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How To Stop Taking Ativan?

Posted on Sat, 29 Mar 2014

Question: My Mother is taking Ativan 2mg for close to 7 years. She is a patient of Insomnia, depression and anxiety. Few months back she became severely sick. She felt unconscious 3-4 times and slipped on floor. She was rushed to hospital. There she was treated under emergency as a chronic patient of depression. She was suggested to stop taking Ativan and other sleeping pills. However, as it was not easy to stop Ativan immediately, doctor suggested 2mg per day for a month. She feels that she is addicted to Ativan and without the tablet she can't sleep at night. Sometimes she increases the dose to get a proper sleep at night. Day by day it's been extremely difficult to stop her from taking Ativan I'm worried, as her hands shiver always and she has withdrawn herself from any physical work. She always feels too tired and sick. Other doctors, who tried to make her quit Ativan, suggested some other tranquilizers, which made her sicker. . Is there any medication / counseling available? I don’t want her to replace Ativan with another similar drug, but want to stop it completely. At the same time, I need to make sure she gets proper sleep at night. (I'm from Hyderabad)

Answered by Dr. Abhishek Kapoor (2 hours later)

Brief Answer: Increase dose of mirtaz Detailed Answer: Hi Thanks for using healthcare magic. I, Dr Abhishek Kapoor, would help you in this query. No doubt after taking ativan for last seven years, now she has become dependent upon it, but it is not high dose that would difficult to leave. In her case, if she would try to stop it abruptly, she would feel withdrawal symptoms, so either she could take benzodiazepine other than ativan or take antidepressant with sedative effect like mirtazapine or trazodone. If you are not in favor to shift on another benzodiazepine, then dose of mirtazapine (Mirtaz) could be increased up to 15 mg or more to get sound sleep and to control depressive symptoms. Mirtazapine could be increased up to 45mg per day but for that you need psychiatrist consultation. She can carry on with tab nexito 20mg. That would give synergistic effect with mirtazapine In case, you need further help, you can ask. Regards Dr. Abhishek Kapoor Psychiatrist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Abhishek Kapoor (25 minutes later)

Thanks Doctor, In case, I start giving her Nexito, will she be able to stop it? As you mentioned, it is again a sedative medicine, she will be addicted to this too. What's the ideal dosage and how long it should be continued? Again, what are the side effects of it? She is extremely weak and is reluctant to take proper food.

Answered by Dr. Abhishek Kapoor (37 minutes later)

Brief Answer: escitalopram Detailed Answer: Hi Nexito (escitalopram) is a antidepressant and it is not sedative or addictive in nature. It would help in controlling her depressive symptoms. Its effective dosage is 20 to 30mg per day and in her case, she has to take it for many years , may be for rest of her life. It has some side effects like nausea, headache, vomiting, constipation etc, but there is nothing to worry about these side effects. She would get sound sleep with mirtaz, which is also a antidepressant, but has sedative effect. She would not become addictive to any of these drugs and it would be better to take them at night. Gradually with escalation of dose she would feel better. Mirtazapine also helps to increase its appetite and that would help to improve her physical symptoms. Better to consult a psychiatrist for proper use of these drugs rather than general physician. Regards Dr. Abhishek Kapoor Psychiatrist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Abhishek Kapoor (47 hours later)

Thanks Dr XXXXXXX The clarification helped. Can I get mirtaz withiout prescription? Again, since now I'm carefully reviewing all the medicines that are available to her, I saw one medicine named Zolofresh 10. Is it a safe medicine for her and should she continue it? is this another alternative of Ativan?

Answered by Dr. Abhishek Kapoor (2 hours later)

Brief Answer: Mirtazapine is not available over the counter Detailed Answer: Hi Mirtazapine is a antidepressant and you need prescription either from psychiatrist or physician. It is not available over the counter. Zolfresh consists of zolpidem and it is a non benzodiazepine sedative and it is like ativan. It could use it on sos basis due to its lesser abuse potential. In case, you need further help, you can ask. Regards Dr. Abhishek Kapoor Psychiatrist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Abhishek Kapoor (2 days later)

Hi Doctor XXXXXXX Than I would like to get a prescription for Mirtaz. However, I'm staying in Hyderabad. Can you recommend someone who can help me?

Answered by Dr. Abhishek Kapoor (12 minutes later)

Brief Answer: Try to find psychiatrist nearby your location Detailed Answer: HI There are lot of psychiatrist in Hyderabad and you can consult one of them according to the place, where you live. I am afraid, I don't know anyone personally in Hyderabad. I can check online to find one nearby your location if you insist. The treating doctor can give you this prescription. In case, you need further help, you can ask. Regards Dr. Abhishek Kapoor Psychiatrist

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Above answer was peer-reviewed by : Dr. Prasad