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3:18am May 10, 2014

dendriforming:

I have the background to know the basics of how Ativan/lorazepam works neurochemically.

I have no clue why I’m able to use it as a rescue med not just for anxiety, but also for executive function and certain movement stuff. I suspect it has something to do with the reasons it’s commonly prescribed for autistic catatonia, but I’m not sure? I don’t know why it’s effective in that context either. Either way, it’s so useful for me, and I’d love to know the science behind it.

It’s always been incredibly useful for me, too:

1.  For anxiety attacks, especially the kind I have whenever I’m hospitalized, they basically put me on Ativan every 4 hours for the duration of any hospitalization and the anxiety attacks miraculously vanish.  Without Ativan, I basically do fine the first day or two then get blindsided by such intense anxiety that it’s all I can do to keep breathing.  This would be bad enough as it is, but with adrenal insufficiency, avoiding unnecessary stress is life and death.

2.  It was the first thing discovered that actually worked on my seizures.  They of course didn’t fully know they were seizures.  My psych records are full of elaborate descriptions of what my friend says are absolutely what my complex-partial seizures look like.  Then they get worse on neuroleptics (which lower the seizure threshold) and better on lorazepam and nobody puts two and two together even as I’m being evaluated for temporal lobe epilepsy.  They still use it sometimes in my IV for seizures if I’m hospitalized and unable to use my feeding tube or (prior to feeding tube) unable to keep food down.

This makes me extra-pissy when I saw a video or a cartoon or something from the point of view of an ER nurse, where a patient says she has seizures that respond to lorazepam and the nurse says “but lorazepam isn’t a seizure med”.  It may not be a usual first-line treatment for seizures, but it does in fact treat seizures, much as many similar meds do.

3.  My parents always said it “grounded” me.  I assume this is because I was having a lot of seizures at the time, but it may also be about the autistic catatonia.

4.  It helps a little bit with my nerve pain, as I’ve been discovering this week.

5.  It works really well on me for nausea as well.  Which is a known thing that it does, even though most people aren’t aware of it.  

Right now I’m prescribed it for nausea and anxiety both (one dose at bedtime, then PRN the rest of the time).  But I also sometimes take it for really bad nerve pain, and it does help me stay in the rhythm of life physically and makes me feel “clear” with my body, i.e. treats the autistic catatonia, I suspect.  I don’t take it often, and when I do take it it’s often just at bedtime, but it works.