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Re: Lorazapam - Br. Bob, Please comment

Posted by Paul on August 14, 1999, at 2:11:20

In reply to Re: Lorazapam - Br. Bob, Please comment, posted by GS on August 12, 1999, at 23:40:52

> > > > > > How can I find out what a lethal dosage of Lorazapam is?
> > > > >
> > > > > Why do you ask?
> > > > >
> > > > > Bob
> > > >
> > > > James here....
> > > >
> > > > There is an ez answer to this, but I would like you to answer Dr. Bobs question first !
> > > > I just started taking lorazapam for anxiety and am wondering how much I could take before I need to worry about phycological addition or overdose. I notice in some articles doeses of up to 10mg, while my persecription is for 1mg tablets, and I sometime take tables. but, I've noticed the effect continues to diminish.
> > > > james
> > ________________________________________________
> > The dosage needed depends on how bad the anxiety is that you are experiencing. First, there seems to be 2 schools of thought in the psychiatric profession about benzodiazapines. To generalize, 1) Benzodiazapines are not good for long term treatment of any anxiety disorder - cognitave therapy in combo with a sedating anti-depressant(such as Serzone)should be all that is about necessary. 2)Benzos are good for long term treatment of anxiety disorders because that is what they are....anti-anxiety agents made specifically for that purpose. Just keep it well managed...especially with a short half-life benzo like Xanax or Ativan. Supplement with cognitive therapy.
> >
> > The 1st group are in my opinion overrating the tolerance and dependence issues surrounding this class of drugs because of lack of understanding in prescribing and managing them. Also, misinterpretation of the PDR as well as listening to other psychiatrists with similar prejudice telling of THEIR OWN prejudice and ignorance concerning the side effects of benzos.
> >
> > It is a semantic argument actually. What is dependence? That if you stop taking benzos you'll become anxious again? Yes there is withdrawl involved in abruptly stopping benzos rather than tapering but does that constitute dependence? No. Yes, one can build up a tolerance to dosage but not something that can't be managed (unless they are being abused or not being taken as instructed).
> >
> > For instance, it doesn't take alot of imagination to know that Ativan can be managed with an augmentation of a small amount of the low or no side effect mood stabilizer Neurontin (900 - 1200mg)to help with Ativan going in and out of
> > the system therefore aleviating the drug induced anxiety.
> > Also, keep the Ativan at a constant level whether it is 2 or 6 or I've read up to 10 mgs. daily...whatever allows you to function the way you need to without the affliction of an anxiety disorder! That is the whole point! So what if you take 3 -4 mgs or 5 -6 mgs. a day! Does it in conjunction with cognative therapy techniques alleviate your anxiety disorder?
> > Don't be scared off by the argument that you are addicted to benzos when benzos are what stops the disease that you're afflicted with! A non -prejudicial psychopharmacologist will help manage your suffering and allay your unfounded fears of addiction that are imposed upon you by the first group of psychiatrists mentioned above. The point is, get the ball in the hole. Until these prejudiced doctors stop heaping these needlessly anxiety - provoking "facts" there will continue to be your type of sad questions worried about by many, many patients in need of relief.
> >
> > If you have an anxiety disorder, you take inti-anxiety drugs (until the purists come up with something THAT WORKS for you with less side effects).
> >
> > Am I pretty much on target Dr. Bob? (assuming that she has a properly diagnosed anxiety disorder).
> >
> > GS
> *******************************************
> Well Dr. Bob, what do you think about my above post regarding the 2 schools of thought re: treatment of anxiety disorders with benzos??????????

All your info seems to be confirmed in a book I just picked up Panic Disorder, The Medical Point of View by William Kernodle. He cites an APA Task Force study from 1990 which basically denounces this benzodiazepene stigma. It seems similar to deriding a diabetic for becoming "addicted" to insulin. At least in GA. this ignorance is fueled by our state medical board which monitors benzos and stimulant prescriptions like they're crack. Seems like many docs are running scared, i.e. reluctant to prescribe benzos and/or stimulants because of this oversight. I too would like to hear what Dr. Bob's opinion on this issue is. Thanks for the post. Paul




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