I got an Ativan script to help w anxiety for an upcoming surgery- and I have struggled w anxiety my whole life – I did try ssris and Wellbutrin, neither made me this relaxed this easily.
I know it’s addictive, but damn I wish it could be the OTC anxiety option like Tylenol or Advil
In: Chemistry
They do different things. Benzos like Ativan enhance the effects of GABA which is an inhibitory neurotransmitter in the brain (it reduces neuron excitability). Increasing the effects of something that inhibits brain activity leads to a calmer state and it works very fast. SSRIs increase the levels of serotonin available in the brain by preventing serotonin getting reabsorbed into neurons. It takes the brain a while to readjust to the increased serotonin levels which is why it takes longer.
I’ve had midazolam for a surgery and it did make me feel calm right away, but when I had a prescription for Ativan for anxiety it just made me feel jittery and hyped up and tense. Different people react differently to the same medications, and one person might react differently to the same family of medications, so it might not be possible to generalize what the mechanism is.
They effect different chemicals that do very different things.
Benzo’s effect GABA, which determines how fast things happen in your brain. Think of a stoplight at an intersection! It tells the stop light to be red and yellow more often. You can change the programming in the sign quickly and traffic won’t really notice – unless you adjust it for months. Then traffic WILL adjust and that’s why getting off benzo’s or alcohol (both effect GABA) can cause seizures or death. Because once the lights are back to normal, the traffic isn’t, and you’ll get a lot more “accidents” – including fatal ones.
SSRI effect serotonin, which does a lot of things in the body, and need to be adjusted very, very slowly because your body needs time to adjust. If you have too many pitchers on the field your body will create more catchers. And if suddenly there’s a lot of catchers and no pitchers, your baseball field gets really messed up. And your body can take a loooong time to hire or fire more pitchers and catchers. Like if you took MDMA and suddenly have a hundred pitchers and one catcher? Your body won’t realize it needs way lay catchers for weeks or months or years!
And your body only wants so many balls being thrown on the field at one time, so your body is making fewer baseballs too! So if you adjust things too quickly or too slowly you may have too many or two few pitchers, catchers, or not enough baseballs to play a game! And it’s really, really important you have enough baseballs to play and the right pitchers and catchers.
We can talk about downstream effects (longer term, more complex) of both but that’s the basic difference.
Minor point, but Wellbutrin is not an SSRI. It’s an NDRI. Similar in the time to effect though.
It’s like using an energy drink to deal with a sleep disturbance issue. Yes it may have a momentary noticeable effect on your feelings of tiredness, and could be used in a pinch to just get through the current moment, but it doesn’t deal with the larger issue and won’t solve or treat things long term. You could then use energy drinks everyday or multiple times a day but not only is it not helping with the sleep disturbance causing the tiredness, it may exacerbate things from continuing to neglect the sleep disturbance or by bringing in other negative side-effects.
If instead you try to tackle the sleep disturbance by say identifying it as sleep apnea, then trying out different techniques that have been beneficial to past patients like tricks to open up the airway to improve your breathing over time and thus sleep quality. You can try those techniques once but that may not have a significant difference. You would need to try it for a couple months and for your body to get used to it to see if it would be effective.
From my understanding (I’m not a doctor) using benzos can be good for acute anxiety like getting through a panic attack or getting through a flight if someone had an extreme fear of flying. But using it daily for generalized anxiety, even though it feels good at first, can often exacerbate the anxiety in the long term.
Latest Answers