Question:
I recently started taking Paxil for anxiety and a worsening insonia problem.
The Dr. put me on Ativan and that helps me get about 6 to 7 hours sleep, but I
still feel tired. Also, I'm worried that I'll become addicted to the Ativan.
This has been going on for three weeks and a couple nights I deliberately
didn't take the Ativan, and I slept terribly and felt extremely nauseaus. I
took the Ativan in the AM and that helped. My doctor says I need 4 to 6 weeks
before the Paxil kicks in.
The insomnia only worsens my anxiety and I believe that if I could just get
over it, I would be able to resolve the anxiety problem.
Answer:
What doses of Ativan are we talking about? The nausea is a withdrawl symptom
from Ativan. Drink a coke when this happens or suck on a butterscotch candy.
You shouldn't stop Ativan (or any other benzodiazapine) abruptly. Where are
you in getting your sleep evaluated?
Paxil is tauted as being for anxiety even though it is an antidepressant. I
went back to the original studies that the FDA approved for this indication
and the improvement over placebo were small and, more importantly, the
percentage of people helped was not that great. However, it works for some
people at 20 mg once a day after 4-6 weeks. Every time a dose escalation is
attempted, it also takes time for an effect to be present.
As far as benzos being addictive, the correct term is dependence (need them
for sleep). Ativan has some caryover to next day which is good for anxiety but
it may make you groggy in the morning.
Whatever you do try to follow doctors recommendations. As you are discovering
these "minor" tranquilizers are effctive but not without side effects.
The problem is that you may have an anatomical sleep disorder such as sleep
apnea or upper airway resistance syndrome, but instead you are treating the
symptoms.
Get thee to an accredited sleep clinic for an overnight evaluation, then you
can monkey around with depression or insomnia or what-have-you.
When I first started taking halcion (a benzo too) I was violently nauseous. It
took several weeks to really subside. I swear, I was so sick I was almost
green. I lost a lot of weight! Now I am totally used to the stuff, and don't
get sick from it. And have definately gained the weight back (ooof!)
Yes, as a much needed sleeping pill. Also, ambien 10 mg. and doxepin 100 mg
and depakote 250 mg. The halcion, if I take a lot of it, more than .25 a
night, makes me very nervous sometimes the next day, as if was having a very
bad anxiety attack all day long. I don't have panic attacks anymore, for
years, just worry too much. I have a primary sleep problem though. Not caused
by anxiety. I got over my panic attacks by digging my nails into my hand and
ignoring them (ie. not running out of the restaurant...) Actually I've just
found ways to control my environment: I never drive with someone else, I sit
on the aisle at the movies, by the door in school, park close, and always know
the location of the nearest exit or bathroom. This way, I am not housebound,
not on anxiety meds (doxepin for sleep, and pretty recent), and don't panic.
