Posted by JLM on October 1, 2002, at 0:26:22
In reply to Re: Tapering off of Ativan for sleep........... » JLM, posted by Alan on September 30, 2002, at 23:27:35
> Generally bzd's like ativan shouldn't be used for sleep because the sedative effect wears off. Of course if an anxiety disorder is what's keeping you awake, bzd monotherapy is completely appropriate to help with sleep.
>
> You could either:
>
> 1) Taper by 1/4 mg every week or few days, not going any faster than your body tells you to.
>
> or
>
> 2) Ask your doc for some klonopin (longer acting) to start or overlap with the ativan and then decrease the ativan slowly. The increase in anxiety from the ativan leaving your system will be taken over by the klonopin leaving your system at a much slower rate. This is a very common method and valium can be used instead of klon. Of course the trick is taking the right amount of Klon (perhaps .5mg at nite) while decreasing the ativan. Or more klon may be needed to start - in two equally divided doses daily since you'll feel the withdrawal throughout your waking hours.
>
> Any stratagies with you doc as to how to address the sleep issue once you're off? Just wondering...
>
>
> Best,
>
> AlanAlan, thanks. Yes, we are going to do a sleep study in a sleep lab it sounds like. My HMO actually has one believe it not.
I think a lot of it is poor sleep hygeine, and the fact that my internal body clock is way out of whack. Its called Delayed Sleep Phase Syndrome. In simple terms, instead of going to bed at a 'normal' time I am going to bed at 4 or 5 in the morning. For about 12 years I worked 2nd shift, and that is generally how it starts. Apparently people with DSPS don't really respond all that well to bz's for sleep, and I seem to be one of those people. The only thing that somewhat works is the ativan, and I don't think it works well enough to justify long term use. I simply don't want to take bz's for any reason, for any length of time.
Usually DSPS is addressed by rolling forward your bedtime by 3 hours a day, until you get back all the way around the clock to an evening bedtime. Its my understanding that most people with DSPS, even thou they sleep, don't get refreshing sleep, and now for me its gotten to the point where I am even having a hard time initiating sleep, which is certainly anxiety producing. It tends to become a viscious cycle, because you lay there thinking 'I really need to fall asleep' and the more your worry about NOT sleeping, the less your able to sleep. Loads of fun ;)
J
poster:JLM
thread:121630
URL: http://www.dr-bob.org/babble/20020930/msgs/121761.html