Alternatives to Ativan (lorazepam)?

Question

Hello, I am a 44 year old woman, I take Lorazepam 1mg in the evening, ... it helps me to sleep because it relaxes me to find sleep, (I am a pretty anxious person especially since covid ). I would like to try to find a different medication that could give me this same benefit so that I can sleep better... do you have any suggestions, advice? (I want to change because a doctor (I don't have a family doctor, so I never talk to the same person) is telling me that I should stop Lorazepam but everything I've tried so far isn't helping me...) Thank you for your advice [name removed to maintain confidentiality]

Naji-tom Samaha · Accepted Answer

Hello, thank you for your question, very important! First of all, I don't recommend any other medication to replace Ativan, I don't recommend any medication at all to use over a long period of time. Sure it is safe and effective to use, but these are options that should be used for a short period of time, 2-4 weeks at the most. The most important thing is to look at non-pharmacological measures to improve sleep hygiene and quality. Here are a few of them: At least 1 hour before bedtime, turn off any type of screen: computer, phone, TV, and handheld readers too. Most of them emit a type of light that is stimulating. Regardless of bedtime, I suggest getting up at the same time each day, which will help establish a sleep routine eventually. Keep the bedroom for sleeping and intimacy only . No reading, working, or watching TV in bed. This way, the body will associate the bedroom with sleep as soon as you enter it. Avoid naps during the day, and avoid stimulants like coffee as much as possible, especially in the afternoon. If you have been in bed for 15 minutes and are not falling asleep, I suggest you get up, go to the kitchen or living room for a few minutes, and then return to the bedroom. This can have a reset effect. If you have a lot of worries, write them down in a notebook or journal at night, so you can be reassured that they won't be forgotten and that you can address them the next morning These strategies can take up to 2 weeks to implement, so take your time, gradually In terms of the desired discontinuation of Ativan, you need to go very gradually. It is suggested that you decrease the dose by 10 to 25% every 2 weeks. We can take our time to give you every chance to succeed eventually. Your pharmacist will be able to suggest a schedule for gradually decreasing the dose, ensure a better follow-up, and communicate with your doctor I leave you this brochure to give you more details. It is mainly intended for an older clientele but I think it applies to any person who takes sleeping pills or is at risk of doing so for long periods of time: https://deprescribing.org/wp-content/uploads/2016/08/Benzodiazepines_Fr-1.pdf I hope I have helped you, and I remain available if you have any further questions! Tom Samaha, pharmacist