![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by AnxiousAndy on September 12, 2004, at 19:23:42
Hi There,
My question is regarding ativan. I have been taking it for 3 days. The first day I took 3 pills (0.5 mg), the second day 2, and today I took only one. I have been fighting anxiety for quite a long time now, and in the past have been on several ad's...all but one SSRIs and I can tell you, my anxiety and SSRIs just do not mix.
4 days ago, my anxiety got so bad I went to the hospital - and I have been admitted to an out-patient (I thank God) counseling center...as well as taking some of the steps I originally took to deal with anxiety in the past...and, mircaculously, I feel about 75% better than I did. Some of it obviously has to do with the ativan, but the counseling has been helping too.
I think I can get through this without an a/d. At least, I want to. If I do end up needing one, I think it's going to be Remeron, I've had the least side effects with it. But the thought occured to me that if I can get through this with counseling and no ad's, and deal with the anxiety until I can learn new ways to deal with my guilt/resentments (which I have learned are directly related to my anxiety), that maybe I can just continue using ativan.
For the last 4 years, I have always had at least a couple of pills (again, 0.5mg) in the cupboard, but used them very sparingly - going months and months between using 1 or 2 pills. So, I don't think I've ever come close to developing any noticeable tolerance.
I've read as much as I could stand to search through on the internet about tolerance, and from what I can see, it looks like ativan should not be used for more than 4 months in a row. I've read on another site that addiction can begin as early as 3-4 weeks, depending on the amount used.
I realize this might be a tough question to ask, but I'm going to put it out there: How much and for how long does it take to get addicted? I'm addicted to nicotine, have tried to quit, and I know it's no fun. The last thing I want is to develop another physical dependance. I'm not really concerned about the psychological dependance because, truth be told, I don't want to be on any meds. (Who does, right?)
Does anyone have any experience with ativan? or other benzos? I would just like to get an idea - if I take 2 pills a day, everyday, how long can I safely do that before developing a habit that I can't quit? It seems some people are very concerned about benzo addiction and other places I read about it not being a big deal. I know withdrawal IS a big deal, but it seems like people take the benzo addiction lightly - as if it doesn't happen very often.
I'm sorry for being so long-winded...just trying to get my point across, albeit a little disorganized. Thanks in advance for any advice!
-AnxiousAndy
Posted by BabbleBeme50 on September 12, 2004, at 20:18:14
In reply to Ativan Tolerance, posted by AnxiousAndy on September 12, 2004, at 19:23:42
> Hi There,
>
> My question is regarding ativan. I have been taking it for 3 days. The first day I took 3 pills (0.5 mg), the second day 2, and today I took only one. I have been fighting anxiety for quite a long time now, and in the past have been on several ad's...all but one SSRIs and I can tell you, my anxiety and SSRIs just do not mix.
>
> 4 days ago, my anxiety got so bad I went to the hospital - and I have been admitted to an out-patient (I thank God) counseling center...as well as taking some of the steps I originally took to deal with anxiety in the past...and, mircaculously, I feel about 75% better than I did. Some of it obviously has to do with the ativan, but the counseling has been helping too.
>
> I think I can get through this without an a/d. At least, I want to. If I do end up needing one, I think it's going to be Remeron, I've had the least side effects with it. But the thought occured to me that if I can get through this with counseling and no ad's, and deal with the anxiety until I can learn new ways to deal with my guilt/resentments (which I have learned are directly related to my anxiety), that maybe I can just continue using ativan.
>
> For the last 4 years, I have always had at least a couple of pills (again, 0.5mg) in the cupboard, but used them very sparingly - going months and months between using 1 or 2 pills. So, I don't think I've ever come close to developing any noticeable tolerance.
>
> I've read as much as I could stand to search through on the internet about tolerance, and from what I can see, it looks like ativan should not be used for more than 4 months in a row. I've read on another site that addiction can begin as early as 3-4 weeks, depending on the amount used.
>
> I realize this might be a tough question to ask, but I'm going to put it out there: How much and for how long does it take to get addicted? I'm addicted to nicotine, have tried to quit, and I know it's no fun. The last thing I want is to develop another physical dependance. I'm not really concerned about the psychological dependance because, truth be told, I don't want to be on any meds. (Who does, right?)
>
> Does anyone have any experience with ativan? or other benzos? I would just like to get an idea - if I take 2 pills a day, everyday, how long can I safely do that before developing a habit that I can't quit? It seems some people are very concerned about benzo addiction and other places I read about it not being a big deal. I know withdrawal IS a big deal, but it seems like people take the benzo addiction lightly - as if it doesn't happen very often.
>
> I'm sorry for being so long-winded...just trying to get my point across, albeit a little disorganized. Thanks in advance for any advice!
>
> -AnxiousAndyHi Andy,
If you can make it through without medication then by all means stick with counseling. You haven't mentioned depression. If your depression is severe, please keep one thing in mind.1)Myths About Benzodiazepines:
* "Benzodiazepines are addictive": FALSE for non drug addicts with anxiety disorders.
* "Benzodiazepines are hard to quit": FALSE (for SP, not GAD). Taper slow. Can cross-taper gabapentin if desired.
* "Benzodiazepine dose keeps escalating": FALSE. Dose stabilizes after a few months with continued efficacy.2)Dr. Keller published a paper 12 years ago which the medical community has slowly accepted over the years. He maintained that brain atrophy can occur without the urgency of treating depression.
2)Dr. Sheline also demonstrated that the longer the episode of depression, the greater is the atrophy. Even if you're aggressive with medication, it may be more difficult to get people back into remission if they actually have brain atrophy.
Posted by 4WD on September 12, 2004, at 20:30:21
In reply to Ativan Tolerance, posted by AnxiousAndy on September 12, 2004, at 19:23:42
> Hi There,
>
> My question is regarding ativan. I have been taking it for 3 days. The first day I took 3 pills (0.5 mg), the second day 2, and today I took only one. I have been fighting anxiety for quite a long time now, and in the past have been on several ad's...all but one SSRIs and I can tell you, my anxiety and SSRIs just do not mix.
>
> 4 days ago, my anxiety got so bad I went to the hospital - and I have been admitted to an out-patient (I thank God) counseling center...as well as taking some of the steps I originally took to deal with anxiety in the past...and, mircaculously, I feel about 75% better than I did. Some of it obviously has to do with the ativan, but the counseling has been helping too.
>
> I think I can get through this without an a/d. At least, I want to. If I do end up needing one, I think it's going to be Remeron, I've had the least side effects with it. But the thought occured to me that if I can get through this with counseling and no ad's, and deal with the anxiety until I can learn new ways to deal with my guilt/resentments (which I have learned are directly related to my anxiety), that maybe I can just continue using ativan.
>
> For the last 4 years, I have always had at least a couple of pills (again, 0.5mg) in the cupboard, but used them very sparingly - going months and months between using 1 or 2 pills. So, I don't think I've ever come close to developing any noticeable tolerance.
>
> I've read as much as I could stand to search through on the internet about tolerance, and from what I can see, it looks like ativan should not be used for more than 4 months in a row. I've read on another site that addiction can begin as early as 3-4 weeks, depending on the amount used.
>
> I realize this might be a tough question to ask, but I'm going to put it out there: How much and for how long does it take to get addicted? I'm addicted to nicotine, have tried to quit, and I know it's no fun. The last thing I want is to develop another physical dependance. I'm not really concerned about the psychological dependance because, truth be told, I don't want to be on any meds. (Who does, right?)
>
> Does anyone have any experience with ativan? or other benzos? I would just like to get an idea - if I take 2 pills a day, everyday, how long can I safely do that before developing a habit that I can't quit? It seems some people are very concerned about benzo addiction and other places I read about it not being a big deal. I know withdrawal IS a big deal, but it seems like people take the benzo addiction lightly - as if it doesn't happen very often.
>
> I'm sorry for being so long-winded...just trying to get my point across, albeit a little disorganized. Thanks in advance for any advice!
>
> -AnxiousAndyHi Andy,
I have a long experience with Ativan, many years in the past. I developed tolerance quite quickly. I took Ativan every night for about 10 years. It probably took a couple of months of every night usage before I started needed to raise my dose. (I used it for sleep, instead of for the anxiety for which it was prescribed. I guess I took enough at night that it also controlled my anxiety during the day.)
I think that if you are very aware of the dangers, and you appear to be, you will be safe. Do not ever increase your dose above what is prescribed. Don't use it for sleep - it loses it efficacy there very quickly and that's where the tolerance develops so rapidly. Use it only as needed and try to skip days. Be aware that with continued use, it can exacerbate depression.
Just be careful, keep a watch for signs of dependency and you'll do fine.
Marsha
Posted by Glydin on September 12, 2004, at 21:18:20
In reply to Ativan Tolerance, posted by AnxiousAndy on September 12, 2004, at 19:23:42
I cannot speak to the use of Ativan. I can speak to the use of long term Klonopin. I have done well and it changed my life for the better.
The word addiction is often misused and misunderstood. Addiction has characteristics: Psycho Social disruption, Tolerance not to maint. dosing, Drug seeking behavior, and Inapprioate use.
There are concerns with any benzo but I will forever fail to understand why the approiate use of benzos for anxiety disorders is so stigmatized. It is well documented evidence that, for a number of individuals, benzos are effective, safe, and really do TREAT the underlying problem with brain chemistry - we tend not to stigmatize (as easily) other classes of meds that alter brain chemistry to the better.
The fact that those of us who use benzos do question our approiate use is a credit to their proper use. I know I'm physically dependent and it really a non-issue for me.
From what I understand, tolerance develops pretty quickly. I've maintained a dose range - quite low, BTW, for 3 years. We are all indivduals, and we all deserve a decent quality of life. There are different paths and treatments to achieve that. Living with toxic anxiety isn't the way I define "quality life" for me.
Hope you find you path and find peace with that path.
Posted by mcp on September 12, 2004, at 21:56:33
In reply to Re: Ativan Tolerance, posted by Glydin on September 12, 2004, at 21:18:20
All I know is that Ativan used to control my anxiety beautifully. It wasn't until a doctor took me off Ativan cold turkey and put me on a cocktail of anticonvulsants, antipsychotics, and antidepressants that the problems started. My personal opinion is that benzos are much safer and have far less side effects than the others. I am still spinning from coming down off that garbage. ANyways, I agree that you should always try counseling first, but if you need a benzo to make you feel "normal", then do it and enjoy your life. Good luck
Posted by Fred23 on September 12, 2004, at 22:33:07
In reply to Ativan Tolerance, posted by AnxiousAndy on September 12, 2004, at 19:23:42
> My question is regarding ativan. I have been taking it for 3 days. The first day I took 3 pills (0.5 mg), the second day 2, and today I took only one.
Most references say that 2 - 3 mg per day is a typical *starting* dose.
My experience is that benzos have a threshhold effect, where one has to take at least a certain amount to get any useful effect. In other words, below that amount does nothing, while above it does something.
You might really need those 2 or 3 mg per day to get any effect at all. Some sort of adjustment (tolerance) will set in, until you stabilize at the "right" dosage. The "later on" type dose is given as around 6 mg.
Also, in my opinion, the equivalence charts are wrong, in saying that Ativan is half the "strength" of Xanax. It seems more like one quarter. One source (http://www.lifesteps.com/gm/Atoz/ency/antianxiety_drugs_pr.jsp) has a more realistic comparison.
Posted by AnxiousAndy on September 13, 2004, at 15:14:56
In reply to Ativan Tolerance, posted by AnxiousAndy on September 12, 2004, at 19:23:42
Thanks for all your help guys! I've made it through today without any ativan...though I probably need it. I just wanted to see what life was like without it today. I may end up taking one yet.
As always, psycho-babble comes through for me with the answers I was looking for. I'm so happy this community exists. Thanks again.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.