Lorazepam

[ocdhelp]

My doctor is taking me off of lorazepam. When I started to reduce the intake of this med, I noticed my intrusive thoughts started to come back. I’m now almost completely off of it and my intrusive thoughts have come back more. I replaced it with ashwaganda vitamins but it’s not helping. Has anyone else faced the same problem and if so, what did you that might’ve helped you?

[specialmom]

Oh gosh, sorry to hear. Intrusive thoughts are so problematic, aren't they?  We tried the ashwaganda with my son and it did zip.  I mean, nothing.  Really nothing did anything.  But what we found is that when we really dug in and went for treatment, it helped.  My son is on medication and doing psychotherapy.  I can understand not wanting to keep you long term on the benzo type drug. It's frankly, addictive and you will need more and more to get an affect. But OCD can be treated with other classes of drugs pretty effectively.  ERP therapy is pretty well respected for treating ocd. It involves exposure. Which is scary, I'm sure.  But with a trained psychologist, they help you through that.  My son uses DBT therapy for intrusive thoughts. It's also been effective.  Have you ever tried an SSRI?

[Paxiled]

As I said, using any herb by itself will almost never help a complex problem.  Ashwagandha would be one small part of a holistic approach.  It does, however, do things that one might not notice because the problem is so large it just won't be enough.  You also might be taking it from a company that doesn't make good products.  You might not be using a therapeutic dose.  You might not be taking it often enough to keep it in your system so it can work.  It is a very helpful herb for the adrenals, but by itself not likely to tackle a serious problem.

[specialmom]

Ya, I'd never recommend it.

[Paxiled]

Well, I would highly recommend it, but not because I believed it would "cure" a major mental disorder by itself.  Again, if used with a combination of substances and therapy and lifestyle changes, it can be very useful.  But when one is suffering from a mental disorder and especially if one is taking meds to treat the symptoms, I would highly recommend it as it is very protective of the health of your adrenals and can help with better sleep.  The fact so many people simply don't know what these nutrients actually do and how to use them doesn't make them something to not recommend, as they can help prevent some of the health problems people with these disorders get.  I wouldn't tell you broccoli cures cancer, but it will help provide antioxidants that will help prevent cancer or the spreading of cancer.  By itself it won't cure anything, but would be a good part of an overall program.  

[specialmom]

To ocdhelp, assuming that is what you are here for.  There is a lot of evidence based, scientific data suggesting that SSRI's actually work quite well for OCD and anxiety disorders along with CBT and exposure therapy. Intrusive thoughts are rough. This article does a nice job talking about the different options that have a history of helping people with intrusive thoughts. https://www.news-medical.net/health/Treatment-Options-for-Intrusive-Thoughts.aspx

[Paxiled]

I think the tricyclics are actually the class of drugs most studied for OCD.  I don't think the SSRIs actually did a whole lot with that other than Luvox, which isn't widely prescribed in the US because it has a lot of interactions with other meds.  But in the end, it has turned out that antidepressants do help a lot of people with anxiety problems even though they really didn't do a lot of research on it and the studies were with quite small numbers of people.  I've always wondered why that was, and why depression gets so much of the attention by the medical community and anxiety is left as the side gig.  It seems to me us anxiety sufferers are a lot of people, and for me, anxiety is a whole lot worse than depression.  Depression is awful but if you get up the energy you can do anything you want.  With anxiety, your life is so circumscribed.  Alas.  I do want to warn, neither CBT nor any known medication has a good success rate at treating any form of mental illness.  All are about 30% effective, which is why it's such a good thing there are so many different therapists and different ways of doing it and so many different meds, because we are very much not good yet at treating this stuff.  It's good therefore to have options so that one of them sticks.  Peace.

[Paxiled]

By that I mean, never give up, the next treatment might just work.  i speak as someone CBT did not work for, and actually made me worse, and yet I recommend it to everyone because I think it's still the best bet.  When it does work, the fix stays around.  

[specialmom]

To the poster, don't get discouraged by negative people or negative comments. Prozac is giving my son his life back. It's been an amazing GAME CHANGER.  Along with CBT and DBT therapy and he has suffered intrusive thoughts.  He has major depression, generalized anxiety disorder (panic, ocd and social anxiety all as well as sub areas) and torette's syndrome.  He's engaged in getting better and shows progress.  I'm happy to report that. He was barely functioning before not wanting to leave the house. Or even his bed.  He is among the living again!  And all of what I write is from current involvement of psychiatrists, psychologists and not from years ago. These things are going on today, working with psychiatrists today, psychologists today and not years ago.  Current information. All the best to you.  It's not that negative to be treated for psychiatric illness, there is a LOT that helps. People DO get better all the time.  

[specialmom]

I'm also going to clarify something with current information. Tricyclic drugs are rarely used for OCD these days with only one ever having evidence of really working, clomipramine.  That class of medication and clomipramine in general had a side effect profile that made it such that when the SSRI's came along, patients greatly benefited from the improved tolerability.  https://emedicine.medscape.com/article/1934139-medication  In today's world, doctors generally use SSRI's. https://iocdf.org/about-ocd/ocd-treatment/meds/  Sometimes SNRI's.   From this article : " Because clomipramine is less well tolerated than the SSRIs, it was given a recommendation grade of 2 (moderate risk benefit ratio), while the SSRIs received the highest recommendation grade 1 (good risk:benefit ratio)" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181958/  This is a nice article that suggests the best way to overcome ocd with many who receive proper treatment being able to do so.  Psychotherapy is an important part of it.  My son has intrusive thoughts as part of his diagnosed ocd, along the lines of obsessive thoughts. He has few actual compulsions.  His diagnosis is recent and from more than one professional. https://www.health.harvard.edu/mind-and-mood/ask-dr-rob-about-ocd  

To the poster, good luck.  I hope that gaba works for you.  I've read that doctors are finding a link between that and intrusive thought. Let me know how it goes, if it helps. best to you.

[Paxiled]

This is true, but clomipramine is a new tricyclic, not one of the old ones.  I believe it's newer than some SSRIs.  But I never took it for that reason, although it was recommended to me, because it's side effect profile is off the charts.  I did take imipramine, an older tricyclic, and I can't say it had more side effects than SSRIs and worked about the same for me, although it stopped working and I had to change to SSRIs.  I did prefer the SSRIs because a couple of the side effects of tricyclics lead to things like bad teeth (dry mouth) and headaches and constipation are no fun either, but on the other hand they don't produce the same weight gain, are much easier to stop taking, the sedation wears off, so again, it's a balancing act here.  There is no drug that isn't a pain in the you know what, but you gotta do what you gotta do.

[specialmom]

SSRI's as a class, while not perfect, have a more favorable side effect profile to tricyclic drugs which is why they are first line and tricyclics are second line. All medications have a downside but SSRI's were a break through in the psychiatric world for a more tolerable treatment to what they had to choose from prior.  

[Paxiled]

Uh, Mom, how many of them have you personally taken?  Because you know, I have a really bad disease and I've taken a ton of them, and because I have this I've spoken to lots of others and have also had a lot of psychiatrists.  The first med I was put on was a tricyclic because that's what the psychiatrist believed was the safest and best choice to start with because it had been around a very long time whereas ssris were much newer.  The actual truth is, each individual decides how much a drug's side effects are tolerable and how much long-term damage is possible.  SSRIs have been linked to dementia.  They have been linked to horrific withdrawal problems when some people stop taking them.  They have side effects that don't go away when you stop taking them.  Tricyclics generally don't suffer from any of these problems.  SSRIs are tied to sexual problems, which can destroy relationships.  They are much more tied to suicidal and violent thoughts.  They change personality.  They cause weight gain that can lead to diabetes and other metabolic problems.  Tricyclics, on the other hand, can cause liver problems, so when I was on them I had to get tested for that regularly.  So what I'm saying is, these drugs are quite odd and vary a lot.  I personally found SSRIs easier in the long run to take, but one destroyed my life because my brain was unable to function without it and my psychiatrist didn't know this even though it is well publicized.  The other truth is, most people do fine on both categories.  One of the biggest problems we have with SSRIs is how they were first introduced, a story most people don't know.  The first was Prozac, and Eli Lilly lied like crazy about it.  They paid a psychiatrist to write a book claiming Prozac had solved the mental illness problem, obviously a lie, and that SSRIs had no bad side effects.  A lot of lawsuits and publicity and gov't enforcement later, nobody should now believe any of this.  It is why I always caution on here against using any medication for anything unless you need it, not just because it's easier than a longer form of help, because all pharmaceutical companies lie and withhold information from us and the FDA and other regulatory bodies, and by the time they get fined and sued they have made so much money they really don't care.  We can all wish this was different, but it isn't.  The FDA just approved an Alzheimer's treatment that costs about 40,000 dollars a year to take and has no proof it does anything beneficial.  It takes about a decade of use before reports become known about what a drug actually does to us.  Statins, the most prescribed drugs, destroy some people's liver and destroys joints.  The damage doesn't end because you stop taking them.  Do these bad things happen to most people?  Absolutely not.  But that's no consolation if it does happen to you.  I only had a major problem with one of the many antidepressants I've taken, and only two of them did anything.  But the one was the end of my life.  Doesn't happen to hardly anyone, but it happened to me.  Could happen to alcoholics who quit.  Could happen to heroin addicts.  Not unique to antidepressants, but it's always good to acknowledge choices.  Everyone gets to decide how they want to proceed, but forewarned is forearmed.  I wasn't, and all I try to do here is let people make an informed choice, because your doctors won't tell you this stuff.  Never told me.  I agree, SSRIs were a breakthrough in a way, but not in being more effective.  We still have no effective treatments for mental illness, just palliatives that work about 30% of the time.  Some day we can hope for better.  As I've always said, if a life is unliveable, take the drugs.  But which drugs depends on the individual, not on a generalization or marketing materials.  Peace.

[Paxiled]

And let me add, I would never tell anyone to take a drug because I did, or not to take one because I didn't.  It isn't about me.  

[specialmom]

well, I'm going by current trends in medical treatment (as in the here and now) for OCD symptoms.  I've taken medication.  I liked prozac the best and got to 40 mg on it.  My social anxiety at that time was completely elevated and I didn't have side effects.  However, the reason I took it was more episodic so it was helpful for a year and then I successfully discontinued it.  I tried two others prior that I wasn't a fan of the start up side effects.  But I also have a vested interest to be completely up to date on information regarding this topic and am in the mix of working with a variety of professionals that their sole job is working on psychiatric disorders.  I am very much involved in what is happening today and things have evolved in treatment over the years. I am sorry that your life was forever changed in such a negative way.  No one should enter into taking a medication lightly.  I agree. But, when doing the pro's and con's, an awful experience like yours is rare.  Benefit verses risk analysis would keep that in mind.  And I'm thankfully watching my son slowly progress and get his life back.  

[specialmom]

* spelling issues.  alleviated.    As in gone.  And my depression and anxiety was better.  I was not taking the medication for OCD.  My son is taking medication for the entire gambit of issues he has and it is nice to have medication options that can treat multiple things.

[Paxiled]

First, the term intrusive thoughts has become a fad, but all thoughts come from nowhere and we all think.  All the time.  It's when those thoughts bother us to the point of damaging our lives that it's a problem, so the fact you think isn't the problem, the fact your thoughts are bothering you is the problem.  Do know that stopping benzos can be really hard, and can pack a bad withdrawal, but in your case, you seem to be doing pretty darned well considering what you just did, but also know that there are no medications for mental illness that cure it.  If you didn't fix it in therapy or other changes in your life, the drug just masked it which is better than suffering all the time but you didn't cure the problem and it looks like it came back.  Treating this with natural medicine is much more complicated that taking one supplement.  While ashwagandha can moderate the adrenal gland, and is a great herb for anxiety sufferers, by itself it isn't going to fix this.  You'd have to do a program of taking several supplements under the guidance of someone who knows how to do that, change your diet, exercise, meditate, and get therapy to make that work, and there would be no guarantees it would work.  You say intrusive thoughts, but as I noted, that doesn't actually say anything, so I assume you mean you are suffering from anxiety.  If you wanted to stop that medication, the thing to do was get into therapy with a psychologist who specializes in treating anxiety and if you wanted to explore natural medicine, adopt a program and see if it works and, if it doesn't, try a different one.  I would say that if stopping the med caused this you weren't medically ready to stop it yet or if you wanted to continue a medicinal approach it would have meant switching to antidepressants or other meds instead.  Peace.

[ocdhelp]

Hi Paxiled. My dr just prescribed gabapentin for me. Have you taken this medication and what do you think of it?

[Paxiled]

This was the drug Neurontin, which was used for nerve pain of a couple kinds and has pretty much been eclipsed by Lyrica for that purpose.  My psychiatrist actually wanted me to use gabapentin but my anxiety is so out of control because it was escalated so beyond my original problem by a failure to properly take me off the drug Paxil, which caused a horrible reaction in me for reasons I'll probably never know.  It kind of sets up an alternate GABA system in your brain -- GABA is the natural relaxant and anti-seizure substance the body naturally produces and that the lorazepam targeted.  As all these meds are trial and error and as this drug was never studied in clinical trials for use for anxiety but has been widely used for that usually in conjunction with an antidepressant that was working but not well enough nobody can predict how you will react to it.  I decided against it as drugs became very problematic for me because of my very rare condition, and you don't and won't ever have that, but the only way you'll know if anything will help you is to try it, unfortunately, and then of course you're on it and have all the problems of taking it and trying to stop taking it.  If you believe you need it, it's a lot less problematic for most people than benzos.  In the end, you have to make your own decisions on how you want to approach this, but my main point was, no drug will cure you but lifestyle changes and therapy might, so no matter what you choose to do medicinally, you should put as much energy as you have into that in the hopes you can rid yourself of it.