# Ativan AND Paxil?!?!



## shyra22f (May 9, 2000)

I went to the doctor the other day to renew my prescription for Ativan. He told me I need to take Paxil as well for a chemical inbalance. He said he wouldn't prescribe me any more Ativan after this because it's addictive. I should add that I've been on the Ativan for about 3 or 4 weeks now, I take 0.5mg about once a day, sometimes two if I feel I need it, and sometimes none at all. I'm leary about taking the Paxil, he gave me two weeks worth free of charge (trial packs). My question is; do I really need to take both? And also, how can a doctor be sure if thier patient actually has a chemical inbalance? I honestly feel that my panic and anxiety is solely brought on by thought patterns. I explained to him that I would rather just stick with the Ativan, that I start therapy on Tuesday and I really didn't feel the need for Paxil (which I'll bring up with my therapist) and that's when he told me that I would become addicted to Ativan if I continued using it. Does anyone take a combination of the two? If I do end up on Paxil, would it affect my IBS and how??? So far I take imodium daily, the birth control pill, and Ativan, I feel like another drug is just TOO much and completely unnecessary. It was also my understanding (please correct me if I'm wrong) that a drug like Ativan is only addictive if it's abused, and I don't abuse it. And isn't Paxil addictive too? I read that you need to taper off of it just like you would a drug like Ativan. So if anyone can offer me any advice, or tell me of their experience I would greatly appreciate it. Thank you!







[This message has been edited by shyra22f (edited 10-29-2000).]


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## Guest (Oct 30, 2000)

ShyraI understand your concern. I take Ativan prn as needed. It is a CNS antianxiety medication. It is about the only thing that alleviates my anxiety that leads to panic attacks. I have .5 mg tablets and I lately take about 1/2 of a pill or less almost daily*and it does the trick. Today, As my father in law had a stroke and I am about sick too, I too another 1/2 at lunchtime. And I could eat lunch and ride home 25 minutes and have no D. Not that I was not a bit concerned all of the way as most days. The only thing I do not like about Ativan is that it makes me a bit sleepy sometimes. A full tummy and activity usually alleviates this. It is used in .5mg IM injections for a pre op that causes amnesia. So the patient does not remember anything about surgery.You asked about Paxil. My 11 y/o grandson took it for about a year and he was a different child. So happy and cheerful. He was so compulsive and a doomsdayer too. It was great but his Dad wanted him off. I think it agreed with him but he is doing better now on his own. It is an antidepressant and is also used for panic attacks but not the major drug used. You might need to alleviate your depression, maybe you do not think you have any! I would take the Paxil and see how it treats you. You should feel quite a bit of difference after taking it a few days. My daughter also took it and was on birth control pills for a few years.You might try cutting the Ativan dose like I do. Usually that is more than enough. I take Buspar instead of Paxil as it seems to work well with the anxiety but the Ativan is all that really rids me of it some days. But I had severe D because of panic attacks so that is why I find results with it.How is someone chemically imbalanced? That is a good question. I assume if we are better after taking certain meds is the criteria.I need to find a good answer to thatThe diagnosis of an addiction according to a pharmacy friend is if you think that you have to have a stronger dose of the medication. If you do well and are IBS free or controlled in general, then I personally do not feel that is addicted. I have been taking it prn for 2 years. And, I do not take it every day either. But you are right about our thoughts causing anxiety. I can think myself sick. That is why I am enjoying Mike's tapes as it explains the subconscious etc and why we get or stay sick with IBS. The Paxil will most likely make your IBS better by alleviating depression and anxiey Therfore that is working against the subconscious that wants us to keep the IBs as the body and mind is used to it.I am sure someone will give you a good answer but this is my experience. I hate taking these medications. But until I am able to function normally without them, I must.[This message has been edited by trishb (edited 10-30-2000).]


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## babydoc_au (Jan 26, 2000)

Paxil is not addictive. It is an SSRI anti-depressant that is also used for panic disorder. Some people find it helps their IBS also, while others find it gives gastro-intestinal side-effects (such as constipation, diarrea, indigestion or nausea). You do have to taper it off because it can cause (usually mild) withdrawl symptoms but this is not the same as being addictive.Ativan is addictive, I'm afraid that it doesn't matter whether you "abuse" it or use it sensibly. This has been discussed here many times before (search for benzodiazepine) but I'll go over the basics once again.Ativan (lorazepam) is a benzodiazepine along with Serepax, Valium, temazepam etc. All of these drugs have much in common , in particular the issue of tolerance and dependence. Tolerance occurs in as little as 2-4 weeks of daily use and means that the drug becomes less effective as your body becomes used to it. Subsequently, you need increasing doses to get the same effect. This occurs whether you 'abuse' the drug or take it as prescibed. Dependency then occurs as your body is so used to the drug that if you stop it suddenly you may experience a withdrawl syndrome (depending on amount and duration of use) . This is characterised by anxiety, insomnia, tremors, nausea, sweating, muscle cramps, seizures, increased blood pressure and heart rate. So the drug will be weaned off rather than stopped suddenly to prevent this.Having said all that ( and hopefully not fightening the pants of anyone!) benzodiazepines are very effective and safe when used for the short term treatment of severe anxiety or insomnia. And this is why your Dr wants you to stop it. He/she is a very responsible clinician-too many people are giving thse drugs without adequate education or monitoring. It sounds like you have use it very sensibly and i doubt you would have withdrawl at such low dose. As to whether you have a chemical imbalance - this is a theory that is yet to be proved in studies. It is based on the fact that for many mental illnesses, a drug is given that alters the chemicals in the nervous system, so it is assumed that ther must have been an imbalance their to begin with. Or that perhaps a way of thinking (such as worrying alot) leads to a chemical imbalance.I think it is great that you are going to see a therapist - this is the best treatment in the longer term. Changing those negative, worrying thought patterns can make a huge difference. Paxil may give you relief but it is unclear whether it 'cures' panic as such. You could try holding off on the Paxil until you see how the therapy goes - soon you may not need either it or the Ativan!(If it's any consolation, I know of people who take 10 different medications each day!)Good luck![This message has been edited by babydoc_au (edited 10-30-2000).]


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## Guest (Oct 30, 2000)

A couple of things. I DID get addicted To Ativan after about 3 weeks. BUT, I was taking a lot (4mg a day). It was no picnic coming off of that! However since you seem to be taking such a low dosage, I do not think that addiction is an issue with you. As far as your doc (Is he a psychiatrist or psychopharmacologist?) being certain that there is an imbalance in your brain, that is just hogwash, because there is NO definitive wasy to know whether such an imbalance is there. As far as the Paxil, I have had a very bad experience with it, and many folks say that it has worked wonders for them. It is up to you whether you want to take it or not.. If you feel more comfortable just taking the Ativan in small quantities, I would tell the doc that.. If he then refuses and insists that you take Paxil, I would REALLY get a second opinion if I were you, since I have a strong belief that anti-depressants should never be prescribed lightly, and that they should only be given by a specialist who will monitor the effectiveness abd side-effects for a while.


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## JeanG (Oct 20, 1999)

Hi shyra:Your doc may have you temporarily on both Ativan and Paxil to slowly wean you off the Ativan. I was taking Wellbutrin and lately have felt it wasn't working, so my doc switched me to Zoloft last week. But, while I am starting with a low dose of Zoloft and increasing it slightly each week, I am also taking a lower dose of Wellbutrin. She will eventually take me off it altogether. You could call her and ask if that is what she is doing.Paxil is a great drug for depression and anxiety. I took it for a while but once the anxiety was gone quit taking it. It's not addictive, but you do have to taper off it very slowly, as with most of the anti-depressants, or you will have strange side effects.Good luck! Talk to both your doc and therapist and have them explain it clearer to you. I know it's frightening to stop a med that is working, to take another one. Let us know what they tell you.JeanG


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## vikee (Feb 5, 2000)

Hi Shyra,I agree with Jean. Your Doc will have to slowly wean you off Ativan. So you will eventually only be taking Paxil. It is not addictive but it too must be gradually tapered off when and if you stop it. It is my understanding that Paxil will help with anxiety and mood and therefore relieve stress. Brain chemistry is a phrase used to describe the state of any bodily stress as it effects the natural chemicals in your brain.Talk with the doctor prescribing the medication about this, since he knows best how to describe this to you. Many people who have IBS develop depression cause of the stressful situation this condition presents on a daily basis.Hope things work out for you. I suggest you give Paxil a try, otherwise you will never know how you react to it. Paxil takes several weeks before you feel the full benefits. Check with your Doctor about this.------------------vikee


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## Patty (Mar 18, 1999)

It is so frightening to read about benzos. I'm taking Tramazepam right now to help me sleep, but I don't take it every night and have not taken it very long (haven't even finished a 30 day supply). It really works well! Don't know what I'd do if I didn't have it when I'm tossing and turning all night.shyra, sorry I can't be of any help to you; I've never taken any antidepressants. It never hurts to get a second opinion.


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## bellyknot (Jul 24, 2000)

Coming from a family of depressed and anxious people we have tried alot of different antidepressants. Paxil is what my daughter takes and it helps with social anxiety etc. but its hell to get off of. The withdrawal symptoms ae really tough. There are lots of other medications to choose from. research it yourself. Your gatekeeper may not know . Good luck


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## zigmissus (May 19, 1999)

Paxil may not be "addictive" in the sense that you eventually need greater and greater doses to achieve the same effect, but it can cause withdrawal symptoms. It also made me very quickly pack on 30 pounds! I've been much happier the last several years taking Ativan on an as-needed basis. I've decreased rather than increased the dosage. I find I don't need it every day, and I didn't like taking the Paxil all the time, regardless of whether I was anxious. I also didn't find that it made a dramatic improvement in my symptoms; I just became a not-happy, not-sad zombie. That's not to say Paxil is the wrong drug for you, however. We're all different. IMO, though, medications for anxiety and depression are best prescribed by a psychiartrist, who has extensive training and experience in the various disorders and what works best to alleviate them. Your regular MD may only have a few hours of instruction (if that) in psychotropic medicines, and I've found that they tend to prescribe the latest thing the drug co. rep is pushing, without regard to whether it's right for you or not.


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## badfoot (Oct 5, 1999)

HiI've been taking Ativan for insomnia for ten years (gut pain at night). I am certainly addicted, and I'm now on 6 1/2 mg. a night. I suffer from memory problems, which is not unusual with long term benzodiazepine use. I have also been on Paxil, which was very useful getting me through major anxiety/depression from IBS. Both drugs should be withdrawn carefully.Paxil and other antidepressants are better long term answers to anxiety than benzos, but you don't seem in any real danger of addiction at the moment. Many doctors are extremely (overly) reluctant to prescribe benzos because of the addiction/abuse factor.I fired one shrink for this problem.As I said, I've been dealing with severe IBS/weight loss etc. for ten years and while medications have helped enormously in the short run, therapy and anxiety support groups have ended up being the most beneficial. Exercise, relaxation tapes and yoga have also helped. best of luck.


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## dina (Nov 17, 2004)

I took Ativan 1mg. nightly for about three months. I wish I was warned about the addictiveness of this drug. I suffered horrible withdrawls that were extremely intense. I started taking Ativan on advice of my dr. and I didn't realize at the time it was addictive. My memory for that three months time isn't that great. If there is something else that can give you relief from anxiety I would try it. I wish you the best.


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