Can you take Ativan until Zoloft kicks in? 

Can you take Ativan until Zoloft kicks in? 

Yes, you can take Ativan (Lorazepam) until Zoloft (Sertraline) kicks in, but only if recommended by your healthcare provider (1). Ativan is a Benzodiazepine with a shorter onset of action, as compared to Zoloft which can take 4-6 weeks to kick in (2,3). 

The use of Ativan with an antidepressant is usually short-term, to prevent the early side effects of Zoloft and 

What are the benefits of taking Ativan until Zoloft kicks in? 

The main benefit of taking Ativan until Zoloft kicks in is the effectiveness of Ativan in controlling the early side effects of Zoloft and making the initial course of your antidepressant therapy tolerable. This combination can also effectively manage depression comorbid with anxiety (4). 

Zoloft is known for causing nerve-racking early anxiety and insomnia (5). Ativan, being an anti-anxiety medication, can control that and since it causes sedation, it can help you sleep too (4). 

However, the use of Ativan should be limited to 4 to 6 weeks and not be used for longer because of its ability to cause addiction (4).

What are the drawbacks of taking Ativan until Zoloft kicks in?

The drawbacks of using Ativan until Zoloft takes effect include (4):

  • Benzodiazepines like Ativan do not have any effect on treating depression, so they are not beneficial for individuals who are experiencing depression only.
  • In some patients, benzodiazepines can cause feelings of irritability and agitation. Therefore, they may not be beneficial for treating depression.

When should you stop using Ativan? 

You should stop Ativan just when  Zoloft kicks in, after which Ativan should be discontinued. Long-term use of Ativan is not recommended as it causes addiction and tolerance (4). 

It’s best to contact your healthcare provider after using Ativan for 4 weeks. Your doctor will guide you further regarding the use of Ativan and the proper way to stop it. 

Alternatives to using Ativan until Zoloft takes effect

There are some alternatives to using Ativan for your early anxiety caused by Zoloft. Cognitive Behavioral Therapy (CBT) and relaxing techniques are frequently used to cope with anxiety (4). 

CBT is a type of talk therapy that can help manage anxiety and depression symptoms (6). It focuses on identifying and changing negative thought patterns and behaviours that contribute to anxiety and depression (7). 

Relaxation techniques such as deep breathing exercises, meditation, and yoga can help reduce anxiety and promote relaxation (8).

Regular exercise has been shown to reduce symptoms of anxiety and depression by increasing endorphins and promoting relaxation (9). 

Although these techniques are quite effective, they may not work for severe anxiety and medications are the only option people are left with. Make sure you talk to your doctor before taking any medication with Zoloft. 

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References

1.-

NHS. Taking lorazepam with other medicines and herbal supplements; [updated 2023 Feb 14; cited 2023 Jun 14]. Available from: https://www.nhs.uk/medicines/lorazepam/taking-lorazepam-with-other-medicines-and-herbal-supplements/

2.-

NHS. Common questions about lorazepam; [updated 2023 Feb 14; cited 2023 Jun 14]. Available from: https://www.nhs.uk/medicines/lorazepam/common-questions-about-lorazepam/v

3.-

NHS. Common questions about sertraline; [updated 2022 Feb 2; cited 2023 Jun 14]. Available from: https://www.nhs.uk/medicines/sertraline/common-questions-about-sertraline/

4.-

Dunlop BW, Davis PG. Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review. Prim Care Companion J Clin Psychiatry. 2008;10(3):222-8. doi: 10.4088/pcc.v10n0307. PMID: 18615162; PMCID: PMC2446479. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

5.-

Näslund J, Hieronymus F, Emilsson JF, Lisinski A, Nilsson S, Eriksson E. Incidence of early anxiety aggravation in trials of selective serotonin reuptake inhibitors in depression. Acta Psychiatr Scand. 2017 Oct;136(4):343-351. doi: 10.1111/acps.12784. Epub 2017 Aug 31. PMID: 28859218. Available from: https://pubmed.ncbi.nlm.nih.gov/28859218/

6.-

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Cognitive behavioral therapy. 2013 Aug 7 [Updated 2016 Sep 8]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279297/

7.-

Harvard Health Publishing. Cognitive Behavioral Therapy [Internet]. Boston: Harvard Health Publishing; [updated 2021 Mar]. Available from: https://www.health.harvard.edu/topics/cognitive-behavioral-therapy

8.-

National Center for Complementary and Integrative Health. Relaxation Techniques for Health [Internet]. Bethesda (MD): National Center for Complementary and Integrative Health; [updated 2021 May]. Available from: https://www.nccih.nih.gov/health/relaxation-techniques-for-health.

9.-

Xie Y, Wu Z, Sun L, Zhou L, Wang G, Xiao L, et al. The Effects and Mechanisms of Exercise on the Treatment of Depression. Front Psychiatry. 2021;12(November). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8602192/pdf/fpsyt-12-705559.pdf