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What Causes Insomnia While Weaning Off Ativan?
Question: I haven't slept for more than 2 hours for 3 days straight. I am scared about tonight.
I am getting a fast Ativan taper from my dad who won't listen. I used to take like up to thirteen MG pee day some days. he's got me on 2 mgs straight and doesn't let me go according to how my doctors 6 MG suggested taper.
now I'm stuck with that and doctor also has me on lyrica but only 50 mga day. I've read that people take way higher doses for anxiety.
Also I'm taking gabapentin. they help a small bit but not close to what I need.
I need to know what to do to get to sleep because I'm
I am getting a fast Ativan taper from my dad who won't listen. I used to take like up to thirteen MG pee day some days. he's got me on 2 mgs straight and doesn't let me go according to how my doctors 6 MG suggested taper.
now I'm stuck with that and doctor also has me on lyrica but only 50 mga day. I've read that people take way higher doses for anxiety.
Also I'm taking gabapentin. they help a small bit but not close to what I need.
I need to know what to do to get to sleep because I'm
Brief Answer:
Slower tapering, sedating antidepressant.
Detailed Answer:
I read your question carefully and I am sorry about the situation you are into.
13 mg is a very high dose. When tapering from benzodiazepines, even more so when the dose is that high it is important to do that in a very gradual way, say by reducing the dosage by 10% every 1-2 weeks as tolerated. Going from 13 to 2 mg can be very harmful, not only leading to anxiety and insomnia like you say but can even risk seizures. Your father should understand that and not go against medical advice. I am not sure why he's taking decisions for you at your age, but you should talk to him, invite him to read independent sources on the internet if he is not convinced.
So for now I think you should go to a higher dose and then taper gradually as already suggested. If even when tapering is gradual there are issues of anxiety and insomnia I suggest the addition of an antidepressant, one with sedating properties like mirtazapine or amitryptiline, which should help both with anxiety and insomnia. Try to avoid adding too many drugs, I do not see why you are adding gabapentin to lyrica, both act in similar ways, combining them doesn't add much and increases possibility of side effects.
I hope you will feel better soon.
Slower tapering, sedating antidepressant.
Detailed Answer:
I read your question carefully and I am sorry about the situation you are into.
13 mg is a very high dose. When tapering from benzodiazepines, even more so when the dose is that high it is important to do that in a very gradual way, say by reducing the dosage by 10% every 1-2 weeks as tolerated. Going from 13 to 2 mg can be very harmful, not only leading to anxiety and insomnia like you say but can even risk seizures. Your father should understand that and not go against medical advice. I am not sure why he's taking decisions for you at your age, but you should talk to him, invite him to read independent sources on the internet if he is not convinced.
So for now I think you should go to a higher dose and then taper gradually as already suggested. If even when tapering is gradual there are issues of anxiety and insomnia I suggest the addition of an antidepressant, one with sedating properties like mirtazapine or amitryptiline, which should help both with anxiety and insomnia. Try to avoid adding too many drugs, I do not see why you are adding gabapentin to lyrica, both act in similar ways, combining them doesn't add much and increases possibility of side effects.
I hope you will feel better soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
II'm asking about sleep though in this questions. also I know all afoul anti depressants and they haven't helped in the past.
also I was hoping I could get some info from u as a doctor about gabapentin and lyricaa. they do work but I need something more potent.
also I was hoping I could get some info from u as a doctor about gabapentin and lyricaa. they do work but I need something more potent.
Brief Answer:
Read below
Detailed Answer:
Hello again and thank you for your feedback.
I know that you are asking about sleep, that is why I specified sedative antidepressants and not any antidepressant. Sedative antidepressants are used for treatment of insomnia. Also you can not think of anxiety as a separate issue from lack of sleep, it is the top cause of secondary insomnia (secondary insomnia meaning for which there is a cause) and one has to treat it as well when present, otherwise will not be as effective.
As for Gabapentin and Pregabalin (Lyrica) you seem to be interested for, as I said before it is either one or the other not both at the same time as they are similarly acting. Benzodiazepine withdrawal is not an approved indication of Lyrica, so technically they are not used for that purpose. However there are several studies which all have shown them to be effective so they are used off label. The dosage used is higher then what you are taking though, 50 mg a day is too little. It should be increased at least to 150 mg and if that is not satisfactory more than that, commonly it is 300 mg, can go as high as 600 (gradually). That does not change the advice about slow tapering of attivan that should be clear.
I remain at your disposal for other questions.
Read below
Detailed Answer:
Hello again and thank you for your feedback.
I know that you are asking about sleep, that is why I specified sedative antidepressants and not any antidepressant. Sedative antidepressants are used for treatment of insomnia. Also you can not think of anxiety as a separate issue from lack of sleep, it is the top cause of secondary insomnia (secondary insomnia meaning for which there is a cause) and one has to treat it as well when present, otherwise will not be as effective.
As for Gabapentin and Pregabalin (Lyrica) you seem to be interested for, as I said before it is either one or the other not both at the same time as they are similarly acting. Benzodiazepine withdrawal is not an approved indication of Lyrica, so technically they are not used for that purpose. However there are several studies which all have shown them to be effective so they are used off label. The dosage used is higher then what you are taking though, 50 mg a day is too little. It should be increased at least to 150 mg and if that is not satisfactory more than that, commonly it is 300 mg, can go as high as 600 (gradually). That does not change the advice about slow tapering of attivan that should be clear.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank u. yes thank u about the dosage for lyRica. my doc is got me at 75 MG daily and I have to convince him about the proper dosage. Lyrica is a new thing for many doctors. The off label benefits for sme reason lots of doctors so far are relatively unaware. That shocks me. I seen a doctor today for a different reason and thought I may as well get his opinion about lyrica and gabapentin. He didn't even know.
But I agree with what u wrote. Just want to make sure u were talking about lyrica dosage in your answer?
But I agree with what u wrote. Just want to make sure u were talking about lyrica dosage in your answer?
Brief Answer:
Yes, Lyrica.
Detailed Answer:
Oh yes, I am sorry if I wasn't clear, you do not mention the dosage of gabapentin only Lyrica, so yes, I meant the dosage of Lyrica which is too low and should be increased
If I were to prescribe Gabapentin the dosage for that is higher, at least 600mg, usually need to raise to 900-1200 mg.
I hopr to have been of help.
Yes, Lyrica.
Detailed Answer:
Oh yes, I am sorry if I wasn't clear, you do not mention the dosage of gabapentin only Lyrica, so yes, I meant the dosage of Lyrica which is too low and should be increased
If I were to prescribe Gabapentin the dosage for that is higher, at least 600mg, usually need to raise to 900-1200 mg.
I hopr to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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