Dose - Dose of Lorazepam for anxiety?

[Kalendren]

With Swim's boyfriend's heroin use, swim is having far more anxiety attacks than usual. He is using doctor prescribed Ativan in 1mg doses twice a day. Swim's doctor is incredibly unhelpful and refuses to give swim anything stronger or increase the Ativan dose. Should Swim take two tablets of Ativan instead of just one when his anxiety gets really bad? Swim doesnt know what to do here. He can't function at his job with the constant anxiety plaguing him.

[staples]

I would not recommend SWIY deviate from his prescribed dosage, but if SWIY does escalate his dosage, he should be sure his doctor understands that he did this and his reasons for it (i.e, be as clear as possible on the exact circumstances).

Clearly (at least from the information given) the issue is mostly psychological and not neurological. However, panic attacks are an iffy subject, regardless of the pathology. On one hand, they are terrifying and can severely impair one's ability to function appropriately so there is a need to treat them as soon as they occur; on the other, treating panic attacks which are ultimately caused by psychological problems with medication can just make things worse in the long run.

While 2mg/day of lorazepam is not ridiculously high (maximum recommended daily theraputic dose is 10mg), I do agree with SWIY's doctor's reluctance to augment the dosage. Is SWIY also seeing a talk therapist? Is that a feasible option?

Good luck, I hope things improve for SWIY

[Kalendren]

Swim tried a talk therapist, and it was about as effective as smashing swim's head against a wall. It hurt, and ultimately resolved nothing. Swim's just at a loss here. He doesn't want to resort to other drugs, like pot or anything. He just wishes Ativan would work like it used to.

[This is bat country]

1) Pot will not help anxiety. Maybe more light-moderate forms of anxiety, but beyond that, SWIH will probably become more upset.

2) Lorazepam is, in my opinion a terrible drug. Out of all the benzos SWIM has tried, it is the one which creates the worst hangover (which includes rebound anxiety). It also leads to frequently-stupid decisions. SWIM suggests honestly looking for something like valium or clonazepam. Lorazepam is good in that it doesn't break your liver like most benzos do, but all that really means is you can drink on it without blowing your liver to shreds. Out of all the benzos, Lorazepam has been the worst for amnesia.

3) If other benzos are not an option, then I suggest sublingual 1mg or .5mg Ativan tablets. They're not generic yet, but they are very fast-acting and can bring down anxiety relatively nicely. It's worth a try.

This is bat country added 3 Minutes and 2 Seconds later...

Probably should have mentioned that you should ask about the .5mg sublingual medication as a supplement to what he is already taking. It doesn't seem like a great deal but its rapid bio-availability will possibly cut off the panic attack before it escalates to the point of no return. Also, .5mg ativan is not really a drug of abuse compared to most benzos because it is such an exceedingly low dose and is expensive compared to generics. (Also the affects are more mild)