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Peanut

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Hi, I was wondering how long it takes Ativan to take take full effect. I need to take it for a specific situation (oral foreign language final :eek:) and I wasn't sure if I should take it like 20 minutes before or a couple of hours or what? I don't want to take it too early and be tired. My prescription just said something like "take as needed" so I'm just not sure when to take it for the best result. Does anyone know?
 

David Baxter

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Ativan comes in a "regular" format which you swallow with water like any other pill - take that 20 minutes to half an hour ahead of time - or in a fast-acting format - these are smaller and you dissolve the little tablets under your tongue... that format will start to work within 5 to 10 minutes tops.
 

Peanut

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Thank you Dr. Baxter!! You're the best. You always know what to do! That information significantly eases my mind-one less thing to worry about!!
 

David Baxter

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You're welcome. One more thing, though: I would suggest that you "try out" the Ativan once or twice beforehand on days when you don't have anything critical to do. Sometimes, the initial dose can make you feel a bit sleepy or dozy. I think most people will adapt quickly even if that does happen but you don't want to discover this on the day of an important exam.
 

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Ativan (lorazepam) is available in some Countries (Canada) in both oral tablet as well as sublingual form.? ?The sublingual form contains the same dosage as the oral tablets but dissolves more quickly and is absorbed into the bloodstream more rapidly when held under the tongue.

In fact, oral tablets can be taken sublingually as well, the only difference is that some of the inactive binding ingredients may leave a small harmless residue under the tongue.? ? In order for Ativan to be fully absorbed sublingually, the tablet should be held under the tongue for three minutes and there should be no swallowing of saliva during that time.? ?This will ensure full absorption sublingually.

As Dr. Baxter stated, Ativan is absorbed into the bloodstream in about 20 to 30 minutes and crosses the blood brain barrier in about 45 minutes from initial administration.? ?Peak effectiveness is reported to occur between the second and third hour and the compound is cleared from the system in about 8 hours.

As it is a relatively short acting member of the class of medications known as benzodiazepines, it can be taken for an acute situation, and is eliminated from the body 12 to 15 hours following injestion of the last dose.

It shouold be stated, that due to this relatively short biologic half life of 12 to 15 hours, anyone taking Ativan for a prolonged period of time, the therapeutic advantage is that the Ativan blood levels stabilize after three days (steady state) but if Ativan needs to be terminated following prolonged use, the physician's instructions need to be followed as the dose needs to be tapered gradually over a period of a week or two. Abruptly stopping to take Ativan following long term use can result in withdrawl symptoms.

As Dr. Baxter alludes to, try the use as needed dose being prescribed before the actual event, as different people react differently, especially if they have never taken this type of medication before.? ?One would be advised not to drive a car or engage in a dangerous task, until the reaction to the medication is known.
 

ThatLady

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Definitely give the Ativan a trial run, or two, hon. See how it works for you. Take it as Dr. Baxter suggested, when you have nothing important to do, and try taking a little online test, or something. See how you do. Benzos react differently for different people, and it's always good to know what to expect. :)
 

Rosa

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is this the same as klonopin wafers???? I'm on Klonopin wafers but maybe this stuff is cheaper?
Rosa
 

ThatLady

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Rosa said:
is this the same as klonopin wafers???? I'm on Klonopin wafers but maybe this stuff is cheaper?
Rosa

While both Klonopin and Ativan are benzodiazepines, the two are different in their methods of action and Klonopin has a longer half-life than Ativan. They should not be used interchangeably.
 

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Klonopin (clonazepam-Roche) is another among the benzodiazepine class of medications. ?

Clonazepam is used differently from most other benzodiazepines, as it is was originally indicated as an anti convulsant. ? In recent years it has found use in other conditions.

If your physician prescribed clonazepam, it is likely because of the condition to be treated, in the context of your medical history and other medication being used.

Has the desired theraputic effect been achieved?
 

Rosa

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Thanks for your replys:) I am very happy with the Klonopin and its effects. I guess I was just thinking this one sounded like what I was taking (ie, melts in your mouth-gee you could sell me M&M's for that matter) so I thought they might be about the same but maybe this one was cheaper.... I never said I was smart:)
Thanks
Rosa
 

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You've asked some good questions and in order to be a partner in your own health care, these are questions that are in your right to be asked.

Differences between medications, even medications withing the same class or category often have very important differences in the way they are absorbed, distributed and eliminated in the body. These properties o a medication are known as the pharmacokinetic properties of the medication, and your physician's understanding of pharmacokinetics should determine the correct choice for each patient, based on the patient's medical history, their diagnosis and the other medications they might be taking.

Delivery systems of medications have evolved to include a delivery system like the wafers you are taking, which allow the ingestion of an oral form of the med without requiring water to drink with it. The sublingual form of Ativan is a little different in that the medication is intended to be absorbed under the tongue, using the same mechanism of absorption used for the cardiovascular medications like nitroglycerin etc. The wafer and rapid melt types of medications are still ingested by swallowing, and and absorbed by the gut.
 

Peanut

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Thanks for all the information about the Ativan (and the other was interesting as well).? I have taken Ativan before many times but since I don't take it for panic attacks, per se , I was unsure of the exact timing.? I have found Ativan to be very effective but also do get quite drowsy after a while.? Since this test is so important (since my anxiety has hindered my participation in class somewhat) and my anxiety is getting really bad in this class, I was trying to figure out exactly when to take it.?
 

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If you are experiencing drowsiness with the current dosage prescribed by your doctor, you may wish to report it to your doctor.? The dose may have to be modified to get the right balance of anxiolytic (anti-anxiety) with the absence of drowsiness.

It should be understood that Ativan (lorazepam) does several things in the body.? The benzodiazepines are a class of drugs with hypnotic (sleep), anxiolytic, anticonvulsant, amnestic and muscle relaxant properties? ?Some physicians prescribe Ativan for night time sedation to help people fall asleep, so the drowsiness is not unexpected.

If the goal is to relieve anxiety, then work with your doctor to find the optimal dose to achieve the desired effect, while experiencing minimal unwanted side effects.

Sometimes the medication has to be changed and/or the dosage modified until the optimal medication/ dose combination is found.

I have found Ativan to be very effective but also do get quite drowsy after a while

Do you mean you feel drowsy after taking one dose, which is not usually followed by another dose....or you take your medication once or twice a day and feel drowsy continuously after a few days?

Is your medication therapy for panic attacks accompanied by supportive psychotherapy to help you deal with your panic attacks?
 

Peanut

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My doctor is uncomfortable prescribing benzodiazepines (and otherwise errs on the very far side of not prescribing anything for anything ever).? I can't get anymore from her, she said that she would only give me 30 pills and then I should not need any medicine because I hadn't take any in a number of years and had been fine.? So I've been breaking the Ativan pills in half in order to reduce drowsiness and also for conservation of the pills.? So, I'm not exactly working with my doctor on this issue.? I am hesitant to go to another doctor seeking these types of pills because I'm afraid that it would seem like I am drug seeking.? I did recently get a therapist but besides asking me if I was nervous we haven't really touched on anxiety and I think that he thinks that I'm fine.? So, that's my situation with that.?

Thanks for asking, I appreciate and value your input.
 

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I understand that some physicians have reservations about prescribing benzodiazepines because of their concerns of habituation ( not exactly the same as addiction). The literature appears to be inconclusive on this issue, so one would have to work out a plan with their physician to treat one's diagnosis using the medications and techniques with which the physician has successful clinical experience.

If you feel you are not receiving the relief from the symptoms that concern you, your options are to have a conversation with your physician to address your concerns, or to get the opinion of another physician.

There is nothing sinister about seeking a second opinion, and in medicine seeking additional opinions are common practice. You may wish to ask for a referral to a specialist for a consultation, and then follow up with your family physician.

Perhaps your physician works with a psychologist with whom you could work to find ways to deal with your panic attacks. Perhaps Dr. Baxter or others would have suggestions along these lines.

I am hesitant to go to another doctor seeking these types of pills because I'm afraid that it would seem like I am drug seeking.

As a responsible adult, if you choose seek a consultation with a second physician, and be frank and honest about your concerns, it should not be interpreted as drug seeking.
 

Peanut

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TSOW, thank you for your advice. It sounds like you are very well informed on this topic and I appreciate that you're taking the time to inform me as well. I also realize I forgot to answer your question, that the drowsiness is on and pill by pill basis (not cumulative for days).

I have been thinking about getting changing doctors though. My psychologist mentioned that he knew some doctors that were not opposed to "treatment" and perhaps he could make a reccommendation for medication to a doctor that he already has a relationship with. That might be an idea...
 

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Good luck to you !? ?In my view, each of us needs to be full partners in our health care, with our team of health professionals.? Our health professionals are the consultants we use to inform us on the basis of their training.? Then, armed with this information, we can make informed decisions on our own health care.

We may not always like what our consultants tell us, and our decisions should be made on a benefits vs risk basis.? If we feel there may be options available to us in which? one particular health professional does not have experience or expertise, we are free to seek other opinions.? ?I don't believe seeking a second opinion is a license to find someone who will tell us what we want to hear, but rather to seek out other options.

Sounds like you are on the road to a successful health plan!

Regards,
 

Peanut

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If we feel there may be options available to us in which? one particular health professional does not have experience or expertise, we are free to seek other opinions.

That's a good point.? I really should make a point to see a doctor who is more willing to prescribe medicine (all kinds).? I think that my doctor's specialty is childbirth and that really doesn't help me that much with this.?She doesn't even believe in taking vitamins.

Thanks again TSOW for all of your input. :)
 

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