Hey guys, thanks a lot for all your responses. Using them every day is precisely what I wanna stay away from.
After reading the withdrawal hell some users on Bluelight have gone through I figure its definitely not worth it to use benzo's on a daily basis.
My panic attacks only come once or twice a week, would it be safe to take 1mg lorazepam twice a week when those attacks occur, or would using that amount long-term still produce bad withdrawals??
Hi Fresco... welcome to the horrific world of anxiety. I'd be able to advise you better if I can ask a few questions? May I ask:
1) How old are you
2) How long have you had symptoms of panic attacks?
3) Can you explain what your typical panic attack feels like, with time scales of their effects?
4) Do you get any early warning signals that one is coming on, or are they fairly rapid?
5) Do suffer from nausea/sickness at all?
6) Finally, do you suffer from significant levels of generalised anxiety at all, or is it all just acute attacks?
Whilst Lorazepam/Ativan can be quite good at treating anxiety, all Benzodiazepines do have several *potential* drawbacks. With prolonged use, even if still infrequent such as twice per week, you're at risk of numerous problems:
1) Tolerance - Taking more of the same substance to achieve the same results. This can still be the case if you only take it once per week, prolonged use of Benzo's can result in them losing their efficacy to some degree, though this is very circumstantial. You have to be very wary/alert of this as it's the first sign of a slippery slope to the following situations.
2) Dependence - Thinking Benzodiazepines are a 'cure' for your panic attacks and then becoming either mentally or physically dependant on them by solely relying on them to help. Fortunately, or unfortunately as the case may be, Benzodiazepines are generally very good at treating panic attacks, and there are not many/any other medications currently on the market that are as effective as Benzo's for the acute treatment of panic attacks.
3) Addiction - Something a lot of Benzo users struggle with. You have a life-dictating problem, panic attacks, and are given a magic pill that treats such problem, and often does so very well. Whenever you get a panic attack it becomes all too easy to just pop a pill and feel the problem melt away. It's very easy to get carried away with the effects of Benzo's and start to use them too often, whether intentionally illicitly or not. This may lead to either psychological or physiological addiction, or even both.
4) Withdrawals - Following addiction or dependence you may suffer from withdrawal symptoms that can be
very nasty and also life-threatening if ignored. So naturally you just keep on taking Benzo's to fight off the withdrawal effects and get to a point where you never tackle your problem. This is only going to become a potential problem if you start using them more often than not. A very real problem from those who use Benzo's on a daily basis to treat their Generalised Anxiety Disorder, but not so much for those who suffer from panic attacks and just use them
pro re nata.
That said, please don't be scared. Benzo's can be a very useful tool for treating a very problematic disorder. I've used them on a
pro re nata basis for about 5 years now for my generalised anxiety disorder, and they work
much better than any other medication I've tried. Which is inclusive of a whole variety of SSRIs/SNRIs/TCAs/Pregabalin/Gabapentin & a few other novel medications, and I'm absolutely fine. I've never had a problem with dependence, addiction or withdrawal due to their use.
Just some of my other thoughts:
- You say 'a low dosage' - I don't think 2mg of Lorazepam is a particularly 'low dose' for the treatment of panic attacks. It's roughly the same as 20mg of Diazepam and a lot of patients are prescribed just 5mg Diazepam for the therapeutic relief of panic attacks, so I wouldn't underestimate that dose. But yeah, in comparison to some long term Benzo users, 2mg may not seem much - so I can understand why you may think that.
- Did you doctor explain they wanted to prescribe you Lorazepam in particular? It is very commonly prescribed for the treatment of panic attacks, so I'm not questioning their decision, but when there are dozens of commonly prescribed Benzo's, it's good to understand the doctor's rationale for picking a particular Benzo over all of the others.
- Did you discuss any other medications such as SSRIs/SNRIs/TCAs/Gabapentin/Pregabalin etc... or even something like Beta Blockers? I don't know where your doctor is based, but in the UK, the first medication to prescribe a patient suffering from panic attacks would be a Beta Blocker such as Propranolol or Atenolol.
- Did you discuss Alprazolam/Xanax at all? It does have quite a bad name because it's so often abused in America, but it is incredibly good at treating panic attacks, and that's what it's most prescribed in the treatment for. It's very similar to Lorazepam/Ativan, but it has a rapid onset of action and is shorter lasting, which is why it's often preferred by those suffering from a panic attack. During a panic attack, you're going to want the drug that works the fastest. Lorazepam isn't slow in it's action, but Alprazolam is often prescribed in preference of other Benzo's due to it's rapid onset, which is usually within just 15 minutes, with a 90% peak of effects within just 1 hour.
I've tried the largely majority of the commonly prescribed Benzo's and Lorazepam notably contributed towards the symptoms of my anxiety. There's a newly emerging body of data suggesting that in higher doses (~4mg), Lorazepam is actually a (insert the name of the word that I've forgotten here!) and significantly contributes towards symptoms of anxiety. This was certainly the case for me, and my brief affair with it only lasted for 2 weeks. That's not to say it wont suit you, but I certainly think that when more papers are published evidencing this, it's rate of prescription will swiftly decline over the next ~5 years or so.
