Temazepam dosage increase? Or should I keep the Ativan? What do you think of my meds?

[Lightning-Nl]

I'm prescribed three, very addicting, very psychologically reinforcing, drugs. These drugs are Adderall (Amphetamine), Ativan (Lorazepam), and Restoril (Temazepam).

All of these drugs are prescribed for legitimate reasons. The Adderall is for ADHD, and lack of energy during the day, the Ativan for sudden and extreme episodes of anxiety, and the Temazepam for insomnia associated with what is probably Restless Leg Syndrome (which would make sense since ADHD and RLS are comorbid 29% of the time). Also, according to my family members - I consistently talk loudly, and "act out" dreams while I'm laying in bed asleep - so I may also have some sort of REM sleep disorder.

Anyways, I'm making this thread because I want input on wha other people think about my med regiment. For full details, you can look at my profile. Specifically, I want input on how sustainable this med regiment will be in the longer-term (meaning a couple years), what issues I may have to face, and if I should be a different med regiment.

I'm prescribed 40 milligrams of the Adderall per day. Lately, I've been using all 40 milligrams per day, but when I was working (and I got another job so I'll be working here again shortly) I was only taking up to 20 milligrams a day. Also, I usually take my Adderall in the evening. Lately, with the first dose (10-15 milligrams) being anywhere from 1-4 PM. The next dosage is almost always 25 milligrams, plugged, anywhere between 6:30-9:30 PM. Sometimes even as late as 11:00PM (but that's rare.) Then the last dose (5 milligrams) usually being around 2 hours later.

The Temazepam I take whenever I go to bed. Sometimes early at 1:00AM or late at 5:00AM. My prescribed dose is 30 milligrams. It's a very effective treatment for my RLS, but once it wares off - I experience pretty bad rebound pain. It's also effective at reducing my sleep talking and movements (from what I've been told) and it keeps me asleep anywhere from 5-8 hours. Usually I wake up after 6 hours though. I honestly thought I was going to have even worse addiction issues with Temazepam, then Ambien.

When I was on Ambien - I was taking handfuls of the stuff and my use of it was quickly spiraling out of control. I was up to 90 milligrams a day when I had to cold-turkey it. Then I was off all benzo's/zdrugs for a couple months (which was hell). Anyways, I promised myself that I'd never do that again - and when I saw my doctor 2 months after that short lived addiction, I made no mention of it to him. I just told him that Ambien had become ineffective for me, so we should attempt to try something else. Since I've literally tried everything else - he decide to put me on Temazepam. I thought, for sure, that I was going to be unable to control my use of it - but... I'm doing pretty damn good if I do say so myself.

I've really buckeled down and kept myself from taking more Temazepam than I'm supposed to. I've stuck to the 30 milligrams I'm supposed to be prescribed, and I've only taken double doses of it twice. Part of the reason for that, is due to the fact that I'm supplement additional Temazepam with some Lorazepam...

I'm prescribed Ativan 1 milligram (Lorazepam) for panic attacks and I can take it up to 3 times a day if I need to. Because of this - I get 90 of them every month. Since starting the Temazepam - I haven needed them at all, so I've stopped taking them. Only problem is, I've been taking 1 milligram of Lorazepam on top of the Temazepam every night. Because I take the Temazepam an two hours or so before I go to bed, I need to Ativan to give an additional "kick" to be able to fall asleep easily.

I'm wondering a couple things. My doctor said that if 30 milligrams didn't work that he would be willing to go above the FDA recommendation to 45 milligrams a night. Should I do tha instead of taking the Ativan? But what if I start abusing the Temazepam? I don't think I will, but what if?

Also, what will stop me from then taking the Lorazepam on top of that Temazepam anyways?

Anyways, I'm just curios on what you guys think. Thanks for the input!

SwampFox

 

[TheLostBoys]

3 MG's of Ativan a day is a lot IMO......Temazepam is great for sleep & is needed for your condition.

I would cut the Ativan in half & take 1/2 mg at a time as needed & save the rest, you never know when you will need them.

I always take less than what I'm prescribed.

As long as you feel comfortable with what you're taking, all is good.

 

[Psychonauticunt]

Hypnotic tolerance becomes a bitch very quickly with regular use so I'd try to maybe take 2-3 days a week when you don't take any temazepam, even if you don't sleep so well (or at all) that night. 3mg Ativan is not THAT much unless you take that amount every day. I've been on 1-3mg Ativan per day and could function fine, go to university etc. But often I would only have to take 1,5-2mg. In any case, anxiolytics are generally indicated for daily use but hypnotics are not, or if so, for the VERY short term. Also, the temazepam will be kicking up your benzo tolerance as well, so when you're taking temazepam only 4-5 nights a week you may find you have to take less Ativan for equivalent relief.

Also note that both are intermediate-acting benzos with relatively balanced effects profiles (temazepam is a hypnotic but is also a decent anxiolytic, muscle relaxant; lorazepam is potent in all effects essentially) - unless you taper carefully you are in for a HELL of a withdrawal. Lorazepam on its own has been the nastiest drug in terms of producing withdrawals I have ever tried.

 

[JarBag]

I HAVE THOSE SCRIPTS TOO. GET THE TEMAZEPAM UPGRADE. IT'S THE GREATEST. Depends on ROA too.. there's one ROA that will probably give you a high like no other, depending on if it's cap or pill doe. I'd say it's the most addicting benzo... especially best on roa.... it can make an ice comedown nihl

Sorry for the sloppy post, currently on 60mg temazepam.

 

[bunge]

Temazepam is known to have a nasty withdrawal (even for a benzo) and tolerence will build quick.
I would personally take any other benzo or z-drug over temazepam.

Tbh, all your meds are pretty hardcore from a WD and addiction PoV. I hope your doctors not nearing retirement because you might struggle to find another doc who will prescribe li kj e that.

 

[Lightning-Nl]

Temazepam is known to have a nasty withdrawal (even for a benzo) and tolerence will build quick.
I would personally take any other benzo or z-drug over temazepam.

Tbh, all your meds are pretty hardcore from a WD and addiction PoV. I hope your doctors not nearing retirement because you might struggle to find another doc who will prescribe li kj e that.

Well it's working atm. I should mention, actually, that the Temazepam is mainly to stop my incredibly severe RLS. I would just use Benadryl, or the first-line treatments for insomnia like Trazodone, or what not - but they actually make my RLS much worse. I feel incredibly tired, but the RLS keeps me up, so they're paradoxical in that sense.

With Temazepam (at 30 milligrams) it acts as an excellent muscle relaxant, plus it makes me very sedated and sleepy. Not agitated, yet sleepy - like all of the antimonoaminergic drugs do. But rather, relaxed and sleepy. That, unfortunately, usually isnt enough to put me to sleep though. So every night, I take 25 milligrams of Benadryl on top of that. That makes me tired, and keeps me asleep for at least 6 hours. The Temazepam then stops the restlessness associated with taking the Benadryl. Plus it makes me feel comfortable, rather than uncomfortable like Benadryl alone dose.

Also, night anxiety is a huge problem for me. Temazepam, being one of the most powerful benzodiazepines in existence, eliminates 80% of that night-time associated anxiety. Where-as, Benadryl, Trazodone, Seroquel, Doxepin, Mirtazepine (etc) actually made it much worse when taken alone.

 

[dilaudiffeine]

The best advice I can think to give you is to only take the benzos when you absolutely need them.. benzo withdrawal is hell my friend, and I would hate for you to have to experience it. I do not know very much about Adderall, as I have never been prescribed ADHD medications, but I have been prescribed clonazepam and lorazepam for severe anxiety and I can honestly tell you coming off of them was worse than some of the opiate withdrawals I have had.. best of luck my friend. Maybe you should try to find a more natural sedative for when you are feeling anxious, but you know what, I know it's not that easy, I've been dealing with severe anxiety for 7 years now... I can just give you my best wishes man.

 

[opivet]

SwampFox

SwampFox:

I think what I would do is back off on the Lorazepam completely for bit, long enough so it's out of your system and give theTemazepam a chance all by itself. I'm not sure what the half life of theTemazepam is but perhaps a therapeutic blood level of it will be reached then give it a trial period just on it's own before bringing the Lorazepam on board. You may be bringing your Benzo tolerance level to a point where all of them will be less effective.

Opivet

 

[Lightning-Nl]

SwampFox:

I think what I would do is back off on the Lorazepam completely for bit, long enough so it's out of your system and give theTemazepam a chance all by itself. I'm not sure what the half life of theTemazepam is but perhaps a therapeutic blood level of it will be reached then give it a trial period just on it's own before bringing the Lorazepam on board. You may be bringing your Benzo tolerance level to a point where all of them will be less effective.

Opivet

That's definitely true. Benzodiazepine tolerance is an issue for me.

However, Lorazepam and Temazepam don't build up in your system. Other Benzodiazepines (like Valium for instance) does for sure. But Lorazepam and Temazepam don't. Why? Because they're not anywhere near water soluble enough to be distributed in body fat with any significance.

 

[Intenselife]

I agree with a lot of the things that many others have already wrote. I am prescribed very similar medications to you. It was Adderall 20x twice a day IR, 30mg temezapam a night, and klonopin that I do take as prescribed which is twice a day. Well I had my adderall switched because of many problems to vyvanse, and neither one of the meds of temezapam and the vyvanse (or adderall when i was on that) I ever took more than twice a week. I am fortunate I can go many days without needing the Vyvanse, and because the side effects seriously make the experience unpleasant for me, and also same with temezapam in the sense I don't want to become dependent on that since I already take Klonopin daily.

What I can tell you is that from what I have read, know and heard is that Temezapam is a pretty bad one to take every night (if you have to you have to), but the reason I say that is because it is known that after sometime the temezapam can reduce its efficacy in putting/keeping you asleep after a few months. As far as your ativan goes, I seriously would take them sparingly as possible! If you were prescribed them to take upto 3 times a week then obviously you were prescribed them on a "per needed basis" unlike me with klonopin. But trust me the less you take it, the more effective it will be when you really do need it sense you won't have much of a tolerance if any. Personally a lot of people do not live ativan, but next to Xanax as per needed, i feel ativan is almost upto par. Even though it is weaker than xanax, ativan was one of the few other benzos that I could take once in awhile, and feel fantastic results.

Also most importantly you do not want to become addicted to either and by addicted I don't even abuse, I am talking about taking it as prescribed sense regardless your "body" will be addicted to it. SO whatever you decide to, just don't ever start regularly start taking both Temezapam and Ativan, because than you are in a loop of trouble, well possibly...

 

[Lightning-Nl]

Unfortunately, I've gotten up to taking 4 Milligrams of Ativan a day again...

Tonight I'm gonna cut that down to three. Hopefully.

 

[T. Calderone]

Swampfox, does the temazepam still help you with sleep? I used it years ago but after some time it didn't work so well.

 

[Intenselife]

Lol aw, I wrote what I wrote a few hours ago with all sincerity and thought of some advice I could write you, but it's too late in the sense you are taking the ativan daily let alone at a pretty high dose. As the person above me wrote, how is the temezapam still holding up for you? If you could go to sleep without the temezapam and just stay on the ativan, that wouldn't be any worse than cutting back your ativan dosage and taking temezapam daily. But as you probably have been informed or personally know the dangers of being addicted to a benzo, and taking higher doses, frequently dosing, and taking more than ONE benzo further just increases tolerance, reduces efficacy usually, and further makes your body dependent.

 

[Lightning-Nl]

The Temazepam by itself, definitely makes me sleepy. It also (after even 3 months) still helps with 95% of the pain associated with my bad RLS issues. So in that sense. It works great still. Ambien never did that for me. It worked for a week, then it's efficacy was literally reduced to 0%. That's why I had abuse issues with Ambien.

Temazepam, strangely enough, I haven't had abuse issues with... Like at all... It still works great for pain. Still makes me considerably tired and while, not as great as it was at first, still makes me feel cozy in my bed. The only issue is the fact that it's effects aren't lasting as long as they used to. And it no longer knocks me out. It definitely makes me tired and very drowsy still. But it doesn't make me so tired tha I can barely keep my eyes open anymore.

That's mainly the reason why I started adding the Lorazepam on top of it. Temazepam + Lorazepam (I also take 50 milligrams of Benadryl per night for allergies) = Knock-out. Literally, it knocks you out. I took my meds one night and went down stairs to get a snack. Made my sandwhich and sat down. Next thig I know I'm waking up at 5AM with a half eaten sandwhich all over my face.

But I've been bumping up the Lorazepam gradually ever since then. It's becoming a problem and I can tell. I need to stop it.

But there's a couple issues with that - 1 milligram of Lorazepam is roughly equal to 10 milligrams of Diazepam (Valium). 20 milligram of Temazepam is roughly equal to 10 milligrams of Diazepam. So if we convert that (30 milligrams Temazepam + 4 milligrams Lorazepam). That means I'm taking the equilavent of 55 milligrams of Valium PER DAY. I highly doubt I can just drop my dosage and not have withdrawals. I'm going to have to taper the Ativan down...

I'm pretty sure the Temazepam + Benadryl would be just fine, but the problem is - most nights I don't want to go to bed and so I take my meds an hour or more before I actually hit the hay. So, by the time I do sleep, I'll want to sleep because my meds have made me tired enough.

I think that if I took the Benadryl like 30 minutes before I go to bed and then the Temazepam like... 10 minutes before going to bed, I'd still be able to sleep just fine. But, in a sense, I'm addicted to staying up late...

 

[T. Calderone]

I know how that goes because I fell into the habit of staying up all night and going to bed like 6-7 am. But I'm back to a more regular schedule now that I moved. So if you want to take extra lorazepam, you might not even need to temazepam for sleep. My concern would be you getting dependent on benzos which you probably know already the withdrawal from these is horrendous.

Another thing, I've read that many people have reported that benedryl makes restless legs worse. So if this is a problem for you, then it might be better to use a different antihistamine. Plus sleep deprivation is known to exacerbate RLS and iron deficiency can play a role too. Make sure you're eating your green leafies or take some vitamin supplements.