My Ativan

[bloodwood]

I have a story about my experience with ativan.

I had been taking it for several years (5-6 years?) "as needed" and found it to be helpful with anxiety and sleeping. My girlfriend was on it too. I had
once met a lady who did research on medications and their addictive-ness. She expressed concern about my situation with ativan because it can be very addictive and the withdrawal affects involve anxiety so you may be apt to take ativan to ease that. I have had doctors and pharmacists mention this too.

My girlfriend and I had always wished we were on less drugs and occasionally removed a drug just to see. We just didn't like feeling so dependent on them. I think a lot of people can get that feeling on occasion

When I spoke to my family doctor about it she said she really wasn't worried about me and the amount I was using so I should continue as I have been. So I did.

About 3-4 years ago I noticed casually that I didn't ever seem to feel OK or good about the day. That I was agitated without relief. Not in a major
way...just always. I started having more trouble with people, social encounters at work and elsewhere. I couldn't put my finger on it and sometimes I did feel kind of OK but never ever good. I damaged relationships, burned bridges and probably should have been fired. I was getting more antisocial, sullen or angry. Unhappy depressed ill-at-ease. Not majorly depressed as it had been in the past but unhappy in my head. I resented having to interact with people.

This went on and I was put on reduced duties at work and often couldn't even talk to people. Or if I had to I was not that pleasant. I just wanted to curl up into dust and blow away. I couldn't even have a constructive conversation with my doctors about how I felt. I can't imagine I was the most wonderful person to live with. And I know I was truly unhappy. I used to think about it and try to remember the last time I felt a contented sense of peace or even a little true happiness.

Then something happened. I ran out of Ativan and couldn't get anymore for a couple of weeks. I figured I would survive and did not ask my doctor to write a new prescription. I thought there might even be a benefit to being off of it for a bit.

At first there was a light agitation for a week but nothing terrible like I'd had with other drugs. So I stayed with it. I went from 2-3 pills a day to one
pill every few days. Even when I could get it from the pharmacist again, I took it rarely. I began to feel better. It was gradual and I can't say which day I started feeling better. But one day I was walking out of my apartment building in the morning to go to work. It was a pleasant spring day and I realized that for the first time in years I felt this nice sense of peaceful contentment. Over the next few weeks I felt better about dealing with people at work. Even those who I had legitimate issue with it just didn't seem worth focusing on and I greeted them in passing.

I found it easier to find pleasure in social contact. I felt more OK about different aspect of myself and my life. I wasn't "born again" but I was a little
relieved. The ease with which I could approach life was a little life altering after having so long in this really bad place. It just made life a little easier to live.

I had been dependent on ativan for a long time and was sustaining the dependency by taking it more and more.

Nothing else changed in my life to explain this transition. I still get depressed or agitated sometimes but never as long or as intense as it had been for
those years. I might take an ativan every few days. If I feel anxiety I just wait it out and it usually passes within 30 minutes or so. As often as anything now it is caused my sugars being off(diabetes). It is bearable now.

So this was my story. I am not fixed. Maybe there is something in it for you but please don't put too much into it or try to find an unhealthy parallel in your own life. Just be aware. Your story is different from mine. See your doctor if you have questions or thoughts about your meds. It took me a lot of years and a simple accident to discover it.

Whatever your story is I hope you can find some type of peace and happiness to live by.


FYI: I still take my other meds but tried this path because the drug was "as needed".

 

[Retired]

I went from 2-3 pills a day to one pill every few days.

What dose was the 2-3 tablets / per day? Was this what you described as "as needed"?

I might take an ativan every few days

What dose are you taking "as needed"?

If I feel anxiety I just wait it out and it usually passes within 30 minutes or so.

It sounds like you have learned an important cognitive skill to manage your anxiety by recognizing the symptoms and using coping strategies until the anxiety subsides. Doing this would certainly reduce your need to use Ativan as the catalyst to calm your anxiety...Good Job!

 

[bloodwood]

Hi Steve,
I like your new picture...or new since I had been here last.

The pills are 1mg and as I say it was PRN - as needed.
There were some days I took none but it usually sat at 1-2 over the years. Then grew.

Part of my point was that with the reduction of ativan and therefore reduction of dependency symptoms it became easier to cope with the anxiety or other issues.
I had no clear knowledge that the overuse existed during that period. But the overall benefit since then has been very nice. I had learned coping over time but the difficulty of the dependency overwhelmed and negated some of that coping skill. Once the difficulty was removed the coping skills have proven sufficient up to now.

I almost fear to trust this new clarity.

Thanks Steve


Without a doubt the cognitive process and skills are so essential.

 

[Retired]

I like your new picture...or new since I had been here last.

Thanks! I had a tie and jacket on one day, so I took advantage of the opportunity for the pix!

I almost fear to trust this new clarity.

I would see it a reassurance that you've grown and gained valuable insights into how to manage anxiety triggers and symptoms.

My interest in the dosages you were using was to equate it to regular dosing, which is typically 2 - 3 mg per day in divided doses 2-3 times a day. Your PRN usage during the period of most frequent usage was actually equal to continuous treatment, which, on sudden withdrawl, could cause some adverse withdrawl effects, due to Ativan's short (about 12 hours) which may have made you feel a bit drowsy and sluggish.

Now that you have developed strategies to manage your symptoms without the medication, your "clarity" may be the benefit of functioning without a medicated brain, a optimistic sign of recovery and improvement!

 

[bloodwood]

Hi
I understand that I have never exceeded what most would call a therapeutic dosage. My girlfriend was on a dosage of up to 6mg per day at one point.
I also understand that different people have different levels of drug response. I had a friend who was a big guy and one tylenol sent him loopy.

All I can guess is that it was the long term use (5-6 years) that got to me. The lady I spoke to who studied ativan said they found it stayed and built up in the system for a surprising long time, though it had a short effect period. The period I spent tapering off the drug was about two weeks. So there was really no profound withdrawal event for me luckily.

I am not qualified to explain the pharmaceutical aspects of what happened. All I can only say is that reduction had a very good effect and in hindsight I was able to see how long those affects had been in my life. I wish I had known more about this sooner. I wish I could understand more about what exactly happened. The sites I visit so far about ativan tend to be highly technical and beyond my understanding in may cases.

 

[Retired]

they found it stayed and built up in the system for a surprising long time,

I don't believe that conclusion is consistent with the pharmacodynamics ( the metabolism, absorption and excretion) of lorazepam (Ativan).

The statement would be correct for other benzodiazepines such as diazepam (Valium) and especially chlordiazepoxide (Librium) both of which have very long metabolic half lifes, and because of their active metabolites (36 to 200 hours), accumulate with the active drug and in people with compromised metabolism, causes serious side effects. Additionally many if not most other benzodiazepines have drug / drug interaction potential that can adversely affect the effectiveness and toxicity of other medications.

Ativan (lozazepam) is unique in that it is relatively short acting (12 15 hour half life), with no active metabolites and no potential for drug interaction because it is not metabolized using the same liver enzyme used by drugs that do interact with other compounds (cytochrome p450).

The result is that Ativan does not accumulate like the others, is a clean metabololizer, and reaches a steady state in about three days, which on discontinuation is the reason it must be tapered, because rapid steady state at the start can cause withdrawl reactions on termination if the medication is not tapered.

These are the technical reasons Ativan is so widely used, and when used judiciously, is effective and well tolerated.

Psychological habituation may be what people are concerned about rather than actual addiction, which is another mechanism altogether. When these concerns are expressed in connection to benzodiazepines, high dose and long duration of use at high dose are usually associated with habituation.

 

[bloodwood]

Hi Steve
Thanks for responding.

As I said earlier I truly am not qualified to engage or respond much to your comments on the drug's lifecycle. I know what I have read on sites that are supposed to be qualified. Pharmacists have mentioned this and doctors have mention the risks to me. I can not debate the things you are saying or explain why they don't match my understanding. One article I read this morning about the risks with ativan said it has a sustained presence.

I also know that you are not without your knowledge and understanding and I know the knowledge you offer on the forum.

Based on what happened the only cause that seemed to fit is the removal(almost) of ativan.
I looked at whether the coming of spring and more sunshine made the difference but during this period there were 3-4 springs and none had this affect. I looked at whether some emotional or cognitive process occurred to make me feel significantly better. I can not come up with one at this point but that may not mean anything . the one thing I changed was the ativan and that matches my understanding but, Steve, I can not explain the chemistry of it.

I would like to know what happened and why it happened. I see so much information on the risks of ativan over long term use. I know that my worse period was for a month or two when I was up to at least 3mg. My girlfriend's doctor is trying to get her off of it for fear of her state.

I read what you say and I understand it but I really have no response for why other sources don't agree and I'm not the one to say why. I see different informed sources disagreeing on a topic that I have a layman's understanding of and I'm stumped.

Peter

 

[amazingmouse]

One thing you might want to consider is to change your Medical Doctor. They should have known better about your situation. It is the responsibility of such professionals to prevent people from having to rationalize random information from all legitimate and not so legitimate sources on the net. Nothing wrong in getting informed, it is just that the availability of so much information creates even more confusion about clinical situations and therefore professional advice is needed in my opinion.
In this country, the quality of medical services seems to be insufficient to manage the needs of the population. I myself am seeing a US Doctor for something when I travel, not eager to make an appointment with my current family physician. It is just a waste of time and taxpayer's money around 95 % of the appointments in my case and in my opinion (sorry Universal Healthcare fans).
I want to pay a few hundred dollars to see a professional who can address all my concerns, versus waste my time to go on 10 appointments with 2 hrs waiting period each to have this precious 2 minutes useless conversation that sends me out of the door before having a chance to say "Good Bye".

 

[bloodwood]

Hi amazingmouse
There is something to what you say. I have to carry part of the blame in not pushing it enough with her (my doctor). I am guilty of not using my professionals as I should.

In hindsight I know I should have made more of an issue of these concerns. I will pursue her or another. I'm not sure where you are but in Ottawa a family doctor can be difficult to find.

Thank you.

 

[David Baxter PhD]

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