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How Much Ativan Can I Take While Avoiding Tolerance? Can't Find Answers.

ativan lorazepam tolerance

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#1 Ink


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Posted 02 March 2012 - 05:18 PM

Ativan is the only thing that dramatically helps me with my severe episodes of anxiety and panic. Because of med phobia (so stupid - afraid to use the stuff that'll help with my fear), it took my pdoc years and years of begging me to try a benzo before I finally reached a point of desperation and took 1mg Ativan. It was like magic. Unbelievable relief. In the 3 years since, it has helped me tremendously - allowing me to broaden my world so much. Just knowing I have it to use is of tremendous psychological benefit to me because I know I have a way to break my anxiety before it becomes unrelenting misery, or that I can try something that frightens me because Ativan will help me through it.

So, I worry a lot about over-using it to the point that it won't work for me anymore. This would be really devastating to me. But I can't find any clear info about how much I can use while avoiding tolerance. I typically use 1mg, 1-3 times per week. During a rough period, I may occasionally take 1mg, 5 times in a week. Questions:
  • How much can I use while avoiding any tolerance/reduction in efficacy?
  • If a person does become tolerant, will they eventually lose tolerance or is it permanent?
Thanks y'all.
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#2 VAL


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Posted 03 March 2012 - 07:24 PM

Some people remain on the same dosage of benzo for years and don't develop tolerance. I think it's individual and not something you can get an absolute answer to. As to whether its permanent if you do develop tolerance, my only experience is with the times I've had to use more vicodin and notice an increase in tolerance. I try and go as long as possible without taking it in between the bad times because once I withdraw from it for awhile, my tolerance does seem to go down and the drug returns to being effective at lower dosages. I have no idea if that is relevant to benzo use.

Edited by VAL, 03 March 2012 - 07:24 PM.

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Current Meds: Lamictal 300mg, Wellbutrin XL 450mg, Neurontin 900mg, Klonopin 1.5mg,  Trazodone up to 300mg and Inderal 20mg PRN
Past Meds: Siniquan, Elavil, Imipramine, Zoloft, Seroquel, Abilify, Nardil, Emsam, Rozerem, Celexa and Ambien
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#3 alluraleigh


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Posted 06 March 2012 - 04:16 PM

Ativan really helps me when I'm having an especially bad anxiety attack. I only take 0.5mg when I need it, and it helps with my back pain also. It does not make me too drowsy to function in the day and have found it is really the only medication that helps my anxiety. I did notice that if I took it more than 2-3 times a week and then went a few days without , my body would have some withdrawal symptoms and my anxiety would be worse than ever before. So I decided to try and not take it any more than absolutely necessary, maybe only once week. I did go absolutely crazy, crying, shaking and fearful to leave my house or be alone for the first week I went without it. Trembling and lightheaded for a few more days after that, but now I'm calmer and feel SO much better. I do deep breathing exercises and work on focusing on other things rather than my anxiety. It's not easy, but the Ativan then works better when I actually really do need it and I don't feel my body craves it. Tolerance or addiction builds up rather quickly I found. But that might just be me.
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#4 notfred


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Posted 07 March 2012 - 08:24 AM

If you don't take it every day you will have not problems. Keep in mine tolerance can be a good thing. You get used to the sedating effects but not the anti-anziety effects. Most do not become tolerant to the ant-anxiety effects. I think you can take it every day for a few weeks without problems.
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I am in full remission (DSM IV 296.36) from Depression. Insomnia, ADHD-PI, Epilepsy, and the Pseudoparkinsonian tremor are well controlled.


Psyc Meds: Forfivo XL 450 mg (Wellbutrin XL), Aripiprazole 15 mg (Abilify), Eszopiclone 6 mg (Lunesta), Vyvanse 70 mg (Lisdexamfetamine), Levetiracetam 2,000 mg (Keppra), Propranolol ER 60 mg (Inderal)
PRN: Belsomra 20 mg (Suvorexant)  Clonazepam 1-2 mg (Klonopin), Lorazepam 1-4 mg (Ativan), Alprazolam 1-2 mg (Xanax), Dextroamphetamine 10-40 mg (Dexedrine), Propranolol 20-40 mg (Inderal), Ondansetron 8-16 mg (Zofran)

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Dx: Depression, Insomnia, ADHD-PI, Temporal Lobe Epilepsy, Dyspraxia, Tremor, Iron and Vit. D deficient 

I also take allergy and diabetes + it's complications meds, Truvada, Turmeric 500 mg PRN

All doses are a daily total.

#5 Ink


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Posted 07 March 2012 - 08:54 AM

I did notice that if I took it more than 2-3 times a week and then went a few days without ... Tolerance or addiction builds up rather quickly I found.

This is definitely not the case with me. I document my daily use on a calendar and I've taken it, for example, 4 times a week and then not needed any for 2 weeks and not had any withdrawals at all. So I seem totally able to maintain a 2-3 times a week average. I just wish I knew how much I could take it during rough patches (like right now) without diminishing its efficacy.
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#6 dymphna


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Posted 08 March 2012 - 12:49 AM

Don't confuse tolerance with addiction:

Addiction, Dependence, and Tolerance

it's in the
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#7 malfeasance


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Posted 08 March 2012 - 10:26 PM

I've just been switched from Valium to .5mg Lorazepam b.i.d. to start with for GAD. So, this is a daily thing. People in forums frequently write "If you stick to PRN you'll be okay, but be careful and don't take it everyday or you'll get addicted!" This word 'Addicted' is thrown around a lot with Lorazepam. I've used Benzo's before daily and have had no problem, except with discontinuing - had to go through that discomfort. I am not worried about addiction, at all. That's me, but not a comment about anybody else.

I know people abuse them sometimes, or drink with them. Definitely asking for trouble.

Lorazepam is recommended for GAD 2 to 6 mg a day. The NIH website does say not to take it daily for longer than 4 months, but it doesn't say why. The Official FDA information says: "The effectiveness of Lorazepam tablets in long-term use, that is, more than 4 months, has not been assessed by systematic clinical studies. The physician should periodically reassess the usefulness of the drug for the individual patient."

For dosing, the Official FDA Information says: "The usual range is 2 to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the daily dose may vary from 1 to 10 mg/day. For anxiety, most patients require an initial dose of 2 to 3 mg/day given b.i.d. or t.i.d."

But, in somewhat of a contradiction, it says: "In general, benzodiazepines should be prescribed for short periods only (e.g. 2 to 4 weeks). Extension of the treatment period should not take place without reevaluation of the need for continued therapy. Continuous long-term use of product is not recommended. Withdrawal symptoms (e.g. rebound insomnia) can appear following cessation of recommended doses after as little as one week of therapy. Abrupt discontinuation of product should be avoided and a gradual dosage-tapering schedule followed after extended therapy."

I'm not sure why Benzos are treated so much different than ADs or other medications, except for the abuse potential. Other than that, discontinuation symptoms will have to be endured if one stops an AD, as well as a Benzo, so tapering is essential, and switching to Valium recommended. But Benzos sure have a bad rap, even though millions of people use them successfully.
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#8 Lking4Hlp


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Posted 10 September 2014 - 04:57 AM

If you're only taking 4-5 mg a *week* you're likely not going to develop too much tolerance.  Some people (like me) take 4 mg/day.

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