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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by msurtees on July 10, 2004, at 7:14:24
I have a prescription of these for when I have those 'tense' days. It states .5mg 3 times a day.
There are times when it feels like I would like to take 1.0 instead. Is that safe/recommended?
Posted by SLS on July 10, 2004, at 10:23:22
In reply to lorazepam dosage, posted by msurtees on July 10, 2004, at 7:14:24
> I have a prescription of these for when I have those 'tense' days. It states .5mg 3 times a day.
>
> There are times when it feels like I would like to take 1.0 instead. Is that safe/recommended?
Here's a link to the information that one would find in the PDR:http://www.rxlist.com/cgi/generic/loraz_ids.htm
Taking 1.0mg three times a day is certainly a safe and reasonable thing to do.
- Scott
Posted by Fred23 on July 10, 2004, at 18:26:10
In reply to lorazepam dosage, posted by msurtees on July 10, 2004, at 7:14:24
> I have a prescription of these for when I have those 'tense' days. It states .5mg 3 times a day.
>
> There are times when it feels like I would like to take 1.0 instead. Is that safe/recommended?I've got the exact same prescription, and have been discussing it in a variety of posts that have all now scrolled into the archives.
The first issue is are you taking the generic, e.g., Mylan, or real name brand Wyeth Ativan? I found the generic to be practically ineffective, compared to the name brand, which I voluntarily switched to, even though the cost (insurance copay) is much greater.
My goal has been to duplicate a pattern I figured out from "borrowed" Xanax, where 0.5 mg per day, taken in the morning would last all day.
Since Ativan is half as "strong" I'm testing where 1.0 mg/day in the morning is "enough". So far, this idea seems to work. Since Ativan has a slightly longer half-life than Xanax, it should.
What "the books" would have you do, though, is take 0.5 mg throughout the day, up to three times. Since Ativan takes longer than Xanax to reach its peak level, it is not so good for "PRN" type usage, however.
What I've found is that benzos have a certain "threshhold" where unless enough is taken to reach that threshhold, there is *no* effect. The goal is to find the dosage timings to keep enough in the system to stay above that threshhold, but not get too much higher, or else the body adjusts to that as a new threshhold. In other words, take as little as possible to have a steady anxiolytic effect.
(Note that my ideas are different than what is considered normal, so balance my ideas against those more knowledgeable.)
Posted by guttersnipe on July 11, 2004, at 2:00:20
In reply to Re: lorazepam dosage » msurtees, posted by Fred23 on July 10, 2004, at 18:26:10
> Since Ativan takes longer than Xanax to reach > its peak level, it is not so good for "PRN"
> type usage, however.I've read that before, but in my experience that seems to be canceled out by the sublingual Ativan getting into the bloodstream a lot more quickly than the swallowed Xanax (especially if there's any food in the stomach).
Anyone else care to share experiences as to which one seems to take effect more quickly?
Thanks.
Posted by Fred23 on July 11, 2004, at 12:28:03
In reply to Re: lorazepam dosage » msurtees, posted by Fred23 on July 10, 2004, at 18:26:10
> My goal has been to duplicate a pattern I figured out from "borrowed" Xanax, where 0.5 mg per day, taken in the morning would last all day.
> Since Ativan is half as "strong" I'm testing where 1.0 mg/day in the morning is "enough". So far, this idea seems to work. Since Ativan has a slightly longer half-life than Xanax, it should.
Though, it seems I may need to do a 0.25 mg after dinner dose, as a springboard, so that the morning 1.0 mg dose doesn't have to "catch up" so much.
Posted by Fred23 on July 11, 2004, at 12:55:38
In reply to Ativan v. Xanax for as-needed dosing » Fred23, posted by guttersnipe on July 11, 2004, at 2:00:20
> > Since Ativan takes longer than Xanax to reach > its peak level, it is not so good for "PRN"
> > type usage, however.
>
> I've read that before, but in my experience that seems to be canceled out by the sublingual Ativan getting into the bloodstream a lot more quickly than the swallowed Xanax (especially if there's any food in the stomach).Would "msurtees" be able to ask the pharmacist for a refill of those, on his own, or need the doctor to re-write the prescription, if he wanted to try the sublingual?
Posted by guttersnipe on July 11, 2004, at 18:55:45
In reply to Re: Ativan v. Xanax for as-needed dosing » guttersnipe, posted by Fred23 on July 11, 2004, at 12:55:38
> Would "msurtees" be able to ask the pharmacist for a refill of those, on his own, or need the doctor to re-write the prescription, if he wanted to try the sublingual?
Good question ... one to which I must admit I don't know the answer. When I was taking Ativan, I think the pharmacy I used carried only the sublingual tablets, because my prescriptions didn't specify sublingual and I didn't specifically ask for that, but that's what I got. I suppose either the doc or the pharmacist should be able to give a better-informed answer than I can ...
Posted by Fred23 on July 11, 2004, at 23:14:48
In reply to Re: Ativan v. Xanax for as-needed dosing » Fred23, posted by guttersnipe on July 11, 2004, at 18:55:45
> > Would "msurtees" be able to ask the pharmacist for a refill of those, on his own, or need the doctor to re-write the prescription, if he wanted to try the sublingual?
>
> Good question ... one to which I must admit I don't know the answer. When I was taking Ativan, I think the pharmacy I used carried only the sublingual tablets, because my prescriptions didn't specify sublingual and I didn't specifically ask for that, but that's what I got. I suppose either the doc or the pharmacist should be able to give a better-informed answer than I can ...What country are you in? The press release about Biovail acquiring Ativan from Wyeth talks about the sublingual being available now in Canada, but not yet in the U.S.
Posted by guttersnipe on July 12, 2004, at 1:36:00
In reply to Re: Ativan v. Xanax for as-needed dosing » guttersnipe, posted by Fred23 on July 11, 2004, at 23:14:48
I'm in the U.S. I'm sorry, Fred, for sowing confusion -- I should have qualified my prior post: I was taking generic lorazepam, not brand-name Ativan. I've read that (presumably because of the different pharmacokinetics) a number of folks found the Ativan to be more effective than generic lorazepam. However, after trying each of them I did not perceive any noticeable difference in effect, so I went for the less expensive generic. I can't recall which company's generic I was taking, though -- and I wouldn't be a bit surprised to learn that some generics are as effective as the brand name while others are not.
Posted by Fred23 on July 12, 2004, at 18:53:22
In reply to Re: Ativan v. Xanax for as-needed dosing » Fred23, posted by guttersnipe on July 12, 2004, at 1:36:00
> I was taking generic lorazepam, not brand-name Ativan.
> However, after trying each of them I did not perceive any noticeable difference in effect, so I went for the less expensive generic.
But the sublingual you had was name brand, or generic?
Posted by guttersnipe on July 12, 2004, at 21:20:11
In reply to Re: Ativan v. Xanax for as-needed dosing, posted by Fred23 on July 12, 2004, at 18:53:22
> But the sublingual you had was name brand, or generic?
The sublingual was the generic lorazepam. The tablets dissolved under the tongue quickly and took effect quickly, and were just as effective as the name brand Ativan (which was not sublingual -- I was instructed to swallow those tablets). Not all generic lorazepam is equally effective, though -- when traveling abroad I bought a different manufacturer's lorazepam, and I had to take twice as much to get the desired effect.
This is the end of the thread.
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