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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by LouieG on August 2, 2000, at 0:38:14
I'm a 28 year old very healthy male who's got everything to live for, however depression and anxiety has turned my life into darkness. After 2 years of trial and error my doctor recently prescribed Serzone, desyrel, and Ativan. So far I'm sleeping better and feel hopeful, however a friend of mine told me that xanax works better for his anxiety and doesn't make him sleepy which is the problem I'm having with ativan (or maybe it's the Serzone, I'm not sure). Can anyone tell me anything about those drugs, I did some reasearch on the internet but were conflicting, are they addictive, should I worry? Please help. Louie
Posted by Greg on August 2, 2000, at 9:05:51
In reply to Ativan or Xanax? Which one is safer?, posted by LouieG on August 2, 2000, at 0:38:14
Louie,
First, I've never seen you post here before, so assuming you're new here, WELCOME!
I can't speak about the Ativan as I've never taken it. But I've been taking Xanax for 5-6 months now and it's been very helpful for me. My anxiety is, in a word, intense! I take a half mg as needed and it always calms me into that "comfort zone". Anymore than a half gets me pretty looped though. The down side is that Xanax is VERY addictive. I have a friend that had to go thru detox to kick it, but she was really abusing it though. It's effect on you may be quite different. You should always discuss these things with your doc and make your decisions together. I've recently been put on Paxil, and it's way too early to tell if it's doing any good for me yet, but I'll let you know how it works if you're interested. I hope this helps and please continue to let us know how you're doing!
Peace,
Greg> I'm a 28 year old very healthy male who's got everything to live for, however depression and anxiety has turned my life into darkness. After 2 years of trial and error my doctor recently prescribed Serzone, desyrel, and Ativan. So far I'm sleeping better and feel hopeful, however a friend of mine told me that xanax works better for his anxiety and doesn't make him sleepy which is the problem I'm having with ativan (or maybe it's the Serzone, I'm not sure). Can anyone tell me anything about those drugs, I did some reasearch on the internet but were conflicting, are they addictive, should I worry? Please help. Louie
Posted by JaneST on August 2, 2000, at 12:10:46
In reply to Re: Ativan or Xanax? Which one is safer? » LouieG, posted by Greg on August 2, 2000, at 9:05:51
Louie:
Hello and welcome! Long story short: After a car wreck and diagnosis of classic whiplash: viscious migraines, neck and back pain, arm and hand numbness...was already being treated for depression and axiety with tofranil and xanax. Over the course of about a year things got worse physically and in my life. so I ended up abusing xanax. I finally got the pain/depression cycle stopped and brought myself down from way too many xanax each day to 1mg...but I always knew if I really wanted to knock myself out, all I would have to do is take another xanax.Some years passed and changed pdocs and she changed my xanax to ativan. Initially I didn't think it was effective, but now, overtime, I can't tell the difference...ativan works well for my anxiety. I spent the past year on Serzone and ativan and did not suffer from undue drowsiness. Could it be the desyrel? I have read a lot of posts here regarding sleepiness and Serzone though.
Ok, so I don't exactly have an answer for you but that's it from where I am!
Good Luck!
Jane> > I'm a 28 year old very healthy male who's got everything to live for, however depression and anxiety has turned my life into darkness. After 2 years of trial and error my doctor recently prescribed Serzone, desyrel, and Ativan. So far I'm sleeping better and feel hopeful, however a friend of mine told me that xanax works better for his anxiety and doesn't make him sleepy which is the problem I'm having with ativan (or maybe it's the Serzone, I'm not sure). Can anyone tell me anything about those drugs, I did some reasearch on the internet but were conflicting, are they addictive, should I worry? Please help. Louie
Posted by Steve2 on August 2, 2000, at 15:10:02
In reply to Re: Ativan or Xanax? Which one is safer?, posted by JaneST on August 2, 2000, at 12:10:46
I would think the sleepiness is mostly from Serzone. As far as Ativin v. Xanax goes, I been on both and I prefer Klonopin myself. But, for Panic, Xanax is where I'd put my money.
Posted by kazoo on August 2, 2000, at 22:02:33
In reply to Ativan or Xanax? Which one is safer?, posted by LouieG on August 2, 2000, at 0:38:14
> I'm a 28 year old very healthy male who's got everything to live for, however depression and anxiety has turned my life into darkness. After 2 years of trial and error my doctor recently prescribed Serzone, desyrel, and Ativan. So far I'm sleeping better and feel hopeful, however a friend of mine told me that xanax works better for his anxiety and doesn't make him sleepy which is the problem I'm having with ativan (or maybe it's the Serzone, I'm not sure). Can anyone tell me anything about those drugs, I did some reasearch on the internet but were conflicting, are they addictive, should I worry? Please help. Louie
^^^^^^^^^^^^^^^^
Greetings & Attention LouieG: don't listen to your friends.
Ativan is a very short acting benzo (2 to 3 hours), whereas
Xanax is a longer acting drug; ergo, if you take Xanax at night,
there's a good chance for a morning "hangover." What do I prefer
for anxiety? A long soak in a hot tub surrounded by cuties in
string bikinis discoursing the socio-economic impact of disco
music in Albania ... that's the ticket, that's the ticket!Also, it is claimed that Xanax imparts a mild "anti-depressant" effect,
although I wouldn't bet the ranch on this.Note to Greg: Ativan is abused and is just as addicting.
Lorazepam was the "favored" drug in the 1980s and many got strung-out on it.
But, let's face it: they *all* are addicting."There's no such thing as addictive drugs ... just addictive people."
Genetics, anyone?
kazoo
Posted by Sunnely on August 2, 2000, at 23:18:12
In reply to Ativan or Xanax? Which one is safer?, posted by LouieG on August 2, 2000, at 0:38:14
> sleepy which is the problem I'm having with ativan (or maybe it's the Serzone, I'm not sure).
Serzone, Desyrel, and Ativan can interact among each other in one form or another. Since all these drugs have sedating or calming effect, the collective effect of these drugs in combination on the site of action (brain receptors) is more intense than if used alone. Therefore, you feel more sleepy. This is called the "pharmacodynamic" drug-drug interaction.
Another form of drug-drug interactions can occur among these drugs used in combination. This form of interaction pertains mainly to each drug's effect on the metabolism (liver) of the others. For example, Serzone is a marked inhibitor of the liver enzyme called CYP3A4. Because of this effect, Serzone will slow down the metabolism of a drug that mainly depends on this liver enzyme (e.g., Desyrel). (Desyrel partly depends on CYP2D6 or CYP1A2 for metabolism.) This in turn leads to an increase in its (Desyrel) blood level, leading to increased in side effects (i.e., you feel more sleepy). Serzone does not interfere with the metabolism of Ativan. In fact, Ativan bypasses the active phase of liver metabolism (cytochrome enzymes) and does not produce active metabolite (daughter compound) of its own.
In sum, there are 2 possible ways increased sleepiness can occur with combination of Serzone, Desyrel, and Ativan. Altogether, they act at the site of action (brain receptors) increasing sleepiness (pharmacodynamic interaction). In addition, Serzone slows down the metabolism of Desyrel, increasing its blood level, leading to increased sleepiness (pharmacokinetic interaction).
Replacing Ativan with Xanax will most probably even worsen the problem. FYI, Serzone, similar to its effect on Desyrel, markedly slows down the liver metabolism of Xanax (via same process), leading to increase in Xanax blood level, leading to increased sleepiness.
If you continue to experience sleepiness with this combination, how about consider reducing the dose of Desyrel to alleviate this problem? FYI, Serzone and Desyrel are related in chemical structure. May be you don't need both meds.
= = = = = = = = = = = = = = = = = = = = = = = = => Can anyone tell me anything about those drugs, I did some reasearch on the internet but were conflicting, are they addictive, should I worry?
Ativan (and Xanax) are both benzodiazepines and therefore, have the capability to produce psychological/physiological withdrawal and abuse. Since they are both short-acting or have shorter half-lives, withdrawal symptoms tend to occur more rapidly and intense (including withdrawal seizures) than the longer-acting benzos. They are also more prone to cause "rebound symptoms" (e.g., anxiety, insomnia). "Rebound" phenomenon is the occurrence of an immediate worsening of symptoms shortly after the patient stops the benzodiazepine.
Posted by stjames on August 3, 2000, at 1:14:12
In reply to Re: Ativan or Xanax? Which one is safer?, posted by kazoo on August 2, 2000, at 22:02:33
>
> Ativan is a very short acting benzo (2 to 3 hours), whereas
> Xanax is a longer acting drug; ergo, if you take Xanax at night,
> there's a good chance for a morning "hangover."James here....
I was just looking, thet have very close peaks and half lifes.
To Writ:
snipFollowing oral administration, alprazolam(Xanax) is readily absorbed. Peak concentrations in the plasma occur in 1-2 hours following administration. Plasma levels are proportionate to the dose given; over the dose range of 0.5 to 3.0 mg, peak levels of 8.0 to 37 ng/ml were observed. Using a specific assay methodology, the mean plasma elimination half-life of alprazolam has been found to be about 11.2 hours (range: 6.3-26.9 hours) in healthy adults.
snip
Lorazepam (Atavin) is readily absorbed with an absolute bioavailability of 90 percent. Peak concentrations in plasma occur approximately 2 hours following administration. The peak plasma level of lorazepam from a 2 mg dose is approximately 20 ng/ml.
The mean half-life of unconjugated lorazepam in human plasma is about 12 hours and for its major metabolite, lorazepam glucuronide,(inactive) about 18 hours. At clinically relevant concentrations, lorazepam is approximately 85% bound to plasma proteins. Lorazepam is rapidly conjugated at its 3-hydroxy group into lorazepam glucuronide which is then excreted in the urine. Lorazepam glucuronide has no demonstrable CNS activity in animals.
Posted by Greg on August 3, 2000, at 10:41:01
In reply to Re: Ativan or Xanax? Which one is safer?, posted by kazoo on August 2, 2000, at 22:02:33
> Also, it is claimed that Xanax imparts a mild "anti-depressant" effect,
> although I wouldn't bet the ranch on this.kazoo,
I'll jump on the bandwagon on this comment. When I take more than my normal dose, I'm no longer depressed. I proceed directly into my "I don't give a s**t" mode. Kinda nice sometimes.....
Be at peace,
Greg (an addictive person)
Posted by shar on August 3, 2000, at 11:17:14
In reply to Re: Ativan or Xanax? Which one is safer?, posted by kazoo on August 2, 2000, at 22:02:33
A long soak in a hot tub surrounded by cuties in
> string bikinis discoursing the socio-economic impact of disco
> music in Albania ...Kazoo,
You've had success with this treatment? How many cuties are needed? Are they all a certain age, or is the criterion more like "under 24" or something? Does the discourse always need to be disco/Albania, or do other topics work for you as well?I am interested in trying this, but I'd like to nail these things down. For me, I think cuties with a six-pack in Speedos will work better; have you tried that yet?
Thanks for the great idea!
Shar
Posted by michael on August 3, 2000, at 21:02:25
In reply to Re: Ativan or Xanax? Which one is safer?, posted by kazoo on August 2, 2000, at 22:02:33
Hey Kazoo -
I may be mistaken, but I thought that Xanax was the shorter/quicker in terms of taking effect as well as duration/half-life. And that ativan was considered more of a "short/medium" .....?
I haven't looked for a while, but I believe there is a benzo equivalency table somewhere here on the site... in the tips area maybe, on the left side... something like that....
Anyway, hope all's going well.... michael
> Ativan is a very short acting benzo (2 to 3 hours), whereas
> Xanax is a longer acting drug; ergo, if you take Xanax at night,
> there's a good chance for a morning "hangover." What do I prefer
> for anxiety? A long soak in a hot tub surrounded by cuties in
> string bikinis discoursing the socio-economic impact of disco
> music in Albania ... that's the ticket, that's the ticket!
>
> Also, it is claimed that Xanax imparts a mild "anti-depressant" effect,
> although I wouldn't bet the ranch on this.
>
> Note to Greg: Ativan is abused and is just as addicting.
> Lorazepam was the "favored" drug in the 1980s and many got strung-out on it.
> But, let's face it: they *all* are addicting.
>
> "There's no such thing as addictive drugs ... just addictive people."
>
> Genetics, anyone?
>
> kazoo
Posted by tina on August 4, 2000, at 19:40:12
In reply to Re: Ativan or Xanax? Which one is safer? » kazoo, posted by michael on August 3, 2000, at 21:02:25
Xanax is so addicting i think I'd steer clear of it if you have any choice at all. I've had a bunch of docs tell me NOT to touch it. It works great for some though so I guess you should make up your own mind on this. Dr Bob has a benzo equivalency chart in his psychopharm tips option if you want to make an informed decision.
Good luck and best wishes
Tina> Hey Kazoo -
>
> I may be mistaken, but I thought that Xanax was the shorter/quicker in terms of taking effect as well as duration/half-life. And that ativan was considered more of a "short/medium" .....?
>
> I haven't looked for a while, but I believe there is a benzo equivalency table somewhere here on the site... in the tips area maybe, on the left side... something like that....
>
> Anyway, hope all's going well.... michael
>
>
>
> > Ativan is a very short acting benzo (2 to 3 hours), whereas
> > Xanax is a longer acting drug; ergo, if you take Xanax at night,
> > there's a good chance for a morning "hangover." What do I prefer
> > for anxiety? A long soak in a hot tub surrounded by cuties in
> > string bikinis discoursing the socio-economic impact of disco
> > music in Albania ... that's the ticket, that's the ticket!
> >
> > Also, it is claimed that Xanax imparts a mild "anti-depressant" effect,
> > although I wouldn't bet the ranch on this.
> >
> > Note to Greg: Ativan is abused and is just as addicting.
> > Lorazepam was the "favored" drug in the 1980s and many got strung-out on it.
> > But, let's face it: they *all* are addicting.
> >
> > "There's no such thing as addictive drugs ... just addictive people."
> >
> > Genetics, anyone?
> >
> > kazoo
Posted by stjames on August 4, 2000, at 23:12:05
In reply to Ativan or Xanax? Which one is safer?, posted by LouieG on August 2, 2000, at 0:38:14
Hmm...
I just re-read your post and noticed you are taking
desyrel. I found it to be very sedating, lasting into
my awake hours. How much are you taking (desyrel) and what
is your Atavin dosing schedule ? For me, I prefer
Atavin for my anxiety.You might want to try less desyrel, if you can or
another sedating AD at night for sleep. I am assuming
this is why you take desyrel. Benzos and AD, esp. the
sedating ones, tend to work synergistically on several fronts
esp. the sedating/sleepy side effect.james
Posted by JudithC on August 5, 2000, at 23:32:15
In reply to Ativan or Xanax? Which one is safer?, posted by LouieG on August 2, 2000, at 0:38:14
> I'm a 28 year old very healthy male who's got everything to live for, however depression and anxiety has turned my life into darkness. After 2 years of trial and error my doctor recently prescribed Serzone, desyrel, and Ativan. So far I'm sleeping better and feel hopeful, however a friend of mine told me that xanax works better for his anxiety and doesn't make him sleepy which is the problem I'm having with ativan (or maybe it's the Serzone, I'm not sure). Can anyone tell me anything about those drugs, I did some reasearch on the internet but were conflicting, are they addictive, should I worry? Please help. Louie
Dear Louie,
To post or not to post;this has been a consideration for me since I first read your's 3 days ago! I am having w/d's from Celexa which I was on for about 8 months and from which I have been off of since July 17,and this has been a piece of cake considering that I am still having protracted w/d's from Ativan after almost 3 years use (as per the doctor's advice); and from which I have been off of since the late spring of 1997,so perhaps I am not the one who should be offering up advice to you except that I can tell you that I have ended-up with major depression due to the Ativan and tinnitus and some other horrible problems and I can also tell you that I am far from alone considering the numerous people who are in my predicament and whom post on various benzo w/d posting boards.Suffice to say,I would hope that you give the matter of whether to take either Ativan or Xanax a long and weighty thought.
JudithC
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