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Gastric bypass


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Hello. I’ve been on lorazepam for 19 months and 3 weeks ago everything went sideways. What used to help so well, gives me hell. I had the gastric bypass surgery in 2001 and medications work different in me now. I’ve been withdrawing from the Ativan since early august 2020. First I had no idea what was going on. Them I realized that every time I took a lorazepam, I’d feel anxious and heart rate went crazy. All my Drs know about my surgery. But the psychiatrist, which was compassionate and understanding at first, doesn’t care. First she told me to just stop the lorazepam and try lexipro. 2 trips to the ER and now she’s telling me it’s all in my mind, bear through it and do jumping jacks. I’m going through hell and I don’t think I’ll survive this. I switched psychiatrists, but I have no trust that he’ll be any different. I have Medicaid and Drs in Fresno Ca do really give quality care to people like me. How am I going to get through this. I just found out that an old friend that killed herself was because benzodiazepines. 2years ago. I have no hope
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Lorazepam is a really poor choice for someone who has had gastric bypass since it will have its already short half-life shortened even further (most benzodiazepines are lipophilic, getting distributed into and stored by the body's fat cells).

 

Ideally you would cross over to 5mg of diazepam three times a day. Its a bit more than the normal equivalence to make up for some potential absorption loss and three times a day to make up for the half-life being shortened. Then you would taper down from there, no more than 5% every two weeks (although I highly recommend liquid titration, it makes it so much easier to deal with than cut and hold).

 

It shouldn't be a big problem to get a doctor to agree to give you such a dose of diazepam. If it were me, I would walk in the office holding a taper plan modeled around the Ashton Manual but with 3% cuts instead of 5% to give yourself some room to work in.

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I would but like I said, I receive Medicaid through the government. Drs here just give up on you and don’t want to help. Just push antidepressants, antipsychotics and other stuff. They think you’re a drug seeker if you try to explain. I have limited choices. And remember, most places are not open. Every appointment I have is through telehealth video calls. I need help. But no one listens or cares. I should have really looked into this drug before I took it. But that’s the past and I feel I have no future. Thank you. I hate acting like a victim. But I’m suffering and the very person that gave this to me, acts like she can no longer help. First do no harm. That’s a joke.
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I mean I'm a Medicaid patient myself and my navigation through the county systems has taught me that they're much more inclined to take you seriously if you present them with a plan of action and a link to the Ashton Manual.

 

It all goes much more smoothly if you don't let yourself get trapped into believing that everything is stacked against you. Where there is a will, there is a way. Even if it comes down to you having to do a taper from the lorazepam you're already prescribed, you can learn to make your own liquid solution at home with which to titrate with, you will just be looking at 4-5 spread doses a day most likely.

 

Try to stay positive. The universe provides, we just have to do some of the legwork ourselves.

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Please do not say that there is no hope for you. I completely agree that with abdominal surgeries, medicine and food gets digested differently. I just had my gallbladder removed in March and am healing slower than my sister because of the benzos. I refuse to believe that my life is forever over and there is no hope. I am not going to tell you what to do, so please do not take my anecdote as facts. But, I quit a very high dosage of Ambien cold turkey and do not take any supplements or pain meds in an attempt to fully heal. I dont even take TUMS, probiotics, or anti spasmodic when my tummy is acting up. I deal with muscle and head pain and haven't touched a pain med in over 4 months.

 

Like you, my pysch and therapist were nice at first and then wanted to put me on more meds because they mistook my withdrawal for a worsening mental illness.

 

Please just don't give up hope.

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Thank you both. It’s just so hard. I gave birth to my kids with no epidural. I used to be able to take pain. I’ve even dealt with drug resistant major depression and anxiety. But this is new and horrific. I never abused my lorazepam. It helped a lot. But I’m addicted and have never experienced this much pain and craziness. I don’t smoke weed, which I wish I could, and I don’t drink, I wish I could do that too. I’m confused, sleep deprived and can’t control my body. My 4 year old granddaughter developed leukemia at 1. And she fought it for 3 years. She in remission now. But most of the time you couldn’t tell she was going through chemotherapy. She’s my hero. Why can’t I be strong like that brave baby girl?
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Don't compare your handling of an illness with someone else. You'll just drive yourself crazy. I know someone battling horrific cancer for like 12 years now and she is just the happiest thing. What I have learned is that she isn't always in pain and can work out without causing her pain. Most benzo peeps can't risk that. We suffer from depression and feeling trapped in our heads so I feel that is where most of our pain comes from. How can we fight enthusiastically if we are depressed to the point of derealization? You've made it this far so you must be strong.
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[87...]

Hello. I’ve been on lorazepam for 19 months and 3 weeks ago everything went sideways. What used to help so well, gives me hell. I had the gastric bypass surgery in 2001 and medications work different in me now. I’ve been withdrawing from the Ativan since early august 2020. First I had no idea what was going on. Them I realized that every time I took a lorazepam, I’d feel anxious and heart rate went crazy. All my Drs know about my surgery. But the psychiatrist, which was compassionate and understanding at first, doesn’t care. First she told me to just stop the lorazepam and try lexipro. 2 trips to the ER and now she’s telling me it’s all in my mind, bear through it and do jumping jacks. I’m going through hell and I don’t think I’ll survive this. I switched psychiatrists, but I have no trust that he’ll be any different. I have Medicaid and Drs in Fresno Ca do really give quality care to people like me. How am I going to get through this. I just found out that an old friend that killed herself was because benzodiazepines. 2years ago. I have no hope

 

Don't lose hope! This period is temporary and will pass.

 

Lorazepam is a unique benzo that gets metabolized through the kidneys. All other benzos work the liver route. You should speak to your doctor to be allowed a different benzo. That just might do the trick I feel.

 

Good luck.

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Don't be too hard on yourself. Benzos break the strongest of us unfortunately.

 

Have you investigated CBD at all? Many have found relief that way, especially for sleep, and since you're on Medicaid, places like Lazarus Naturals have patient assistance programs that make CBD very cheap. I got two bottles of tincture and a bottle of capsules on that program for less than $25. It doesn't seem like the right treatment for me because I'm so far into my taper that I'm sensitive as heck to everything but I wish I would have known about it earlier for sure.

 

Keep us posted on what your doctor says and we can go from there. I would draw up a taper plan just in case if it were me.

 

https://www.benzo.org.uk/manual/bzsched.htm#s8

 

That schedule is twice the lorazepam you're using so you would have to adjust it accordingly. That plan includes a substitute taper that transitions you off of lorazepam and onto diazepam. I'm not really convinced that lorazepam is a benzo that needs a substitution taper rather than just switching from one to the other but I never really found lorazepam to do anything for me period unless it was IV in the hospital when I was having a meltdown panic attack so I'm not the one to ask there.

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What kind of taper plan? This is hard. I looked at the Ashton manual and it said that 10mgs of diazepam equals 1mg of lorazepam. I’m a bit confused. How many months do you think it would take. My tapering is just so messed up. Psychiatrist told me to drop down to one 0.5mgs and a diphenhydramine at night only. This hard. My body is always on fire. I can’t think clearly.
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[0a...]

What kind of taper plan? This is hard. I looked at the Ashton manual and it said that 10mgs of diazepam equals 1mg of lorazepam. I’m a bit confused. How many months do you think it would take. My tapering is just so messed up. Psychiatrist told me to drop down to one 0.5mgs and a diphenhydramine at night only. This hard. My body is always on fire. I can’t think clearly.

According to Ashton plan from 10 mg reduce 1 mg every week until you reach 5 mg, then reduce by 0.5 mg every two weeks. That is six weeks to reach 5 mg, then ten weeks to jump.

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  • 2 weeks later...
My new psychiatrist has me on 5mgs of diazepam. He wants me to take half a pill 3 times a day. I’m scared.  He said that would be a total of 7.5 mgs a day. I think it’s too low. But I really don’t know.
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