How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Ralph LMHC Your Own Question

Ralph LMHC
Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience:  20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
Type Your Mental Health Question Here...
Ralph LMHC is online now
A new question is answered every 9 seconds

I left a message the other day to ask a question about Ativan.

Customer Question

I left a message the other day to ask a question about Ativan. I am taking Ativan 1 mg in the morning and now a .5 mg at noon. The higher dose in the morning is because I have a lot of gaggy feelings in the morning (which I still can't get rid of), which does tend to get better as the day goes by. I have a panic disorder, and when I had a panic disorder 30 years ago, the same thing happened, though it seems worse this time. I was taking 1 mg of Ativan in the morning and 1 mg ativan at noon, and have reduced the noon one to .5 mg. My psychiatrist stated I can pretty much regulate based on my own needs. Does this sound like a good reduction and if it goes well, how do you recommend reduction down the road? I have been on ativan for about a month, on different doses - no more than than the 2 mg/day. sometimes it is .25 mg tid. I could not handle the SSRI's. I tried klonopin, but with the excessive salivation, went back to Ativan.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Ralph LMHC replied 3 years ago.

Hello, I am in agreement with the doctor who is saying that your own bodily reaction is the best indicator. I am somewhat confused when you mention klonapin and ativan .and then mention SSRI's. Both Klonapin and Ativan are benzodiazapines with no relation to SSRI's. The feeling of unreality if attributable to meds or anxiety can only be determined if you stop the ativan and still have the same reaction. Remember you cannot just stop Benzo's abruptly without the risk of seizure or convulsions. If you have further questions I will answer, but I must get off for a few hours. good luck.

 

Sincerely,

Ralph LMHC

If you require further clarification or more information, feel free to ask! If you would, please fill out the feedback form after accepting. I appreciate this opportunity to help you out today. If I can be of further service to you in the future, just put "Ralph" in the front of your new question, and I'll be the one to answer it. Please click the green "ACCEPT" button on this page if you are satisfied with my answer so that I get credit for my work. Your positive feedback is most important and bonuses are always welcomed. If this is a mental health, or medical emergency, please call emergency services (911 in the USA), or go to your nearest Emergency Room. The opinion provided does not replace an evaluation by an appropriate professional. Use of this website DOES NOT CREATE a provider-client relation and this information is for educational purposes only.

 

Ralph LMHC, Therapist
Category: Mental Health
Satisfied Customers: 872
Experience: 20+ years as therapist, supervisor, clinic director at mental health, substance abuse treatment ctrs
Ralph LMHC and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
The reason I mentioned the SSRI, was just to let you know a while back I tried those, but couldn't tolerate them. The Klonopin was mentioned just so you knew that a while back I was on that for a couple of weeks but because of the excessive salivation, switched back to Ativan. So, I have been on a benzodiazepine for at least a couple of months. The Ativan. I've presently been on Ativan (never more than the 2 mg/day at any time. The psychiatrist says I can kind of increase/decrease based on how I feel. The question I had then, was that for the past week or so I had been taken Ativan 1 mg. in the morning and 1mg at noon. The last few days I have reduced the noon one to .5 because I tend to have more trouble in the morning with nerves and less as the day goes on. Is this a reasonable reduction (I didn't want any bad rebound or like you said risk of seizures). And in the future, to reduce more, how would be a safe way to do it?
Expert:  Ralph LMHC replied 3 years ago.

Hello,

Sorry it took so long to get back to you. It is a reasonable reduction which your body will confirm. If you experience discomfort then it is not a reasonable reduction, but I doubt that you will have any discomfort. If you do then it is too large a reduction which you should discuss with prescribing doctor. Best wishes.

 

Sincerely,

Ralph LMHC

Customer: replied 3 years ago.
Thank you for your answer. What things would I be looking for that my body may not be adjusting to it? More anxiousness? My psychiatrist thought I should do pretty good, because according to her I am on a low dose to start with. She does kind of leave it up to me how to adjust it. Would the next dose reduction be in the morning to .5 and then leave the .5 at noon for awhile also (how long do you usually wait between reductions)? I would not want to get myself into any serious problems with seizures, etc. though that may be more common on higher doses. I could also reduce after that down to .25mg because they are scored - I used to take the .25 mg a few times a day when I started out a couple of months ago.
Expert:  Ralph LMHC replied 3 years ago.

 

Hello:

 

As you say increased anxiety or signs there of. Restlessness, difficulty concentrating, problems with focusing, and just about just about anything that are out of the ordinary. As your doctor says you should really not have a problem because of low dosage. Seizure is not a major issue. Most physicians suggest changes weekly. I cannot really sagest a dose reduction as only physicians can prescribe. I can suggest you cease worrying as you are reducing slowly and you never were on a high or even moderately high dosage. So I suggest you relax and follow your doctors directions.

 

 

Sincerely,

Ralph LMHC

Customer: replied 3 years ago.
Thank you.
Expert:  Ralph LMHC replied 3 years ago.

And thank you for your generosity and please relax there is little or nothing to worry about.

Ralph LMHC

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education