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.
"You buy the ticket, you take the ride ..." -- HST