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xanex to ativan
the doctors want me to quit taking xanex after 10yrs of taking it and go to ativan ( lorazapam)...but he wants to gradually take me off xanex while putting me on ativan...has anyone else ever did this..im scared of the withdrawals from xanex and taking the 2 meds together one in the morning and the other in the evening.
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480448 tn?1426952138
Hello!

Did you doctor say WHY he wants to make the change?  Sometimes, to tackle tolerance issues (needing a higher and higher dose to maintain the same level of effectiveness) doctors will recommend switching to another med in the same class.  Are you having issues with tolerance?  Is the Xanax just not working like it once did?

Your doctor is planning on gradually weaning you off the Xanax, while at the same time, gradually stepping you up in doses with the Ativan.  That's the proper way to do it.  As long as he is planning on putting you on a dose of Ativan that is somewhat comparable to your Xanax dose, you shouldn't have any major w/d issues.

If you're having problems with tolerance, and you take these meds on a regular basis (every day), then you may want to ask your doc about trying Klonopin.  

Klonopin is a longer acting benzo that keeps a person at a more steady state of calm versus the ups and downs you would tend to see with the shorter acting benzos, like Xanax and Ativan.  Xanax and Ativan are best used on an "as needed" basis, like a "rescue med", whereas Klonopin is more appropriate for longer term, more regular use (ie, daily).  Klonopin has less issues with tolerance as well.

What dose of Xanax are you on, and what is your doc's dose plan for the start of the switch to Ativan?

Let us know how you're doing!
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i take a .5 of xanex in morning and 1mg at night to help me sleep but i have been on it so long just dont seem like its working anymore...i tried switching once b4 to ativan and i was up all night with not being able to sleep, i was hot then cold and my heart felt like it was racing, when i called the pharmacy they said t was bc i went from a 1mg of xanex to 1 mg of ativan and ativan is only half the strenght of xanex that i should of been on 2 mg of ativan to equal out to the 1mg of xanex....the reason he is trying to wean me off xanex is mainly bc of my concernes of withdrawals from xanex, he told me they was in the same classifactaion of medicine and i should be fine but of couse my anxiety kicks in and i start panicing about taking a new med!
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i also do take xanex everyday and have for years, they say ativan is longer acting then xanex and is more for generalized anxiety like i have, they have never even mentioned klonopin to me but i might have to ask them bout that
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3149845 tn?1452625053
Xanex reacts quicker after you take it but dosent stay in your system as long as ativan. ativan  stays longer in your system and is consider stronger. Ask your doctor why the switch. Xanex is more for panic attacks and ativan is more for anxiety and sleep disorders.
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the xanex just doesnt seem to be working anymore...and like u said its more for panic attacks where i got more of the generalized anxiety and they said ativan would work better..just scared of coming off a med i been on for 10yrs:(  wonder how long a 1mg ativan will stay in your system?
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480448 tn?1426952138
Actually, the above info is not entirely correct.  Both Xanax ans Ativan have an onset of about 30 minutes.  While Ativan's duration is longer (24-48 hours vs 4-6 hrs for Xanax), it is not "stronger".  Their half lives are almost the same, and their time to peak plasma levels are also very similar.  

Actually, for equivalency purposes, Xanax would be considered "stronger", with 0.5mg of Xanax equalling 1mg Lorazepam.  As far as "equivalencies" go, it's tricky, because it's not an "exact" science.  Those equivalency figures are approximates, as close as they can be estimated.

Also, it is not correct to say that Xanax is more appropriate for panic attacks, etc.  It depends solely on the doctor prescribing the meds and a whole host of others factors as to which benzo is Rx'd for what condition.  There are no fast and steady rules.  Both of these meds are used for all anxiety conditions.

OP...your doc is making the switch because of your tolerance issue.  I really urge you to have a conversation with him about Klonopin.  With you taking these meds daily, tolerance (with both meds) is going to be an issue.  Klonopin will not have the same tolerance issues as the Xanax or Ativan will.  Also, while a switch to Ativan MAY help you to get more relief, there could be cross-tolerance issues, meaning, you will still not experience the full effectiveness of the Ativan, due to you having built up a tolerance to the Xanax.  Please speak with your doctor.

Here's some info for you to compare the two drugs.  You have to keep in mind it is not an exact science.  You definitely need to speak with your doc.

(These figures will vary from chart to chart)

Xanax:
Onset: 30 min
Time to peak plasma level: 1-2 hrs
Duration: 4-6 hrs
half life: 12-15 hrs

Ativan:

Onset: 30 min
Time to peak plasma level: 1-6 hrs
Duration: 24-48 hrs
half life: 14 hrs


As you can see, there are pretty broad ranges.  For example, Ativan has a duration of 24-48 hours.  Everyone will react differently.  Tolerance will decrease these figures for sure...which is why you're in this boat.

Please call your doc, get this cleared up before you start this transition.  IMO, you really would be much better maintained on Klonopin versus either of these shorter acting benzos.

Best of luck.
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can you explain what onset,duration and time to peak plasma levels and exspecially the half life means?  thank you
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480448 tn?1426952138
You're over thinking this.  

Onset means how long the med takes to work, before you would feel it.  Duration is how long that feeling lasts (approximately), peak plasma levels just means the time it takes to have the HIGHEST level of the drug in your system and the half life has to do with how it is excreted from your body.  It's a bit complicated to explain.

If a med has a half life of 10 hours, and your dose is 1mg, then in 10 hours, 0.5 mg of the med is out of your system.  In another 10 hours (if you didn't re-dose), the dose would be gone.

Just speak with your doctor about your concerns.
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ok thank you so much for explaining that to me!
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well on day 3 of taking a ativan in morning and one xanex at night...so far so good:)
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480448 tn?1426952138
Excellent!  I think you'll be just fine!  Thanks for the update!
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ty and yw:)
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well ativan didnt work so they put me on effexor xr but its making me very sleep any suggestons or advice about this medicine. they put me on it for pere menapause symptoms?
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