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Benzos lorazepam (Ativan) seems much 'harder to handle' than other benzos

Interesting. It shows how our brains react to substances differently. I've been prescribed Ativan for well over a decade now. I generally take 1mg twice a week. I only go up to 2mg if I have to drive on the highway or over a bridge. For me, it's far more effective for my panic disorder with agoraphobia than xanax. I've had xanax in the past and while it works for my anxiety it wasn't as effective for the agoraphobia component. I also don't like how short acting xanax is. Ativan will cover me for a good 6 hours, xanax for maybe 3 hours.
 
Most of those conversion charts are dose per 24 hours.

The original was taken from the Ashton Manual.

I noted that Dr. Heather Ashton had failed to mention that clobazam is not cross-tolerant with other benzodiazepines so I wrote a very polite, very tentitive E-mail with many references. The response was terse to the point of 'damn you for making me do more work after complaining that she had retired.

To her credit, she cleardly DID either modify it herself of pass it on to whomever was responsible for maintaining the manual.

Clobazam was simply omitted.
 
^ I had heard she was not the most pleasant to communicate with. Especially regarding any updates on her work. That sucks she is like that.

Lorazepam has a longer halflife than alprazolam so shouldn't that skew things towards lorazepams potency? Or am I being dyslexic again....

Omitted is kinda better than nothing but that is a crappy attitude to have. a real "I wrote the book on this dont you tell me" type --- yea yea but you still a fallible human and the inability to accept new information is not a great look.
 
Interesting. It shows how our brains react to substances differently. I've been prescribed Ativan for well over a decade now. I generally take 1mg twice a week. I only go up to 2mg if I have to drive on the highway or over a bridge. For me, it's far more effective for my panic disorder with agoraphobia than xanax. I've had xanax in the past and while it works for my anxiety it wasn't as effective for the agoraphobia component. I also don't like how short acting xanax is. Ativan will cover me for a good 6 hours, xanax for maybe 3 hours.
I have Clonazepam prescribed for the same reasons and I much prefer it over Xanax. Ativan is nice but it knocks me out with any dose above 2mg.
 
@notsmokeymcpot42088 - As I stated, all of those conversion charts I've seen are based on equipotency over 24 hours. Even then, it's generally only when a patient has been given one benzodiazepine for a while so that a steady plasma level has been reached. Even if a drug has a half-life of 12 hours, it will still slowly accumulate for weeks if taken daily.

Obviously ROA makes a huge difference and I'm not entirely convinced that plasma levels are an accurate guide. I think all benzodiazepines tend to concentrate in the brain, are then redistributed to all fatty tissue within the body and are sometimes metabolised (some having active metabolites) before final excretion. So the duration of action and plasma half-life can differ a lot.

Don't forget that 1,4-benzodiazepines all potentially bind to four receptor subtypes - a1,a3,a4 and a5 and the subjective effects differ depending on which one(s) they fabour. Nitrobenzodiazepines mostly demonstrate high affinity for the a1 subunit (as do the Z-drugs) so subjectively, most people consider them more potent.

Most people I've met consider 5mg of nitrazepam as potent as 10mg of diazepam. Now long ago I recgonized that ANYTHING that targets the a1 subunit screwed with my judgement so I avoid them even at low doses. But given just how complex their action and how each person's subjective effects will differ, I've always been suspicious of a table being of much value. I mean, if a patient/client has been taking 100mg of temazepam/day for months, yes, obviously I would use the table for a rough guide but RESPONSE would be of more value in that situation.

It can take a LONG time for a client to detoxify from a benzodiazepine and then all benzodiazepines seem to produce a 'kindling' effect i.e. even after years, brain-chemistry remains altered so in some people dependence returns pretty fast. Or, possibly, tolernce never truly disappears so the person who restarts using benzodiazepines goes back to the higher doses they used to get the sought subjective effects.

Whatever the case - a person who has been dependant on a bendoziazepine (even when legitimately prescribed) is at a higher risk of becomeing dependent again.

To be fair, they are a lot safer than the drugs they replace but equally, we are now discovering that after about 8 weeks, some people might never be able to safely detoxify and as I've said, benzos are MOST dangerous when a dependent user suddently has no access to them. That's when fatal seizures DO occur.

I think that's one aspect of the 'mystery powder game' most users don't consider.
 
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