Posted by Alan on December 6, 2002, at 16:57:55
In reply to Re: Regarding Benzophobia - PS. » Alan, posted by bluedog on December 6, 2002, at 3:23:10
> Hi Alan
>
> Thankyou for your views on this topic. I'm just wondering whether you could share some of your experience as how to properly work with the benzo's? I would really appreciate this.
>
> What Benzo's have you taken during the years?
Over the last 20 years I've undergone clinical trials with Klonopin, Valium, Ativan, and Xanax. Presently on klonopin maintainence at .5mg 3X's a day and ativan 1mg 3X's a day.
>
> I am currently on Diazepam for social anxiety? I am in the experimental stage as to how to get this drug to work best for me.
>
> I currently take 2.5mg Diazepam at night and another 2.5mg in the morning.
> Is this enough to treat my social anxiety?
> Would 5mg at night and 5mg in the morning be a better combination?
> Or perhaps 5mg at night, 2.5mg in the morning and 2.5mg in the afternoon?
> Is it best to take it with food or better to take it on an empty stomach between meals?According to dosing instructions you are at the relatively LOW end of the spectrum since the range is 2 - 10mg's, 2 - 4 times daily. That's between 4 and 40 mgs sum total.
The only way to know what works best for you is to perform your own clinical trial. No one can tell you how you will do based on a preconcieved template for what is given as a "statistical average". You are not a statistic afterall.
You will have to be able to distinguish between the feelings of withdrawal and the return of your orginal symptoms (both being anxiety but slightly different types - one will be distinguishable as drug induced with a little experience). Knowing this will tell you when the drug has or is beginning to lose it's theraputic effect. Only then will you know when and how much to titrate your dosage. This is what mixes many up.
I've tried klonopin 2, 3, and 4X's a day and found a level that felt comfortable to treat my GAD symptoms.
The caveat being, anxiety fluctuates, waxes and wanes, at varying degrees and speeds over time. So three times a day may be fine but you may find some weeks or months needing to add a little before bed or in the middle of the day. That is alright. Only if the dose suddenly escalates rapidly from 10 to let's say 40 -50 mgs in a few days would I become concerneed that the med is not right for you.
>
> I definitely found the 1st couple of weeks of taking Diazepam the hardest and I had to exercise discipline not to take more because it initially gave me a bit of euphoria but fortunately that has settled down and now and this so called addictive craving effect has passed and I now consider the drug as helpful and as healing for my condition as my generic Prozac at 20mg per day and I no longer give it a second thought. I find the Diazepam and the Prozac very complimentary as the Prozac is activating whilst the Diazepam reduces my anxiety giving my mind sufficient rest to start the healing process. This includes giving me restful and healing sleep! I do NOT believe that the Diazepam interferes with my natural sleep cycle because I am still dreaming (and recalling my dreams) and I am waking up refreshed and without any drowsiness! In fact since starting the Diazepam I am actually MORE alert during the day with HEAPS more stamina and concentration!This "euphoric" effect is usually not a craving per se but a relief of symptoms. There's a HUGE distinction that needs to be made, usually is not, and the fear of "addiction" suddenly becomes the boogeyman. I hope that you understand the difference between "addiction" and sustained medical dependence.
If you are fine at your current dose then stay there. But if the anxiety waxes and wanes you may need to titrate your dosage.
The different bzds act differently for different individuals - just like any other psychotropic. Here is a bzd eqiv. chart for you:
http://www.dr-bob.org/tips/bzd.html
If you want to "exchange out" one for the other there is a system to follow that many docs also do not know how to use. But it's too involved to go into here...
Best,
Alan
>
> I noticed that Benzo's are also now used to treat chronic fatigue syndrome which as I mentioned above I am also suffering from. See the attached link as an example http://www.immunesupport.com/library/showarticle.cfm/id/3154/searchtext/klonopin/
>
> I fully agree with you that proper treatment means getting the right diagnosis and then the doctors practicing responsible medicine by using the right medications for the right illnesses. In other words it boils down to professional and competent medical management which unfortunately is in rather short supply in western society.
>
> Looking forward to your response to my questions
>
> regards
> bluedog
>
>
poster:Alan
thread:130480
URL: http://www.dr-bob.org/babble/20021203/msgs/130804.html