Ativan Taper

Hi - I have been on 2MG and less of Ativan for the past 10 years.  I am trying to taper down with the help of my psychiatrist.  I was just recently down to 1-1/4 mg and started having problems sleeping again. So she upped my to 1-3/4 mg and Melatonin and I feel defeated.  I am not having panic attacks anymore and am tired of this rollercoaster ride. I want off the Ativan and the 45 mg Remeron that I am on - I have a wonderful life, have reduced my stress considerably and am in a loving relationship.  But this part of my life is awful!! Please help!

[Julia M Aharonov, DO]

In my opinion, since you have asked me for one, you should keep on cutting down on your dose, regardless of your sleeping pattern. She was right to put you on melatonin, but wrong to back off on the taper. There is nothing wrong with having one or two sleepless nights. If you do not make a big deal out of it and don't get all stressed out over it, you will eventually sleep. But most importantly, you will also accomplish your goal of being off of benzos!  
Insomnia is a very common condition and most people have poor night's sleep here and there. Don't obsess over it, even as you taper the Ativan.
Continue to have a wonderful life. Make sure that you have a good, healthy sleep ritual, and sleep will come eventually. Good luck.

[stelo63]

Hi - thank you so much for your response.  I have been battling sleep issues and this for a while and I value a straight on answer like the one you gave me.  I do have one more question, I tried the Melatonin and not a big fan of it.  Is it possible to do the Ativan taper without Melatonin.  My doc had me cutting my dose by 1/4 mg and staying on that for 2 weeks, then down again by another 1/4 mg.  How would you do the taper, keeping in mind that I try my hardest not to get stressed out over a sleepless night - except mine are sometimes more than 1 or 2 nights - never in a row though - I guess your body will sleep when it gets tired.  i'm just so frustrated that I am now back up to 1 - 3/4 when I was down to 1-1/4 a week ago.  I don't want to have to take the Melatonin - and I want a taper schedule that gets me off this stuff.  I don;'t mind the Remeron - although that will be the next goal that I strive for.  Thanks so much for giving me your time Dr. Aharonov - I value your opinion.  Lori

[Julia M Aharonov, DO]

Lori,
Melatonin has been shown useful in establishing a normal circadian rhythm, but if you do not like it, I would not mind if you did not take it. I do not find it particularly useful in all of my patients. It is a bit of a hit or miss.
I often recommend simple herb teas that they sell in Whole foods and elsewhere "Sleepytime" and such. Believe it or not, a relaxing cup of tea can be very helpful. Try not to watch TV, instead read a book in bead, take a warm shower before turning in. Good night.

[stelo63]

Thank you - I wish you were my doctor!!!  Just one last thing:

1)  do you think I was premature to say the Melatonin was not for me - only took 3mg for 3 nights -
2)  do you prefer the tea over Melatonin? - do any of the ingredients in the tea not agree with the Remeron/Ativan - I am very sensitive to medications
3)  With regard to the taper - I am now back up to 1-3/4 mg - should I step down to 1-1/2, and reduce by a 1/4 mg each week.  My doctor has me staying at a dose for 2-3 weeks.  

I do read a book in bed at night - have a pretty calm routine - had another bad night last night - but doing ok today - I just need to get in a rythym again - I am all out of whack - it's more like 3-4 nights a week that I'm not sleeping good - I guess that's my fate.  Melatonin may be the right answer in getting my rythym back.  

I really appreciate your time.  Wish I could afford your program!!