ativan and treatment drug withdrawal

Hi folksters, long time no visit....been a rollercoaster ride here since mother's day!

As some of you may remember when I began tx I had a rather severe reaction to the Ribavirin. By severe I mean my whole body shaking and quivering uncontrollably, waking up with my whole abdomen quivering like a bowl of jello being shaken, and not being able to sleep for time spans as long as 3 days, and once five day with no sleep.
The rash, mouth sores and dry eyeballs were the minor sides as far as I was concerned. It was the wired like I had just drank 15 Redbulls that had me discomboobulated.

Due to all this I was put on .05 ativan twice daily (with each Riba dose) and remeron at night 15 mg. plus 12.5 Ambien (which I'd been on prior to tx).

I was very grateful for the relief these 3 afforded me, and feel that the rest and relative calm they afforded me allowed for the extended treatment (80+wks that ensued) and is now completed.

However, I feel it's important to forwarn folks of what I've now been going through in getting off the ativan.
My doctor warned me it would be hard to get off the stuff, but I said we will face that when the time comes. Having kicked cigs and coffee, how hard could kicking one little pill be?

Well I found out how hard in the last 8 wks. First I cut the dose in half, and that went ok,  except for some spacey yukky moments.
So after a month I cut it again in half and all heck broke loose.
It started with foot and leg pain so deep I thought it might be deep vein thrombosis...
I returned to half dose, and symptoms subsided.
But after a couple weeks I began having chest muscle cramps on my heart side. they were so deep it was hard to tell them from heart pain....and so for only the 3rd time in 58 years I was forced to go to emergency. If you wait 5 hrs to treat a heart attack you can permanently damage the heart, and since only one mucsle was seizing I had to find out, is this my heart.

It wasn't my heart, thank God, but it sure felt like it!
Several days later the cramps began in the chest again, but this time in the neck as well, both sides of neck muscles seizing up. This is all new to me. Leg cramps I had throughout life due to so much activity, but I've never had the subsurface musculature go crazy, not it these weird places.

I have haved, and now quartered my pills, and am currently taking 1/2 or 3/8 of my original .1 mg a day.
so my dose is now .012  3x per day.
cramps are being kept at bay, just barely/

you would think at these low doses just quitting would be easy as pie...but this drug packs a lot more punch than we realize. This is the first real "withdrawal" I've ever gone through, and it's not been fun.

I realize part of the problem may be that the riba has not entirely cleared my system, which makes this more difficult to come off of, but I still think it's important enough for my liver's health to try to get off of as many meds as I can, as soon as I can.

Just thought I'd warn you all, so you will recognize some of the alarming sides of ativan withdrawal, if you've been placed on it.
I have read that some doctors put patients on valium to withdraw the ativan, because the half life of valium is much longer...so you don't get the hebbie jebbies and cramps as much between dosages.
If these symptoms don't clear up pretty soon I may ahve to resort to that.

Other than that there is good news:
life is slowly returning to normal. I have a little more energy and attitude is improved.
The will to do things has returned, but the energy to get them done is not always present.
This is frustrating, I want to work much longer than my joints or breath will allow for.
Also activity is causing more inflammation than every before, but then after so long being inactive that's to be expected. I'm hoping and praying this too will pass as limbs readust to more activity.
Hoping as well that
we all do well following treatment, but am realizing that not everyone just bounces back, as some do. This tx did take a lot out of me, and I'm just beginning to realize how much. But at LEAST, I'm out gardening a little again, and deadheading my roses again...last summer, I didn't even step into my back yard...I was a prisoner of my couch....a chimp hiding under her blanket.

merrybe

[newleaf09]

VERY scary!  Rocker made reference to Ativan in a post; he was completely unnerved by the possible side effects. Didn't know withdrawal was so horrible and am sure we all appreciate your cautions.  Sounds like you are creeping up on it now and will be able to get off of it before too much longer.  Thanks for sharing.

[Rockerforlife]

Not for me...i just got back from my doc last week and i could have got some and i said no,they gave me 30 pills at .5 mg each and i did 2 right away and they helped me big time....i  continued taking 2 a day for a week and i was good....i popped 3 one day as o was worried too death....all was ok...problem i had was i had some weird dreams after i stopped takin em...and i mean they were real ...more real than reality....i thought when was sleeping that was real and the real life wa sthe dream....LOL....you are correct to say this is one very dangerois medicene....funny how such a small pill can do so much damage....its almost like LSD in a sense...whAt do they weight adIvan im....micro grams..THESE BENZOS ARE only designed for short term TX...the sides are worst than smack

[epiphiny]

Exactly the same thing happened to me!  I went cold turkey (what an idiot) and it was horrendous.  I sought help and have been put on a slow withdrawal tapering plan but first I was transferred over to diazapam as it comes in the lowest mg form (2mgs) of the benzoid family, has the longest half life and therefore easier to control dose reductions and withdrawal symptoms.

Check out the Ashton Manual as it has slow tapers for all drugs and ativan will be there...here's the link

http://www.benzo.org.uk/manual/bzsched.htm

I had to swap over to the equivalent dose of diazapam and start from there once I had stabilized.  At first the doc told me to decrease by 2 mgs ever 14 days but I decided I would go with 1 mg every 14 days (some people recommend 10% per 14 days).  

I'm onto my 2nd reduction and this time I'm having no wd's to speak, i just notice a slight mood change for about 24 hours and then I level out.

Please check out the link above and the following link also has great info:

http://www.thetrap.org.uk/

Please let me know how you get on MerryB cos it's a hard time withdrawing from those nasty benzos.  It is well recognized that it is harder than the opiate withdrawal.

Wishing you well,

Epi xxxx

[annieCinMD]

Benzo withdrawal is dangerous. That and alcohol can kill you if it isn't done right. I know with alcohol, your blood pressure goes up too high. They give you blood pressure pills to get you through. Not sure about benzos, but probably something similar. Opiates will not kill you, but you will wish you were dead. Cold turkey is a bad plan with benzos. I am currently being real careful with my Xanax intake because I don't want to deal with that, but on the other hand it is the only thing keeping me sane right now.

[merryBe]

well, it sure came as a surprise, and thanks dor the links!!

Don't get me wrong, there's no way I could have made it without the drug through treatment. Treatment can strip serotonin AND cholesterol which protects serotonin from being stripped from the brain. Since I had very low cholesterol at start of tx this may be part of why the SOC jittered me to pieces. I am NOT an overly ancious type, normally, but the tx gave me my first inklinking as to what psychosis might be about...and a lot more sympathy for the mentally ill.  After all, it's NOT just mental anguish or manufactured worry when you are in a dead sleep having convulsions as well as when awake...  gives new meaning to sock (SOC) it to ya !!!!!!!!!

so take it if you need it is still my advice, but be prepared for some real discomfort is all.

Incidentally I used to ride horses for years so I know what it's like to be stepped on, kicked or bucked by a horse. This foot and leg pain was every bit as bad as my worst horse kick, so nothing very light weight about it.

sheesh, my pill were . point five, not .05 but .5    so dose is now ,12 3x's.

Rocker, with our livers it doesn't take much to OD. I only took more than recommended one day, for a funeral of a friend of 30 yrs.
If you are going to take it, take the minimum you can get by on.
I added the remeron in an attempt to smooth out the jitters more and not need as much ativan. As soon as the rem. kicked in (2 months) I was able to lower my dose to the .5 for the whole following year, but that's still enough to cause withdrawal probs.

perhaps if I had gone to 30 remeron instead of 15 I might have been able to take less ativan, but every time I tried that dose I had bad headaches.

The thing about staying on the stuff though is long term its really dangerous.
I remember they stopped librium and cut way back on valium because people on it for ten or more years were becoming permanently spastic. Seizures every few moments, all day every day...totally disabling them, so getting off this now is super important.
However it's sure put a cramp (pardon the pun) in my ability to enjoy no more SOC.
Just trafing one set of probs for a new set for now.

so yeah Epi, to the short term thing. I knew that was what it was for.
My choice though was, discontinue treatment, shake like a leaf for hours each day, or join the Shakers where at least I'd fit in.. or find a drug that would help that wasn't too hard on the liver. Ativan fit that bill better than most.

[epiphiny]

Yeah, I'm with you MerryB.  I don't regret using them to get me thorugh tx but I had no idea what the effects were going to be when I stopped!  I just thought, well, the drug (IFN) that was causing my depression/anxiety has stopped so I'll return to 'normal' (whatever that may be) and so I don't need them any more.  Holy Haka, how wrong I was!!

I also feel I just traded one set of probs for another and that it is in my best interest to get offf the diazapam as soon as.  With taper program I feel much more confident of that and of not sustaining ongoin protracted withdrawal symptoms.

I find your liver/cholesterol/serotonin link extremely interesting as I just got a cholesterol test and I have HIGH (6.6) and it's all in the bad cholesterol range!  I got a huge shock, esp as my cholesterol only 6 years ago was 2.2 and had always been low all my life.

I have also read a thread about a connection to SVR & high cholesterol so, for the time being, I'm hoping this is another sign the tx has worked and when I hear those 3 lovely letters I will take action on the cholesterol.  Certainly explains heaps about depression and HCV.

The further in to the woods we go, the trees get closer and closer together!  And I thought it was going to be simple!~ Hah!

[epiphiny]

I also just cannot believe how bad my typing has become.  Is a long term effect of tx enlarged finger pads, cos my fingers don't seem to fit my keyboard anymore.....

[meakea]

"I am NOT an overly anxious type, normally, but the tx gave me my first inkling as to what psychosis might be about...and a lot more sympathy for the mentally ill. "

-----------------------------------

I did tend to be a bit of an anxious person prior to starting TX but not to the point that I needed treatment for it but, now that I'm on TX, I totally agree with what you said about "my first inkling as to what psychosis might be about..."!

I'm not on ADs but I do have a few Xanax that I can take now and then but, for the most part, I don't take them and I try to ride it out.  I tried ADs early on but they gave me horrible side effects that I could not deal with on top of the TX sides.  

Last night I had a horrible night full of full-blown anxiety and I didn't sleep at all because of it.  I should have gotten up and taken a Xanax but I didn't even have enough good sense in my brain during all that anxiety to do so.  My 25 yo son was in a motorcycle accident the day before and ever since finding out about that I can't seem to control my emotions at all.  At least before his accident happened, I had a bit of control.  

Anyway, it's daylight now and that always makes anxiety subside so I'm back at work today. I guess my point is that the mental fallout from this tx is overwhelming at times and I feel bad for anyone who has to deal with an anxiety disorder on a daily basis.  It must be exhausting!

[merryBe]

update:

I was given this extremely helpful link:

http://www.benzo.org.uk/manual/

yes, it's a book (68 pages of info) but much of that is taper charts.

I liked it because this doc has upteen years tapering people off benzos.

Unfortunately, my GP refused to look at it, and says her experience using valium to taper off ativan ha not been good.

That's probably true for those not really wanting off this stuff...but I want off.
the theory made sense to me, because you have a 36 hr life vs a 5 hr life with diazepam vs lorazepam.  therefore with the valium you skip thoe peaks and valleys that cause all the headache/cramps/hebbie=jebbies.

anyway, it is a good read for understanding GABA receptors and why quick withdrawal doesn't work.

My doc did say to return to 3/4 dose (not the half dose that's been messing with me...
and that we would shoot for being off it in 5 months time...not the original 2 or 3 I had hoped for.

so at least I maybe will stop feeling so incredibly weird and sore.

Epi, and Mekea...nothing about this disease is simple LOL....and just think, after getting off the Ativan, I've still got the remeron and the Ambien to go!!! (and Ambien works on Gaba the same as the benzos....remeron like the trycylics...so none of this stuff is easy to get back off of.  

I like the way the Oxford doc in my link decribes withdrawal...she says the sides can be so bad that this causes its own Post traumatic stress syndrome....pretty funny....or not.

mb