dyslexic

6mg Ativan i dont need mood stablizers

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Bipolar 1 never use Antiphychotic meds, or  conventional  mood stabilisers   . first  when lot younger to combat mood ,self medicated with drink, anxiety stopped me getting fat and I cruised mental but loved by the ladies.  I also used Ativan to chill into the space cadet mood , the drink finally put me in hospital with pancreitis  I lost my gall bladder and a ruptured bile tract. Now drink is out and meds are in I moved up a gear with Ativan has my mood stabiliser I has hell with anxiety  to 4mg a day now after 15 years 6mg a day , I also in my plan take 10mg of Lexapro has to combat the depression no manic crisis now just a low lying boring depression that drags on me.  NOW I don't want a lecture on ATIVAN  they have saved more lives than ruined I no I would be dead without them , I have gone up 2 mg in 15 years I don't call that addiction . I cannot stop them though that would kill me , plus I would need a new Benzo anyway. If you  are wired this way you live best you can . I am asking you kind folk of another AD other than LEXAPRO  its not for killing clinical depression lord knows that's a bummer. I am fine with my Ativan they side effects are medium depression ,has it would there slowing my mind so has not to implode,  5MG LEXAPRO is not enough 10m is the limit I can take at 68 in England . I used  fast overnight taper with Sertraline  and when that started to fail then overnight tapper Lexapro , but this golden goose is cooked . any idea,s to prop up my Ativan so it still works but don't bring me down with depression.    many thanks

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If you haven't tried it I would suggest Wellbutrin as it plays fairly well with bipolar depression with less a chance of mania, however I understand that you can't take it for depression in England which is too bad. If you've only tried two SSRI's then that leaves a few more to try or at least a couple of more and then there are Tricyclics which help some and something like Lamictal which works well for bipolar depression though it's approved for mania. I will warn you though that it can be a rocky start up with anxiety and agitation but your Ativan should help you with that. Lithium is a possibility. If you were willing to take an anti-psychotic I would suggest pairing one with your anti-depressant if you don't find one helping sufficiently. Here across the pond, Seroquel and Abilify are approved for depression as an adjunct to an AD and Latuda is a newish AAP that can treat depression as a stand alone treatment-I don't know if you have that in the UK yet. 

 

No preaching about Ativan. I've taken Klonopin at the same dose for years and many on the old forum did well on them long term but there were always people coming along insisting you'll sink into an addicted hell with hellish withdrawals if you use them more than five minutes. I stop Klonopin whenever I want at 1.5mg's without issue and cold turkey but you are on a higher dose of Ativan. I'm good with it though. 

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Dyslexic,

It looks like you have tried sertraline and lexapro and both worked for you for awhile, did not make you manic, but stopped working.  Is that correct? 

Have you tried Citalopram (Celexa)?  Citalopram and Lexapro are two sides of one molecular coin, so to speak.  Lexapro is a "cleaner" version of Citalopram.  But some patients have luck with both because of their similarities.

Another option I might recommend would be lower dose Cymbalta.  It's an SNRI but at lower doses the norepinephrine wouldn't be as potentially agitating as an SSRI like Prozac, which isn't really a good choice for someone with high anxiety. 

I would recommend Effexor, which is another SNRI but for some patients it has a withdrawal syndrome that is fairly awful.  I would also recommend Paxil except for a similar issue when withdrawing.  Paxil is approved for all five types of anxiety disorders and would probably be your most calming SSRI, but it sounds like you have your anxiety well-treated with Ativan and are looking for more pep in your step.  That's why my top recommendations would be trying Citalopram or Cymbalta.

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I would agree with AnnaTroy and try Paxil.  It is the most potent of the SSRIs and the most calming,  at least for me.

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14 hours ago, Val said:

If you haven't tried it I would suggest Wellbutrin as it plays fairly well with bipolar depression with less a chance of mania, however I understand that you can't take it for depression in England which is too bad. If you've only tried two SSRI's then that leaves a few more to try or at least a couple of more and then there are Tricyclics which help some and something like Lamictal which works well for bipolar depression though it's approved for mania. I will warn you though that it can be a rocky start up with anxiety and agitation but your Ativan should help you with that. Lithium is a possibility. If you were willing to take an anti-psychotic I would suggest pairing one with your anti-depressant if you don't find one helping sufficiently. Here across the pond, Seroquel and Abilify are approved for depression as an adjunct to an AD and Latuda is a newish AAP that can treat depression as a stand alone treatment-I don't know if you have that in the UK yet. 

 

No preaching about Ativan. I've taken Klonopin at the same dose for years and many on the old forum did well on them long term but there were always people coming along insisting you'll sink into an addicted hell with hellish withdrawals if you use them more than five minutes. I stop Klonopin whenever I want at 1.5mg's without issue and cold turkey but you are on a higher dose of Ativan. I'm good with it though. 

Wellbutrin you are right it is banned as an AD  in ENGLAND . I am trying to keep well away with the traditional BIPOLAR    meds, has they give you  monster body weight , that was my reason for Ativan has to play the mood stabilizer card.  I have friends die early with heart problems do to weight,  having being introduce by English shrinks to  shed loads of heavy duty meds  thanks 

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Thanks for you replies CITALOPRAM  may be cool, I tried it many years ago but the wife said I was getting a nasty   temper on the med but that could have been down to anything at anytime anyway I came of to keep the peace , the family has put up with a lot from me and my damaged brain most caused by mental hospital shrinks I may add.  PAXIL a SSRI  with a massive weight issue, mostly weight shunned in England a lot for that reason, but never say never. SNRIS Effexor the kiss of death to me . a shrink stopped all my Ativan in 1 and had me up to 300mg  Effexor in 2 weeks . I  overdosed and I think any one would with that detox and start up Effexor being the worse start up med for suicide  . My GP saved my life and overturned the shrink ruling . and had to start me back on 2  30mg   Valium  doses  to stop shakes ,then quickly transferred to 4 mg Ativan has Valium is just a dizzy headache  to me . We all find a Benzo  we like ,and ATIVAN is ENGLAND s  front line BENZO /  I am not looking for a back up to drag me out a deep depression  I am in a lower bracket . I am trying to find a low dose AD  that stops  the procession to clinical, its all about prevention. the ATIVAN does a great job .sleep is not a problem a bipolar nightmare to most. it just has a depressive side at high doses which I can see why,  I don't think I need a large amount of a AD  or it may go the wrong way do you understand me . with the help of fellow sufferers I look after myself shrinks are just pill dispencers and always the wrong ones, my GP   lets me pick any med that in the NHS  bible has he admits I know my own illness a lot better than him.  thanks again

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18 hours ago, Val said:

If you haven't tried it I would suggest Wellbutrin as it plays fairly well with bipolar depression with less a chance of mania, however I understand that you can't take it for depression in England which is too bad. If you've only tried two SSRI's then that leaves a few more to try or at least a couple of more and then there are Tricyclics which help some and something like Lamictal which works well for bipolar depression though it's approved for mania. I will warn you though that it can be a rocky start up with anxiety and agitation but your Ativan should help you with that. Lithium is a possibility. If you were willing to take an anti-psychotic I would suggest pairing one with your anti-depressant if you don't find one helping sufficiently. Here across the pond, Seroquel and Abilify are approved for depression as an adjunct to an AD and Latuda is a newish AAP that can treat depression as a stand alone treatment-I don't know if you have that in the UK yet. 

 

No preaching about Ativan. I've taken Klonopin at the same dose for years and many on the old forum did well on them long term but there were always people coming along insisting you'll sink into an addicted hell with hellish withdrawals if you use them more than five minutes. I stop Klonopin whenever I want at 1.5mg's without issue and cold turkey but you are on a higher dose of Ativan. I'm good with it though. 

VAL  I never heard of AAP  all are meds are generic, has given from the NHS bible all Shrinks and GPS  have to use to save money , my Lexapro is Escitalopram , and Zoloft  is Sertraline  , This in  itself  is a problem, they say generics are the same ( bullshit I say) the Chemist goes for the cheapest  not the best . The price difference from real lexapro to fake is  a lot . They try to get patients  on SERTRALINE   that generic is way way cheaper than Escitalopram   . The hospital shrinks wont give even Escitalopram   only      CITALOPRAM  to save money  . It was the GP that let me have generic LEXAPRO  , The shrinks at the mental hospital saying its just citalopram in a different box , I said cancel my check up hospital  appointments  because if you can blatantly  lying to me face you are (SHIT) . and just the thought of you triggers me . I will use my GP at least he knows my name , I am not a number to him.

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It's good to know some more of the medications you have already tried - that helps us not to suggest them to you.  So you have tried:

1. Effexor (bad)

2. Celexa (bad temper)

3. Lexapro (good)

4. Zoloft (Did it stop working for you?)

5. Paxil is associated with weight gain and not prefered

6. Wellbutrin is banned as an anti-depressant in the UK

I like VAL's idea about adding on an anti-psychotic like Abilify to your Lexapro.  I have been on Effexor XR for many years and it has stopped being very effective but the withdrawal is so horrible for me that my Doctor keeps me on it.  We added in a small dose of Abilify and it lifted my mood very well.  So it could possibly recharge the Lexapro and help it to work again.  Another good option for you would be Lamictal.  It definitely has given me a boost this year and lifted me out of a depression. 

There are also many SSRI's that are newer - I would ask your Doctor if any of the newer SSRI's are good for lifting depression without causing increased anxiety.

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Posted (edited)

ANNATROY    LEAPRO AND ZOLOFT are my 2 main weapons  , they use to last at least a year and when poop out straight tapper overnight to the  other  it worked a great , but the time spans are getting shorter  now so the may both give up .   A lot of meds you quote like Abilify and Lamictal   would need shrink approval  has a GP is only geared to SSRI and SNRI,   shrink  meds are not there field they are GENERAL practioners  like back pain and flu  ect ect.   There is no way I will go back to the mental zoo to ask for anything ,plus I discharged myself last time before they killed me. Very rare you get combo,s   with the NHS  even in mental hospital they will try 1 med , 1 stabiliser  tactic . till the find a med that lets you walk out the door with a goodbye and good luck, total bollocks.  I   have lost to many friends to that hospital 50 year olds turning to heroin has a last hope, and dead within a year. The brit way is drink yourself to death at least you have fun, I tried that  and the end result is below, Pancreitis , gall bladder removal . bile trak reconstruction and 2 hernias , I will try the citalopram whe I slip below my  40% depression level  . England is not geared up for mental health  . you cannot sign your self in a mental unit, it will take a year or 2 of process  . If you went in the waiting  entrance  holding a severed head you may get admitted , 

 

Edited by Velthir
Inappropriate picture.

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I refuse to take benzos because I struggle with addiction to opiates. I know benzos are very different than opiates, but I have an addictive personality so I want to stay away from addictive drugs in general. I believe I am on my way to being stable, at least I hope so. I take 30 mg of Abilify and just added Lamictal, slowly working my way up to 200 mg. Everyone is different, some people don't take meds at all, not even benzos, and they manage just fine. I wish I could do that. Maybe in the future.

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THE people that manage without meds, are not that ill or believe me they would, I managed without meds I drank the photo is just above what happens there after time . BUT yes addictive  personality  is a downer for trying any suspect drug.   I  don't really smoke but can spark up a cigar when I feel like it and never have another for months it was the same with cigs when I drank I would smoke when I wasn't drinking I wasn't smoking. But I was drinking to stun my brain nothing more , I could drink a bottle of vodka in 1 swallow to knock myself out, just to have 1 hour out off this brain numbing depression , when I was told not to drink it never crossed my mind again .   I myself found what works for me enough to let me function, all I needed then was GP that would agree . You wont find many shrinks in ENGLAND that would script 6mg ATIVAN . They don't wont you on any , They were terrified with the patients ATIVAN  law suit   which the patient lost . but it scarred then into not scripting benzos

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7 hours ago, weathergeek95 said:

I refuse to take benzos because I struggle with addiction to opiates. I know benzos are very different than opiates, but I have an addictive personality so I want to stay away from addictive drugs in general. I believe I am on my way to being stable, at least I hope so. I take 30 mg of Abilify and just added Lamictal, slowly working my way up to 200 mg. Everyone is different, some people don't take meds at all, not even benzos, and they manage just fine. I wish I could do that. Maybe in the future.

That's very mature and responsible of you. I'd hate to see you get mixed up in Ativan and risk relapsing on opiates. The risk of respiratory depression is high and so is death.

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9 hours ago, peacelizard said:

That's very mature and responsible of you. I'd hate to see you get mixed up in Ativan and risk relapsing on opiates. The risk of respiratory depression is high and so is death.

Actually the risk of death from benzos is very small.  That is why they are prescribed in place of their predecessors barbiturates.  That is not to say they are not addictive, because certain ones, such as xanax, are addictive.

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YOU are right CRAZY DOG , it hard to overdose on Benzos  ,  IN hospital a lady came in who had taken 40mg of  Ativan has a suicide attempt  . all they did was put her to bed, she slept for 2 day and woke with a screaming headache nothing more , if   she had  taken an overdose of EFFEXOR  she would have had a gut pump and be monitored with blood test , or if taken not found  then she would be DEAD . I would sooner be tolerant to ATIVAN than EFFEXOR  anyday   that is a brutal med to detox if on 400mg or higher . benzos are no worse than ADS IF YOU HAVE BEEN ON BOTH YEARS AND YEARS

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For reference, you don't need to go to a mental health facility to see a psychiatrist, it's entirely possible to see them in a random outpatient clinic/centre. You also have a choice where you're referred, so it's worth trying for a referral again and going somewhere else since psychiatrists are far more equipped to handle complicated cases like bipolar.

GPs can technically prescribe antipsychotics or mood stabilisers, it's just uncommon for them to do so without psychiatrist guidance. However, if you're refusing to see a psychiatrist and they have overturned psychiatrist decisions before then you might be able to get them to prescribe one of the weight neutral mood stabilisers like Abilify (aripiprazole). That would be my first suggestion since you have a bipolar diagnosis and SSRIs are starting to not work for you any more. Either that or lithium/a weight neutral mood stabiliser. Unfortunately improperly treated bipolar tends to get worse over time, so it's really worth trying to get onto a proper mood stabiliser.

If that really isn't an option, you could try Cymbalta (duloxetine) which is normally weight neutral but may cause additional anxiety, especially to start with. Prozac may be also worth trying, it doesn't always cause weight gain. Aside from those, you could try generally weight neutral tricyclics like nortriptyline or lofepramine which a GP can definitely prescribe, especially when you've tried several 'standard' medications. There's also the option of moclobemide (reversible MAOI, very safe) but I do doubt that a GP would prescribe that.

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Posted (edited)

VELTHIR   I live in ENGLAND It don't work like that . first I ask a doctor then I wait maybe a year to see a shrink nurse , who then either puts my name on the list to see a shrink or not depending how she views you, then wait another year   A GP  needs a  shrink  to start a   toxic med route  like poison  LITHIUM  if I had gone on lithium for 40 years my liver would have took some hammer by now, I was on lithium many years ago and CYMBALTA  both never worked for me I am afraid . PROZAC worked after 12 week trial I always go the last mile, it  STOPPED  the day the NHS  went GENERIC  no more real Prozac it cost the NHS 10 times more I crashed and burnt . The shrinks wont treat me till  I come off  6 mg of ATIVAN  . I have very painful memories  of mental hospital  inside and out patient  you don't pick which unit you go , they do and there is only 1 in  my town a multi million clinic with no staff   and are total crap. My friend  next door to my house  went for ECT  and they failed to notice on his records he had a metal plate in his jaw near blew the place up.  He went in for 8 weeks came out worse and his dead now suicide at 44 . I will take my chances with the GP.  MOST  hard core meds you mention  and stabilisers  carry massive weight gain , and a wrong food could Kill you, The side effects are mega  crippling thanks but no thanks, I have push the boarders with my own Benzo intake .I have a life all be it fragile . But I keep the manic phases  low to medium  and I can handle them In fact I can go into extreme happiness  for a time , of course  the lows follow  but  I don't require hospital , that would really put me low . life is  life I am damaged and been through a lot , but I worked// bought up my kids and have a shed load of grandkids who all love me , some normals don't have that 

Edited by dyslexic

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For reference, I'm in England too. My experience has been that as soon as you've got a condition that a GP isn't comfortable treating you can get a referral pretty quickly, especially if you keep pushing the issue. I understand that some areas are worse than others though. 

The ability to choose where you're referred to for mental health stuff has only existed for a year or so since the implementation of the 'NHS 2014/15 Choice Framework', so it might be worth giving it another go and getting a referral to a clinic in another town. 

Regarding weight gain/food interactions: Moclobemide is an MAOI that doesn't interact with food unless you overdose on it, which is why it's considered safe enough for GPs to prescribe under some circumstances from what I can tell. Only one of the three common mood stabilisers tends to cause weight gain and none of them interact with foods. Tegretol (carbamazepine) and Lamictal (lamotrigine) being the ones that don't cause weight gain generally.

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19 hours ago, CrazyDog said:

Actually the risk of death from benzos is very small.  That is why they are prescribed in place of their predecessors barbiturates.  That is not to say they are not addictive, because certain ones, such as xanax, are addictive.

Benzos alone, yes, I agree. I've seen it first-hand where i work. Many times. But when you mix it with virtually anything else, especially a CNS depressant, you're much more likely to OD and die.

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I'm pretty sure benzos have a specific reversal agent In case of od...flumazenil 

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Wow.  A lady came into the hospital and slept for two days after ingesting 40 mgs of Ativan?  I swallowed 60 mgs with a shot or two of Vodka last December during the worst of my winter depression and woke up on schedule, then did a cold-turkey withdrawal from hell over the next week.  I vowed never to take another benzo again.  Why?  Because it wasn't ME that swallowed the 60 mgs - benzos can disinhibit some people and so basically I took what was prescribed for me, but then I wasn't thinking clearly and tipped the whole bottle back in a bit of a haze.  I wasn't suicidal at all.  Very scary stuff.  Benzos are not harmless meds for some people and I currently take gabapentin and it does the trick nicely, thank you very much.  I'm sure in the future we will discover some polymorphism that makes benzos safer for some patients than others.  I became almost an instant addict - that's how much I loved the feeling Ativan gave me of being totally blissed out.

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1 hour ago, annatroy said:

Wow.  A lady came into the hospital and slept for two days after ingesting 40 mgs of Ativan?  I swallowed 60 mgs with a shot or two of Vodka last December during the worst of my winter depression and woke up on schedule, then did a cold-turkey withdrawal from hell over the next week.  I vowed never to take another benzo again.  Why?  Because it wasn't ME that swallowed the 60 mgs - benzos can disinhibit some people and so basically I took what was prescribed for me, but then I wasn't thinking clearly and tipped the whole bottle back in a bit of a haze.  I wasn't suicidal at all.  Very scary stuff.  Benzos are not harmless meds for some people and I currently take gabapentin and it does the trick nicely, thank you very much.  I'm sure in the future we will discover some polymorphism that makes benzos safer for some patients than others.  I became almost an instant addict - that's how much I loved the feeling Ativan gave me of being totally blissed out.

Just an example of what I was talking about.  Benzos normally don't kill people, even when an OD happens.

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Exactly - it's usually a combination of alcohol and benzos.  I'm lucky I only took a shot or two of Vodka.  It's a game of Russian Roulette a patient probably shouldn't play, though.  :$

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Drinking  and  ATIVAN is a favorit with the drug set, you dont get drunk just cool feeling you can drink all night, its on the dangerous drug list  for wrekky drugs now. if caught with them on you or in your car without your script your in trouble. I have a strip of 10 behind my window sun blocker . I will be in trouble if stopped by cops I don't carry my script my wife is in charge of my meds  since my Effexor overdose 10 years ago brought on by a shrink who stopped all ATIVAN and has me on 300mg EFFEXOR within 10days and now you no why I hate shrinks . the only thing that saved me was I drank a bottle of brandy straight back and puked every capsule up without even breaking a Effexor seal . the gods were with me that day, well mabye not I was admitted to the zoo , were they smoked heroin in the cig yard under the noses of the staff , I had no meds only 10mg and still 300mg EFFEXOR .  to sleep the lads on day release smuggled me vodka in evian  water  bottles I spent all day in a walk in shower water freezing to cool my body , I crept  the corridors when every one slept  security didn't give a flying f**k  and 1 Chinese doc for 5 wards at night,   NOW YOU WANT ME to go back to that  I would sooner  kill myself   and the next  mental hospital is Nottingham housing some of the craziest nut on the planet  , no thanks I will work through my own problems  till I carnt any more then I will be off  with the fallen angels . there broken to .

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I just want to say that if the OP is going to have a procedure done where he goes under or into twilight sleep, he needs to tell that anesthesiologist that he's been taking 6 mg of ativan forever. 

He will have a much higher tolerance to sedation than the normal patient of his height and size.

(I woke up during a colonoscopy for specifically this reason. I was like, WTF, and called out "I'm awake!." They quickly put me back under. And I wasn't on anything like 6 mg of ativan. Just 45 mg of temazepam at the time.)

Now, I was around 115 pounds at the time and 5' 4", so they probably thought I needed less than the normal dose.

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I was on 4mg of Ativan when I had a 6 hour op for pancritis   and gall bladder removal . I never woke up but they damaged my bile track   and all gall stones has to be retrieved , put it back like a bent hose pipe. also 2 hernias while under the knife. ( funny story ) I was great on morphine  tttttttttthen the put me on tramadol ????????  big mistake ripped my caffatas out  pulled out my penis drain ,and don't forget there is a inflated balloon on that . and it was still inflated  , stripped and walked down the ward corridor stark naked  , SERATONIN SYNDROME . the wife flipped out and though I would be always like that . next morning could not remember a thing but the walls were still shimmering  . Another hospital blunder NOBODY READS YOUR NOTES . I could write a book on mental and general hospital   , listen to this, a guy came in the main ward from the mental hospital  , he had drank all the hand wash bottles on the beds for the alcohol  in them , next to nothing , he was farting and blowing bubbles all day , we were falling out of bed laughing and some were terminal cancer patients it just goes to show  us Brits have balls B|

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