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Dr. Bob is Robert Hsiung, MD,
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Posted by burnedout on December 5, 2003, at 11:38:41
In reply to Re: A Balanced Alternative View of Xanax » maxx44, posted by Viridis on December 5, 2003, at 3:32:17
Viridis,
I agree with much of what you have to say.
My pdoc will not even prescribe Xanax or Ativan anymore, but he does prescribe Klonopin.I hope he is right about it being less of a challenge to come off of than Xanax or Ativan.
He is also vigilant for signs of my body starting to "need" it and so am I.
We have my dose of Klonopin where it needs to be to relieve the anxiety/stress (PTSD). If we see that I'm starting to need more to get the same results, that's the RED flag. That's when instead of going up, we will start backing me off.
Your statement though, that when your doctor sees signs of you needing more of the benzo, will cause an "immediate" stop, concerns me.
I hope the "immediate" really means taper-off.
If you are take more than a certain amount of Xanax, Ativan, Klonopin, there is a high probability of a seizure if "immediately" stopped.
My doc didn't tell me how many Klonopin it is, but he did tell me that 3 mg of Ativan/day is "iffy," 4 mg. & above is an almost definite. He didn't say how much Xanax was the equivalent to watch out for, but somewhere I read that 1.5/mg/day over a couple of weeks would be not advisable. So it's number may be around there?
As far as benzo-phobia, I probably have that, but I have no choice but to take the stuff. My doc says I should be thankful that we've found something that works. And I am. Even though I hate to have to take it.
I imagine a Chemotherapy patient feels much the same way. They know the damage that therapy can do to their body and how uncomfortable it is to take go through it all, but given the choices, it's the only option if you want to survive a bit longer.
In reserve, I have a quantity of Ativan, in case of a "breakthrough" need. I have signs posted all over the house to take it, if I get into trouble. Otherwise I will wind up wishing I had. (benzo-phobia)
I've had to use it twice in eight months--but only when there was no other choice.
A few weeks ago, I had to execute our (the doc's & mine) mergency plan & take 1mg every hour until I either got better or feel asleep. The stragety being that going to sleep was preferable to having so much panic/anxiety that I would end up in the hospital or do something worse.
At the end of the third hour, after three pills, I was still going downhill, but it was slowing and mercifully, I feel asleep. The emergency plan worked.
Before the Klonopin, I had been taking 3 mgs/Atavan/day for two years! The switch to Klonopin was hardly noticeable--I was lucky.
From only my personal experience, the person who said that a "world organization" that tracks the difficutly of comming off benzos compared to SSRIs found that the SSRIs to be worse, I would strongly agree.
As I mentioned, I had been on Ativan for two years. I went through withdrawal from it. I suppose it is close to Xanax.
I've gone through withdrawal from Effexor-XR, a SSNRI, a little more potent than Paxil, which is an SSRI.
So I've had to go through "discontinuation" of both.
For this body:
Even though EXtremely unpleasant//////////////////
I would take the witdrawal from the benzo, ANYtime, compared to that of the SSRI.
Posted by burnedout on December 5, 2003, at 12:21:09
In reply to Re: anyone want to just talk effexor again??, posted by moose100 on December 5, 2003, at 11:03:03
Ok, I didn't read far enough back to know that this was a thread about the good of Effexor.
A comment on that:
After 4 weeks at 75 mg./d, I finally went up to 150 mg/d, which I think is the lowest level that is considered "theraputic."
Almost immediately, my depression & anxiety easied. It was a blessing. --until three days later, when it got me.
So it is good for those who can take it.
But no matter whether it is good for you or not, if you've taken it for more than a couple of weeks, I think it is probably inadvisable to stop cold turkey.
So, yay for the good it does.
Be careful when coming off it.
It usually takes 4-6 weeks for an anti-depressant to fully work. But, if you're not out of the woods on the "side-effects" by the end of the 2nd week, and I think this may hold true for most anti-depressant, get off it quickly and try something else.
Posted by J9 on December 5, 2003, at 16:48:15
In reply to Re: starting effexor... keep posting.. success/dosage? » lg, posted by sasha71 on December 1, 2003, at 7:58:09
I have been on effexor for approximatley 4 months now. I take 150mg first thing in the morning because it gives me energy to get through the day. I love what effexor xr has done for me. It helped my marriage, job, and general everyday life. My only SE is that it is hard to sleep at night, therefore I take 100mg of Trazadone, which I also love. I have very vivid dreams of which I can pick. How you ask? I chose what I want to dream of as I am falling asleep and I dream of it!!!
I have not had one SE that has been posted on this board. This is the best med I have ever taken and hope to continue on.
Just my story.
J9
Posted by moose100 on December 5, 2003, at 18:51:57
In reply to Just my story, Effexor XR success, posted by J9 on December 5, 2003, at 16:48:15
> I have been on effexor for approximatley 4 months now. I take 150mg first thing in the morning because it gives me energy to get through the day. I love what effexor xr has done for me. It helped my marriage, job, and general everyday life. My only SE is that it is hard to sleep at night, therefore I take 100mg of Trazadone, which I also love. I have very vivid dreams of which I can pick. How you ask? I chose what I want to dream of as I am falling asleep and I dream of it!!!
>
> I have not had one SE that has been posted on this board. This is the best med I have ever taken and hope to continue on.
>
> Just my story.
>
> J9
Thanks for posting. You made my day.
Posted by camel on December 5, 2003, at 19:03:01
In reply to Re: Just my story, Effexor XR success, posted by moose100 on December 5, 2003, at 18:51:57
I feel the same.......however....having gone thru Paxil withdrawl I know when the time comes it may be a problem...but for now I am very happy...and loving each minute of each day!!!!
Posted by maxx44 on December 5, 2003, at 19:11:09
In reply to Re: Just my story, Effexor XR success, posted by moose100 on December 5, 2003, at 18:51:57
good to hear. and trazadone, i've used it off and on for years---i think it's one of the Great ADs. not many modern drs. think of it as more than a sleep-inducer---it's an 'odd-bird' of ADs---kind of in its own category. all i know is it works---good to hear a happy effexor result---whatever floats your boat.
Posted by maxx44 on December 5, 2003, at 19:53:06
In reply to Re: anyone want to just talk effexor again?? » moose100, posted by burnedout on December 5, 2003, at 10:35:53
hi moose, met quite a few in alaska---if effexor works for you, it works. i would not be overly concerned on the 'withdrawal' reactions of others. we're all unique. personally i've yet to meet a truly addictive AD. certainly not trazadone. depression may only hit you once/lifetime. when it lifts, people usually seem to no longer need meds--i've gone 10 years w/o an episode. i suspect, from experience, even in the folks pissed with effexor 'withdrawal', that trazadone alone would keep you, and perhaps them, from even seeing 'withdrawal'. best wishes
Posted by maxx44 on December 5, 2003, at 22:30:07
In reply to Re: anyone want to just talk effexor again??, posted by loni on December 5, 2003, at 11:34:20
god, nagual, life, jesus, holy ghost---may loni's post bring understanding. on the map of life there are, as ancient mariner's maps, areas marked, 'here be monsters'---regrettably for me and tens of millions, we saw 'the monster' a bit late. thank you, loni.
Posted by maxx44 on December 5, 2003, at 23:13:05
In reply to Re: anyone want to just talk effexor again??, posted by loni on December 5, 2003, at 11:34:20
for loni---i got hit by 'atypical neuroleptic syndrome'---glad it wasn't plain old NMS. but 3 year's out and my bones still ache---you're the 1st person i've seen post on that. and before i was cycling 20 miles/day, now i can walk ten--you mention 'balance', it's just coming back. before your mention of 'bone-ache', i never thought any AD capable of any long-term, neuroleptic-withdrawal type sypmtoms. but that's what you're discribing. walking helps ease that pain for me.
parnate's an old maoi as nardil. i know them well. i don't like saying this, but before a risperdal trial for depression---i was much more 'normal'---nardil used to make me hypomanic quick. i was put on it---zip. risperdal in 3 months harmed my dopamine deep brain factory, which controls much emotion, cognitive and motor skills. your effexor symtoms are too close for comfort to neuroleptic-use ones, from my previous view of ADs---i only have brief experience with these newer ones. bailed quick. risperdal has been approved for long-term depression---i've pretty much been a sick mole in a hole since. sound familiar? comments please?
Posted by maxx44 on December 5, 2003, at 23:43:51
In reply to Re: anyone want to just talk effexor again??, posted by moose100 on December 5, 2003, at 11:03:03
i initially came here for effexor data, and just ran into xanax---my one response triggered about 30+ posts---what to do? ignore or respond? this has turned into 8 hours work/day---i didn't start it, others did. but i do know the turf. and i'm curious? why would you be expecting only happy stories on effexor or even aspirin? what honest use would there be in a site reporting only positives, as obviously that's not always the case. therefore your premis and reasoning seem flawed on that---academic talk, nothing personal, but my interest is seeing the negatives from others, so when encountering them myself, changing direction seems appropriate. regards
Posted by maxx44 on December 5, 2003, at 23:54:07
In reply to Re: anyone want to just talk effexor again??, posted by moose100 on December 5, 2003, at 8:24:59
aplogies. my error. i am interested in effexor-happy users info, as i tried it briefly and bailed--i do not discount a re-try. i respond to perhaps 100 mails/day---you may see that could confuse anyone, now and then. glad it's working. regards
Posted by loni on December 6, 2003, at 0:10:56
In reply to Re: anyone want to just talk effexor again??, posted by maxx44 on December 5, 2003, at 23:13:05
Maxx--
All I can say is that without long-term post market testing, we are all at that mercy. None of these guys do post-market testing. Their pre-market testing is limited and short. And that is all that is required. So where are they post market testing? In the field. On us.
Write your congressperson today. You can get their email and snail mail address at
http://www.vote-smart.org/It does make a difference if everyone does it. Pharmaceutical companies are the largest corporate contributors to campaigns...period. Their special interests mean lighter restrictions on them all of the time, year after year.
Take care everyone. Use what works for you. Fight for what you need or ask someone else to fight on your behalf if you need to spend the day under the bed (we all do, once in a while.)
Posted by Viridis on December 6, 2003, at 0:41:36
In reply to Re: A Balanced Alternative View of Xanax, posted by burnedout on December 5, 2003, at 11:38:41
Hi Moose,
Thanks for the feedback and concern. When I said "immediate", I was referring to Xanax, rather carelessly. What I meant was that my pdoc was somewhat concerned about my tolerance to it, but not overly worried because my use is so infrequent. So, he said that if I found myself needing it regularly at increased doses, he'd insist that I stop using it.
He's well aware of the risks of sudden benzo discontinuation, so I'm quite sure that, if I were to become dependent on Xanax, we'd work out a gradual discontinuation schedule. The risk of this seems very low anyway, given my and his awareness of what's going on, but he certainly wouldn't pull a patient off a benzo cold-turkey. After all, he's told me several times that benzos are not drugs that you can just stop suddenly if you've been using them for very long on a regular basis.
The bottom line is that Klonopin seems very safe (for me, anyway) and I have no plans to stop taking it any time soon. If I ever do, it will be gradual. Xanax works extremely well and I have no trouble controlling its use, so at this point stopping it wouldn't be a problem -- I can easily go without it for weeks at a time. But I'd rather have it available for those times when I do need it, and my pdoc is comfortable with this, as long as I don't find myself "needing" more and more on a regular basis.
Posted by maxx44 on December 6, 2003, at 0:43:33
In reply to Re: please be civil » maxx44, posted by Dr. Bob on December 5, 2003, at 3:38:04
i'll watch myself---i am bipolar---stable now, if anything, over-worked for no pay. my choice. when, and if mania hits me, you'll notice fast---block me fast. i really hate seeing a 'wild' post that goes to me. i must remember this is a public board. the xanax thing took on a life of its own---my interest is the new thread i started on the newsweek article re. madness regarding neuro-pathogens. i put it in the 'alternative treatments' slot--but it's a pure md. matter. perhaps it should be re-directed? regards
Posted by maxx44 on December 6, 2003, at 1:28:04
In reply to Re: anyone want to just talk effexor again??, posted by loni on December 6, 2003, at 0:10:56
thank you loni---this old ship can use some confirmation. perhaps appreciation---most don't know 'They' are the 'lab-rats' of modern drug cos. or that there are good drs. and bad. we're trained to trust. i was 21 when i went 48 hours in motorcycle-racing boots, wet--my left leg was discolored by the boot dye, and clearly swollen, awful looking. 1st dr. i saw? he said 'gangrene' and was having his nurse set up an immediate removal of my lower left leg. i've tons of allergies. i told the 'unmentionable'as to what i thought of him and walked. the next dr. listened, looked, said 'allergy'--gave the area a big shot of some anti-histamine---next morning, normal leg. close call. that's why i 'push' 'talk-therapy first'---the wrong drug won't make your leg fall off---but for tens of millions, i feel many would make that trade vs. what may be very close to at least partial chemical lobotomy. your wise cynicism and appropriate rebelliousness influenced this post. still got my leg. but dopamine factory? joy? marketing skills? just have to hope they return---the brain is robust. regards
Posted by maxx44 on December 6, 2003, at 2:57:56
In reply to Re: A Balanced Alternative View of Xanax » maxx44, posted by Viridis on December 5, 2003, at 3:32:17
this goes to ethics. both mills' 'greatest good for the greatest number' and kant's 'categorical imperative'---kant means 'whould you have your decision made a law of nature?' you are 1, even if not an addict, but the accidental victims demonstrably outnumber you enormously. your ethical issue is simple---do you personally want to make it a 'law of nature' that the interest of 1 supercede that of the many? very human, very tobacco, very drug dealer, very auto maker---but i think you may see kant's point. would you like living at the mercy of 1 person? 9 of 10 benzo addicts, my estimate, should never been scripted long-term. until you've experienced the absolutely common withdrawal effects, finding yourself psyhchotic for the 1st time in life, i must cosider your position erudite. and hope it stays at that. if it quits working, or you feel adverse effects and want off---use the dr. ashton protocol. avoid the madness of rapid withdrawal. regards
Posted by maxx44 on December 6, 2003, at 22:33:43
In reply to Re: A Balanced Alternative View of Xanax » maxx44, posted by Viridis on December 5, 2003, at 3:32:17
to me, the 'keyword' of your dr. w/klonopin clients is 'indefinently'---with daily use, you will usually see no problems, save perhaps 'blunting' and in the case of my second ex, depression. it's when the drug is suddenly stopped big trouble shows up. when klonopin 'arrived', as i've said, it became the 'darling-drug' for bipolars and panic clients. as you have apparenty not experienced sudden withdrawal from klonopin, nor apparently your dr., i may understand your 'beef' with dr. ashton's 'taper-model'. but the world agrees--it's, so far, the only safe way out for long-term users. xanax produces euphoria, which quickly nails many, as heroin, or crack. and that's why your dr. says he'd cut you off at signs of 'abuse'. smart move, but he's missed the fact that klonopin sudden withdrawal seems to produce the same horrific effect as xanax sudden cessation, just days later. i'm not beating a dead horse. but my arms are tired. until you encounter full benzo withdrawal, do you have the experience to predict? to have any idea as to its severity? unlikely, as that deal is unique to direct experience. nothing i may say will prepare anyone for such. but someday, you may wish to put klonopin and xanax aside---the ashton paradigm will be your best ally.
Posted by maxx44 on December 6, 2003, at 23:24:29
In reply to Re: starting effexor... keep posting.. success/dosage? » maxx44, posted by KimberlyDi on December 2, 2003, at 13:28:15
well, boy howdy, and well, well, well---'suicidal' wd effects from an AD? i've seen that, but only small scale from the old tcas/maois. i'm very surprised at the # of effexor wd posts that i've seen, several sound identical to long-term benzo use, or recovery from atypical neuroleptic syndrome---major issues. the 'fall-out' often irreversibe. not having used it, save 2 weeks, i'm relying on posts, as from loni, and what i see is mixed. the 'i love effexor' posts look near euphoric. makes me wonder, as i watched my 'normal' cousin become truly manic on zoloft, myself be manic at high tca AD doses, i wonder if the effexor lovers haven't simply become manic or hypomanic? don't know. they would feel great, but judgement ability? gone and went. unless you get a stable hypomanic result. that=$$$ in those with history of such. history is important.
Posted by Viridis on December 7, 2003, at 1:46:36
In reply to Re: A Balanced Alternative View of Xanax, posted by maxx44 on December 6, 2003, at 22:33:43
Maxx,
I'm confused -- what I said was that my doctor warned me that all benzos (including Klonopin) should NOT be discontinued suddenly, and that gradual withdrawal is always necessary after any substantial period of use. He has had many patients on Klonopin long-term, and has also supervised numerous, very slow withdrawals from this drug (usually due to the patient's desire to stop use). He says these generally work out fine , as long as the taper is gentle and tailored to the patient (although the original anxiety state is likely to return, no better or worse, unless another med like an SSRI proves effective). He is more concerned about Xanax than Klonopin because in his experience, people are more likely to have difficulty with withdrawal, so he monitors its use especially closely and tries to avoid regular use of Xanax in the first place.
He told me all of this from day one, so I can hardly call him irresponsible, even if I do wind up having problems should I decide to go off these meds.
Posted by maxx44 on December 7, 2003, at 2:03:01
In reply to Re: A Balanced Alternative View of Xanax » maxx44, posted by Viridis on December 7, 2003, at 1:46:36
no arguement here---good dr., if you look carefully at your prior posts you'll notice how anyone may have been confused. this, for me, is you're 1st--'just plain makes sense post'. thank you.
Posted by AnneL on December 7, 2003, at 15:25:54
In reply to Re: A Balanced Alternative View of Xanax, posted by maxx44 on December 7, 2003, at 2:03:01
> no arguement here---good dr.,
"if you look carefully at your prior posts you'll notice how anyone may have been confused".
Maxx -
Please do not generalize or make statements that are global in an attempt to back up your argument.
I have been following your multiple postings regarding Xanax, et al., and your disagreement with Viridis. I for one am not confused over anything concerning the statements made by Viridis
regarding the use of Xanax/Klonopin. This is truly a decision best made between doctor and patient. I understand that your experience has made you jaded toward benzos. Please let others express their own opinions and experiences. We can only truly learn through our own experiences.
Best wishes to you. . . Anne :)
Posted by maxx44 on December 7, 2003, at 16:32:33
In reply to Re: A Balanced Alternative View of Xanax » maxx44, posted by AnneL on December 7, 2003, at 15:25:54
you mistake my intent, perhaps---long-term studies clearly show Any long-term user will suffer horrific withdrawal if not tapered. you may note 'lethality possibility upon sudden cessation', as now warned in the lit. only those millions who have 'experienced' the event are qualified to report back on it. no generalization at all. this drug family is like no other. my intent is to protect naive users, and based on fact and experience. search the net. see for yourself. i've indicated the value of benzos both for short medical procedures (colonoscopy), and very infrequent anxiety use, or for daily use by 'terminal' patients, or those with rare internal damage. if i seem strident, well, maybe.
but consider this---now any dr. scripting benzos daily, long-term? unless they are doing so for the aforementioned reasons, if caught, they will lose their liscense to practice. why? regards
Posted by camel on December 7, 2003, at 19:13:44
In reply to Re: starting effexor... keep posting.. success/dosage?, posted by maxx44 on December 6, 2003, at 23:24:29
Maxx...I can tell you I am NOT manic. Your assumption that because we are having positive results from Effexor relates to mania is a little presumptuous. As we ALL know...each person reacts differently to each med. Please don't catagorize us because we are having success. I am starting to think your posts are just a little bit of a downer! I am not belittling your experiences only that you seem to dwell on the negative.
Posted by maxx44 on December 7, 2003, at 20:00:50
In reply to Re: starting effexor... keep posting.. success/dos, posted by camel on December 7, 2003, at 19:13:44
what you read is your choice, sir. correct? i looked at the one you refer to. i made no assumptions---rather, i said i was 'wondering'---hardly an assumption. an area of inquiry. i would encourage anyone to avoid unfounded negatives. on the other hand, being a floridian, and knowing alligators from youth, i would advise anyone not to walk their dog near a lake at night. that may appear negative, but is actually positive, helpfull observation based on experience. i would say if my posts effect your affect negatively--change the channel. right?
Posted by camel on December 7, 2003, at 20:07:45
In reply to Re: starting effexor... keep posting.. success/dos, posted by maxx44 on December 7, 2003, at 20:00:50
First of all Maxx...as for your "assuming"...I am NOT a man..I am a full blooded AMERICAN woman...so I guess you did make an assumption. As for changing the channel...seems to me when you recieve negative feedback from your posts you immediately go on the offensive.....hence one poster has already been blocked for 6 weeks.....maybe you should consider being a little less combative and a little more helpful and supportive. Or as you so aptly put it...change the channel!
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