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Taking two pill of lorazepam and anti-depressant. What to do?

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Psychiatrist
Practicing since : 2008
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hello, I am currently taking about two pill of lorazepam of 1 mg. But I have not take them everyday at the same time for a month, (I have take it for 3 weeks now for the first time).
I was taking an anti-depressant too, for a moth but I really did not need it. I also am taking lorazepam (as needed)
About lorazepam: it really help me a lot, But I have been taking irregularly
Question: but if I take it at the same time: one in the morning and one at 2 or 3 in the afternoon it would be better right? (which I do some times, but not at the same time)
Now, can lorazepam eventually "cure" my anxiety and stop taking it?
If I feel that I need 3 pill of lorazepam of 1 mg a day, and that would makes me feel real "normal" would that be better?
Posted Sun, 27 Oct 2013 in Mental Health
 
 
Answered by Dr. Anjana Rao Kavoor 1 hour later
Brief Answer:
Details of antidepressant and other drugs needed.

Detailed Answer:
Hi,
Thanks for writing in to us.

I have read your query in detail.

Taking lorazepam along with antidepressants is given in a lot of patients having anxiety. Best results are seen after taking it at a particular dose as started initially and slowly monitoring dose carefully by analysis of your problems and the improvement after being on medication.

It is important for me to know which anti depressant you were given fir a month including its dosage.

Sometimes more than one medication might be required to get desired results depending on patient's presenting problems.

Do write about any other medicines that you have been given for your anxiety and other problems.

Waiting for an update from your end.

Dr.A.Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 14 minutes later
Hi Dr. yes, I was given Escitalopram 10 mg for two weeks, I skipped 3 or 4 pills.
and later the dose was 20 mg of Escitalopram which I took for about 20 days at bedtime. It was not good for me.
I don't think I was depressed because I was thinking about doing things and riding my bike and going back to school (at 57) to finish my master in mathematics.
what happened was that I exercised to hard and I got very sick. I was so weak I thought it was my heart but I really don't know. I am a lot stronger now but still with pains. by the way, I got the GERD at the same time but I had mild problems before. Thanks
 
 
Answered by Dr. Anjana Rao Kavoor 6 hours later
Brief Answer:
It is advisable to not take lorazepam regularly.

Detailed Answer:
Hi,
Thanks for writing back with the details,

Lorazepam is not a “cure” for anxiety problems. It only temporarily alleviates symptoms and is usually given only as a cover during the first few weeks of an antidepressant treatment. Please note that antidepressants are not only prescribed for depression but for many conditions, and this includes anxiety. Benzodiazepines like lorazepam are not given on a regular basis because of the risk of dependence and tolerance and severe withdrawals on stoppage. If you continue taking it, it will not cure the problem, but you will get addicted to it and will not be able to stop taking it. On stopping it, you will have more anxiety and worsening of symptoms eventually. Antidepressants are given on a regular basis to treat anxiety with no side effects of dependence. If Escitalopram did not help your anxiety then please go back to your psychiatrist to get the antidepressant changed. There are many antidepressants available. You may only take the lorazepam till the antidepressant begins to start showing response on being prescribed by your psychiatrist. I would advise you to kindly visit your psychiatrist for the treatment. I strongly recommend you to not take lorazepam regularly and take it only as advised on ‘as needed’ basis.

Any further queries are welcome.
I hope this helps,
Dr. A Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 35 minutes later
ok. my problem was that I was taking the antidepressant at night and would feel very weak, but maybe was not due to the antidepressant. I have an appointment tomorrow with my new appointed Psychiatrist, and talk about it.
Q. so the antidepressant is not addicted and it can be stopped once it works?
Can I continue taking escitalopram tonight to avoid any problem with having quit suddenly?
Or maybe I don't need anxiety problem and I should address more my physical problems such as body aches and my GERD that seems to be worsening?
 
 
Answered by Dr. Anjana Rao Kavoor 3 hours later
Brief Answer:
Address both problems.

Detailed Answer:
Hi,
Thanks for writing back with the details,

Antidepressants are usually given in the mornings. Only in case it causes sedation doctors give it at night time but if you are taking it at night by yourself (without doctors advise) then the problem is that it can cause disturbed sleep. Weakness can be due to many reasons, depression being a very common one. Other causes are physical problems, for which you can go to a physician and get some routine tests done to check your physical fitness to see if that may be causing the fatigue and weakness. Antidepressants rarely cause weakness.

Yes, antidepressants are not addictive but they cannot be stopped soon after it shows response. It has to be taken atleast for a few months or years after your symptoms disappear. The exact duration will be decided by your psychiatrist after a detailed history and assessment.

Yes you should continue taking escitalopram till your visit to psychiatrist. If you have been taking it at night and if it has caused you no sleep disturbance then continue it till you XXXXXXX your doctor.

If your anxiety problems are causing trouble in your day to day activities then you should consult a psychiatrist and get it treated. You may also benefit from psychotherapy for anxiety without any medications if this problem is not severe enough to interfere with your daily work. Discuss this with your psychiatrist. Body aches can again have many causes, amongst the common ones; one is physical cause (consult a physician to rule out/ confirm this cause) and psychiatric causes like depression etc. Sometimes it is seen that in patients with depression, symptoms of GERD does not subside completely till the psychiatric problems/depression is treated. So I would suggest you to see both a psychiatrist and physician.

Any further queries are welcome.
I hope this helps,
Dr. A Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 11 hours later
I have a headache (not necessarily strong) and I've been taking lots of antiacid medication and pills for pain. This pain began when I was taking escitalopram, (and lorazepam which I still take). This pain is one of my main concerns now because it makes me "weak" I mean it gives me a dizzy or lightheaded felling.
Any comment as to what the cause may be? I will comment this to the psychiatrist tomorrow in my appointment. This may be the last question. Thanks for being there.
 
 
Answered by Dr. Anjana Rao Kavoor 11 hours later
Brief Answer:
Both Escitalopram and lorazepam can cause headache

Detailed Answer:
Hi,
Thanks for writing back with the details,

If the headache has begun after taking Escitalopram and Lorazepam, it could be caused by the drug. It would be difficult to pin-point which drug is causing it since you started taking both together.

Escitalopram is known to cause headache in few patients. Alternately, since you take the drug at night, it may be causing some disturbed sleep and subsequent headache during the day. You may take the drug in the morning for a few days to see if it improves. Another option is to divide the dose of the drug, to take half in the morning and half at night. This has shown to improve headache in many patients. If this still does not help then you may speak with your psychiatrist to change the drug if the headache is severe.

Weakness and headache are common side effects of Lorazepam as well. If this is the cause, it would be advisable to taper and stop this drug slowly. Discuss this with your psychiatrist in detail.

Any further queries are welcome.
I hope this helps,
Dr. A Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 12 hours later
Ok. you said weakness and headache are common side effects. Would you know the percentage in cases: what percentage would get those side effects.
Are antidepressants known to alleviate physical pain such as muscle pain or other?
What are the odds of taking antidepressants (in needed) for life, short time (months, 1 year) or longer time (2 years or more)
I went to my appointment and I am supposed to taper and stop in about 24 days.
But I still am open to go back (to another clinic) and see if I really need it. Right now I have some physical problems that I have to wait and see if I improved a lot, then see what happens.
My problem might be that I live alone? How much would I improved living with someone I like?
 
 
Answered by Dr. Anjana Rao Kavoor 6 hours later
Brief Answer:
Detailed answer below.

Detailed Answer:
Hi,
Thanks for writing back with details.

Headache might occur as a side effect in 3 to 4% of those reporting side effects after taking Escitalopram and/ or Lorazepam.

Weakness might occur as a side effect in 3 to 5% of those reporting side effects after taking Escitalopram and/ or Lorazepam.

Antidepressants are known to keep the mind in balance. Physical and muscular pain perception can be altered by the state of the mind. Therefore when we are happy, we tend to ignore pains and when gloomy, even the smallest pain gives makes us uncomfortable. Therefore indirectly taking antidepressants may alleviate physical and muscular pain.

Any illness needs a particular treatment with certain medications. The illness can be physical or in the mind. If ignored, any illness can make an individual sicker. At the same time every medication may have some rare adverse effects that need not affect every patient being treated with it. The only fact is that self medication should not be encouraged and regular follow up with your doctor is essential.

I suggest you discuss your physical problems too with your doctor and take a second opinion if felt necessary.

Your personal and social life is as important as your health. It is not living with someone but living with someone who you would like to care for and you must also care for them. In other words a healthy relationship is necessary for a good personal and social life.

Any further queries are welcome.
I hope this helps,
Dr. A Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 15 hours later
I have been taken over the dosage prescribed of antiacid medication for my "GERD"
in the last four days a have developed a terrible headache when I wake up for the first time in the morning and begin to walk about my apartment, if I go back to bed, it goes away. Today was my worse, I took a LOT of pain tablets and I got scared what I felt. Yesterday I took fewer, but still over the suggested, but I took one mg of lorazepam early before taking the pain pills. Today I did not take it before but afterward, like 10 hours after I took all those pain pills.
It seems also that the more I ride my bike the day before, influences how much pain I will get. But I worry and do something.
I wonder what is causing the pain besides riding my bike: do I have a head injury or some of the pills for my stomach problem contributing. Today I did not take all those stomach (acid) pills. Who knows what is going on.
So you suggest that if I need lorazepam, I definitely need and be better off taking an anti depressant at the same time right? Because all the "physical" problems I have really depressed me.
I bike when I feel okey but most of the time i am fighting these ailments.
 
 
Answered by Dr. Anjana Rao Kavoor 4 hours later
Brief Answer:
Detailed answer below.

Detailed Answer:
Hi,
Thanks for writing in with an update.

Any medication is best taken at recommended dosages as prescribed by your doctor. It is unlikely that Lorazepam has caused any interaction with your antacid or pain killer intake. However, it would be best to know what medications you are taking for GERD and the pain killers.

As GERD symptoms are increased on taking pain killers, taking pain killers can neutralize the effect brought about by antacids leading to more severe symptoms of GERD at times.

Since Lorazepam can cause headache and weakness in 3-4 % patients, there is always a possibility that it may be responsible for your headaches. If I were to relate bike riding and headaches, dusty environmental exposure can cause allergy and sinusitis headache in many patients.

I would suggest that you always take antacids if there is a need to take pain killers. Antacids must be taken on empty stomach in early morning or at least 30 minutes before food. Pain killers must be taken after food. Pain killer ointments can also help and you may always consider that as an option.

Yes, I confirm that Lorazepam acts as a cover for treatment with an antidepressant. That being the situation, lorazepam is a temporary medication until the antidepressant stats acting in its full potential. Therefore lorazepam should be taken along with an antidepressant to deal with the depressive symptoms in a better way.

Its nice that you relax by going biking but take precaution from dust exposure. You do not have any head injury if there is no contributory history of having hurt your head in the past.

Any further queries are welcome.
I hope this helps,
Dr. A Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 13 hours later
Thanks for the tips.
I was prescribed Omeprazole, which was not giving me much relief. I took 11 pills (one each morning) of Prevacid a while ago, which claims to cure it. I take pepsid sometimes, and lately I have been taking tagamet and pepto bismol for the most part, but it may be like you say, that the pain medication is neutralizing the effects.

So, yesterday I avoided most of them (antiacid), just took Omeprazole in the morning and avoided more for the rest of the day even though I had some pain, which eventually subsided in the evening.
Today, the pain in my head (the most bothersome) was a bit less but I have not taken any pain pill, I took lorazepam though as the doctor told me to taper it, but it did some good (I guess. although without the headache I would not know if I need it).
Instead of taking pain pills I rested a bit after I ate a little, I still have the headache, but more manageable, I will try some pain pill but not much. Yesterday I rode my bike in the cool evening of the day (night) and for not that long as the day before.
When I say head "injury" I mean some type of inflammation caused by the medicines which ever it is I am taking, or combination of them; or perhaps I should stop biking for a while and the headache might heal??
I use spray and icy hot and Bengay for my back and chest pain.
Is there any spray for the head, or alcohol is the one I should buy to rub on it?

I had a similar problem about 7 years ago (a abit worse) in my head which did not let me go to school, the only thing I took was Aleve (naproxen sodium tablets) and eventually the "inflammation" in my head went away. That was horrible. My problem in the beginning was that the hospital pharmacy might have given me an expired medication, then I found out it was naproxen and I bought it over the counter and it worked.
 
 
Answered by Dr. Anjana Rao Kavoor 17 hours later
Brief Answer:
You may try pain reliever ointments.

Detailed Answer:
Hi,
You are welcome and thanks for writing in with an update.

I am glad to know that you reconsidered the dosage of your GERD and pain pills and this has shown improvement, however little it may be.

I do not think there will be any head injury due to the medications alone. If your headache shows improvement on stopping biking then you may rest awhile. For the headache, I suggest you apply some pain reliever ointments for headache.

Naproxen is a good pain killer and used by many. The drawback of naproxen and other NSAIDs is that they can irritate the lining of your stomach. This may cause stomach GERD symptoms, ulcers or bleeding in your stomach.

Any further queries are welcome.
I hope this helps,
Dr. A Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 10 hours later
I wanna stop lorazepan: after taking mostly 2 mg a day, the doctor suggests 1 mg a day for 10 days (knowing that I had 16 pills left). then half a day.

after doing this, I think: 1 mg and a quarter or 1 mg and a half. a day, then 1mg then 3 quarters ... by quarters. what do you think.

what happens if I stop altogether at once? how long would the withdrawal would last, and how XXXXXXX Or can it be done?

I got like 70 1 mg pills. before I went to the doctor I already had the prescription for one more month.
 
 
Answered by Dr. Anjana Rao Kavoor 12 hours later
Brief Answer:
Please find detailed answer below.

Detailed Answer:
Hi,
Thanks for writing in with an update.

Its nice to know that you are intending to stop Lorazepam under your doctor's supervision.

You must follow your doctor's instruction and that way you can make your discontinuation most comfortable.

If you stop all at once, there is very less likelihood of any serious withdrawal effects. Your dose is low enough and it will not be XXXXXXX in any way.

If you have 70 pills extra, I suggest you return the left over ones to your pharmacy.

Any further queries are welcome.
I hope this helps,
Dr. A Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Taking two pill of lorazepam and anti-depressant. What to do? 1 hour later
thanks
 
 
Answered by Dr. Anjana Rao Kavoor 10 hours later
Brief Answer:
Welcome.

Detailed Answer:
Hi,
You are welcome and wishing you good health.

Regards,
Dr.A.Rao Kavoor
Above answer was peer-reviewed by
 
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