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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by janejj on December 17, 2002, at 20:09:44
hi,
I take 1mg Lorazepam (aka Ativan) at night, however i don't find it effective any more. I could take more but then my doc will prob think I am addicted and not prescribe me anymore! I am getting into a really bad sleep rountine....fall asleep at 4am and then get up at 3pm, i am fed up of wasting half the day. If I get up early and try to stay awake I find that I just fall asleep anyway.
What shall I do ?
jane
Posted by oracle on December 17, 2002, at 21:22:57
In reply to Lorazepam doesn't work anymore, posted by janejj on December 17, 2002, at 20:09:44
> hi,
>
> I take 1mg Lorazepam (aka Ativan) at night, however i don't find it effective any more.Talk to your doc about a better sleep med ?
Posted by gheld on December 18, 2002, at 8:36:10
In reply to Lorazepam doesn't work anymore, posted by janejj on December 17, 2002, at 20:09:44
I'd certainly give up on the Ativan as the sleepiness it causes is known to wear off after a couple of weeks. Same with the other benzo's.
However, if it's anxiety keeping you awake, you might consider talking to your doc about switching to Klonopin, which is more sedating, and a larger dose of it. It doesn't make me sleepy but it does relax me. I take 1 mg at night. I believe 1 mg of Klonopin is roughly equal to 2 mg of Ativan in effectivenenss.
Posted by Jaynee on December 18, 2002, at 11:33:56
In reply to Lorazepam doesn't work anymore, posted by janejj on December 17, 2002, at 20:09:44
Add passion flower tincture. I tried that a few times and didn't have to take as much ativan. It works.
Posted by Aadika on December 18, 2002, at 12:27:43
In reply to Re: Lorazepam doesn't work anymore, posted by Jaynee on December 18, 2002, at 11:33:56
Though I'm currently stabilized on my dose of Klonopin and have been for well over a year, back when I was taking lorazepam and found that it was beginning to poop out I'd do one of three things, depending on the circumstances. One would be to simply not take it for a couple days (though I'd highly advise against doing this without talking to your prescribing physician first!!)... also, cimetidine (OTC Tagamet) taken about 45 minutes before the lorazepam greatly increases how much of it gets into your blood. Finally, you could try taking a sedating anti-histamine with it... maybe 25-50mg diphenhydramine?
Oh, and Jaynee's suggestion regarding passion flower is also a good one... especially if brewed into a tea with skullcap, hops, and valerian... perhaps even with a capsule-full of the amino acid l-taurine (the thing in turkey that makes you sleepy) mixed in. Also, readily absorbable combination calcium / magnesium products have long been known to provide a good night's sleep. So mom was definitely onto something bringing you a glass of warm milk before bed each night. :-)
Best of luck,
~ Aadika~ Aadika
Posted by BrittPark on December 21, 2002, at 0:34:23
In reply to Re: Lorazepam doesn't work anymore, posted by gheld on December 18, 2002, at 8:36:10
As gheld said benzos are not effective long term sleeping pills. The body becomes accustomed to the hypnotic effect of benzos in a few weeks. My psychiatrist when he prescribes benzos for insomnia has his patients on a 2 weeks on 1 week off schedule. If you are taking benzos because you are anxious and it's the anxiety that's keeping you awake, then it makes sense to use benzos and quite reasonable to raise the dose if the anxiolysis is inadequate.
Outside of benzos and the benzo-like sleeping pills (ambien etc) there are other choices. Remeron at doses below 30mg is quite sedating. Trazadone is commonly used for insomnia. It's not much of an antidepressant but it makes a good sleeping pill. Personally I'd stay away from so-called natural remedies. Plants didn't evolve to produce substances for the benefits of man but as mechanisms of self defense. Morphine is produced by the opium poppy not to provide humanity with a pain killer but as a way to keep critters from eating it. Morphine is a very useful medicine but is quite toxic in the wrong dose. If you do try something like valerian, don't mix it with benzos. There probably isn't any danger in doing so but you never know.
Good luck finding the right solution,,
Britt
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