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Pharmacy - ativan/anxiety
Expert: Dr Alan Galbraith - 10/28/2009
Question
"hello...i will try to make this short.. i have had a panic disorder pretty much the most of my life..from about age 15 to now, i am 41. Back in 2000, i suffered bad panic attacks and agoraphobia after breaking up with a boyfriend of 7 years. i have managed my way since then, but last june of this year, i lost my fulltime job with no warning, and i just recently bought a house by myself.
during june and july.. i will say i had panic 'attacks"..lasting 20 minutes to an hour..but frequently throughout the day. i am familar with all the symptoms of feeling like your dying.. heart attack.. not breathing etc. my doctor put me on ativan .. low dose .50 mg, and i only take 1/2 pill a day, because i do not want to get addicted to this pill and go through withdrawal. ..BUT i have been doing this for going on three months. i take 1/4 pill in am when i get up.. 7am...and usually another 1/4 pill in evening...
my problem i am having as of about a month ago, i wake up to a CONSTANT extremely nervous anxiety state of mind...they are not "attacks".. its every minute that i am up.. and i feel like im going to go crazy from it. i guess a way to describe it would be a supercharged scary adrenaline feeling....all the time. i personally feel it is the ativan that has changed me.. and maybe i am having withdrawal reactions from the drug because i have been on it for months, even at a low dose..and its wearing off sooner in day.. and the anxiety feeling is coming back with a vengance. my doctor/psychiatrist feels i should stay on the drug. in fact he quoted it as "my new vitamin for the rest of my life"...and would have to continue to up the dose frequently the longer i am on it.. i refuse to be on it for the rest of my life.. but for the time being until i find something/someone to help me 1/4 ativan is needed to calm me down for a few hours, even though i know i will have hell to pay in about another 10 hrs...worse anxiety.. i notice i am starting to slurr speech.. arm and leg restlessness/tremors/...can this be from such alow dose of ativan? i read something about ativan damaging nerve transmitters?
i tried zoloft, paxil and cymbalta.. they all made me very nauseated and vomiting was pretty extreme..i lost 12 pounds in a week.i am pretty sensitive to medication..
i have tried deep breathing, relaxation techniques, i talk to a counselor, i have a treadmill and exercise 30 mins a day, but i cannot shake this constant dibilitating scary anxiety stricken feeling. i have the tools to handle agoraphobia, and going into shopping malls, stores, etc...but this constant super anxious feeling i cannot control and its scaring me. i feel like im going to go crazy.
any suggestions or comments on ativan or other possible meds would be greatly appreciated.
"
Answer
Dear Cindy
A lot of what you are going through is almost certainly, in my opinion due to the Ativan. I cannot agree with your doctor saying your quoted statement re vitamin. I would be changing my doctor as these drugs ie benzodiazepines will only but worsen your described effects eg slurred speech etc.
Its a pity that you have had problems with Zoloft etc - nausea being quite common with this type of drug. I think that you should be back on them and initially take a drug like domperidone to counteract the nausea until you get used to the drug. There are so many options these days in this class of drugs that you may be lucky and find one that does not produce nausea - but it would take luck given your history on these drugs. These drugs are not addictive (Ativan is) and should not harm the nervous system as Ativan can. I would advise you speak to your present prescriber and if he still wants to keep you on the Ativan try for a second opinion.
Regards
Dr Alan Galbraith
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