Psycho-Babble Medication Thread 127923

Shown: posts 1 to 18 of 18. This is the beginning of the thread.

 

Alcohol substitute - what's best?

Posted by hok on November 16, 2002, at 12:09:38

I'm hoping to start a forum for all those who self-medicate for anxiety with alcohol....

What anti-anxiety med helps best mimic alcohol? Moderate drinking seems to be the only thing that really works for me in calming me down in social situations. I've tried most of the neuroleptics and beta-blockers as well as neurontin, but they aren't nearly as effective. Would love to know what other people's favorite anti-anxiety drugs are and why.

Considering that GABA, glutamate, and NMDA are all involved in the depressive effects of ethyl alcohol, I'm assuming an ideal drug candidate would have all the same properties.

I've never tried klonopin or ativan. How do these stack up against xanax, the beta-blockers, or neurontin?

Any input would be greatly appreciated.

 

Re: Alcohol substitute - what's best?

Posted by Mats on November 16, 2002, at 14:27:54

In reply to Alcohol substitute - what's best?, posted by hok on November 16, 2002, at 12:09:38

You never tried a SSRI? I am on 137 mg Zoloft and my social inhibitation just is melting away! Its a high dose but this is my third trail.

Behind alot of alcohol abuse, theres a depression.
For temporary relief from panic attacks, theres always xanax.

 

Re: Alcohol substitute - what's best? » hok

Posted by oldhand on November 16, 2002, at 18:11:05

In reply to Alcohol substitute - what's best?, posted by hok on November 16, 2002, at 12:09:38

(I am not proud to say) I have been using alcohol for years. Think it started as social and went from there to self-medicating for depression. After seven years of treatment for depression with practically every medication known to mankind I begin to think that the failure of the meds is due to my continued use of the alcohol over the course of treatment. A recent trial of Effexor proved so bad I had to be weaned off but during that time I did not feel at all like drinking. Whether this was due to the psychotropic action of the drug or due to the fact that it made me feel so crappy, not eating, anxious, electric, itchy, sleepless, headachey, etc., I do not know.
I have been weaning off of Effexor (withdrawal worse than heroin) and on Lexapro now for five days. Don't feel much like drinking but I would say to you to use the product that is least addictive to you. If that is alcohol for your anxiety, so be it. If it is one of the drugs, so be it. And well, as always talk to ur doc.

 

Re: Alcohol substitute - clarification

Posted by hok on November 16, 2002, at 18:33:26

In reply to Re: Alcohol substitute - what's best? » hok, posted by oldhand on November 16, 2002, at 18:11:05

I'm sorry, perhaps I should've clarified. I take 10mg of Lexapro daily for atypical depression. Unfortunately, anxiety is still a big problem. In fact, I have always registered more anxiety/excitation on the SSRIs than when I'm not taking them. A lot of atypical depressives tend to feel this way supposedly.

Celexa was better for me in terms of anxiety than Lexapro, but the daytime sleepiness is much less on Lexapro. So I'm sticking with it for now.

Anyway, back to the alcohol issue. I'm not really a heavy drinker and I think I'm no where near the boundary of alcoholism. However, I do realize that having a couple of drinks is my best weapon to fight anxiety in social situations. This is usually not a big deal considering I do most of my socializing in bars and the like.

I guess my question is that, for those that do enjoy drinking as an anxiety crutch socially, what anti-anxiety drug do they feel accomplishes the same calmness without too much sedation and numbing. I find alcohol is great because unlike a lot of the neuroleptics, it doesn't make me zoned out and withdrawn. And more specifically, I was hopefully looking for some of our resident neuroscience experts to chime in about which drugs are chemically similar to alcohol in their effects.

Hope this speaks to more of what I was thinking.

 

Re: Alcohol substitute - what's best? » hok

Posted by BrittPark on November 16, 2002, at 18:34:06

In reply to Alcohol substitute - what's best?, posted by hok on November 16, 2002, at 12:09:38

How much are you drinking? If it's no more than 2 drinks a day (if you're a man) or 1 drink a day (if you're a woman), then if the alcohol works for you there's no reason to stop. From the cardiovascular point of view 2/1 drink(s) a day is considered optimal. If you're drinking more than that you probably should be considering another drug for your anxiety.

The best drugs purely for anxiety are the benzodiazepines. They are safe, unlikely to lead to dose escalation, and are suitable for long term treatment of anxiety disorders. You will find a good many "benzophobic" doctors out there, who will not prescribe benzos especially if you've been "abusing" alcohol.

The other common pharmacological treatment for anxiety is an antidepressant. Antidepressants don't work immediately but they do work for most people.

Outside of benzos and antidepressants there are atypical antipsychotics like zyprexa, risperdal and others which are anxiolytic in some people.

Finally there is psychotherapy particularly cognitive behavioral therapy that many people find helpful.

Now as to what drugs are most like alcohol in there subjective effect I'd have to say opioids. There's a lot of evidence that part of the "high" people get from alcohol is mediated by the opiate receptor system. There are very few doctors who would prescribe opioids for anxiety, however.

Feel better,

Britt

 

Re: Alcohol substitute - what's best?

Posted by dreamerz on November 16, 2002, at 18:57:39

In reply to Re: Alcohol substitute - what's best? » hok, posted by BrittPark on November 16, 2002, at 18:34:06


Effexor stopped my drinking straight away (heavy drinker for about 13 years), started on 75mg...now 225 been on it 4 years
Had very little craving..just a couple of binges..
Hope you find something that works for you.

 

Re: Alcohol substitute - what's best?

Posted by utopizen on November 16, 2002, at 18:57:58

In reply to Re: Alcohol substitute - what's best? » hok, posted by BrittPark on November 16, 2002, at 18:34:06

Um, can someone explain to me why it's easier to get alcohol than Klonopin? Um, or at least pretend to explain to me we live in a reasonable society that doesn't make it hard for mature adults to avoid alcohol with benzo treatments?

I've been trying out meds for a year now, now two 1/2 months of Effexor 225mg, no side effects, nothing, just nothing. I give up, I just want Klonopin, but I also know that would require getting a new doc, and I feel like I've put too much time into my current doc to switch. I will probably just keeping upping the dose and combining it, but I know it won't work, it's just not going to work. Social anxiety just doesn't work on these things, those who claim it does probably forget that we're only really anxious at certain triggers, and eventually you will be triggered at a point that will remind you the drug hasn't stopped you from getting triggered all of a sudden...

I really just give up. Why do I continue taking Effexor when I know it doesn't work??

 

Re: Alcohol substitute - what's best? » utopizen

Posted by BrittPark on November 16, 2002, at 19:16:05

In reply to Re: Alcohol substitute - what's best?, posted by utopizen on November 16, 2002, at 18:57:58

I can't agree with you more. Benzos should be OTC. (Then I think most drugs should be over the counter. I'm sick of the AMA's monopoly on medication dispensation. Perhaps some examination or examinations should be required in order to self prescribe.) Benzos are healthier than excessive alcohol, not to mention more effective.

I'm sorry the effexor isn't working for you. It seems to me that you should find a better psychiatrist meaning one who is willing to prescribe benzos. Of course that means the Catch 22 of drug seeking behavior. It's probably worth the effort though.

Feel better,

Britt

 

Re: Alcohol substitute - what's best?

Posted by utopizen on November 16, 2002, at 23:37:31

In reply to Re: Alcohol substitute - what's best? » utopizen, posted by BrittPark on November 16, 2002, at 19:16:05


> I'm sorry the effexor isn't working for you. It seems to me that you should find a better psychiatrist meaning one who is willing to prescribe benzos. Of course that means the Catch 22 of drug seeking behavior. It's probably worth the effort though.
>

It's actually more convenient for me to switch docs. I go to a college with an infirmary, and it has p-docs I could go to without as much as a $5 co-pay. But I've been seeing this guy I walk 30 minutes from campus to each time.

My campus dermatologist told me if I wanted a benzo I should just see one of the p-docs here. I asked him because the room he saw me in had a posting with all of the benzo names on it (sweetness!) (it's a room other docs share with him).

Heh. I wish I already went to a doc that's office had a posting of all the benzo names. That's not even useful, lol

 

Re: Alcohol substitute - what's best?

Posted by FredPotter on November 17, 2002, at 23:31:19

In reply to Re: Alcohol substitute - what's best?, posted by utopizen on November 16, 2002, at 23:37:31

I feel at home here. I nearly died a year ago after decades of self-medicating with alcohol. I discovered panic would magically disappear after a glass of brandy (that was when I was young - it took a lot more when I was older). Eventually, decades later, things got worse and my health suffered from all the alcohol.

Now I don't drink at all. I take Antabuse every morning so I can't use drink. It's so very tempting when God-awful, end-of-the-world-terror- of-nothing takes over that I take away that choice. The funny thing is that I rarely feel that bad these days. I take antidepressants, lithium, fish-oil and I have a kind Dr who prescribes me Xanax despite the pressure put on him not to (here in New Zealand it's like that).
When I was in hospital a year ago they stopped the Xanax more or less cold-turkey. This as well as suddenly stopping drinking led to a seizure and a couple of days unconsciousness. It was all so misguided: my behaviour and theirs.

However I have to say that even though I'm grateful for the ability to have Xanax in my pocket at all times, it doesn't really work. It takes about 1.5 mg to have any anxiolytic effect and that probably wouldn't be enough for a big freak-out. I mostly content myself with knowing that time passes and I eventually get over it. For fun I study Zen and meditate, enjoy Nature, reading, music and hey - I smoke my pipe. Nothing works like alcohol it seems. I really miss it. There are of course several potential substitutes. I've tried kava, but that doesn't do much for me, if anything. The other stuff like GHB or opiates well I wouldn't have the courage.

I admire your honesty Hok for starting this thread. Keep it going

Fred

 

Re: Alcohol substitute - what's best?

Posted by oracle on November 18, 2002, at 0:22:28

In reply to Re: Alcohol substitute - what's best?, posted by utopizen on November 16, 2002, at 18:57:58

> Um, can someone explain to me why it's easier to get alcohol than Klonopin? Um, or at least pretend to explain to me we live in a reasonable society that doesn't make it hard for mature adults to avoid alcohol with benzo treatments?

There is no good reason. Alcohol kills lots of people and destroys lives.

I think the main reason is Alcohol is a big industry.

 

Re: Alcohol substitute - what's best? » oracle

Posted by Alara on November 18, 2002, at 18:39:31

In reply to Re: Alcohol substitute - what's best?, posted by oracle on November 18, 2002, at 0:22:28

> > Um, can someone explain to me why it's easier to get alcohol than Klonopin? Um, or at least pretend to explain to me we live in a reasonable society that doesn't make it hard for mature adults to avoid alcohol with benzo treatments?
>
>
Oracle, I am with you on this one! I have self-medicated my anxiety with alcohol for years and am only now starting to break free of my addiction. Thankfully, I found a doctor about a month ago who made the good decision to prescribe some Xanax. Being only too aware of the dangers of tolerance and addiction, I use it sparingly to promote a much needed good night's sleep (such as the night before a job interview) or to stop myself from a drinking binge after a stressful day.

Alcohol is so easy to obtain that even kids can get it! (Big brother or sister needs no script.) Statistics show that one in ten people have a problem with drinking. Alcoholism is the third leading cause of death in the US.. Yet often people with common anxiety problems have no other readily available medications.

I can understand why medical authorities around the world have put strict controls on the dispensation of benzodiazapines: Benzos are widely abused and are sought after by suicidal women. (Men jump off bridges or shoot themselves; women take pills.) Sure, some control is needed. But I believe that majority of doctors have been miseducated about benzo abuse. I know somebody who died from drinking a bottle of methylated spirits after a GP refused to prescribe him something for a series of panic attacks!

Is the alcohol industry really contributing so much to the world economy at large that we want to see one in ten people develop alcohol problems after obtaining booze without a prescription? Obviously there are no clear-cut solutions but I do believe that some improvements can be made. For example, what about introducing legislation to include compulsory warnings like "Alcohol Kills" on alcohol packaging? In Australia, tobacco manufacturers must write "Smoking Kills" on all cigarette packets. And what about the idea of partial prohibition? If we, as a society, could come up with a way of making alcohol more difficult to buy, alcoholism rates would decline. Anyone have any thoughts on that one?

How about forcing pharmaceutical companies to manufacture and market benzos in smaller quantities? Measures like this could ease the minds of many GPs who are reluctant to prescribe benzos for fear of abuse. (I do not see that this would be a problem so long as scripts are not written in high-turnover medical centres.)

My last point concerns mental health education. (Sorry, I'm just venting here!) Anxiety is a very real health concern for many people and yet few of us really know what to do about it. Society encourages us to mask the symptoms by either guzzling the booze or by swallowing a few shameful pills in secret. Until now, I (as an anxiety sufferer) underestimated the value of cognitive-behavioural techniques. Thankfully I have come to my senses and (like Fred) am taking a more holistic approach to my mental health (meditation etc). This makes me far less dependent upon `medication', which is now taking a back seat in my recovery. It has taken me many years to get here because society favours the quick fix.

Oracle, I have gone off on many tangents here, but I guess the answer to your question is three-tiered: Legislation - Society's Attitudes - Doctor/Patient Education.

Vent over! :-)

Alara

 

Re: Alcohol substitute - what's best?

Posted by utopizen on November 18, 2002, at 19:24:44

In reply to Re: Alcohol substitute - what's best? » oracle, posted by Alara on November 18, 2002, at 18:39:31

On my dorm's hallway, there's a sign that says "drinking alcohol to avoid anxiety is the first sign of alcoholism."

I'm reading that a year after seeking treatment for my anxiety, so it's obvious to my now. But I wish someone posted that in my high school or something, before I started messing around with alcohol. Sadly, after the dozens of organized and well-funded lectures my high school had for alcohol prevention, not a single time was the word "psychiatrist", "psychologist", "depression", "mental health", or "anxiety" ever mentioned.

And this comes from one of the three high schools in the country to participate in the "controversial" National Depression Screening Day in 2000! (Controversial because the scientologists tried to get people into the idea that it was to promote Prozac, when it wasn't, and that talking about depression spurs sucidal idealation, which it also doesn't).

So even though it was forward-thinking with mental health, it never connected the two-- substance abuse and mental health. Sad.

 

Re: Alcohol substitute - what's best? » hok

Posted by Dinah on November 18, 2002, at 20:54:44

In reply to Alcohol substitute - what's best?, posted by hok on November 16, 2002, at 12:09:38

I really hate to say this, because it sounds pro-alchohol or something. But I haven't found anything that adequately substitutes for alchohol. I rarely drink, but I find that one drink works for me in certain conditions in a way that klonopin can't. Alchohol calms severe agitation far better than klonopin. I'm waiting for my next agitated episode to try Risperdal for it. That may work better. I know that's just me and that it actually causes agitation in some of my relatives.

In fact, it works so well that I tried to abstain, because I come from a family history of alchoholism.

 

Re: Alcohol substitute - what's best?

Posted by FredPotter on November 18, 2002, at 21:06:50

In reply to Re: Alcohol substitute - what's best? » hok, posted by Dinah on November 18, 2002, at 20:54:44

Yes Dinah I agree. There's nothing like alcohol for calming anxiety. AND it's fun too! Unfortunately it nearly killed me so now I no longer have my friend to fall back on. I think it's true that using alcohol to calm nerves is the first sign of alcoholism. If we define alcoholism as being dependent on alcohol and given that many have constant anxiety problems, this is to be expected. The problem is, eventually health, your Dr, friends and family will probably force abstinence and then there's nothing. Xanax is almost nothing for me.

 

Re: Alcohol substitute - what's best?

Posted by jonh kimble on November 19, 2002, at 1:49:33

In reply to Re: Alcohol substitute - what's best?, posted by FredPotter on November 18, 2002, at 21:06:50

I think klono has the most effect on nmda receptor of the benzos, but I could be wrong. All the mood stabilizers are also nmda antagonists, arent they? Maybe thats why alcohol brings (at least me) to a stable level. If Im suicididal because I cant find my jacket, alcohol kinda slaps me in the face and I realize, wait a minute, this aint so bad.

Sorry, Ill be quick, but Does anyone have any idea what this could be? I missed a homework assignment today and I seriously thought my life was over. Im better now but this kind of thing happens ALL the time! I hate it and its also quite dangerous, I think I might hurt myself sooner or later. Thanks

 

Re: Alcohol substitute - what's best? » jonh kimble

Posted by JonW on November 19, 2002, at 4:20:48

In reply to Re: Alcohol substitute - what's best?, posted by jonh kimble on November 19, 2002, at 1:49:33

> Sorry, Ill be quick, but Does anyone have any idea what this could be? I missed a homework assignment today and I seriously thought my life was over. Im better now but this kind of thing happens ALL the time! I hate it and its also quite dangerous, I think I might hurt myself sooner or later. Thanks

How often do you drink large amounts? I mean, even if it gets you high while drinking or the day after (ironically), do you get repercussions a day or two down the road? I know that's how it was for me. You might want to keep a mood log and compare to your alcohol use. My moods would go up and down, but it seemed to be worth it for the good times. Sometimes it's hard to realize the cure is the disease. It sounds to me like you are self-medicating and it should be easier to control your drinking once you get your life under control -- meds and otherwise. Just a thought...

Jon

 

Re: Alcohol substitute - what's best? » JonW

Posted by oldhand on November 19, 2002, at 5:12:31

In reply to Re: Alcohol substitute - what's best? » jonh kimble, posted by JonW on November 19, 2002, at 4:20:48

What wonderful ideas going around here. I too have abused alcohol for many years. To the person who has one drink and it works for them, more power to you! In my case social drinking led to tolerance and abuse and I am of the opinion that alcoholism is progressive and for me came after abuse. Since I am a former herion addict the docs will not give me anything even remotely addicting and I have to admit I do like it when the dentist slips up and prescribes Tylenol 3 or vicadin :)
I feel frotunate to have experienced only three or four anxiety attacks in association with the depression and sympathsize with those who cannot get the meds they need to deal with them.
Keep uo the good fight all.........


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