Expert: Jacqui - 11/4/2009

Question
QUESTION: Hi, I hope this is an appropriate question for you. I have been taking ativan for quite a few months now. I take 1mg in am, 1mg in afternoon, and 2mg before bed. I have a bad cold and the doctor just gave me tussionex Pennkinetic which is 5mg hydrocodone and an antihistimine in a 12 hour time release. I am very concerned about this since that seems like a lot of CNS depressants. The Ativan makes me a little tired but does not knock me out, maybe the 2mg at night does. Can I cut back the Ativan at night to 1mg until I finish the cough medicine? I realize you cannot just stop Ativan. Or am I being a nervous nelly? I do hope this is an appropriate question for you, I have asked you things before and you never judge...just like you say! thanks! :-)

ANSWER: Hi Dianna,

I don't think you are being a nervous nelly as these are pretty heavy medications.  I am assuming there are other issues than a cold, as a doctor prescribing hydrocodone for a bad cold is being a little over the top ... but then there could be other issues.

Anyway, probably the best thing to do at this stage is speak to your doctor because he wrote the original script.  I am not medically training, so can't give medical advice.  I have made suggestions about withdrawal regimes before for people who didn't have access to a GP, which isn't ideal.  But, if you are really loathe to speak to your GP, then you could consider reducing a small amount of ativan for a short period.  Benzo reduction is usually done in small increments, such as 1/2 a tab a day, so you might want to try that (i.e.: reduce your ativan to 1.5 at night).  I assume that your doc knows you are on the ativan, so he must not be too worried about the drug interactions, but it is good you are considering this.  This is especially important if you have a few drinks as well.  You could give half a tab a try, and if that all goes without a hitch, then try taking one at night.  But you need to be careful and seek medical attention if there are any problems.

As I said initially, it is ideal that you speak to your doc.  I think it is great that you are looking after yourself like this and being careful about what you take!

I hope all goes well and good to hear from you again!

Take care and stay safe,

Jacqui



---------- FOLLOW-UP ----------

QUESTION: Thanks Jacqui, just wanted you to know I actually went and asked my pharmacist and he said that since I have been on the Ativan for so long it would not be a problem and he was right! Yes, my doc prescribes the Ativan as well so he knows what I am taking and he gave me the hydrocodone for the cough since I have bought every OTC out there and none of them touched it. I complained b/c I had not slept in 3 days. Just wanted you to know all the answers to your questions and thanks, you really did help. I want to get off the Ativan (at least cut back a lot) but my doc will not switch me to a longer acting benzo...cannot find a doc to do it in the small town, so it is nice to know I can at least ry cutting back 1/2 mg daily. Imagine, not one doc who realizes you cannot just cut Ativan by 1/2mg until you are off. Thank you again!

Answer
Hey Diana,


VERY IMPORTANT!!!


Just one thing ... if you have been on it for a long time, I would not do 1/2 a day.  When I said half a tab, then another, I meant to stop there.  If you are going to reduce for the long term, I would actually do it MUCH slower.  At the most, 1/2 a tab a week.  

Withdrawals from benzos can be really serious, so it must be done slowly.  I am sorry you misread my email!

Jacqui