Prescribed Ativan for infrequent anxiety, not sure how it will make me feel.

[simple2013]

I travel a lot overseas for work and many times I arrive at my destination in the morning exhausted. Usually that first night I start falling asleep during dinner. When I get to the hotel and lie down i start getting anxious, which makes it impossible to fall asleep. Many times as i doze I startle awake in a panic, which results in a long sleepless night. I've tried everything from Melatonin, to exercise, to, stretching, quiet time before bed, and the result is still the same. The only time I really feel anxiety is when I travel.

I went to see my Dr for a physical and mentioned it to him. He gave me a prescription for 1mg Ativan. I mentioned to him that I really don't like taking pills, (as a child I was prescribed Ritalin and hated the way it made me feel). He told me to try it at home in comfortable surroundings first, maybe even a half a pill if I liked. I suppose my biggest worry is Ativan having an opposite effect on me and causing me to panic or flip out.

Am I over thinking this? I weight 190 pounds, is .5 even going to have an effect on me? The only other pill I've ever taken was Norco after surgery and 7.5 mg was the most I could handle and it took a couple days to get to that point. I did get a shot of valium prior to being put under for the surgery and it made me feel relaxed and totally at ease.

 

[chymist]

If you have no benzodiazepine tolerance whatsoever, Ativan (lorazepam) will make you feel very much like the Valium made you feel. 0.5mg Ativan is considered to be the equivalent of 5mg diazepam, so you can use that to judge. The major difference is that Ativan has a shorter half-life (6-7 hours-ish), and as such, its effects will last much shorter than diazepam.

Taking it prior to going to sleep should be enough to calm your anxiety and induce a hypnotic (sleep-aiding) effect and by the time you wake up, the majority of the drug's effects will have worn off. If 0.5mg doesn't cut it, there's no harm in 1mg (=10mg Valium) considering your build. Smaller doses infrequently are preferable with regards to benzodiazepines. They are useful medications, but tolerance and dependence can become apparent easily if you're not careful.

 

[pasha]

I'd say you're certainly over thinking this. The lorazepam (ativan) will definitely make you feel the exact same way as when you had diazepam (valium) as they're both in the same family. Many people like a low dose lorazepam for performance anxiety (eg. presentations) because it's effects taken that way are for some people, not very pronounced, like causing unwanted sedation, or marked decreased cognition. The lorazepam will definitely rid you of the anxiety that you're feeling and it's usually tolerated extremely well. You will not panic, or flip out.

A lot of travel anxiety stems from homesickness, and the idea of the 'unknown', nonetheless try not make a habit of it and take it as needed as they are dependence and addiction causing drugs. Also I would take your doctors advice on trying it in familiar surroundings at first, to get a gist of how the drug will affect you in terms of sedation. Start low such as the 0.5 milligrams you've set out for yourself, if that dose is sufficient in erasing your anxiety, stick to it.

These drugs are the most effective and negative side-effect free anti-anxiety drugs prescribed today. With benzodiazepines, you can rest assured your anxiety is in good hands.

 

[chymist]

These drugs are the most effective and negative side-effect free anti-anxiety drugs prescribed today.

Are you considering other anxiolytics such as beta blockers (e.g., propanolol) and pregabalin? There are no dependence or tolerance issues with either. The only major difference I can see is that the two mentioned treat generalised anxiety, whereas benzodiazepines treat it in the short term on an as-needed basis.

 

[pasha]

Are you considering other anxiolytics such as beta blockers (e.g., propanolol) and pregabalin? There are no dependence or tolerance issues with either. The only major difference I can see is that the two mentioned treat generalised anxiety, whereas benzodiazepines treat it in the short term on an as-needed basis.

Pregabalin is mostly effective in treating social anxiety in most people, and probably has the fastest rising tolerance of any psychiatric drug today. It also carries the risk of dependence, addiction, and withdrawal. Pregabalin may seem gentle to those who tolerate it, but it has a huge array of side effects, physical, neurological, and psychological. Also a lot of the time its effects are hit or miss.

Propanolol is mostly effective in panic disorder by ridding the user of the physical symptoms of anxiety (eg. stopping norepinephrine release by blocking the PNS). However it fails miserably at treating generalized anxiety disorder and even in panic disorder it's never guaranteed to stop anxiety attacks because it doesn't address the 'core' of anxiety by attaching to affected neurotransmitters.

Diazepam and propranolol in panic disorder and agoraphobia:

The response to diazepam and propranolol hydrochloride was compared in 21 patients who (with one exception) met DSM-III criteria for panic disorder and agoraphobia. Each drug was administered for two weeks in double-blind fashion according to a crossover design. The response to diazepam was significantly superior on all measures. By observer rating, 18 patients showed at least moderate improvement with diazepam compared with seven receiving propranolol. Panic attacks and phobic symptoms responded to diazepam, but not to propranolol.

http://www.ncbi.nlm.nih.gov/pubmed/6367691

This is why benzodiazepines remain the gold standard for all anxiety related disorders.

 

[mrflowers00]

stick .5mg under you tongue until it dissolves then swallow whats left and you should feel calm in about 30 minuets if you don't do the same with the other half a pill

 

[Pagey]

Yeah you're definitely over-thinking it. As others have mentioned, it'll have similar effects to the diazepam (valium) you'd been given. It'll just make you feel nicely calm and relaxaed, I've never heard of benzos making people more anxious (at least not while they were on them -rebound anxiety on the other hand, is common).
Just be sure not to start making excuses to use it when you don't absolutely need to as lots of people get hooked on them

 

[Treefa]

yeah i was on ativan for a while.

Don't try to abuse it, it's not worth a shit in that regard, but can be somewhat usefull for anxiety.

Also don't make a habit out of it like ^ said, alot of people just start popping them all the time, not just when they need them.

 

[pally pete]

This is why benzodiazepines remain the gold standard for all anxiety related disorders.

This so true, Benzodiazepines really do work exeptionally well for Anxiety, yet unfortunately they are extremely addictive and tolerance issues make them something of a double edged sword.

 

[Pagey]

Yup, you've definitely got to be very careful with benzos. I used a muscle relaxant one for a neck injury last year and ended up getting addicted to it and it was absolute hell to get off. It'll work well, don't worry about that, just be careful!

 

[hydroazuanacaine]

you're gonna love it. ativan is peace and comfort. a beautiful prn/take as needed benzo. most similar to and rivaled only by diazepam/valium, which you said you responded well to. it doesn't sound like you are an abuser. if you use this responsibly and only occasionally, it's a wonderful drug.