Hi doctor, I have taken Ativan for the past three years and really feel like I am addicted to it. I currently take 1.5 mg daily but used to (last year) take 2 mg daily. I usually wake up with anxiety, headache, neck pain, back pain, nose numbness and some eye pressure. I take .75 mg around 8:30 AM and by 9 AM most of my symptoms are gone. I take my second dose of .75 mg at around 3 PM and usually feel like my symptoms from the morning are coming back. That is what usually reminds me that it is time to take my afternoon dose. I have a very stressful life and have been told that stress can eventually lead to experiencing real pain as a result. Ativan seems to help me with this pain, but now I feel I am addicted to it and I do not know what my next step should be. I have tried tapering, but perhaps I am doing it incorrectly.
Hello. It is good that you are trying taper off Ativan (Lorazepam) as long term use is not advisable due to physical and psychological dependence. You have already managed to cut down from 2 mg daily to 1.5 mg daily which is a positive step forward. Did you have any withdrawal symptoms at that time? You can try to taper very gradually to minimize withdrawal symptoms. For example, try taking 0.75 mg in the morning and 0.5 mg in the afternoon for about a month. If there are any significant withdrawal symptoms at any stage, go back to the original dose. If you are able to tolerate, then cut down to 0.5 mg twice daily for a month. Then cut down to 0.5 mg in the morning and 0.25 mg in the afternoon for a month and so on. In this manner you should be able to wean off completely by 5 to 6 months. If it is not possible to taper down safely, you may need rehabilitation therapy and medically assisted detox. Practise relaxation techniques like progressive muscle relaxation for atleast 15 minutes daily to manage stress. Consult your doctor for review of your mental health. If there are significant anxiety symptoms, other medication like SSRIs can be considered which will be safer for long term use.