Is it bad to take Ativan?

June 4, 2007 7:09 PM

Is there anything wrong a grad student with taking an anti-anxiety medication, Ativan, to get through the end of a school term?

It seems like the drug of choice for grad students in this high-pressure research university. The student health service doles it out pretty easily. Is this bad?

posted by anonymous to health & fitness (27 comments total)

I think the answer will depend alot upon your frame of reference and axis of analysis, here.

On a case-by-case basis, if your (qualified) health professional prescribed it to you after a thorough consultation and in concert with appropriate non-pharmacological mental health treatment, and stress coping techniques, then I'd say of course its perfectly appropriate.

On a more sociological scale, is it ideal to be pressuring students to the point where the only way they can successfully complete a term of study is with the aid of drugs, no, that's probably not a great thing.
posted by ChasFile at 7:22 PM on June 4, 2007

Do you mean to ask is there anything wrong with obtaining it without a prescription? Yes. It's illegal.

Otherwise, if it's been prescribed by a competent physician based on accurate information, it's all good. Any further questions should be directed to the doctor.
posted by winston at 7:23 PM on June 4, 2007

In theory, there's a concern that so many people are taking medication to "solve" all their problems.

In reality, you (presumably) have anxiety problems, are in a high-stress environment, and can talk to a doctor to make sure anti-anxiety medicine is right. Assuming that getting the medication is above-board, I don't see a problem at all.

FWIW, I'm on Lexapro for anxiety, and it's had a clear effect on my ability to get to sleep without tossing and turning for three hours, and on my ability to focus during the day without doing the same.
posted by fogster at 7:24 PM on June 4, 2007

[derail] fogster - I have one word for you:

Seroquel

Not on it myself, but I've seen it do some pretty amazing things, and is definitely worth asking about. Truly a wonder drug.
posted by ChasFile at 7:28 PM on June 4, 2007

Ativan is a bit strong for someone with (presumably) garden-variety anxiety. I personally would suggest one of the lighter varieties of anxiolytics. It could help greatly.
posted by nursegracer at 7:28 PM on June 4, 2007

BraveNewWorldFilter

If you have a neurological disorder that inhibits your normal functioning, medication is a good thing to resort to (any wetware hacking carries some risk, whether it be with crack or SSRIs). It seems to be that your problems stem from lifestyle issues - and if you altered your lifestyle, your anxiety problems would be solved (unlike, say, a schizophrenic). As is, you are using the medication to enable you to do something akin to doping in sports (letting you push your body further than it would go naturally). Whether that's immoral is up to you (personally, I'd say no, but I'm not sure if finishing the semester under a pharmacological influence would be worth it).

I have a learn disability I don't take medication for. I don't like to tamper with the functioning of my brain, even if it makes many things harder for me. In your situation, you don't really have what society deems a disability. Not sure how that changes things.

Interesting question.
posted by phrontist at 7:39 PM on June 4, 2007

OK then -- I will be the first to issue a strongly-worded warning about how Ativan is extremely addictive.

And a bit retro. I'm sure I'm not the only thirty-something here who had a relative get stuck on this stuff and/or consequently drink themselves half to death to compensate... in the 1980s.
posted by genghis at 7:52 PM on June 4, 2007 [1 favorite]

Caveat: IAAD, or rather, IAAPhD

It's impossible to answer without knowing you. If the problem is medical, then no, there's nothing wrong with it. If the problem is life-style, well that's more complex. Are you just trying to get through a rough time. Well, may it's okay. Do you hate what you do? Then meds are not the answer.

I say this as a PhD who is incredibly happy having left academia behind.
posted by gesamtkunstwerk at 8:27 PM on June 4, 2007

I used to show up at exams with a tiny box of (1) Tic-Tacs, (2) sublingual Ativan. Worked a treat.
posted by kmennie at 9:05 PM on June 4, 2007

Here's my advice. Finish your degree. If you are at risk of dropping out or failing out, embrace better living thru chemistry. But you can't keep taking the drugs when the ephemeral situation is past.

I agree with genghis. Ativan is addictive. take Paxil. Then you wont have anxiety or any troublesome libido.
posted by ohshenandoah at 9:11 PM on June 4, 2007

It's rather difficult to speculate on why people are taking what without all the details such as medical history and the like. However, accepting the hyperbole in your tone, based on what little information you've provide something sounds fishy. Very few people should be on Ativan long-term, and on an as needed basis it's utility is probably limited to panic attacks due to it's relatively short duration of action. Occasionally some people use it as a sleep aid, but I'm not a personal proponent of this (or most any sleep aids for that matter). Moreover, it's highly sedating and may have some amnestic properties so anyone actually trying to learn something (ie grad students) might be best served avoiding it unless absolutely necessary. It also has an abuse and addiction potential, and may cause rebound anxiety. Either way, I suspect most practicing physicians wouldn't use it to treat so-called Generalized Anxiety, or as a salve for a high pressure career.

Again, it has it's uses, so without a case-by-case assessment it's hard to say if such a thing is 'bad,' and 'bad' depends on both the values of the person taking it, and the ability to make an informed decision weighing the risks and benefits of its use.
posted by drpynchon at 9:14 PM on June 4, 2007 [1 favorite]

I think morally it's not wrong until you do it too much. Doing it a little to get through finals as long as you dont keep with it is not bad in my eyes. you really have to think about how you feel about it because there is no Yes/No answer to it.
posted by rubberkey at 9:34 PM on June 4, 2007

As a professor who trains many grad students, I can say with assurance that many of your fellow students are taking medications for depression, anxiety, and learning disorders, all of which often manifest into a diagnosis for the first time under the extreme stress of a PhD program. As others are saying, if your doctor prescribed Ativan for legitimate reasons, there is nothing wrong with using it, nothing to be ashamed of, and nothing unusual about you.

If you're self-diagnosing and self-medicating with pharmaceutical psychotropic drugs, please stop and get help. Your school's counseling services exists to help you, and has seen it all. Please, please see them.
Hang in there, and good luck.
posted by spitbull at 9:38 PM on June 4, 2007 [1 favorite]

learning "disorders" should be"disabilities," sorry . . .

And generations of grad students have used stimulants to get through exams and dissertations and final papers, or depressants to manage anxiety. Just like generations of people in almost any stressful professional training context. Your concerns are addiction and dependence, and you need to have good counseling help if that's what happening.
posted by spitbull at 9:41 PM on June 4, 2007

I took Ativan for anxiety for a while. It was "as needed." Unlike Paxil and other meds (at least in my experience) Ativan is fast-acting per dose without a need to build up in your system.

When you are mega-stressed, Ativan can bring you down to "normal." If you are NOT keyed up, then Ativan can totally knock you out.

I didn't find it addictive, but I'm sure it can be.

To answer the question, I think YES it's a bad thing. Everyone has their stresses, but I had it prescribed to cope with a very stressful divorce. It helped me to function, but once after a while it just made me tired, which lessened my ability to function. Getting through the end of the school term is a stressful, but normal, event. I don't think relying on meds to cope with it is a good idea.

Unless your stress level is such that you are on pins and needles, having trouble sleeping, and generally feel physical symptoms of the stress, I would say try anything else you can other than meds first. I am not anti-med, but it shouldn't be the first solution either.
posted by The Deej at 10:34 PM on June 4, 2007

All benzodiazapenes can be addictive, although Ativan is not as bad as the rest. It's quick and short acting: onset is within a half hour, it lasts around 2-4 hours. Unless you're really in medical need of something like this, I wouldn't recommend it. It may cause more problems than it would solve.

Ulitimately it's your choice of what you need and what you can handle, but I wouldn't choose it as a first course of action.
posted by Orrorin at 11:03 PM on June 4, 2007

I don't think it's wrong but I'm biased. I'm a grad student who has a standing prescription for Ativan. I very, very rarely take it but it helps to know that I can if I need to. Among my grad student friends, things like Ativan are usually treated as a stop-gap measure to get you through stress-related panic so that your anxiety doesn't end up causing more problems (failing a comprehensive exam because you were up all night having a panic attack; not showing up to give a conference paper because you're a puking, shivering mess hiding in the bathroom; that sort of thing) that will only lead to more anxiety.

The forward-thinking ones take the Ativan to get through the immediate future and then get themselves to campus counseling as soon as possible to develop better coping mechanisms. Some people just stick with the Ativan. And some of us go with both, just to make sure we're covered.
posted by atropos at 11:39 PM on June 4, 2007

PhD student here with a running prescription for xanax. Am very aware of the addictive qualities, am very careful, am using it just when needed. Having worked before going back to school, I wonder if there is actually anything more stressful than the end stages of grad school. Taken with care, it can be enormously helpful.
posted by meerkatty at 2:16 AM on June 5, 2007

FWIW:

I took paxil and xanax for my senior year. I rarely took the xanax, and the 1/2 tab worked well for getting rid of the anxious, nervous, freaked out energy. A full tab put me right to sleep.

I did have lowered libido with paxil, and I found the withdrawal to be too bad, even if I missed one pill.

And taking meds now to help you isn't forever. It's for now. After finishing my senior year of college, and one more year of adjusting to being away from college, I quit taking my meds all together, and haven't really felt like I needed them since.
posted by santojulieta at 5:09 AM on June 5, 2007

My experience mirrors santojulieta's, but on a smaller scale.

The only time in my life that I've ever taken anti-anxiety medication, and the only time I've ever had the panic attacks that necessitated it, was during my PhD orals. The first time I took the exam, I had an attack (sweating, elevated heart rate, throat closing up, all that), and failed. After that, I couldn't study without falling asleep--my brain and body would just shut down. Doc gave me xanax, I could study. He also gave me two Inderal, one for the night before and one for the day of the next shot at the exam (which I passed).
posted by MrMoonPie at 7:58 AM on June 5, 2007

Another vote for doing what you need to do to get through this time (with care, of course, and attention to dangers like abuse and addiction), and then focusing on long-term strategies for coping in the future. In other words, if you're not already seeing one, get thee to a therapist.
posted by walla at 8:01 AM on June 5, 2007

Getting through the end of the school term is a stressful, but normal, event.

Ha! I'm guessing you're not a grad student....

To anonymous:

It's not clear if this question is for you or if you are concerned about others in the grad program. In general, taking drugs to alleviate an acutely stressful situation isn't inherently bad; however, there is some danger in becoming dependent. If it's for you, then I'm with walla*. If you are concerned about friends, then perhaps showing some concern for their general well being now, with a follow up conversation when the worst is over to see if they've stopped taking the drugs. If they haven't, then encourage them to get counselling.



(*My doctor once said that the best treatment for depression/anxiety is good sleep and diet, and regular exercise. It's worked really well for me, and can be worked into a grad program most of the time. Make a commitment to stop working when your productivity falls below a certain level, at which point you can cook a meal, get some exercise, or socialize/sleep. You get more done, and your anxiety goes way down.)
posted by carmen at 8:29 AM on June 5, 2007

I am finishing up my second year of a post-doc in a neuroscience lab. If your experience is anything like mine has been, then you'll need a very long-term solution for anxiety. Knowing what I know now, grad school was the easiest part of this career. The post-doc is more stressful for me than orals were. The junior faculty I know are even worse off, and these are the ones who are just trying to keep grants--they don't even have to teach. I'm quitting this career, because it's too much long-term stress.

I used ativan for a few days during this post-doc, and then couldn't stop thinking about it. I wanted to have it in me all the time. That was scary, so my psychiatrist and I tried Celexa, an SSRI that's good for anxiety, along with therapy. Through this process, I have become much more adaptable to the daily stress of the job. And through the talking, I discovered there are a lot of less stressful things I can do with my training, so I am leaving in three weeks.

My point is that you may be in for a longer period of stress than you think, and in my experience, ativan was not the right solution. The SSRI makes me much calmer and able to sleep, but I don't feel obsessed with when to take the next one. Being this much calmer has helped me see life more clearly and make better decisions.

My anxiety has been with me since childhood, though, and you may really like your next academic steps after grad school. This is just one experience with ativan and academics.
posted by aimless at 8:50 AM on June 5, 2007

*My doctor once said that the best treatment for depression/anxiety is good sleep and diet, and regular exercise. It's worked really well for me, and can be worked into a grad program most of the time. Make a commitment to stop working when your productivity falls below a certain level, at which point you can cook a meal, get some exercise, or socialize/sleep. You get more done, and your anxiety goes way down.)
posted by carmen at 11:29 AM on June 5

This is very good advice indeed. I would strongly encourage you to try these things before using a chemical to do what nature can do for you (unless this is a prescribed medication).
posted by ob at 8:54 AM on June 5, 2007

"take Paxil. Then you wont have anxiety or any troublesome libido."

You may have troublesome libido if you take Paxil. I did. I took Paxil for about 3 months a few years ago. Satisfying intimacy with my husband became non-existent while I was taking Paxil. Quite frustrating.

And, my father has been on Ativan for at least 30 years and he is addicted to it. He is not nice to be around when he hasn't had his Ativan.

My advice is to try your best to deal with life's ups and downs without getting medicated. If you feel you can't, talk to a doctor (or two or more) about whatever's bothering you, and be honest. They can then suggest resolutions based on their expertise.
posted by susiepie at 9:44 AM on June 5, 2007

Knowing what I know now, grad school was the easiest part of this career.

Damn straight. I wish it weren't so. But looking back, grad school was utopian.

That said, all the "you'd be better off without meds" answers strike me as either obvious or holier than thou. Sure, you'd be better off. And life would be sweet and we'd all be eating rainbow stew. But in the meantime, if anxiety is making it impossible to function, ativan is a very safe drug when used with some care and restraint under medical supervision (actually, it's very safe even when used with abandon, it's just addictive). It doesn't affect your basic cognitive skills (crucial in this situation). And it (like other antianxiolytics in its class) is taken by millions and millions of people who would have trouble functioning well under high (inhuman) levels of stress.

When you find you don't need it or develop other approaches, then you won't need it anymore. But there is NO SHAME IN USING A MEDICAL APPROACH TO DEPRESSION AND ANXIETY IF IT IS WRECKING YOUR LIFE AND YOU HAVE A GOOD DOCTOR HELPING YOU. NO ONE IS BETTER THAN SOMEONE ELSE BECAUSE S/HE DOESN'T USE MEDICATIONS TO FEEL OK.

Sorry to shout.
posted by spitbull at 4:47 AM on June 6, 2007

to do what nature can do for you

For example, in other words.

Depression and anxiety are things "nature" does to you. Nature is not always benign.
posted by spitbull at 4:48 AM on June 6, 2007