Last Updated on December 29, 2023 by
Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD
Let’s start by saying clearly, there is no cookie-cutter approach to Ativan tapering. Many factors can be considered in designing a workable set of steps to come off a benzodiazepine like Ativan as safely and as gently as possible. At Alternative to Meds Center, our protocols are successful because they include a wide array of therapies to soften and ease the tapering experience. You are invited to call us at any time to discuss how our program uses holistic therapies for the best patient outcomes possible.
An in-patient taper program is going to be quite different than what an outpatient program will look like. You are welcome to explore the various treatments on our services page and discuss these with your prescriber so you can blend these into an outpatient program if that is how you plan to proceed. Please choose a prescriber who understands and is sensitive to your needs and situation before embarking on Ativan tapering. This may take some time as many physicians are untrained in benzo tapering and may not feel equipped to help.
(Please note that the following summary of Ativan tapering guidelines is expanded further below.)
Do not attempt Ativan tapering until you have stabilized sleep and anxiety. While this may sound counter-intuitive for some, there are ways to help stabilize sleep and anxiety before beginning your Ativan taper. Please review the Ativan alternatives page and discuss with your doctor whether some natural therapies can be put in place to help settle things out before tapering Ativan. If you are already constantly in panic mode, tapering Ativan might elevate such symptoms, resulting in an impasse. Get some help to bring severe adverse effects under control before attempting to taper.
Constant Anxiety
Is your anxiety constant and unrelenting? Is it something you always experience, because it is always strongly present? It may have gradually built up over a period of time but now it is constant. At Alternative to Meds Center we have found that most often, neurotoxic poisoning is the reason for this phenomenon. For instance, certain heavy metals drive anxiety, insomnia, ruminations, and other stimulatory symptoms. Mercury, lead, pesticides, and other accumulations can impact mental health in very real ways. Another example is Lyme disease, a medical condition that can present symptoms of panic as well as depression and others. Treatment for such a medical condition must be given priority before tapering can be initiated. Testing is an invaluable tool to help determine what toxic load your body may be carrying. Cleaning out these accumulated poisons will relieve constant anxiety symptoms where they are caused by neurotoxic poisoning.25-29
Intermittent Anxiety
Does your anxiety come and go? Some days it is there, and some days it is not? Perhaps mornings are fine, but as the day goes on it worsens? Are you okay in the summer but suffering in the colder months, or perhaps vice versa? On investigation, this intermittent anxiety may be related to one or more of the following factors.
You are invited to learn more about strategies to address these issues on our services page. Reactions that occur between doses are not uncommon and can be related to the speed of the taper. You may need to slow down your rate of reduction. Benzodiazepine tapering is an incrementally slow process.
Also, you can learn more about options for treatment on our medication tapering page. For example, your doctor may suggest staggering your dosage over the day so that your intermittent anxiety phenomena lessen. This could be important if such symptoms emerge during Ativan tapering. Sometimes these newly emerging symptoms are misinterpreted as “mental illness” or “relapse” when in fact they are vital signposts that can lead to a resolution if you are able to investigate their causes. Various methods of tapering are described on our medication tapering page that may be appropriate for your unique situation.
Research the topics of intermittent anxiety and constant anxiety, and discuss your concerns with your prescriber so you are both on the same page.
There are few things more painful than witnessing the suffering of others. Generally, people will want to help if you ask them. Tell the people close to you what you are planning, so they understand, and they are confident that you have good medical assistance to allay their concerns. It can be really hard on those around you to see you suffer. In fact, this is a valid reason so many people opt for inpatient treatment. Not only is it more productive and easier to endure, but it also relieves the stress and worries of those close to you.
A fascinating study authored by Pettinati et al published in the Psychiatry Quarterly reported that outpatient drug treatment was 4 times as likely to result in early treatment failures than inpatient treatment.30 However, if inpatient care is just not available to you, putting a strong support system in place may be instrumental to your success. For example, you might try showing some videos of the struggles of others who have gone through it. Peer support groups may also be available in your area — medication has become nearly endemic in today’s world, and there are many who have walked your path before you. In these ways, your family and friends can become more compassionate and understanding of your situation, and this can have a calming effect on their fears and concerns for your well-being.
Avoid caffeine in coffee and energy drinks during your taper. Other stimulants to steer clear of include MSG, glutamate, and Aspartame©.
Caffeine can throw a wrench into the process of eliminating benzodiazepines from the system. In a review published in the Journal of Brain Research, authors Nehlig et al conclude that caffeine has obvious effects on anxiety and sleep, and suggests that caffeine enhances the release of dopamine, and may also affect serotonin neurons. The authors call for more research on the mechanics involved.31
Similar effects have been studied on the effects of excess glutamate from foods, especially those processed with flavor enhancers such as MSG, Aspartame©, and other chemicals. The body breaks down such chemicals in the process of digestion, and some of these can have significant stimulatory effects. Avoid them wherever possible to tip the scale in favor of your health recovery, especially while attempting to safely come off benzodiazepines.12-15
Blood sugar can go too high, or too low. Both of these scenarios can induce psychiatric symptoms that have nothing to do with a psychiatric diagnosis.
Especially during coming off benzodiazepines, diet modification can be a potent tool for energy as well as balancing blood sugar. This can help to avoid unnecessary mood swings, dropping energy, or other mental and physical phenomena associated with blood sugar spikes and crashes.
Become informed on the symptoms of hyperglycemia and hypoglycemia so you can recognize them should they present.16,17
Anxiety can feel like a sort of paralysis, leading to inactivity. You may find that gently easing into an exercise routine can help, though it may initially seem like an impossible task. A phenomenon called “anxiety sensitivity” has been studied, where a person becomes anxious about the physiological effects of exercise.6 Just the thought of exercise can increase feelings of anxiety and can cause a kind of resistance to any motion. However, with practice and self-compassion, the discomfort associated with exercise will become lessened over time.7 At Alternative to Meds, we offer trainer-led exercise sessions, that are designed for your current and increasing tolerance and ability levels.
If you are attempting Ativan tapering in an outpatient setting, you can still start implementing a very gentle, gradual, regular exercise regimen that will get your body moving. The range of benefits from exercise is vast, including protection against aging and memory loss, better sleep, improved appetite, and helping to gently detox certain organs in the body.8,9
You can ask your prescriber for the lowest available dosage of Ativan, which is 0.5mg, to more easily configure decreasing dosages along your taper. This will allow for the most exact totals. For example, to come down from 4mg to 3.75, a person can configure this dosage using 3 x 1mg tablet, and 2 x 0.5, plus cut 0.5 in half for the remaining 0.25 to make up the total of 3.75mg. This can greatly simplify the math involved.
Are you taking multiple medications along with Ativan? Some of these may be driving anxiety or insomnia and can be eliminated first. Examples could be Provigil, SNRIs, or others that could have a stimulant effect. Your Ativan taper will go more smoothly if you can reduce or eliminate these medications first.10
On the other hand, if you are already taking drugs such as SSRIs, or mood stabilizers like Depakote or gabapentin, continuing these may assist the benzodiazepine taper. Your doctor may decide it’s better to stay on those until the Ativan taper is complete and you are stable. Otherwise, you may be left in a difficult position of having no support for tapering the benzo, which is more difficult to taper in comparison. Speak with your doctor about the most logical sequence in regard to reducing multiple medications.
Alternative to Meds Center offers a wide variety of therapies to assist with medication cessation. IV treatments have their place and can be extremely beneficial while tapering. For example, NAD+ IV therapy is one of our favorites, known for its significant benefits in easing the tapering process.
NAD+ IV therapy helps sleep, and mood, and supports the immune system, resulting in a treasure trove of benefits to overall health improvements and longevity. We have found it is tremendously useful during benzodiazepine and other medication cessation.11
In outpatient treatment, Valium crossover tapering is sometimes used where the Ativan tapering has reached an impasse, where even the smallest of cuts cannot be tolerated by the patient. You can read more about this and other methods of tapering that may be useful on our benzodiazepine tapering page. Share this information with your outpatient physician in case it should become useful during your treatment.
There may have been a response to the presence of certain toxins in the body. A medical situation such as Lyme disease can have similar responses that are debilitating. Where Ativan or other medications have been prescribed to dampen these symptoms, there is value in investigating elements of toxic load in the body, and taking steps to remove such toxins as part of an overall health recovery plan.
We have found that not doing so can result in Ativan tapering being much more difficult than it ever had to be. There are many factors that can be addressed in preventing or resolving protracted symptoms including genetic issues, liver and kidney health, and the presence of heavy metals or other toxins in the body. Addressing these factors can greatly simplify Ativan tapering.32
Tapering Ativan done too abruptly or without proper preparation, can result in reactions that may be impossible to endure.
Monitor these symptoms closely, especially within 1 to 4 days after a reduction in dosage. Slowing the taper is recommended to avoid serious or lingering adverse reactions.33,34
Do not be dismayed if your Ativan taper becomes more difficult after the halfway point. This is not an uncommon occurrence. Stay well-coordinated with your prescriber so that smaller cuts and more time can be allotted to settle out at each new dosage. Do not be discouraged because it is going slower than you had hoped. When it comes to benzodiazepine cessation, “slow is fast” as the saying goes.
Please feel free to review and share the pages on our site that specifically address holistic and alternative therapies that are useful during inpatient benzo tapering. Please see Ativan alternatives and Lorazepam cessation. Also, recommended reading is medication tapering strategies and the benzodiazepine cessation page.
Tapering Ativan or other benzodiazepines can be eased with exactness, precision, and compassionate support.
Ativan tapering doesn’t have to be a nightmare that goes on forever. There are some important things to consider for comfortable cessation. No two individuals are exactly alike. No two benzodiazepines are alike either. While they may share certain adverse effects, Klonopin tapering, Ativan tapering, and Xanax tapering will differ because of the half-life and other characteristics specific to each drug.
However, we can say that generally, 2 months is about average for many persons to taper from Ativan when it is done inpatient at Alternative to Meds. The body needs to transition slowly and gradually, and some may require more time where, for example, a person took the drug for many years. Other factors enter in such as multiple medications or health conditions. In an outpatient setting, a realistic estimate might be anywhere from 8 – 20 weeks or much longer, based on a gradual reduction of approximately 10-25% every 2 weeks or longer. This can allow symptoms to settle out at each reduction. But these figures will be different for different scenarios and each unique individual.
This is the first step, especially when a person cannot enroll in an inpatient setting. One can look for help in outpatient settings by searching for a nutritional psychiatrist, or an integrative or holistic MD who is familiar with benzo tapering and demonstrates they are confident about helping you.
There is a comprehensive directory you can find at IMMH.org which may help you to find someone local to your area to help you.
Ativan has ranked in the top 60 most prescribed drugs globally since 2011 and its use is still rising some ten years later.35
Ativan has become a popular street drug as well. Skyrocketing non-prescribed use of benzodiazepines is now called America’s “other” prescription drug crisis, with many similarities to the opioid carnage of recent years. Like many other prescription drugs that develop a street presence, Ativan is also produced in “pill mills” across the nation, and across the world.
Whether one began taking Ativan after a doctor visit, or elsewhere, we have been successfully helping our clients to solve this problem in safe and comfortable ways, holistically, for nearly 2 decades now. Over that time we have helped many thousands of people to learn how to get off Ativan while at the same time actually improving their health. Stopping Ativan is possible. There is hope. We can help you or your loved one in the process of safely getting off Ativan. Our program is time-tested, proven and thorough, and it is the safe and gentle nature of the program that is the key to the success of our clients.
Some would say the pharmaceutical industry largely overtook the good old practice of medicine in recent decades. While some absolutely amazing medical breakthroughs have been achieved in physical health, we see many a tragic misfire in the mental health sector.
For example, there is an increasing number of patients needing hospitalization and specialty care, not a decrease in these numbers. Drug use is skyrocketing, not decreasing. Psychiatric diagnoses are also increasing on a similar trajectory — parallel with the increase in prescriptions. But thankfully, holistic practitioners and protocols have shown, proven through clinical trials, more favorable results using non-drug-based treatments. The speed at which these results are becoming widely known has unfortunately been much slower than that of the pharma industry. Could it be that perhaps some of these new and exciting holistic research breakthroughs have even been suppressed?
A recent study published in the British Medical Journal found that individuals taking benzodiazepines such as Ativan, Xanax, Valium, and Klonopin had an increased risk of developing Alzheimer’s Disease. In fact, the study’s authors found that individuals who had taken benzodiazepines for three months or more had a much higher risk of developing Alzheimer’s Disease in the future. This is an alarming trend.
Although a link has already been associated between benzodiazepines and short-term cognitive impairment, this groundbreaking study has now also solidified a causal relationship between benzos with Alzheimer’s disease. The study found that an individual taking these medications for at least three months had a 50% higher chance of developing Alzheimer’s Disease. Moreover, those individuals who took benzodiazepines for six months had nearly double the risk of being diagnosed with Alzheimer’s. The researchers found that the longer one is on the medications or the higher the dose of benzodiazepines, the higher the likelihood is that one would develop Alzheimer’s.5
These findings help provide yet another reason to taper off benzodiazepines such as Ativan. A large percentage of the population suffers from symptoms that are generally called “anxiety” or “anxiety-related.” We pay a high price emotionally for modern living. Choosing processed and fast foods, living on the edge of financial ruin and social stresses, living in a toxified environment, and juggling marital and family worries, all can take a toll. Many live in a daily time-pressured and sleep-deprived state.
No wonder so many of us have been looking for instant relief from Ativan. They do provide near-instant relief, an artificially induced relaxed state, but there is also a price to pay in terms of adverse effects, that may become problematic in themselves. Another problem is developing tolerance, meaning that these drugs become less efficacious over time. Ativan, like all benzo drugs, is regarded as having a high potential for dependence.
Another concern is mixing benzos with cough syrup, alcohol, or opioids. The synergistic effects of combining such substances can injure or kill. And trying to quit Ativan, especially without guidance and help is like throwing gasoline on the fire. And these concerns describe some of the troubles associated with benzodiazepines.2
WARNING: As much as one might want to, NEVER ABRUPTLY STOP ATIVAN or other benzodiazepines. To do so can be injurious to one’s health. Stopping Ativan should be done gradually, under medical care or at least competent supervision, and should never be rushed. There is a correct and highly workable set of strategies and protocols that enable one to get off Ativan, and that can make Ativan cessation as comfortable as possible.
The Nutrition Journal published a study decades ago, authored by Lakhan and Vieira that found 71% of patients involved in the study found relief from anxiety and depression when given holistic solutions for anxiety. They provided herbal and nutritional aids to participants in the trial to see how effective these agents were. They got overwhelmingly positive results.
The study’s authors reported in 2010 that approximately 55 million people suffer in the US from symptoms of depression and anxiety. That is nearly double the population of Canada. The number has probably grown significantly higher since then. That is a lot of people.
It is truly tragic that holistic solutions that are KNOWN to be effective are not used and not recommended more frequently. Puzzling as this is, it is an important topic that does need significant time and attention to correct such trends to improve the future of medicine. We encourage anyone to do the research and understand the problem in the context of truthful investigation and reporting.
At Alternative to Meds we provide our clients with the kind of Ativan tapering help that we wish were more readily available all across the country, and all across the world. In fact, we have many international clients who come to us for help.
After the Tokyo subway disaster of sarin gas affecting 5000 commuters, a Japanese clinical study showed that toxic exposure has led to major ramifications even years after the event. In this case, 5000 people exposed to sarin gas experienced insomnia, anxiety, and depression.3Find Out More about the Alternative to Meds Center Ativan Tapering Program
If you or your loved one have been struggling with how to get off Ativan safely, we invite you to contact us at Alternative to Meds Center for more information on our holistic orthomolecular-based programs and for more details on the protocols we use — there are too many to list here in this brief article. Please take the opportunity to call us at Alternative to Meds Center, and ask about our holistic approach to Ativan tapering and improving your health or that of your loved one naturally, under medical supervision.
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3. Kawada T, Katsumata M, Suzuki H, Li Q, Inagaki H, Nakadai A, Shimizu T, Hirata K, Hirata Y. Insomnia as a sequela of sarin toxicity several years after exposure in Tokyo subway trains. Percept Mot Skills. 2005 Jun;100(3 Pt 2):1121-6. doi: 10.2466/pms.100.3c.1121-1126. PMID: 16158698. [cited 2022 June 8]
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Originally Published Nov 4, 2019 by Lyle Murphy
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
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