Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
How To Taper Down Ativan Slowly Without Any Side Effects?
Question: Hello toady-
My doctor switched me from Xanax 4 x 1 mg q.i.d. to Lorazepam ( Ativan) 4 x 2mg q.i.d for the longer half life of Ativan so I could sleep thru the night ( it has a dosage equivalent 1/2 xanax) . I have some mild but annoying side affects with the Ativan and I would like to go back to Xanax. Can I do a switch right away or do I have to taper down the Ativan and taper up the Xanax. I have benign but disruptive daily PVCs and this helps calm me down when anxious. What do you recommend as a transition procedure back to Xanax. Eventually I will taper off the Xanax, but now my cardiologist prefers no major changes as he adjusts my beta blocker ACE and statin. What is the recommended taper method when I am ready ? Can one stay on a maintenance dose of Xanax if he is anxious as I usually am at 73 1/2 years of age.
My doctor switched me from Xanax 4 x 1 mg q.i.d. to Lorazepam ( Ativan) 4 x 2mg q.i.d for the longer half life of Ativan so I could sleep thru the night ( it has a dosage equivalent 1/2 xanax) . I have some mild but annoying side affects with the Ativan and I would like to go back to Xanax. Can I do a switch right away or do I have to taper down the Ativan and taper up the Xanax. I have benign but disruptive daily PVCs and this helps calm me down when anxious. What do you recommend as a transition procedure back to Xanax. Eventually I will taper off the Xanax, but now my cardiologist prefers no major changes as he adjusts my beta blocker ACE and statin. What is the recommended taper method when I am ready ? Can one stay on a maintenance dose of Xanax if he is anxious as I usually am at 73 1/2 years of age.
Brief Answer:
No you can switch without tapering - right away
Detailed Answer:
Hello ,
Thanks for writing to us.
Xanax is more potent than ativan. If you switch to previous dosage without any tapering directly, there will be no discomfort.
However in long run ativan is good than xanax so try to reduce xanax. But if you feel better wih xanax, considering your age you can be allowed to take for lifetime.
Hope I have answered your query, I would like to help further if any.
Regards,
Dr.Chintan Solanki
No you can switch without tapering - right away
Detailed Answer:
Hello ,
Thanks for writing to us.
Xanax is more potent than ativan. If you switch to previous dosage without any tapering directly, there will be no discomfort.
However in long run ativan is good than xanax so try to reduce xanax. But if you feel better wih xanax, considering your age you can be allowed to take for lifetime.
Hope I have answered your query, I would like to help further if any.
Regards,
Dr.Chintan Solanki
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi and thanks - could you explain this sentence more thoroughly "However in long run ativan is good than xanax so try to reduce xanax. But if you feel better wih xanax, considering your age you can be allowed to take for lifetime". DID YOU MEAN ATIVAN IS BETTER THAN XANAX?? IF THAT IS WHAT YOU MEANT , WHY IS IT BETTER?? WHAT MAKES IT A BETTER CHOICE? DO YOU ALSO MEAN I SHOULD NOT OR NEED NOT TAPER OFF XANAX EVER - ISN'T IT TRUE THAT IT IS A TENDENCY TO CONSTANTLY WANT OR NEED MORE IN THE LONG RUN?? SO I CAN SAFELY TAKE XANAX FOR THE REST OF MY LIFE?? GREAT BUT.. WILL MY MOST DOCTORS ALLOW THAT??
Brief Answer:
benefit vs side effect ratio is always with xanax treatment.
Detailed Answer:
Hello,
Let me clarify.
1. Yes, ativan is better on the long run since it has less dependence potential than xanax. In my whole career, I have hardly seen 2-3 patients who were able to safely take xanax (alprazolam) without dependence. If some one on ativan, he/she can reduce to it minimum (say 2 mg per day) or even stop easily rather than who is on xanax. Therefore ativan is preferred for long term treatment. This was precisely the reason why I mentioned ativan is better. But as a drug, xanax is more potent than ativan.
2. If you are going to switch back from ativan to xanax, tapering of ativan dosage isn't really necessary, thanks to the potency of xanax. But one will definitely need tapering while going off xanax.
3. In the current context, if you are unable to go bear the discomforts of ativan, I won't have any problems to put you back on xanax. Since you were already on 4mg with no significant side effects, we can switch back to the same drug. I have no problems to put you back on ativan in patients with severe anxiety at this age, the benefits (of xanax) outweighs side effects. However if there is a need to be on it for long time (as it looks like), it is preferable to bring down the dosage to 2mg +/- two doses of 0.5mg of sustain (slow release) preparation.
Discuss with your doctor about these details. I think he/she will allow you if you understand and permit.
In short and simple words, I will also prefer that you stay on ativan. But given the scenario should ativan not help you, I will agree to make the switch back to xanax.
Hope I have given answers to your query, if still any, do not hesitate to ask.
Regards,
Dr.Chintan Solanki.
benefit vs side effect ratio is always with xanax treatment.
Detailed Answer:
Hello,
Let me clarify.
1. Yes, ativan is better on the long run since it has less dependence potential than xanax. In my whole career, I have hardly seen 2-3 patients who were able to safely take xanax (alprazolam) without dependence. If some one on ativan, he/she can reduce to it minimum (say 2 mg per day) or even stop easily rather than who is on xanax. Therefore ativan is preferred for long term treatment. This was precisely the reason why I mentioned ativan is better. But as a drug, xanax is more potent than ativan.
2. If you are going to switch back from ativan to xanax, tapering of ativan dosage isn't really necessary, thanks to the potency of xanax. But one will definitely need tapering while going off xanax.
3. In the current context, if you are unable to go bear the discomforts of ativan, I won't have any problems to put you back on xanax. Since you were already on 4mg with no significant side effects, we can switch back to the same drug. I have no problems to put you back on ativan in patients with severe anxiety at this age, the benefits (of xanax) outweighs side effects. However if there is a need to be on it for long time (as it looks like), it is preferable to bring down the dosage to 2mg +/- two doses of 0.5mg of sustain (slow release) preparation.
Discuss with your doctor about these details. I think he/she will allow you if you understand and permit.
In short and simple words, I will also prefer that you stay on ativan. But given the scenario should ativan not help you, I will agree to make the switch back to xanax.
Hope I have given answers to your query, if still any, do not hesitate to ask.
Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
