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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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I have horrible anxiety which interferes with all aspects of

Customer Question

I have horrible anxiety which interferes with all aspects of my life. My dr put me on lorazapam and now I can't get off of the drug and it is making me worse. I do not do anything that I used to like to do and I live in constant fear. Just last October I was fine, but had two traumatic expweriences and hyperthyroid. Could not sleep so dr put me on lorazapam and metopolol. I fear I am going to lose my job, my family and friends. I also feel a bit disconnected from things, but think that is the drug. My brain feels like it is on fire most of the time. Can you help?
Submitted: 5 years ago.
Category: Mental Health
Expert:  MN Psychiatrist replied 5 years ago.
Hello, I am a psychiatrist.

This sounds miserable.

For me to best answer this, I need to know all the doses of all the medications you take (and when you take them), and also how long you have been on the lorazepam. Also, how long have you been on the metoprolol? If you have hyperthyroidism, are you currently treated for it, and if so, has your thyroid levels been checked recently? This is very important because hyperthyroidism can cause or significantly worsen anxiety. Lastly, I need you to describe what your anxiety is like (all the time, episodes of panic, etc.).

I will be online intermittently this morning but I will check back for your response.
Customer: replied 5 years ago.
I was put on klonopin the middle of October and switched to Lorazapam in November. I was taking 1 mg at night to sleep and .5 in the morning. I have since cut my dose down to .5 at night just to sleep , but most nights I either don't sleep or don't sleep very much. I was put on the Metoporol the first part of December. I take 25 mg in the morn and 25 mg at night. I have been trying to cut down to just .25 in morn. I have also been put on Zoloft - made me crazy first day so switched to Lexapro which made me much more anxious and then switched to Cymbalta which made my head hurt and felt worse so I tapered off Cymbalta. I am very sensitive to meds which is why I think the Lorazapam is causing so many problems. My anxiety is very high - like a piece of coal burning in my chhest. I have been this way since the beginning of october and I am very tired. I lost 17 pounds in three weeks - I have been able to gain some weight back, but do not feel like eating anything. My brain feels very strange and I can't figure out simple problems. I don't ever relax and I feel disconnected from people I love very much. My kids are my life and I don't feel very connected with them - which is very disturbing to me. Just a few months ago, I was a very dynamic, loving, caring, strong, smart woman. I don't know where I went - I am scared of everything and can't watch TV or even listen to music anymore. I am very jumpy and startle easily. I am supposed to go on a trip today and can't even figure out how to do it. Please help. I am so very tired.
Customer: replied 5 years ago.
My thyroid was .46 at the last check - which has come up from .08. I am low on vitamin D
Expert:  MN Psychiatrist replied 5 years ago.
I see.
Reducing lorazepam from a daily total of 1.5mg to just 0.5mg is quite abrupt, especially since you have been on it for several months.

You will likely have to return to a higher dose of the lorazepam for a while, and then go down on it much more slowly than you were.

How long have you been on just 0.5mg or lorazepam at night? That will determine the best way to proceed from here.
Customer: replied 5 years ago.
I have been on .5 for about two months. I have even tried to taper further and was just taking it 3 to 4 nights a week, but I was not sleeping at all. The lack of sleep is a huge problem. Can you suggest a way to taper and be able to sleep? Do you think the daytime anxiety is duue to the drug?
Expert:  MN Psychiatrist replied 5 years ago.
Since you've been on this dose of lorazepam for a couple of months now, what I would suggest (please discuss this with your doctor, since he/she knows you) would be to go back to 1mg of lorazepam at night for a month. Hopefully, that will help you to sleep again. After a month at that dose, I would decrease it to 0.75mg nightly, for 3-4 weeks, then decrease it nightly to 0.5mg nightly for 3-4 weeks, then decrease it to 0.25mg nightly for 3-4 weeks, and then stop it altogether. That should give you a much smoother transition off of it than what you're experiencing now.

Ideally, it would be best to wait until you are off of the lorazepam entirely before reducing the metoprolol; decreasing both of them at the same time may lead to you tending to have a racing heartbeat and feeling physically anxious. As such, it might be best to resume the metoprolol at 25mg twice daily again, and then when you are done with the lorazepam, cut it to 25mg once daily (morning or night - either time is fine) for a 2-4 weeks, at which point you can simply stop it.

Does this make sense?
Customer: replied 5 years ago.
Have you known people who can come off the drug this way? I feel horrible on the lorazapam. Even when I was on the higher dose, my anxiety was intolerable. Is there anything to help with the anxiety? I am losing weight every day and a lot of my hair has fallen out. What do you think the timeframe will be to come off the lorazapam? I have not smiled or laughed for five months and I was hoping to be back to myself soon.
Expert:  MN Psychiatrist replied 5 years ago.
I'm not sure what you're asking; Are you asking if I've know patients who struggle to come off of lorazepam when doing so like you? If so, yes, that is a hard way for most people to do it. If you are asking if I've known patients who can come off of lorazepam by following the schedule I suggested, the answer is yes - which is why I get people off of it that way.
That said, since you were still very anxious while taking more of it, you could switch back to Klonopin. The Klonopin could then be tapered in a manner similar to what I described for the lorazepam.
MN Psychiatrist and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
I am very sensitive to meds. While on the Klonopin, I was sick too - I feel like I am in a very hard situation. My job,health and fmily are on the line. Two big problems I am having are sleep - is there anything else that can help with that that is not addicting? And the HORRIBLE anxiety I feel eveery minute of every day - is there anything that will help with that? My brain feels numb most of the time and I do not have a vvery good memory anymore. I have to be sharp at work, but my brain won't focus. In your experience, do patient's brains and emotions and happiness go back to normal?
Expert:  MN Psychiatrist replied 5 years ago.
Since I haven't assessed you face-to-face, I really cannot make more specific recommendations. (A good psychiatric evaluation often takes 60-90 minutes.) As to whether or not people's levels of functioning return to previous levels, that depends on so many factors; unfortunately, this is really getting beyond the scope of what can be addressed via an online exchange such as JustAnswer.