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How much ativan is too much?


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#1 khaleesi

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Posted 18 August 2011 - 05:32 PM

I just hunted back a few pages and didn't see the answer, so sorry if it's already been asked/answered.


Pdoc gave me ativan 0.5mg PRN. In the beginning, that was enough to make me feel fairly calm and sleepy. I took it rarely, like maybe 1 or 2 days/week.


Over the last few months, I've been taking it more often, like 0.5mg 4-5 days/week. Pdoc knows and is perfectly fine with it. But lately, it feels like it doesn't do much for me. I talked to pdoc about it and he said I was on a very small dose and wasn't worried if I took more than 1/day. After all, he prescribed PRN. I asked him how much was too much, and he hedged his answer, then told me "Just take it as I've prescribed it." Okay, I can see why he said that. But I'm still wondering. I see others on here who take 2mg 3x/day or even more. So even if were to knock back a handful (disclaimer: just a smart ass example, I'm not really planning on taking a handful of pills), the worst that would happen is that I'd take a very long sleep, right? I've been wandering around the internets for days and it seems like ativan OD is rarely fatal. Maybe some respiratory depression, coma at the worst. But rarely death. And I'm not planning on ODing anyways. I have no suicidal ideations whatsoever. But if I did end up taking too much, a nice long sleep wouldn't be tragic.


So how much is too much? Where is the danger zone? Pdoc gets sorta freaked when I start asking these sort of questions and I understand why. But I'm still curious.


k


(edit: typos)

Edited by khaleesi, 18 August 2011 - 05:33 PM.

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What torments me: BP1 (usually mixed state and/or rapid cycling), migraines, history of eating disorder, IBS

 

What I do about it: lamictal (100 mg in the morning, 200 mg at bedtime) wellbutrin xl (300 mg in the morning)

my prns: seroquel, ativan, zofran
my OTCs: omega 3s daily, diet coke and red licorice PRN. Also a pilfered children's gummy vite here and there.


What didn't work:

-prozac (worked for awhile, then pooped out)

-zoloft (worked for awhile, then pooped out)

-elavil (never worked)

-paxil (maybe sorta worked for a short while, then didn't work. Beware the nightmare discontinuation syndrome!)

-celexa (sorta maybe kinda helped for a short while, then definitely did NOT help and zombied me out)

-abilify - after 3 weeks, made me too manic so pdoc switched it to geodon, which then pushed me into a full blown manic nightmare

-lithium

-ignoring it and hoping it'll go away



#2 confused

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Posted 18 August 2011 - 05:47 PM

I don't know the answer to your question, but I was prescribed ativan prn. I was really anxious. I don't know how many I took, but I got really depressed and my pdoc said I was taking too many. He was suggesting I have someone dispense my meds for me.

schizoaffective bipolar type, social anxiety, depersonalization disorder
abilify, lamictal, lexapro, wellbutrin, seroquel

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#3 jt07

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Posted 18 August 2011 - 05:57 PM

I don't know how much is too much, but yeah, it would be really, really hard to kill yourself using benzos.

Dx: Atypical MDD with anxiety, possible ADD, OCD (mostly recovered)
Rx: Citalopram (20 mg), Remeron (45 mg), Abilify (30 mg), Carbamazepine (800 mg), Lamotrigine (200 mg), Ritalin (20 mg AM, 10 mg PM)


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#4 Sweetest1

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Posted 18 August 2011 - 06:01 PM

I have ativan .5mg (which is the smallest dose you can get) as a PRN too. Some days I take none, some days I take 3 or 4. I'm Rx'd for 2/day. My pdoc knows I take it this way and is fine with it, but you don't want to take it in such a way that you're running out before you can get more. How much is too much is different for everyone. I would just follow my pdoc's instructions and take it as prescribed if I was you.

DX Bipolar 1, rapid cycling - PTSD - Anxiety disorder NOS

RX Epival 1250mg - Wellbutrin 300mg - clonazepam 1.5mg - ativan 1mg PRN

previous Rx - lexapro, seroquel, lithium, effexor, topamax, zyprexa, trazadone, risperidone, zeldox/geodon, zopiclone


#5 khaleesi

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Posted 18 August 2011 - 06:21 PM

Thanks for the replies. I was wondering if too much would make my depression worse, which is why I'm interested in how much is too much. But so far it seems the answer is clear: it depends. And I wonder about the rebound. So if I took a few pills at once (let's say 4, so 2mg), and I've never taken that much before, what will I feel like when it wears off. Would that be not worth whatever relief I was after? I feel like a human guinea pig. Or both the researcher and the rat all in one! lol


jt07: That's what I thought, too: I'd have to really work at it to kill myself with ativan. But I don't really want to go into a coma, either. :-P Seems that's a much more likely result of OD.


k

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What torments me: BP1 (usually mixed state and/or rapid cycling), migraines, history of eating disorder, IBS

 

What I do about it: lamictal (100 mg in the morning, 200 mg at bedtime) wellbutrin xl (300 mg in the morning)

my prns: seroquel, ativan, zofran
my OTCs: omega 3s daily, diet coke and red licorice PRN. Also a pilfered children's gummy vite here and there.


What didn't work:

-prozac (worked for awhile, then pooped out)

-zoloft (worked for awhile, then pooped out)

-elavil (never worked)

-paxil (maybe sorta worked for a short while, then didn't work. Beware the nightmare discontinuation syndrome!)

-celexa (sorta maybe kinda helped for a short while, then definitely did NOT help and zombied me out)

-abilify - after 3 weeks, made me too manic so pdoc switched it to geodon, which then pushed me into a full blown manic nightmare

-lithium

-ignoring it and hoping it'll go away


#6 Eden

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Posted 18 August 2011 - 06:32 PM

the dosage changes for everyone, where you really run into trouble is dependance. if you find yourself taking more each week without significant changes in stress to explain it then youve found the danger zone. take it as often as you need, up to your prescribed amount (and if you dont take any one day but have a stressful day after, by all means take another.) but dont take more than one at a time.

you could do what my mother did, she was prescribed 2 a day and put them in a weekly sorter. when she found on friday that she was wayyyy too stressed she just took another from tuesdays.

no more than prescribed in the span of a month (dont take them faster than your supposed to). no more than prescribed at one time (dont take 2, and wait however long your supposed to for another, i think like 4 hours but thats just a guess). but still, as needed. at the end of the day its a sedative, it just has a tendency to make people feel.. 'good'. so dont take them for the hell of it and watch for signs of addiction.

EDIT: sorry i didnt read your concerns as clearly as i should have. if your having a problem with dosage tell your pdoc its not enough. he may up the dosage.

also... in the category of irresponsible, i have been known to take 2 or 3 of my prescribed dose. truth is your on a low dose to begin with so no, as long as your careful, and dont drive or something stupid like that you should be fine. just... take 2 if you have to. dont beeline it to 4

Edited by Eden, 18 August 2011 - 06:35 PM.

New Dx: Psychosis NOS, MDD + Aspergers and ADHD Inattentive type w/ social anxiety.
Also: Celiac disease and chronic 'flavor of the week' insomnia.

-Scratch that, uncle Sam gave me a clean bill of health cuz I talk gud n stuff.

 

"Mankind are a herd of knaves and fools.
It is necessary to join the crowd, or get out of their way,
in order not to be trampled to death by them" William Hazlitt.


One does not simply walk into dictionary.


#7 rowen

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Posted 18 August 2011 - 07:58 PM

It depends on the person, like it's been said.

The one thing my pdoc told me is don't mix benzos with alcohol. He lost a patient that way. I had a drink or two with benzos a few years ago, and I didn't think anything of it. Current pdoc's caution has stuck with me.
I have been every flavor of Bipolar, and have now come back to Mood Disorder NOS. Heh. Also, OCD and working on AvPD
Old issues: ED NOS
Meds - Lamictal 200mg, Effexor XR 150mg, lithium 900 mg, trazodone PRN, Ativan PRN
Old meds - Lexapro, Remeron, Wellbutrin, Cymbalta/Seroquel, Abilify, Geodon/Ambien, Lunesta, Sonata/Klonopin

May all beings be free from all pain and suffering.

I am not a doctor. Keep that in mind.

#8 crtclms

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Posted 18 August 2011 - 08:11 PM

the dosage changes for everyone, where you really run into trouble is dependance. if you find yourself taking more each week without significant changes in stress to explain it then youve found the danger zone. take it as often as you need, up to your prescribed amount (and if you dont take any one day but have a stressful day after, by all means take another.) but dont take more than one at a time.


I am wondering if you are confusing dependency and addiction. There is an article distinguishing them pinned at the top of this forum.

Dx: Bipolar 1; GAD; Migraine w/ Aura; Migraine w/o Aura; Renal Tubular Acidosis (caused by Zonegran); Status Migrainosus
Rx: Alprazolam; Botox; Buproprion; Dihydroergotomine via IV Infusion; Flexeril; Lamotrigine; Latuda; Lithium; Metoclopramide; Midrin; Migranal; Potassium Citrate; Prilosec; Promethazine; Riboflavin; Tizanidine; Verapamil; Vitamin D3
Currently Shelved: Abilify; Amerge; Anaprox; Atenolol; Buspar; Cafergot; Cymbalta; Depakote; Di-Hydro-ergotamine, injected; Gabapentin; Geodon; Imitrex Tablets; Klonopin; Maxalt; Namenda; Nortriptyline; Norvasc; Propranolol; Prozac; Risperidone; Relpax; Sansert; Sumatriptan injectables; Tegretol; Trazadone; Zoloft; Zolpidem; Zomig; Zonegran


Affectations can be dangerous. -Gertrude Stein

 

I moderate Bipolar, Panic/Anxiety, Dissociative Disorders, Migraine, Seizures, Not Otherwise Specified, Anticonvulsants, Side Effects, Family Feud, and I Still Have Issues. Remember, I am not a medical professional. PM me if you have any questions


#9 muriel

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Posted 18 August 2011 - 08:11 PM

You should be taking a.) how much you're prescribed and b.) no more than you need to get a handle on your anxiety so you can use coping skills to alleviate it.

If you're taking 2mg to put yourself to sleep to avoid feeling bad over a situation, that's not the way you're supposed to be using it.

It's not a good drug for sleeping because the sedation side effect wears off pretty quickly.

#10 notfred

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Posted 18 August 2011 - 08:30 PM

6 mg/day is the max in the PI.

nf

#11 notfred

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Posted 18 August 2011 - 08:37 PM

The LD 50 is thousands of mg/kg in the rat. You are not going to die from an Ativan alone OD with the amounts a patient can get their hands on, by a long shot.

nf

#12 khaleesi

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Posted 18 August 2011 - 08:44 PM

It's not a good drug for sleeping because the sedation side effect wears off
pretty quickly



Sometimes I think this is what I want so that 1) I don't feel hung over at work the next day and 2) I can wake up in the middle of the night if one of my kids needs me (I have two little ones). But then again, I also start the tossing and turning some time in the wee hours of the morning. Clearly, I need to discuss sleeping meds vs anti-anxiety meds with my pdoc. I'm just really resistant to sleeping meds because of the two reasons above.


But then part of me thinks: "If i take a few extra, then I'll make it through the night asleep but because it's short-acting, I'll still be able to get up and go to work and take care of kids the next day." My gut tells me this is faulty reasoning, but I'm not really 100% sure why.


Thanks notfred for the PI info on max daily dose. I swear I looked before I posted and didn't find it. I swear!! I think I've seen someone on here who said they took up to 10mg/day. I'll have to go hunting. Wouldn't be the first time that my reading comprehension skills have failed me.


k



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What torments me: BP1 (usually mixed state and/or rapid cycling), migraines, history of eating disorder, IBS

 

What I do about it: lamictal (100 mg in the morning, 200 mg at bedtime) wellbutrin xl (300 mg in the morning)

my prns: seroquel, ativan, zofran
my OTCs: omega 3s daily, diet coke and red licorice PRN. Also a pilfered children's gummy vite here and there.


What didn't work:

-prozac (worked for awhile, then pooped out)

-zoloft (worked for awhile, then pooped out)

-elavil (never worked)

-paxil (maybe sorta worked for a short while, then didn't work. Beware the nightmare discontinuation syndrome!)

-celexa (sorta maybe kinda helped for a short while, then definitely did NOT help and zombied me out)

-abilify - after 3 weeks, made me too manic so pdoc switched it to geodon, which then pushed me into a full blown manic nightmare

-lithium

-ignoring it and hoping it'll go away


#13 AnneMarie

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Posted 18 August 2011 - 09:08 PM

If you pdoc has you on a low dose, why are you asking about maximums and how much is too much?

Bipolar I and ADD


#14 Eden

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Posted 18 August 2011 - 09:14 PM


the dosage changes for everyone, where you really run into trouble is dependance. if you find yourself taking more each week without significant changes in stress to explain it then youve found the danger zone. take it as often as you need, up to your prescribed amount (and if you dont take any one day but have a stressful day after, by all means take another.) but dont take more than one at a time.


I am wondering if you are confusing dependency and addiction. There is an article distinguishing them pinned at the top of this forum.


im actually cautioning against both, but i do tend to be unclear

New Dx: Psychosis NOS, MDD + Aspergers and ADHD Inattentive type w/ social anxiety.
Also: Celiac disease and chronic 'flavor of the week' insomnia.

-Scratch that, uncle Sam gave me a clean bill of health cuz I talk gud n stuff.

 

"Mankind are a herd of knaves and fools.
It is necessary to join the crowd, or get out of their way,
in order not to be trampled to death by them" William Hazlitt.


One does not simply walk into dictionary.


#15 khaleesi

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Posted 18 August 2011 - 09:36 PM

If you pdoc has you on a low dose, why are you asking about maximums and how
much is too much?


He gave me 0.5mg pills but also said prn. I'm having trouble deciding the prn.

Some days I do think it would be nice to run away for awhile and in those moments I think that an extra little bit of ativan might get me there. But like I said, I have no suicidal ideation, so I'm not trying to end my life. I'm just trying to get a break from my life for a little bit. What I don't want to happen is that the next morning I can't be awakened and then my husband and kids would have to see me like that. Then I'd have to be answering all sorts of questions and I'd lose the trust of my family and pdoc. Reminds me of Girl Interrupted when they ask Winona Ryder's character why she downed a handful of pills and then chased it with vodka. She keeps insisting that it was nothing more than: she had a headache. Of course, no one believes her.

Initially, I didn't trust myself to take ativan responsibly and I confessed that to pdoc. Now he only gives me ten 0.5mg pills at a time. Last time I went for a refill, he had upped it to 20 pills. Shortly thereafter, I called him and said maybe we should stick to the 10-at-a-time dose. But then I started thinking about the fact that he upped it to 20 pills per refill and I started thinking maybe I shouldn't be so afraid of ativan.

k

~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~
What torments me: BP1 (usually mixed state and/or rapid cycling), migraines, history of eating disorder, IBS

 

What I do about it: lamictal (100 mg in the morning, 200 mg at bedtime) wellbutrin xl (300 mg in the morning)

my prns: seroquel, ativan, zofran
my OTCs: omega 3s daily, diet coke and red licorice PRN. Also a pilfered children's gummy vite here and there.


What didn't work:

-prozac (worked for awhile, then pooped out)

-zoloft (worked for awhile, then pooped out)

-elavil (never worked)

-paxil (maybe sorta worked for a short while, then didn't work. Beware the nightmare discontinuation syndrome!)

-celexa (sorta maybe kinda helped for a short while, then definitely did NOT help and zombied me out)

-abilify - after 3 weeks, made me too manic so pdoc switched it to geodon, which then pushed me into a full blown manic nightmare

-lithium

-ignoring it and hoping it'll go away


#16 muriel

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Posted 18 August 2011 - 09:44 PM

Some days I do think it would be nice to run away for awhile and in those moments I think that an extra little bit of ativan might get me there. But like I said, I have no suicidal ideation, so I'm not trying to end my life. I'm just trying to get a break from my life for a little bit.


This is bordering on or is abusing your meds. It's certainly a good way, if done habitually, to give yourself substance abuse problems. You need to find alternate coping strategies to get the same feeling, and the best place to find those is in therapy.

#17 khaleesi

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Posted 19 August 2011 - 12:10 AM


Some days I do think it would be nice to run away for awhile and in those moments I think that an extra little bit of ativan might get me there. But like I said, I have no suicidal ideation, so I'm not trying to end my life. I'm just trying to get a break from my life for a little bit.


This is bordering on or is abusing your meds. It's certainly a good way, if done habitually, to give yourself substance abuse problems. You need to find alternate coping strategies to get the same feeling, and the best place to find those is in therapy.



I wasn't planning on making this a habitual thing. I wasn't actually really planning anything. But I understand how it could quickly turn into a substance abuse problem.
Pdoc and I have talked about therapy. He suggested I start with groups, but I don't do well in groups. I don't play well with others. I told him I was open to one-on-one therapy but I don't want to sit there and relive my childhood and all that crap. I'll explore some goal-oriented therapy perhaps. He booked me for the next available appt, which happens to be at the end of September. Yikes. That's a lot of time to talk myself out of it. I'm supposed to call next week when I'm done with my celexa taper so we can discuss the next step. He wants to add abilify and we're going to see what groups are available. I might try it. We'll see. Anyways... now I'm way off topic and I'm the one who started the topic to begin with! :-P

~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*~~
What torments me: BP1 (usually mixed state and/or rapid cycling), migraines, history of eating disorder, IBS

 

What I do about it: lamictal (100 mg in the morning, 200 mg at bedtime) wellbutrin xl (300 mg in the morning)

my prns: seroquel, ativan, zofran
my OTCs: omega 3s daily, diet coke and red licorice PRN. Also a pilfered children's gummy vite here and there.


What didn't work:

-prozac (worked for awhile, then pooped out)

-zoloft (worked for awhile, then pooped out)

-elavil (never worked)

-paxil (maybe sorta worked for a short while, then didn't work. Beware the nightmare discontinuation syndrome!)

-celexa (sorta maybe kinda helped for a short while, then definitely did NOT help and zombied me out)

-abilify - after 3 weeks, made me too manic so pdoc switched it to geodon, which then pushed me into a full blown manic nightmare

-lithium

-ignoring it and hoping it'll go away


#18 gizmo

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Posted 19 August 2011 - 01:01 AM

Taking above and beyond your recommended dose at bedtime isn't such a good habit to get into - it often turns into a need to take them every night to fall asleep. When I quit taking xanax at bedtime (back when I took xanax), it was a real bitch trying to get to sleep at night.

Taking a benzo for sleep is not like taking a sleeping pill to sleep - you don't get groggy and have a hard time waking up in the middle of the night. Nor do you have a morning sleep hangover. But this is coming from someone who doesn't have hangovers from taking a sleeping pill and only sleeping 3 hours in a night (that's not normal, it's just what I'm dealing with right now.)
Diagnosis: BP I with Psychotic Features, GAD, ADHD, Chronic Migraines, various physical stuff.
Meds Currently On: Depakote 2000 mg, Risperdal 8 mg, Latuda 80 mg, Prozac 60 mg, Vyvanse 70 mg, Propranolol 40 mg BID, Klonopin 2 mg BID PRN
Meds Sort-Of Mental Related: Lipitor 40 mg, Zofran 4 mg PRN, Fioricet PRN, Stadol PRN, Botox received on 8/16/13

I post on an iPhone, so please forgive grammatical errors or strange word inclusions. It's the auto correct!

#19 crtclms

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Posted 19 August 2011 - 01:34 AM



the dosage changes for everyone, where you really run into trouble is dependance. if you find yourself taking more each week without significant changes in stress to explain it then youve found the danger zone. take it as often as you need, up to your prescribed amount (and if you dont take any one day but have a stressful day after, by all means take another.) but dont take more than one at a time.


I am wondering if you are confusing dependency and addiction. There is an article distinguishing them pinned at the top of this forum.


im actually cautioning against both, but i do tend to be unclear


Well, you can't really "warn" against dependency, dependency is a feature of most psychoactive meds. I am dependent on Lamictal as a mood stabilizer, and if I stopped it suddenly, I might have seizures. I need to taper down slowly. The same is true of benzos. I am dependent on Xanax for anxiety, but if I stopped it suddenly, I might have seizures. Benzos just require a much slower taper than most psychoactive drugs. What matters is what her pdoc thinks is an appropriate amount. People exaggerate the risk of addiction on benzos. There are people on the boards who have substance abuse issues, yet are able to use benzos without an issue.

Dx: Bipolar 1; GAD; Migraine w/ Aura; Migraine w/o Aura; Renal Tubular Acidosis (caused by Zonegran); Status Migrainosus
Rx: Alprazolam; Botox; Buproprion; Dihydroergotomine via IV Infusion; Flexeril; Lamotrigine; Latuda; Lithium; Metoclopramide; Midrin; Migranal; Potassium Citrate; Prilosec; Promethazine; Riboflavin; Tizanidine; Verapamil; Vitamin D3
Currently Shelved: Abilify; Amerge; Anaprox; Atenolol; Buspar; Cafergot; Cymbalta; Depakote; Di-Hydro-ergotamine, injected; Gabapentin; Geodon; Imitrex Tablets; Klonopin; Maxalt; Namenda; Nortriptyline; Norvasc; Propranolol; Prozac; Risperidone; Relpax; Sansert; Sumatriptan injectables; Tegretol; Trazadone; Zoloft; Zolpidem; Zomig; Zonegran


Affectations can be dangerous. -Gertrude Stein

 

I moderate Bipolar, Panic/Anxiety, Dissociative Disorders, Migraine, Seizures, Not Otherwise Specified, Anticonvulsants, Side Effects, Family Feud, and I Still Have Issues. Remember, I am not a medical professional. PM me if you have any questions


#20 Stars

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Posted 19 August 2011 - 08:43 PM

I'm very tolerant ( I guess or my anxiety is very severe) to benzos ( my doc says "your body laughs at benzos"). It takes 4 mg to do anything to me and if I am very anxious I take 6 mg. Of course when the crisis is over I will sleep for about 24 hours. I have had to do this for a trip to a dentist. However, now ativan is not enough.I have had to use the ant-seizure drugs to get through a dental appt. My anxiety hits the Richter scale.
I don't take ativan daily, just when the anxiety eg, dentist trip is bad. I do take klonopin 2mg at hs but I have been on it so long I can't even tell I have taken it.

Edited by Stars, 19 August 2011 - 08:46 PM.






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