I have been using lorazepam for the past two years for the anxiety disorder. Currently I am taking 1 mg daily morning and night along with propranolol tr 40 twice a day (taken 4 mg in the beginning and reduced to 2 mg). Doctor suggest to reduce medicine gradually, but I could not to do so, in turn my anxiety levels are worsening. My question is, can I use the lorazepam for a long period of time? I mean to say is it safe if using the lorazepam medicine for long time? Please suggest and help.

Dr. Saranya DevanathanPsychiatrist51yrs exp

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Dear Balaji, Why is the doctor suggesting to reduce medicine gradually? It is in your good interest. Otherwise you become dependent on lorazepam, gradually increasing the dose for the same effect. At one point, no benefit from it and still you can not stop it. It is good that you have reduced it to 25% already. Reduce to 0.5 mg , alternate days, once a week and stop. For your anxiety level to reduce, you have to undergo Jacobson's deep muscle relaxation exercise or yoga and pranayama or therapy. 

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Mr. Saul PereiraPsychologist51yrs exp

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Sir, I recommend that you go for counseling along with the medication. Anxiety is abnormal fear because you are not handling normal scare for a long time, I think. Anxiety has all to do with fear and your inability (or so you would tend to think) to handle the same. Fear is based on looking too much into the future and imagining things that usually do not tend to happen (usually 90% of your fears will not happen) and expecting too much out of yourself. You need to change your perception of the fearful stimulus then you can change your response to the fear. The first one is the best and will preempt the need for the second. If you are already far gone into the reaction mode, then you need both responses to counter the attack. The way we see things in life (like half empty or half full glass) is very dependent on our attitude. Attitude may have developed over many years but fortunately can change in a matter of sustained choices made and acted up on now. Accordingly you choose to see things as either threatening or as an opportunity. The opportunist will be positive and work with the situation to make good out of it. The individual who sees it as threatening, will, out of fear, try to avoid/run away from the situation or react with anxiety. Yes, self-belief does impact it too, but you can see that prior to that, perception will tarnish the belief system too. Here, you can see that all the resolution lies in just changing your perception/attitude, even if it is against odds. Changing your response, despite the perception, is building up of your reserves and resources to handle any contingency that life throws up at you. And life throws up situations quite regularly and heavily. For this you need to develop a fit mind and body: the former, by meditation and mind exercises; and the later, by exercises and proper diet. You need good sleep too. Included in the development of the mind is the handling of emotions, in your case, fear. These changes will give you a handle on life and your perceptions and responses. Prayer is really powerful, if you are a spiritual person. Repeat some personally framed affirmations that are geared to calming you down and building confidence. Do a personality development course too. Anything that develops you personally will be of great assistance in building resilience.  

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