![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by SamAnon on March 22, 1999, at 19:55:49
I am currently taking 3.5 milligrams of lorazepam. I have had to increase the dosage over the past five years because of tolerance. I told a doctor that I wanted to get off of this drug. He prescribed 5 mg Valium because it has a longer half-life. I tried the Valium but it only seemed to increase my anxiety, and the morning after effects are terrible. I have been told to not abruptly stop taking the lorazepam because of possibility of seizures. I don't think that I can just take a little less each day. What can I do. I am a bit afraid now. In-service treatment is NOT a possibility for me. Any one with suggestions?
Posted by AnnAnon on March 22, 1999, at 22:59:56
In reply to Lorazepam, posted by SamAnon on March 22, 1999, at 19:55:49
Klonopin is another long acting benzo that is said to have a smoother onset of action than Valium. Also because of Valium's history of abuse, some docs prefer Klonopin. From my personal experience, a Dr once put me on Xanax (a short half-life benzo) but I became rapidly addicted and the short half-life was a roller coaster ride. To come off I was put on Elavil 25mg which is relaxing and quite sedating during the night - a great thing as I was waking up with panic attacks and nightmares.
Posted by SamAnon on March 24, 1999, at 21:35:00
In reply to Lorazepam, posted by SamAnon on March 22, 1999, at 19:55:49
> I am currently taking 3.5 milligrams of lorazepam. I have had to increase the dosage over the past five years because of tolerance. I told a doctor that I wanted to get off of this drug. He prescribed 5 mg Valium because it has a longer half-life. I tried the Valium but it only seemed to increase my anxiety, and the morning after effects are terrible. I have been told to not abruptly stop taking the lorazepam because of possibility of seizures. I don't think that I can just take a little less each day. What can I do. I am a bit afraid now. In-service treatment is NOT a possibility for me. Any one with suggestions?
Is it possible to take a lethal overdose of lorazepam?
Posted by saintjames on March 25, 1999, at 2:17:11
In reply to Re: Lorazepam/Lethal overdose?, posted by SamAnon on March 24, 1999, at 21:35:00
>
> Is it possible to take a lethal overdose of lorazepam?James here...
How do you think someone kills themselves with sleeping pills ?
Posted by Elizabeth on March 26, 1999, at 3:12:35
In reply to Re: Lorazepam/Lethal overdose?, posted by saintjames on March 25, 1999, at 2:17:11
> How do you think someone kills themselves with sleeping pills ?
They don't. The lethal sleeping pills that are still sometimes used as a plot device in works of fiction are the barbiturates, which are hardly ever prescribed anymore. You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine; their safety is considered one of their big plusses.
Posted by Dr. Bob on March 26, 1999, at 9:16:33
In reply to Re: Lorazepam/Lethal overdose?, posted by Elizabeth on March 26, 1999, at 3:12:35
> You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine...
Not that anyone should try or anything, of course...
Bob
Posted by SamAnon on March 26, 1999, at 11:13:16
In reply to Re: Lorazepam/Lethal overdose?, posted by saintjames on March 25, 1999, at 2:17:11
Thank you. Feel better after reading your sensible response and knowing that you *heard* my question.
Posted by saintjames on March 26, 1999, at 14:44:45
In reply to Re: Lorazepam/Lethal overdose?, posted by Dr. Bob on March 26, 1999, at 9:16:33
> > You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine...
>
> Not that anyone should try or anything, of course...
>
> BobJames here....
I did some checking as to the human LD-50 but could only find animal ld-50. In terms of mgs/kg
it is huge. Now that I think this over I realize
the persons I know who tried to go out on a benzo
in reality used ethanol plus many other pills.Using benzos alone or with ethanol it would surely
take a huge dose. I know some who have tried this
which makes for a nasty hangover along with dealing with the fact that you just tried to kill yourself. Sorry I jumped the gun on this....I have a friend who almost died on Xanax and I forgot that he had taken a whole medicine cab.
of pills plus Xanax and ethanol. It was a long time ago and one tries to forget these happenings
and more one.
Posted by sam on March 27, 1999, at 11:54:06
In reply to Re: Lorazepam/Lethal overdose?, posted by saintjames on March 26, 1999, at 14:44:45
> > > You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine...
> >
> > Not that anyone should try or anything, of course...
> >
> > Bob
>
> James here....
>
> I did some checking as to the human LD-50 but could only find animal ld-50. In terms of mgs/kg
> it is huge. Now that I think this over I realize
> the persons I know who tried to go out on a benzo
> in reality used ethanol plus many other pills.
>
> Using benzos alone or with ethanol it would surely
> take a huge dose. I know some who have tried this
> which makes for a nasty hangover along with dealing with the fact that you just tried to kill yourself. Sorry I jumped the gun on this....I have a friend who almost died on Xanax and I forgot that he had taken a whole medicine cab.
> of pills plus Xanax and ethanol. It was a long time ago and one tries to forget these happenings
> and more one.James,
Right ;-)
And I suppose that Dr. K is not an option these days...
If a revolver is used, should the bullet be a hollow point? Seems I read somewhere that a hollow point doesn't have a clean exit but ricochets around doing LOTS of damage. Guess it would be helpful to be sitting out in the middle of nowhere so that, if death were not immediate, one would eventually bleed to death? Better to go through the roof of the mouth or try for the heart?
Posted by Elizabeth on March 28, 1999, at 3:21:15
In reply to Re: Lorazepam/Lethal overdose?, posted by Dr. Bob on March 26, 1999, at 9:16:33
> > You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine...
>
> Not that anyone should try or anything, of course...Ahh, Dr. Bob, always The Responsible One. :-)
I have trouble knowing what to say when someone on a forum like this one makes this sort of statement (you know, the ones that seem to translate to "I'm feeling suicidal but I don't want to ask for help"). I get really uncomfortable for some reason, and I usually end up either ignoring it or saying something flippant. Do you have any advice? Is there some textbook response they teach you guys on the first day of residency or something, or is it just a matter of intuition plus experience? (Or is my reaction as goofy and over-the-top as it feels?)
Posted by sam (SamAnon) on March 28, 1999, at 8:07:28
In reply to implicit suicide threats - q for Dr. Bob, posted by Elizabeth on March 28, 1999, at 3:21:15
> > > You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine...
> >
> > Not that anyone should try or anything, of course...
>
> Ahh, Dr. Bob, always The Responsible One. :-)
>
> I have trouble knowing what to say when someone on a forum like this one makes this sort of statement (you know, the ones that seem to translate to "I'm feeling suicidal but I don't want to ask for help"). I get really uncomfortable for some reason, and I usually end up either ignoring it or saying something flippant. Do you have any advice? Is there some textbook response they teach you guys on the first day of residency or something, or is it just a matter of intuition plus experience? (Or is my reaction as goofy and over-the-top as it feels?)Elizabeth,
Unfortunately suicidal thoughts are a part of my life, but I haven't acted on them in many, many years. The last post of mine was in response to what I thought *was* a rather flippant response. I confess to having been angry at the time I wrote the post (anger unrelated to anyone's responses), and I apologize for my remarks/questions about the bullets. Sometimes the only way I can survive another day in this life is to do something weird like post a reply to a web site. What more can I say? I am at the bottom, trying to figure out how to climb back out.
Posted by SamAnon on March 28, 1999, at 8:19:00
In reply to Re: Lorazepam/Lethal overdose?, posted by Elizabeth on March 26, 1999, at 3:12:35
> > How do you think someone kills themselves with sleeping pills ?
>
> They don't. The lethal sleeping pills that are still sometimes used as a plot device in works of fiction are the barbiturates, which are hardly ever prescribed anymore. You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine; their safety is considered one of their big plusses.You might find it helpful to read the post: Suicide Act as a DESPERATE Call for Help
Posted by Dr. Bob on March 28, 1999, at 16:42:42
In reply to Re: implicit suicide threats - q for Dr. Bob, posted by sam (SamAnon) on March 28, 1999, at 8:07:28
> > Ahh, Dr. Bob, always The Responsible One. :-)
:-)
> > I have trouble knowing what to say when someone on a forum like this one makes this sort of statement...
It *is* hard to know what to say. Especially in a forum like this.
> > Do you have any advice? Is there some textbook response they teach you guys on the first day of residency or something, or is it just a matter of intuition plus experience?
There's no textbook (at least not that I know of), so I guess it's just the latter.
> The last post of mine was in response to what I thought *was* a rather flippant response.
I don't think I'd call it flippant. It may just have been a response to the actual question, rather than any underlying issues.
>I confess to having been angry at the time I wrote the post (anger unrelated to anyone's responses), and I apologize for my remarks/questions about the bullets. Sometimes the only way I can survive another day in this life is to do something weird like post a reply to a web site. What more can I say? I am at the bottom, trying to figure out how to climb back out.
It's not so weird to post to a web site. :-)
Hope you make it out,
Bob
Posted by Carol on March 31, 1999, at 16:15:48
In reply to Re: implicit suicide threats - q for Dr. Bob, posted by sam (SamAnon) on March 28, 1999, at 8:07:28
> Elizabeth,
> Unfortunately suicidal thoughts are a part of my life, but I haven't acted on them in many, many years. The last post of mine was in response to what I thought *was* a rather flippant response. I confess to having been angry at the time I wrote the post (anger unrelated to anyone's responses), and I apologize for my remarks/questions about the bullets. Sometimes the only way I can survive another day in this life is to do something weird like post a reply to a web site. What more can I say? I am at the bottom, trying to figure out how to climb back out.Sam,
Some of the thoughts about suicide never go away. I find that if I'm having a hard day or week, all of a sudden I'll be doing something else and a random "thought" seems to pop into my head, and it is something like--why do I bother, I should just kill myself-- I'm able to quickly tell myself that this is not reasonable, and I move on to other things. I continue to pay attention to my self-talk. I have found that if I allow my thoughts to go unchallenged, that I can slide back into one of my depressed states. The suicidal snippets are just another type of self talk I need to stop and replace with some other line of thought. This works for me most of the time--but it is an effort some days. When I'm at the bottom looking up, there are many things which feel more logical from there.
At least you know that there is an "up" to go to, and just having this understanding is an improvement over some of the emotional places I've been.also--sometimes if you don't know what to say, say less rather than more
Carol
Posted by Teresa on May 26, 1999, at 23:27:36
In reply to Lorazepam, posted by SamAnon on March 22, 1999, at 19:55:49
Sam,
My little brother, aged 26, was admitted to a psychiatric hospital in Britain 2 weeks ago. He never got out alive. He had begun to suffer from a psychotic illness. His first psychotic episode (hearing voices, which distressed him) was about a month before. That time, he was admitted involuntarily, kept in for a couple of weeks, then released - in pretty good spirits - on a drug called Droperidol.
However, he began another psychotic episode - much milder than the first - and was committed to the psychiatric hospital a second time. He was exhausted, hungry and dehydrated (he'd walked 20+ miles, hadn't slept, eaten or drank any fluids in 2 days). Mum pleaded with the doctors to take into account his weak condition and not to inject him. This time, the doctors 'strongly dissuaded' my parents from accompanying him to the hospital. My brother was taken from home in an ambulance at around 8pm. At around 9.15pm he arrived at the hospital. At around 9.30pm he was 'medicated'.
The social worker who accompanied my brother to the hospital returned to my parents at around 11pm to pick up his car. He said that my brother was fine when he left. They'd injected him, given him a little bit extra because he was 'slightly agitated' upon arriving at the hospital. Mum started to panic, but the social worker assured her that her son was 'tucked up in bed and sleeping like a baby' when he left the hospital.
At 12.15am, mum and dad got a call from the hospital. My brother has had a 'bad reaction to his medication', please come quickly. When mum and dad arrived at the hospital at 1.15am, my brother was dead. In fact, the nurses admitted he was already dead when they called. They'd officially declared him dead at 11.59pm
Apparently, they had checked in on him and found he was having breathing difficulties'. Some saliva had drooled from his mouth. His pulse was 'weak', they said. They called a crash team from the hospital across town (can you believe that???) and attempted rescuscitation for 30 minutes. They failed.
Mum and dad found my brother stripped naked, covered by a white sheet. His clothes had been washed, they were still soaking, in a polythene bag on the floor. My brother's body was stone cold, not a trace of warmth anywhere, not even on his torso. His skin was solid, hard and unmoveable. Mum couldn't fold his arms or move his feet. His body was so stiff, she was afraid of breaking his bones. My dad tried to lift his leg and failed. My brother was 6' 4" and weighed 11 stone. Both mum and dad thought that the rigor mortice was so bad, he must have been dead much longer than the hospital staff claimed.
The doctors would not let our family see his medication record. My aunt - who arrived just after mum and dad - seized the document from a doctor's hands. They called the police. The police called the CID. The CID photocopied the documents.
We looked at the medication record the following day.
Drug---------Route--Prescribed--Spec.Instr.----Given---By
Dropiridol i/m 10mg 40mg max/dy 10mg PC
Lorazipam i/m 2mg 4mg max/day 10mg PCIt looks like he was overdosed. But it's too obvious. They had at least an hour and a half alone with my brother (and his records)before my family arrived. Probably longer. Certainly enough time to strip him and wash his clothes (why the hell did they do that? He was dehydrated, his bladder would have been empty when he died!)
Meanwhile, surely one of the staff would have noticed the 'misprint'? Why was the error left for the CID to find? My brother had two autopsies, carried out by a Home Office pathologist. The pathologist's verdict was that my brother did not die from natural causes. The only cause of death he hasn't ruled out is poisoning.
My brother's body has - we're told - been screened for everything, although we haven't had the results back yet. The hospital staff claim he wasn't overdosed on anything, the 10mg, they claim is a 'misprint'. My brother wouldn't have committed suicide, he wasn't suicidal. I'm sure he didn't take anything before he went to the hospital.
They killed my brother.
Posted by Thirty_somethin on May 26, 1999, at 23:58:17
In reply to Maybe you can. My brother is dead. Read this!, posted by Teresa on May 26, 1999, at 23:27:36
Teresa,
My heart goes out to you. Doctors would never admit any mistakes even when challenged in court. They possess this high superiority complex that's both innate and medical school cultivated. The whole reasoning being why should a medical doc suffer for a small misdiagnosis after going thru all these years wasted getting trained... and for what!!.. a person that's probably wacko to begin with and uneducated...do you follow where that logic could lead?
The age of that old-time good-old family doctors that made housecalls and knew each family member personally has gone for good, alas...> Sam,
>
> My little brother, aged 26, was admitted to a psychiatric hospital in Britain 2 weeks ago. He never got out alive. He had begun to suffer from a psychotic illness. His first psychotic episode (hearing voices, which distressed him) was about a month before. That time, he was admitted involuntarily, kept in for a couple of weeks, then released - in pretty good spirits - on a drug called Droperidol.
>
> However, he began another psychotic episode - much milder than the first - and was committed to the psychiatric hospital a second time. He was exhausted, hungry and dehydrated (he'd walked 20+ miles, hadn't slept, eaten or drank any fluids in 2 days). Mum pleaded with the doctors to take into account his weak condition and not to inject him. This time, the doctors 'strongly dissuaded' my parents from accompanying him to the hospital. My brother was taken from home in an ambulance at around 8pm. At around 9.15pm he arrived at the hospital. At around 9.30pm he was 'medicated'.
>
> The social worker who accompanied my brother to the hospital returned to my parents at around 11pm to pick up his car. He said that my brother was fine when he left. They'd injected him, given him a little bit extra because he was 'slightly agitated' upon arriving at the hospital. Mum started to panic, but the social worker assured her that her son was 'tucked up in bed and sleeping like a baby' when he left the hospital.
>
> At 12.15am, mum and dad got a call from the hospital. My brother has had a 'bad reaction to his medication', please come quickly. When mum and dad arrived at the hospital at 1.15am, my brother was dead. In fact, the nurses admitted he was already dead when they called. They'd officially declared him dead at 11.59pm
>
> Apparently, they had checked in on him and found he was having breathing difficulties'. Some saliva had drooled from his mouth. His pulse was 'weak', they said. They called a crash team from the hospital across town (can you believe that???) and attempted rescuscitation for 30 minutes. They failed.
>
> Mum and dad found my brother stripped naked, covered by a white sheet. His clothes had been washed, they were still soaking, in a polythene bag on the floor. My brother's body was stone cold, not a trace of warmth anywhere, not even on his torso. His skin was solid, hard and unmoveable. Mum couldn't fold his arms or move his feet. His body was so stiff, she was afraid of breaking his bones. My dad tried to lift his leg and failed. My brother was 6' 4" and weighed 11 stone. Both mum and dad thought that the rigor mortice was so bad, he must have been dead much longer than the hospital staff claimed.
>
> The doctors would not let our family see his medication record. My aunt - who arrived just after mum and dad - seized the document from a doctor's hands. They called the police. The police called the CID. The CID photocopied the documents.
>
> We looked at the medication record the following day.
>
> Drug---------Route--Prescribed--Spec.Instr.----Given---By
> Dropiridol i/m 10mg 40mg max/dy 10mg PC
> Lorazipam i/m 2mg 4mg max/day 10mg PC
>
> It looks like he was overdosed. But it's too obvious. They had at least an hour and a half alone with my brother (and his records)before my family arrived. Probably longer. Certainly enough time to strip him and wash his clothes (why the hell did they do that? He was dehydrated, his bladder would have been empty when he died!)
>
> Meanwhile, surely one of the staff would have noticed the 'misprint'? Why was the error left for the CID to find? My brother had two autopsies, carried out by a Home Office pathologist. The pathologist's verdict was that my brother did not die from natural causes. The only cause of death he hasn't ruled out is poisoning.
>
> My brother's body has - we're told - been screened for everything, although we haven't had the results back yet. The hospital staff claim he wasn't overdosed on anything, the 10mg, they claim is a 'misprint'. My brother wouldn't have committed suicide, he wasn't suicidal. I'm sure he didn't take anything before he went to the hospital.
>
> They killed my brother.
Posted by alan on May 27, 1999, at 19:15:57
In reply to Re: Lorazepam/Lethal overdose?, posted by Dr. Bob on March 26, 1999, at 9:16:33
> > You'd be hard pressed to kill yourself by ODing on Ativan or any other benzodiazepine...
>
> Not that anyone should try or anything, of course...
>
> BobIt is almost impossible to kill yourself with benzos and it is very difficult to kill yourself with alcohol (without heroic feats of consumption, as at fraternity initiations). Why then is it easy to kill yourself with both together? Or is it? Don't worry, I'm not making plans.
Posted by Sam on May 27, 1999, at 19:22:42
In reply to Re: Maybe you can. My brother is dead. Read this!, posted by Thirty_somethin on May 26, 1999, at 23:58:17
Teresa,
I just wanted to check here to see if anyone had posted to another thread that I started. I am so sorry for what has happened to all of you. I will write later this evening...Sam
Posted by alan on May 27, 1999, at 19:41:55
In reply to Teresa, posted by Sam on May 27, 1999, at 19:22:42
I wish to express my condolences. I pray that you and your family shall find comfort. If you persist in seeking justice for your brother, I pray that you achieve it soon.
Posted by from St James to Teresa on May 28, 1999, at 14:28:47
In reply to Maybe you can. My brother is dead. Read this!, posted by Teresa on May 26, 1999, at 23:27:36
Sorry..... you cannot overdose on Lorazipam, and 10 mgs, while high is not dangerous....I've taken 4 mgs a day for months with no effect. There is no known lethal dose of Lorazipam in humans. I assume Droperidol is Halodol in the states...the doses given him were normal and lozizipam and Halodol can be given together.
Your brother sounds like he was schizophrenic....did he ever get a diagnosis? The other reason for psychotic episodes is drug use....did the pathologist report turn up any drugs in his body ? I'm not trying to put your brother down but drug use commonly causes these problems. The hospital should have done a drug screen when his was admitted to rule out this....if he was on drugs this would of made the whole picture as to what and why they gave him in terms of meds very different.
My guess is that as your brother was very dehydrated his heart rhythms got messed up. Again the hospital should of checked his electrolytes; when these get messed up the heart can stop beating or beat irregularly. Had the hospital of had a crash cart at hand your brother would be alive. Not having a crash cart at hand is HORRIBLE and I suggest a consult with a solicitor at once !
The other posibitity I can think of is that he had a allergic reaction to the meds (this is very rare, but happens) Again, a crash cart at hand would probably mean your brother would be alive. There is really no way to know if someone has a very rare allergy. Had he taken the meds b4 and had no problems ?
There are many other reasons why he died but had the crash cart been at hand he would of had a fighting chance. Let me know what the rest of the tests show. Given the short time frame from meds to death they should be able to tell you how much of the meds were in his body and if they were excessive.
I think you should post this to the list (Psycho Babble) to see what they come up with. If you would like I can post it for you if you would like to remain unknown. I'm not a doc, so take what I said accordingly. I AM SO VERY SORRY THIS HAPPENED. Keep in touch....if you need to yell and vent you are welcome to yell and vent to me.
james
Posted by Teresa on May 28, 1999, at 14:32:58
In reply to Re: Maybe you can. My brother is dead. Read this!, posted by from St James to Teresa on May 28, 1999, at 14:28:47
Thanks, James.
Uh, yeah, I'll post your reply to me on the board. And this one, okay? You came up with a few more possibilities. We've considered them all except one. I should say that my brother was not a drug abuser. He didn't smoke and never did drugs. He never had more than a couple of beers. He was very health conscious. He'd think twice before even taking an aspirin. Sorry, I should have made that clear at the start.
I guess my bro was suffering from schizophrenia, although most of the symptoms came on recently (prior to that, he was being treated for agoraphobia) and the doctors hadn't officially diagnosed him as schizophrenic yet.
From my conversations with him, I've leant that my brother was able to have lucid dreams; he enjoyed them very much. Lately, he was also aware of 'multiple personalities', which he was *convinced* weren't just facets of himself. The only explanation he could accept was that they were external to him, possibly other beings intruding in his mind. At first he was intrigued by them, even encouraged them, later he was frightened by them. Finally, he tried very hard to ignore them. He failed, and this led to his two episodes of psychosis.
The other possibility you mentioned, an allergic reaction? Hmm, I don't know. Unlikely. My brother experienced some side-effects, though. He had problems with 'Olanzapine', the anti-psychotic they tried him on the first time. He had nasty muscle spasms, starting with his face and progressively spreading to his whole body. He was given an 'antidote' drug to counteract these side-effects and treatment continued. Later he was switched over to Dropiredol. After 4 days of observation, he was released from hospital on 10mg Droperidol a day. I don't really know if he'd ever been given Lorazipam before. I can't phone the hospital to find out, the CID have told us not to talk to them. They wouldn't talk to us anyway. :-(
I am very angry at the psychiatric hospital. I know they have no facilities for medical check-ups or for emergency rescuscitation. For sure, 'electrolyte levels' are not measured - how would they do that? - I didn't see my brother's blood pressure or pulse being taken the first time he was admitted and administered drugs, nobody listened to his heart, there wasn't a stethoscope in sight. I'm pretty sure they didn't do this stuff second time round, either. At this place, pills are handed out like M&Ms. If you refuse to swallow your pills, you are forcibly injected. The 'wards' look more like student dorms than a hospital. It has more in common with a prison.
My brother was totally non-violent by nature, and he would have only resisted the doctors passively, i.e., he might have struggled, he might have tried to run, but he wouldn't have hurt anybody. I don't recall him ever striking out at anybody in his whole life. Why did they have to dope him up like that? Wy not just calmly and patiently talk him down? My mum begged them not to inject him because he was so dehydrated. Why didn't they listen? :-(
Teresa
Posted by Steve on May 28, 1999, at 20:58:59
In reply to A little more info about my brother..., posted by Teresa on May 28, 1999, at 14:32:58
I'm not sure what the case law is in England, but as an attorney I can tell you that you should consult with a good malpratice lawyer.
A lawsuit can never bring back a beloved family member, but it can force institutions to change their behavior.
This is the end of the thread.
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