Switching from Xanax to Ativan

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?

Hope that makes sense!!

Thank you!

[greenlydia]

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.
Peace
Greenlydia  

[hazyworld]

hello,when my new i got in march put me on xanax from ativan he had me do no taper and i had been on ativan a year.......its a higher dose of xanx but could withdrawl (withdrawal) from ativan be part of my problem

[allmymarbles]

What I don't understand is why you were ever given such a high dose of Xanax. You were taking 6 mg a day!! That strikes me as outrageous. Maybe you don't have the right doctor.

[MrGreen]

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.

[cj29]

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?

[BARBMARCH1958]

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...

[MrGreen]

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.

[heartfluttersflyawayplz]

oh no did ryan really die this time i hope not

[MrGreen]

No he didn't. Just my sick sense of humour. As he has vanished again. I know. Bad. But that's me. Good at being bad.

[heartfluttersflyawayplz]

oh lol ok i know it was told years ago he had so was not sure . no problem

[Linduh]

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".

Thanks again to ALL OF YOU!!!