Brief Answer: No particular dose. Explained below. Detailed Answer: Hi, Welcome to Healthcare Magic! The risk of dependence to Ativan or other benzodiazepines does not depend on the strength of dosage as much as it depends on the duration and regularity of dosage. In simple words, if you were to take a reasonably high dose of Ativan, say around 4 mg, once every two to three days, your risk of getting dependent on it would be far less than if you were to take a low dose, say around 1 mg per day every day for a few weeks. That is, regular intake of even a low dose has a risk of dependence. This can be minimized by taking the benzodiazepine for as small a duration as possible and seeking alternate long term management strategies. One also needs to be watchful for the development of tolerance to the drug. Once your body develops tolerance, you will notice that higher dosages are needed for the same effect. This indicates that the brain cells have got habituated to working in the presence of the drug and need a higher dosage for therapeutic effect. If one quits the drug abruptly, the brain cells find it difficult to function in the absence of the drug and one suffers from withdrawal symptoms. The bottom-line is that there is no particular dose that can be taken daily for a long term without developing dependence. You need to use the drug as sparingly as possible and keep an eye on the development of tolerance. If possible, try taking Ativan only on an 'as and when required' basis allowing the body time to function without the presence of the drug in the system to prevent dependence. If you take it regularly, then whenever you stop Ativan, take care to taper off the dose rather than abruptly stopping. I hope this clears up things for you. Please feel free to ask if you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry

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Brief Answer: Go slow and adjust according to your body's needs. Detailed Answer: Hi, Welcome back! Before deciding to taper off, check if you are ready to do so. That is, assess if the problem for which Ativan was started has been taken care of. For example, if Ativan was started for anxiety, then it is time for Ativan to be tapered off when another medicine has been started for anxiety like an SSRI and has started showing response. Once you decide to taper off, go slow. From 6 mg per day, try reducing 0.25 mg per week. If this is not comfortable, do it every ten days or more. Do not hurry but wait for your body to adjust to a new dose before reducing further. If you have been on this dose for years, then it would be better to go even slower, around 0.25 mg per month. If you are taking two or three divided doses, it is better to reduce the afternoon or morning dose first as a reduction in night dose can affect your sleep. Let me know if you need to know anything else. Take care. Best wishes. Dr Preeti Parakh MD Psychiatry

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