Lorazepam (ativan)

[Deb1023]

I am new here, but I just read that Ryan is the whiz kid to ask about meds.
I have been taking Lorazepam for about 4 months due to extreme axnxiety that came out of the blue. I started at a low dose of .5mg and took them only at bedtime and took Suntheanine during the day and lemon balm. Then after about a month I quit the Lorazepam. No one said to taper at all. Suddenly I wasn't able to sleep a wink and didn't know why. The Dr. should have given me a different sleep aid or told me it would go away eventually, but he increased the dosage to 1 mg. at bedtime. I needed sleep so bad that I used them & became unable to sleep w/out them.
Then my Dr. told me he really wasn't good at dealing with anxiety & sleep issues and that I should see a pyschiatrist who could be of more help. I couldn't get an appt. for over a month. He then tried to switch me over to Klonopin because of the longer 1/2 life. After being on it for 5 days, I had a strange allergic reaction of itching all over my body and in my throat. He took me off them and tried Valium and Librium. I had the same reaction. We wondered if I was reacting to the fillers or dyes? Anyway, after I had tried the stronger doses he said he had to up my Lorazepam dose to 2 mg. a day spread out over am.5mg,  afternoon  .5mg.,  & bedtime  1 mg. I have now built up a tolerance and have interdose withdrawal symptoms. I know I will have high anxiety when I try to taper off them because I feel it sometimes already. I am terrified that I won't be able to handle it. Will I be anxious all the time, or just when I make the cuts for awhile each time? I plan to taper very slowly because I am very sensitive and also have hypoglycemia and fibromyalgia. They both can trigger panic and anxiety, so it's much harder. Also Lorazepam has such a short 1/2 life so I have these symptoms more often. Do you have any helpful ideas of how to reduce the anxiety or how to do the taper? Cut out a part of the afternoon dose, or both am and afternoon equally in small doses? I could take 1/4 -1/2 of the bedtime dose and add to the afternoon, but then would I be able to sleep? I am using 25 mg. trazadone for the past 2 weeks to help with that since the med only gives me 3-4 hrs. now.
Do you know if it's okay to take Suntheanine while tapering? I've heard some say yes, and others say not until after the taper. I take some milk peptide tabs through Immunical that help a little, but not nearly enough. Thanks! Deb1023

[nicksad]

"When you tapered, was muscle pain the only negative symptom? Did your anxiety get really bad? I know everyone is different. I am just so afraid of the anxiety coming back as it was when I started the Lorazepam. The effect it has on me helps the anxiety, but I get very fatigued and have stomach pain and nausea from it. I wish I could lose the fear of tapering off it. So you were on it about as long as me, but at 1/2 the dose. You're lucky to be down to such a low dose! Wish I was."


It was strange getting off, like a fog lifted.  The muscle spasms were the most noticed when I realized things really changed.  IMHO - don't stress about it and keep taking it as needed.  I got completely off for a couple weeks and then once I realized I wasn't going through any withdrawal type issues (which I was worried about too) I take it as needed which is about every other day on average.  IMHO - take the minimum needed for it to work, and it seems to work in about 30 minutes.  If I find I need it I take one and mark the time.  If thats not enough I take another little chunk.  1/8th to a 1/4 mg is enough for me anymore.

BTW - I got the book "Anxiety Disease" by David Sheehan and it was about as good as a dose of this stuff reading it.  It was the first book/doctor that actually described accurately the weird problems this sickness gives you.  Between that and this site and getting it into my brain that this anxiety is all in my brain I am getting close to being recovered.

[Paxiled]

Looked up the melatonin thing.  Apparently it is contraindicated with certain autoimmune disorders because it stimulates the immune system.  Other research shows that with certain autoimmune disorders, it actually helps.  You would have to discuss this with your doctor, obviously.

[Paxiled]

Sorry, don't know about the autoimmune connection with melatonin.  As for theanine, I'm not sure if they know exactly how it works.  They don't know exactly how St. Johns Wort works.  They don't exactly how antidepressants work.  The brain is still beyond us.  What you want to avoid are substances that act on GABA receptors directly, such as valerian, while you're on benzos, though even that is disputed by many.  The problem is, the natural medicine world and the allopathic medicine world don't communicate very much or very well.  Seeing a naturopath along with your doctor would give you better answers than anyone on this board can.  I can also tell you that anxiety is weird, it often comes from nowhere, as mine did, and often comes from somewhere, so there's no way to know in your case.  Fibromyalgia and thyroid are both implicated in both depression and anxiety, so your situation is particularly problematic.  A book you might want to read, just to get you started, is Natural Highs by Hyla Cass, a psychiatrist at UCLA.  It will tell you about all the natural remedies used to deal with mood disorders.  Another good book is Prescription for Nutritional Healing, which has many of the contraindications in it, but as I say, you have two conditions at least which can in and of themselves cause your emotional problems.

[Deb1023]

PS. --So Sun L-theanine doesn't work on the same receptors in the brain as Lorazepam?
That's good to know. So you feel it's safe? I may increase the dose & see if that helps.
How much melatonin is safe? Someone told me that people with autoimmune disorders shouldn't take it. What about using a sun lamp or blue light box? Deb1023

[Deb1023]

Thank you so much for all of your good advice. I need all the help I can get.
Fear and worry are my biggest enemies. I know this, and yet I still have them despite trying many things to help. I've seen a therapist twice and plan to continue. (cognitive therapy) 5htp, huh? I have to look into that, and the suntheanine isn't helping much.
I take magnesium glycinate for muscle pain at bedtime and coQ10 for heart. My pharmacist recommended them. I get massage, but my fibro is still bad.
I'm not on an ssri, but I do feel depressed sometimes because my life has changed so much since the anxiety began 5 months ago. Before that I had a great, active & happy life. I'm not sure if my anxiety is medically related or from radically changing my diet and exercise routine to avoid going on a statin drug & being anxious about it & my blood pressure. I also had 3 mercury amalgams removed 2 months prior to the onset , and they were not properly removed as I was told they would be. Scary stuff. I also have thyroid enlargement and nodules with compression.  My endo doesn't think it's from that,
but still says I should have my thyroid removed. I need another FNA biopsy of a cold nodule. So there are plenty of possible reasons for the anxiety. I don't know which is the one or if the anxiety will go away after the tapering or not. I've dropped 20 lbs. without trying to, and no longer have the cholesterol issue. I still feel it may be linked to my thyroid somehow. Deb1023  Thank you again!

[Deb1023]

When you tapered, was muscle pain the only negative symptom? Did your anxiety get really bad? I know everyone is different. I am just so afraid of the anxiety coming back as it was when I started the Lorazepam. The effect it has on me helps the anxiety, but I get very fatigued and have stomach pain and nausea from it. I wish I could lose the fear of tapering off it. So you were on it about as long as me, but at 1/2 the dose. You're lucky to be down to such a low dose! Wish I was.
Deb 1023

[nicksad]

Lorazepam I found to be much more powerful than my doctor thought (at least with me).

I ended up cutting the 1mg pills into 1/4 sized pieces.  While my anxiety was at its worse I took no more than 1.25mg a day.  Too much of it made me dizzy which was the worse part and was like anxiety.  Also in between doses the anxiety would build back up I noticed.

I found that when I tapered off (I used them for about 4 months) that once I went to 0.5mg a day all the muscle tension they were hiding arrived (Lorazepam is an excellent muscle relaxer)  Tapering off by dropping 1/4mg every week worked good for me.

I am at the point where 1/8 of a 1mg pill is enough to cut the edge off my anxiety.  It takes about 20 minutes to kick in and I don't have the side effects at this small of a dose.

[Paxiled]

Oh, one other thing.  For sleep, try melatonin or a homeopathic remedy such as Calm's Forte by Hyland.  Doing benzos for sleep is just taking too strong a medicine for the problem.  And then get into therapy to see if you can't figure out why this is happening.

[Paxiled]

I'm not Ryan, and he's going to be much better on your medication question.  However, I do know natural remedies very well.  Lemon balm is way too mild for your reported level of anxiety, and my guess is you're not taking nearly enough theanine for therapeutic effect -- the amount on the bottle, as is common with natural remedies, is much lower than the research tested.  So I don't think that's a problem.  What would be a problem are relaxants than also worked on the same receptors as a benzo, such as valerian or kava or even passionflower.  If you're very sensitive, these should be avoided until you've quit the benzos, if that's what you intend doing, but when you have quit they can be very useful for sleep and relaxation.  They won't be as strong as benzos, however.  As for the mild peptides, you have an inflammatory disease, fibromyalgia, so dairy is probably a problem for you.  What's probably helping you in that is the tryptophane, another amino acid (theanine is also an amino acid, found most in green tea).  Better would be 5htp, the metabolite of tryptophane; it has a much better chance of getting to the serotonin in the brain, whereas tryptophane might go more to the serotonin in the gut or the blood vessels.  Now, I say this assuming you're not also taking an ssri, in which case 5htp shouldn't be taken at all.

For the rest, Ryan will be of much more help than I can be, but if you have to quit a medication that might give you a withdrawal, better to have a positive attitude than fear.  Work with your psychiatrist on a tapering schedule that fits you, not one that is generalized to everyone, since we all react differently, and if your psychiatrist isn't willing to work closely with you, get a different one.