f/u to earlier post: ativan and lexapro?

[homebird]

I went to see my doctor today because I was not feeling better. In many ways, I feel I am getting worse. I can't seem to stop this cycle of panic and anxiety. Every morning I wake up with severe anxiety (sometimes panic attacks) that last for most of the morning. As the day goes on, it usually decreases and by evening I feel normal. When I wake up the next morning, the cycle starts all over again.

My doctor gave me a rx for ativan. He told me to take .5 mg pill (up to 1mg pill if I REALLY feel it's necessary) and it should *snap me out* of this episode.

My qustion is - does it really work? Is one pill really going to get me out of this hellish cycle? I geuss I'm skeptical. I'm afraid I'll take the pill today, feel fine, and then wake up tomorrow and feel like crap again.

FWIW, I know it's addictive, and that terrifies me. He told me if I don't feel better in a day I should see him again and he'll refer me to a psychiatrist for further evaluation.

[alankay]

Yep. ativan is a good med. I used it years ago. It's one that if you need it to work a little faster you can let it dissolve under your tongue. You can try it if you like by placing there, rolling it around to get it wet and let it dissolve there. It will taste sweet like sugar. I think if you are having significant anxiety and not getting better via your doc, do indeed see a pdoc(psychiatrist). I did and it took some work on both our parts and I'm better now. I take an ssri in the AM and have valium for times I cannot calm myself or situations like interviews/presentations, etc, but am much better and all is under control. Message me any time. To get "addicted" you'd need to use it quite a while and at higher doses than what we're referring to here in general. Respect benzos, don't fear them.

[homebird]

It's reassuring to hear that it worked for someone. I am taking lexapro (10 mg a day) right now, so my doctor thinks I will only need these on the (hopefully rare) occasion that I have breakthrough anxiety and panic. I guess if it doesn't work my lexapro may need adjusted.

Sometimes doing research is a bad thing, because I read some really awful things about ativan (benzos in general). I almost had a panic attack just making the decision to take one.

Anyway, I took one this morning and I feel ok this afternoon, but afternoons are generally good for me. I'm not sure I notice a difference. I may have to wait until tomorrow morning (when my panic is the worst) to tell if it snapped me out of it.

[alankay]

Homebird, I also take lexapro(escitalopram) but at 20mg. I've been on prozac, zoloft, celexa and now lexapro. Of the group it has the fewest side effects and is known for that. I did well on prozac as well. Anyway since your anxiety seems higher in the AM why don't you take it either right at bedtime or just when you wake? Ativan has a half life of about 20 hours(give or take based on you physiology, etc) so will likely work best for the part of the day that's worse anxiety wise. If you're not feeling anxious, don't take it. Benzos work fairly quickly. Not like ssri's which usually take weeks(which is their down side) but they have overall safety for the long term as a GIANT up side. While one pill won't stop it all, it might be very valuable to have against it as the lexapro starts to work. If your working with a counselor(highly recommended, I did) to help find why you're feeling this way, that takes time as well. In the mean time practice progressive relaxation(google it), deep breathing, get some aerobic exercise(great way to calm body and mind), limit caffeine and alcohol, and even see if you can get a copy of Reid Wilson's book "Don't panic". Very good book. Message me any time.

[homebird]

Well, I was under the impression that one dose of ativan would *snap me out* of this episode.

I've been on lexapro for 4 months now and felt fine. The attack came out of nowhere, so I geuss he thought I needed a little *jolt* back to reality. He didn't meant for me to continue taking the ativan.

However, today I called him and told him that the ativan worked, but the anxiety came back when it wore off, so he gave me a rx for chlonopin and told me to take it 2xs a day.

Am I wrong, or is this another highly-addictive drug? I feel like these are just masking the problem. Yeah, they work. I feel fine when I take them, but they're not solving the underlying problem - the anxiety that keeps coming back.

I feel like my lexapro dose needs adjusted, but he won't agree to let me try that. He said to try the chlonopin and if it doesn't work call him and he'll refer me to a psychiatrist. I'm tempted to just skip the chlonopin and tell him to get me to a psychiatrist ASAP.

What do you think?

(Oh, and I finally bit the bullet and set up a counseling appointment. My first one is Monday. I'm scared, but hopefully it will help me through this).

[homebird]

Just wondering, is this forum generally pretty slow? I'm on some other (unrelated) forums and they are so fast paced. I guess I don't need to check back here very often. :)

[alankay]

Homebird, counseling is a great thing to do. Now for klonopin(clonazepam) is just another benzo. It is a longer acting benzo(longer than ativan) and therefore a tad safer. I've used it and it's fine drug. It can also be dissolved under the tongue for a bit faster action if needed. You're RIGHT, these don't fix the problem. The counselor will see if there is some conflict within you causing the anxiety. It's common for folks with very busy lives to become so stresses they can experience anxiety. Sometimes it's a change(moving, going off to school). Sometimes changes/stresses at work can contribute. Often family issues, often unresolved can make you anxious. That's why a counselor/therapist will help just by talking to figure out what, if anything, could explain why your feeling the way you are. If they find something maybe it's something that can be changed/addressed. In the mean time you need something to calm you down so you can function normally and stop/reduce the hideous symptoms your experiencing. If nothing can be found in the way of significant stressors/unresolved issues/past abuse. etc, it might be, as in my case, more a biological predisposition to anxiety. I was analyzed for several months going over my live and present situation(first years in college) and they could find nothing going on to explain my anxiety and panic attacks. The therapists gave her report the the psychiatrist(who was great and I trusted) and he told me I had an "anxious personality". I kind of didn't want to hear that but when I thought about it always did have anxious thoughts as a kid. Even as a little boy but never anxiety or panic attacks per se. He said, "yep, takes time to develop fully to this point, often around your age". So I have set about trying to use ALL strategies(meds, exercise, progressive relaxation, deep breathing, reading good books on the subject) and have learned to manage my anxiety. Not that that will be your path but that's where I come from. Hopefully in your case they can find something really stressing you that you can do something about thereby ending/reducing your anxiety. UNTIL then, until the therapist has had enough time to work with you(it takes time), use the meds just to help you get by instead of needless suffering. Use the klonopin ONLY as you need to. Message me ANY time. I'm sorry I can't honestly tell you 1 pill would end it forever, very sorry.

[homebird]

I had to call my doctor back because I was really confused about the klonopin.

Apparently he wants me to take the klonopin for a week. I was functional on 10mg of lexapro before, and he basically wants to see if I can be again. He's thinking a week of klonopin may give me a break from the panic/anxiety and allow my body/brain to return to normal. If after a week of klonopin the anxiety returns, we know there's something wrong with my long-term med (lexapro). He will refer me to a psychiatrist who can re-evaluate my meds and dose.

I think that sounds reasonable? For some reason when they explained it to me this morning I wasn't understanding anything. I'm skeptical it's going to work, but at this point I'll take a week of relief if they're offering it to me.