Weening off ativan and lexapro

[bishop90]

My doctor prescribed ativan for anxiety in December, 2008. I was taking .5mg. three times daily.  It got worse and he prescribed lexapro (10mg) a day in conjuction with the ativan.  It got worse and he prescribed 1mg of ativan three times daily. I am now down to two mg daily and I fell better.  However, he suggested I take ..5 mg in the morning and .5 in the evening.  Immediately, it brought on a severe anxiety attack. I want to ween safely. Please advise.  I stll take lexapro at night.  I often feel anxious once I take that.  He said that it is unusual to fee that way.  I have been on these medications for three months now. I do not have high blodd pressure or any other issues.  I am very concerned.

[J T Junig, MD PhD]

Ativan is a 'benzodiazepine' similar to valium, xanax, and Klonopin;  the only difference between meds is the onset and and length of action.  They are fine for short term anxiety, but beyond a few weeks a person becomes tolerant and the dose must go up to get the same effect.  All benzos reduce a person's concentration;  in fact one short acting benzo, midazolam, is used to induce amnesia during surgical procedures.  All benzos will cause amnesia and black outs if taken at high doses.

Many people get into a 'cycle' where the medication makes them calm, but then as it wears off the person feels 'rebound' anxiety, and has to take another dose. The person ends up thinking they have a serious anxiety disorder when in reality the person is only experiencing withdrawal from the medication.  Even during a slow taper, insomnia and increased anxiety are typical and unavoidable to some extent.

The SSRI's like lexapro work in an entirely different way.  They will, for example, eliminate panic attacks in many people-- but the patient will 'feel' no different, and often it has to be pointed out that the panic attacks are gone, or they will think the medication isn't helping.  Most SSRIs cause temporary symptoms that can be unpleasant for two or three days, and they don't have a therapeutic effect for at least several weeks.  Their effect depends on the growth of neuronal dendrites, which takes time to occur.

10 mg is a low dose of Lexapro; it often takes twice that dose or more to relieve anxiety.  But it won't 'feel' the same as ativan;  there won't be that relaxed 'spaced out' feeling that you get from a benzo.  On the other hand, it won't impair your concentration, and it won't wear off over time.

[dave42a]

In my opinion. there is no need to wean off of such a low dose of ativan. if you are only taking one tablet of 0.5mg per day, you could stop cold turkey and not risk any medical problems such as seizures, etc.  However, you will still have to address the insomnia/anxiety either through drugs or psychotherapy---generally, if one can financially afford it, the combination is ideal. good luck.  

[12Stepper]

Slow tapering is necessary to not experience high anxiety attacks. I do not recall the amt. of mg per pill, but I went from one to two pills per night over a 6 month period to help me sleep. I thought I would be fine to stop cold turkey, not realizing I had become dependent and had terrible anxiety attacks. I didn't know what was going on, but a friend suggested I taper and that relieved the anxiety. I cut the little pills into four pieces, and would take the same lower dose for a few nights, then a little less. I was grateful when it was over. It was a frightening experience. I finally started sleeping with only herbal tea or tylanal PM once in a while. I hope this helps :)

[star30058]

I was put on Ativan 11 years ago  when I was in the hospital for 4 months  after my lungs clasped, then I wake upon a vent and then dx'ed with Myathenisa Gravis  ( this just a short version)

I told  my doctor I can't sleep so he put me on Ativan to take .5 mg before going to bed. All this time until this year I been told by another it not a sleeping pill  it's for anxiety. I'm not addicted to it because I hate swallowing pills all my life  like some people hate milk or cheese. So that other doctor just told   to  take Ambein and don't take it and Ativan together. I took one Ambien  5 mg.  I wake up next morning  drizzy and off balance.   Then  to1/2 some problem 1/3 same problem. So I had to cut down to I/4 of the pill in order to wake up with out being drizzy so I was on it for 4 day. Then I was haven't withdrawal of beeing off of Ativan I can't breathe right it also seem like I was getting real jitery. I wasn't told That I have to be weaned out of Ativan. I stop taking Ambeim  and got back on Ativan.

Now my Question is: Can you tell me how to  wean off Ativan .5 mg.?



My Insomina been back since 6/08 . Right now I been up two nights I did sleep about 4 hours yesterday after eating lunch. I've never stayed up more then two days.

Thanks ahead of time.

Star
      

[Dylan465]

Ativan is a terrible drug in my experience and my husband's. He was given it for panic attacks. Turns out this drug was giving him daily attacks!!!

I weaned off. It took a couple of weeks. The symptoms were like a steroid rage (I imagine)--I felt so full of rage it was crazy but got of it pretty quick and the rages stopped immediately.

Hope that helped.