tedh
Journeyman
Reged: 12/27/01
Posts: 57
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I've been using Ambien for insomnia but don't want to develop a tolerance to it, so I decided to try Ativan because of all the recommendations on this board. I have a few questions. How many milligrams of Ativan should I take?
Approximately how long before going to bed should I take the Ativan. Any info is greatly appreciated! Thanks.
Ted
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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If you stopped using Ambien to avoid getting a tolerance, Ativan is not going to help the situation- Ativan too causes tolerance and dependence, moreso than Ambien IMO.
But if you're going to use it anyway and don't care about any of that, 2 mg a half hour before bedtime would do approximately the same job that 10 mg of Ambien would.
Don't take it every day if tolerance/dependence is your concern.
-yawkaw
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Imago
Member
Reged: 01/12/02
Posts: 154
Loc: Lone Star State
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tedh,
Some time ago, I was having terrible tension/stress headaches. I would wake up with them and they would usually last for 2 days. My doctor started out prescribing Vicodin ES but once he realized these headaches were happening more than just once or twice a month (more like 1 or 2 times a week), he decided to try a different approach.
He continued rxing the Vicodin but added Ativan, which was to be taken at bedtime. Since I was WAKING UP with the headaches, he felt like something was going on while I slept and perhaps I wasn't getting a really good night's sleep.
It worked great. I've never liked benzos much (they make me feel doped up) but Ativan didn't make me feel too loopy, unlike Valium and Xanax. And I was taking it at bedtime, which was different than taking it during the day.
My doctor only prescribed it for a couple of months, saying it was a very potent drug and wasn't intended for long-term use yada yada yada. Luckily for me, the headaches stopped not too long after I stopped the Ativan.
Anyways, he gave me the 1mg tabs (they come in .5 and 2mg as well). They were plenty strong enough for me. Once again, I've never taken benzos much, so 1mg worked well but your situation may be different. If you're benzo tolerant, you might need a stronger dose. But if you're like me, I would suggest starting at 1mg and seeing how that works.
Ativan works pretty fast, so I usually took it about 30 minutes before going to bed. Once you start feeling drowsy, get in bed right then.
To me, the best thing about this drug (besides stopping the headaches) was waking up without any sort of hangover feeling. Of course, I realize everyone is different....they may not affect you the same way.
I hope this helps. Good luck with the Ativan.
Imago
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potatoboy99
Permanent Fixture
Reged: 02/04/03
Posts: 1211
Loc: Deep North (East)
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The only benzo I take on any kind of regular basis is Ativan (maybe three times a week on average), and it's never made me drowsy. I take it for anxiety. So personally it's not what I would use for sleeping.
I think Ambien is great, but unfortunately you just can't keep taking it. The product literature recommends using it for up to ten days max, I think.
I don't have a lot of trouble going to sleep usually, and I don't always have Ambien at hand. Believe it or not I find ExcedrinPM to be really effective when I need to get a good night's sleep. (I don't drink anymore, but a couple of ExcedrinPM's and half a glass of red wine used to be my sleep aid of choice).
There are a lot of other really effective natural sleep aids that can be more powerful than you might imagine, like a good cup of strong Camomile tea. Or Vervenne tea. Or Valerian tea. Oh I'm getting sleeeeeeeeeeeeepppppy........................
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prettyday
Threadhead
Reged: 02/09/03
Posts: 965
Loc: Coastal Sage Scrub
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All these suggestions work....also shower before bed, have your pillows and sheets the way you like them, don't have something stimulating on the TV, yada, yada.
When I go a while without taking Ambien, it works wonderfully again for a deep restorative unbroken sleep. When I did take it for longer, it did stop working...
I too take Ativan occasionally to sleep...but beware if you have any depression issues...I noticed a difference in mood enough that I really regard it with consideration now...sigh.
I go get generic Benedryl and this is a good sleep aid.
Ultimately, I wish I would get it in gear and arrange my life so well that I could reflect with serenity on my day and peacefully go to sleep. But pain and depression do complicate things, don't they?
Best of luck to you as you find what works. 
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First they ignore you, then they laugh at you, then they fight you, then you win.
- Mahatma Gandhi
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Trampy
Pooh-Bah
Reged: 04/02/02
Posts: 1241
Loc: Southwest U.S.
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There are basically two kinds of insomnia: difficulty falling asleep, and difficulty staying asleep. Ativan is one of the lesser-sedating benzos and it's also short-lived, so it doesn't seem like the best choice either way. It certainly won't help you get 8 hours of sleep because it usually wears off in about 4 hours.
If you have only occasional difficulty in *falling asleep* due to anxiety or racing thoughts, then maybe Ativan would be helpful. Otherwise, it's pretty far down the list and it would probably only be prescribed by a doctor who thinks it's less prone to abuse than the other benzos.
Ambien is clearly the front-line U.S. treatment for insomnia and most people can get a good 6-7 hours of sleep from it and wake up without grogginess. It's not a benzo but it hits the same receptors. It's only FDA approved for short-term use but there are doctors who prescribe it long-term. It's not cheap in the U.S.
Ativan often causes drowsiness only when it's used initially. It's one of the least sedating benzo tranquilizers, in general.
If Ambien doesn't work, the next up to try is Restoril, which is an FDA-approved sleeping pill. Ativan is a tranquilizer, not a sleeping pill.
Trampy
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Your mileage may vary ...
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tedh
Journeyman
Reged: 12/27/01
Posts: 57
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Thanks to everyone who responded. I really appreciate all the information.
Ted
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Opie_Yates
Old Hand
Reged: 08/11/03
Posts: 481
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In my opinion, 2 Mg of Klonopin is great for sleep. For less sedation and a more refreshed awakening, you may consider 10 Mg of Valium.
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I'm not a doctor, I just play one on a message forum!
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Trampy
Pooh-Bah
Reged: 04/02/02
Posts: 1241
Loc: Southwest U.S.
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As Ativan, Klonopin is a non-sedating benzo. If their use is very infrequent, each drug can cause sedation, but many people take those drugs during the day regularly without any impairment whatsoever.
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Your mileage may vary ...
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Opie_Yates
Old Hand
Reged: 08/11/03
Posts: 481
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Quote:
As Ativan, Klonopin is a non-sedating benzo. If their use is very infrequent, each drug can cause sedation, but many people take those drugs during the day regularly without any impairment whatsoever.
Mmmmmm....as an "experienced" Klonopin user, I have to use the board adage here: "YMMV".
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I'm not a doctor, I just play one on a message forum!
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t_oshan2003
Board Addict
Reged: 10/17/03
Posts: 326
Loc: East
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I find ambien to work great. I can take 5mg and sleep like a bear, if its a tough night than 10mgs. I have noticed that online its very expensive, My PM doc gives me 30 10 mg a month and my co-pay is $5.00, refills all year so I don't even have to go into his office to visit, I normally take 5mgs a night and I used to have super sleep problems every nigh before ambien, its been a miracle for me, but every body is different.
I also found that most MD's will prescribe it pretty easily, guess they are not pressured buy the DEA for writing scripts for it compared to valium and xanax.
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tone
Veteran
Reged: 06/29/03
Posts: 554
Loc: Chicago
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naturally all benzos are a treatment for insomnia, and all are going to have dependance.
I have found that dyphenhydramine, the classic antihistamine thats known as "Benedryl", "Nytol", "Unisom", "Tylonal PM", "Generic Allergy Pills", "Over the counter sleeping aids of various lables", Etc Has no dependance and helps get tired for sleep. some people dont bother to read lables and buy expensive unisom, or take tylonal PM when they dont need any APAP with the diphen. why this is i have no idea. but diphenhydramine might be able to let you take a lower dose of benzos if you mix them. or it might work good enough by its self. taking too much diphenhydramine causes side effects like restlessness and jerking, what ever benefit you get out of 50 milligrams, thats all you can get, raising the dose higher inst a good idea.
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rivotril
Newbie
Reged: 05/05/04
Posts: 36
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Hi. Ativan is a worse drug to be dependant upon and use regularly than Ambien...Ambien is actually a benzo-like drug that just causes less dependency and fewer withdrawl symptoms than most benzos, particularly the short-acting ones, which are NOTORIOUS for bad withdrawals (think Halcion, Ativan, Xanax). Instead of Ambien, I'd recommend: dipenhydramine 50mgs (might stop working after a while), Sonata (if your insurance will cover it, pretty good stuff if your problem is getting to sleep. Best part: if you wake up in the middle of the night, you can take it again). Klonopin's good, too.. (occasionally...personally, I started taking it as a sleeping pill and now its my daytime anxiety med)usually you start at .5-1mg and go up to 2mgs for sleep. If you reach a point that 2mgs won't sedate you, I'd try something new. Valium's good...ProSom, Restoril, and Doral are also good benzos for sleep, but kinda hard to find. If you don't drink or take anti-anxiety meds there's always phenobarbital. It's the only barbiturate in the CIV class b/c of its relative safety. Its long-acting, so it'll keep you asleep. Don't take it if you take multiple meds of any kind...barbiturates go crazy in terms of med interactions. Good luck!
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sanclemente
Banned: also posting as Bruja
Reged: 01/18/04
Posts: 120
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On the way to bed (even getting late on the West Coast - yeah, Lakers), so if I posted this before, I apologize:
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Relief Coming Soon for Insomniacs (New Drug)
by Anthony Pascale and W. Biondic
Published May 08, 2004
Its the worst feeling, being tired all day and the irresistible urge to catch a few winks at your desk but then tossing and turning in your bed at night.
More than 70 million Americans suffer from insomnia and are willing to do just about anything to get rid of it.
More than just lack of sleep, insomnia is poor quality of sleep with frequent waking and daytime drowsiness and you could even gain weight because of lack of sleep.
"When you don't sleep well you may have diminished metabolism, and therefore you don't burn calories that perhaps someone with a good eight hours of sleep may do," said Dr. Thomas Lo Russo of the Nova Sleep Diagnostic Center.
Treating this torment is a multi-billion dollar industry that may soon get a little more competitive with the introduction of a new pill Estorra.
Sepacor, its maker, released six separate studies this week showing it's effectiveness in getting people to sleep faster, with longer stretches of uninterrupted sleep and greater amount of total sleep time. Perhaps most interesting was its safety of use even after 12 months. Currently, most doctors won't prescribe sleeping aids for more than a few weeks.
Also, it is appropriate for elderly insomniacs, which have been a notoriously difficult population to treat because of concerns about nighttime disorientation.
Those who might get the best use out of it are people with a long-term pain condition or on-going stress such as an ill family member. Its not so good for those with sleep apnea or those with only occasional sleep problems.
Still the FDA will have to review these studies before final approval, which may come later this year.
Estorra, if approved, could be available as early as June. Before jumping to yet, another pill consider good sleep hygiene: comfortable clothes and bed, limited caffeine before sleep, daily exercise and avoiding pre-sleep heavy meals and alcohol.
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tone
Veteran
Reged: 06/29/03
Posts: 554
Loc: Chicago
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this is really anoying because this news story says absolutely nothing about what eszopiclone is and i just searched pubmed and the web and got some stuff but nothing on what eszopiclone is. anyone have info on what eszopiclone's pharma mechanism is?
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redhill
Banned. Flames, offending others
Reged: 06/02/03
Posts: 278
Loc: Hell on Earth, for now
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In Holland, even back in 1994, I used to be prescribed 'regular' Zopiclone for occasional insomnia. I imagine EsZopiclone is a newer and cleaner (isn't that what they are always aiming for?) version of it.
It worked GREAT. Better than any sleep drug I've taken in the US, and that includes restoril and prosom.
No hangover, wonderful, relaxed sleep, and less of a weird feeling upon taking it than Ambien.
The funny thing is that it's very closely related to Ambien, except, the FDA has no 'incentive' to approve another drug that is so similar. I think some of us have an idea of how the FDA do their approving - wink wink.
Anyway, the only negative effect that Zopiclone would give me was a metallic taste in the back of my mouth during the first hours of the new day. For some, I imagine that might constiute a wee snag, though.
Oh before I forget - it's all about what we are TOLD is allowed, as far as prescribing Ativan for insomnia goes. The thing about restrictive behaviour around off-label uses is what makes some drug companies richer, and makes some people more miserable.
Ativan, is repackaged as Lormetazepam in Europe, and is designed to be a sleep drug. Well, actually Lormetazepam is somewhat of a parent drug to Lorazepam so to speak (a chemical engineer or chemist, I am not, so that's my lingo for it).
red
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