Hi. I'm new here, and the forum for asking the doctor has reached it's limit of questions for the day, so I came here. I took Ativan (2 mgs 3x/day) for about 4 years. I ended up with no insurance and it was too expensive to continue, so my doctor switched me to Xanax (2 mgs 3x/day). I had no problem with that switch over. Ativan is definitely my drug of choice, but I just couldn't afford it.
The price has come down and my doctor has written me a script for Ativan (2 mgs 3x/day). I have researched and read so many times over the years that Xanax is very difficult to come off and you need to wean yourself off of it. When asking my doctor, he said "they are both benzos, just stop taking the Xanax and start taking the Ativan". No! I'm NOT going to do that! He's not a psych, he's just my GP.
My therapist and I had discussed this beforehand. Unfortunately right now she is out of the office for the next 2 weeks, but I want to get this Ativan script filled. She had originally said to start weaning myself off the Xanax by about 1/4 for 2 weeks; and then another 1/4 for weeks, etc. That makes sense. However, my question is, do I take the full dose of Ativan 3x a day + the lesser dose of Xanax 3x a day at the same time?
I'm glad you disregarded your GPs advice to just simply switch from Ativan to Xanax. Most especially since you' d been on it for 4 years at a fairly high dose.
Your therapist sounds like she has a much better understanding of psychiatric meds and I would discuss this with her in greater detail.
Not being doctors on this side of the forum, we can not tell you to alter your meds in ANY way. Sorry.
I understand your therapist is out of town for two weeks, but does she have no one covering for her?
You can also talk to a pharmacist who can give you some advice, but they also cannot tell you to change any doctors orders. They can tell you if it would be OK to take the two doses in combination since they have been prescribed by a doctor. Please just continue to take the dosages your therapist talked about until you can consult with her again. It is NEVER wise to start altering your own meds.
Just hang in there, be patient until you can talk to your therapist.
As odd as it may seem, and I stand to be corrected, but 6mg is within the limits of xanax use per day in some cases. Sounds high to anybody who has ever been on a lower dose. But I do reading somewhere that the amount allowed per day even goes higher. That would be just in some cases. Spread out over the course of the day. It would also mean a harder taper. Unless the new medication is a higher dose. Which I somehow doubt. The normal method is to introduce one into your system while you are easing off the other. So you may be taken them both for a while. The old ones morning and night, with the xanax at night. Slowly switching over. Pushing the old one out as you go. Can be a slow process. No doubt with some withdrawls. But it can done. The right way. Not like your doctor suggested.
I would have to agree that switching meds is definitely tricky and must be done very carefully. I agree with greenlydia that your pharmacist can be an excellent resource. Ativan and Xanax are usually prescribed on a more short term basis. Have you ever discussed other options with your psychiatrist?
Hi, I have an idea here. Let's NEVER forget the amazing amount of accurate, up-to-date, information held in the brains of our local pharmacists! My pharmacists have worked in conjunction with my doctor for YEARS and have directed him on several crucial issues. Now, my MD is incredibly special; not only is he considered on the the best psychiatrists in the US, but HE'S OPEN TO SPEAKING WITH MY PHARMACIST - which means he recognizes that a psychiatrist simply cannot know everything about all of the "mental health" drugs on the market so his ego is intact. Some MDs might not "lower" themselves to speak with a pharmacist. My MD also (right during an appt.) often calls the manufacturer of the drug and gets information from their pharmacologist. Now, you have the right to ask ANY pharmacist - even one you don't use - for their thoughts; and you also have the right to call the toll-free phone number of all drug manufacturers (these folks are INCREDIBLY helpful). Both will probably ask you for a list of your other meds so they can check for interactions of concern...but talk about brain power - WOW! Good luck...
Em, how will that help her find out the right way to switch from one medication to the other? That was the original question. In the original post. There is a method for doing it. But the person who used to know all this sort of stuff has gone and died on us again for the second time. He's a bit like Jesus. He keeps coming back after a while. But we still recall the methods he always quoted. Stepping one in as you ease the other out and the likes. That's what the original poster needs to really find out. How to make the switch over in a safe way.
Thanks to all of you for your suggestions and comments!
I am filling the script today for the Ativan. I have not only spoke with the pharmacist, but also finally my therapist. They both agree on the same method of tapering off of the Xanax. The Ativan and the Xanax are the same.... both 2 mgs 3x a day. For the first week, I will break both in half... take 1 mg of each 3x a day. The second week, I will increase the Ativan by 1/4 and decrease the Xanax by 1/4, etc., until I am completely off of the Xanax. It may take longer than a week each change.... if I start to experience withdrawal, I'll adjust it accordingly. The goal is to wean off of the Xanax onto the Ativan with as little withdrawal as possible.
Someone mentioned possible other meds. I have tried them all over the years. I am now 52 years old and on disability for my anxiety. I have always produced a high level of adrenaline (and yep, have had thyroid, among other things tested.... there is no "medical reason'), and now that I'm older, any type of stress or "bump in the road" sends my blood pressure into stroke level zone. I've accepted the fact that I will be on a Benzo for the rest of my life. Yes, they are addictive (obviously), but i've tried everything else on the market. I'd rather be addicted to something that helps me than to not be on anything at all and suffer.
So.............. here we go with the plan. As for my doctor, he's a great doctor, but no psychiatrist. However, i do enough research on my own and stay on top of things and I have my therapist of 5 years that helps a great deal. I'll be extremely happy to be back on the Ativan. Xanax is great for a quick fix.... it strikes fast, but it also leaves you quickly. Ativan is one that is more time released and stays with you until the next dose. I'll continue to have .05 Xanax for EMERGENCY PURPOSES only for any "break throughs".
Therapists are JUST as scary as your Doctor. Pharmacists are as useful as art history majors- they memorize a standard protocol and thats it. DO NOT rely on a 22 year old kids advise from behind a counter at walmart.... whom is trained to watch you like a hawk because your juggling Narcotics and he has you labeled as a flight risk as soon as he sees your track record of abuse.
1st I recommend learning more about the meds your taking- because they have you by the balls, ma'am. Stopping use of Xanax suddenly, as I'm sure your aware can be fatal. Alcohol withdrawals are similar and just as serious, then below that on the withdrawal list comes your street drugs like heroin crack and meth, then heavy pain meds, cigarettes, etc. This is a cold way to think about it but when a person gets thrown in jail addicted to heroin for years he/she will get thrown in the rack and let to die-but they don't die, I'm sure its close to hell as they want to get but its not fatal. Your on the top of the list quitting Xanax and cold turkey or mixed with other medications or booze all of the sudden can be fatal-and must be taken more serious then WEB MD bs.
Your Doctor is an HACK for not informing you, how ever your therapist ***** too. You need to know YOUR trading vodka for beer in pill form. If you get your hands on Ativan take it as prescribed, and ween off the Xanax- but the 1/4 a week taper format is for a patient willing to give up Benzos all together. This is why your therapist ***** and this should have been addressed years ago. Ativan is a much slower acting medicine and works slightly different then Xanax- but you'll be doing the same thing in 6 months when you start to become immune.
For your situation you are and need to know it, completely dependent on an extremely dangerous and heavy medication. That is perfectly normal, you take myself and ten of the assholes that posted up above and stick em on xanax, all 10 will be in your same position- addicted. So to successfully ween off Xanax SAFELY (Witch I strongly recommend ) Ask your doctor for a faster Taper Chart For Xanax- you can safely do it in 2-4 weeks, with a re-inducement of Ativan to your body, don't bother all the pill switching your brain will remember the chemical make-up of Ativan and make it much easier to trick your body into ridding it of Xanax. With both medications in hand do a daily ween. Not Bi-weekly, you'll end up out of Xanax with out reason, happens 9 out of 10 times. Do NOT follow the monkey business I read above about pill flipping with lorazapam and alprazolam, believe me they don't work like that. You NEED a WEEN CHART. Go back to the doctor, see what his success rate is shaking people off Benzos- switch your Primary to a doc that's done this several times to other patients as a primary. Tell your shrink. Get a new one. Otherwise your chasing your tail juggling pills in the same family- you'll be doing it for years to come. On a positive note your doing the right thing by ridding your body of Xanax- newer western medicine methods have changed the way alprazolam vs lorazapam is administered, for instance I will not prescribe either medication as a long term solution to anxiety disorders- for more than a month for Xanax, 6 months for an Ativan (for healthy, stable patients that will avoid alcohol the entire time on either med )
Get a book written post 2008 on the subject of Anxiety disorders and Prescription Medication over use and addiction. Avoid the webs tangled medical information. First you need to check yourself and see what your doing this for. Money? Insurance? ********. Dont lie to Doctors and Lawyers, they always know. And more importantly don't lie to yourself its as transparent as a crackhead asking for a dollar for food. Go see a good Doctor, then worry about a shrink, chiropractor, vudo doctor, pharmacist, Native American Medicine Man in that order. You can shake it all easy with good- positive intentions and honesty.
Eventually you should be led to an anti-depressant that works hand and hand with anxiety such as Celexa, Butiprion, etc. Non Narcotics= better healthier and safer lifestyle. You haven't tried them all, your dependent on benzos and have convinced yourself they're your only hope. Its pure textbook.
I'll say it again: Go see a new Doc, is my biggest piece of advice. The one you stated could have killed you or sent you into anything from a panic attack to shock or overdose. Pick a younger, 40 y/o doctor more versed in the street meds your on. You just got your first free consultation from a 56 y/o heart surgeon in San Diego. Please take this advise, take care and make it happen.
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