# Atvian

**URL:** <https://boards.straightdope.com/t/atvian/778187>\
**Category:** In My Humble Opinion\
**Created:** [January 25, 2017, 9:55pm UTC](https://boards.straightdope.com/t/atvian/778187 "2017-01-25T21:55:53Z")\
**Posts on this page:** 20\
**Page:** 1

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**Author:** ![Patx2](https://avatars.discourse-cdn.com/v4/letter/p/73ab20/32.png) [@Patx2](https://boards.straightdope.com/u/Patx2)\
**Post date:** [January 25, 2017, 9:55pm UTC](https://boards.straightdope.com/t/atvian/778187/1 "2017-01-25T21:55:53Z")

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Is anyone familiar with this for anxiety? Does it help and are the side effects bad? Is it like Xanax?

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**Author:** ![tomndebb](https://avatars.discourse-cdn.com/v4/letter/t/b9e5f3/32.png) [@tomndebb](https://boards.straightdope.com/u/tomndebb)\
**Post date:** [January 25, 2017, 10:02pm UTC](https://boards.straightdope.com/t/atvian/778187/2 "2017-01-25T22:02:54Z")

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I presume you mean Ativan:

> **[Ativan: Uses, Dosage, Side Effects & Warnings - Drugs.com](https://www.drugs.com/ativan.html)**
>
> Ativan is a benzodiazepine used to treat anxiety disorders or anxiety associated with depression. Learn about side effects, interactions and indications.

> **[Ativan Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing...](https://www.webmd.com/drugs/2/drug-6685/ativan-oral/details)**
>
> Find patient medical information for Ativan oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.

I cannot address your questions, directly, but my hospice care nurse wife frequently administers it to patients who are anxious or (apparently irrationally and atypically) hostile.

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**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\
**Post date:** [January 25, 2017, 10:05pm UTC](https://boards.straightdope.com/t/atvian/778187/3 "2017-01-25T22:05:41Z")

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Since this is a medical question, let’s move it to IMHO.

Colibri  
General Questions Moderator

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**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\
**Post date:** [January 25, 2017, 10:32pm UTC](https://boards.straightdope.com/t/atvian/778187/4 "2017-01-25T22:32:16Z")

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> [@Patx2](#):
>
> Is anyone familiar with this for anxiety? Does it help and are the side effects bad? Is it like Xanax?

Ativan. AKA lorazepam. Yeah, it’s a lot like xanax.

It can help anxiety, but chronic usage of it often leads to abuse, dependence, and problems getting off of it. It should NOT be mixed with alcohol or other depressants in general, and is relatively contra-indicated for people with a history of substance abuse or addiction/alcoholism.

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**Author:** ![buddha\_david](https://avatars.discourse-cdn.com/v4/letter/b/ee7513/32.png) [@buddha\_david](https://boards.straightdope.com/u/buddha_david)\
**Post date:** [January 25, 2017, 10:41pm UTC](https://boards.straightdope.com/t/atvian/778187/5 "2017-01-25T22:41:31Z")

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Ativan is amazing. Soothes the nerves with hardly any side effects, unlike Xanax & others.

The only major problem is that it’s _very_ habit-forming. As in, if I take it more than once a day for any length of time, I’ll start jonesing for it. Not necessarily a deal-breaker, but it does require very careful management.

YMMV.

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**Author:** ![Patx2](https://avatars.discourse-cdn.com/v4/letter/p/73ab20/32.png) [@Patx2](https://boards.straightdope.com/u/Patx2)\
**Post date:** [January 26, 2017, 12:08am UTC](https://boards.straightdope.com/t/atvian/778187/6 "2017-01-26T00:08:15Z")

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> [@Colibri](#):
>
> Since this is a medical question, let’s move it to IMHO.
> 
> Colibri  
> General Questions Moderator

Thanks!

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**Author:** ![Patx2](https://avatars.discourse-cdn.com/v4/letter/p/73ab20/32.png) [@Patx2](https://boards.straightdope.com/u/Patx2)\
**Post date:** [January 26, 2017, 12:09am UTC](https://boards.straightdope.com/t/atvian/778187/7 "2017-01-26T00:09:59Z")

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Thanks for the info.

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**Author:** ![bobkitty](https://avatars.discourse-cdn.com/v4/letter/b/c67d28/32.png) [@bobkitty](https://boards.straightdope.com/u/bobkitty)\
**Post date:** [January 26, 2017, 12:15am UTC](https://boards.straightdope.com/t/atvian/778187/8 "2017-01-26T00:15:03Z")

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It can knock you on your ass at the beginning; we used to have to caution the docs on our lockdown unit to not prescribe Ativan at the same time the patients were taking Milk of Magnesia or other digestive-related medication, because we’d had several incidents where the patient who’d taken both had passed out in their beds and pooped themselves. Definitely takes the edge off of anxiety, though.

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**Author:** ![RivkahChaya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rivkahchaya/32/8919_2.png) [@RivkahChaya](https://boards.straightdope.com/u/RivkahChaya)\
**Post date:** [January 26, 2017, 12:34am UTC](https://boards.straightdope.com/t/atvian/778187/9 "2017-01-26T00:34:06Z")

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I had it as a PRN for sleep for a while. I have something else now. You habituate to it very easily so that you either need a higher dose or something else. Since my goal was sleep and not to “feel” anything, I didn’t care for it, and it kind of scared me how fast it stopped not working even though I was taking it only maybe three times a week, at a very small dose.

IMO, it should should be reserved for very occasional anxiety, like dental chair anxiety, or fear of flying for people who do not fly on a regular basis. Or maybe jet lag for people who travel abroad once or twice a year.

FWIW, it did knock me out the first couple of times I took it, with no hangover, and no side effects (like sore muscles or cotton mouth, which other things have given me).

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**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\
**Post date:** [January 26, 2017, 12:42am UTC](https://boards.straightdope.com/t/atvian/778187/10 "2017-01-26T00:42:02Z")

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I have a script. I get about four pills at a time - maybe six. And I only call in for it every few months. They handle this stuff with kid gloves due to its addictive properties.

As to how it works - it does take the edge off. If the edge has gotten to sharp, I can take two - and it doesn’t touch the anxiety.

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**Author:** ![Hedda\_Rosa](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hedda_rosa/32/1204_2.png) [@Hedda\_Rosa](https://boards.straightdope.com/u/Hedda_Rosa)\
**Post date:** [January 26, 2017, 1:13am UTC](https://boards.straightdope.com/t/atvian/778187/11 "2017-01-26T01:13:56Z")

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I have been using Ativan for more than a decade, as needed, for a fear of flying…I travel someplace 10 or 12 times a year. My prescription is for .5 mg and I usually break it in half, so I’m taking the very smallest dosage possible. I occasionally use it off-label for sleep. Never had a problem with dependency, except that I’m _not_ getting on a plane without it. Don’t ever feel any side effects like grogginess or anything the next day.

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**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\
**Post date:** [January 26, 2017, 1:18am UTC](https://boards.straightdope.com/t/atvian/778187/12 "2017-01-26T01:18:01Z")

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For 30 years I used “ETOH” for sleep.

I actually WAS surprised to learn I had developed an addiction.

Want to guess what the hospital gave me to cut the anxiety?

Lorazepam.

I got to check off yet another benzo with that script (yes, my PCP’s stand-in for the day wrote a script for it).

Don’t remember which drug I was using for sleep. I think it was temazepam.

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**Author:** ![elbows](https://avatars.discourse-cdn.com/v4/letter/e/b3f665/32.png) [@elbows](https://boards.straightdope.com/u/elbows)\
**Post date:** [January 26, 2017, 1:28am UTC](https://boards.straightdope.com/t/atvian/778187/13 "2017-01-26T01:28:39Z")

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Huh. I didn’t know it was basically lorazepam!

I take it occasionally as a sleep aid, or flying long haul sometimes. Get ithirty at a time. With refills. So I’m surprised to read about these issues here.

Of course I take a very low dose, .5 mg, so maybe it’s not a worry?

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**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\
**Post date:** [January 26, 2017, 1:41am UTC](https://boards.straightdope.com/t/atvian/778187/14 "2017-01-26T01:41:15Z")

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> [@elbows](#):
>
> Of course I take a very low dose, .5 mg, so maybe it’s not a worry?

It’s up to you whether or not to worry about it. But it’s a potentially addictive drug, and attention must be paid to that feature of it. Useful, when used properly. Possibly devastating when not used properly. Often causes significant problems for people. Not all the time, or even most of the time. But often enough that all users of it need to know that.

If your dose has been stable over time, it’s less likely to represent a problem for you.

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**Author:** ![outlierrn](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/outlierrn/32/3005_2.png) [@outlierrn](https://boards.straightdope.com/u/outlierrn)\
**Post date:** [January 26, 2017, 3:04am UTC](https://boards.straightdope.com/t/atvian/778187/15 "2017-01-26T03:04:17Z")

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It’s one of our go to drugs for seizures, alcohol withdrawal, and general craziness in the ER.

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**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\
**Post date:** [January 26, 2017, 3:30am UTC](https://boards.straightdope.com/t/atvian/778187/16 "2017-01-26T03:30:57Z")

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> [@elbows](#):
>
> Huh. I didn’t know it was basically lorazepam! …

No “basically” about it - it’s a brand name for lorazepam, but I imagine generic lorazepam is widely available.

There is quite an array of [benzodiazepines](https://en.wikipedia.org/wiki/Benzodiazepine)available. It includes well-known drugs such as Xanax (alprazolam), Valium (diazepam) and Klonopin (clonazepam), and less well known one such as Halcion (triazolam) and Versed (midazolam; not routinely prescribed outside of hospitals as far as I know ). They all have different profiles as to preferred usage etc.

All have the ability to lead to dependence issues. My daughter has some issues with anxiety and has one to take as needed; I’d have a lot of worries if she wound up needing to use them routinely, though fortunately this has not become an issue.

Back when I was first pursuing a Restless Legs Syndrome diagnosis, Klonopin was one drug commonly used for it. It didn’t help the twitches, as far as I understand, just made it possible to sleep despite it. I had one neurologist really push me to try either that or Sinemet (a Parkinson’s drug that was gaining fame but also causing lots of issues with augmentation).

I later met with the RLS specialists at Johns Hopkins, one of whom said essentially “it’s not quite as easy to become dependent on Klonopin as on opioids, but if it happens it’s harder to get off them”.

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**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\
**Post date:** [January 26, 2017, 3:38am UTC](https://boards.straightdope.com/t/atvian/778187/17 "2017-01-26T03:38:32Z")

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> [@outlierrn](#):
>
> It’s one of our go to drugs for seizures, alcohol withdrawal, and general craziness in the ER.

- the Party Pack - Ativan, Haldol and Benedryl.

I have a friend who is an ER doc. I say “the only person who is going to party on that mix of meds is the ER staff when the patient is drooling into their pillow.”

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**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\
**Post date:** [January 26, 2017, 3:48am UTC](https://boards.straightdope.com/t/atvian/778187/18 "2017-01-26T03:48:07Z")

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As a sleep aid (when you have chronic major depression and anxiety, you get lots of pills) I get Trazodone.

For day to day anxiety, I have hydroxyzine.

I really can’t imagine my doctors handing me benzos to fly. I’m someone whose anxiety limits my ability to hold a job - and they won’t give me benzos.

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**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\
**Post date:** [January 26, 2017, 3:57am UTC](https://boards.straightdope.com/t/atvian/778187/19 "2017-01-26T03:57:23Z")

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> [@elbows](#):
>
> Huh. I didn’t know it was basically lorazepam!
> 
> I take it occasionally as a sleep aid, or flying long haul sometimes. Get ithirty at a time. With refills. So I’m surprised to read about these issues here.
> 
> Of course I take a very low dose, .5 mg, so maybe it’s not a worry?

Ativan is the brand name for lorazepam. It’s fine for occasional use; one of its more worrisome side effects, when used on an outpatient basis, is amnesia. It’s not as bad as, say, Ambien WRT to this, but be cautious before driving or doing anything you may need or want to remember later.

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**Author:** ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)\
**Post date:** [January 26, 2017, 4:50am UTC](https://boards.straightdope.com/t/atvian/778187/20 "2017-01-26T04:50:02Z")

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> [@Dangerosa](#):
>
> - the Party Pack - Ativan, Haldol and Benedryl.
> 
> I have a friend who is an ER doc. I say “the only person who is going to party on that mix of meds is the ER staff when the patient is drooling into their pillow.”

That is a Non R - SI combination used in patients exhibiting TSB.

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