Doctors' Answers to "Frequently Asked Questions" - Ativan

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Ativan [posted 12//08/98]
Question: I've been taking ativan 0.5 mg twice a day for the last year or so. How can ativan help an anxiety condition? Is it safe to take ativan for long periods and during pregnancy? How can I restore my previous health without depending on ativan & completely recovering from anxiety disorder? Is there any tendency of getting asthmatic problems from anxiety?

Answer: Ativan is addicting both to you and your fetus. It should be avoided if possible, while pregnant. Drugs like prozac, paxil etc can be used-but, the effect on the fetus is less well known. I'd probably recommend as low a dose of ativan as possible. But, you're in a bit of a pickle. Anxiety does not cause asthma, but anxiety often makes one feel short of breath.(Then again so does pregnancy).

Ativan General Information [posted 10/13/98]
Question:  Would you please help me by finding this medication fundamental and the need for it. I must do research on Ativan, for school, thanks. 

Answer: Happy to help;but, what do you need? Ativan belongs to a class called benzodiazepines which are used for sedation, anxiety disorders etc. I would refer you to a basic text like Goodman and Gilman's Pharmacological Basis of Therapeutics by Hardman(available in all medical libraries and most large libraries) for a long discussion.

Ativan Dependency Concerns [posted 10/13/98]
Question: I have a prescription to take ativan for anxiety and wonder what the proper way is to take it. Should it only be used sometimes during anxious periods or on a daily basis? I am concerned about dependency. Also, are there problems taking it with St Johns Wort?

Answer: It can be taken as needed or on a regular basis. The more that is taken and the more regularly that it is taken will increase the risk of dependence. There is no obvious interaction with St. John's Wort.

Ativan Costs [posted 9/29/98]
Question: A good friend of mine is manic-depressive and was taking Ativan for years until the market was cornered for the drug. Now the price of Ativan has apparently sky-rocketed and is unaffordable. He is currently taking another drug which is described as a cousin to Ativan. He is having terrible side affects. He would like to know who would distribute Ativan at an affordable price. Can you help us out?

Answer:Ativan is sold under the generic name of lorazepam and is made by at least two other companies than the brand name.. I'm not aware of any monopoly price fixing concerning this drug. However, I do think many drug prices are over inflated. Some of my patients travel to Mexico and return with a years supply of various medications for about 1/2 price or less. There are many pharmacies just over the border in Texas and California who specialize in this business.

Ativan Prescription Filling [posted 7/22/98]
Question: I think you misunderstood the person who had trouble filling the Ativan prescription dated 8/28/97. According to her post, the date on the prescription was correct. It had, however, been less than a month since her last prescription. That should be none of the pharmacist's business. It is not up to him to decide how often the doctor can write prescriptions. I would not be surprised, however, if the pharmaceutical insurance carrier had a one refill per month limit though.

Answer: Most states have limits on controlled drugs that do not allow a pharmacist to fill it after a certain time duration so that unless the number is increased on the prescription it cannot be refilled.

Ativan [posted 7/21/98]
Question: I have taken ativan for 10 years for panic disorder. I feel I am addicted to ativan and would like to decrease my dosage. I am taking 1 mg in the morning and 1 mg in the afternoon. When I miss or am late taking my pill, I have extreme side effects/withdrawal. Is there any other drug I could substitute and would not be habit forming or would help me lower my dosage.

Answer: Sometimes the SRI antidepressant group, Prozac, Paxil, Zoloft will be useful in blocking the anxiety while you withdraw. Do not stop this drug all at once because seizures can occur. You will need to slowly cut back - decrease your dosage 0.25 mg a week for 8 weeks or so. Start the SRI first or as you get to a total dosage of about 1.5 mg.

Question: What is Ativan used for?

Answer: Ativan is a sedative in the benzodiazepine class (like valium, librium, xanax). This drug is used to treat anxiety, help induce sleep, panic disorders, etc.

Question: Could you please explain to me what is a safe level dosage and an over dose level?

Answer: Ativan is dosed by individual symptoms. Some individuals will require fairly high doses, some smaller. When side effects are seen, the drug should be decreased in dose. For some, depending on size, age and other medications this may be 0.5 tid or so. Others will develop tolerance over time and will need much larger doses. Toxicity in these individuals is rarely seen.

Temperature Sensitivity
Question:My paramedic unit recently began carrying Ativan. The problem is that we are now being told that it will be pulled from the unit because it is temp. sensitive. We were told at first that we would just have to replace it monthly but the company is now doing studies and finding that thisthat this may not be good enough. Can you offer any more info?

Answer:Ativan is a drug used to sedate individuals or treatment of anxiety. I really have no idea why you even carry this drug since it requires strict inventory control like any narcotic or sedative. Information on heat sensitivity and out-dating can best he obtained from the company which manufactures it (Wyeth-Ayerst Labs).

Natural Alternative
Question: Is there a natural alternative to ativan? A friend of mine has been taking it for several years and I'm worried about it's potential for liver damage.

Answer: Why is your friend taking ativan? This depends a great deal on whether there is an alternative drug.

Addictive Nature
Question: I am concerned about a despondent relative taking this drug and is it addictive? What are the effects of a habitual user. Do I have reason to be concerned. Should I take steps to try to convince this person not to use this drug regularly?

Answer: Ativan belongs to the class of drugs called benzodiazepines. This class includes valium, librium and several more. They are addicting and should not be stopped "cold turkey" as seizures can result. The drug is a sedative and will have the side effect of depression in some patients. When used on a regular basis for more than 3 months or so you can expect some physical and mental dependency. I would express my concerns in a non-judgmental way. It would be helpful if other family members or friends would gather for this purpose. Sometimes a facilitator from a drug treatment program is useful to moderate(fee of course). Attacking in a judgmental way will rarely lead to results.

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Last modified December 09, 1998