aregon Posted June 3, 2014 Share Posted June 3, 2014 Hello all, Due to my generalized anxiety disorder, lasting for years by now, I'm prescribed 150mg of lorazepam a month, for 4 months by now. It is very, very much indeed, though, I'm not taking it daily or most part of the time I don't intend to. At first, 2.5 - 3 mg/day in the morning was enough, but as you already know, tolerance occur quickly. Anyway, when I have to go to school or in places crowded by people, I now have to take a huge dose, like 6 - 8 mg at once, in the morning, giving me relief for the entire day and good, dreamless sleep. So now depression eats me up inside, even at that dosage! I have a lot of work to do in the current month, given my last studying year - all I do is chew my nails and worry all the time, not that my brain stopped working, but because I'm mostly disappointed, uninterested and discouraged everyday. I was also on pramiracetam and pyritinol in the past months, now taking a break, hoping my tolerance decreases for these two. I'm very addicted to lorazepam, but is the best med out there for me - I have tried a bunch lot of other benzos, antidepressants and all that stuff that makes you dumb, fat and impotent. Quiting it is not an option, not now, these next two months. Currently, as I have to stay home, most of the time, studying, I think it's also a good time to decrease drastically that large dosage hoping my tolerance decreases. What should I do? Thank you! Link to comment Share on other sites More sharing options...
MiaB Posted June 3, 2014 Share Posted June 3, 2014 (edited) Honestly, I'm finding this a very difficult situation to understand. You have been prescribed 150mg of lorazepam a month, which essentially breaks down to 5mg a day over 30 days. And yet you are now in the position of taking up to 8mg at once in order to function. I have heard of 10mg per day being prescribed, but as far as I know, that is relatively uncommon. The question is, are you really functioning? You say that this is the "best med out there" for you, and yet you report struggling with symptoms of depression and anxiety. Both of which can actually be side effects of lorazepam use. I'm very addicted to lorazepam, but is the best med out there for me - I have tried a bunch lot of other benzos, antidepressants and all that stuff that makes you dumb, fat and impotent. I don't know if addiction or dependence is the best word to use here, but you are certainly in a tough spot. Why do you say this is the best med for you? If you have gotten to the stage where you are needing to take more and more, it isn't working in the way it should. Are you seeing a psychiatrist, and does s/he know the way in which you are taking this medication? I'd also like to hear more about the "bunch lot" of stuff that makes you "dumb, fat and impotent" that you've tried. Quiting it is not an option, not now, these next two months. Currently, as I have to stay home, most of the time, studying, I think it's also a good time to decrease drastically that large dosage hoping my tolerance decreases. What should I do? Quitting on your own from such large doses should never be an option. It can actually be seriously dangerous. What should you do? Get really honest with your psychiatrist or whichever care provider gave you this med, and slowly work on getting off it with professional assistance. Stop damning entire classes of drugs because you think they'll make you fat and stupid, and really explore your options frankly and with an open mind. edit: I am moving this to the benzo forum, because I think the content fits best there. Edited June 3, 2014 by miab Link to comment Share on other sites More sharing options...
jt07 Posted June 3, 2014 Share Posted June 3, 2014 I don't really understand the question. What should you do about taking so much Ativan? Or what are the alternatives? I'm not exactly clear. I think that you need to be upfront with your prescriber about how you take the Ativan. Perhaps they can find a way to help you reduce your dependence. You should not try to quit the Ativan without the help and advice of your psychiatrist because coming off such a large dose can have major health consequences (such as seizures) if not done correctly. I just want to warn you that benzos can cause depression. I notice that you are also taking nootropics. I'm not sure whether you are aware that benzos can also cause cognitive impairment. Could you list some of the other meds you have tried for anxiety? Link to comment Share on other sites More sharing options...
aregon Posted June 3, 2014 Author Share Posted June 3, 2014 (edited) Hello, I don't know what to say, frankly, though honestly, it's very true - I'm in a though spot here. My psychiatrists prescribed me along the years a bunch of stuff that worked for me a while and a lot that did not. I can remember the following, in no particular order: clomipramine, doxepin; selegiline; buspirone; paroxetine, escitalopram, mirtazapine, duloxetine, milnacipran, venlafaxine, bupropion; diazepam, clorazepat, clonazepam, bromazepam, alprazolam; olanzapine, quetiapine, aripiprazole, and if i recall right, some valproate salts and sometimes as an acid formulation. I consider bold ones the most effective in the beginning of the treatment and afterwards some weeks though none, in my opinion are working as good as lorazepam, on the long run. Frankly, I would give it a chance to phenelzine, though I can't find in my country such drug... My understanding with my doc is: "You take 6 a day when you need to go out, but, next day you should take the smallest amount to feel alright, when home, that's way we can avoid complications." She said... something like that. Anyway, my point is - I'll tapper off to 4 mg a day maxim - when needed, then even less, so my tolerance would decrease. Do I have any other option? I cant just yet abandon this med. Thank you! edit: I'm off lorazepam since 5 days ago - because I wanted to - it's terrible, but from tonight I'll take .5 at bed, it's so annoying not to sleep half the night.... Edited June 3, 2014 by aregon Link to comment Share on other sites More sharing options...
MiaB Posted June 3, 2014 Share Posted June 3, 2014 The point that both jt07 and I were trying to make is that tapering off this med on your own isn't safe. Essentially (although it sounds counter-intuitive) you are self-medicating and taking some serious risks. This really is not something to mess around with by yourself. I would say this to you even if you had a medical degree. The safest way to cut down on what you are taking is to speak to your pdoc, explain that you have been taking doses above what she prescribed, and ask for help. That's what she's there for. Trying to come up with complicated tapering schedules and stopping and starting like this is just not responsible behaviour. Note that I am not saying that you have to stop taking ativan, but it's exceptionally clear from both your posts that it's not doing the job in controlling your anxiety. I understand the frustration of trying multiple medications, but try working with your pdoc to find a solution to this. It's meant to be a teamwork relationship, and right now you're playing around on your own. Link to comment Share on other sites More sharing options...
Cerberus Posted June 3, 2014 Share Posted June 3, 2014 Aregon - Bear in mind that for a pdoc prescribing is an exercise in chemistry. Your prescription is based on assumptions about how very specific quantities of meds are known to react, break down, and interact with other meds inside the chemistry of your body. If you take your meds in a way that is different from what your pdoc prescribes, all of his or her calculations about how to achieve the best benefit with the least side effects are going to be off. You really should try to maintain the prescribed dosages, or at the very least be up-front with your pdoc about what you're doing and why. Link to comment Share on other sites More sharing options...
jt07 Posted June 3, 2014 Share Posted June 3, 2014 I'm not at all sure that if you taper down, your tolerance (resistance) will lessen. I don't think it works that way. Usually you have to go completely off a med for some considerable length of time to reset your system. Do not do this on your own. You need to be working with your psychiatrist. Link to comment Share on other sites More sharing options...
Phoenix_Rising Posted June 3, 2014 Share Posted June 3, 2014 You do have other options that you could use to augment ativan. You could use a beta blocker such as metoprolol. You could also try gabapentin. I use these in conjunction with my benzo (klonopin) and find it to be a very effective combo. Titania mentioned this, but another good option is therapy. Learning to deal with your anxious thoughts is very helpful. Link to comment Share on other sites More sharing options...
crazyguy Posted June 4, 2014 Share Posted June 4, 2014 Hello, edit: I'm off lorazepam since 5 days ago - because I wanted to - it's terrible, but from tonight I'll take .5 at bed, it's so annoying not to sleep half the night.... This is crazy You should not go from taking 5mg of lorazepam per day to quitting cold turkey over 5 days. You are bound to get withdrawals or rebound anxiety at some point and withdrawing from higher dose of benzos too fast can be dangerous as well. I think you should talk to your doctor ASAP. They will have dealt with this type of thing before, you will not be the first person who has not taken medication as prescribed...... especially not if they routinely prescribe higher doses of benzos. The other thing is if you are having to take huge doses like 8mg for it to 'work' then maybe it isn't the right medication for you anyway - as to be honest from what you write it doesn't sound all that effective for you. Link to comment Share on other sites More sharing options...
Equivilency Posted June 17, 2014 Share Posted June 17, 2014 Definitely sounds like ativan is not for you if your gaining a tolerance that quickly. Have the pdoc help taper you off or your gonna be in for some nasty (and potentially serious) withdrawals. Link to comment Share on other sites More sharing options...
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