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1298588 tn?1330318981

A few questions about Ativan

So, I have suffered from panic attacks for some time now. However, they have recently gotten so bad that after a lifetime spent in adamant opposition to all forms of medication, I have decided to take the plunge and give it a try. I went to my doctor, who prescribed Ativan. I have heard that it is pretty safe, and I have a low dosage (0.5 mg) but I am still very nervous about taking it. I have a few specific concerns that I was hoping to address.

First of all, is Ativan best to take regularly or as needed? I am hoping to take it only for the worst of my panic attacks. On the other hand, I am afraid that such a decision might cause a shock to my system: if I am in the throes of anxiety and take the drug, won't the abrupt sensation of calm be hard on my body? Also, if I take it once and then do not take it again for several days, I fear that it will cause all sorts of strange withdrawal effects , or a rebound effect, in which my anxiety levels after the drug wears off become worse than they were before I took it in the first place. I have heard of instances of this happening, and I don't want it to happen to me.

Secondly, how long does it take to feel the effects of this drug? I have heard that for some people, it takes quite awhile. I can just imagine my panic rising as I wait for it to work, fearing that it will not work at all.

Thirdly, how long can the effects of the drug be felt? Will I get a good long period of calm, or will I be tempted to re-dose within an hour or two?

Finally, like almost everyone else who has a fear of medication, I worry about side effects. I have done a lot of reading about the various side effects of Ativan, from drowsiness to dizziness to worse, and I don't know which I will experience. I know that it is different for everybody, but I'd love to hear some feedback from anyone here.

Again, I realise that my reaction to medication will not be identical to anyone else's, but the more I know, the less scared I will be. If anyone could share their stories with me and reassure me that this drug will not kill me and may actually help me live my life without the constant terror of anxiety attacks,  I would be grateful. Thanks!
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480448 tn?1426948538
Hello there!

For starters, "dependency" and "addiction" are two different things.  We're discussing dependency, not addiction.  I get what you're saying about the psychological factor (not an "addiction"), but there is also something called rebound insomnia, which is not in your head.  That results from the use of sleep aids on a regular basis for an extended period of time.  Basically, upon cessation of the sleep aids, the insomnia returns, and often times is worse than when you started.

Everyone is different for sure, but when any habit-forming med is taken on a regular basis (even once a day), there is a risk for withdrawals if stopped abruptly.  I do get what you're saying about the half life and how the med works, but you're still putting it in your system regularly.

I'll give you an example.  My dad has been an insomniac as long as I can remember.  He has taken Xanax at bedtime every day for decades.  It's the only thing that has worked for him (and he's tried a lot of stuff).  One time, when he was travelling, he forgot to take his Xanax along...so he assumed he was just in for a few sleepless nights (as he understands about the rebound insomnia that occurs with the cessation of any sleep aid).  Well, unfortunately, he went through some pretty intense withdrawals for a few days.  He actually thought something was wrong with him, and went to the ER, as he didn't even think w/ds were a possibility.  Sure enough, as soon as he took a Xanax when he got home, all of the symptoms disappeared within 20 minutes.  

Whether or not a person will actually experience w/ds depends on a whole bunch of things....length of time a person is on a medication, the dose, other medications they make be taking, just to name a few.  So, while you may not experience w/ds when stopping the Ativan, it's still adviseable to taper off if you decide to stop taking it, to be on the safe side.  

Also, you recognize the issue with rebound insomnia that occurs when using sleep aids for an extended period of time.  I personally have no issue with people who need to take a med to help them sleep, but if at all possible, it's best to limit the courses of those meds to a shorter length of time, as to not make the original problem worse.  The other option is to just resign yourself that you will take the med indefinitely.  I would just encourage you, if you haven't already, to look into some other alternatives for sleep.  I too am a pretty bad insomniac, and have learned some tricks of the trade.  TRULY there are techniques that, with practice and consistency, will improve your sleep.  I'll post them for you in the next reply (it's a long post).

Here's to a good night's sleep!

Helpful - 1
Avatar universal
From what i know, Ativan and Klonopin are similar (they're both benzos) but Klonopin has a much longer half life, which is what i take. So, the advice/input I give is based on that! If anything, side effect-wise, you will probably feel a nice "calm" after you take it. It may make you sleepy, but that should stop when you get used to it. I used to take Klonopin as needed but my psychiatrist thought routinely would be better. I only have GAD, no panic attacks (anymore.)

I wish I could take it as needed, but he insisted. I believe as needed is the best way to go with benzos especially if it's for panic. It takes me up to an hour to feel its effects, some people feel it after 15 min, and they actually last most of the day. Ativan may be different because it does not stay in the body as long. I broke my dose into 3x a day since I already have a steady level of the drug in my body & it wouldn't make me super sleepy.

I prefer Valium over Xanax or Klonopin. I've never taken ativan. You're also less likely to experience rebound anxiety with a long half life Benzo.

I see you don't want meds, but I always recommend an SSRI over a benzo for anxiety. Much safer (most of them) and easier to get off of. They're also pretty effective in stopping panic attacks.
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The withdrawals are equally as severe and can be dangerous withdrawing from SSRIs as they are benzos. You may not have seizures, but you won't with the benzo either unless you are taking high doses IE 4 mg a day and over of Xanax. But you can get hallucinations, psychosis, debilitating panic attacks, suicidal thoughts, muscle twitching, rapid heart rate and blood pressure changes, burning sensations, ect when you withdraw from both drugs. I've noticed a lot of people are not informed over the equally as dangerous SSRIs and try to tell people they are safer when this simplly isn't true. Keep in mind also, unlike gaba, serotonin is a hormone so you are severely disrupting your hormones when taking on top of killing your serotonin receptors. That's how SSRIs work to keep the serotonin in your brain longer. They also have an inflammation effect on the brain and body. That's why several of them have even infection listed as common side effects.

Klonopin and Valium have long half lives and don't really work as well when taken on an as needed basis so that is why your doctor wants you to take them daily. They will work better in that regard. Xanax and ativan are faster acting so they are a bit more ideal for severe panic attacks as needed. Valium and Klonopin both give me severe panic attacks so I can not take either one so they are better to take as needed.
Avatar universal
If I give a routine dose of Ativan how soon after the routine dose can I give a prn dose
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1 Comments
Even if the prn dose is Ativan also?
Avatar universal
I have been taking ativan 1mg a day for 7 years  .25  in am .25 afternoon and .5 at bedtime.  I recently upped my dose to 1.25 due to terrible panic and not functioning well.  somehow i got messed up on my dose and wound up on 1.5 a day for about a week or so and then tried to bring it down but when I did that I had horrible horrible withdrawl, I don't undestand why I had such trouble if my dose was going up....I think maybe when I took it all those years I wasn't as precise with the dose as I should have been I would break the pills and sometimes it was a little more sometimes less and I am wondering if I was really taking more than i thought I was, I went to pdoc and he  changed my dose to 2.0 mg a day taking .5 four times a day.  I was afraid to take it that way and stuck with .5 bedtime, .25 morn .25 noon .25 evening but still the withdraw was so horrible finally today I took the .5 like he told me and the withdraw seems a little better but I am still feeling weird and sleepy but not sleeping good when I take it it really knocks me for a loop for a couple of hours and sometimes when I take it within two hours I get terrible tachycardia and pounding heart beat but if I don't take it I won't make it.....if I stay at the dose he told me .5 four times will I stablize and how long will it take about....I am having more anxiety over the meds than anything, I just want to feel normal again.....any help would be appreciated...
Helpful - 0
Avatar universal
Hey guys - I am currently due to go on holiday to Fiji (from New Zealand)in 3 weeks.  This will be my first over seas holiday in about 12years.  I struggle to be away from my normal everyday life.  I haven't slept for the past week just thinking about this holiday, pretty pathetic I know.  Its got to the point where my kids and husband are missing out because of my anxiety which is not fair. I feel incredibly scared about the unknown of my holiday destination, I worry I will loose my **** and have a complete mental breakdown.  I struggle not being in control and I find it really hard to relax.  I am currently on 20mg of prozac but I actually don't think this does anything for my generalised anxiety disorder but I don't have time to change my meds.  Basically my question is IF i HAD to take 1mg of Lorazapam for the duration I was away and actually leading up to it, do you think I would be ok?  And do you think it would allow me to actually be able to relax and enjoy my holiday with my family?
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1 Comments
Absolutely
Avatar universal
I too have a 1mg Ativan (Lorazepam) prescription but also use it very sparingly because of its addicting property and especially its tolerance and withdrawal potential.

I also have what may be a great alternative prescription...Hydroxyzine Hydrochloride (Pamoate), which is also anti-anxiety but doesn't run those risks mentioned with Ativan.

Give it a try, folks...you may be able to wean off the Benzos.
Helpful - 0
Avatar universal
Ativan, a trade name for lorezepam, are very safe.  It's in a drug class called benzodiazepines like clonazepam, diazepam, etc.  This drug class replaces barbtiturates for sleep and anxiety back in the 1960's.  The main reason was that people who were suicidal could easily over dose on barbiturates(for example Seconal)and die.  It is really hard to over dose on "benzos", UNLESS you mix them with alcohol and some certain other drugs.

Most people feel the effects of Ativan almost immediately being the fastest and shortest acting of the benzodiazepine group.  I would try to take them as needed.  Once you get on a regimen of 3 or 4 every 6 hours, they are the most difficult drugs to witdraw from(yes, ironicallyy worse than heroin)

Here's a thing you can do for nothing when having a panice attack.  Breathe into a paper bag.  Why?  because panic attacks come about because your emotions have an effect on your breathing.  You build up to a panic attack because you are inhaling oxygen and not exhaling enough carbond dioxide.  this imbalance brings on the panic attack.

good luck, try not to stay on it too long on a regular basis.
Helpful - 0
Avatar universal
right now its making me feel so damn good I am so clamed and relaxed it gives you good n happy feeling it makes you very happy and helps you focus on other things more you feel less talkative and makes you anti-social but overall it is helping me so much with my anxiety and panic attacks I have been having for years Ativan 1 mg has helped me so much! Be safe for whatever purpose you are using it for do not abuse it.  
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Avatar universal
right now its making me feel so damn good I am so clamed and relaxed it gives you good n happy feeling it makes you very happy and helps you focus on other things more you feel less talkative and makes you anti-social but overall it is helping me so much with my anxiety and panic attacks I have been having for years Ativan 1 mg has helped me so much! Be safe for whatever purpose you are using it for do not abuse it.    
Helpful - 0
12253241 tn?1481835499
I've enjoyed reading your comments. I have had insomnia in the past 5 weeks due to anxiety about some heart palpitations I have recently developed.  Now my anxiety seems to be centered around the feeling that I will not be able to fall asleep.  It has gotten into a vicious cycle.  I may go 3 nights without sleep, then sleep two nights, etc.  I've tried different teas, melatonin, soft music, but nothing works consistently, just some of the time. My doctor prescribed 0.5mg of Lorazapam 2 weeks ago, but I have been hesitant to take any meds for this. Last night the anxiety was so bad I took one, and 90 minutes later I was less anxious, but still not sleepy, though I had not slept at all the night before.  I eventually fell asleep, and this morning I feel less anxious than recent mornings.  I am hoping not to have to take another dose tonight. If I feel drowsy during the day, at this point I will welcome it.
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Avatar universal
Littleden why are commenting on a drug you have no knowledge of?? It takes a full hour for Ativan to work but you can feel it to start working in about 1/2hr but it depends on if you have food in your stomach and how bad your Anxiety is at the moment!! You might not feel better for an hour so I would take as soon as your anxiety starts to get bad!! Or even better use them for when you know your going to be panicky or very anxious! Then you avoid it all together!! I have taken them for years on/off. They are not addictive in the sense as a druggy,meaning your body gets used to them over time and only if you take more then 1 a day! And if you rely on them instead of working with a counsellor, psychiatrist. Good luck I'm off to take one now! I'm pretty bad. Be safe!
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Avatar universal
I take 0.5 mg of Lorazepam every night at bedtime. My anxiety built up slowly over the years since retirement in 1998. we do not have a pension so relay on SS and investments which we have watch erode from 2002 -2008. Then in 2010 our 20 year old grandson died suddenly from a ruptured appendix. He had seen a doctor the day before who sent him back to the college dorm. That was when it started. My attacks only occur at night around  2 in the morning. I feel find when I go to sleep and then it happens. When I wake up with the attack and take the medicine it takes about 20-25 minutes to calm down and go back to sleep. If I try to work thru it that takes about 4-5 hours. So my issue is I can wait to see if I wake to a attack or go ahead and take one and sleep very well sometimes thru the entire night without a bathroom call. At my age I think the benefits outway the risk.
DMT
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Avatar universal
Will taking Ativan and then going to play playing tennis relieve the anxiety..Is exercising good for the anxiety...
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Avatar universal
GDV
Hi, I am taking Ativan also, I do not have panic attacks, but I feel anxious a lot. I had hoped it would calm me but my mind still runs. I started taking 1mg three times a day and I guess since it did not live up to my expectations I am not sure what it is doing. It does keep from the edge because after awhile with nothing I focus on when is this going to stop.

I am worried about the addiction part too, so I started taking it only twice day 1mg each time. I do sleep pretty well. I tried Xanax and it did nothing for me, it was like my anxiety just burned through it........it is good to hear others are having good results, we just need to keep looking till we find our perfect fit.

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Avatar universal
I am on both Klonopin 2mg three times a day and Ativan 1mg as needed.  I too suffer from agoraphobic panic attacks and my safety net is my home.  You have to have a mind set that this medication is like a life line and know that when you take it sublingually your attack will pass as quickly as it came.  It sounds like you might need to increase your dose to 1mg,
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Avatar universal
My doctor just started me on 0.5 Ativan for pelvic pain and sexual dysfunction related to pelvic pain.  He also gave me daily Cialis to take.  Honeymoon is next Friday.  Has anyone taken Ativan for performance anxiety issues??? When is the optimal time to take it before sex??

M
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Avatar universal
My brother is experiencing similar but more extreme side-effects of trying to tapir his use - he's been on 1mg 2x day for 18 months.  He was gradually cutting it down starting last fall but got to .25 mg and in his words started losing his mind.  Note- he was prescribed this for bouts of uncontrollable vomiting- never had anxiety issues nor insomnia.  
Like you, when he experienced the extreme effects of withdrawal, he upped his dose again but still hasn't stabilized.  He went to a psychiatrist (retired AF) who told him he should be fine since he's never seen combat.  
The doctor that prescribed it originally won't see him because he was trying to take himself off the drug himself, therefore, he's "non-compliant."
I'm at a loss as to how to find help for him.  He's been sobbing for days-can't sleep can't eat ...  My uneducated opinion of this drug?  Use caution!
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Avatar universal
Im on Ativan 2mg and i sit at work all day do you think i can take it while at work...its says every 12 hours
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Avatar universal
I take 1mg of Ativan at 8 am and 2 pm to last me all day. So as I was reading it won't make me have withdrawals when I eventually stop using it?
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Avatar universal
I have taken one table of 0.5 mg of lorazepam (Ativan) daily off and on for 25 years to manage what is mostly mild anxiety.  More recently, in the midst of some rather unsettling physical problems and temporarily unable to exercise, I have on occasion increased my dosage to 1 mg.in the morning.  As I have begun to approach retirement I have been more regular in my use of lorazepam and even after such an extended period of taking it I have not noted any lessening of its effectiveness.  

I would not pretend that I could stop taking lorazepam tomorrow, but after 25 years I probably worry less about issues of dependency than other commenters on this forum.  Lorazepam was part of a treatment regimen (that included a similarly small dosage of an SSRI through 1999) that I believe made it possible for me to work regularly and I believe successfully, raise three children with my wife, put those children through college and reach early retirement age more or less intact.  I am grateful for these medications and fortunate to have a competent therapist.  But what is odd, and one of the reasons I have started visiting these forums in the first place, is I thought that with the prospect of retirement and the less stressful life it promised my anxiety would slowly dissipate.  Unfortunately, I have found just the opposite to be true, though as I mentioned above, I have had heart and esophageal procedures within the past 12 months and I don't believe they can be entirely separated from my long-standing genrealized anxiety disorder.  For the older commenters on this forum, is it common to experieince heightened levels of anxiety, regardless of specific circumstances, as one ages?   As I mentioend above, I have found this to be the case, much to my surprise.  

So, it apprears that I will remain with the lorazepam some while longer.  Do I wish it were otherwise -- absolutely --but what I can tell you is that faced with the prospect 25 years ago of trying to work and support a family with a life beginning to spin out-of-control, the decision to take a medication with known beneficial results was an easy one for me.  And one I do not regret.      
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Avatar universal
I used to take klonopin to help with nighttime anxiety that prevents me from sleeping.  I got to a point where I simply didn't want to take any meds anymore so came off of that, Effexor, and adderall.  I was completely med free for over a year and in general have handled it well despite consistent anxiety keeping me from getting to sleep and lack of ability to concentrate which I believe is fueled more by anxiety.  I have been under an enormous amount of stress and finally went back to my dr.  He started me on .5 to 1mg if ativan prn.  It did help me relax to get to sleep but did not help me stay asleep through the night and upon waking up I feel such anxiety that its very difficult to get back to sleep, even on nights I took the ativan.  Went back today and he is putting me back on klonopin on prn basis.  

My question is, if I take a very low dose of the klonopin only a few nights per week, but end up pregnant (husband and I are just letting it happen if it does), would it be a huge concern?
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480448 tn?1426948538
If your doctor has prescribed it, and you need it during an especially stressful, anxiety producing time, then take it as directed.  Don't be afraid of taking a medication prescribed to help you, just be aware of the considerations and precautions (like we talked about in this thread).

If you need any more info or support, please start your own thread, it's far easier to follow along when a post isn't tacked onto an older thread, plus, you'll get more replies.

Take care!
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Avatar universal
I'm going through a particularly stressful time at the moment and am considering taking ativan daily for the next week or so, but am worried that this is a bad idea. I'm not on any other drugs, don't drink or smoke etc.... but I really do rely on ativan for those times of intense panic. Still, this is the end of my semester at school and I'm not getting anything done because of shame and anxiety, and when i took an ativan last night, i got so much done because i wasn't anxious anymore. I usually take .25-.5 mil as I am a small creature. Thoughts?
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Avatar universal
Hi Nursegirl, thank you for taking the time to respond, both times.  I thought that I'd get an email notification when someone posted in this thread, so when I didn't get the email I didn't check.  I wish I did though.  You are definitely right, especially when you say benzos aren't bad, it's the people advising poorly on them and the people using them....or should I say, misusing them.  I misused and paid the price.  Live and learn.  I just felt bad that I posted that bad information here and wanted to make sure it was corrected.  Glad you were also here to fact check the information.

Take care!
Todd
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