Lorazepam / Ativan - why isn't it helping for agitation and social anxiety?

[crazyguy]

As the title says really, why would lorazepam 1mg (3 per day) not help for either agitation or social anxiety. I'm completely new to benzos having previously tried loads of other meds.  I was expecting the benzo to help me cope with social interaction but so far I've used a few times with no success at all.   Today I tried a double dose (2mg) and still wasn't able to talk or ask questions in class and in the end I left early. 

 

The benzo was my doctors idea and a bit of a last resort option as everything else has failed to help with the agitation and anxiety.  - I'm talking years of various therapies, antidepressants, meditation, exercise, etc. 

 

Maybe my expectations were too high but I feel quite disappointed right now and I'm not sure where to go from here.  My Dr said go back in 1 month but I think I need someone different as lorazepam just isn't hitting the spot. 

 

 

Anyone else had similar experiences? 

 

[jt07]

Yep, benzos really never helped my social anxiety. They tend to relax me more physically while the psychological anxiety is still there. Have you tried therapy?

[crazyguy]

Yep, benzos really never helped my social anxiety. They tend to relax me more physically while the psychological anxiety is still there. Have you tried therapy?

Yes I've tried therapy in the past. CBT got me so far (out the house, able to function to a certain level) but I have not progressed beyond that in the last 5 years or so.  I would like to function well enough to graduate and get a decent job or preferable have the confidence to be self employed. 

 

I was hoping a benzo might relax me enough that I could engage better with my studies and maybe even consider doing some voluntary/charity work experience.   Guess I was being too optimistic. . 

 

The strange thing is the antidepressant I'm currently on is working a bit..... better motivation, concentration, less pain and fatigue........ just it is doing shit for the stress and anxiety which is actually holding me back. 

Edited December 9, 2013 by crazyguy

[jt07]

Well, all I can say is that I completely empathize. My depression is under control, but my anxiety is running wild right now.

[Wooster]

Sometimes people find that umh....I can't recall if it's alpha blockers or beta blockers at the moment... but a med used for high blood pressure... can help with social anxiety more than benzos.

 

I'm glad the antidepressant sounds somewhat effective.

 

This might be an obvious question, but are you applying what you learned in CBT that helped you get out of the house to new situations? If not, you might benefit from a booster review? Wondering aloud here.

[malachite]

Woo is right; beta blockers can be helpful for the physical reactions of anxiety. Also I was on Ativan for 10 years at least, and switching to Klonopin has helped me immensely. I'm not saying that you necessarily need a different benzo, but some work better than others for certain people. I guess I am urging you not to give up hope and talk about your options with doc.

[crazyguy]

Woo is right; beta blockers can be helpful for the physical reactions of anxiety. Also I was on Ativan for 10 years at least, and switching to Klonopin has helped me immensely. I'm not saying that you necessarily need a different benzo, but some work better than others for certain people. I guess I am urging you not to give up hope and talk about your options with doc.

I tried beta blockers in the past without much luck but that was many years ago. 

 

In social situations  I get stressed;  racing paranoid thoughts, very physically tense, inhibited (difficult to speak, etc),  find it difficult to sit still, feel disconnected from everything, short tempered.   I don't get the classic 'panic' symptoms of racing heart, shaky, dizzy, etc.  I do get sweaty. I end up getting incredibly frustrated because I can't get over the tension/difficulty to communicate and therefore do not achieve what I want/need.  

 

At home I just get very worried/stressed about everything, obsess and ruminate....... sometimes just wish I could switch my brain off.  IN fairness the lorazepam did help a bit with that when I was at home but just does nothing for more stressful situations. 

 

I don't know. I am going to see my DR sooner than we originally planned to discuss perhaps changing to a different benzo or maybe an alternative (what I don't know because I've tried so much already). 

[IndieVisible]

Well first off I get better results for social anxiety from Zoloft then any benzos and I've had them all. Also before I continue please note I am not a doctor and what I am about to say in no way is a dosage recommendation or diagnoses or any thing at all related to pretending I'm a doctor.

My doc provided me this linke to help me understand the differences between the mg reading of various benzos. They are NOT all the same 1mg of one benzo doesn't equal 1mg of another. For example I emphasize EXAMPLE 1mg of Ativan is equal to .2mg of Klonopin. (source: http://www.globalrph.com/benzodiazepine_calc.cgi). I suggest you talk to your doctor, let him know how you are doing and how you feel about ativan and ask him if the link I provided is valid and let him tell you what to do, no one else.

But in my own personal experiences, benzo's are not the best for social anxiety. For me, Zoloft is GREAT, you may want to ask your doctor is Zoloft is right for you. I still take benzos but only as needed and since I started Zoloft fewer and farther apart.

Again please do not misunderstand I am not subscribing any thing here for you or making any recommendations other then talk to your doctor about this. I merely shared my own experience and a link my doc gave me to help me understand the different mg ratings so I am not so quick to complain to him

[mcjimjam]

Maybe a different benzo would work better. I've only tried Valium and Ativan, but I found Valium better for my social anxiety. 

[Wooster]

Buspar is another non-benzo alternative that some people find helpful.

[crazyguy]

Buspar is another non-benzo alternative that some people find helpful.

I've not read one positive review about Buspar and I'm not sure it is compatible with the antidepressant I'm on as it is yet another serotonergic medication.   If 2mg ativan doesn't help is buspar really likely to help?

 

I'm going back to my dr to discuss alternatives soon..... although alternatives are limited from what has already been said. 

 

Depression has hit hard again today.  I feel I cannot overcome this anxiety and will therefore never achieve goals...... heck I can't even have any dreams at the moment, let alone realistic goals.

[Wooster]

My understanding is that buspar has a different mechanism than benzos, but I'm not super versed in psychopharmacology beyond the basics.

 

Depression is a liar who tells you filthy lies like "You're never going to achieve your dreams or goals so why bother trying." Don't buy in to its crap.

[crtclms]

Buspar is in a different class of meds than benzos, please don't ask me which. The deal with Buspar is either it works like a charm, or it is like sugar pills with side effects, it seems to be an all or nothing proposition. It is worth giving a try, imo. There are people on the boards who like it. I can't speak to the interaction with your AD.

[Equivilency]

Ativan never really helped me with social anxiety. It worked really well for other types of panic. My Pdoc said Ativan doesn't work well for social anxiety, maybe consider another medication?

[crazyguy]

Ativan never really helped me with social anxiety. It worked really well for other types of panic. My Pdoc said Ativan doesn't work well for social anxiety, maybe consider another medication?

Well now they put me on 2mg doses of Ativan twice a day which seems more effective, although it still doesn't make me confident or outgoing, just 'chilled'.  

 

The problem I find is Ativan wears off really quickly and Ideally I think I will need 3 doses on bad days because the 2nd dose wears off before the end of the day and I already know taking less than 2mg doesn't help.  My doctor set me a reasonable limit of 2 doses per day and 10 a week and I'm not sure how comfortable he would be with increasing that............. especially as ideally what I would want is 3 doses a day 5 days a week (I can cope without at weekends because I don't have to go out) and that is 50% more than  what was originally prescribed.    

 

 Hence I am going to ask about alternative longer lasting benzos at my next appointment; one that can last the whole day.   I keep hearing people with social anxiety say Clonazepam is good, so I may ask about that.  Or maybe Diazepam. 

Edited December 26, 2013 by crazyguy

[Derek]

I may get some flak for this but not sure you should be relying on drugs for something like that.  That's more of a work it out yourself type of thing.  You get into that frame of mind you might be taking it all the time.  If you have to go out and deal with the public, and have to take them, I understand that, but not every situation is going to be handled with Ativan.

 

I take ativan for panic attacks and anxiety before sleeping mostly. 

Edited December 27, 2013 by Derek

[crazyguy]

I may get some flak for this but not sure you should be relying on drugs for something like that.  That's more of a work it out yourself type of thing.  You get into that frame of mind you might be taking it all the time.  If you have to go out and deal with the public, and have to take them, I understand that, but not every situation is going to be handled with Ativan.

 

I take ativan for panic attacks and anxiety before sleeping mostly. 

Not sure I understand your logic here.  Please define ''for something like that".   It appears to me you are saying it is acceptable to take  medication to help with panic anxiety and anxiety before sleeping............... but not for social anxiety during the day? 

 

I could equally say I think you should work it out yourself really; panic attacks and  lack of sleep are a mindset and aren't going to kill anyone. If you get into the frame of mind of taking ativan when you are panicy or need to sleep then you might be taking them all the time.............    oh and I naturally assume you haven't tried therapy, antidepressants and other safer alternatives. 

[San]

Luvox can help too. Benzos or beta blockers can help a bit, but you also have to do some work on yourself. Maybe go for a walk a bit each day, gradually introduce yourself to social situations, work on some CBT. It's hard, but it can be done.