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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Mary-Teresa on December 8, 2001, at 15:17:39
Cam after a terrible experience with zoloft, I have a problem with tinnitus elevating every time I try a non benzo type med. Right now 3 mg daily of lorazepam is working quite effectively to control the anxiety, and not effecting my ears. My question is how viable would lorazepam be for long term use, and what doesages are prescribed normally? Will it stop working in weeks, months years? Maybe as I calm down, I won't need as much. I would appreciate your thoughts-Mary
Posted by Elizabeth on December 8, 2001, at 20:17:42
In reply to Cam- Question on long term use of lorazepam, posted by Mary-Teresa on December 8, 2001, at 15:17:39
High-potency benzos (such as lorazepam) have been shown to continue working in the long term for panic disorder. I'm not so sure about generalized anxiety. Do you happen to have a diagnosis?
(3 mg/day of lorazepam isn't so much, BTW.)
-elizabeth
Posted by jay on December 9, 2001, at 15:13:03
In reply to Re: long term use of lorazepam » Mary-Teresa, posted by Elizabeth on December 8, 2001, at 20:17:42
> High-potency benzos (such as lorazepam) have been shown to continue working in the long term for panic disorder. I'm not so sure about generalized anxiety. Do you happen to have a diagnosis?
>
> (3 mg/day of lorazepam isn't so much, BTW.)
>
> -elizabethBeing the pro-benzo guy I am..< grin >..I just wanted to second Elizabeth's comments. Like pain medications, to control your anxiety, increased doses are highly unlikely. People usually only need to increase the dose if they are looking to abuse the drug, or get "high" from it. Otherwise, it works great in the short and long run for GAD and any anxiety disorder. 3-6mg b.i.d. or t.i.d. seems to be an "average" dose, and up to 10mg's a day is listed as being effective at www.rxlist.com
Best wishes..
Jay
Posted by Elizabeth on December 9, 2001, at 21:24:48
In reply to Re: long term use of lorazepam, posted by jay on December 9, 2001, at 15:13:03
> 3-6mg b.i.d. or t.i.d. seems to be an "average" dose, and up to 10mg's a day is listed as being effective at www.rxlist.com
Uh, do you mean 1-2 mg b.i.d. or t.i.d.? 6 mg of Ativan t.i.d. -- 18 mg/day -- would be getting awfully high.
On the other hand, when I was in the hospital (for acute respiratory distress syndrome, cause still unknown) back in February, I'm told I was on 10 mg/hour (IV infusion) at one point and they somehow managed to get me off it. So anything's possible! (IV infusion is different from taking a single dose all at once -- you're getting it continuously.)
-elizabeth
Posted by Cam W. on December 9, 2001, at 21:55:15
In reply to Cam- Question on long term use of lorazepam, posted by Mary-Teresa on December 8, 2001, at 15:17:39
Mary - I agree with Elizabeth (as usual) and Jay. I would add that, while the vast majority of people will not need to increase their Ativan™ (lorazepam) dose over time. Those that do seem to have more problems with addiction and withdrawl. As long as you use the Ativan for the anxiety and not for escape, these problems are minimal. - Cam
Posted by Alan on December 9, 2001, at 22:49:34
In reply to Cam- Question on long term use of lorazepam, posted by Mary-Teresa on December 8, 2001, at 15:17:39
> Cam after a terrible experience with zoloft, I have a problem with tinnitus elevating every time I try a non benzo type med. Right now 3 mg daily of lorazepam is working quite effectively to control the anxiety, and not effecting my ears. My question is how viable would lorazepam be for long term use, and what doesages are prescribed normally? Will it stop working in weeks, months years? Maybe as I calm down, I won't need as much. I would appreciate your thoughts-Mary
************************************************
Absolutely agree with all above (not surprising).The World Health Organisation has even examined all of the long term studies of 30 + years and conclude that they show aproppriateness of short AND long term use of BZD's for anxiety disorders. It's a question as to whether you want to be dependent on anxiety running your life or you being medically dependent on a med that allows one to live their life.
Experiment with dosages without fear since studies show that due to false, stigmatising, political, moralistic, half-truthed reports about "addictiveness" (medical dependence), most anxiety sufferers UNDERutilise their BZD's rather than OVERutilise them.
I've used them in mono therapy for over 20 years with no increase except to trace a natural waxing and waning of the anxiety levels themselves.
Great day when the ill informed doc (or entire medical system as in Canada and the UK) doesn't go around saying NOPE, can't prescribe an anxiolytic for anxiety - too addictive. Such ignorance is stupifying to say the least and depriving legitimate anxiety sufferers of meds that will relieve their suffering at the most.
Alan
Posted by Alan on December 9, 2001, at 22:52:52
In reply to Cam- Question on long term use of lorazepam, posted by Mary-Teresa on December 8, 2001, at 15:17:39
You may also want to look at this link re: "addictiveness" posted by our illustrious elizabeth from months previous:
http://www.dr-bob.org/babble/20010618/msgs/67768.html
Enjoy!
Alan
Posted by Alan on December 9, 2001, at 22:55:18
In reply to Cam- Question on long term use of lorazepam, posted by Mary-Teresa on December 8, 2001, at 15:17:39
Another link and scroll down to benzodiazapines (and ssri's for that matter):
http://bearpaw8.tripod.com/pd.html
VERY informative...
Alan
Posted by Elizabeth on December 10, 2001, at 11:02:40
In reply to Re: Cam- Question on long term use of lorazepam » Mary-Teresa, posted by Cam W. on December 9, 2001, at 21:55:15
> Mary - I agree with Elizabeth (as usual)
Heh heh. Thanks -- we seem to have a mutual admiration society going here. < g >
> I would add that, while the vast majority of people will not need to increase their Ativan™ (lorazepam) dose over time. Those that do seem to have more problems with addiction and withdrawl.
That's an excellent point: if you do find yourself needing to increase the dose of a benzo, I think that would probably be a sign that it's not right for you, or maybe that you're using it for the wrong purpose.
> As long as you use the Ativan for the anxiety and not for escape, these problems are minimal.
I've always been a little fuzzy as to where the line is between anxiety relief and escape, but something else that benzos tend *not* to work for in the long term is insomnia. (On the bright side, this also means that sedation is usually a transient side effect.)
-elizabeth
p.s. Cam, how did you make the superscript "TM?"
Posted by Cam W. on December 10, 2001, at 18:57:38
In reply to Re: long term use of lorazepam » Cam W., posted by Elizabeth on December 10, 2001, at 11:02:40
> p.s. Cam, how did you make the superscript "TM?"
Elizabeth - I use an iMac, not a computer. A couple of years ago someone on this site started posting neat things, and that is how I discovered this function on my Mac. The "alt/option" key plus the "2" key makes the superscript. - Cam
Posted by Elizabeth on December 10, 2001, at 19:17:27
In reply to Re: long term use of lorazepam » Elizabeth, posted by Cam W. on December 10, 2001, at 18:57:38
> Elizabeth - I use an iMac, not a computer.
< giggle > Okay, that answers my next question (why?) too!
-e
Posted by christophrejmc on December 10, 2001, at 22:19:34
In reply to Re: long term use of lorazepam » Cam W., posted by Elizabeth on December 10, 2001, at 19:17:27
('™', ASCII char #153) can be done on a PC by pressing Alt+0153 (use the keypad numerals w/ numlock off). Shouldn't it be '®', though?
Posted by Cam W. on December 11, 2001, at 8:35:49
In reply to trademark » Elizabeth, posted by christophrejmc on December 10, 2001, at 22:19:34
Christophrejmc - LOL! Is it supposed to be ®, and not a ™? Well ˜œƒ§ß!! I don't know; I'm in science. Is it a wonder that I got a 3 in English? - Cam
Posted by Elizabeth on December 11, 2001, at 14:08:43
In reply to Re: trademark » christophrejmc, posted by Cam W. on December 11, 2001, at 8:35:49
> Christophrejmc - LOL! Is it supposed to be ®, and not a ™? Well ˜œƒ§ß!! I don't know; I'm in science. Is it a wonder that I got a 3 in English?
I wouldn't call this "English." But anyway, either would be correct; I'm sure that drug brand names are registered trademarks. You can put "TM" on just about anything, indicating that it's a trademark, but registration actually requires some sort of legal process. At least, I think that's how it works -- any lawyers out there?
-e
Posted by christophrejmc on December 11, 2001, at 16:43:47
In reply to Re: trademark » Cam W., posted by Elizabeth on December 11, 2001, at 14:08:43
Perhaps ™ is proper in Canada, they also have that "SM" (sales mark, I think) symbol which might be used in the way that ™ is in the states.
> I wouldn't call this "English." But anyway, either would be correct; I'm sure that drug brand names are registered trademarks. You can put "TM" on just about anything, indicating that it's a trademark, but registration actually requires some sort of legal process. At least, I think that's how it works -- any lawyers out there?
>
> -e
Posted by Dr. Bob on December 11, 2001, at 23:35:53
In reply to Re: trademark » Elizabeth, posted by christophrejmc on December 11, 2001, at 16:43:47
> Perhaps ? is proper in Canada...
How about if this part of this thread gets redirected to Psycho-Social-Babble? :-)
Bob
Posted by wendy b. on December 12, 2001, at 12:17:16
In reply to Re: Redirect: trademark » Dr. Bob, posted by Cam W. on December 12, 2001, at 0:13:59
> Dr.B. - Okay, we'll stop. Won't we guys. - Cam
>
> ;^)
Once in a while I disagree, respectfully, with Dr Bob about which board a certain discussion takes place. This is one. Since the issue is how drugs are registered, and how that is notated in discussion, or in writing, I think it very much belongs here on the regular PB board.And this discussion on relevance to one board or another belongs on the Admin board, so they gotcha comin' and goin'...
as always,
Wendy
Posted by Dr. Bob on December 12, 2001, at 21:16:14
In reply to Re: Redirect: trademark - P.S., posted by wendy b. on December 12, 2001, at 12:17:16
> Once in a while I disagree, respectfully, with Dr Bob about which board a certain discussion takes place. This is one. Since the issue is how drugs are registered, and how that is notated in discussion, or in writing, I think it very much belongs here on the regular PB board.
>
> And this discussion on relevance to one board or another belongs on the Admin board, so they gotcha comin' and goin'...I know, I get confused myself sometimes. :-)
But, though still related to drugs, this got, IMO, too distantly related. :-)
Bob
This is the end of the thread.
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