equialent of ativann to xanax

[ode2shel]

does anyone kow the equivalent of potency of these 2 meds?  I was on ativan for years, it worked better for my panic attacks than xanax, but when i became pregnanct they switched me to xanax bc they felt it was safer.  Now my psychiatrist was saying she didnt get why my 1st doc did that, but since im 29 wks preggo she's keep me on the xanax, along q prozac, and after the babe comes she'd put me back on ativan

[RCA7591]

ALL Benzodiazepines are contraindicated in pregnancy. They are known to cause birth defects. In this regard, there is no difference between Xanax and Ativan, they both carry a high risk of causing birth defects. So does Prozac.

Xanax is twice as potent as Ativan, but the effects of the drug are essentially reduced by 1/2. Xanax has a four hour half-life, and Ativan has a eight hour half-life. Neither drug is indicated for the long-term use.

0.5 mg Xanax = 1 mg Ativan.

You need to get off of these drugs ASAP, until delivery. Any doctor who knowingly prescribes Benzodiazepines to a pregnant woman is an idiot. The risk of birth defects is extremely high (all documented in the literature).

ATIVAN:

"Ativan (brand of Lorazepam) may cause fetal damage when administered to pregnant women. An increased risk of malformations associated with the use of minor tranquilizers during the first trimester of pregnancy has been suggested in several studies"

XANAX:

"Xanax is assumed to be capable of causing an increased risk of congenital abnormalities when administered to a pregnant woman in the first trimester"

"It is to be considered that the born child of a mother who is on benzodiazepines may be at some risk for withdrawal symptoms from the drug during the postnatal period. Also, neonatal flaccidity has been reported in children born of a mother who has been receiving benzodiazepines"

Both Ativan and Xanax fall into pregnancy category "D" Both drugs are also secreted in breast milk.

-Ryan

[debaser23]

****.  I bet you scared her half to death.  Ode, I'd consult with you OBGYN immediately and have him/her work a plan to get you off of all this stuff as quickly as possible.  It won't be comfortable, but in the long run you'll be glad you did it.

[ode2shel]

I go to a high risk unit of Johns Hopkins Hospital bc of the xanax.  They said it was a low dose i was on, and not to worry about it during pregnancy.  The director of the dept of psychoatry for perinatal psychiatry @ hopkins said to stop beating myself up about taking the xanax bc I have tried to wean off, and failed.  She just put me on prozac and saidthis was safe during pregnancy and to nurse on.  Now i can certainly choose to not take the prozac, since ive only taken it for 4 days now, but i do not know how to wean off the xanax.  when i have tried by body goes numb and my attacka are worse, and i dont kow what to do

[RCA7591]

"Now i can certainly choose to not take the prozac, since ive only taken it for 4 days now"

--end quote--

I think that is the best option at this point. You would definitely want to limit the amount of psychotropic drugs to just one. And frankly, the Prozac is likely to make you very nervous. In my opinion, it isn't worth the risk. The Xanax alone should suffice (at least until you deliver).

Prozac has a separate set of risks, but I'm not going to discuss any of them. I just wouldn't take it.

As far as the Xanax goes, nothing can be done at this point. Xanax, if it is going to effect the fetus, will do so in the first trimester. You're in the third trimester. You can't turn back time. What's done is done.

You can also look at it this way (as I'm sure the doctor did): Xanax has the shortest half-life, IT is rapidly eliminated from the body. The drug doesn't accumulate, ever, because of the short, four hour half-life. Accumulation increases the risk of birth defects, as it has a prolonged action in the fetus. Xanax doesn't linger around for days or weeks, it is rapidly eliminated from the body. This is bad for anxiety, but good for the baby in that the risk of congenital birth defects are reduced. Xanax has only one active metabolite, Alprazolam.

The catch 22 is a high probability that the baby will be born "dependent" on Xanax, and that the baby may need to be monitored for a short time afterwards. This can be effectively managed if necessary.

--begin quote--

"The director of the dept of psychoatry for perinatal psychiatry @ hopkins said to stop beating myself up about taking the xanax bc I have tried to wean off, and failed"

--end quote--

I have mixed feelings on this one. I think you could've done more in the beginning to taper the Xanax effectively, rather than giving up and saying "I failed". You have a responsibility as a mother to protect the life within you to the best of your ability. In my opinion, giving up Xanax or Ativan temporarily in return for some "anxiety" would've been a small price to pay for the ultimate health of your baby. The doctor is nothing more than an "enabler" by telling you not to beat yourself up. He/She knew the risk(s) involved, and did nothing to intervene. This is unacceptable from my point of view.

On the other hand, I don't know you, and I haven't lived in your shoes. Due to that fact, I can't judge you for the decisions that you've made, nor can anyone else. Nobody is perfect. Having said that, I do wish the very best for both you and your baby.

Respectfully,

Ryan

[anxiety11yrs]

I am about 1 and 1/2 months pregnant, and am taking klonopin.  My doctor is slowly tapering me down.  He says that in the 3rd trimester the meds can do harm to the baby.  He also has me on prozac which studies have it as a safe med.  I know that klonopin, which is in the same class as xanax can cause cleft pallet and spinal bifida.  Not something that I like to think about, but if I were you I would get another opinion.  Maybe speak to the psychiatrist that is at the hospital that you are going to deliver at.  They have the most experience.


Best of luck to you,

Lorrie

[ode2shel]

all of my docs are aware of the meds i am on, and i came onto this forum for support.  When I tried cutting the xanax down, i ended up in the er.  My whole body went numb, and i was blacking out.  When I went for my appt last week w my psychiatrist, i talked to her about getting off the xanax, and she said my dose was low to where i shouldnt focus on it.  She just put me on prozac, and said that it would take a few weeks to kick in, at which pt i may feel like i can skip a dose of my xanax, or be able to wean off of it, but she said not to worry about it.  Do you mind me asking how much prozac you take?  She startde me on 10mg, and wanted me to up the dose to 20 mg after a week?

Ryan-  I have beat myself up for 6 mos about this, and it has NOt been a question about paying the small price of a little anxiety for the health of my baby as you were quick to say.  I can handle anxiety, what i cant handle is blacking out on highways and calling 911, when i have a 3 yr old in the car.  I appreciate your knowledge and different prospective, but the judgmental attitude is very condescending and hurtful.  i care very much about this child growing inside of me, as I do my 3 yr old, and simple anxiety attacks ARe manageable as you were quick to insinuate, asd I had them throughour my 1st pregnancy, but panic attacks are very different.  You are a doctor correct?  Do you suffer from panic attacks, or are you going by the classic dsmIV

[Ginasouthcarolina]

i agree with ode..it depends on the indivdual..I am on xanax .05 mg 3x aday i am also on 25 mg of zoloft wich i am weening off of right now..I also have tried to get off xanax and the effects were horrible i ended up in the er..i had night sweats treamers nightmares..and something that felt like a siezure...it is not easy i have spoken to my gyno and also to gp about pregnancy and they also told me that they would like to see me try to ween off the xanax to 2x aday..but that the benifits way out the bad effects..i want to be a mother so bad and i have tried for 7 years to get off the xanax and i cant..So unless you have walked in our shoes for one day...which i can garontee you would not want to do...you will never know...The thing that upsets me is that there is not more resurch on panic and anxiety....i wish that someone would start a foundation to study why this happens to us...And i agree ode you are on here for support and we are all her for that also....Best of luck ......Gina

[ode2shel]

thank you so much.  Im glad someone understands.  Before I became pregnant this time around, I had cut down on my anxiety meds, and the ob, which I have seen about 12 in the practice, along with the psychiatrist, all say .5mg twice a day is a very low amt...maybe not to someone who takes it for anxiety as opposed to panic attacks, but I have been told that by ALL docs I have seen.  There is nothing harder than wanting to have a child, or being pregnant, and wanting a healthy child, but as you said, being at your emotional best is just as imperative to the pregnancy and motherhood as anything else, and if the benefits outweigh the risks, then it is what it is, and Im so tired of being judged.  I have done the research, Im aware of the unknown with these meds, but I came on here for support, not judgement

[anxiety11yrs]

I am taking 20 mg twice a day.  This is for the first month then my doctor is raising the dosage, and weening me off the klonopin alittle more.  It takes about 3 weeks to a month for the prozac to get into your system.  I know how hard it is to even taper down on the meds.  I have 24/7 anxiety not situational, which is most common.  So I definitely hear where you are coming from.  


Lorrie