Opinions - Switching Benzos at the docs?

[Nahbus]

SWIM was perscribed Ativan for social anxiety. He later told his doctor that he had tried valium and found it helped much more. SWIM now wants to try a new benzo in search of better anti anxiety. What sucks, though, is that his doc was suspicious about his valium use (past drug abuse problems and whatnot). He thought SWIM was selling it or abusing it, but is still perscribing it after SWIM assured him otherwise.
Anyway, SWIM is now afraid to bring up anything about the meds to the doc in fear of getting the boot on benzos. They really do help anxiety, but SWIM feels valium is losing its touch and just makes SWIM sleepy.
What do you predict the doc would do if SWIM said the valium seems to be losing it's effect and increasing in sedation, and wants to try a different anti-anxiety pill?
SWIM really isn't trying to pull any funny business here. He really just wants to try other benzos to find out which one best curbs his anxiety.
Valium is definately better than nothing, and needs these pills... so he needs to think of a way to just switch benzo perscriptions. His doctor does know SWIM did a bunch of drugs and still smokes pot (and shouldnt even be perscribing benzos to "drug abusers"). Maybe it's best to just stay with the valium?
Any advice? Thanks.

[Nahbus]

Also, out of curiosity: how's xanax compared to valium?
Of course, SWIM won't be asking for specific benzos, obviously.
I dont want SWIMS doc to think hes trying to get abusable drugs, because surprisingly this is not the case.
I think if SWIM does try and switch he will just be flat out honest. I just hope he doesn't cut SWIM off!

"Well doc, like I've said.. everything is going pretty well. Although... I've noticed that my valium doesnt seem to be helping with my anxiety like it used to. It is still helping, and is much better than dealing with my anxiety alone, but I was wondering if there are other options we can look at?"

Are there any pills that are for anxiety besides benzos? Think the doc would stay in the benzo field? I feel SWIM should stay with benzos, but wants to try something better than ativan and valium.
SWIM is so unsure if he should even bring it up or not in fear of losing his perscription.
Hmmmmmmmm...

[MrMouse]

So your Doc prescribed Ativan (Lorazepam) and you personally tried Valium (Diazepam) ... or he also prescribed Valium? Anyway, not that it's that important.

Yes, I'd be very careful suggesting alternative medication to your Doc although his/her reaction will depend on your age. For some unfathomable reason Doc's immediately think "abuse potential" if you show too much knowledge. I'd ask if he/she might suggest alternatives which you can then explain you'd like to research after all you both seek the same goal

The medication which is most suitable really depends on your symptoms. Beware the trap where you say Benzo's are not too effective and your next script is for an SSRI or SSNRI. That said these work for many people but are horrible drugs IMO/IME.

Xanax (Alprazolam) is a fast acting potent but short lived med and has the potential to be habit forming and addictive. If used sparingly on an as needed basis then it's very effective.

As a very general rule of thumb, the shorter the half life the more potent the benzo but consequently the shorten the span of effectiveness. Each Benzo has different affinity to different receptors or at least different strength of action on the same receptors. They are all cross tolerant so regular daily use isn't advised longer term.

Personally, from experience I'd suggest you knock the weed on the head as a first course of action even if you THINK it's not a major factor as well as caffiene, high levels of sugar and nicotine. Easier said than done!

Good luck

http://www.benzo.org.uk/manual/bzcha01.htm *This is in the file archive* Please post full text or upload info to the archive. Links get broken and the info is lost.
Edit: Unsure what you require but here is the link to the archive ... http://www.drugs-forum.com/forum/loc...s.php?catid=27

http://en.wikipedia.org/wiki/Benzodiazepine

[Nahbus]

Yeah, SWIM should cut back on weed. He does smoke like everyday. Drinks a LOT of coffee, too. I think SWIM should try to cut back on these things, stick with the valium for a bit, but maybe mention the fact to the doc that SWIM will stay on valium, but noticed it's slight loss of effect, and ask about other options that he can think about. For now, though, I think SWIM is ok with the valium..
Cutting down on the weed is the hard part (even though SWIM knows he should). Sheesh..

Thanks for the advice.

[Nahbus]

Actually, SWIM wishes his Valium was from Roche. He gets generic brand, but believes Roche would be more potent and helpful. How could SWIM possibly suggest this without sounding like he knows a lot about drugs or wants to sell them or some crap (the selling part is not true. He really just needs them for anxiety. I do believe Roche Valium would be better. Although, he does know a lot about drugs ). There is a box on the perscription that you check or something if you want brand-name meds. It's probably more money, but would anyone really find out if SWIM checked the box (altering a perscription is nothing to mess with!)?
Would flat out asking the pharmacist work? Thanks.

[Forthesevenlakes]

asking the pharmacist usually works, sometimes they'll just oftentimes give swiy the generic type to save swiy money, but swim has had them ask if he wanted generic or brand name before.

[Nahbus]

I figured. It's still the same medication, it's what he's perscribed. Wonder how much more it is?

[adzket]

ask to be perscribed trifloperazine its good for anxiety with out being adictive like benzo's he probibly got suspisious after swiy sugested valium cause swiy said there had tryed them he probibly asumed swity got them on blackmarket. also trifloperazine is not bought or sold on blackmarket as far as swim is aware as it has no effects that people other than those with anxiety would want.

[Abrad]

If SWIY follow SWIadzkets advice be aware that you would be getting into anti-psychotics rather than benzos. SWIY should research this drug and its side effects before talking to your doctor.

[adzket]

no there not swim get them from doc for anxiety aswell as valium cause he did not want me on any more benzo's as swim is on deiazepam for anxiety aswell and loprazolam for sleep but need something extra for anxiety the safty leflet says nothing about them being anti psychotics i can get it and copy it brand name is stelazine

[Abrad]

From http://www.mentalhealth.com/drug/p30-s04.html

Pharmacology

Antianxiety - Antiemetic - Antipsychotic

Seems it is an antipsychotic that is also indicated for anxiety. What kind of side effects (if any) have SWIY experienced with it?

[adzket]

or you could also ask for propranolol (bedranol) is also used to treat anxiety and again not a benzo so no need for doc to be suspisious or miss trusting if it is for anxiety swiy wants them and not just to get messed up on another benzo. benzo's are not good trust me swim has been on them for 5yrs perscribed and altough they help at times he has not had them with him he has gone nuts with out them withdrawel was alfull worse that h and swim was on that for yrs too befor kicking the habbit.

[Abrad]

Propranolol is a beta-blocker, it is only used for anxiety if the patient is heart palpitations or racing heart. They do nothing to relieve anxiety.

[adzket]

Propranolol does help with anxiety swim has been perscribed that to as for side effects from trifloperazine none at all on 6mg-10mg a day sorry if it is an anti-psycotic but it does not say that on safty leflet that comes with said perscription. should swim be worryed about taking anti psycotics?

[Jatelka]

Originally Posted by adzket

should swim be worryed about taking anti psycotics?

There is a shiny new sub-forum on anti-psychotics here:

http://www.drugs-forum.com/forum/forumdisplay.php?f=132.

These drugs are often prescribed by ignorant doctors for anxiety (mainly because they are terribly sedating. They have not been called a "Chemical Cosh" for nothing).

[Micklemouse]

At the levels prescribed for anxiety, antipsychotics do actually make a lot of sense. Although I would query the use of Typical Antipsychotics (e.g.Trifluoperazine, Haloperidol, Chlorpromazine) outside of a clinical setting, or without a prescription of an antimuscarinic such as procyclidine (Kemadrin)) or bexhexol/trihexphynidyl (Artane) to counter side effects, A Certain Mouse tells me he has seen excellent results from low dose antipsychotics used for short term and chronic anxiety.

Pro's - no abuse potential, little or no chance of 'paradoxical' reaction (a surprisingly common occurrence where the benzo taken actually increases the levels of anxiety/agitation), little or no chance of physical dependance (at the low levels used for anxiety).

Cons - potential for nasty side effects especially from the older antipsychotics; potentially more dangerous in overdose.

[adzket]

Originally Posted by jatelka

There is a shiny new sub-forum on anti-psychotics here:

http://www.drugs-forum.com/forum/forumdisplay.php?f=132.

These drugs are often prescribed by ignorant doctors for anxiety (mainly because they are terribly sedating. They have not been called a "Chemical Cosh" for nothing).

swim will have a look at that sub forum also swim dose not agree about ingorant doctors swim doctor is very good he has helped swim threw h addiction put him in touch with cmht for exstra help. does everything he can to help swim. swim is on two benzo's already so instead of perscribing swim more or another type of realy addictive substance he perscribed something else to help being stelazine swim has had no side effect from this at all. and does not find them sedating at all. people will have to make there own choises wont they. and its not a cost thing eather as in the uk all perscription drugs are same price no mater what they are or free under some personal surcumstances.

[adzket]

Originally Posted by Micklemouse

At the levels prescribed for anxiety, antipsychotics do actually make a lot of sense. Although I would query the use of Typical Antipsychotics (e.g.Trifluoperazine, Haloperidol, Chlorpromazine) outside of a clinical setting, or without a prescription of an antimuscarinic such as procyclidine (Artane) to counter side effects, A Certain Mouse tells me he has seen excellent results from low dose antipsychotics used for short term and chronic anxiety.

can i ask why trifluoperazine should only be used in a clinincal setting as this is what swim is on and whats an antimuscarinic when its at home though swim has had no side effects any way but would be good to know the possiblitys.

[Micklemouse]

I wouldn't say it should only be used in a clinical setting, but that it should be used with caution and under supervision if the patient has never taken a Typical Antipsychotic before (= Neuroleptic Naive) due to the possibility of extra-pyramidal/Parkinsonian side effects such as stiffness in the joints and neck, tremor, restlessness, blurred vision, dry mouth, ocular-gyrrhic crisis (virtually uncontrollable rolling back of the eyes into the head - very uncomfortable to say the least...). At the low doses used for countering anxiety these side effects are relatively rare, but by no means unheard of, and there is no way of predicting them. If they're going to happen it's usually, but not always, early on in treatment, and often, but not always, pass as the body/cns becomes accustomed to the medication. Ideally your G.P./cpn should have told you about this possibility. Otherwise, yes it does sound like you've got one of the good ones G.P's that is!)!

Antimuscarinics are drugs used primarily to treat Parkinson's Disease, but are also useful in treating side effects that are similar to Parkinson's caused by antipsychotics and occasionally high dose SSRI's (very rare, but again not unheard of).

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