Her primary is gradually lowering the dose and now she hardly eats. She does drink ensure all day but stays in bed and is becoming more depressed. Not sure who or where to turn for proper help.
I going to jump back in here. Your mom needs to be seeing a psychiatrist who is well versed in the aging brain. There is a HUGE stigma about taking any kind of psychotropic drugs--trust me, I know all about it. I can't imagine her dr prescribing enough that she can be taking more than, say, 8 mgs per day. (DON'T use my dosage as anything but a comment, I don't know much about Ativan.)
Honestly, at the end of life (if that is where she is) does it MATTER? If she needs these to remain calm or deal with anxiety that's severe enough she can't function--then why the worry?
Many antidepressants are used in conjunction with benzos. They can take weeks to see if they "work" and then if one doesn't, weeks to get off that one and try another. This is not an easy fix.
Until the FDA went crazy a couple of years ago and began putting drs in the hotseat about prescribing some classes of medication as being too addictive, etc., thinking they were solving the drug problem in America--a dr could write a scrip for a patient and not quake in fear they'd be censured for it.
You need a better kind of dr., and you need some empathy for mom. Maybe she is having night terrors or just general anxiety. There's more to this story than "Mom is addicted".
I can say that I have had to take a benzo everyday for the last 20 years. It works for me, every time, every dose. When my dr has tried to lower my dose, I also don't want to get out of bed, and I also don't want to eat. The anxiety is truly crippling.
Please find a dr who better able to treat your mom. My heart goes out to her.
The problem with benzos in older adults is that they worsen balance and mental function. So they increase the risk of falls, and they make thinking worse. Both of these issues might be barely noticed in someone who is middle-aged but can become serious problems as a person ages and becomes more prone to falls and memory issues. There is also some research that suggests benzos may be associated with an increased risk of developing dementia.
(If you are middle-aged and taking these drugs, I highly encourage you to look into getting off them. It tends to get harder to do so as you get older, especially if you develop any memory problems.)
So this is why doctors are supposed to try to help older adults taper off benzos. The problem is that benzos cause physiologic dependence, so it's often hard to taper them without causing withdrawal symptoms. These can range from uncomfortable to crippling to life-threatening, depending on how much of a dose decrease the person experiences.
In response to the original poster, my thoughts would be: - Is the Ativan taper a sensible slow taper? Experts in this topic recommend reducing the total weekly dose by 15% every two weeks, so it usually takes several months to reduce. A faster taper often causes more withdrawal. If the person is experiencing too many withdrawal symptoms, the taper needs to be slower. Some people also benefit from being switched first to a longer-acting benzodiazepine, although this can br tricky to manage. Google the "Ashton manual" for more info on this.
- Signs of depression and loss of appetite are very concerning. This absolutely needs to be discussed with the primary doctor. It could be related to benzo withdrawal or it could be something else, either a physical illness or psychiatric one.
In terms of "why bother an old person with an Ativan taper?": it's true that for some older people, the likely burdens seem to outweigh the likely benefits. This tends to be true for those who are declining and seem likely to die within the next year or so.
Otherwise, often an older person and a family do want to reduce the risk of falls, and do want to help the older person think their best. In such cases, it's usually worth attempting a taper.
Not all doctors will make this attempt because honestly, it is a lot of work for everyone involved. But clinical studies have shown that it IS possible for many older adults to taper off these drugs. So I believe all older adults and families should give it serious consideration.
Lastly, re "addiction" and the need for recovery groups: it's important to distinguish between an older person who is physically and psychologically dependent on benzos, versus someone who is exhibiting problematic behavior such as escalating the dose, abusing other substances (painkillers, alcohol, etc), "doctor-shopping," lying to people in order to get the drug, and so forth. I have encountered some older adults with these behaviors and yes, they need services (such as rehab, specialized counseling, special support groups) designed for this type of addictive behavior.
But most older adults "addicted" to ativan are people who have been on a steady dose for a while and develop symptoms if they miss a dose or if a reduction is attempted. They don't need rehab; they need a more thoughtful approach to slowly reducing their benzos and finding other ways to manage any insomnia or anxiety that might have put them on benzos in the first place.
Don't ask4 handout--- We don't know the mom's age of general physical health. Taking her meds and destroying them and throwing mom into detox is probably not the way to go.
I think some gentleness and a better dr's care is more appropriate. Drugs have their place in our lives. Yes, they can be dangerous and they can be abused. Not arguing that--but take an elderly person, throw away their meds, take them to an involuntary commitment and you run the chance of death from withdrawal.
If you haven't walked the path of addiction--well, you can't talk about it so lightly.
Mom isn't a criminal. She's likely sick or depressed or something. Let's get some more info from the OP. Age? General health? Recent loss? Something is going on.
Being "addicted" (more likely, just taking more than prescribed occasionally) to Ativan isn't going to land anyone in rehab. I just feel such pain for this poor woman.
Yikes! I'm sitting quietly on a Sunday morning and then I read dontask4ahandout very strongly worded suggestion that you should throw your Mom into detox, have a family intervention, change her diet, change her food and force her to start exercising. I got anxiety just reading that.
Some questions? How old is your Mom? Is she at the end of her life? What is the dosage of Ativan? Have you told your Mom she is "addicted"? How did she react to that? Just because someone has used a RX for 15 years doesn't always mean addicted even if it is a benzo.
My Mom's primary care Dr. is wonderful and caring. Her whole philosophy is "don't bother the old people" and she enforces it. She believes in caring and loving attention couple with common sense situations. If you want a glass or two of wine or a Ativan to make you happy while you watch Lawerence Welk reruns she is full support. My Mom is 91, has vascular dementia and a host of other things but will fight everyone on taking a simple aspirin. So we don't.
I agree with others, there's more details that we don't know. Detoxing anyone is not as easy as people think and can cause many more problems if you attempt to change their entire life at the end of their life.
My recommendation is to talk the Dr., find out the dosage, and do your own research. Drinking ensure all day is not healthy either as it should just be a supplement not the main source of nutrition so a caring round of questions might be more beneficial than a forced situation "for her own good".
I understand your situation but don't panic, and move a little more slowly. She's been doing something for 15 years, don't attempt to do anything in a quick fashion and update us if you can on more details.
DO NOT THROW HER MEDICATION OUT as suggested above. You cannot just stop mental health medication without horrible side effects. Please speak to a medical professional who is knowledgeable about benzos and how to safely stop...if she truly needs to.
Okay, I have to interject here. I was taking Ativan, lowest dose, 0.5 mg. once a day. One doctor told me the dose is so low that it was almost a placebo. Well, I beg to differ. I did not get my prescript refilled in time and decided to quit cold turkey. Not a good idea........I felt like I was going through an emotional roller coaster, had severe headaches, crying jags. I went on-line and it said it is extremely dangerous to try to quit Ativan without a doctor's supervision. Some people can even have seizures and die. I doubt that would happen at the dose I was taking. But your Mom is elderly and probably taking a higher dose than me. Definitely, do not throw out her medicine. Take it back to the pharmacy and get them to throw it out safely but don't do anything until you've spoken to her doctor.
Thank you Gershun--people who have attempted to quit benzos cold turkey have experienced seizures and death.....you do NOT want to play with these things.
I have taken Clonazepam for 20 years. It is the ONLY thing that has kept me sane the past 20 years. Same dose, no early refills. It's simply self limiting. The few times I have run low at the end of a refill have been awful---and I am far too proud/embarassed to go the ER for what is simply a panic attack.
The MAX dose of most benzos is pretty high, if used for epilepsy, for one, and nobody who has simply GAD would be on more than 4mg per day.
I hope the OP comes back. I really feel sorry for her mom.
Ativan is a benzodiazepine. If she is truly abusing it, she'd sleep all day. I cannot imagine a dr prescribing this in doses high enough to cause this. Sounds more like depression/anxiety.
My mom has been on Lorazapam (also a benzo) for several years as well. At one point in time she was taking them consistently throughout the day. What kind of doctor is weaning her off of them. Like any type of mental health medication, it needs to be done carefully as the withdrawal can be difficult. It can even cause nausea so that may explain why she isn't eating. I would definitely speak with her doctor or consult a psychiatrist who knows how to wean someone off slowly without as many withdrawal symptoms.Maybe her primary is doing it a bit too fast.
I can't imagine her dr prescribing enough that she can be taking more than, say, 8 mgs per day. (DON'T use my dosage as anything but a comment, I don't know much about Ativan.)
Honestly, at the end of life (if that is where she is) does it MATTER? If she needs these to remain calm or deal with anxiety that's severe enough she can't function--then why the worry?
Many antidepressants are used in conjunction with benzos. They can take weeks to see if they "work" and then if one doesn't, weeks to get off that one and try another. This is not an easy fix.
Until the FDA went crazy a couple of years ago and began putting drs in the hotseat about prescribing some classes of medication as being too addictive, etc., thinking they were solving the drug problem in America--a dr could write a scrip for a patient and not quake in fear they'd be censured for it.
You need a better kind of dr., and you need some empathy for mom. Maybe she is having night terrors or just general anxiety. There's more to this story than "Mom is addicted".
I can say that I have had to take a benzo everyday for the last 20 years. It works for me, every time, every dose. When my dr has tried to lower my dose, I also don't want to get out of bed, and I also don't want to eat. The anxiety is truly crippling.
Please find a dr who better able to treat your mom. My heart goes out to her.
(If you are middle-aged and taking these drugs, I highly encourage you to look into getting off them. It tends to get harder to do so as you get older, especially if you develop any memory problems.)
So this is why doctors are supposed to try to help older adults taper off benzos. The problem is that benzos cause physiologic dependence, so it's often hard to taper them without causing withdrawal symptoms. These can range from uncomfortable to crippling to life-threatening, depending on how much of a dose decrease the person experiences.
In response to the original poster, my thoughts would be:
- Is the Ativan taper a sensible slow taper? Experts in this topic recommend reducing the total weekly dose by 15% every two weeks, so it usually takes several months to reduce. A faster taper often causes more withdrawal. If the person is experiencing too many withdrawal symptoms, the taper needs to be slower. Some people also benefit from being switched first to a longer-acting benzodiazepine, although this can br tricky to manage. Google the "Ashton manual" for more info on this.
- Signs of depression and loss of appetite are very concerning. This absolutely needs to be discussed with the primary doctor. It could be related to benzo withdrawal or it could be something else, either a physical illness or psychiatric one.
In terms of "why bother an old person with an Ativan taper?": it's true that for some older people, the likely burdens seem to outweigh the likely benefits. This tends to be true for those who are declining and seem likely to die within the next year or so.
Otherwise, often an older person and a family do want to reduce the risk of falls, and do want to help the older person think their best. In such cases, it's usually worth attempting a taper.
Not all doctors will make this attempt because honestly, it is a lot of work for everyone involved. But clinical studies have shown that it IS possible for many older adults to taper off these drugs. So I believe all older adults and families should give it serious consideration.
Lastly, re "addiction" and the need for recovery groups: it's important to distinguish between an older person who is physically and psychologically dependent on benzos, versus someone who is exhibiting problematic behavior such as escalating the dose, abusing other substances (painkillers, alcohol, etc), "doctor-shopping," lying to people in order to get the drug, and so forth. I have encountered some older adults with these behaviors and yes, they need services (such as rehab, specialized counseling, special support groups) designed for this type of addictive behavior.
But most older adults "addicted" to ativan are people who have been on a steady dose for a while and develop symptoms if they miss a dose or if a reduction is attempted. They don't need rehab; they need a more thoughtful approach to slowly reducing their benzos and finding other ways to manage any insomnia or anxiety that might have put them on benzos in the first place.
We don't know the mom's age of general physical health. Taking her meds and destroying them and throwing mom into detox is probably not the way to go.
I think some gentleness and a better dr's care is more appropriate. Drugs have their place in our lives. Yes, they can be dangerous and they can be abused. Not arguing that--but take an elderly person, throw away their meds, take them to an involuntary commitment and you run the chance of death from withdrawal.
If you haven't walked the path of addiction--well, you can't talk about it so lightly.
Mom isn't a criminal. She's likely sick or depressed or something. Let's get some more info from the OP. Age? General health? Recent loss? Something is going on.
Being "addicted" (more likely, just taking more than prescribed occasionally) to Ativan isn't going to land anyone in rehab. I just feel such pain for this poor woman.
Some questions? How old is your Mom? Is she at the end of her life? What is the dosage of Ativan? Have you told your Mom she is "addicted"? How did she react to that? Just because someone has used a RX for 15 years doesn't always mean addicted even if it is a benzo.
My Mom's primary care Dr. is wonderful and caring. Her whole philosophy is "don't bother the old people" and she enforces it. She believes in caring and loving attention couple with common sense situations. If you want a glass or two of wine or a Ativan to make you happy while you watch Lawerence Welk reruns she is full support. My Mom is 91, has vascular dementia and a host of other things but will fight everyone on taking a simple aspirin. So we don't.
I agree with others, there's more details that we don't know. Detoxing anyone is not as easy as people think and can cause many more problems if you attempt to change their entire life at the end of their life.
My recommendation is to talk the Dr., find out the dosage, and do your own research. Drinking ensure all day is not healthy either as it should just be a supplement not the main source of nutrition so a caring round of questions might be more beneficial than a forced situation "for her own good".
I understand your situation but don't panic, and move a little more slowly. She's been doing something for 15 years, don't attempt to do anything in a quick fashion and update us if you can on more details.
I have taken Clonazepam for 20 years. It is the ONLY thing that has kept me sane the past 20 years. Same dose, no early refills. It's simply self limiting. The few times I have run low at the end of a refill have been awful---and I am far too proud/embarassed to go the ER for what is simply a panic attack.
The MAX dose of most benzos is pretty high, if used for epilepsy, for one, and nobody who has simply GAD would be on more than 4mg per day.
I hope the OP comes back. I really feel sorry for her mom.
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