Lifelong use

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Okay I have crippling social anxiety and AvPD to the point where I was afraid to answer the telephone even. After trying other routes my doctor put me on Clonazepam. This was chosen because I was once severely addicted to Alprazolam(10-15mg a day, constant blackouts, car accidents). I've learned my lessons the hard way, I went cold turkey from 10mg of Alprazolam, it was a nightmare. I ended up in the hospital with seizures. But I beat it in the end. Haven't taken Xanax in 5yrs.

So far Clonazepam has worked wonders for me. I'm motivated, I can go to classes without panicking, I've gotten a much better job. The thing is my doctor essentially wants to keep me on them until I die basically. He says given the severity of my anxiety and how much it controls my life that the benefits of benzos outweigh the risks. I'm not worried about getting out of control. I've been on them 2 years now and haven't abused them at ALL. I take 1mg at night and 1mg in the morning. I'm just wondering what are the issues associated with being on benzos for decades? My doc says it's safe as long as I'm strict and take them exactly as directed, but I'd like to hear some other advice, especially if any of you have been "medically addicted" for years. I agree with my doctor I think. Clonazepam has truly helped me a lot, but I still worry about being on such a substance for the rest of my life.

[Bluedrip]

The most serious *potential* problem is that tolerance could build to the point where no dose of benzo will prevent withdrawal--a situation often called "hitting the wall" or the "tolerance ceiling." This does *not* happen to everyone though, and it might not happen to SWIY. Tolerance to the effects of benzos build at very different rates in different individuals. It is definitely prudent to be as conservative in usage as possible. Never increase the dose unless SWIY absolutely must do so because of a tolerance increase.

If SWIY never "hits the wall," then the risks associated with longterm benzo use are probably pretty similar to the potential adverse effects discussed in the PDR (relative to short term use). SWIM has often heard long term benzo users complain of increased depression, apathy, and memory impairment. In SWIM's non-medical opinion these are reversible. There is also a high risk of rebound anxiety/insomnia if the dose is not adjusted upward if and when SWIY become tolerant to the existing dose. Everyone is different though.

If SWIY just recently started the clonazepam, SWIY may be able to get relief taking less than 2mg./day (equivelant to 40mg. diazepam per Ashton). For example, SWIY could try taking 0.5mg. twice a day and see if that is enough. If it is, your tolerance would be lower which is always a good thing.

SWIM doesn't think the benefits outweigh the risks, but chronic severe anxiety definitely sucks. SWIM uses exercise, meditation and Kava to cope with anxiety after tapering off over valium following years of daily use. CBT therapy is also used with success by many people. SWIM also uses a beta blocker (propranolol) to help with physical symptoms associated with anxiety.

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Thank you for the info. SWIM has been on Clonazepam for two years and he often can take just 1mg a day. SWIM usually ends up with leftovers each month. SWIM has actually went down in those two years. In the beginning SWIM was prescribed 1mg in the morning and 2mg at night because of insomnia. Since the insomnia has gotten under control SWIM finds 1-2mg a day sufficient for anxiety issues. SWIM has noticed a tolerance but atm that seems good as SWIM has only noticed this with the "recreational" effects." SWIM never feels wobbly, lazy, or even sleepy but anxiety remains under control. SWIM could definitely see apathy being a long term effect though. Perhaps he will try a taper if only to gauge what his anxiety is like currently as it's been controlled by medicine for years and he honestly doesn't know if it would still be as bad as it was.