Anybody know about Ativan? - Mothering Forums

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#1 of 11 Old 11-08-2004, 01:17 AM - Thread Starter
 
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Hi all,
some of you probably know my story. Basically I have been having pretty severe antenatal depression which has manifested into a constant panicky feeling. I'm 30 weeks pregnant. Probably about 80% is biological and the rest situational (There are some crazy things going on in my life right now)

My pshychiatrist and ob have decided to start me on a low dose of Ativan (.5 miligrams). Anybody have any experience with this drug? I know its a class C, and technically you're not supposed to take it while you are pregnant. But I think we've all decided that being in a permanent state of panic is far worse for the baby.
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#2 of 11 Old 11-08-2004, 02:29 AM
 
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My dd takes this for sleep issues and to reduce muscle tone (she has cerebral palsy). Just to let you know, she is 22 lbs and takes the same dose you do, .5mg at 7:30pm and another .5mg at 2:30am. So your dose is miniscule. I don't know about the pregnancy effects, but you are pretty far along and so the risk to the baby is way lower.

Ativan is very close to Valium; it is shorter-acting and tends to pack more of a quick punch. You do tend to get tolerant to it very quickly. My dd switched from Valium to Ativan about three months ago and we are at 5x the original dose (actually 10x since she initially only got one dose a night).
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#3 of 11 Old 11-08-2004, 08:54 PM - Thread Starter
 
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That's what I figured. I think the regular dose for a small child is about 1.5 mg.

I took the first dose last night and I felt sooo much better. It didn't really make me feel super groggy or drugged up or anything like that, it just kind of took the edge off. I was kind of nervous about taking it but it seems like it will be fine. I actually got a good night's sleep too. I still woke up a few times, but instead of laying there with my mind racing, I was easily able to fall back into a deep sleep. I actually feel quite refreshed today.
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#4 of 11 Old 11-08-2004, 09:14 PM
 
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I keep it on hand for panic attacks. I don't know about taking it continually for panic. I take Zoloft for ongoing anxiety and it helps. I have no idea what strength my pills are but they are very small and white. I would guess they are 0.5 mg?
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#5 of 11 Old 11-08-2004, 09:33 PM
 
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I don't usually visit this board but I saw the word "Ativan" while scrolling down the forum list and I wanted to put in my two cents.
Ativan is really, really easy to get hooked on. I was prescribed .5 for panic attacks, and slowly but surely my dosage kept getting raised, and raised, and raised until I was taking handfuls at a time. DT was awful.

Everyone I know who has taken that drug has become hopelessly addicted as well. So, be very careful with it...
I found valerian root and chamomile tea to be helpful, and safer. But it doesn't work for everyone.

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#6 of 11 Old 11-09-2004, 03:59 AM
 
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Hi, I was just perusing this thread and wanted to put my 2 cents in too. I work in the psych field ( ER) and we give Ativan quite often to agitated pts. b/c it's fast acting. Our Psychiatrists like to give klonopin for pts. with anxiety b/c its slower and longer acting and thus less addictive.
Hope that helps.
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#7 of 11 Old 11-12-2004, 06:17 PM
 
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Sorry I'm coming in late here, but I was having trouble posting and this is the first time I've been able in a few days.

I was on Ativan for a while and still have a script for any "just in case" needs. My script is for .5mg and I find that it works great for me. I began taking it in combo with an SSRI (Lexapro) and was able to pretty much quit Ativan in about a week or two after beginning both of them. The Lexapro was able to keep my anxiety and panic pretty much in check after that. I think I only had to take an ativan a couple times in the nine months I was on an SSRI. I have been on both Lexapro and Zoloft and they both worked great for the panic. Have you tried a daily SSRI to keep it under control?

As for the Ativan, here was what I was told by doctors. My Obgyn told me it was an absolute no no. She said that it is thought to cause birth defects. My psychiatrist also told me that it was a no no, for the same reason. I asked about the birth defects and he mentioned that there is a concern that it can cause limb malformations. That's not the only concern since it is a powerful neurological drug. Benzodiazapan's are heavy duty meds, and yes, they can be highly addictive, and anyone using them should be closely monitored. That being said, my psychiatrist told me when I was considering getting pregnant I should definitely try to deal with panic without meds, but if I were to take an Ativan early on not knowing I was pregnant (that was my fear) that I shouldn't worry too much. Once at a low dose would likely do one of two things -- it could do nothing, or I could miscarry very early on. They don't really know what would happen.

You are in a different situation in that you are at 30 weeks and the risk of limb malformation isn't much of a risk anymore. However, remember that you are taking a powerful brain altering medication at the time that your baby's brain is doing a huge amount of growth and formation. This isn't a decision that anyone can make for you and you should do your own research and make your own informed decision. I'm just giving you the information that I was given. I got lucky and when I went off my SSRI I didn't have any problems and the issue never came up. If it had I personally wouldn't have taken an Ativan, I would have gone back on an SSRI.

I'm not sure that comparing a fetus receiving Ativan to that of an infant is a fair comparison. The brain formation and development of a third trimester fetus isn't the same as the development of an infant. If you haven't considered an SSRI, I would encourage you to talk to your psychiatrist about it, or get a second opinion from another psychiatrist. Some are more versed in how to treat pregnant or breastfeeding women than others.

Whatever you decide, I wish you luck. Anxiety and panic are miserable.
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#8 of 11 Old 11-12-2004, 06:33 PM
 
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I have a lot of problems with anxiety and panic attacks, and I have a perscription of .5 Ativan too. I am VERY careful with meds, so I have had this same bottle for almost year and still have half the bottle left. I have found that breaking one in half (tiny pill, but it can be done) and putting it under my tongue (sublingually is the best route for this drug, I was told by my psychiatrist who gave it to me) is plety for me. So far I have never taken more than 1/2 at a time. It always calms me down enough if I feel that I am racing away with my panic thoughts and can't stop.

It has helped me a great deal. So far I have decided not to take Lexapro (which my doctor wanted me to go on) but I may someday do that. I worry about the sexual side effects and weight gain on Lexapro, and don't want to go down that road if I don't have to.

I hope you feel better soon.
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#9 of 11 Old 11-12-2004, 09:16 PM - Thread Starter
 
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Hi guys,

Well, I have been doing a lot of research about being on the Ativan as compared to an SSRI. I've also been talking to my psych and Ob who are both awesome and totally supportive.

We've all decided that my staying on the Ativan is probably the best thing to do right now. I was worried about the baby having withdrawals (that seems to be the biggest side effect of benzodiazepine usage in the last trimester) but since I am so close to delivery and on such a low dose that its not really a significant risk. It takes a lot longer than 6 weeks to become physically addicted too.

Additionally you have to weigh the risk of the baby essentially being in a constant state of panic. Its brain is basically being bathed in adrenal cotrisol hormones which poses a significantly higher risk than the low dose of Ativan. Especially at such a great time of brain development. I don't want my poor little baby developing too many receptors for stress hormones! A low dose of GABA is much healthier.

I also discussed starting an SSRI (zoloft) and none of us think that would really be a good idea right now, for various reasons. Mainly because the startup could make my anxiety and moodswings worse, which means I would have to take a stronger dose of anti anxiety drugs or be hospitalized. Second, although Zoloft is relatively safe, the baby could also have withdrawals from it, and I don't want to compound two psych meds on the fetus at a time. I am also really close to delivering and I'm hoping that this will subside after the delivery. If not, then I will consider an SSRI. Right now the Ativan seems to be keeping my feelings in check and is the gentler alternative.

I understand that benzos are very strong meds (I'm a nursing student for goodness sake) But I think that in some situations you have to weigh the risk vs. benefit.
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#10 of 11 Old 11-29-2004, 12:09 PM
 
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I would not take Lorazepam while pregnant!

I have taken it for PPD, as needed. It helped me a lot. But it is one of the reasons I stopped feeding my newborn breasmilk. My Dr. told me that it would go into the breast milk so I stopped (exclusively) pumping. If it goes into breastmilk, I would assume it affects the fetus. I was on a higher dose than you are, significantly higher, so maybe a tiny dose isn't a big deal.
but I would still be very careful.

The long term side effects of Lorazepam includes damage to the liver and dependence. Thought I'd mention that since no one else brought it up.

edited to say: sorry, I missed your last post saying you'd decided to take the Ativan. I still think that I would not take it, and just go on Zoloft. Assume you're going to have a hard 1st week on it, and then things will improve. Zoloft helps with anxiety too, and it's not harmful to the baby. but do what you will. It must be really bad if you cant even wait a week for something like zoloft to kick in.
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#11 of 11 Old 11-29-2004, 01:09 PM
 
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hi,
it seems you are getting a varied response. here's one more.
both my husband and i take lorazepam (.5 for me, 1 for him) for anxiety. it helps us so much and neither of us are anywhere near addicted (though i don't think either of us have addictive personalities)
I did not take while pregnant but have been having a lot of anxiety since daughter's birth, particularly last couple months (she is 5 months). I was so worried about it in breast milk but was reassured by a pediatrician who i love and who many people i know love and respect, a psychopharmacologist who comes highly recommended, and even the people from la leche league. i agree that being really panicked is probably worse. hope this helps. it is never something to take lightly but i sometimes remember that my mother, grandmother and beyond never took pre-natal vitamins, drank, smoked etc. not that that is a great thing, but people are pretty resilient.
i hope you feel better!
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