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How much ativan is too much?

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Posted (edited)

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

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Posted

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.

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Posted

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

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Posted

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.

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Posted

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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Posted (edited)

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

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Posted

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.

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Posted

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.

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Posted

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.

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Posted

6 mg/day is the max in the PI.

nf

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Posted

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

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Posted

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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Posted

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

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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

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Posted

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

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Posted

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.

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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

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Posted

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.)

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Posted

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.

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Posted (edited)

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

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Posted

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.

Good point and very well stated. I have been on Loraz for decades and never even developed dependance-I never have taken for more than eight contiuous days without a significant break. My take on the benzo phenomenon is simply first get your house in order. Exercise-diet-therapy and then go from there. If your drinking a lot of booze or a lot of coffee for instance you need to get that stuff resolved-same goes for a junk food diet and how you manage the other aspects of your life from marriage/kids to job/responsibilities etc. Don't rely on a pill to solve everything!

Once you do all that (while using the benzo sensibly as prescribed) then and only then re-assess your need for the drug and take the absolute minimum to lead a dignified and comfortable life.

Benzos are wonderful drugs-they absolutely change lives for the better for many. Just the other day I had to go to a big party with all kinds of people-very stressful group-but I had to do it. Thank GOD for Loraz because I would have been a social outcast without it! Instead all went smoothly and now I can breathe a sigh of relief!

OTOH many folks do not have good experience with these wonder drugs. For them they are a nightmare. In my humble opinion I see them as simply something to be used very cautiously and as a last resort. that can be anything from taken prn to taken everyday as Prescribed by an intelligent and informed physician/ p doc. If dependence is necessary to live a dignified life and all else has been tried then by all means become dependent as crtclclaims says "its a feature of psychoactive drugs" and many other drugs I would add.

Colin

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