swim has been using .5 mg of ativan twice per day for about a month and it has NO effect on anxiety. and in the past he used .5 mg of clonazepam 3x per day for like 6 months and noticed nothing but maybe slight mood elevation.
what's left? barbituates? or should swim just learn to live with anxiety?:mad:
try buspirone you shouldent have a problem just asking your doc for it if hes willing to prescribe benzos:
Buspirone
From Wikipedia, the free encyclopedia
Rx-only, not a controlled substance
Routes oral
Buspirone (brand-names Ansial, Ansiced, Anxiron, Axoren, Bespar, BuSpar, Buspimen, Buspinol, Buspisal, Narol, Spitomin, Sorbon) is an anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam in treating generalized anxiety disorder.[1][2]
It shows no potential for addiction compared to other drugs commonly prescribed for anxiety, especially benzodiazepine medications. The development of tolerance has not been noticed. Cross-tolerance to benzodiazepines, barbiturates and alcohol does not exist. Furthermore, it is non-sedating.
It is thought to act by interfering with the function of the neurotransmitter serotonin in the brain, particularly by serving as a 5-HT1A presynaptic receptor partial agonist. Additionally, it acts as a mixed agonist/antagonist on postsynaptic dopamine receptors. GABA-mediated effects are lacking. Buspirone may also have indirect effects on other neurotransmitters in the brain.
The action of a single dose is much longer than the short halflife of 2-3 hours indicates. The bioavailability of buspirone is very low and variable due to extensive first pass metabolism. The drug is quickly resorbed. Taking the drug together with food may increase the bioavailability. The drug is highly (95%) plasma-bound. The active metabolite 1-PP is also a 5-HT1A partial agonist with anxiolytic properties, but weaker so than the mother-drug.
It is also useful as an augmenting agent, for the treatment of depression, when added to SSRIs.
The main disadvantage is that 1 to 3 weeks elapse before the anxiolytic activity becomes evident. Often patients have to be initially cotreated with a benzodiazepine for immediate anxiolysis. Generally, buspirone works less well than benzodiazepines. Therefore, benzodiazepines are often the first approach in immediately treating panic attacks and social phobias. It is also particularly difficult to treat patients pretreated with benzodiazepines knowing the immediate effects of these tranquilizers.
Bristol-Myers Squibb gained FDA approval for Buspirone in 1986. The drug went generic in 2001.Indications
* Generalized anxiety disorder of mild to moderate intensity (it is not considered effective against other types of anxiety disorders such as obsessive-compulsive disorder, with or without agoraphobia and social phobia)
* Augmention of SSRI-treatment against depression
[edit] Contraindications
* Myasthenia gravis
* Acute closed angle glaucoma
* Severely compromised liver- and renal-function
* Concomitant treatment with a MAO-Inhibitor (severe hypertensive crises have been seen)
* Preexisting heart conditions (e.g. myocardial infarction)
[edit] Side-effects
Rarely, side-effects have a dangerous nature or intensity. Some tend to disappear with continued therapy, or are less frequent if the initial dose is low and increased gradually (vertigo, agitation, insomnia).
* Most frequent: vertigo, headaches, nervousness, agitation, light-headedness, nausea;
* Often (>1%) : drowsiness, insomnia, concentration disorders, confusion, depression, agitation, intestinal disorders, paresthesia, coordination disorders, tremors, disturbed vision, tinnitus, fatigue, weakness, Angina pectoris, sore throat, tachycardias, palpitations, dry mouth, pain in muscles and joints;
* Seldom: allergic reactions, subdermal bleeding, extrapyramidal symptoms, hallucinations, psychosis, ataxia, epileptic seizures, syncope, tunnel vision, urine retention, alopecia, pruritus, hot flashes.
There are no dyscognitive side-effects like those seen in benzodiazepines.
Other side-effects have been seen, but are not more frequent than those encountered with placebo. An unusual side effect reported by patients has been an enhanced sense of smell.
[edit] Drug abuse and dependence
Buspirone has no known potential for abuse, psychological and physical dependence.
[edit] Interactions
* Haloperidol : increased plasma-levels of haloperidol
* Rifampicin : decreased plasma-levels of buspirone
* MAO-Inhibitors : severe hypertensive crises are possible.
* Alcohol : The sedative properties of alcohol are increased slightly.
* Grapefruit, Grapefruit juice, Grapefruit extract : drastically increased plasma-levels of Buspirone [3]
[edit] Dosage
Initially, 10-15mg in 2-3 single doses per day. The dose may be increased to a maximum of 60mg daily (3 times 20mg, a single dose should not exceed 20mg).
[edit] Duration of treatment
The duration of treatment is not limited, but the prescribing physician should reassess in regular intervals, if continued treatment is still necessary.
[edit] Other remarks
Buspirone should not be used as a substitute for benzodiazepines, barbiturates or alcohol before withdrawing these agents properly. No residual signs of withdrawal should exist when Buspirone is started. Buspirone is not able to alleviate any withdrawal symptoms caused by these drugs.
[edit] References
1. ^ Cohn, JB; Rickels K (1989). "A pooled, double-blind comparison of the effects of buspirone, diazepam and placebo in women with chronic anxiety". Curr Med Res Opin. 11 (5): 304-320.
2. ^ Goldberg, HL; Finnerty RJ (September 1979). "The comparative efficacy of buspirone and diazepam in the treatment of anxiety". Am J Psychiatry 136 (9): 1184-1187.
3. ^ Lilja, JJ; Kivisto KT, Backman JT, Lamberg TS, Neuvonen PJ (December 1998). "Grapefruit juice substantially increases plasma concentrations of buspirone Do not mix the pills in grapefruit juice. Resulting so would be in euphoria". Clin Pharmacol Ther 64 (6): 655-660.
JaWill88
26-12-2007, 20:27
if benzodiazepines don't work for anxiety then buspirone is even less likely to work. swiy should try a higher dose of benzodiazepines. swim is perscirbed to clonazepam. .5mg wouldn't do anything for his anxiety and swim doesnt really have a tolerance. swim takes either 1 or 1.5mg. that gets rid of anxiety. try 1.5mg one time and if that doesn't get rid of the anxiety than most likely nothing will. but i bet all the money in the world 1.5 will get rid of anxiety. also, it's not good to take benzos every day. swiy does NOT want a physical dependence to them. its probably the worst physical dependence there is. swim takes the clonazpem a couple times a week. swiy should only take it when is anxiety gets REALLY BAD. everyone gets anxiety from time to time and benzos are not necessary for that. they are only necessary when its really interfering with swiys life. but try what swim recommended and let swim know how it goes.
why do you feel that because benzos wont work buspirone wont work?
swim went to his shrink today and got xanax xr 2mg tablets. he used one today to test it out and swim has to say that he felt EXTREMELY euphoric. he was surprised because other benzos fell short. he hasn't been this calm in a long time. but one question. would green tea interact with xanax because of the caffeine content?
Laudaphun
29-12-2007, 22:31
swim went to his shrink today and got xanax xr 2mg tablets. he used one today to test it out and swim has to say that he felt EXTREMELY euphoric. he was surprised because other benzos fell short. he hasn't been this calm in a long time. but one question. would green tea interact with xanax because of the caffeine content?
I would guess that this would vary a bit from individual to individual, but if you are highly sensitive to caffeine they might cancel one another out to some extent. I'm not sure of the duration of your alprazolam 2mg tablets, but for the average person I'd guess that it would it interact simply by reducing the amount of anxiety that the alprazolam alleviates or perhaps counteracting some of the drowsiness if that is the case. If you can normally drink a cup of green tea with no ill effects caused by the caffeine, then I'd "guess" that you would be fine.
if benzodiazepines don't work for anxiety then buspirone is even less likely to work.
I'm not a big advocate of buspirone for the simple fact that it caused side-effects and did nothing for me, however that does not mean that it will not work for you. You are correct in assuming that it is a weak anxiolytic, in fact it does little for many people that try it. But some people, in combination with another medication many times, find that it does help. As stated in the post by Fnord: "Taking the drug together with food may increase the bioavailability." We are talking like MAJOR increases in bioavailability... like up to 7 times that of on an empty stomach. I can personally attest to this, as often this meant the difference in whether it would cause side-effects or not.
Also 0.5mg lorazepam is a very small dose that many people will not feel relief from, but some people(older people especially) might be effected quite strongly by. The doses of benzos you have tried are very small, maybe you just need a different benzo or a different dosage. Ativan(lorazepam) is a particular benzo that some people love and others find ineffective, the same goes for klonopin(clonazepam).