Is there anyone out there who has seen major side effects in pt's taking Ativan (even at low doses)? My Grandmother's PCP put her on it a few weeks ago to help her relax so she can sleep. She's tried Ambien and Lunesta, but it doesn't help because she's too anxious. But I noticed it seems to be making her extremely confused and emotional. She's even been a little bit violent. Yelling, being combative, etc. I called her PCP back and she doesn't think it's the Ativan, but won't see her to rule out anything else. Obviously I'm not happy about that. I also spoke to the pharmacist, but he didn't really know of side effects from Ativan. The package insert does mention MILD confusion, but nothing else that I'm seeing. Right now she's taking 0.5 mg. BID. Thanks for any info.

I have had many pt's that have gotten confused,combative,paranoid on ativan.It may be worth checking into it further, but it is very possible that the med is causing the problems.Some people do have the reverse effect

Thank you all! At least now I know I'M not crazy...lol. I think I will wean her off of it. I don't want to do it "cold turkey" since she's been on it several weeks, but I seriously think it's doing more harm than good. Her PCP doesn't seem to get it. Any suggestions for a RX to help her sleep (as I said, she's already tried the Ambien and Lunesta) that WON'T cause adverse side effects?

pezzy..yes, we've tried the Benadryl, it didn't work. She'd fall asleep and wake up again about an hour later and be awake for the rest of the night. Yes, the doc is trying to find something to help her sleep, but I think her problems are deeper than that. The Dr. won't refer her to a psychologist, even though I've requested it numerous times and her insurance won't pay for it w/ out a referral. I personally think she's depressed and has LOTS of anxiety. She's been battling breast CA for over a year, we thought we had it beat and then about a month ago we were told she had spots in her liver that are likely metastasis (another story, her oncologist Dx'd it as that BEFORE a biopsy!). Now we're waiting for the official results. There's been all kinds of financial woes she's been going through non-stop for about 4 years now, and I've been dealing with all of it and then some. So I'd say that's enough to drive anyone to depression/anxiety. As for dementia, she's been getting forgetful for a few months, and we got a cranial CT, but it was negative for Alzheimers. I do think she has some form of dementia, though. The Dr. won't confirm it, but from what I've been seeing I think so. I mentioned Xanax or Prozac to her Dr. a long time ago and was brushed off (this Dr. has a thing against me because I'm "just" an EMT, so I couldn't possibly have anything intelligent to say. I'm rather tired of it!), I suppose I'll bring it up again. Thanks for your help...any and all info. is greatly appreciated!

Yes, i agree, she has alot going on and needs something.I would go to her oncologist, to get more information.It sounds as though this is getting bigger than the pcp can handle.You and your grandma has req a psychriatrist and he refuses?That is ridicilous!That is unfair to your grandma and i would be more persistant on that level as well.I feel the oncologist would be a better choice to handle the med request giving her diagnosis.She is past just a pt needing to sleep.I hope things get better for you and grandma.You will be in my prayers.Keep us informed...Good luck and God bless.

Thank you all for the info.

Damomb, no, we haven't tried melatonin yet. It's a good suggestion, thanks. I'll get w/ her pharmacist to see if there are any potential drug interactions. Unfortunately she won't change PCP's, this is the Dr. her mother had (who died of colon CA in 1995) and she trusts her unwaveringly. I saw her a few times and that was it. I was NOT impressed (lots of reasons for that). I think she should AT LEAST see another Dr. for a 2nd opinion, but she doesn't want to risk upsetting her Dr.

pezzy, her oncologist won't refer her to a psych. because he says it's her PCP's place to do that. As far as a sleeping med. goes, he has given her Ambien CR, but again, it doesn't help. Thank you for praying for us, we really need it!

StarlightRN, I see your point about the brain metastasis, but the CT was negative for any abnormalities, thankfully. The oncologist knows about her lack of sleep, he's given her Ambien CR and it didn't help either. I really think it's a combination of stress, depression and anxiety. I'm to the point now that I'm going to take her to our local health dept. and get her some mental services that way. If nothing else they will refer her to someone.

Thank you all for the information, but we won't be having the sleeping issue anymore. My grandma passed away on Aug. 20. The CA metastasis was in her liver and she died of Hepatic-Renal Syndrome because of it.

So sorry for your loss.

Thank you starlight and iluvnrsing, it's hard but we will manage. Breniaha, I won't need the clock test for my grandma (refer to my previous post) but it could definitely come in handy in numerous other ways. If you have the info. I'd love to have it. Thank you.

emtpixie,   I am so sorry for your loss.  I know how it feels.  I just loss my dad in April.  It will never be the same without him, but I think of him each day and that keeps him alive to me.

Thank you Damomb and Mamadawn, we know she's in a better place and isn't suffering anymore. That's the only good thing about it all. We're coping, I guess that's about the best way to say it. Right now I'm not only upset about it all, I'm angry. The Dr. dropped the ball on this one. He had the nerve to call me the night my Grandma was admitted to the hospital to tell me that we would have had a better chance of beating this had we known it was in her liver back in May when the CT was done (his nurse told me the report on it was clear). Instead we didn't find out until we saw him at the end of June that the report ACTUALLY showed 3 "spots" (about the size of ice cubes) in her liver. Then during the same conversation he told me quote "I'm sorry, I've been moving my office and she just slipped through the cracks". That may be honest, but it's NOT an acceptable "reason". I'm well aware that the chances of survival are basically zero once CA gets in the liver, and treatment may have caused more harm than good, but at least she would have had the opportunity to make the decision for herself about what to do. We wouldn't have had to decide on hospice and all of the DNR stuff. THAT was hard!

ckruszka- she did have an infection. She had peritonitis due to the liver being so enlarged. Fortunately it didn't happen until almost the end and she didn't suffer with it due to the pain meds.

emtpixie, Sorry for your loss. I have been there myself. My mother was seeing her PCP regularly and her WBC would be elevated her would give Antob. and it would go down. She was finally Dx. with liver CA on March 13, 2006. She chose to fight it with chemo. She passed away with my head on her chest on June 20, 2006. I know the feeling of having to talk to the person who you love about what they want when they pass. I was the one that my father would say " you need to talk to her and see what she wants" Like if she wanted her wig on, or what she wanted to be put on her, etc... Really hard to do when she still up until the hour before her death said she was going to beat it. She was 58.  If you need an ear to listen let me know. I also lost my father in law April 5 , 2006 from brain CA.  Just keep it in your mind that you helped her in her finale days by just being there.

  As for the discussion on Ativan I have seen confusion alot in the elderly. My father who is 63 takes xanax HS for sleep. The Dr. put him on Ambien and he would take it and then do things like play cards with friends and not remember. It was awfulo to find this out. It was a side effect that they did not tell us about.

My mother is undergoing 9 rounds of chemotherapy at the moment.  That combined with the steroids keep her awake at night.  Ativan has given her many side effects including nueropathy in her toes.  Althought this is not listed as an ativan side effect, http://ativansideeffects.com/ we all think that ativan contributes to it.