resource written by Heather Ashton which is available online at benzo.org.uk. This manual contains examples of withdrawal schedules:

    BENZODIAZEPINES: HOW THEY WORK AND HOW TO WITHDRAW (aka The Ashton Manual). PROTOCOL FOR THE TREATMENT OF BENZODIAZEPINE WITHDRAWAL. Professor C Heather Ashton DM, FRCP.

    Please let us know what happens, it would be good to know if you're ok and have found some help.
     
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  3. OccularFantasm

    OccularFantasm Silver Member

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    The sensations of skin feeling like its on fire or on needles is not normal for benzodiazepine withdrawal in my experience. The sense of worry or hysteria You may be feeling is entirely typical of benzodiazepine withdrawal however, so worry not there.

    What has happened is You is experiencing a rebound effect, that is the plasticity at the GABA-A receptor site has become too high. The result of this is the requirement of excess GABA-A receptor site binding/agonization to elicit the same effect as initial administration. The rapid attenuation (especially cold turkey) creates a point where the experienced level [plasticity*concentration] of the neurotransmitter is lower than it was initially without the GABA agonist (the ativan).

    There are a couple effects that are the result of this new equilibrium. One is that the glutamate and GABA receptor become somewhat unbalanced due to differential plasticity. GABA produces inhibitory action towards glutamate, and glutamate produces excitatory action towards GABA. (the reason why too much caffeine can induce anxiety, while benzodiazepines induce anxiolytic effects.)

    Given yous dosage and length of duration, I don't think there should be any life threatening issues at hand from discontinuation. Usually lethal withdrawal occurs after years of use, so You has been kind to themselves by stopping at this earlier stage.:thumbsup: That said cold turkey is not the medically advised route, although it is my preferred route. This is because although it is harsher and more intense, the plasticity and functioning in the brain also recovers more quickly.

    There are things that You can do to help with the withdrawal. An alpha-2 adrenogenic agonist such as clonidine may help alleviate some symptoms, such as "crawling" sensations on the skin and hypertension. (It is often used in opiate, alcohol, and nicotine withdrawal for these same reasons.) It decreases levels of the anxiety inducing excitatory neurotransmitter norepinepherine, thus decreasing overall anxiety- although at the cost of lethargy. A dosage of 0.05mg 4-8x a day depending on yous blood pressure and reaction to the drug would be suffcient, or perhaps a low-dose patch to keep up with the effects. This route would require You to see a doctor however to obtain a prescription.

    Supplemental dosage of beta-phenyl-GABA may also prove helpful, as it is an active form of GABA, which due to its chemical structure is able to pass through the blood brain barrier. This would increase the levels of GABA in the brain without agonization of the receptor site, providing some relief without worsening the condition. You might also consider taking some magnesium glycinate, L-taurine, and pyroxidal-5-phosphate to help convert excess free glutamate into additional GABA into the brain (100mg, 500mg, 30mg respectively would be acceptable parameters). These two methods produce a more minor effect than clonidine or a benzodiazepine would, however they also induce less negative side effects and are available without a prescription.

    I would caution against drinking alcohol. Alcohol stimulates acetylcholine, antagonizes NMDA, and most pertinent to this discussion agonizes GABA-A receptors. This last part is the same mechanism to which the benzodiazepines act. If it gets too bad a shot or a beer may be able to calm the nerves by acting much like the benzodiazepine would, however with more side effects.

    One thing not often discussed is benzodiazepines role in sleeping. Nearly all the cycles of sleep are interrupted via benzodiazepine administration. This can lead to alterations in restfulness, alertness, perception, learning, and mood in general. [also exhibited by alcohol]

    If You is scheduled for surgery they may be able to kick start the recovery, that is if Propofol and ketamine were used as anesthetizing agents. The Propfol has exhibited effects at reducing desensitization at the GABA-A receptor, while ketamine has its use in regulating the sleep cycles, namely through activation at the sigma receptor site. The odds are low that You will be having surgery soon, but SWIM still thought it worth a mention.

    Another thing worth mention, is when I was in a detox for opiate addiction, the doctor had prescribed clonidine and alprazolam (xanax) as concomitant medications. There are some cautions with such mixtures, since each potentiates the others effects. The result however, is the ability to use a significantly lower dose of the benzodiazepine to achieve a similar result. On a tapered dose, this combination may provide a more comfortable and safer withdrawal for you.

    [If You does goto a doctor for clonidine, mention if You is on amitriptyline as well. SWIM brings this up because administration of clonidine and amitriptyline together led to corneal lesions in rats in 5 days, although I am unsure if that side effect is replicated in humans or not.]

    SWIM wishes You good luck on their recovery.
     
    Last edited: Feb 14, 2012
  4. Mindless

    Mindless Gold Member

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    "All sorts of strange tinglings, pins and needles, patches of numbness, feelings of electric shocks, sensations of hot and cold, itching, and deep burning pain are not uncommon during benzodiazepine withdrawal." Source: The Ashton Manual.

    I think that you are underestimating the potential for both addiction and serious withdrawal effects in Astal's case. It may seem less likely to you, but there is still a risk of dependency here. Two to three months' regular use is mentioned, especially as Astal is unclear about daily doses and his duration. He does talk about 2-3 weeks daily use, which could lead to physical dependency. Hallucinations are another indication that he may be experiencing acute withdrawals, as is his current mood. Hopefully I'm wrong, but I don't think it's worth taking risks with benzodiazepine withdrawals. His best choice would be to seek medical help now.

    Mindless added 12 Minutes and 12 Seconds later...

    Have you any citations or other evidence for these claims that lethal withdrawal only usually occurs after years of use, or that brain function recovers more quickly after abrupt cessation of use? I have seen individuals become addicted to benzodiazepines over periods of weeks or months, especially with shorter acting benzos such as lorazepam.
     
    Last edited by a moderator: Sep 10, 2017
  5. Astal

    Astal Mercury Member

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    Will a hospital ER do this, ive checked and there are no local Detox clinics that just do detoxes, they are all 28 day programs. I dont wanna be away for 28 days as i have other health problems as well.

    What do I do if my doctor says no, i have like 80 ativan left my gf found an old bottle of hers and gave them to me to try to use to wean off the problem is i can be semi stable at 1mg x 4 a day until around 6-8pm then all hell breaks loose and im sick as fck until 6 am the next morning.
     
  6. Mindless

    Mindless Gold Member

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    I'm glad to hear you are still safe. If you're needing 4mg or more during the day, and withdrawing at night, then switching over to diazepam gradually would stabilise things more effectively. I'm not a drug worker or prescriber, and these are the people best placed to help. There is a schedule by Heather Ashton for your apparent level of dependency; Schedule 3. Withdrawal from lorazepam (Ativan) 6mg daily with diazepam (Valium) substitution. (6mg lorazepam is approximately equivalent to 60mg diazepam). You can find this in table form here.

    What were the hallucinations you experienced? Were they visual or other? As for the 28 day programme, I don't know what services you have available locally, but a home detox supervised by your GP or a community drug worker might be an option. It might be an idea to have a copy of the table to show your own doctor. I don't have the experience to suggest a taper based on your current supply of lorazepam, maybe some of our other members will have an answer. Thank you for the update, I hope things go well with your doctor.
     
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  7. Astal

    Astal Mercury Member

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    Hi guys, im really confused, today I only took 2 1mg ativan, and had minor problems, my BP is 160/110 (not sure if the meter is right we just got it and im not sure how to use it, i feel like I have a bp head ache but its been this high before) anyway. I feel great besides chills right now and my last ativan was 10 pm last night and the one before was 8am the morning before that. So im wondering how I went from 1mgx4 with bad withdrawls to 1mgx2 with like hardly any. Im gonna try not taking any today and see what happens. Will keep you posted.

    Not sure if i mentioned or not but i was munching 60-80mg baclofen 1-2 times a day for around 2 weeks because it gives me extreme euphoria im wondering if i never did have ativan withdrawl and it was just the baclofen
     
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  8. Mindless

    Mindless Gold Member

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    The baclofen use is interesting; this drug can itself cause hallucinations, and serious adverse effects can be felt on sudden discontinuation. I imagine this has something to do with baclofen being a GABA B agonist. It does increase the sedating effect of anxiolytics and hypnotics. Baclofen should be tapered down gradually over a week or two at least, longer if the withdrawals are too much. Baclofen withdrawal effects include:

    "risk of hyperactive state, may exacerbate spasticity, and precipitate autonomic dysfunction including hyperthermia, psychiatric reactions and convulsions."

    The maximum daily dose of baclofen is 100mg, divided into three doses. Dosage should be increased gradually. The usual maintenance dose is 60 mg daily. Baclofen may indeed be a cause of the problems you have been experiencing, although this is not certain. Source: BNF 62 September 2011.

    At this point I can't give a meaningful answer. You may or may not be having problems with withdrawals, either from lorazepam, or baclofen, or both. I think it's safest to discuss this with your doctor or someone else suitably qualified. A blood pressure reading of 160/110 is not healthy, the diastolic of 110 could cause you some problems and may explain the headache. This warrants medical attention, it might be prudent to speak to your doctor today.
     
    Last edited: Feb 16, 2012
  9. Astal

    Astal Mercury Member

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    checked my bp it was 120/87, i had the cuff too tight lol. So far im ok will continue to post if things get worse ill go to dr or er
     
  10. Mindless

    Mindless Gold Member

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    I hope things continue to go well. Thanks for keeping us informed. Those digital blood pressure machines are tricky buggers. Stay safe.
     
  11. Astal

    Astal Mercury Member

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    Well 2 weeks off, still getting numbness and tingling in the right side of my chest and back at times. Still not sleeping good. Still getting some anxiety attacks, but im taking 800 mg of valerian root and 1000 mg passion flower to deal with it.

    Still having unbearable chills and feeling cold all the time having a temp of 96.5-97 f at times but that happened before the withdrawl also.

    I cant take 5htp or any kind of brain chemical supplement because it causes a withdrawl effect in me.

    So im pretty sure my brain still cant adapt to chemical changes.

    Im waiting for hormone blood work slips from my doctor.

    I need to see if i need to start taking iodine again cause that helped before after taking it for a month
     
  12. Natural Life

    Natural Life Newbie

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    Hey man, hang in there, im going through the "same" thing, last year i grinded a lot of benzos, around 60-100mg/day of diazepam for months... something like 6-10mg of ativan.

    All i can say now, after all ive been through... well, idk if im ever going to be happy again, most of the time i just want to die to stop being paranoid and thinking i am a piece of ****, that everyone hates me (i had the worst self destructive behavior i could think of while on this drug) and i feel SO LONELY no matter what i do or who im with...

    And for me I dont think this is going to end anytime soon... man i couldnt sleep for months, had hallucinations, muscle spasms, the worst paranoias etc etc... still have most of it, except the hallucinations and muscle spasms, i dont think smoking is helping but im afraid its going to be worse if i quit... i fear for my life every day, and mostly i mean what i could do to myself :-

    We have some though times up ahead and the worst thing is that other people that doesnt know me see this in the worst possible ways for me, for example: im a drug addict, im violent, im paranoid, im sad, im crazy, im stupid, im reckless, etc.
    And im none of them.

    Have fun in this trip, nice thing being alive heh??

    :vibes:
     
  13. Astal

    Astal Mercury Member

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    Well ive been off of ativan, baclofen and percocet for 2 weeks now. Im staying off the ativan and baclofen for a good while now, not sure if imma take ativan again ever or not.

    I hurt my back severely somehow in my sleep and I woke up and couldnt move so Im back on the percocet wagon again :(. I really have no choice plus the headaches are back too.

    I know they are from hormones and im doing a regemine of B vitamins and stuff to try to help with my hormones ect...

    Looks like ill be going through percocet withdrawl again damn it :(
     
  14. Natural Life

    Natural Life Newbie

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    dont take any more percocet, switch to ibuprofen and not more than 1200mg/day and youll be fine.
     
  15. Astal

    Astal Mercury Member

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    lol dude ive been taking 800 mg 3 times a day and it still dont help, it helps when combined with percs but other than that it doesnt

    believe me i tried
     
  16. Natural Life

    Natural Life Newbie

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    I know, it is not about trying, i can see you are having a hard time and you wont be able to take it forever, the sooner you quit, the better.

    You should gradually reduce the dose for a couple of days, no more than a week, remember that the more painkillers you take the more you need, so youll have to man up, take a good massage, everything will be improving and you will start to feel good again very soon.

    You and i know that you cant take drugs forever, specially benzos and opioids.

    Dont forget that you are very lucky to have someone next to you, im almost completely alone and that drives me crazy.
     
  17. Astal

    Astal Mercury Member

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    You do realize that when I dont need to take these pain meds I dont, When i cant move because im in so much pain i dont have any other choice lol, id rather go through withdrawl than be unable to move for several days at a time. Massages dont do anything for me, neither does accupuncture, still takin 800 mg ibprophen 3 times a day along with em so I dont have to take as much. Sucks when you have to take shit for pain, its so much easier if your just taking it recreationally cause u can take em once a week with no problems and then stop.

    Y iknow i cant take em forever which is why im saving up a bunch encase of an emergency. Im tryin to reduce as much as I can, like my back started hurting tonight and i could barely move :( sucks
     
  18. Natural Life

    Natural Life Newbie

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    You do realize that if i dont take my benzos im going to die because i cant handle being alive, inside this body and mind?
    Today i feel a bit alive but on saturday i was a zombie looking for a quick death..

    There is always a choice, to make the right decision is up to you, the sooner you realize whats good for you the sooner your life gets better.
    Im not going to lie, there is no real hope for you and me but as long as im taking the pain instead of drugs i know things will improve, same as if i eat healthy i know i will be healthier, one day at a time.

    Try to find a different way to ease the pain, i could give you a thousand examples but your the only one that can make the right choice, not only for you but also the ones you love and care about.

    Just a few things to consider.. therapy, exercise, eating healthy and looking for a new hobby are all good things you should keep trying.

    I know you probably tried this several times but go see another doctor, there should be a healthier solution for your pain.
     
  19. Astal

    Astal Mercury Member

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    I appreciate your concern, I am seeking other options and the pain medicine is for the short term (until ive been treating with natural herbs ect... and therapies) i gotta wait till may 8th for my disability hearing. In the mean time i will be taking high doses of b vitamins, DHEA ect... and trying to get my hormones fixed. The pain medicine is the best and worst thing for me at the moment
     
  20. Natural Life

    Natural Life Newbie

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    Im glad to hear that, hang in there, just a couple of days :)
    For me this is getting worse, the only thing left is hope. Im having the toughest moments of my life and im scared of everything, i cant even watch a movie, i have to change a lot and im so scared... i feel im crazy all the time and i cant control myself, i lost myself somewhere, i have to create a new life from the ashes and im still trying to find them :laugh:

    Stay strong.