Benzodiazepines

[AmZ]

Can someone please recommend a site or post some information about Benzodiazepines please?

I wanted to know how each one is different from the other such as which are short-, intermediate- or long-acting and also which are known to make you more sleepy than others?

i.e. 1mg Lorazepam works enough for my morning anxiety, but sends me to sleep (almost!) by the time I start my journey to work/get to work and sit down. 0.5mg works less but mostly OK, is better to be less sleepy, but then feel like by lunchtime, I need another dose (I've not done this before and am 'behaving' myself in not relying on them!). On the other hand, if it's worn off totally by lunchtime, I still have another 7 hours to sit at work and can be in a pretty bad place anxiety-wise which is not very bearable as much brave as I try to be.

Thanks in advance :2thumbs:

---------- Post added at 11:20 AM ---------- Previous post was at 09:05 AM ----------

Scrap that... It was as easy as Wikipedia!!

List of benzodiazepines

The below tables contain a list of benzodiazepines that are commonly prescribed, with their basic pharmacological characteristics such as half-life and equivalent doses to other benzodiazepines also listed, along with their trade names and primary uses....

 

[Retired]

What exactly was your doctor's instruction on how and when to take your lorazepam medication; how many times a day and how much totla daily dosage?

Considering the other medications you reported taking, I would want to persuade you to stick with lorazepam and find a dosing schedule that would work for you. The reason for staying with that particular medication is that it is a clean metabolizer, and is unlikely to interact adversely with any other medication you might be taking. There are no active metabolites that can accumulate to make you feel drowsy, and if you find a way to take the medication that your symptoms are relieved during the time you need relief, you should find it to be very effective.

Your doctor may recommend other options because of your particualr situation and medical history, however.

 

[AmZ]

Thanks again Steve ;-)

I am on 2mg of Lorazepam a day.

He really didn't say when to take it and how much each time, just that it's 2 x 1mg tablets a day. In the past, he first put me on Alprazolam 0.25mg just to take in the morning, and I did that for a week and it didn't help me whatsoever. Then when I went back, it turned out that I had misunderstood or he assumed that I knew I could do so, but he said to me 'so take more when you need it'. (2-3 tablets a day of 0.5mg each) OK! After this, he moved me to Lorazepam and said that he doesn't know how I feel so can't give me specifics of when/how to take it, so basically, 2 x 1mg is the dose and I can take it as I please.

I've been on the Benzos for 6 1/2 weeks already and am aware of the long term use issues of it and coming off of it, so this is why I'm still cautious really. I take 1mg at night, but couldn't say whether it's actually helping me to sleep or not or whether I need to take 1mg then... I have no problem falling asleep at night, in the last couple of weeks, but not sure whether that's because I am just tired from the Effexor, the Lorazepam, or just generally, I have been feeling tired all the time anyway!

In the morning, I've actually been taking 0.5mg for the last several days, because 1mg made me too drowsy. So if I felt like I needed, I guess I could add the other 0.5mg at 2pm or something? Again, I just don't want to become dependent on this stuff so have often 'suffered' with the anxiety from early lunchtime onwards rather than taking more Lorazepam.

The ideal plan of course is for the Effexor to start to work and then taper off of the Lorazepam... But from what I understand, the Effexor can take 2-4/6 weeks to kick in, and it's only been 10 days or so (!) at 75mg.

My psychiatrist said that I would most likely go up to 150mg of Effexor after a month, so we'll see about this also, as also, from what I understand, 75mg isn't a very common dosage, unless a person's symptoms are mild and it suits them. I have about 17 pills left of Effexor and then will need to go back to the psychiatrist and see how I feel then, and also see about what may need to be changed.

A lot of decisions and all of this thinking seems to have been left to me - I'm not sure how it normally works, but with this psychiatrist, we don't have appointments set or anything. It's basically when I want to speak with him, I can call, and he'll tell me when I can come to meet with him in the following couple of days. He did however say to call him (now I remember) after 2 weeks of taking the Effexor and tell him how I am feeling... So another 4 days time or so. But not sure whether already something needs to be changed, or whether I should just continue with the 75mg of 17 tablets (days) I have left.

Anyway, I think the psychiatrist situation will be better soon, as he works in the emergency clinic, so he's always very busy and it's hard to get in touch with him most of the time and meetings aren't so thorough. He said that in most cases, new patients still meet with him first and then move over to a new psychiatrist in their outpatient clinic after a month or so or once they are 'set' on their medication.

BTW, I am sorry for all of my ranting on here - I hope it's not annoying people. I just really have no other outlet, and this really helps me not only think my thoughts through and put them in to words, but of course, everyone's advice seriously helps also. So thank you :thankyou:

 

[Andy]

Don't apologize. It's always nice to get feedback and support when you have no other outlet.
I was wondering, and this is just me wondering I'm not suggesting anything, if your doctor maybe meant that you were to take the Lorazepam up to 2 times a day(no more than) as needed and not necessarily take it twice a day? I just ask that because I know how dopey it can make you feel and also the addiction factor. Again, do not change anything until you speak with your doctor.

Also, yes continue with the rest of your Effexor prescription. When you talk to your doctor next he(I think you said "he" somewhere) will decide whether you should stay at 75mg or increase it. There is no "common" dose. There is a minimum and maximum but no common dose. Everyone reacts to medication differently, people's weight and medical history are two factors. If your on a low dose it does not mean that your problems are less serious. You don't have to be whacked out on high doses of medication, it doesn't make your problems any less. You said 75mg would suit someone that had mild symptoms, but someone with serious symptoms may be really sensitive to Effexor and only be able to take 75. Point being, don't go by the dose, go by how it makes you feel. If you feel fine at that dose then stay there, if not then talk to your doctor about an increase.

I hope you do get a better more stable Psychiatrist soon. Not stable as in "whoa your Psychiatrist is unstable coocoo" I mean one that is definitely easy to get a hold of.

 

[Retired]

You can feel comforted to know many people have been taking both these medications for years to help relieve symptoms successfully. As STP has suggested and I would concur that you may want to customize the dose pattern of lorazepam to fit your lifestyle, needs and how the medication affects your alertness, within the total prescribed by your doctor.

If 1 mg makes you drowsy in the morning, take 0.5 mg. Divide the dosages 12 hours apart to reduce the amount of accumulation from the previous dose, perhaps even trying 0.5 mg every 12 hours.

This medication is cleared from the system in about 12 hours, with no active metabolites, but there can still be some residual effect of the previous dose in the bloodstream that can add to the subsequent dose in 12 hours.

You may have to experiemnt a bit to find what works best for you, always reporting your results to your doctor so (s)he has a clear picture of how you respond to medications.

 

[AmZ]

Don't apologize. It's always nice to get feedback and support when you have no other outlet.

Thanks, yep, is tough. I have just me and myself. No family to talk to, no friends, no psychologist (right now) and the psychiatrist only really wants to hear that I'm OK side effect wise and very generally how I feel with no extra questions in-between.

...if your doctor maybe meant that you were to take the Lorazepam up to 2 times a day(no more than) as needed and not necessarily take it twice a day?

He said 1 1mg tablet twice daily, so 2mg max. However, I'm sure it's of course not a hard and fast rule that I need to have 1mg and 1mg like that. Today I did it differently and it was better. 0.5mg at 7.30am, then 0.5mg at 3pm and tonight, I guess I'll do my regular 1mg an hour or so before bedtime. I'm maybe tempted to just take 0.5mg at bed time and see what happens. I don't want to take more than I need of course. I am sleeping max 6 hours a night, and even though it feels like a solid good sleep, I wake up feeling and looking still very tired. Hopefully over time, this will get better.

STP - Thanks for the other info about the Effexor. I'd love for 75mg to be enough for me but we'll see what happens and how I am feeling after I finish the last 16 tablets I have left.

I hope you do get a better more stable Psychiatrist soon. Not stable as in "whoa your Psychiatrist is unstable coocoo" I mean one that is definitely easy to get a hold of.

Thank you. Yes, I really in general, like anyone else would feel, to feel that the help I need is there when I need it and that I am not 'bothering' the person and that the right time and care is taken in ensuring the medication is OK and my questions are answered. I guess all psychiatrists are different. I work with someone who says hers is the total opposite - She's even more like a psychologist and really takes the time to ask all the questions in much more detail and seems to understand her on a total different level than my psychiatrist understands me. Anyway, that will be something that I'll need a little patience for also and I'm sure will work out much better once I have a psychologist sorted out also.

You can feel comforted to know many people have been taking both these medications for years to help relieve symptoms successfully.

Thx. I know it just takes time and little hiccups along the way... Like those awful 2 weeks I had trying the 2 different SSRI's, that was sure a hiccup along the way and now I am v happy that I have hardly any side effects from the Effexor. That's a positive thing!

If 1 mg makes you drowsy in the morning, take 0.5 mg. Divide the dosages 12 hours apart to reduce the amount of accumulation from the previous dose, perhaps even trying 0.5 mg every 12 hours.

I don't really think that will work time-wise. But think I will stick to 0.5mg in the morning for sure and no more (I think in fact, I am just tired in the morning generally from not sleeping thoroughly and takes me a while to wake up and 'get with it', so not neccessarily because of the 1mg of Lorazepam I was taking before) - Nevertheless, I don't want to take more than I need to, so 0.5mg for now.
Then I think, especially on my work days which I seem to have issues with, to take 0.5mg again at 3pm or so - But I guess it's kinda bad that I don't make it a daily routine thing? Is that OK to do this 3/4 times a week and not on the other days?
At night, I'm kinda stuck on that one also. Debating to either stick with the 1mg or try 0.5mg and cut down already on it when I don't need it. Since taking the Effexor (I take it between 11-1pm depending on my eating/schedule), by 9/10pm I am very tired anyway, so don't know how much even the Lorazepam is 'working' or doing anything on the dose I take before I go to bed. That's why I thought maybe to just take 0.5mg and see what happens.

 

[Andy]

Thank you. Yes, I really in general, like anyone else would feel, to feel that the help I need is there when I need it and that I am not 'bothering' the person and that the right time and care is taken in ensuring the medication is OK and my questions are answered. I guess all psychiatrists are different. I work with someone who says hers is the total opposite - She's even more like a psychologist and really takes the time to ask all the questions in much more detail and seems to understand her on a total different level than my psychiatrist understands me. Anyway, that will be something that I'll need a little patience for also and I'm sure will work out much better once I have a psychologist sorted out also.

It depends on the Psychiatrist you get. Some Psychiatrists offer different types of therapy and some just do diagnostic and prescriptions. My Psychiatrist does CBT as well as the basics but only when he has a low client base which is rarely so he basically just does the basics. Personally I'd save any kind of talking you want to do for a Psychologist unless you actually find a Psychiatrist like your coworker has found.

I'm glad the splitting seems to be working. If you don't have problems sleeping then you probably don't need to take it at all at night unless you get anxious of course.
For example I only take my benzo when I have severe anxiety that I know I cannot get out of with deep breathing(works for me), but addiction runs heavy in my family and I can go that way easy so I try to take it as little as possible.
I obviously wouldn't suggest anything if this was a medication that has to be taken like your Effexor, and it's best to talk to your doctor, all this is just my opinion and/or experience. I just wonder about the amount your taking daily as that can easily turn into 4 a day etc. or a full blown addiction.

Ok. babble

 

[AmZ]

Personally I'd save any kind of talking you want to do for a Psychologist...

Agreed. That's what I prefer anyway. I guess the issue is just that my psychiatrist is so busy and things don't feel thorough with him. The first meeting with him was 15 minutes and I could see that he was looking at the time as he had a group session he was running at 1pm or whatever the time was, and it's been like that the other two times I've met with him also (10-15minutes and counting down the time). But enough complaining and being negative. Whatever. I have the medication and am taking it and am getting on with it.

I just wonder about the amount your taking daily as that can easily turn into 4 a day etc. or a full blown addiction.

I'm not worried about this. In fact, I've been quite the opposite because I have been so aware of the addiction possibilities and tapering/dependency issues. Asides from today, the last several days I have actually only taken 1.5mg and not the 'full' 2mg - I even did this when I was at work on Sunday and for hours I sat there with awful anxiety for hours and just refused to take the other 0.5mg because I don't want to depend on it every time or in general. Not once in the 7 weeks of being on Benzos have I taken more than I was prescribed for daily use.

If anything, it's just a good thing that I can't drink alcohol with the medication, because that's probably something I would abuse now and again to be honest as a way to 'escape' (and mega relax) for some hours!!!

So I am behaving like a good girl

---------- Post added August 12th, 2010 at 08:14 AM ---------- Previous post was August 11th, 2010 at 10:32 PM ----------

Think the Effexor is kicking in, but more side effects wise lol... Slept 9 hours and woke up with my mind awake but body feeling like it's paralyzed and couldn't move or open my eyes for a good 15 minutes until I 'came to'!! Additionally, yes, the most vivid dreams ever!

We'll see if those extra few hours of sleep does me any better today

 

[David Baxter PhD]

The vivid dreams are common and normal. That's just the extra serotonin. Don't worry about it - it can't hurt you.

 

[AmZ]

Thanks. Yeah, I'm not worried.

Haha, even though my dream was that I got a new psychologist and he canceled on me lol.

If I understand correctly, the side effects of sleepiness from Effexor can last for up to a month usually?
I'm not worrying about this either, just going with it and prepared to because I know I have to.

It's just been taking me more and more time in the mornings to 'come to' in the last few days, physically feeling like I'm still more than half asleep and my body is still asleep, but mind awake.

Just wondered what people generally/are more likely to experience.

Thx.

 

[Andy]

It's pretty cool how some meds can make your dreams more vivid eh? I rarely remember any dreams but some meds I have tried in the past would make me remember them.

Everyone is different in how long any side effects last. Usually most side effects that you experience should start to mellow out by then if not sooner BUT it could be a little longer. If it's something that is really bothersome and you have given it a good amount of time to go away then talk to your doctor.
Your probably (not necessarily) going to notice changes in the way your feeling until you get to the right dose that helps you if your not at it already. It would be great if your one of those people who gets little side effects at all but I think most people get the mild ones.

As per usual this is just my experience and/or opinion. Take it as such.:2thumbs:

 

[AmZ]

It's pretty cool how some meds can make your dreams more vivid eh?

Yeah, pretty weird, I agree! I'm just waiting for the good ones to come along, because mine haven't been so pleasant!! A few times, I've literally woken up physically crying from my dream - Weird and not nice!

It would be great if your one of those people who gets little side effects at all but I think most people get the mild ones.

I tried 2 SSRI's before going on to Effexor (SNRI) and wow, on the SSRI's I had all of the side effects which were listed as 'serious' like having a rash, awful pounding headache, being sick for hours on end not able to keep any fluids down (and ended up in hospital for several hours on an IV on fluids, a high dose of Benzo to calm down the side effects and even hooked up on a ECG because my heart was irregular!).

Then switched to Effexor, and well, I still think they must have given me sugar pills or something lol because I have had hardly any side effects whatsoever! Literally, first 4 days I felt a tiny nauseous after eating, the mildest headache and now just the sleepiness and vivid dreams.. But that's it! What a difference!? I've been on 75mg for 10 days, so can't see any bad side effects coming along now (I hope!).

Well, I made it to work after having a marvelous 50 minute sleep on the bus! Totally out of it! But feel OK now... Time for some food and my next dose of Effexor

 

[Andy]

Yeah, pretty weird, I agree! I'm just waiting for the good ones to come along, because mine haven't been so pleasant!! A few times, I've literally woken up physically crying from my dream - Weird and not nice!


Then switched to Effexor, and well, I still think they must have given me sugar pills or something lol because I have had hardly any side effects whatsoever! Literally, first 4 days I felt a tiny nauseous after eating, the mildest headache and now just the sleepiness and vivid dreams.. But that's it! What a difference!? I've been on 75mg for 10 days, so can't see any bad side effects coming along now (I hope!).

Oh yeah, I suppose it wouldn't be pleasant to be having bad dreams. I have had some bad dreams and I have woke up crying before too but most of mine are just far out there and I forget all the details within 5 minutes for most of them.

Well that is really great that your not getting to many side effects, nothing wrong with that at all.:2thumbs:

 

[AmZ]

Yea, pretty unpleasant. I'm OK as long as I don't remember the details of the dream, but sometimes I do and/or it just makes me in a sad/bad/anxious mood all day - I guess that's why I had the bad dream in the first place though, so not surprising!

Well that is really great that your not getting to many side effects, nothing wrong with that at all

Absolutely. I was feeling really awful before on the SSRI'S and every time I'd have to end up stop taking them, it was making me lose hope. Without wanting to sound dramatic, really, I felt like I was loosing my mind and that nothing could help me and it made me worse mentally. At one point, I was actually going to go ahead and be 'hospitalized' so that I could get myself sorted out and be cared for and have constant help by a doctor if needed.

Even though I still have my days and hours still here and there, I have been feeling different in the last couple of days... I won't look too much in to it, (because I know I've had 2 days here and there before which were OK with no medication). But maybe it is starting to work

Now I have found 3 psychologists and am debating which one to go with... Hope to get this sorted by tomorrow.

 

[Andy]

Yes, it's all a big process. You sound like your well on your way though. I hope you can find yourself a Psychologist. I take it you decided against the OCD specialist?

 

[AmZ]

I'm trying ;-)

Yes, I was in touch with the OCD specialist in the hope that he also may have offices in the city that I live in also, but he doesn't. By car, the journey is only probably 20 minutes, but I haven't got a car. By bus, it's two busses that are once an hour, so is a nightmare to get to!

I have 2 psychologist options going privately and am also looking in to going through my health care (where it will be half price compared to going privately), but has lots of cons, so will most likely go private in the end.

It's a really bad thing, but now I've felt OK for the last 2 days, I start to tell myself that I don't need to go to a psychologist! I don't know why it happens, but I totally forget about

 

[Andy]

Oh I see. Well whatever works best.

Don't let yourself think like that. If you combine your medication and some type of therapy you will have a much better outcome. When you start to feel better it's automatic to think "Yay I'm better" but you know that not everyday is a good day and if you already have the supports in place instead of frantically looking for someone every time your not doing well, it will be a lot less stress and you can tackle the problem right away instead of waiting for the next available Psychologist. Know what I mean? Nice run on sentence there.

 

[AmZ]

Oh I know... And thanks for the push

Silly really, because I KNOW that it's going to happen again... My posts on here have been a ridiculous one day (or even hours!) feeling better and the next, awful... As Dr Baxter once rightly said, I'm in a cycle of anxiety.

So will really get moving on this today. Just called on and have to call back in 30 minutes.

Wish me luck and thanks for the advice :2thumbs:

 

[Andy]

Good job! I hope you find the right person right away. Good luck!:2thumbs:

Yeeesh. I have to get up in 2 hours so I am off. Thanks for the chat. Have yourself a good day!

 

[AmZ]

Yikes!!

I hope you get a couple of hours sleep then! Sorry to keep you up!

Have a great day also, once you get up and start your day that is!!

Take care