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Dr. Vikas
Dr. Vikas, Doctor
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Experience:  MBBS; MD
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Im prescribed 1mg Ativan prn up to 3 times a day for anxiety,

Resolved Question:

I'm prescribed 1mg Ativan prn up to 3 times a day for anxiety, also given 50 mg trazadone for 4 days, 100mg the next 4, 150 mg the next 4, until it reaches 200mg a night for sleep and mood. I'm wondering if Ativan and trazadone gets to be a dangerous combo as the dose of trazadone goes up? my phsych is on vacation and I dont trust his colleagues.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Vikas replied 1 year ago.

Dr Vikas :

Hello,

Dr Vikas :

Except that both Trazadone and Ativan can cause sedation there is not much to worry about in my view. Trazadone can be combined with Benzodiazepines in certain cases.

Dr Vikas :

The dose of Ativan is also not very high and probably your will be taking it on as an if needed basis.

Dr Vikas :

Therefore you need to be cautious about sedation and should try to avoid any activity which requires active attention for example, driving, operating a heavy machinery, swimming etc if you notice increased sedation while taking them in combination.

Dr Vikas :


are you online right now?

Customer: ues
Dr Vikas :

OK

Dr Vikas :

good

Dr Vikas :

waiting for your reply.

Customer: so my doc told me to try and avoid the Ativan at night and use the trazadone because it should also help with anxiety. and he wants to start to ween me off the Ativan I've the trazadone reaches therapeutic levels. this sound correct? sorry but paranoia Is part of my gad
Customer: but takin 3 mg throughout the day and 200mg trazadone at night won't kill me?
Dr Vikas :

The Usual dosage range of Trazadone when used as a monotherapy is150-600 mg per day for depression although it is an unusual choice for treating GAD in my view.

Dr Vikas :

Are you noticing excessive sedation while taking this combo?

Dr Vikas :

are you there?

Customer: well trazadone knocks me out but are you talking a out durring the day?
Dr Vikas :

yes

Customer: yawn a lot but I'm not like tired really
Dr Vikas :

OK, then I don't think there is much to worry about

Dr Vikas :

you are noticing improvement in your symptoms?

Customer: yea I'm having a lot less panic attacks but still on 100mg, I was on celexa but it was causing a lot more panic attacks
Dr Vikas :

but while taking Celexa, were you also takign Ativan in combination or not?

Customer: Yea but I was only at .5mg a day 3x if needed
Dr Vikas :

this could be the reason why you are experiencing less panic attack now because of increased dose of Ativan

Dr Vikas :

In my view, you can discuss with your doctor about adding Sertraline (Zoloft) initially in a low dose of 25 mg to start with and after a week,increased up to 50 mg per day which will augment the antianxiety effect of Trazadone.

Dr Vikas :

using this strategy your dependence on Ativan will decrease slowly.

Dr Vikas :

Ativan being a benzodiazepine should not be taken for long duration because of risk of developing dependence to it and tolerance to its effect.

Customer: well I was put on rameron and the same dose of Ativan .5. and I went to the emergency room again and he raised my Ativan but then I had an allergic reaction to the rameron which is why he wanted to try trazadone.
Dr Vikas :

SSRI antidepressants like Zoloft are the first line medicine for treating anxiety, GAD and in my view, a combination of Trazadone with Zoloft can be very useful in your case.

Customer: ok I'll discuss it with him I know he said once I get at a week of 150mg of trazodone complete he's gonna remove 1 dose of Ativan then the next week another, then the last dose will be dived into .5 2x a day as needed, then .5 once a day as needed then be re assed for my anxiety. but I'll ask about Zoloft thanks
Dr Vikas :

You are most welcome. Do you have any other question to ask?

Customer: if I wake up in the middle of the night would it be dangerous to take a dose of Ativan to get back to sleep?
Dr Vikas :

Since Trazadone is itself very sedative so won't be needing it but if possible try to avoid doing it.

Dr Vikas :

just to avoid extra sedation

Dr Vikas :

still waiting for your reply.

Dr Vikas :

I guess, you are not online right now.

Dr Vikas :

Kind regards

Dr Vikas :

Vikas

Dr Vikas :

I hope I have answered your question. Please feel free to discuss further if you have other questions and press the reply back button. If you are satisfied with my answers, please rate one of the positive ratings (3,4,5) as this is the only way how we are compensated for our time and expertise.

Dr. Vikas, Doctor
Category: Medical
Satisfied Customers: 2219
Experience: MBBS; MD
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