Brief Answer: Substitute ativan if required, but avoid injection Detailed Answer: Hello sir and welcome. Thank you for writing to us. I understand how you feel ativan (which has the active ingredient lorazepam) belonging to the group of drugs called benzodiazepines, should not be used for the long term. Firstly, you should know that there are individuals who are using this medication for the long term, although it is not ideal, if you can learn not to completely depend on this medication, then it can be used for a long duration of time. As for discontinuation of this medication, I would recommend you stay under the supervision of a medical practitioner and gradually wean off this medication instead of immediately and abruptly discontinuing it. Substitutes for lorazepam providing the same effect can be: -Alprazolam -Clonazepam -Diazepam -Clorazepate -Chlordiazepoxide -Oxazepam -Bromazepam You can choose from any of these. As for the option of shifting over the an intravenous route, I do not think this would be a safe option. You can choose from any of the above benzodiazepines or continue with ativan, along with the amitriptyline. Although I would like to add that it would be best to wean off the ativan and try yourself. See if you really need to ativan or not, if you succeed to manage without it, then you need not use a second drug at all. But if at all you start experiencing symptoms of anxiety or depression again, then either restart the ativan or any one of the benzodiapines. I hope I have succeeded in providing an answer to your queries sir. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.

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Brief Answer: Both drugs are independent of each other sir Detailed Answer: Hello once again sir. Ativan is used to treat symptoms of anxiety, whereas amitriptyline is used to treat symptoms of depression. So these medications are not co-dependent and stopping one will not make the other one less potent. Although, if either on of these needs to be stopped, you will have to slowly taper the dose and gradually discontinue it, making very sure you do not abruptly discontinue either one. It is best if you do so under the supervision of a doctor, and as per his/her instructions. If you and your doctor have chosen to taper you off ativan, then restarting this medication will not be discussed or even considered an option in the future. So do not worry about this sir. I hope I have successfully answered your queries. Wishing you all the luck you need and more sir. Best wishes.

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Brief Answer: The cause seems to be the medication sir Detailed Answer: Hello sir. If you do not mind me asking, have the headaches been present from before you started with the amitriptyline or have they only started after you initiated the amitriptyline? I only ask this as headaches are a common side effect of amitriptyline. So if these headaches have begun only after the initiation of the medication I would say that you have waited long enough and you do need to revisit your doctor and request for either another medication to help tackle the headaches, or reduce the amitriptyline dosage, or substitute the medication with another one to suit your individual needs. I hope this information helps you sir. Please feel free to write to me anytime sir. I would be more than happy to help. Best wishes.

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Brief Answer: Best to address the hyperacidity Detailed Answer: Hello once again sir. And thank you so much for that information. I shall surely address each aspect of your query and the information you have provided above. As we had discussed in our previous discussion, I had pointed out that the GERD is most probably the cause for your headaches sir. So, although antacids should help reduce the acid production and in turn help to reduce the headaches, it is unfortunate that they in turn have aggravated your headaches. What I would like to add her is that is most probably because of your acid production, and would request you to add a syrup called sucralfate that should help neutralize all the acid in your stomach, do discuss the same with your doctor. This just might help to reduce the headaches. I am particularly suspecting the acid production to be the cause, as it also matches this description of yours: 'headaches start in the morning and get worse with activity'. This description is very specifically a hyperacidity headache. As for the anti-inflammatory injections sir, no doctor will prescribe the same for long, not these and not any other pain management medication sir. As they have many long term side effects, and are quite frankly not the solution. We will have to treat the cause, and not the symptoms. Also, please make sure you do not take any pain management medications orally, as they can irritate your GERD and aggravate it. I hope this information helps sir. Do try to solve the hyperacidity issue, as this is the main culprit sir. Trust me. Best wishes.

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