Benzos Ativan Question

[LynnD]

I have been taking benzodiazepines frequently until two weeks ago; I stopped on November 24, 2017 (The benzodiazepines I would take are Clonazepam and sometimes Ativan - I would never take both the same day; I took Clonazepam because I have severe social anxiety due to being bullied/harassed all of my life, I stopped taking Clonazepam three weeks ago because I didn't like some of the side effects - I found it was making me gain weight even though I exercised and ate the same foods I always ate and it also caused me to have bad acne even though I take care of my skin - very few people gain weight or have bad acne because of it; when I mentioned this to my doctor he said it can happen and agreed that I could stop the drug - I'm already on anti-seizure medication due to epilepsy so there is no risk of me having a seizure when I quit cold turkey).

That day, I took 6 mg of Ativan (my normal dose for Ativan is usually 6 mg) because of some really bad things that happened that day - I ended up going to my doctor and getting a prescription for Ativan because something horrible happened that morning, which resulted in me feeling extremely anxious and I was crying (side note: my doctor is aware that I take 6 mg, he prescribes 2 mg pills and I take three of them - my body has always had a natural tolerance to benzodiazepines, even before I started taking them; I used to take 3 mg of Ativan in 2008; in 2009 I went up to 5 mg, after that year it became 6 mg since I started taking them once a week due to some very stressful issues going on at the time). The 6 mg sort of worked; I had eaten food fourteen hours prior to taking the pills but drank Blueberry Juice four hours before I took the pills; I find that if I eat or drink anything even a few hours (less than 10 hours) before I take the pills, they don't work or barely work, even if they are sublingual.

I have decided to only take 4 mg for an appointment I have on December 14, 2017. In the past, I would go one month without taking the pills and would take 6 mg but fall asleep. I also tried 5.5 mg after 27 days but I appeared to be really "stoned", according to a family member (that is not what I wanted to happen - I don't take these pills in order to get stoned!). I tried 4.5 mg on June 13, 2017 after abstaining for 13 days and the pills worked a little; I fell asleep before the appointment but woke up in time so I could get to the appointment - I find that for some reason if I fall asleep after I take the pills then wake up, even if it's just a half hour later, the pills aren't working at all and it's like I never took anything.

Since I am abstaining from taking any Ativan for 19 days (the last time I took anything was November 24, 2017 and I will be taking 4 mg on December 14, 2017) I am wondering if anyone thinks the pills will work. I know that nobody can really answer that question for me but I am wondering if anyone has done something like this before (abstained for almost three weeks and then taken a lower dose of a benzodiazepine) and if they found the lower dose worked OR if, from what I mentioned about 4.5 mg making me fall asleep after I took it (because I abstained for 13 days), the 4 mg will work (because it's a lower dose and I will not fall asleep this time - my mistake the last time was getting back in bed to watch TV after I took the pills). I only have two 2 mg pills left (making 4 mg); I don't want to appear "stoned" and/or not be able to do other things I want to do after the appointment.



Another note: I know I said this before but I will say it again: I used to take benzodiazepines once or twice a week - when I was on Clonazepam I would take 2 mg if I had to go anywhere that made me feel anxious because of social situations; my doctor wanted me taking Clonazepam for social anxiety and the fact that I suffer from Complex Post-Traumatic Stress Disorder due to being bullied all of my life (and I still am bullied). When I would take Ativan, it would be for medical appointments - my doctor didn't want me to take Clonazepam for a dentist appointment or any other type of medical appointment, yet he wanted me to take it because of social anxiety and Complex Post-Traumatic Stress Disorder. They have a cross-tolerance so the Ativan didn't work very well, that's why, when I went to my doctor after something horrible happened November 24, 2017 (not because of the Clonazepam) I told him I wasn't taking Clonazepam anymore; he decided to prescribe Ativan because of the panic attacks I was having (not from withdrawal - the only withdrawal symptom I had was insomnia) and for the dental appointment I would have this month.

 

[Bananananas]

Have you considered asking your doctor for a different benzodiapine? Possibly Xanax or valium? I hate to hear that your being bullied, that's horrible and no one should have to endure that kind of abuse. PTSD ( I have it though for a different reason) is tough to treat. But a different benzo may help, I personally take Clonazepam for my PTSD and trauma issues, but have found that Ativan is not the greatest for me. I hope this helps, and I hope you get more support. Ill also add that I understand not wanting to feel stoned but wanting relief.

 

[LynnD]

Thanks; unfortunately I can't take Xanax or Valium. Xanax made me throw up and Valium gave me a headache and I became freezing cold, even though it was summer.

 

[aihfl]

Lay off of them as often as you can and you should be fine. Tolerance has the potential to build pretty quickly. Just try to use them as sparingly as possible. I also take Ativan. My doc said Xanax was out of the question given my history of alcoholism. I keep a stash I try to exclusively keep for alcohol withdrawals so I can self detox when I go on a bender. I've been in enough detox centers I know the drill and am confident to ride it out at home. Ativan/clonidine/propranolol and I'm good to go after a couple of days.

 

[LynnD]

Thanks; I have been staying away from them for a while now. My question wasn't answered so I'll ask it again: If I abstain from taking any Ativan (or any other benzodiazepine) for 19 days (close to three weeks) and then take the pills after 19 days, will the pills work? And will they work at a lower dose? In the past, when I would abstain for anywhere from 13 days to one month, I would take the dose I normally take 6 mg (once it was 5.5 mg and another time it was 4.5 mg) the pills would knock me out. So, given that fact, do you think that 4 mg might work? I know nobody is a doctor or pharmacist and I am only asking for opinions.

 

[tacodude]

No can say how much it will affect you, but your tolerance will definitely be deceased

 

[LynnD]

Thank you; I wasn't sure and I am hoping it will at least relax me - I don't want to be fucked up or stoned, I just don't want to be anxious.

 

[aihfl]

Start with a low dose, I would suggest 2-3mg given your past dosing, give it time to kick in (up to half an hour), and if you need more, then take it. You can't untake a dose but you can always take more.

 

[Jabberwocky]

What other treatments have you tried in conjunction with the pharmacotherapy OP?

CBT, DBT and other forms of therapy can be really useful adjuncts when trying to work with and overcome anxiety and social phobia issues. Same with MBSR (obviously I'm a big fan of MBSR, but different things work for different people and I try to respect that). Sounds like you'd benefit from working with someone who has a trauma informed practice regardless of the modality you choose to engage with.

Basically I'm suggesting you explore ALL your options. Pharmacotherapies are generally far more effective when combined with some kind of cognitive, behavioral, psychological, relational and/or emotional work. Together they're far more effective for those in need than they are alone.

 

[LynnD]

Start with a low dose, I would suggest 2-3mg given your past dosing, give it time to kick in (up to half an hour), and if you need more, then take it. You can't untake a dose but you can always take more.

As stated in my original post, I used to take 3 mg in 2008 but ended up increasing in 2009 due to the frequent times I took the pills (not for abuse). I have always found that less than 3 mg doesn't work; I tried 3 mg a couple of times and it didn't work. I am hoping that 4 mg will work, I only have the 4 mg left.

 

[LynnD]

I've tried CBT and other forms of therapy but have found all to be ineffective; unfortunately, where I live, the psychologists and psychiatrists don't really care about the patients - I am in Newfoundland and everyone has a MCP (Medical Coverage Plan) card that we present to each appointment, so we don't have to pay. The doctors don't try to help you with CBT or other therapies; if you don't understand an aspect, instead of helping you understand, they abandon you. To them, as long as you show up for the appointment, present your MCP Card and are called in, they can say "I can't help you" if you don't understand what they mean when they explain something (and I do try to understand what they're saying), since they will be paid if they record your MCP Card Number and the time you showed up - they just have to send this in to government to be paid. I guess that's what you get when you have free health care in Canada - you're lucky if the doctors care about the patients; a lot of the time, the only thing they really care about is the money they will be paid for seeing you.

 

[Lorne???]

Yes, it will lower your tolerance and be much more effective;

On a side note, Xanax(alprazolam) didn't make you puke; you got unlucky.

I would try a REASONABLE dose of alprazolam, with say, 25-50mg hydroxyine(or promethazine, though hydroxyine can potentiate benzo', and has no anti-cholingergic effects.

Clonazepam and alprazolam are a good combo for severe anxiety/PTSD

Anyway, don't wanna load you up, just giving advice/info