Best way to approach dr. about upping dose!

[blackdb1]

Swim is currently on alprazolam for GAD and panic disorder. A while back swim posted about seeing his psych and the chances of him keeping swim on them.

Well Friday afternoon swim went into his psychiatrist and told him that he had been put on .25mgs of alprazolam 3x a day. Swim told the doc at that dose it wasn't sufficient enough as swim would need .5mgs to START to see relief. Swim also stated that the dosage of .5mgs was just for general anxiety and not for full-blown panic attacks. When swim is having a severe panic attack which happens at LEAST one time a day needs around 1-2mgs. Swim did not tell the doc that he needed doses that high for panic attacks as that would indicate swim was taking 4-8 of his pills at a time.

swims doc ended up giving .5mgs alprazolam 3x a day. This is still however not enough to keep swim calm! If he has a great day he can get by with .5mgs 3x a day but these "great days" only happen once or twice a month!

Swim went to see his suboxone dr. for his first appointment Friday evening and was put on 16mgs a day (8mg AM, 8mg PM). The sub doc knows swim was put on this dose of xanax and is fine with swim being on benzos for the time being...

Today swim had a relatively good day and managed to only use .5mgs once this evening. However an hour or so after that dose swim had a bad panic attack so he took 1mg of his xanax which used up all of todays allowed dosage. This did NOT relieve swim of even 50% of the anxiety so swim was forced to take another 1mg dose. Now swim is feeling fairly well; at least well enough to keep calm enough to write this post...

So basically swim is wondering how to approach getting the dose he needs as he CANNOT get on with his life with this anxiety! He doesn't wanna come across as trying to score drugs that he doesn't need.

Should swim call his psych and tell him this dosage is not working well enough? Swim also has bad insomnia so usually likes to take .5mgs before bed but this leaves swim with only 1mg to get through the day. Swim was thinking along the lines of klonazepam 1mg 2-3 times daily with the alprazolam for panic attacks???

Swim REAAALLLYY needs advice from others to put him in the right direction of getting the meds he NEEDS! Should swim tell the sub dr. that his xanax is not working well enough and ask him if he could call in somemore anxiety meds?

All help is GREATLY APPRECIATED!!!!!! Swim really just wamts to get the right meds so he can "get on" with his life!

[JaWill88]

just be straight up honest imo. thats what swim has done. unfortunately he eventually landed on 18mg clonazepam a day. btw clonazepam and alprazolam (xanax) are the same potency so swiy can probably see swim is on a VERY high dose. this is something swiy should NOT want to achieve. benzodiazepine withdrawal is deadly and is hard to taper. there WILL be withdrawal symptoms from every day use. btw swim has been on suboxone for a little over a year and a half and is finally getting off that bitch too. swim would rather kick heroin cause suboxone withdrawals last incredibly long due to buprenorphines 32 hour half life. anyways swiy should consider not taking it every day so then on the really bad days swiy has enough and at the same time is avoiding physical dependency. sorry if this is not what swiy wanted to hear but it is the best advice swiy will be given. swim wouldn't have wanted to hear this a few months ago even. but benzo addiction is really, really fucked up. but if swiy really doesn't care about getting physically consumed by this drug then just say what swiy posted, the truth. tell the doc swiy has had to take more just cause of the panic attacks and swiy has found that 2mg makes them go away. if swiy has a good doc he will understand. but hopefully swiy thinks about things a little more. good luck.

[spacelord]

Yes, being honest is the way to go in this situation. Seems SWIY does not abuse these substances. But doses seem to be pretty high, so he might want to work out a plan how long he should take these pills. What about psychotherapy? This is quite an important part in effectively tackling anxiety disorders and will surely help not to escalate doses too much.

[blackdb1]

Swim appreciates both of swiyour replys greatly!!! The straight up honesty is what swim will do to try to get the dosage adjusted correctly.

Swim like swispacelord said is not abusing his medications, he just just truly needs anxiety relief. Swims whole life he has suffered from HORRIBLE anxiety and that resulted in swim abusing drugs at the age of 16 to cover up his SAD, GAD and panic disorder. He has been on all kindsa anti-depressants and antipsychotics but around age 17 swim quit all RX'ed meds and discovered OXYCODONE!!! Swiy knows where that led swim to...He had done all types of hallucinogens, cocaine, meth, benzos and whatnot then hydromorphone, morphine, hydrocodone, heroin, and recently IV roxicodone. Swim loved the way his anxiety disappeared on opiates but the scoring and dope sickness got outta hand. So now swim is on the bupe and benzos to get away from the drug fiending lifestyle he lived until now (age 20).

Swim is NEVER going to say again that he will never use illicit drugs again as he's said that many times before and did not succeed. Swijawill swim has seen many of swiyour posts over the past couple years and has ALWAYS seen swius as very alike. HaHa

Well swims going to call his doc in a little while and tell him about the current dosage not working. Swim thanks the both of swiyou very much. Swim will update and let swiyou guys know how it went. Swim is also going to make future threads about his progress in recovery/addiction. Later and all you swimmers have a WONDERFUL day!!!

[iluvlory]

lol your all retarted aprazolam and clonzapam are not the same aprazolam is a short acting benzo and clonz is a LONG acting benzo id say your best bet would be to dump the xanax all together and suggest to your doc you want to try 1mg clonzapam 3x a day possibly its much more effective for long term treatment of ongoing panic disorder

[blackdb1]

Swim didn't say anything about alprazolam and klonazepam being the same nor did anyone else... SwiJaWill stated that mg for mg they have equal potency which is TRUE!!! No one stated anything along the lines of regarding half-lifes and whatnot!

Swim was actually contemplating using klonopin as a safe guard to prevent anxiety and panic. While swim could use the alprazolam to deter panic attacks quickly as that's what it is intended for.

This site doesn't tolerate flaming and it will get swiy BANNNED!!!! Read Jawills post again and inform swim of where swijawill stated that alprazolam and klonazepam are the SAME drugs!!! SwiJAWill stated that the potency is equal between the 2!

[JaWill88]

yeah please no flaming here. everyone who posted is probably well aware of the different lenght of time of the drugs. swim ended up an intravenous heroin user for like 5 or 6 years and realized he was doing it to get rid of his severe anxiety disorders. he then got on suboxone and clonazepam. oh yeah btw swim didn't think anyone was intending to abuse this medication.

[blackdb1]

Yeah swim has heard MANY people get addicted to opiates who were depressed or had bad anxiety and didn't even know thats what they were takin it for. Swim however noticed very quickly (in his early days of opiate abuse) that a couple percs or sniffing 10mgs of IR oxycodone made him very outgoing and not so self concious!!! He loved being able to open up and chat with friends about serious topics that would usually have had him there starring at his feet just hoping to god he wouldn't be called out in front of a group of people! Now this led swim down a worse path than he was heading down before the opi's. Swim just LOVED being able to talk to a random person working at a gas station or seeing a stranger and being able to freely talk without fiddling with his fingers, biting his nails, etc. Swiyou guys get the idea here... hahaha Swims feeling really content right now while listening to some Weezy coming outta the stereo!!! He took 3 valerian root capsules, 100mgs seroquel (lil bro has extras sometimes), and he just popped 1mg of alprazolam which is currently kicking in.

Today swim decided to experiment with the doses as to see if he could find an effective dose... he started the day with his 8mgs of bupe and 1mg alprazolam. This kept swim from having any panic attacks (well FULL-BLOWN panics) and this held him good till around 10:30PM. At that time he took another 1mg dose which has kept him all good till recently (around 3AM) swim decided to take another mg cause he had been feeling the usual difficult breathing, chest pains and racing, cycling thoughts.

Wow! Swim has made what he thought would be a short 5 sentence reply into the usual short novel! haha

Well all in all today went very well!!! Phweeew---- RELIEF! So swim made a pretty long day for him quite comfortable with the dosages used today! Swim thinks 1mg xanax 3-4 times a day might be about where he needs to be at? He still thinks around 1-2mgs klonopin 2 or 3 times a day with the xanax for sudden relief of panic attacks? He has used klonazepam MANY times before and it has always worked wonders for his anxiety especially having to dose way less frequently; the downside is the longer time for it to take effect. With xanax it hits him in literally 2 or so minutes!!!

Swim is SORRY for the ridiculous long post again as always!!! haha He needs to get some pointers from an experienced writer to figure out how to shorten the length of sentences and paragraphs as he KNOWS this could be worded with waaayyyyy less characters!
Oh yeah SwiJaWill could swiy empty his PM inbox as swim would like to tallk with swiy about the suboxone, opiate addiction in general, and talk bout tha benzos and how long till swiy got to an effective dose...???
-PEACEASY FELLOW SWIMMERS-

[iluvlory]

Oh im sorry i didnt mean to sound like i was flaming the "your all retarted" was more of just joking but yeah i must have misread the question :(

[JaWill88]

it's all good. btw swim cleared out some messages from his pm box so if people do want to pm swim they can.

[Spare Chaynge]

swim thinks being honest is the best way to go. Xanax is ussually used for panic attacks soooooo......

[blackdb1]

Well swim called his sub dr. and he called in 30 2mg Klonazepam until swim sees him next Fri. It has worked wonderfully so far!!! swim will keep all updated on progress. -bdb1-

[JaWill88]

swim is now on 300 phenobarbital instead of the 18mg of clonazepam and must say he likes it way better. but it's much more intoxicating. but swim is about to find another doctor now that he's back from california (orange county). swim is thinking about changing back to benzos and going to xanax. swims not sure yet. 18mg of clonazepam a day wasn't doing much pretty much just preventing panic attacks and major bouts of anxiety. but it started to lose effect on things like his social anxiety. any suggestions?

[blackdb1]

SwiJawill swim has found the xanax to be awesome for the panic attacks and SAD but klonopin keeps him more neutral feeling. He hated the ups and downs of xanax by itself!!! Now he is more steady with his daily anxiety. He hasn't had any major panic attacks yet!?

Maybe swija could try a long-acting and a fast action benzo to get the positives of both?

[dark12]

Hey Blackdb1,
I have been struggling with GAD for a couple years now and I am currently on 2mg xanax a day for it. I had massive issues with my speech class a month or two ago and I would take 3mg before each speech and it would help me remain calm enough to stop stuttering, but as far as taking smaller doses throughout the day it doesn't seem to help at all.
It's nice to hear that it is working for you though. When you take a small dose like .5mg-1mg how does it make you feel? I don't really feel anything until I take a large dose, in which case I just feel tired.
SWIM has found that xanax makes a marijuana high much more pleasant and calming though.