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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by adamie on December 3, 2001, at 13:43:16
hi. this med which is for anxiety and sleep... does it have more effect the longer you take it such as anti depressants or do you feel the full effect after just one dose since this med is "take when required"?
i am just worried about the med possibly making my depression worse just like many meds I have tried. if it doesn't make me worse the first times i took it then surely it cant make me worse later on right?
i am not sure but maybe it is helping with my mind torture a bit. hard to tell.
I am also taking zoloft and risperdal.
Posted by IsoM on December 3, 2001, at 17:12:12
In reply to Ativan, more effect over time?, posted by adamie on December 3, 2001, at 13:43:16
Ativan is the brand name for a sublingual benzodiazepine, in other words, a tranquiliser. Benzodiapzepines have the tendency for people to develop tolerance to them & find they need to increase the dosage to get the same effect, especially if they're used frequently or regularly. There's a strong tendency for addiction to develop too. This is why doctors prefer to give them only for short-term use or to take occasionally as needed.
If used properly, they can be very helpful for short-term anxiety problems but as a long-term help in controlling anxiety, there's better & less addictive meds. Some people who are depressed do find it helps their depression, but generally benzodiazepines aren't recommended for SEVERE depression. Even if it hasn't bothered you with a dose or two, it's not guaranteed not to be a problem with continued use.
(RE: following message)
> hi. this med which is for anxiety and sleep... does it have more effect the longer you take it such as anti depressants or do you feel the full effect after just one dose since this med is "take when required"?
>
> i am just worried about the med possibly making my depression worse just like many meds I have tried. if it doesn't make me worse the first times i took it then surely it cant make me worse later on right?
>
> i am not sure but maybe it is helping with my mind torture a bit. hard to tell.
>
> I am also taking zoloft and risperdal.
Posted by adamie on December 3, 2001, at 17:25:51
In reply to Re: Ativan, more effect over time? » adamie, posted by IsoM on December 3, 2001, at 17:12:12
what meds are better long term for anxiety?
> Ativan is the brand name for a sublingual benzodiazepine, in other words, a tranquiliser. Benzodiapzepines have the tendency for people to develop tolerance to them & find they need to increase the dosage to get the same effect, especially if they're used frequently or regularly. There's a strong tendency for addiction to develop too. This is why doctors prefer to give them only for short-term use or to take occasionally as needed.
>
> If used properly, they can be very helpful for short-term anxiety problems but as a long-term help in controlling anxiety, there's better & less addictive meds. Some people who are depressed do find it helps their depression, but generally benzodiazepines aren't recommended for SEVERE depression. Even if it hasn't bothered you with a dose or two, it's not guaranteed not to be a problem with continued use.
>
> (RE: following message)
> > hi. this med which is for anxiety and sleep... does it have more effect the longer you take it such as anti depressants or do you feel the full effect after just one dose since this med is "take when required"?
> >
> > i am just worried about the med possibly making my depression worse just like many meds I have tried. if it doesn't make me worse the first times i took it then surely it cant make me worse later on right?
> >
> > i am not sure but maybe it is helping with my mind torture a bit. hard to tell.
> >
> > I am also taking zoloft and risperdal.
Posted by IsoM on December 3, 2001, at 17:59:34
In reply to help » IsoM, posted by adamie on December 3, 2001, at 17:25:51
I've had so much experience over 15 years finding the right medications for my family & me that I've learned a lot. I've asked doctors & other professionals lots of questions, & extensively read medical & science journals, but I'm certainly NOT as knowledgable as a good doctor (though I'm better than some!). It's something you need to talk to your doctor about.
I used to have a problem with anxiety but mine seemed more related to my general disposition - I tend to be a very hyper-sort of person. I feel everything, life included, very intensely. As my depression got under control so did my anxiety. It often works that way for many people. The anxiety grows out of the depression & while they may not be obsessive/compulsive, the thoughts sure can be.
I'll list some of the meds used for treatment of generalised anxiety disorder (GAD). What's effective for one person can be entirely different for another - actually making them more anxious. That was the case with Buspar (buspirone) with me. If Buspar works for you, it'll need to taken for a couple of weeks to find out as it's a long-term fix & doesn't have immediate action, but many find it very good. Some of the SSRIs are supposed to be very good at decreasing anxiety, while some seem to increase it. My adult son was helped by Anafranil (clomipramine) which is a tricyclic antidepressant. What works for one isn't always good for another. That's why it takes patience to find what works best as it's almost like a mixture of science & art with a good doctor being willing to keep trying different meds.
(RE: following message)
> what meds are better long term for anxiety?
Posted by Alan on December 3, 2001, at 21:57:27
In reply to Re: Ativan, more effect over time? » adamie, posted by IsoM on December 3, 2001, at 17:12:12
> Ativan is the brand name for a sublingual benzodiazepine, in other words, a tranquiliser. Benzodiapzepines have the tendency for people to develop tolerance to them & find they need to increase the dosage to get the same effect, especially if they're used frequently or regularly. There's a strong tendency for addiction to develop too. This is why doctors prefer to give them only for short-term use or to take occasionally as needed.
>
> If used properly, they can be very helpful for short-term anxiety problems but as a long-term help in controlling anxiety, there's better & less addictive meds.
*********************************************This is simply not true as evidenced by the facts about benzodiazapines of which Ativan (not designed sublingually but used that way in many cases) is just one. I take it.
Please read this link and scroll to benzodiazapines:
http://bearpaw8.tripod.com/pd.html
Specialists that treat chronic anxiety as well as the World Health Organisation have reviewed ALL of the evidence from hundreds of studies and concluded that this medication is safe for short AND long term use without fear of "addiction" and "escalation" and all the negative connotations that these words invoke. "Medical dependence" is the less obselete usage. The distinction in the two terms is borne out by the facts. Doseages remain the same once the proper level is found providing that one has a legitimately diagnosed anxiety disorder. Tapering off of ANY med including the ssri's including Paxil, etc have shown just as many discontinuation problems and the BZD's are over 40 years old and going strong. The effects of the tapering process is just as risky and can be as difficult for any other medication even though they are not technically considered "addictive".
Please read. I'm sure that despite the webpage's longishness, it is well worth understanding...
Alan
PS. Ativan works immediately unlike the start up time needed for AD's.
Posted by Alan on December 3, 2001, at 22:03:02
In reply to help » IsoM, posted by adamie on December 3, 2001, at 17:25:51
adamie:
You may want to access this post from the archives here explaining the differentiation between addiction and medical dependence. It is very well written by one of our very own here at babble named elizabeth.
http://www.dr-bob.org/babble/20010618/msgs/67768.html
I hope that this helps. Don't give up on the BZD's. One responds as differently to the different kinds of BZD's as one respods differently to different AD's.
Best to you,
Alan
Posted by IsoM on December 3, 2001, at 22:37:42
In reply to Re: Ativan, more effect over time?, posted by Alan on December 3, 2001, at 21:57:27
Alan, I do agree with you in many ways but the reason I gave the previous advice is:
-Adamie was asking about Ativan, not for panic disorders but for anxiety & help in sleeping. Panic disorder wasn't mentioned.
-For help in falling asleep, higher doses do need to be taken if used for any length of time. The anxiolytic effects will stay remain but the sleep-inducing effect often diminishes.It's just so hard to find a doctor who is willing to regularly prescribe any benzodiazepine for any length of time. People who do develop dependance (or addiction) to drugs will go to great lengths to conceal it from their doctor & doctors have become overly wary. Not to mention, other doctors monitor any doctor they think prescribes to easily.
I know alprazolam (Xanax) worked very well for me & I made sure never to take more than was prescribed but when I moved & had to find a new doctor, no doctor will prescribe them for me other than a short period. I wish Buspar did work for me. I would prefer something that didn't frighten doctors so much.
(RE: following messages)
> This is simply not true as evidenced by the facts about benzodiazapines of which Ativan (not designed sublingually but used that way in many cases) is just one. I take it.
>
> Please read this link and scroll to benzodiazapines:
>
> http://bearpaw8.tripod.com/pd.html
>
> Specialists that treat chronic anxiety as well as the World Health Organisation have reviewed ALL of the evidence from hundreds of studies and concluded that this medication is safe for short AND long term use without fear of "addiction" and "escalation" and all the negative connotations that these words invoke. "Medical dependence" is the less obselete usage. The distinction in the two terms is borne out by the facts. Doseages remain the same once the proper level is found providing that one has a legitimately diagnosed anxiety disorder. Tapering off of ANY med including the ssri's including Paxil, etc have shown just as many discontinuation problems and the BZD's are over 40 years old and going strong. The effects of the tapering process is just as risky and can be as difficult for any other medication even though they are not technically considered "addictive".
>
> Please read. I'm sure that despite the webpage's longishness, it is well worth understanding...
>
> Alan
> PS. Ativan works immediately unlike the start up time needed for AD's.
Posted by Alan on December 9, 2001, at 13:25:59
In reply to Re: Ativan, more effect over time? » Alan, posted by IsoM on December 3, 2001, at 22:37:42
> Alan, I do agree with you in many ways but the reason I gave the previous advice is:
> -Adamie was asking about Ativan, not for panic disorders but for anxiety & help in sleeping. Panic disorder wasn't mentioned.
> -For help in falling asleep, higher doses do need to be taken if used for any length of time. The anxiolytic effects will stay remain but the sleep-inducing effect often diminishes.
>
> It's just so hard to find a doctor who is willing to regularly prescribe any benzodiazepine for any length of time. People who do develop dependance (or addiction) to drugs will go to great lengths to conceal it from their doctor & doctors have become overly wary. Not to mention, other doctors monitor any doctor they think prescribes to easily.
>
> I know alprazolam (Xanax) worked very well for me & I made sure never to take more than was prescribed but when I moved & had to find a new doctor, no doctor will prescribe them for me other than a short period. I wish Buspar did work for me. I would prefer something that didn't frighten doctors so much.
>
> (RE: following messages)
> > This is simply not true as evidenced by the facts about benzodiazapines of which Ativan (not designed sublingually but used that way in many cases) is just one. I take it.
> >
> > Please read this link and scroll to benzodiazapines:
> >
> > http://bearpaw8.tripod.com/pd.html
> >
> > Specialists that treat chronic anxiety as well as the World Health Organisation have reviewed ALL of the evidence from hundreds of studies and concluded that this medication is safe for short AND long term use without fear of "addiction" and "escalation" and all the negative connotations that these words invoke. "Medical dependence" is the less obselete usage. The distinction in the two terms is borne out by the facts. Doseages remain the same once the proper level is found providing that one has a legitimately diagnosed anxiety disorder. Tapering off of ANY med including the ssri's including Paxil, etc have shown just as many discontinuation problems and the BZD's are over 40 years old and going strong. The effects of the tapering process is just as risky and can be as difficult for any other medication even though they are not technically considered "addictive".
> >
> > Please read. I'm sure that despite the webpage's longishness, it is well worth understanding...
> >
> > Alan
> > PS. Ativan works immediately unlike the start up time needed for AD's.
*****************************************
Sleeplessness - BZD's no for long term. Don't know diagnosis - sleep problem could be depression related.Chronic anxiety - whatever form it takes - YES for long term treatment with BZD's without fear of adverse side effects. This is what is not in dispute. Ill informed doctors will just have to come around especially for those non-specialists on the receiving end of the media blitz by the ssri's for the treatment of generalised anxiety disorders - medications that usually have to be augmented with BZDs in the end either PRN or as maintianence anyway. And the side effects!
Alan
Posted by IsoM on December 9, 2001, at 14:08:22
In reply to Re: Ativan, more effect over time? » IsoM, posted by Alan on December 9, 2001, at 13:25:59
It's fortunate that you've found a well-informed doctor then. Rmember how doctors in the 60s used to dish out Vallium like it was candy? I wonder if this is the resulting backlash. You see listening to all these doctors (who are SUPPOSED to know what they're talking about- though I've haven't always believed that) talk about the addictive properties, I thought that perhaps I was rather unique in the way I handled it. I don't form habits easily, either good or bad - thought that I just didn't have the addictive personality. I wish more doctors would come around to understand benzodiazepines then.
I've been writing adamie through e-mail, & I've encouraged him about what you've said about the Ativan. His case seems so sad that even IF it were somewhat addictive, he really needs it badly at this time in his life. Apparently, before he ever took Accutane (a synthetic derivative of vitamin A for acne), he had no problems whatsoever. So much for the rare depressive problems on it & the easy reversal of symptoms.
> *****************************************
> Sleeplessness - BZD's no for long term. Don't know diagnosis - sleep problem could be depression related.
>
> Chronic anxiety - whatever form it takes - YES for long term treatment with BZD's without fear of adverse side effects. This is what is not in dispute. Ill informed doctors will just have to come around especially for those non-specialists on the receiving end of the media blitz by the ssri's for the treatment of generalised anxiety disorders - medications that usually have to be augmented with BZDs in the end either PRN or as maintianence anyway. And the side effects!
>
> Alan
This is the end of the thread.
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