Post surgery, xanax switch to ativan

[saoirse1]

Good evening,

I had a craniotomy May 12 for a right frontal convextiy benign meningioma.

Had been taking xanax on occasional basis, on and off for several years, for anxiety. Prescribed by PCP.  No problems with that, usual dose was maximum  .50 per day .  Weeks would go by no use at all. SSRI's were/ are  not tolerable for me.

After tumor diagnosis , I was told could continue xanax , daily basis. Very high doses of steroid pre-and post surgery , Dilantin side effects , and simply the situation all made me very anxious.  Xanax has helped this.  In hospital , I was given 1.50-2 mg a day.

As of 6/18/05 was being weaned off  dilantin.  From 400mg -300-200 over the course of several weeks.   In midst of weaning, experienced  itching and rash  7/07/05; was removed from dilantin right then. Was about to go to 100 mg wean dose for 1 week.

I have had discontinuation symptoms from this. Shakiness, tremor, and exacerbating sense of high anxiety, this similar to when I was started on the Dilantin, adjusting to it.  Xanax helping,  but I don't want to end up completely dependent on it.  Right now taking 1.50 mg day, 3 divided doses.

Called the neurologist to report dilantin withdrawal symptoms.   Also reported that I am concerned about continuing  daily doses of xanax for an extended period. Asked for possibly something longer acting or easier to stop taking.  PA called back later that day, very nice.  Ativan was called in for me.  1 mg,  label says 1 tablet, 2 x daily.  
Am told these discontinuation symptoms from the Dilantin  should abate approximately 2-3  weeks.  

Can you advise how one should go about the actual switch from xanax to ativan, with these doses,  in such a way as to be most effective, least likely to cause complications?
Thanks for your time :)

[Roger Gould, M.D.]

The safest way is a very short overlap.. take a small dose of xanax, and one ativan at same time, being prepared during that interval to be a little bit medicated, then stop xanax and keep on your twice a day ativan......alternatively, you could simply start ativan the next day, taking no xanax, and deal with a short spell of anxiety which you probably won't have....r..g

[saoirse1]

Thanks very much. I had read that stopping xanax suddenly could precipitate possible seizure activity. This would be ironic in a very terrible way, as I have been so far able to avoid any seizure activity through brain surgery and the aftermath. Only the small one pre-diagnosis, an experience I dont wish to repeat.  

I am hoping that tapering the ativan directly will not be a problem as it might be with xanax.

[KittyMeghanLeah2]

Klonopin withdrawl also can cause seizures.  Taking wellbutrin if you have bulmia and (something else I forgot) can also cause seizures. just an fyi.