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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can tapering from Lorazepam cause any withdrawal side-effects?

Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5033 Questions

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Posted on Fri, 8 Jun 2018 in Mental Health
Question: Hi. I have been taking lorazepam 1mg, 0.5mg in the morning and evening for almost 2 months. I also started cipralex for 2 months also. My doctor has now reduced my lorazepam to just 0.5 in the evening for 7 days, then once every 2 days and so on. Even though i feel better then i did 2 months ago, i am worried about withdrawal effects from lorazepam. Today i was more anxious and had some panic during the day, this being my 1st of reducing.
doctor
Answered by Dr. Seikhoo Bishnoi 1 hour later
Brief Answer:
Dose should be reduced gradually.

Detailed Answer:
Hello thanks for asking from HCM

The dose should be reduced very gradually in order to prevent withdrawal. You were on 1.5 mg per day and then the dose reduced to 0.5 mg in evening only. This is the probable cause of panic and anxiety you had.

You can talk with your doctor to reduce doses gradually. The dose can be reduced to 1 mg for about a week and then to 0.5 to 0.75 per day for one more week and then 0.25 per day followed by use on SOS basis. Dose reduction in this manner will not cause withdrawal.

Thanks and take care
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Seikhoo Bishnoi 26 minutes later
Hi. And thanks for taking the time to answer my question. I was not on 1.5mg. I was on 1mg, i took half of 1mg in the morning and half in the evening.
doctor
Answered by Dr. Seikhoo Bishnoi 12 hours later
Brief Answer:
Reduce the dose gradually

Detailed Answer:
Hello again

I am sorry I missed this. Even if you are on 1 mg per day even then reduce the doses gradually. You can take 0.25 in morning and 0.5 mg in evening for about a week and then reduce the dose again.

Thanks and take care
Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Seikhoo Bishnoi 23 minutes later
Well, i already started not taking the morning 0.5. Instead i take a natural anxiety pill called Stresclin complex, don't know the international name. I hope it will help calm down the anxiety during the process.
doctor
Answered by Dr. Seikhoo Bishnoi 4 hours later
Brief Answer:
Yes you can take Stresclin complex

Detailed Answer:
Hello again

Yes you can take Stresclin complex. The supplement has constituents like Ginseng. This will help in improving cognition and will control the anxiety too. So yes this will help to control the anxiety and will calm you.

Thanks
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Seikhoo Bishnoi 39 minutes later
Perhaps you can help me with this:
I started reducing 1mg of ativan and i am trying to figure out how the concentration in my blood is lowering. So if i took 0.5 in the morning and 0.5 in the evening, and sincer yesterday (Monday) i only take it in the evening, and the drug has a half life of 15h that means that each day the concentration should lower by 0.05 and in approximately 7 days i should get from a constant 1mg to 0.5mg. Is my calculation correct?

Thanks!
doctor
Answered by Dr. Seikhoo Bishnoi 3 hours later
Brief Answer:
Yes you are correct in that.

Detailed Answer:
Hello again

Normally 6-7 half lives are needed to make drug to stable levels after its stopped or doses are decreased or increased. So yes you are right in that. In 4-6 days the drug should become at constant levels. This is the reason I asked to reduce the doses and to continue to take for at least a week.

Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Seikhoo Bishnoi 32 minutes later
Hi. Thank you again for your answer. I spoke with my doctor and i will start to take 0.25 from tomorrow morning and 0.5 in the evening for 7 days, and then reduce again by 0.25. I guess there is no problem that i took just 0.5 yesterday and today. This evening should i take 0.5 as usual or 0.75? Considering i usually take it around 20.30 pm, and now it's 19.00 pm.
doctor
Answered by Dr. Seikhoo Bishnoi 12 hours later
Brief Answer:
Go with 0.5 mg in evening.

Detailed Answer:
Hello again

I am sorry for replying late. You can go with 0.5 mg dose from this evening. Take morning 0.25 mg if needed. Reduce the dose again gradually.

Thanks and take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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