Opinions - Goin to doc today: Which benzo? Any Alternatives?

[Donmeka]

SWIM is actually going to a doctor 200 miles away whos been with the family since SWIMS grandmother to ask for a xanax prescription. i also have social anxiety, with i guess some other kinds maybe GAD(this is why SWIMs seein a doc p) and anxiety associated with depression( the depression gets savage evry couple weeks or so 3-6 id say)

SWIM has tried Valium and it seemed to make SWIM sleepy quite easy (5mg SWIM believes, the lil v cut in) when SWIM had a panic attack he was givin .5mg of xanax and that would set SWIM good for a whole day w/o feeling even slightly and that amazed him, this is what got SWIMs mother to call the doc in interest.

Klonopin? isnt that a stronger benzo? ive heard bad things about some anxiety meds like wellbutrin i think im not sure just want to know what not to rly take.

is there anything else SWIM should talk to the doc about, or med SWIM should mention?

[Nicaine]

Originally Posted by Donmeka

Klonopin? isnt that a stronger benzo? ive heard bad things about some anxiety meds like wellbutrin i think im not sure just want to know what not to rly take.

Klonopin is "strong" in terms of potency (i.e. 0.5mg equals 10mg of Valium, or thereabouts) but not particularly strong in terms of how well it relieves anxiety or whatever. It doesn't produce any kind of a high for SWIM (Xanax definitely does) and he's had no tendency to want to escalate his dosage or abuse it... whereas he definitely did with Xanax.

[Nagognog2]

Any doctor worth his pay will try to steer one away from benzodiazepines if it appears these would be taken on a daily basis. This is due to their incredible addiction rate - 2 weeks and one will end up in a nasty, possibly fatal without treatment, withdrawl.

Wellbutrin is a stimulant related chemically to Tenuate - used as a diet-pill. If one is suffering from anxiety, that's the last thing one needs. That reminds me of Tweak in South Park and his dad trying to calm him down with coffee!

A friend of mine has a nasty anxiety attack every week or so. She takes an Ativan (Lorazepam) for this. She says they work well. But again this is only if one were to take them occasionally. There is no safe benzo for daily, long-term use.

[Benzhead]

SWIM agrees with "Evil Troll" moderator

Expect the doctor to give you a full psych. test before prescribing anything. If the Doc. SWIY is seeing isn't a psy Doc., she/he would be remiss in not referring SWIY to a P-Doc for a full screening.

Expect a first-line antidepressant(AD) to be prescribed(see below).

SWIM is on Klonopin(clonazepam) 1mg 4x daily. This was only after many failures with various combinations of antidepressants(ADs), Buspar, etc., etc.

Klonopin(clonazepam) has a very long half-life, which lowers its potential for recreational use. However, if SWIY is of the mind that SWIY'll eat enough to get that feeling of being in a mental warm bath, then SWIY most likely will do so.

SWIM implores that SWIY does not do this.

Benzos are not the first choice medication therapy for GAD. SSRIs(Selective Serotonin Reuptake Inhibitors), or SSNRIs(Selective Serotonin & Norepinephrine Reuptake Inhibitors)are more often prescribed as a first trial.

The problem for someone that suffers from anxiety is that these types of meds typically cause a bit of heightened anxiety and some nausea during the adjustment phase. This typically lasts from between 5-7 days.

SWIM has been prescribed Desyrel(trazodone), but found it to sedating the next day. Your mileage may of course, vary.

However, there are newer ADs, such as Remeron(mirtazapine) that is well tolerated by anxious indivduals..the method of action is as an NaSSA(Noradrenergic and Specific Serotonergic Antidepressant). Doing a quick search on your favorite search engine will provide you with more information.

SWIM finds that the two biggest downsides to this agent are:

1) it can increase cholesterol levels in some individuals

2) it is likely less effective for longer term treatment

SWIY will not likely find #2 above in any material on the web. SWIM noted this effect with his P-Doc. and she told SWIM that this is sometimes the case.

Be honest with SWIYr care providers. Most of them really do wish to help.

Reputation Comments on this post:

Informative post. Thanks

[Donmeka]

k SWIM went to the doc and he was a great guy, very christian doctor but good guy. SWIM explained his whole situation and it was alright. SWIM blew up once during the whole meeting because he did not understan what SWIM was saying and because of that repeated himself, and being already in an anxious state it grew and grew. he acted cool and SWIM almost left the room but came back and sat and repeated his self. the doc was trying to talk about prozac and lexapro and SWIM totally waved that idea off the map because of the negativity he has heard about those drugs. SWIM told him about his panic attack and ow well xanax worked.

it took a lot of talking but the doctor finally believed xanax would be helpful but he also like you said before accepting xanax as treatment he suggest SSRIs. He sent SWIM home with 30 .5mg brand name xanax and 30 10mg Celexa a SSRI. i do not no much about celexa. SWIM injested one a bit earlie to see how he reacts and to see if its a better solution than the xanax. should he not be mixing these? or sould he just stick with the SSRI if it works and take the xanax if he gets anxious still? doctor said to just give the SSRI a shot so SWIM did that today because he did not take a xanax yet today.


thanks everyone for your posts ^_^

[Donmeka]

k Celexa seems to give SWIM a sense of well being and energy to go out and do things, just a happy feeling all and all. but since SWIM is injured (foot) he cant really do much so it like an abundance of energy that SWIM cant realy get rid of. SWIM then injested .5 of xanax and he got a good lil buzz with some good butter kush. the kush or maybe .25mg alone would just take that lil edge off im thinking.

SWIM has experienced no side effects that he is aware of atm

[Donmeka]

k today i had an anxiety attack around a group of ppl i was with and had a nervous twitch and just nervousness lol. i kind of dont want to take the celebrex anymore. but i dont know if xanax can work for me as a daily thing. like .5-1mg a day would be my suggestive dose that seems to work well. but xanax cannot be relied on permanently or for long periods of time i mean from what i hear.

[Kristy]

SWIMs sure your doctor said this already but..it can take up to 2 or 3 weeks before you start to see the benefits of SSRI's.

SWIM hears Celexa can also help with anxiety.

[wellhelm]

If one has an addictive personality an informed doctor will not perscribe xanax, and even those that don't have one, are usually dependent on it with in the first couple of weeks because the tollerance builds quickly. Xanax is generally perscribed for short term use. I think Xanax only has a half life of 6 hours.
Swims doctor has perscribed seroquel in low dosses to combat anxiety and other manic states.
Swim was also perscribed celexa to combat major depression. This took about a month before swim started felling the benifits.
Remember drugs are never a cure all for depression and should be used in combinataion with some form of therapy.
If its as savage as you say ask you doctor about a mood inhibitor such as Depakote. this will help keep you on a "base line" mood wise.
Then again with this shit its different strokes for different folks and it usually takes many try's with many drugs before its just right.

[wellhelm]

Just to be sure, i ment short term use and half life as 2 different things. it's not perscribed for 6 hours at a time. probably did not need to say that but you never know.

[Riconoen {UGC}]

swim adives swiy to stay the fuck away fro xanax, the withdrawal sympton can kill you. swim would suggest klonopin (clonozepam) for anxiety, swim has it prescribed for use occasional when he feels an anxiety attack coming on and it works like a dream. swim does use kpin recreationally though, the .5 mills is not enough for swim to feel anything other than a calm feeling, swim would recommend 3 mills of kpin to make swiy feel GOOOOD, not an opiate euphoric high but a mellow like you've just taken a warm bath only twice as much kind of high. and swiy'll feel really stoned as well.

[Jatelka]

At the risk of sounding like a broken record:

Cognitive Behavioural Therapy is very effective for anxiety(more so than benzos in several studies) as is BioFeedback for panic attacks.

[Donmeka]

Originally Posted by Jatelka

At the risk of sounding like a broken record:

Cognitive Behavioural Therapy is very effective for anxiety

also looking into that

[Alicia]

Originally Posted by Jatelka

At the risk of sounding like a broken record:

Cognitive Behavioural Therapy is very effective for anxiety(more so than benzos in several studies) as is BioFeedback for panic attacks.

`oh yes CBT yeh,can be effective, but pricey considering NHS Standerds and is not always effective. as boyo found out. Benzo would be more approiate but nooooo.... They'd ,uch rather fuck u up on SSRL and respirdone. then give benzos..

[Donmeka]

SWIM has been on celexa and was given 1mg xanax if he couldnt sleep or had a bad episode. SWIM usually smokes weed instead and doesnt combine it with the xanax unless its a social event. but SWIM never goes over 1mg orally. SWIM has been on risperdal but he hasnt taken it in 5 days because he lost a bunch and cant refill till the 10th so he cant take any till tomorrow. but SWIM feels fine and hasnt had any psychotic episodes or anything rly, but he has also been smoking kush everyday which could be chillin him out.

when SWIM goes to doc in 1 month with half the bottle of xanax to show responsibility and thta no abuse is rly present he will probly ask to increase celexa to 20mg daily and stop taking risperdal. with xanax or mj SWIM seems to be managing well.

[painfully_lost]

Xanax can be used long term. I have been on it for a while. My psychiatrist is working with my psychologist and they both feel it is the best method of treatment available for me now. I am scripted 2mg/day. I at noon and 1 before bed. The short half life allows it to be out of my system before each next dosage. I have some of the top psych docs working on me, they would not take chances. SSRI's made me very ill, we tried 7 of them. I am also scripted fent patches/percs for nerve damage, so I am legally set pretty good. hence, no swim terminalogy needing in this post. all legal...

[shuanna]

temazepam or xanax is a shorter-acting benzo, with short half-life. temazepam usually used as hypnotic, xanax usually as anxiolytic or sedative. A shorter half-life makes its "abuse potential" higher. valium has a longer half-life, and a wide range of clinical applications. Clonazepam 2mg is very strong and has also a longer half-life, one of its uses it control of epilepsy.

Yeah when SWIM fronts up to her doctor saying "I'm stressed, anxious, sleeping problems", they try to get her into all this non-medical stuff. Like no tea or coffees in the hourse before bed, no late big meals, no intense mental stuff like the net or stuff close to bedtime. Then, SWIM has been prescribed an SSRI antidepressant, efexor [venlefaxine] 37.5 mg [once daily] initially then when SWIM reports its no good, 75mg once daily, then 150mg once daily.

On that last occasion the doctor questioned SWIM if she was actually taking the meds. At this medical centre, SWIM has not declared her IV or other drug use, nor had any physical examinations that revealed IV drug use [look out when they ask to take your B.P.]

On another occasion SWIM had been taking prescribed analgesic pills [codeine/paracetamol 30/500 mg] for a dental problem. The script was for 20 pills, SWIM finished them in around 7-10 days. SWIM's physician seemed unconvinced by SWIM's account that she needed this much analgesia for the painful dental problem [which was truly genuine]. Either the physician formed the view that there was diversion of meds taking place, taking excess of therapeutic dose and/or that SWIM is not opioid-naive [eg SWIM is opioid dependent or regularly uses opioids non-medically]. By way of background SWIM has a history of IV use of heroin and meth, she's not into pot.

Anyway SWIM got the next script from her physician for the meds for her dental problem. She recalls that the Doctor seemed a little intrusive in her questioning and insisted on taking a second look at the "sore tooth awaiting treatment".

Perhaps SWIM was silly and did present sometime with miosis and ataxia while staggering into her physicians consulting room, or she presented with mydriasis and other symptoms.

[Donmeka]

today "my flamingos" doc switched her from 1mg xanax to 1mg ativan because he had her take no more than 1 xanax a day. My Flamingo told him that that didnt rly work well all the ime because the short half life and that she had a huge panic attack one day. after the convo he thought last time he gave her lorazepam instead of xanax which she found funny. throwing that misunderstanding aside he presicribed my flamingo ativan today. she has yet to pick it up and see how it goes on the daily but will see tomorrow.

[Donmeka]

today my flamingo noticed that at ,5-1mg of lorazepam a day seemed to work tons better than alprazolam ever did. it more just took away the anxiety and chilled her out unlike alpazolam with a more "drunk" effect. shes been working at a convention in town and has done a good job being social and talkative with potential customers and visitors.

[Donmeka]

SWIM will be going to doc again to either refill/raise his lorazepam or possibly ask about klonopin. SWIM has heard on this forum and from our local walking klonopin that it is a wonderful benzo that works effectively. SWIM may get his mother to come with and mention the klonopin so as not to arouse any suspecting that SWIM is switching benzos just to get high. which is not the case at all. justy because SWIM is still a young man he worries about this

SWIM is just looking for that benzo that suites him perfectly. SWIM believes xanax is too short acting and drowsy. ativan at 1mg works alright and the life is a good 10-12hrs which is great for SWIM since it lasts through most his active day. he will bring up to 2mg and see how that works. if he favors the ativan jump he will ask about a klonopin trial of some sort just to test to see if it works more effectively.

from what SWIM has said does anyone have some insight on a benzo that might work for him better? any comments are appreciated

[Donmeka]

SWIM has stopped taking his SSRI and risperdione recently and has been fine, he has been without prescribed benzos for a week or 2 and the anxiety is worse probly because of stopping the psych meds. SWIM like you said feels more comfortable taking benzos to control his anxiety problems then to stay on more pills.