Posted by Ame Sans Vie on August 7, 2004, at 2:24:36
In reply to Re: Xanax vs. Valium.... » Ame Sans Vie, posted by Fred23 on August 7, 2004, at 0:55:32
> > Yeah, it's definitely a good drug, but (once again) possesses some qualities which make it more effective for some than for others. For example, Ativan has well-documented anti-hostility effects
>
> (Which may explain why I'm getting more mellow with my co-workers, then.)lol, yes, that very well could be.
> As I posted elsewhere, my perception of the difference between Xanax and Ativan is that Xanax gives some sort of separation from reality, like having had too much to drink that one is "out of it" while Ativan is like having had enough to drink where one is relaxed and fully and jovially participating in something.
I think that's certainly true, but usually only in the beginning of treatment. The pleasant, contented happiness associated with detachment from the 'real' world that alprazolam provides typically doesn't doesn't last long once a patient is stabilized on a certain dose for a few weeks or so. I'm led to speculate that lorazepam may exert a different type, quality or amount of effect upon the serotonergic and dopaminergic systems than alprazolam does. It's known that alprazolam, for example, causes increased serotonergic function in select areas of the brain, at select receptor subtypes. Lorazepam may be less precise... perhaps it induces a more widespread and/or less selective increase of 5-HT function, which in turn causes temporary downregulation of dopaminergic function to compensate. One possibility would be lorazepam causing increased activity to occur at 5-HT1a receptors (as buspirone [BuSpar] does) all the while diminishing the activity of dopamine at key receptors, such as D2, which are commonly implicated in paranoid and delusional disorders and are common targets of dopamine antagonists used to treat psychosis/hostility/mania. Anyway, such a combination of serotonin potentiation, dopamine downregulation, and benzodiazepine agonism could certainly lend itself nicely to a relaxing, jovial experience, as you put it. Of course this is nothing but an educated guess. I'm sure I'm wayyyy off, lol.
> But, each person does have their own unique reaction to each particular benzo. It seems that most of the discussions here pit Xanax against Klonopin or Valium, but less frequently against Ativan.
I just think Ativan isn't prescribed as often these days as it perhaps should be. I've seen well over a dozen psychiatrists and not one of them has ever recommended Ativan to me -- Tranxene, Serax, Halcion, Restoril, ProSom, Doral, Dalmane, Paxipam, Librium, Valium, Xanax, Klonopin, Lexotan and Mogadon... but never Ativan. The one time I did use it, it was prescribed per my request.
For many people, though I hate to pidgeonhole, it appears that lorazepam and diazepam are better suited to generalized anxiety disorder while alprazolam and clonazepam are generally more helpful with social phobia, agoraphobia, and panic disorder. And there is, of course, that subset population of the elderly and those with hepatic impairment for whom lorazepam is a very attractive option as it undergoes glucuronidation, bypassing the liver.
~Michael
poster:Ame Sans Vie
thread:374589
URL: http://www.dr-bob.org/babble/20040805/msgs/374974.html