Posted by TylerJ on March 15, 2006, at 6:13:20
In reply to Re: Doc decreases Traz while increasing Ativan » TylerJ, posted by yxibow on March 15, 2006, at 3:07:13
> > > Fantastic too -- I would add that when you get into the 200 to 300 range you are actually starting to take an adult dose of an antidepressant (which was eventually a nonstarter for the drug because it was so sedating for patients until Serzone came around and started causing jaundice...) and it can cascade further and further up.
> > >
> > > I did the Trazodone updose and downdose and updose merrygoround at various points -- its really a yucky medication to go to sleep, dizzyness, and that male black box problem.. mrm, it happens more than you think.
> > >
> > > Thank goodness for more modern pseudobenzodiazepine meant only for sleep (Ambien, etc) medications except that some doctors are reluctant to prescribe them to depressed patients because they think they'll overdose or they're just benzophobic or whatever.
> >
> > Yeah, I don't understand why my pdoc won't just give me Ambien or Lunesta...Instead he insists on Trazodone. When I ask him, he say's he doesn't want to add another "depressant"..Yet he prescribes ativan for me which doesn't even work after 20 years!! I don't get it..it frustrates the hell out of me.
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> He continues to prescribe lorazepam for 20 yrs ?? I know a lot of doctors are stuck on the Trazodone scripting for off-use because they think it has low abuse potential for extremely depressed patients but it has the potential -- quite likely to dose escalate itself into a zombie range until one has to reduce and then go back. Plus the priapism issue which is I believe a black box. (and yes, when I was on a prescribing situation with that I experienced it not once but several times, mildly, and I was even younger than now so it didnt do much harm thankfully.)
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> Express yourself to your doctor -- I can see that he doesnt want escalation of benzodiazepine related drugs but by equivalence you are only on 2.5mgs of Klonopin, give or take -- only a medium range dose. Lunesta would seem to me to, besides that fresh and tasty metallic mouthful (only few people experience that side effect beyond sleep), provide a much less groggy after-night, as very short half life pseudobenzodiazepine like agents are supposed to. Or Ambien CR. Yes, the PDR cautions about depressed patients, but if Ativan came out now it would also, so it seems a non sequitor. But I'm not your doctor. If you truly want something other than Trazodone, convince your doctor that the Ativan isn't doing anything anyhow, and when you wash it out of your system maybe you can try a sleep drug. But I also dont know what other medications you're on, and I obviously can't supercede what your doctor is saying, only you can discuss -- it is your life too after all, doctor-patient relationships should be a two way street I think. Anyhow, if you're comfortable with the Trazodone for now, pleasant dreams.
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> Tidings
>
> - Jay
Thanks Jay,
You're right, after 20 plus years, ativan isn't helping anymore, what we are trying to do is taper off the ativan which will take a LOOOOOng time. He thinks part of my insomnia is caused by reducing the Ativan too quickly . A week a go I was on 3 mgs. a day. But as of yesterday I went back up to 5-6 mgs. daily. Parnate takes care of my anxiety, so I don't feel i need the ativan for anxiety...However, I'm hooked on the ativan, and this is the main reason i still take it. Pdoc said when I'm off the ativan completely he will switch from Traz to Lunesta or Ambien. It's always something you know. :)Ty
poster:TylerJ
thread:618754
URL: http://www.dr-bob.org/babble/20060315/msgs/620510.html