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Ativan


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#1 lordrobin

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Posted 22 October 2010 - 03:28 AM

I was just wondering if anyone could share some success stories, or the opposite, of Ativan treatment?
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Meds I've had experience with: Abilify, Seroquel, Zyprexa, Geodon,Risperdal, Zoloft, Paxil, Effexor Xr, Prozac, Celexa, Cymbalta, Klonopin, Xanax, Adderall XR, Concerta, Provigil, Buspar, Welbutrin XL, Symbyax ,Depakote ER, Ativan.




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#2 notfred

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Posted 22 October 2010 - 07:09 AM

I was just wondering if anyone could share some success stories, or the opposite, of Ativan treatment?



Look around the benzo section as this question gets asked again and again, so there are lots of good threads on Ativan and peoples experiences.
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Dx: Major Depressive Disorder, Attention Deficit Disorder PI, Refractory Insomnia, CSA, Temporal Lobe Epilepsy, Dyspraxia, Tremor
Psyc meds: Aplenzin 522 mg, Abilify 15 mg, Vyvanse 70 mg, Lunesta 6 mg, Levetiracetam 2000 mg, Propranolol ER 60 mg
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#3 Suboxer

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Posted 23 October 2010 - 02:47 AM

It's worked very well for me, both for breakthrough anxiety and as by far the best treatment for refractory insomnia.

No negative side-effects: it's much cleaner than Klonopin, according to many people on here, and less likely to cause emotional issues. I've never had a problem with grogginess, ataxia, amnesia, etc., but nor have I with any other benzos, even Dalmane.

However, it is not nearly as effective as a mood-stabiliser as Klonopin, both due to a shorter duration of action - Ativan seems to last for about 6 to 8 hours, but I use it on a PRN basis and not frequently - and Klonopin lasts for about 12, with residual effects as long as 18 to 20 hours - and intrinsic effects.

Ativan is much more sedative and more effective for insomnia, even in 2mg doses with a tolerance to 6mg of Klonopin a day - it hits the α1 subunit much harder, or so it seems. Klonopin is hardly sedating in the least after the first week or two.

If you use Ativan only for anxiety, and consistently, I can see breakthrough anxiety and interdose withdrawal being a problem; Klonopin often allows for once or twice-daily dosing, compared to the four-times-daily dosing often needed with Ativan, leading to clock-watching and drug craving. If you need a daily benzo, talk to your doctor about Klonopin, as it lasts longer and thereby maintains a more steady blood level, acting as a prophylactic against anxiety and panic, instead of being used to treat them once they have manifested. For this reason, I also believe Ativan is more psychologically addictive than Klonopin (but not nearly as much as Xanax).

Note: contrary to popular opinion, even though Valium has an extraordinarily long elimination half-life, the actual duration of action is very short, around 2 hours; much shorter than Ativan, Klonopin, or Xanax, because it redistributes quickly out of the vascular compartment in to adipose tissue.

If you need a benzo on a PRN basis, or for short-term use, for occasional bouts of panic or insomnia, but don't require a daily treatment, Ativan, in my opinion, is the best option, far better than Xanax.
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Dx: (currently under revision) schizoaffective disorder - bipolar type, GAD, PD w/o agoraphobia, opioid dependency, PTSD, HPPD, temporal lobe epilepsy, refractory insomnia, paranoid personality disorder.

Medical might cost $600 a month, but pays for $5k in treatment. Try getting "Batshit crazy - with a heroin addiction" covered as a pre-existing condition.

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Anxiolytics: lorazepam 2-4mg PRN; clonazepam 2mg TID; pregabalin 300mg TID
Mood-stabilizers/anti-epileptics: sodium valproate 500mg BID; lamotrigine 150mg BID
Neuroleptic(s): quetiapine 200mg BID
Addiction management: buprenorphine 8mg BID; 60mg baclofen QID; 1 Camel Wide cigarette q30m
Sedative-hypnotics: estazolam 4mg or flurazepam 60mg or lorazepam 2-4mg QHS

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#4 lordrobin

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Posted 25 October 2010 - 04:05 PM

It's worked very well for me, both for breakthrough anxiety and as by far the best treatment for refractory insomnia.

No negative side-effects: it's much cleaner than Klonopin, according to many people on here, and less likely to cause emotional issues. I've never had a problem with grogginess, ataxia, amnesia, etc., but nor have I with any other benzos, even Dalmane.

However, it is not nearly as effective as a mood-stabiliser as Klonopin, both due to a shorter duration of action - Ativan seems to last for about 6 to 8 hours, but I use it on a PRN basis and not frequently - and Klonopin lasts for about 12, with residual effects as long as 18 to 20 hours - and intrinsic effects.

Ativan is much more sedative and more effective for insomnia, even in 2mg doses with a tolerance to 6mg of Klonopin a day - it hits the α1 subunit much harder, or so it seems. Klonopin is hardly sedating in the least after the first week or two.

If you use Ativan only for anxiety, and consistently, I can see breakthrough anxiety and interdose withdrawal being a problem; Klonopin often allows for once or twice-daily dosing, compared to the four-times-daily dosing often needed with Ativan, leading to clock-watching and drug craving. If you need a daily benzo, talk to your doctor about Klonopin, as it lasts longer and thereby maintains a more steady blood level, acting as a prophylactic against anxiety and panic, instead of being used to treat them once they have manifested. For this reason, I also believe Ativan is more psychologically addictive than Klonopin (but not nearly as much as Xanax).

Note: contrary to popular opinion, even though Valium has an extraordinarily long elimination half-life, the actual duration of action is very short, around 2 hours; much shorter than Ativan, Klonopin, or Xanax, because it redistributes quickly out of the vascular compartment in to adipose tissue.

If you need a benzo on a PRN basis, or for short-term use, for occasional bouts of panic or insomnia, but don't require a daily treatment, Ativan, in my opinion, is the best option, far better than Xanax.

THanks for the info. I'm sticking to the 0.5mg Klonopin bid or prn script I just got. Although I ahven't taken it for a year I found I had needed in the past anyway between 2 and 3mg for total anxiety and panic control
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Meds I've had experience with: Abilify, Seroquel, Zyprexa, Geodon,Risperdal, Zoloft, Paxil, Effexor Xr, Prozac, Celexa, Cymbalta, Klonopin, Xanax, Adderall XR, Concerta, Provigil, Buspar, Welbutrin XL, Symbyax ,Depakote ER, Ativan.




Feel free to ask me how I liked each and how they worked for me!

#5 Suboxer

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Posted 28 October 2010 - 05:16 AM



Note: contrary to popular opinion, even though Valium has an extraordinarily long elimination half-life, the actual duration of action is very short, around 2 hours; much shorter than Ativan, Klonopin, or Xanax, because it redistributes quickly out of the vascular compartment in to adipose tissue.


Not if you are skinny. Not if you take it daily either. It takes nearly a week to load on diazepam/Valium and once loaded the balance between free and fat bound diazepam leaves that long half life on your side. There is a significant difference between single dose kinematics and regular dosing.

Also, all these times listed seem to map to the benzo-buzz and not the the anxiolitic effect which is much subtler in feeling than the sedative effects.


You are correct in people with low body fat, and partially correct, depending on circumstances, with chronic administation; a significantly overweight individual will experience much less benefit even after drug levels have become constant. Valium also has an extremely large range of half-lives and plasma concentrations depending on many variables, some of which have been mentioned. In general, the smaller the delta between the shortest and longest half-life, the more consistent the drug behaves in different individuals. For younger people, on non-enzyme-inhibiting or inducing drugs, a benzodiazepine with a half-life of 36-200 hours (desmethyldiazepam), or 40-250 (flurazepam's active metabolite), will typically have a half-life of around 50 hours and 70 hours respectively. Half-lives are longer in females by around 15-20%. The 200-250 hour upper limit generally only applies in people with liver damage, much older people, or those on enzyme inhibitors.

I wasn't noting the time of the sedative effects, or the "benzo buzz," but quoting figures out of the literature for the duration of anti-epileptic effects, which I believe the be the most reliable indicator of the drug's duration of action, with the least room for subjective interpretation. Drugs that have a relatively constant half-life and stay relatively confined to the vascular compartment are the most predictable, but not necessarily the best for a specific indication. However, outside of muscle issues, I don't believe there is a valid indication for Valium, though some would disagree with me (most Pdocs wouldn't, as evidenced by the fact they no longer prescribe diazepam in the vast majority of circumstances); chlordiazepoxide should be used for taper, as it comes in much smaller equivalent dosages, is roughly 20-25% the strength of Valium, and has the same active metabolites (mainly DMD, with some oxazepam and temazepam), and is not much harder on the liver than Valium or Klonopin (which all three require extensive oxidation, and in the case of Klonopin, reduction as well). For anxiety, Klonopin works better on a chronic basis, and Ativan or Lectopam (or the loath Xanax) better on an acute basis, and for sleep, lorazepam, temazepam, nitrazepam, lormetazepam, estazolam, and flurazepam, or triazolam (or z-drugs in some situations).

The anti-epileptic effect of diazepam lasts for around 45 minutes.
The anti-epileptic effect of lorazepam lasts 6-8 hours.
The anti-epileptic effect of Klonopin lasts 6-16 hours depending on the individual, but is not administered IV and takes quite a while to "kick in" (nitrobenzodiazepines have a huge range of potencies in different individuals; up to a 90% difference in blood plasma concentration).

I find the sedative effect of diazepam to last around an hour, the sedative effect of lorazepam to last about 12, and the sedative effect of clonazepam non-existent (but the anxiolytic effect lasting about 12 hours).
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Dx: (currently under revision) schizoaffective disorder - bipolar type, GAD, PD w/o agoraphobia, opioid dependency, PTSD, HPPD, temporal lobe epilepsy, refractory insomnia, paranoid personality disorder.

Medical might cost $600 a month, but pays for $5k in treatment. Try getting "Batshit crazy - with a heroin addiction" covered as a pre-existing condition.

℞:
Anxiolytics: lorazepam 2-4mg PRN; clonazepam 2mg TID; pregabalin 300mg TID
Mood-stabilizers/anti-epileptics: sodium valproate 500mg BID; lamotrigine 150mg BID
Neuroleptic(s): quetiapine 200mg BID
Addiction management: buprenorphine 8mg BID; 60mg baclofen QID; 1 Camel Wide cigarette q30m
Sedative-hypnotics: estazolam 4mg or flurazepam 60mg or lorazepam 2-4mg QHS

I walk The Path of Bullshit Reduction: join me.

#6 In_Remission_bige1030

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Posted 28 November 2010 - 08:20 PM

I tried Ativan 0.5 mg prn for the occasional panic attack, and that dose wasn't effective. The first time I had 1 mg, administered in the ER for a panic attack, it made me feel incredibly at peace. I never got that feeling again, though.

It was never sedating for me, not even the time I had 3 mg because of elevated blood pressure and tachycardia (turned out it wasn't working because this was due to infection, not panic). I could drive and stay awake. However, whenever I wanted to fall asleep, it made that easier. It just didn't make me feel drowsy whenever I didn't want to be.

I tried it for a while 0.5 mg bid, which made me feel like I was on a fuck-it-all pill. It didn't eliminate the worries, though, just kind of damped them. I didn't have panic attacks during that time, though. Strangely, though, it helped my depression, or at least I felt like it did.

Edited by bige1030, 28 November 2010 - 08:21 PM.


#7 In_Remission_sleeper

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Posted 29 November 2010 - 01:41 AM

ativan keeps you held hostage if you become dependent on it...it's only lasts a few hours. I hate Ativan it's ruined my life but I am doing something about that now,getting off all benzos.


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