avoiding addiction or tolerance w/lorazepam

[PricklyPear]

Are there best practices for avoiding addiction or tolerance with benzos on general, and lorazepam in particular?

My psychiatrist prescribed me lorazepam to help me sleep (I have a v. unstable sleep schedule, with significant trouble falling asleep at night). He said to use .5 mg minimum, 1 mg maximum, and that it's not for every night. I have 15 mg for a 30 day supply.

To try to avoid addiction, should I try to use it even less frequently? As things stand now, I have trouble falling asleep every night. I'm often up until 3 an or later. Sleep hygiene, etc, does not help.

I'm not sure if that would start to change once I've used it- that is, if using the lorazepam occasionally would sort of help to rest my sleep schedule, so that I needed it less frequently, if at all.

[Likeabowlof0ranges]

You don't have it in your signature, and I'm sorry if it's a dumb question, but do you have a sleep med? Ever tried Melatonin? or do you take any sedating meds in the evening? It might help people answer you're question better. To avoid addiction it shouldn't become a regular part of your routine, asides from that I don't have anything helpful.

[PricklyPear]

I don't have any other sleep meds. Besides this, I'm on allergy medication, Lamotrigine, and a migraine med prn. I've tried ambien, rozerem, and lunesta in the past but they had no effect. For some, I also had very, very bad side effects. I have anxiety, but probably not an anxiety disorder, and I think that's why my doctor was thinking a benzo for my insomnia. Often, the anxiety is a significant part of why I can't sleep.

[Wooster]

Taking as prescribed seems like a reasonable way to approach it.

Your doc has specified that its not for every night, which might be a pain in the rear, but it seems like that instruction would be to help reduce the likelihood of building up a tolerance.

Taking as prescribed, for sleep (as opposed to taking not as prescribed for reasons other than sleep) should also help keep you on this side of addiction as well.

I definitely understand your concerns. I didn't want to take a benzo for a long time because I had unfounded fears about addiction. If you use it as prescribed, and do EVERYTHING else you possibly can to support the med, its unlikely you will have problems.

[Antigone]

I agree with everything Wooster said. I've been on the same amount of clonazepam for four years. I take it as prescribed for the reasons prescribed. I have never habituated to the dosage, so it remains effective.

One of the things I have done for my own reassurance is to take medication holidays from clonazepam (don't do this if you take a steady dose as it can result in seizures). I don't take it steadily, and I titrate down then off for a bit of time, then start back as needed. I'm not saying you should do this on your own, but you can discuss it with your doctor if you really begin to worry that you are becoming addicted to it. It wouldn't be something to try at a time when you are unstable with symptoms.

That's how *I* handle the addiction worry, with my pdoc's complete knowledge and approval. I think just being concerned and following your doctor's orders, as well as being honest about your concerns goes a long way toward avoiding addiction.

[PricklyPear]

Thank you all for sharing! I feel much better about this now. I'll definitely keep in touch with my pdoc

[Alien Navel Cord]

I take lorazepam too, and I also do the 'med holidays' thing with it. I am prescribed daily, but I was honest with my pdoc and told him I don't take it daily as prescribed, I only take it when I need it (which, ugh, lately has been almost every day my anxiety is so awful and now I'm getting panic attacks again). So I like to take breaks from it for a few days, to ensure I do not develop a tolerance and therefore need a higher dose. I am prescribed 1-2mg daily and the pdoc said I shouldn't take any more than that, so I try not to take it unless I have to.

[midnightman]

I take lorazepam too, and I also do the 'med holidays' thing with it. I am prescribed daily, but I was honest with my pdoc and told him I don't take it daily as prescribed, I only take it when I need it (which, ugh, lately has been almost every day my anxiety is so awful and now I'm getting panic attacks again). So I like to take breaks from it for a few days, to ensure I do not develop a tolerance and therefore need a higher dose. I am prescribed 1-2mg daily and the pdoc said I shouldn't take any more than that, so I try not to take it unless I have to.

I think this is a good perspective on taking benzos in any situation. There are a lot of people on maintenance doses of benzos that might have a week of vacation where they feel less stressed than usual, and decide to take a bit less than they usually do because they don't feel they need as high a dose. I think that this can be very helpful in avoiding tolerance, as well as allowing people to not feel as dependent on the medication as some others may. I personally don't like the concept alone of being addicted to a medication that can cause seizures if I stop taking it, so periods of tapering back a bit when I don't feel like I need them as much can be very helpful for me psychologically.