Is this particular situation a good time to use my Ativan prescription?

January 20, 2016 4:56 AM

I have an Ativan prescription that is intended to help me deal with panic attacks. I rarely use it because my panic attacks are quite rare. I have a work event coming that turns me into a ball of anxiety every time I have to do it (2-3 times a year) and I'm wondering if this might be an appropriate time to make use of my prescription.

This work event basically involves me having to be "face" of our company and be gregarious for hours on end - something that I am naturally ill-equipped for. I've done it before and it's exhausting and torturous every time though I suppose I do a good enough job as I haven't heard any complaints

Would it be okay to take Ativan as a crutch just this once? Would it be helpful or would I start spacing out?

To be clear, I know Ativan is addictive and I intend this to be a one-off. I'm also working on strategies to deal with my anxiety long term as well as moving into a career that is a better fit for my more low-key personality.

posted by anonymous to Health & Fitness (15 answers total)

This is exactly what I use a very occasional klonazepam for. Nothing has ever befallen me apart from the wretched event being easier.
posted by chesty_a_arthur at 5:05 AM on January 20, 2016

Have you interacted with other people while on Ativan? Could they tell that you were taking a prescription? A friend's mother took one before a family wedding and she was zooted long before the bar opened. Everyone was asking if she was ill. It might be a good idea to take one when with a trusted friend and to get an honest assessment of your behavior and speech patterns.
posted by defreckled at 5:19 AM on January 20, 2016 [16 favorites]

To answer your question: yes, that's a perfectly reasonable use for Ativan. If you have something that is coming up, and it's terrifying you - it's okay to take an Ativan to help you through. I take them for flying or before surgery.

However: don't drink with it - it will mess you up, and not in a good or healthy way. You will feel drunk much faster (even after 1 drink), and it will make you very cloudy. Also, you might find that Ativan will make you sleepy. You probably won't space out on a low dose, but you could be just a bit tie-tie (tired).
posted by Dressed to Kill at 5:20 AM on January 20, 2016 [3 favorites]

If you're not sure about the answer to defreckled's question, then yes, take one beforehand sometime and see if it makes you sleepy / visibly weird as reported by a trusted friend / whatever. Assuming not, then yes, absolutely take the Ativan.

FWIW, I say this as someone who likewise has an "as-needed" Ativan prescription, and struggles a lot with what "as needed" means. One of the cruel ironies of anxiety is the knots it makes you tie yourself in wondering if you're anxious enough to take the thing to help you with the anxiety. After a year or so of sorting through this, and discussions with my therapist, I have come to the conclusion that rare really-high-stress-inducing work events (public speaking, for me) are very good times to take the damn pill, since I know that it doesn't make me act weird/sleepy/spacey.
posted by Stacey at 5:38 AM on January 20, 2016 [5 favorites]

The fact that you are putting this much thought into one of your single-digit annual uses of a drug that you are prescribed for a condition that you do have pretty much rules out addictive behavior. Don't try to be a hero- if you have a situation which aggravates a medical condition you have, take your prescription. If you were an asthmatic, you wouldn't go for a run without your inhaler.
posted by BuddhaInABucket at 5:47 AM on January 20, 2016 [17 favorites]

Totally fine. Make sure you've taken it once before when not panicking just so you know if it will make you sleepy or something like that. Ativan is addictive but not like heroin-addictive.
posted by jessamyn at 6:01 AM on January 20, 2016

What Defreckled said. I'd personally be a bit leery of taking a benzo before a social event, because benzos make me helicopter high and I just wouldn't be able to function.

However: I am very, very, very afraid of flying, but have to fly relatively often for work, usually going straight into a presentation afterwards. I always take beta blockers to take the edge off my flight anxiety without the sedative benzo effect. This is super YMMV, because beta blockers are an actual cardiac medication, but it might be worthwhile talking to your doctor about an alternative medication for this situation.
posted by nerdfish at 6:01 AM on January 20, 2016

Test it out beforehand if you can because everybody does react differently to it, but this is precisely what Ativan is designed to do: take the edge off anxiety enough that you can function comfortably.

DO NOT DRINK ALCOHOL if you take it. Ask me how my husband, who was the best man, did a great job giving the speech at his brother's wedding but does not remember a single thing that happened after the ceremony and someone handed him a beer.
posted by lydhre at 6:08 AM on January 20, 2016 [1 favorite]

Nthing the idea that this is 100% absolutely fine, but to test it out just to make sure it won't make you too loopy to function.

FWIW, I take a small dose of a different benzo. I go through about 10 pills every 6-8 weeks and my doctor and I are both happy with that. She regularly reassures me that this frequency is nowhere near high enough for me to become dependent or addicted.

Also, taking medication for anxiety is not a "crutch." It's a perfectly legitimate tool to manage a medical condition. You might try reframing this in your head - responsible use of Ativan or any other medication is not a sign of weakness.
posted by schroedingersgirl at 6:27 AM on January 20, 2016 [6 favorites]

I take a different benzo (alprazolam) several times a year for situations exactly like this.
posted by notjustthefish at 8:33 AM on January 20, 2016

You can also take a half tab before the event and take the other half hours later if you think you need it.
posted by littlewater at 9:47 AM on January 20, 2016 [2 favorites]

I'm pretty nervous about when to take my Ativan - I take it maybe a couple times a year. By now you've hopefully realized that yes, this is the exact reason why the medication was prescribed in the first place. YMMV, but when I take a low dose of Ativan, I behave like myself but without terrible thoughts weighing me down. I assume this is how people without anxiety problems are most of the time.

So, this sounds super dumb, but for future use: I try to think of what I'd do if a friend came to me in the same situation and was basically asking me for permission to take one.
posted by giraffe at 1:06 PM on January 20, 2016 [1 favorite]

I carry my benzo with me almost everywhere. If I start to feel super anxious, I chew half a tab so it gets in my system faster. Could you do something similar as a halfway "crutch" (although agreed with schroedingersgirl that anxiety medication is not, itself, a "crutch").
posted by mchorn at 1:32 PM on January 20, 2016

I would take one a few days before the event to see how they affect you. Plus it helps your body adjust so the next time you take it, it won't hit you as hard. You'll also want to know if you'd be able to drive or commute.

I take Xanax or Ativan to get to doctor's appointments. I also hate meds and take them all carefully. But I have a chronic illness that spikes my anxiety and related physical symptoms when I have to be active and the meds help me calm down. I've used about 28 doses in the past year (half a pill of the lowest dose.) The only slight issue I had was when I took one dose at night to help me sleep, and one the next day and the following night I had a bit of extra anxiety. I do feel kinda out of it for about an hour after taking it.
posted by Crystalinne at 1:39 PM on January 20, 2016

littlewater is correct, it appears that defreckled friend's mother took too high of a dosage. You can take, what, a 1/4 milligram? Taking too high of a dose may make one feel overconfident, which may manifest into you being incredibly talkative, or appear tipsy. It's best to naturally work through certain types of anxiety, but don't let that advice dissuade you from using the prescription.
posted by captainsohler at 2:39 PM on January 20, 2016