Opinions - Dr. keeping swim on benzos long-term?

[blackdb1]

Swim has been stressing alot lately about his next appointment with his suboxone dr.!!! The reason is that on the last visit the doc said he didn't want to keep swim on Klonazepam indefinately and said he wanted to try anti-depressants. Swim has had BAD anxiety and panic attacks since he was a child and they first tried dealing with it with anti-depressants. They had him on SSRI's, MAOI's, wellbutrin, etc... They all had WAY too harsh of side effects for swim!!! Swim told his dr. this last month and the doc wrote him 60 2mg klonopin. Swim is stressing badly about his appointment on the 18th, because he is afraid the dr will want to take swim off of it!!! Swim feels that if he is taken off the klonopin he will be at high risk of relapse when he has high level anxiety!!! He thinks the dr should be willing to work with swim on this since the dr's goal is to keep swim sober and comfortable not make his life a living hell...???

Swim is basically wondering if anybody has any idea about the dr keeping swim on benzos for the time being? Swim really, honestly thinks that he will be at HIGH risk of relapse if he is taken off his anxiety meds this early! Swim has been on xanax for 3 months .5mg 3 times a day from his psychiatrist and 4mgs klonopin a day from the sub doc for 2 months.

Swim really wants some insight on this as to see if anybody else has had drs want to take them off the benzos but they really needed them and got the doc to keep them on them? Swim is literally about to break down crying and have a panic attack just typing this and thinking about trying to live sober without any anxiety meds!!! Thanks in advance for any replys!!! Swim really wants to see if he has a chance of staying on benzos as he TRULY needs them and does NOT abuse his meds just really needs it for his anxiety!!!???

[Panthers007]

As long as SWIM is not abruptly taken off the benzodiazepines, there should be no problem. They are safe if used correctly - though physically addictive. It would be abrupt cessation that would cause danger to SWIM. Bongo has a friend who has been on Klonopin for many years due to bi-polar disorder. It hasn't done her any harm, only good.

The primary rule all physicians must swear to abide by: Do no harm.

[infekt]

SWIY should know that benzos are EXTREMELY addicting. SWIM should know, SWIM has been addicted to them, as well as opiates (heroin). SWIM believes SWIY's doctor is only doing what is sensible.

if SWOY must be medicated, maybe try Kava Kava? how about Buspar (Buspirone)?

[Panthers007]

The danger is from abrupt withdrawl. If a newer, better drug comes down the road - the doctor might take SWIM off the benzos. But would not stop them suddenly. They would be carefully tapered off to reduce danger and discomfort to a base minimum. Used medically for their intended purpose, anxiolytic in this case, they are perfectly good. Screaming kids with a steamer-trunk full is another matter entirely.

Kava~Kava is effective for low-levels of anxiety. Certainly worth a try.

[tryptamaster]

Swim has had horrid expierience wit buspar, it was given for anxiety and did nothing to help it and made swim feel mentally retarded

[blackdb1]

Yea swim is just going to have to tell the dr. HOW much it is helping him to stay sober! The statement about to do no harm is what swim was thinking, as if he gets taken off currently it will do nothing but harm! Everyone wish swim luck that the dr. is understanding and helps swim in the way he needs to be treated!

[Spare Chaynge]

swim allways told the dr that he had tried many anti depressants and they had adverse affects look them up and pick the one that best fits swim. swim told the dr every time he took the anti depressents he went manic and stayed up for days.. the problem with this is they will ask you what you have tried and some how figure out one that you havent that might not do this to you... but chances are it will delay the reduction and if swim is witty enough swim can say you took it and it had the same adverse reaction to the others.. by the way swims drs allways said going manic was unusual but swim some how countinued to decieve them... also the sub dr deals with addicts regularly he knows the tricks of the addict.

[blackdb1]

Yea swim could tell the 1st evening he went to his suboxone dr. that he knows how to tell if something you're saying is true or you are just trying to score drugs which swim is not trying do!!! Swim told him about the adverse sexual reactions, feeling manic and not happy or sad just felt like a zombie on that stuff! Swims dr. mentioned lexapro and one other med that swim has read many times have withdrawal very similar to benzodiazepines... Swim doesn't see any gain there as far as physical addiciton but he can see it being significantly less psychologically addicting to be on the anti-depressants!

Swim knows his dr. is probably the most understanding and caring doc hes had yet so he thinks the dr should be able to see the good this is doing for swims life! Swim doesn't see why he would want to take away something that is working perfectly? Hopefully he will keep swim on for the time being for the sake of swims sobriety and staying away from illicit drug use.

Thanks greatly for the responses!!! Anymore input would still be very appreciated!!!

Oh yea swim had one more question swims doc prescribes the evening dose of 2mgs of klonazepam for swims insomnia so if he were to take swim off for anxiolytic usage would he most likely RX a hypnotic benzo or something like the new Z drugs? Swim has no insurance and it's already taking ALOT of swims income to buy the subs so to buy zolpidem too would be damn near impossible! Is there a generic form of ambien yet? Swim is sure swiyou guys can see how bad his anxiety is by the way he types out his racing thoughts!!! Thanks again!!!

[Spare Chaynge]

swims dr has your long term future in mind from a medical stand point.. benzo addiction is horrible.. he sounds like a great dr. Swims had dr who knew nothing of benzo addiction and would just keep on presribing swim more and more seizure after seizure. swims advice is just go with it. It also sounds like swim has two drs. presribing him benzos. the alprazolam should be enough,

[Orchid_Suspiria]

Doctors don't mind keeping people addicted as long as it is to new and fashionable drugs that they get percs for prescribing.This is why doctors are so in love with antidepressants yet try to tell people benzodiazepines and opiates are the root of all evil.Fucking hypocrites!They don't care about anyones well being they just care about getting a big check.

[Spare Chaynge]

true that but.. swim does not see many people having seizures and dropping dead from anti depressant withdrawl. Then again anti depressants are probably one of the hardest drugs swim had to kick.

[blackdb1]

The xanax dosage isn't quite high enough to cut it on its own... Swim would need about 4-5 mgs of alprazolam a day, this being the worse days!!! He usually takes 1mg for a panic attack and that only leaves him .5mg to last him the rest of the day plus he needs something for his insomnia. His psych who RX'ed the xanax has only had one appointment with swim. At that appointment swim told him the truth, kinda backtrackin in words but swim had to be evaluated before able to see the psych then a 2 month wait after the evaluation so swim evaluation dr. gave him a slip of paper with his GAD, SAD and panic diagnoses on it along with what meds she suggested which were fast acting anxiety meds (benzos)... So a month before swim went to see his psych for the first time he had to go to the E.R. because of anxiety getting soo bad and the E.R. dr. wrote swim 60 something .25mg alprazolam to help him make it until swims psych appointment. When swim saw his psych he was only in the office for maybe 3 minutes tops!!! The dr asked what's the problem and swim replied anxiety, panic, and insomnia. Swim then handed him his evaluation sheet and told him about the 3 .25mg xanax he had been RX'ed and that it took .5mg to feel any relief and he said is .5mg 3 times a day enough which swim said was. Swim saw his suboxone dr that same night and he RX'ed 16mgs of sub a day.

2 weeks later swim called his sub doc and told him the xanax were NOT cutting it and he really needed something so he wrote swim 30 2mg klonazepams for maintaining anxiety and told swim to use the xanax to combat anxiety attacks. So that is what dosages swim has been on up until now where he is at a comfortable dosage!!! Swim just looked up and saw how much he wrote!!! Wheeew ramble, ramble!!!! haha

Swim has been thinking about this a LOT lately and has decided he is going to tell the dr he went without somedays and that on these days he had horrible anxiety! Resulting in the thought of opiate relapse significantly more!!! Swim honestly is willing to try the anti-depressants and will do so if that is what doc thinks is best but he 1st off is not depressed since being on suboxone. Secondly he has tried SOOO MANY DIFFERENT ANTI-D'S!!!! But swim will try it and is pretty sure the doc will keep swim on a decent dose of klonopin during the transition and then if it makes swim feel like it did before or swim notices no decrease in anxiety/ panic he will call dr and inform him...

By reading through this swim is sure those who don't suffer from anxiety are able to see how MUCH one little, well pretty big thing affects swim soo much! He hasn't been able to work the past few days because the anxiety of the thought of a BAD DAY and not having his anxiety meds!!! However this will not result in losing his job as swim is self-employed! kinda lucky there but unlucky at the same time!!!

Swim says sorry so long but he just has a TON to get off his chest and found this to be the best place to put it and receive intelligent answers from people!!!

Thanks all greatly!!! Have a wonderful evening and night and be safe all!!! -bdb1- Swim is going to smoke a bowl of some good bud to calm down now!!! phweeeew

[Spare Chaynge]

Swim knows the horror of anxiety. And things that go along with it ptsd, panic attacks and such. This is not what swim would of wanted to here when swim was in your position, but therapy and a weening off all drugs was the answer for this swim. It took 2 years. And swim is still dealing with social anxiety and phobias. But it beats the shit out of what he use to have.

Swim when he was in your stage, swim lives in the united states, found that any walk in clinic dr, When shown the bottle from the ER room and told a slightly modified story. "this is what they gave me until i could see you" would prescribe the exact same thing as the er did maybe even more. Swim did this untill he had 5 drs all presribing 120mg of alprazolam a month.. this ruined swims life not suggesting it. but if it comes down to getting hiv from sharing a needle or going to a dr?????

Those benzos actually increase anxiety as you can see a whole thread talking about swims shortage of benzos. this was swim 2 years ago.
Of course when swim feels no anxiety what so ever the anxiety he expirences with out the benzos seems unmanagable.

swim prays that your situation will be resolved. Swim has been through the methadone situation and knows all about what swim i going through.

[TheNewLeft]

swim was on benzo's for 6-7 months straight....started with zopliclone, then moved on to zopliclone and lorazopam....then ditched those two for just massive amounts of xanax.

this is when swim was still totally ignorant about the effects of benzo withdrawls....i had already detoxed from a heavy oxycodone habit...so i thought benzo's would be a breeze....how wrong was swim.

[allyourbase]

swim's doctor a few years ago liked to keep swim sedated, and for a while swim enjoyed being sedated, and it quickly lost its fun. swim's advice is to follow one's gut with those sorts of medications (if you arent commited, there is nothing they can force upon you). if SWIY is enjoying the medication continue, but if it has left swim feeling bored, perhaps unfulfilled, or particularly when one's days on medications seem monotonous, talk to your doctor about different treatment.

[Politicalchalk]

Swim is somewhat surprised with the poster's Dr. Rxing MAO-I meds BEFORE benzos. In fact, in the US literature Swim's familiar with, electro-scock therapy should be tried BEFORE MAO-I's. God, Swim can't believe anyone is still on those nasty things, or that they are ever made anymore! Talk about interactions!!! And not just with drugs, things like wine (not just the alcohol), cheese, you name it. Baaaad drugs, no doubt about it. Freaky deaky.

Docs don't like to have people on buprenorphine also on a benzo just due to the increased risks, like any narcotic. 2mg is a fairly high dose of clonazepam to just start out on. Also, being on bupe makes you an addict by association, and so, from a medical standpoint, you're more likely to abuse benzos than just take them as Rxed.

If you're seeing the Bupe doc through an addiction clinic or something, wouldn't hold your breath. If the anxiety is so bad, though, a refferal to a Psych doc, or even going ape-shit at your local hospital might help. In the US, they cannot force psych meds on you, unless you need to testify on trial or something, and even than it's a tricky game to play.

Like the previous post Swim posted in, ask the doc about hydroxyzine. It's an older antihistamine. I know, I know, it's not a benzo, but it IS effective in treating anxious states for many people, along with a whoooooole range of other indications.

[Mr. Giraffe]

In Ireland, at least, the official view is that Benzos should only be perscribed for very short periods of extreme anxiety (ie 2 to 4 weeks), saying that the drugs are no longer effective after a short period, and are addictive.

Nevertheless, doctors continue to overperscribe these drugs to a large extent, so says the Medical Times

[Jatelka]

Can I just please remind people that links to sites with other forums is against the rules?

Prof Ashton's famous site contains forums and therefore cannot be linked to.

[Laudaphun]

SWIM's marmoset has been prescribed a plethora of different benzodiazepines over the past several years, however SWIM keeps the marmoset in check most of the time. Even though the marmoset had been taking less per day than prescribed, the marmoset eventually discovered that even daily use of doses that seem sensible to SWIM ultimately have had an overall reduction in SWIM's performance in school.

Clonazepam which seemed to be the best to use while in school, while temazepam and alprazolam were reserved (either one or the other, only on occasion combined) for sleep, and the alprazolam was pretty much the benzo of choice for any social events where SWIM felt... "out-of place" which i suppose is the best way to describe it. Overtime even normal prescribed amounts of these substances taken on a daily basis seem to have reduced the marmoset's performance on academic examinations. A drastic reduction in benzo usage was not painful at all surprisingly. Not sure how the decline went, but the marmoset just began using less and less. More and more often going to sleep without the aid of a pill. Perhaps this is all in SWIM's imagination, but examination scores just seem to have dropped. Probably a good possibility that there are other external factors leading to this, as it seems to be only in a single course.

SWIM's marmoset typically takes a single pill at a time (does not take all these during the same day), but they are all high strength, 1mg clonazepam, 2mg alprazolam, 30mg temazepam. and some 10mg diazepam and 15mg & 25mg chlordiazepoxide which have been lying around and are seldom taken. SWIM really hasn't been able to figure out yet what is going on but her marmoset currently believes that aside from the potential of dependency, regardless if a dr. leaves you on a benzodiazepine long-term, or perhaps you need to be on them long-term... moderate use is the best. Even clonazepam which SWIM takes most frequently seems to have a cummulative effect that is very subtle so it is hard to notice over time. If SWIY is prescribed clonazepam t.i.d. then take them 3 times each day if necessary, but if you can get by on 1 or 2 per day, you will be further ahead in the long run... Not suggesting that you suffer to try and get by on a lesser dose, but if you can, it would be an good idea. Probably something that has been said 4000 times already, but figured SWIM would say it for a 4001st time.

The marmoset may just be paranoid, but something just hasn't been right with her exam results this summer. Either a failing grade or an A... no matter how much effort she puts into studying. However, it is an extremely difficult course which the class exam average is typically around 55%... and most of the class has taken the course before and is repeating it. Arrggg... Very frustrating. Not sure what is going on but SWIM has never gave something 150% and recieved grades like some of the one she's gotten this summer. The marmoset is ready to give up on all medications except for methylphenidate.

On a side note, SWIM thinks that after you have been on benzodiazepines for a long period of time, some doctors may become apprehensive about taking you off of them. The psychiatrist that SWIM's marmoset goes to, tries to wean everyone off of benzodiazepines, and if they can get off of them then he is happy, but if they struggle and are not able to, only them (especially if they are recovering from alcoholism) will he leave the patient on benzos as his opinion is that in certain cases in which people just have a really hard time getting off of them or are recovering from alcoholism, that it's better to just leave them be, so long as they use the meds responsibly. He has a real passion for addiction medicine so he closely monitors most of his patients.

[blackdb1]

Swims suboxone dr. was VERY reluctant to even consider putting swim on them a second time (as in 2nd scrip in a row)! Swim saw his doc about 2 and a 1/2 weeks ago. He kept swim on the 4mg Klonopin a day and also put him on Paxil. He seemed to realise that swim TRULY DOES suffer from horrible anxiety thus stating that for now he's going to keep swim on it to keep from swim going back to illicit drug use.

Swim is happy about this as his dr. seems weary to keep someone on benzos more than a couple weeks. Swim assumes the dr. (being an addiciton specialist) gets many people just trying to score abusable prescriptions and he can tell if they are just trying to 'score' or if they are truly suffering from something that needs medication.

On a side note swims dr. stated that he was probably going to try putting swim on some sort of amphetamine drug for ADHD! Swim didn't think many dr's are willing to RX amphetamines and benzos to the same patient? Swim honestly needs these meds however and the more he gets to know his sr. the more he realises he is a very intelligent, caring, and is willing to help in ways most docs will not do if the patient is an addict!!!

[Spare Chaynge]

be very careful with the whole amphetamine and benzo script.. ever seen requiem for a dream.. the grandmother goes insane.. swim went insane on uppers and downers and eventually tried to take his life... it was all scripts.

[blackdb1]

That is swim is weary about!!! Being on amphetamines, suboxone, and his benzos seems like ALOT to just feel normal!!! Swim is going to see the dr who RX'ed him the alprazolam on Aug. 26th. Hopefully he understands swims situation and keeps him onn the xanax!

If he were to take swim off of the xanax and swim explains to him that the Klonazepam is used for anxiety moreso than xanax, where the xanax is used for panic attacks and sleep. If he takes swim off the alprazolam do you swimmers think that he would be willing to RX swim some zolpidem? Swim needs something for sleep everynight and has HORRIBLE thought cycling which keeps him from falling asleep!

Swim appreciates any input from anyone!!! Thanks in advance!!!

[Razorblade]

I am surprised at what Dr.s are prescribing you, however, there are OTC drugs in the US that are effective at combating anxiety and insomnea such as Diphenhydramine HCL and Melatonin. However, SWIM was prescribed 45mg of Diazepam, 40mg Amphetamine Combo, and 80mg Oxycodone as well as 20mg Paxil. A majority of those were either consumed or sold within a week, and most of the time it was to further a nasty Heroin habit. After a while, SWIM was admitted to the local county hospital for Chemical induced Psychosis and went through a full detox without the aid of anything but 5mg daily of Diazepam to stay alive. After about a week and a half of living hell, SWIM has NEVER had any ideation of relapse and went on to become an addictions councilor. In SWIM's opinion, when you use a substance to bring yourself to another level of pleasure, you must also suffer another level of pain to truly understand why going back is not an option. Just $0.02 offered.

[Laudaphun]

To update the situation of SWIM's situation is that while some may argue against it, it is possible to have several different metal disorders at the same time. Benzos and amphetamines might sound like a weird combo for a dr to RX a patient, however, in the case of SWIM's marmoset (who had spent her whole life, hating any kind of stimulants and thinking the whole ADD thing was nothing more than academic doping "in 95% of cases"). However after being diagnosed (and untreated for ADD at age 5) SWIM's marmoset went about her life proceeding to self-medicate (opiates, ironically helped with attention, ambition, and focus in school)... But that was ultimately destructive to the marmoset's life. Finally at around 23-25 SWIM made her marmoset begin seeing a dr to try to get the marmoset from self-medicating. Anxiety problems grew worse and worse, even while on an opiate maintanence program... Finally SWIM got fed up and took her marmoset to a psychiatrist to get the anxiety delt with properly... SWIM informed the psych of prior diagnosis's and lack of efficiency in the treatment thus far. So after an hour of talking about anxiety (all the while taking notes on SWIM's marmoset) the psych asked out of the blue, if the marmoset had ever been tested for ADD... SWIM was speechless, as in fact she was, but her parents choose not to put her on medication. Shrink asked if we wanted to try and treat the anxiety attacks or methylphenidate. SWIM said she had no preference. After being given a trial sample of methylphenidate SWIM was still not convinced this was the correct course of action for the marmoset. Then the psych turned over the paper he'd been jotting down over the course of the past hour. SWIM was amazed at the observations noted over the course of the hour. The marmoset was put on clonazepam 1mg t.i.d. shortly there after but found that the anxiety was greatly reduced with methylphenidate and anxiety medication was needed far less frequently. Lately SWIM's life has been a nightmare for reasons beyond her control... The point SWIM is getting to is that SWIM's marmoset is proof of someone who gains anxiety-relieving benefits from both methylphenidate and clonazepam, with the clonazepam used as infrequently as possible. But the thing is... after several years of being on this or that benzo... when life throws you a curve ball, you might find that no dose of any benzo will help. Just relating recent observations from SWIM's marmoset. As far as a benzo, ADD, suboxone combo... as long as the meds are used within reason, not abused, and prescribed for REAL conditions, SWIM doesn't see any harm in this combo as long as it helps a person better themselves. Some marmoset's SWIM knows complain the most about the constipation of a "long-acting" opiate, being conpounded by use of ADD stimulant meds... Intestinal compaction does not sound like much fun.

Laudaphun added 4 Minutes and 43 Seconds later...

Originally Posted by Razorblade

I am surprised at what Dr.s are prescribing you, however, there are OTC drugs in the US that are effective at combating anxiety and insomnea such as Diphenhydramine HCL and Melatonin. However, SWIM was prescribed 45mg of Diazepam, 40mg Amphetamine Combo, and 80mg Oxycodone as well as 20mg Paxil. A majority of those were either consumed or sold within a week, and most of the time it was to further a nasty Heroin habit. After a while, SWIM was admitted to the local county hospital for Chemical induced Psychosis and went through a full detox without the aid of anything but 5mg daily of Diazepam to stay alive. After about a week and a half of living hell, SWIM has NEVER had any ideation of relapse and went on to become an addictions councilor. In SWIM's opinion, when you use a substance to bring yourself to another level of pleasure, you must also suffer another level of pain to truly understand why going back is not an option. Just $0.02 offered.

A problem in the states is with all the patent laws and such. Especially someone getting back on their feet who may or may not have insurance. SWIM sticks to older meds for this reason. SWIM's marmoset has not yet found anything OTC that has been effective at either anxiety or insomnia unless one is very clever with herbal combinations. Of course, none of that is FDA approved or isn't approved "officically" for treatment of any disorder. SWIM has heard that kava has been successful in cases of mild anxiety.

[blackdb1]

Well swim went to his appointment last week so figured an update was in order... Swim went in and the 1st thing they talked about was swims sub dose and swim told him he is still at 8mgs and the dr. said STAY AT THAT DOSE!!! Swim agreed to do so as he has no intention of coming off the subs this early. Next he asked how the Paxil had been working and swim told him he hadn't noticed any effect on his anxiety from it yet. The dr. asked how the Klonazepam was working and swim told him it is still working GREAT!!! Then the doc asked if swims been attending N/A meetings which swim has and also asked about swim starting to work on a regular basis...

Swim told the doc that he had been working some (swim works with his father repairing lawn mowers) but only when swim NEEDED the cash and when swims dad really got on his arse!!! Swim told him that the ADHD diagnosis they had talked about the previous month was really preventing swim from working!!! Swim told him his mind races and can't stay on ONE THOUGHT for more than a minute! He also told him about daytime sleepiness and GREAT lack of motivation... Swims dr then looked in swims med file and said "You told me you have used methamphetamines in the past" and then asked "did you ever take a low dose and notice your ADD symptoms lessening?" which swim had. Swim also told him he had tried methylphenidate, dexmethylphenidate, amphetamine, methamphetamine, and adderall and that he noticed increased concentration and motivation.

Swims dr then wrote him an RX for 30mgs adderall a day (20mgs AM and 10mgs afternoon). Swim was VERY happy as this was his last obstical to overcomeand knew from previous experience that adderall works for swim!!!

Swim dosed the 20mgs in the morning and noticed some effects but today swim tried 30mgs followed by 10mgs more an hour later and swim accomplished more work than he has in the past 3months ALL TOGETHER!!! Swim is not sure how to go about telling his dr that the 20mg dose is effective but that he tried 30mgs one morning and that made a HUGE DIFFERENCE!!!??? The dr. said this was just a "guess dosage" and told swim this would most likely need to be adjusted as neccessary...

Well that is swims current regiment and wanted to update to let everyone know how the appointment went. Everyone have a great evening and be safe -bdb1-