anxiety meds?

[Jane]

Over the past few years Josh has had bouts of anxiety and has only been treated with a daily depression/anxiety med. This week (end of the term/ finals exams) he's been having more frequent and sever anxiety attacks. Our NP just recommended klonapin or ativan.

He's used ativan before PICC placement, but it seems to make him very sleepy. Does anyone have some experience/ advice in this area?

Thanks

 

[Jane]

Over the past few years Josh has had bouts of anxiety and has only been treated with a daily depression/anxiety med. This week (end of the term/ finals exams) he's been having more frequent and sever anxiety attacks. Our NP just recommended klonapin or ativan.

He's used ativan before PICC placement, but it seems to make him very sleepy. Does anyone have some experience/ advice in this area?

Thanks

 

[Jane]

Over the past few years Josh has had bouts of anxiety and has only been treated with a daily depression/anxiety med. This week (end of the term/ finals exams) he's been having more frequent and sever anxiety attacks. Our NP just recommended klonapin or ativan.
<br />
<br />He's used ativan before PICC placement, but it seems to make him very sleepy. Does anyone have some experience/ advice in this area?
<br />
<br />Thanks

 

[Havoc]

All the medications you mentioned are benzodiazepines, the main difference is the half-life (the amount of time it takes for half of the medication to be metabolized) and perhaps to a lesser extent onset of action.

Benzodiazepines are commonly used for anxiety, insomnia and seizures. Somnolence is common with these types of drugs, but sometimes will decrease after you have been on them for a period of time. The other options are SSRI's, TCA's and some MAOI's. I am not a fan of most of the psychotropic drugs as they can have really nasty side effects and are often not effective for everyone.

Here is a breakdown of the benzos you mentioned:

Xanax (alprazolam): C-max (peak concentration) occurs 1-2 hours after administration. T1/2 (half-life) averages to 11.2 hours.

Ativan (lorazepam): C-max occurs about 2 hours after administration and its T1/2 is about 12 hours. It does have an active metabolite which has a T1/2 of 18 hours.

Klonopin (Clonazepam): C-max occurs 1-4 hours after administration and T1/2 is about 30-40 hours. This might be a good bet as he could take them at night and they would help for sleep and then would still be active the next day to ward off anxiety attacks. The only down side might be daytime somnolence since the medication would still be active.

Keep in mind that people with CF often have increased metabolism on the P450 cytochrome (which metabolizes benzos), meaning that the T1/2 might be reduced and the dose might need to be higher than one would expect for a regular person. Also, there are sometimes oral (sublingual) preparations of these medications which have a more rapid onset, which can be useful if he's having an attack.

 

[Havoc]

All the medications you mentioned are benzodiazepines, the main difference is the half-life (the amount of time it takes for half of the medication to be metabolized) and perhaps to a lesser extent onset of action.

Benzodiazepines are commonly used for anxiety, insomnia and seizures. Somnolence is common with these types of drugs, but sometimes will decrease after you have been on them for a period of time. The other options are SSRI's, TCA's and some MAOI's. I am not a fan of most of the psychotropic drugs as they can have really nasty side effects and are often not effective for everyone.

Here is a breakdown of the benzos you mentioned:

Xanax (alprazolam): C-max (peak concentration) occurs 1-2 hours after administration. T1/2 (half-life) averages to 11.2 hours.

Ativan (lorazepam): C-max occurs about 2 hours after administration and its T1/2 is about 12 hours. It does have an active metabolite which has a T1/2 of 18 hours.

Klonopin (Clonazepam): C-max occurs 1-4 hours after administration and T1/2 is about 30-40 hours. This might be a good bet as he could take them at night and they would help for sleep and then would still be active the next day to ward off anxiety attacks. The only down side might be daytime somnolence since the medication would still be active.

Keep in mind that people with CF often have increased metabolism on the P450 cytochrome (which metabolizes benzos), meaning that the T1/2 might be reduced and the dose might need to be higher than one would expect for a regular person. Also, there are sometimes oral (sublingual) preparations of these medications which have a more rapid onset, which can be useful if he's having an attack.

 

[Havoc]

All the medications you mentioned are benzodiazepines, the main difference is the half-life (the amount of time it takes for half of the medication to be metabolized) and perhaps to a lesser extent onset of action.
<br />
<br />Benzodiazepines are commonly used for anxiety, insomnia and seizures. Somnolence is common with these types of drugs, but sometimes will decrease after you have been on them for a period of time. The other options are SSRI's, TCA's and some MAOI's. I am not a fan of most of the psychotropic drugs as they can have really nasty side effects and are often not effective for everyone.
<br />
<br />Here is a breakdown of the benzos you mentioned:
<br />
<br />Xanax (alprazolam): C-max (peak concentration) occurs 1-2 hours after administration. T1/2 (half-life) averages to 11.2 hours.
<br />
<br />Ativan (lorazepam): C-max occurs about 2 hours after administration and its T1/2 is about 12 hours. It does have an active metabolite which has a T1/2 of 18 hours.
<br />
<br />Klonopin (Clonazepam): C-max occurs 1-4 hours after administration and T1/2 is about 30-40 hours. This might be a good bet as he could take them at night and they would help for sleep and then would still be active the next day to ward off anxiety attacks. The only down side might be daytime somnolence since the medication would still be active.
<br />
<br />Keep in mind that people with CF often have increased metabolism on the P450 cytochrome (which metabolizes benzos), meaning that the T1/2 might be reduced and the dose might need to be higher than one would expect for a regular person. Also, there are sometimes oral (sublingual) preparations of these medications which have a more rapid onset, which can be useful if he's having an attack.

 

[krisgabes]

Hey Jane,

I used to be prescribed Xanax .25 mg for anxiety in the past but I didn't like the fact that it was a narcotic and gave me side effects. I also didn't like the potential for dependence. Now my psychiatrist has me take a med called Vistaril 25 mg. She said sometimes they give it to you in the hospital for general anxiety. I find it takes the edge off without the narcotic side effects. It may be worth looking into.

 

[krisgabes]

Hey Jane,

I used to be prescribed Xanax .25 mg for anxiety in the past but I didn't like the fact that it was a narcotic and gave me side effects. I also didn't like the potential for dependence. Now my psychiatrist has me take a med called Vistaril 25 mg. She said sometimes they give it to you in the hospital for general anxiety. I find it takes the edge off without the narcotic side effects. It may be worth looking into.

 

[krisgabes]

Hey Jane,
<br />
<br />I used to be prescribed Xanax .25 mg for anxiety in the past but I didn't like the fact that it was a narcotic and gave me side effects. I also didn't like the potential for dependence. Now my psychiatrist has me take a med called Vistaril 25 mg. She said sometimes they give it to you in the hospital for general anxiety. I find it takes the edge off without the narcotic side effects. It may be worth looking into.

 

[Havoc]

Xanax isn't a narcotic, although there is a slight risk of dependence (it's a schedule IV). Vistaril is very closely related to benadryl and other anticholinergics. It has it's own list of side effects, which typically are longer than that of benzodiazepines. In my experience anticholinergics can worsen anxiety in some people and tend to have a much more pronounced sedative effect.

 

[Havoc]

Xanax isn't a narcotic, although there is a slight risk of dependence (it's a schedule IV). Vistaril is very closely related to benadryl and other anticholinergics. It has it's own list of side effects, which typically are longer than that of benzodiazepines. In my experience anticholinergics can worsen anxiety in some people and tend to have a much more pronounced sedative effect.

 

[Havoc]

Xanax isn't a narcotic, although there is a slight risk of dependence (it's a schedule IV). Vistaril is very closely related to benadryl and other anticholinergics. It has it's own list of side effects, which typically are longer than that of benzodiazepines. In my experience anticholinergics can worsen anxiety in some people and tend to have a much more pronounced sedative effect.

 

[krisgabes]

It all depends on the person. All I said was it was worth looking into as an alternative because he has used both Xanax and Ativan with some side effects. I'm in the field myself Havoc, I'm aware of the medications used to treat anxiety.

 

[krisgabes]

It all depends on the person. All I said was it was worth looking into as an alternative because he has used both Xanax and Ativan with some side effects. I'm in the field myself Havoc, I'm aware of the medications used to treat anxiety.

 

[krisgabes]

It all depends on the person. All I said was it was worth looking into as an alternative because he has used both Xanax and Ativan with some side effects. I'm in the field myself Havoc, I'm aware of the medications used to treat anxiety.

 

[Havoc]

I think hes only used Ativan for PICC placement, and the only side effect he noticed was somnolence. He's on an unnamed anxiety medication, probably an SSRI, which doesn't seem to be cutting it. Klonopin and ativan were suggested by his nurse practitioner, and I agree with that practitioner. I would not go experimenting with anticholinergics unless the benzos were intolerable. The only thing that comes close to that kind of mechanism of action that might help is low dose Doxepin.

 

[Havoc]

I think hes only used Ativan for PICC placement, and the only side effect he noticed was somnolence. He's on an unnamed anxiety medication, probably an SSRI, which doesn't seem to be cutting it. Klonopin and ativan were suggested by his nurse practitioner, and I agree with that practitioner. I would not go experimenting with anticholinergics unless the benzos were intolerable. The only thing that comes close to that kind of mechanism of action that might help is low dose Doxepin.

 

[Havoc]

I think hes only used Ativan for PICC placement, and the only side effect he noticed was somnolence. He's on an unnamed anxiety medication, probably an SSRI, which doesn't seem to be cutting it. Klonopin and ativan were suggested by his nurse practitioner, and I agree with that practitioner. I would not go experimenting with anticholinergics unless the benzos were intolerable. The only thing that comes close to that kind of mechanism of action that might help is low dose Doxepin.

 

[Asexyblond23]

I have taken xanax for years. I take it daily but I also will take .25mg at times for high anexity. Like surgries, or even before a PFT test because I get really anexious about it.

 

[Asexyblond23]

I have taken xanax for years. I take it daily but I also will take .25mg at times for high anexity. Like surgries, or even before a PFT test because I get really anexious about it.