tapering ativan

[jothenurse]

I've been on Ativan since April. I have tapered off of it once a couple of months ago, then my doctor wanted me to take a little until my weight went back up. I had lost 20 pounds, and have gained about 15 back. I tapered it down to .25 mg at 6 AM and .25mg at noon. (A usual dose is .5mg).
Yesterday the doctor said I could taper my noon dose if I wanted to. So, I started that yesterday, and am still taking the .25mg at 6 AM. I am feeling anxious and have some feelings of unreality (which I can get even on more of the ativan). The doctor said I should have no withdrawal because I have been on such a low dose for quite awhile. I am wondering if this is just me focusing in on my symptoms because I know I have decreased my ativan. I don't want to get panicky about this because my goal is to eventually just have the ativan prn (as needed). So, I'm trying to tell myself that I'm not having withdrawal symptoms (as two doctors, including a psychiatrist told me that I am on too low of a dose for that) but was told that you can get more anxious because you know you took a lower dose. Any ideas or help with this?

[Worry-wart]

jothenurse,

I too was taking ativan. .25 mg a day is nothing. If you have been taking that for a few days, you can completely stop at this point. However, I noticed that even after a week or two after tapering off and stopping altogether, I started to have mild symptoms which subsided as well so expect minor issues but I think that was just me learning to cope naturally to stress rather than having a drug do it for me.

[jothenurse]

How much ativan were you taking?
Today now I have had two episodes of tachycardia. One, with distraction, went away fairly quickly. The other one, I was hauling some hoses, then noticed my pulse was elevated (from the hauling, I would suppose), then I got a hot flash, and then it really started pounding. Got scared, like usual, and ended up getting into my car and driving down by the hospital because I didn't think I could get it to calm down. I noticed after a couple of blocks, it started slowing down. It felt like it was in the 160's, like I've had before and EKG's have show just tachycardia from panic attack. It's hard to believe sometimes that it can go into high gear so fast like that. I get scared it is an SVT or something, but my doctor is not concerned.

[Worry-wart]

At peak I was taking 2mg a day. At minimum I was taking .25mg when I tapered off. From the sound of it, you have not fixed the underlying issue. Are you exercising and eating proper foods and vitamins?

When I'm on the Ativan I tend to let myself go and rely too much on the drug. When you are off of it you really need to work to keep the anxiety in check.

Also, once you notice your heart beat, you have a tendency to focus on it which effects your heart beat. This turns into a vicious feedback loop.

[jothenurse]

I'm getting counseling with my anxiety. I'm not always sure where the anxiety comes from. I was told when it started that it was an accumulation of stress over a couple of years and that I was giving more out than receiving in. My boyfriend had been living with me for 4 years without helping out financially, I have a very stressful job, and at that time my mother's health started to fail. Since then, my boyfriend moved out, though we still remain friends, and right after that I started to have tachycardia, which really scared me. Had a few episodes that I went to the ER for, and found out they were sinus tachycardia. One doctor thought I may have had an SVT which is a fast pulse, but that is supposedly not dangerous, but scary. They could never see this on an EKG, even when I wore a 24 hour halter monitor, it was always sinus even when it went to 167 in a panic. My mother passed away a couple of months ago, which is very sad. I continue to work on my anxiety, and my counselor states that the more I push myself and do things that scare me, the faster the anxiety and all it's wonderful symptoms (tachycardia, feelings of unreality, panicky feelings, faint feelings) will go away. I try to exercise, but with the tachycardia, as soon as I feel my pulse go up, I get scared. I used to run, work out at the fitness center, take my dog for walk, hike, and do lots of physical things. Now, I am scared, but I try to push myself. I have noticed some increased anxiety with the lower ativan dose, and my doctor said if my tachycardia was worse to take the noon dose. But, I really want to get off the ativan and only use it as needed. I'm not always sure how to get through this anxiety.
Thanks for your reply.

[jothenurse]

I have had more tachycardia, so will probably go back on taking the Ativan at noon. It is still just a small amount. Not sure if these episodes are due to an increase in anxiety or what. I had problems with my retina the last few weeks and had to have a laser treatment which really scared me, though that went pretty well even if my heart did pound some. My mother passed away a couple of months ago and I wonder with the holidays coming that that may be some of my anxiety, too. I have a stressful job. I just don't want to get so frightened about the tachycardia. When the pulse is a little fast I usually can deal with it, but when it starts pounding (sometimes with my hot flashes, sometimes it just happens) I get really scared. Any advice? My doctor has reassured me in the past that my heart is fine, but sometimes I wonder if they missed something.

[blueangel]

Reading this and your other post about menopausal symptoms, it just sounds to me that the hot flushes are going to make the tachycardia worse, as this is precisely what it did to me. I also found that palpitations/tachycardia got worse as I went perimenopausal, even before I got the hot flushes.

I've always had a tendency towards tachycardia anyway, and have suffered longterm with ectopics and SVTs, so I suppose all this was part of the ongoing package for me. I do agree though, it's all so disruptive as you find yourself waiting for the next attack of them (which of course makes them happen!!)

[jothenurse]

You mention SVT's. This is what I always worry is happening, but everytime they have done an EKG, and also with the 24 hour monitor, it was sinus tachycardia, though one doctor thought I may have had one.
What do you do to deal with the tachycardia/SVT's? Do you take medicine?

[jothenurse]

Just bumped this up to see if anyone has a reply from my last post.

[Tish]

As far as I'm aware, Ativan isn't prescribed in the UK. It used to be (I took it 27yrs ago) but the side effects were horrific. My GP told me they don't prescribe it anymore. Maybe this is why you're not geting much feedback