Hey erol34,
If I were tapering short acting meds without a switch (which I have done but it's not something I enjoyed) I'd go with the old "take a small chunk out of the pill every few nights" method. If you really are set on it and know the risks (namely in your case, rebound insomnia) then 0.5mg or even 1mg in a month shouldn't (but COULD) be much of a problem. There's an inherent risk with any kind of benzo taper but your situation is rather unique.
The alternating only really serves to see how your body reacts to it and make sure that it's capable of handling the switch. To answer your other question, zolpidem works on and in much the same way as benzos on the same (GABA) receptors. In theory a total cutoff of Ativan COULD result in nothing at all of note different with the zolpidem taken into consideration. In practice it would be dangerous as hell. If your intent is to come off of one or more narcotic medications, you could ask your doctor about gabapentin. It's something of a longshot that they would be willing to switch you over but there's always a chance and it's worth asking. Some doctors are only too happy to try non narcotic medications if you bring them up, particularly to treat things associated with a head injury, but I'm guessing that since this IS the result of a head injury they've already tried that route with you. As I said, though, there's always a chance.
Shmokey- I wouldn't use it for insomnia for any real duration of time. Tolerance rises quickly and day to day anxiety can pop up out of nowhere between doses. As I've suggested to other posters, doxylamine succinate can be bought OTC in most places and can be a huge benefit to most people. Store brands are cheap and if you're in the US then they can be purchased on Amazon for $10-$12 for around 200 under the brand Kirkland. As I said before (possibly to you? Sorry, a lot of benzo/sleep questions) doxylamine works the same way benadryl does just much, much better. I just checked a few Amazon listings for doxylamine and with almost 1,500 reviews that drug has a pretty constant 4/5 rating.
There's also melatonin which CAN BE extremely effective but usually isn't. This is solely the fault of pill poppers that don't follow instructions. Where melatonin ASSISTS in sleeping, it doesn't actually put you out the way sleeping meds or benzos do. It's actually used to regulate circadian rhythm disorders. The way it works, essentially, is by signaling the brain that it's getting dark out and to be prepared to sleep. That is to say that if you work a night shift, blinds and curtains need to be closed and things need to be very dark for as long as possible after taking the pill. It also can't be taken any time like most people think. It should be taken 1-2 hours before sleep, sometimes a bit longer if 1-2 isn't working and you're actually taking them late in the day.
Ome more point about melatonin - the dose is all wrong. The companies that make most brands know this but they also like the fact that to most people, "more is better" in the way of active ingredient. A couple of years ago we ran a sleep study with traditional sleep remedies vs modern medications. The melatonin actually fared very well, better than some well known narcotic sleep agents, ONLY IN LOW DOSES. People were given various doses of various compounds. What we ended up finding was that people who took the most easily accessible melatonin from a drug store or supplement shop (2-5mg) actually got less quality sleep than people that were taking 125-300mcg doses.
I hope that helps and if not, id be happy to answer anything at all with other suggestions. Oh. One last thought regarding melatonin (pill form or natural, internally produced): Google "light therapy." This can also be beneficial with practice and following the guidelines but even I am not long-winded enough to go into detail here haha. That is unless you'd like me to explain further. As was my mantra when I was a teenager "i'm up for anything, just let me know when"
If I were tapering short acting meds without a switch (which I have done but it's not something I enjoyed) I'd go with the old "take a small chunk out of the pill every few nights" method. If you really are set on it and know the risks (namely in your case, rebound insomnia) then 0.5mg or even 1mg in a month shouldn't (but COULD) be much of a problem. There's an inherent risk with any kind of benzo taper but your situation is rather unique.
The alternating only really serves to see how your body reacts to it and make sure that it's capable of handling the switch. To answer your other question, zolpidem works on and in much the same way as benzos on the same (GABA) receptors. In theory a total cutoff of Ativan COULD result in nothing at all of note different with the zolpidem taken into consideration. In practice it would be dangerous as hell. If your intent is to come off of one or more narcotic medications, you could ask your doctor about gabapentin. It's something of a longshot that they would be willing to switch you over but there's always a chance and it's worth asking. Some doctors are only too happy to try non narcotic medications if you bring them up, particularly to treat things associated with a head injury, but I'm guessing that since this IS the result of a head injury they've already tried that route with you. As I said, though, there's always a chance.
Shmokey- I wouldn't use it for insomnia for any real duration of time. Tolerance rises quickly and day to day anxiety can pop up out of nowhere between doses. As I've suggested to other posters, doxylamine succinate can be bought OTC in most places and can be a huge benefit to most people. Store brands are cheap and if you're in the US then they can be purchased on Amazon for $10-$12 for around 200 under the brand Kirkland. As I said before (possibly to you? Sorry, a lot of benzo/sleep questions) doxylamine works the same way benadryl does just much, much better. I just checked a few Amazon listings for doxylamine and with almost 1,500 reviews that drug has a pretty constant 4/5 rating.
There's also melatonin which CAN BE extremely effective but usually isn't. This is solely the fault of pill poppers that don't follow instructions. Where melatonin ASSISTS in sleeping, it doesn't actually put you out the way sleeping meds or benzos do. It's actually used to regulate circadian rhythm disorders. The way it works, essentially, is by signaling the brain that it's getting dark out and to be prepared to sleep. That is to say that if you work a night shift, blinds and curtains need to be closed and things need to be very dark for as long as possible after taking the pill. It also can't be taken any time like most people think. It should be taken 1-2 hours before sleep, sometimes a bit longer if 1-2 isn't working and you're actually taking them late in the day.
Ome more point about melatonin - the dose is all wrong. The companies that make most brands know this but they also like the fact that to most people, "more is better" in the way of active ingredient. A couple of years ago we ran a sleep study with traditional sleep remedies vs modern medications. The melatonin actually fared very well, better than some well known narcotic sleep agents, ONLY IN LOW DOSES. People were given various doses of various compounds. What we ended up finding was that people who took the most easily accessible melatonin from a drug store or supplement shop (2-5mg) actually got less quality sleep than people that were taking 125-300mcg doses.
I hope that helps and if not, id be happy to answer anything at all with other suggestions. Oh. One last thought regarding melatonin (pill form or natural, internally produced): Google "light therapy." This can also be beneficial with practice and following the guidelines but even I am not long-winded enough to go into detail here haha. That is unless you'd like me to explain further. As was my mantra when I was a teenager "i'm up for anything, just let me know when"