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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Caleb462 on February 18, 2003, at 23:52:35
After a two-month trial on Risperdal, and a raised dose of Effexor, with no decrease in my anxiety level, I decided I needed to be put on a benzo. Klonopin, to be specific. I wasn't going to say this outright, I was hoping I'd be able to slide it in at some point during the appt. The oppurtunity never came, so I just said "I've been reading a lot about Klonopin, and was thinking maybe it would be a good drug for my anxiety."
His response: "Klonopin is an addictive drug. I don't like to prescribe to benzos to anyone, especially not to someone like you, who has used substances in the past."
I had figured this guy to be a reasonable, open-minded doctor, but apparently not. I have been on Zoloft, Paxil, Celexa, and now Effexor XR and Risperdal. My diagnosis is GAD/OCD/Depression/Mild Social Phobia. The depression is mostly under control, and I'm able to manage the OCD fairly well, but I'm as anxious as I've ever been, if not more. But is he interested in giving me the most effective treatment? No, instead he wants me to take more Risperdal and is giving me a freaking anti-histamine to take "as needed" for anxiety. Blah, whatever, I need a new doc (again).
Posted by utopizen on February 19, 2003, at 0:03:54
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
> After a two-month trial on Risperdal, and a raised dose of Effexor, with no decrease in my anxiety level, I decided I needed to be put on a benzo. Klonopin, to be specific. I wasn't going to say this outright, I was hoping I'd be able to slide it in at some point during the appt. The oppurtunity never came, so I just said "I've been reading a lot about Klonopin, and was thinking maybe it would be a good drug for my anxiety."
>
> His response: "Klonopin is an addictive drug. I don't like to prescribe to benzos to anyone, especially not to someone like you, who has used substances in the past."
>
> I had figured this guy to be a reasonable, open-minded doctor, but apparently not. I have been on Zoloft, Paxil, Celexa, and now Effexor XR and Risperdal. My diagnosis is GAD/OCD/Depression/Mild Social Phobia. The depression is mostly under control, and I'm able to manage the OCD fairly well, but I'm as anxious as I've ever been, if not more. But is he interested in giving me the most effective treatment? No, instead he wants me to take more Risperdal and is giving me a freaking anti-histamine to take "as needed" for anxiety. Blah, whatever, I need a new doc (again).
>>>>I've taken that Atarax antihistamine- it's a joke. It gave me nightmares anyway. I've tried Effexor at high doses, buspar made me anxious as heck, wellbutrin was a placebo for me, so was celexa. I'm on a trial of Abilify at 7.5mg, it's an antipsychotic. I've got ADD and Social Phobia, both untreated totally. I've tried Desoxyn, Ritalin, Dexedrine, Adderall. I'm on Adderall, even though it gives me the worst anxiety out of them all. Doc doesn't want to change two meds at once during my Abilify trial.
Great. Day 12 on Abilify, and no difference in anything. Great, doc. I'm crying myself to sleep right now. I'm afraid of things I couldn't describe to myself. I'm scared of my life right now. Going to class is a nightmare. Or my life is dull and boring. Or the drug is making me so tired, I sleep in and almost fail my class. Or what. Or I could be treated with Klonopin.... but that's addictive.
Posted by viridis on February 19, 2003, at 2:57:17
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
You just have the wrong doctor (wrong for you, and wrong in terms of his attitude). Keep searching, and you'll find the right one. It's really unfortunate that you have to go through all of this, but it will resolve if you're persistent.
Posted by linkadge on February 19, 2003, at 9:59:26
In reply to Re: My psychiatrist decided to let me suffer » Caleb462, posted by viridis on February 19, 2003, at 2:57:17
What you really need to find is a doc
that has a psychiatric problem themselves.
They listen and know the extent of
psychiatric suffering. Just like if you
walked in with a passing kidney stone
- 'morphine is addictive, here try some
tylenol'.Linkadge
Posted by fachad on February 19, 2003, at 13:33:01
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
There is lots of this stuff all over the place, I suggest you do a search in google, but here is a nice document:
http://www.abainternational.org/sub/membersvcs/journals-pubs/rtrrebt/index.asp
The whole document is posted at the above link, here are a few excerpts that seem appropriate to your situation. Point 6 is copied in full, as it specifically addresses your concern.
Key Points:
1. An Individual Has a Right to a Therapeutic Environment
2. An Individual Has a Right to Services Whose Overriding Goal is Personal Welfare
3. An Individual Has a Right to Treatment by a Competent Behavior Analyst
4. An Individual Has a Right to Programs That Teach Functional Skills
5. An Individual Has a Right to Behavioral Assessment and Ongoing Evaluation
6. An Individual Has a Right to the Most Effective Treatment Procedures Available
An individual is entitled to effective and scientifically validated treatment. In turn, behavior analysts have an obligation to use only those techniques that have been demonstrated by researchers to be effective, to acquaint consumers and the public with the advantages and disadvantages of these techniques, and to search continuously for the most optimal means of changing behavior.
Consistent with the philosophy of least restrictive yet effective treatment, exposure of an individual to restrictive procedures is unacceptable unless it can be shown that such procedures are necessary to produce safe and clinically significant behavior change. It is equally unacceptable to expose an individual to a nonrestrictive intervention (or a series of such interventions) if assessment results or available research indicate that other procedures would be more effective. Indeed, a slow-acting but nonrestrictive procedures could be considered highly restrictive if prolonged treatment increases risk, significantly inhibits or prevents participation in needed training programs, delays entry into a more optimal social or living environment, or leads to adaptation and the eventual and the eventual use of a more restrictive procedure. Thus, in some cases, a client's right to effective treatment may dictate the immediate use of quicker-acting, but temporarily more restrictive procedures.
A procedure's overall level of restrictiveness is a combined function of its absolute level of restrictiveness, the amount of time required to produce a clinically acceptable outcome, and the consequences associated with delayed intervention. Furthermore, selection of a specific treatment technique is not based on personal conviction. Techniques are not considered as either "good" or "bad" according to whether they involve the use of antecedent rather than consequent stimuli or reinforcement rather than punishment. For example, positive reinforcement, as well as punishment, can produce a number of indirect effects, some of which are undesirable.
In summary, decisions related to treatment selection are based on information obtained during assessment about the behavior, the risk it poses, and its controlling variables; on a careful consideration of the available treatment options, including their relative effectiveness, risks, restrictiveness, and potential side effects; and on examination of the overall context in which treatment will be applied.
> After a two-month trial on Risperdal, and a raised dose of Effexor, with no decrease in my anxiety level, I decided I needed to be put on a benzo. Klonopin, to be specific. I wasn't going to say this outright, I was hoping I'd be able to slide it in at some point during the appt. The oppurtunity never came, so I just said "I've been reading a lot about Klonopin, and was thinking maybe it would be a good drug for my anxiety."
>
> His response: "Klonopin is an addictive drug. I don't like to prescribe to benzos to anyone, especially not to someone like you, who has used substances in the past."
>
> I had figured this guy to be a reasonable, open-minded doctor, but apparently not. I have been on Zoloft, Paxil, Celexa, and now Effexor XR and Risperdal. My diagnosis is GAD/OCD/Depression/Mild Social Phobia. The depression is mostly under control, and I'm able to manage the OCD fairly well, but I'm as anxious as I've ever been, if not more. But is he interested in giving me the most effective treatment? No, instead he wants me to take more Risperdal and is giving me a freaking anti-histamine to take "as needed" for anxiety. Blah, whatever, I need a new doc (again).
Posted by djmmm on February 19, 2003, at 14:57:24
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
Your doc could easily give you a script for Klonopin, even when there is a past history of drug abuse.
In certain situations, benzo scripts are written with very specific instructions e.g. NO refills, and giving only a 30 day supply...Even if the prescription includes refills, the doc can request that the med not be refilled before a certain date.
A competent doc has to realize that there are certainly some circumstances when a benzo is needed...to say that "I don't prescribe benzos to anyone" seems a little irresponsible, if not unethical.
Posted by jesus on February 19, 2003, at 15:54:22
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
im sorry to hear that you weren't able to get the klonopin you wanted..but from my understanding of medical practice, giving out controlled substance scripts to patients with a significant history of abuse is a big time no-no. I doubt hardly any pdoc would write you a script for a benzo if your abuse record is bad,...but maybe I'm way off.
Posted by jennygump on February 19, 2003, at 18:45:40
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
klonopin is wildly addictive and should not be taken by people with past drug abuse history...that's my experience.
in the past, i have taken low doses of neurontin for anxiety and had great relief without the abuse potential of benzos.
something to consider.
good luck
Posted by ace on February 19, 2003, at 20:21:08
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
> After a two-month trial on Risperdal, and a raised dose of Effexor, with no decrease in my anxiety level, I decided I needed to be put on a benzo. Klonopin, to be specific. I wasn't going to say this outright, I was hoping I'd be able to slide it in at some point during the appt. The oppurtunity never came, so I just said "I've been reading a lot about Klonopin, and was thinking maybe it would be a good drug for my anxiety."
>
> His response: "Klonopin is an addictive drug. I don't like to prescribe to benzos to anyone, especially not to someone like you, who has used substances in the past."
>
> I had figured this guy to be a reasonable, open-minded doctor, but apparently not. I have been on Zoloft, Paxil, Celexa, and now Effexor XR and Risperdal. My diagnosis is GAD/OCD/Depression/Mild Social Phobia. The depression is mostly under control, and I'm able to manage the OCD fairly well, but I'm as anxious as I've ever been, if not more. But is he interested in giving me the most effective treatment? No, instead he wants me to take more Risperdal and is giving me a freaking anti-histamine to take "as needed" for anxiety. Blah, whatever, I need a new doc (again).This doesn't suprise me. See a family doctor. They can prescribe all the pills, and have done some training in psych. If you learn heaps yourself you can diagnosis your self. Psychiatrists are poor, except a few.
BTW, were you on Risperidone for OCD? What has helped your OCD most?
Posted by sienna on February 19, 2003, at 20:47:56
In reply to My psychiatrist decided to let me suffer, posted by Caleb462 on February 18, 2003, at 23:52:35
Atarax has worked for me in the past for anxiety. I have a few different drugs that i use for anxiety, but i find that Atarax works pretty well when i need something to work fairly quickly. (around 15minutes) It is an antihistamine but is prescribed for anxiety. I use it to fly sometimes too.
Have you tried any of these drugs for anxiety? The main reason that I use Atarax instead of benzos sometimes is because i am afraid of being benzo dependent. I do have them prescribed to me, but find that often Atarax works just fine.
Sienna
Posted by sienna on February 19, 2003, at 20:52:33
In reply to Re: My psychiatrist decided to let me suffer, posted by sienna on February 19, 2003, at 20:47:56
Also, as I have helped a friend through the most horrific addiction experience i have ever seen or could ever even imagine when she was addicted to Xanax, I can say that if you think theres even a tiny chance that you are going to have a problem, I would try some of the other drugs that are used to treat anxiety. Benzo withdrawal can be deadly.
That said, I believe that you will be able to find someone to write you a script for klonopin. If that is what you think will help.
Sienna
Posted by judy1 on February 23, 2003, at 17:07:27
In reply to Regular docs just don't understand anxiety, posted by linkadge on February 19, 2003, at 9:59:26
wow, is that ever the truth. my shrink (who also suffers from panic disorder) has never hesitated to prescribe benzos for me despite a history of drug abuse- which is just another way to say 'self-medicating'. take care- judy
This is the end of the thread.
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