![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 73. This is the beginning of the thread.
Posted by detroitpistons on January 3, 2006, at 15:21:05
I've been thinking about starting Klonopin, but I just wanted some feedback from other benzo users. I take small amounts of Xanax and I can feel better by taking as little as .25mg. However, it can make me depressed and lethargic.
I'm on Effexor XR 225 mg, and it has not totally relieved me of anxiety, although it picked me up out of a depressive episode. I'm familiar with the pro-benzo vs anti-benzo debate. I guess what I'm trying to get at is this: How bad does anxiety have to be in order to justify taking a benzo? I realize this is a very difficult question to answer, but I just wanted to hear some other people's thoughts.
I can generally function without a benzo (or even an AD for that matter)...I can leave the house, go to work, be in social settings with people I don't know (although rarely comfortably). In short, I can get along with life, but I never feel quite right. I feel like everything is forced. I feel like I'm operating at 75%. I probably wouldn't regard my anxiety as severe (not agoraphobic, for example), but I do think it interferes with my life and prevents me from being all I can be.
Where is the line? When is taking a benzo justified? I've always been scared to overmedicate myself. In fact, it took me a good amount of pain and suffering before I broke down and tried an AD. I've never liked the idea of taking 1 psych drug, much less 2 or 3. Sometimes I feel like I'm "cheating," like the only people who should really be on meds are the ones who can't get out of bed in the morning, can't leave the house, can't go to work, etc.
Can anyone relate to this sort of "psych med reckoning" I'm going through?
And back to the original point, any thoughts from benzo/Klonopin users? The first and only psych med I took that worked was Effexor, and it seemed like a godsend at the time (for both anxiety and depression). Now I tried it again, and it just doesn't seem to be working as well on the anxiety. I think my condition(s) may have worsened over the past couple of years, and quite frankly, it feels like the meds may have contributed to that (e.g. caused a permanent change in brain chemistry--which I know sounds very paranoid).
Any thoughts?
Posted by MGOLDW on January 3, 2006, at 17:23:45
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
Hi! Great question. I take Lexapro 10mg and have been faced with the same questions as you. I am going through a difficult time and my anxiety level is high enough to make me very uncomfortable but not high enough so that I cannot function. I can find relief with as little as .125mg of Xanax, but I hate to take it for the same reasons that you explained in your post. Are we suffering for no reason, are we right in not taking a Benzo unless we cannnot longer function?
I hope somebody has an answer.
Good luck.
Posted by Phillipa on January 3, 2006, at 18:28:18
In reply to Re: When are benzos justified?, posted by MGOLDW on January 3, 2006, at 17:23:45
Have you considered theraphy for the rest. That's great how well you both are functioning now. Or sxcercise? Fondly, Phillipa
Posted by kerria on January 3, 2006, at 20:02:56
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
Hi. i have taken Klonopin but now i take diazapam. My justification=
Benzos / any med doesn't do a whole lot - it's not doing much to make things easier anyways. It's still mostly just us:(
take care,
kerria
Posted by Glydin on January 3, 2006, at 22:03:41
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
I was on Klonopin as my only med for three years. Now, I'm on Lexapro and use Klonopin as needed which is not very often. But, Klonopin has been a true trusted friend for me.
As to your question on justification..... I had a very smart person tell me something that has stuck with me when considering the use of chemical interventions for my mood disorder. It goes like this:
We have a finite number of days on this earth. We have some choices in how we want to live them. We can be proactive in trying obtaining the best quality of life possible or we can make the choice to accept things as they are.
Personally, I believe a measure of contentment of life makes for a good quality life. The ability to function is very important but one can be functional and still be in a miserable state.
Benzo's can be tricky and one does need to be careful and avoid pitfalls. Yes, I'm a well-worn veteran of the "benzo wars" but I'm happy to say I used them approiately for quite a while and I was not a benzo "casuality" (in a manner of speech).
For me, head meds made the difference between the "plugging along" survival mode and a "contented and comfortable" enjoyment of my life. Good treatment for mind issues can be elusive but there are successes and if you believe your life would be improved by the addition of a benzo - well, you won't know unless you try.
Good Luck to you....
Posted by 4WD on January 3, 2006, at 22:13:50
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
> I've been thinking about starting Klonopin, but I just wanted some feedback from other benzo users. I take small amounts of Xanax and I can feel better by taking as little as .25mg. However, it can make me depressed and lethargic.
>
> I'm on Effexor XR 225 mg, and it has not totally relieved me of anxiety, although it picked me up out of a depressive episode. I'm familiar with the pro-benzo vs anti-benzo debate. I guess what I'm trying to get at is this: How bad does anxiety have to be in order to justify taking a benzo? I realize this is a very difficult question to answer, but I just wanted to hear some other people's thoughts.
>
> I can generally function without a benzo (or even an AD for that matter)...I can leave the house, go to work, be in social settings with people I don't know (although rarely comfortably). In short, I can get along with life, but I never feel quite right. I feel like everything is forced. I feel like I'm operating at 75%. I probably wouldn't regard my anxiety as severe (not agoraphobic, for example), but I do think it interferes with my life and prevents me from being all I can be.
>
> Where is the line? When is taking a benzo justified? I've always been scared to overmedicate myself. In fact, it took me a good amount of pain and suffering before I broke down and tried an AD. I've never liked the idea of taking 1 psych drug, much less 2 or 3. Sometimes I feel like I'm "cheating," like the only people who should really be on meds are the ones who can't get out of bed in the morning, can't leave the house, can't go to work, etc.
>
> Can anyone relate to this sort of "psych med reckoning" I'm going through?
>
> And back to the original point, any thoughts from benzo/Klonopin users? The first and only psych med I took that worked was Effexor, and it seemed like a godsend at the time (for both anxiety and depression). Now I tried it again, and it just doesn't seem to be working as well on the anxiety. I think my condition(s) may have worsened over the past couple of years, and quite frankly, it feels like the meds may have contributed to that (e.g. caused a permanent change in brain chemistry--which I know sounds very paranoid).
>
> Any thoughts?
I agree with what Glydin said in her post above.For over a year, I took the absolute minimum of Klonopin to allow me to be partially functional because I was so scared of it. (I was totally nonfunctional). Taking small amounts of Klonopin kept me from crawling in the floor crying and begging God to make the terror stop and allowed me to at least just sit on the couch and cry and fret.
Finally, I surrendered. I now take .5mg of klonopin 3 times a day. It still scares me but you know what? Even though I still have anxiety, I went to work today. I laughed and told jokes. I'm a bit scared right now and could take a bit more klonopin but I'm trying to figure out how much anxiety is tolerable (just like you). I'm even thinking that maybe I ought to go ahead and increase it a bit and NOT HAVE ANXIETY at all. I don't know. I'm still struggling with this same issue.
What I really want is not to take klonopin at all. But not at the price I paid for over a year.
I almost died because I was too stubborn to take the klonopin prescribed for me.Marsha
Posted by detroitpistons on January 3, 2006, at 23:08:38
In reply to Re: When are benzos justified? » detroitpistons, posted by Glydin on January 3, 2006, at 22:03:41
All,
Thank you so much for your responses...They really help. I think Glydin hit the nail on the head. Quality of life is definitely a big part of this issue.
I may be "functional," but sometimes barely so. When I'm in a pretty bad period of depression, I really just want to crawl into a hole, but I keep pushing on, probably because I'm stubborn. Actually, it's probably because I have a fear of "losing it." I have a fear of not being able to PAY THE BILLS, and of just basically alarming everyone around me and disrupting the little bit of normality that I have. I keep up a facade. It's actually pretty ironic...My anxiety can be the cause of my depression and also the reason why I don't completely "lose it." So I keep plodding along. I think I've sort of adapted to living like this.
Today I took Xanax twice (.25mg each time) throughout the day, and it really helped a lot. I felt so much better. I believe my depression is largely anxiety driven. If I can control the anxiety, I may be able to prevent major depressive episodes (and also your basic dysthymia) from happening.
I think I'm going to get my money's worth out of my next pdoc appointment...It's about time.
Thanks again all!!
Posted by nicky847 on January 4, 2006, at 12:05:19
In reply to Re: When are benzos justified?, posted by detroitpistons on January 3, 2006, at 23:08:38
I think everybody's path to healing is different. I don't know how good your p doc is but I've always found that being honest with your doc and trusting him is the best policy. Tell your doc how you are feeling and that you are wrestling with whether or not to use benzos. He'll probably tell you the positives and negatives of using them and help you make an educated decision.
Posted by Cairo on January 4, 2006, at 12:17:27
In reply to Re: When are benzos justified? » detroitpistons, posted by Glydin on January 3, 2006, at 22:03:41
I'm going through the same thing with Klonopin prescribed for panic attacks brought on by taking Topamax. I tried weaning off over the holidays as I don't like the thought of being reliant on a benzo, only to have all my symptoms return full force.
I don't think my fears of taking meds are completely irrational since I have yet to take a med that doesn't give me side effects. I weigh the good versus the bad for each med. I've concluded right now that I need the Klonopin for the time being.
Are we really any different than a diabetic that needs insulin to function? You would never fear taking insulin if you needed it, nor would people stigmatize you for it.
I will continue to search, however, for a med that I can tolerate better, or lower dose combos. And I need to lessen stress where I can.
As Jerry Springer signs off on all his shows: "Be good to yourself...and each other." We shouldn't beat ourselves up about wanting a good quality of life.
Cairo
Posted by yxibow on January 4, 2006, at 16:05:20
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
> I've been thinking about starting Klonopin, but I just wanted some feedback from other benzo users. I take small amounts of Xanax and I can feel better by taking as little as .25mg. However, it can make me depressed and lethargic.
Depression and lethargy are common side effects of all benzodiazepines. Xanax is generally prescribed for more short term anxiety although there are people who have taken your dose for years, it is quite often prescribed for tinnitus.
That you "feel better" is its intention -- Xanax has a more immediate gratification than Klonopin in general.>
> I'm on Effexor XR 225 mg, and it has not totally relieved me of anxiety, although it picked me up out of a depressive episode. I'm familiar with the pro-benzo vs anti-benzo debate.Yes, there are various camps. For me, I believe that if someone is not born with a physical addiction problem, and tapers on and off of them properly, there shouldn't be an issue. They were and still are the safest psychiatric drugs out there.
I guess what I'm trying to get at is this: How bad does anxiety have to be in order to justify taking a benzo? I realize this is a very difficult question to answer, but I just wanted to hear some other people's thoughts.
That's a very individual matter. You can have ****-kicking, crying, awful anxiety. I would say that's a highly likely situation for a benzodiazepine. You can have specific fear situations for PRN (as needed) social anxiety, fear of elevators, airplanes, herds of rhinoceroses [sorry, just thought I'd put some humour in], and you might carry a little Xanax or Valium along.
>
> I can generally function without a benzo (or even an AD for that matter)...I can leave the house, go to work, be in social settings with people I don't know (although rarely comfortably).Sounds fairly "normal" as they say. But normal to one is not normal to another, and I really hate that concept. But you already can leave the house -- no agoraphobia, go to work -- no more anxiety than the next person who is hiding it far too well when their boss yells at them, or be in uncomfortable social situations -- not too high of a social anxiety disorder.
In short, I can get along with life, but I never feel quite right. I feel like everything is forced. I feel like I'm operating at 75%.
We're all operating at 75 or 80%. As they say, if you can get the job done 80% of the time, you're probably doing just fine and if you have a boss otherwise he's anal retentive.
I probably wouldn't regard my anxiety as severe (not agoraphobic, for example), but I do think it interferes with my life and prevents me from being all I can be.
If you do believe though that you have some social anxiety, a small amount of PRN benzodiazepine might be of some benefit. There's no shame in a little help, and it doesn't have the hangover that we all get when we have a drink to basically get over that hump -- that's primarily why people drink in bars.
>
> Where is the line? When is taking a benzo justified? I've always been scared to overmedicate myself. In fact, it took me a good amount of pain and suffering before I broke down and tried an AD. I've never liked the idea of taking 1 psych drug, much less 2 or 3.I've never liked the idea that I have to take medication, but it is a cost-benefit analysis. If your life is such that you feel it is deteriorating in quality, why force yourself to "tough it out" when a medication may bring some hope and promise. Of course, it has to be weighed against side effects. These come with all medicines -- there is nearly no medicine yet that is so clean that it doesnt do anything but what it does (even aspirin.)
Sometimes I feel like I'm "cheating," like the only people who should really be on meds are the ones who can't get out of bed in the morning, can't leave the house, can't go to work, etc.Those are people with severe depression and severe social anxiety, or schizophreniform and bipolar disorders. But there are other equally valid reasons for medications that don't have to be earth shattering.
>
> Can anyone relate to this sort of "psych med reckoning" I'm going through?Yes -- its called ordinary common sense, rationalizing, and what in medical terms is called "informed consent". You are told what a drug does, its side effects, you consider what it could be on it, or not on it, and you make your decisions from there. And they are your decisions and yours only. And nobody can fault you for them. Its your life. Even for the most severe disorders. Although I would say if you are in a state where you are in immediate danger of harming yourself or others, the choice whether to medicate becomes more of a societal decision than purely your own, whether you like that idea or not.
>
> And back to the original point, any thoughts from benzo/Klonopin users? The first and only psych med I took that worked was Effexor, and it seemed like a godsend at the time (for both anxiety and depression). Now I tried it again, and it just doesn't seem to be working as well on the anxiety. I think my condition(s) may have worsened over the past couple of years, and quite frankly, it feels like the meds may have contributed to that (e.g. caused a permanent change in brain chemistry--which I know sounds very paranoid).Its possible that medications may cause a change in brain chemistry but not to be a company shill, a typical drug takes up to 10 years to come to market (save for fast track medications like antivirals and vaccines.) Compounds have to be tested extensively on animals before they are even put inside a human. Then so-called "healthy" people are given them just to see what happens. Then there are stage II and stage III trials involving tens to thousands of people around the world, until finally the FDA approves a medication.
Now, back to the Effexor -- in me personally it would only serve as an antidepressant, and a bad one at that, compared to Cymbalta, in terms of jumpiness. It seems to me that most all SSRIs and SSNRIs either work for depression (mostly) or anxiety (sometimes) but not both, in me.
But as you were saying, you are trying it again.. body chemistry can change in a couple of years -- its not just affected by internal change, but life changes, psychological factors which in turn change the chemistry in your brain. Talk therapy is as much a brain chemistry changer for some conditions as a medication (or in combination).
Hope that helps put things in perspective. And never feel ashamed that you "have" or "need" to take a medication. Many people have to take drugs for a variety of things and the person in the cubicle next to you may be happy go lucky and so cheerful its nauseating but they may have a terminal illness you never heard about.
So, do you take a benzodiazepine or not. Well, sometimes they're prescribed along with SSRIs and SSNRIs/SNRIs (like Effexor) for a period of time until the anxiety mitigating factor of the drug kicks in as well as the antidepressant effects. And sometimes for a whole host of reasons that I mentioned above. To just take one because it well, makes you feel good -- maybe that's justified too. Its all relative.
There's the obvious factor of benzodiazepines that some day one will become acclimatized (used to) one -- it still may not matter, because it still may be providing relief, you just dont feel the "immediate" kick. Some claim they're addictive. I personally call them habituating. That has to be watched too. If you're taking 1mg of Klonopin and suddenly in a few weeks you're up to 10mg, that is a sure sign of habituation (not to mention a strain on the liver).
So, hope that helps
Tidings
Posted by JohnKeats on January 5, 2006, at 12:19:56
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
> I've been thinking about starting Klonopin, but I just wanted some feedback from other benzo users. I take small amounts of Xanax and I can feel better by taking as little as .25mg. However, it can make me depressed and lethargic.
>
> I'm on Effexor XR 225 mg, and it has not totally relieved me of anxiety, although it picked me up out of a depressive episode. I'm familiar with the pro-benzo vs anti-benzo debate. I guess what I'm trying to get at is this: How bad does anxiety have to be in order to justify taking a benzo? I realize this is a very difficult question to answer, but I just wanted to hear some other people's thoughts.
>
> I can generally function without a benzo (or even an AD for that matter)...I can leave the house, go to work, be in social settings with people I don't know (although rarely comfortably). In short, I can get along with life, but I never feel quite right. I feel like everything is forced. I feel like I'm operating at 75%. I probably wouldn't regard my anxiety as severe (not agoraphobic, for example), but I do think it interferes with my life and prevents me from being all I can be.
>
> Where is the line? When is taking a benzo justified? I've always been scared to overmedicate myself. In fact, it took me a good amount of pain and suffering before I broke down and tried an AD. I've never liked the idea of taking 1 psych drug, much less 2 or 3. Sometimes I feel like I'm "cheating," like the only people who should really be on meds are the ones who can't get out of bed in the morning, can't leave the house, can't go to work, etc.
>
> Can anyone relate to this sort of "psych med reckoning" I'm going through?
>
> And back to the original point, any thoughts from benzo/Klonopin users? The first and only psych med I took that worked was Effexor, and it seemed like a godsend at the time (for both anxiety and depression). Now I tried it again, and it just doesn't seem to be working as well on the anxiety. I think my condition(s) may have worsened over the past couple of years, and quite frankly, it feels like the meds may have contributed to that (e.g. caused a permanent change in brain chemistry--which I know sounds very paranoid).
>
> Any thoughts?
You brought up a few deep points . First up - if you've got acute anxiety symptoms, especially social anxiety related, then I think that benzos are the best choice for managing the anxiety and alleviating the suffering. You're almost 100% guaranteed to see significant relief in a very short time. Now long-term use of benzos is another story and you will have to go through a long and painful process to determine if you should use it as a long-term treament or not, but it's your quality of life now that matters. If a drug is improving your quality of life, even if it's that extra 25% you're missing, I would go for it.With regard to when or when not to take drugs; when I was 17/18 I made a firm promise never to take psychiatric drugs. I felt like drugs were totally dangerous and would screw your brain up and send you nuts (I thought then that you could easily lump people into sane and not sane) It took a long while of pain and suffering for me, just like you, to realize that many, if not most people with mental ilness need drugs, and I was no different. Like Cairo said in one of the posts, how could there be anything wrong in taking insulin for diabetes? Although today's media likes to characterize psych drugs as happy pills, they're not, they treat diseases just like all other drugs. You can't read a book, jump out of bed and say, "Today will be a new day; I will conquer my mental illness with my positive attitude." Doesn't work like that, positive thinking can't lower blood sugar levels.
This post is running on and I'm late, so I'll finish the rest of it another time. But to answer your first two questions: if your anxiety is debilitating, take the benzo. Later on when you have the symptoms under control you can look at therapy, meditation, aromatherapy, exercise, etc... as well as decide on a long-term drug regime. Wrt drug use - psych drugs aren't cheating. People do abuse them, especially benzos, but if you've got a genuine anxiety disorder, you need it. Take care of yourself and good luck.
Posted by detroitpistons on January 5, 2006, at 13:48:54
In reply to Re: When are benzos justified? » detroitpistons, posted by JohnKeats on January 5, 2006, at 12:19:56
JohnKeats, yxibow, Cairo, nicky, great posts. Again, thanks for all of your thoughts. This really is helping me. When I said that sometimes I feel like I'm operating at 75%, that's probably a very conservative estimate.
I probably underestimate the amount of discomfort that I experience. It's probably because deep down, I don't want to believe that there is something really wrong with me, so I try to shrug it off. I realize now that that thinking is counterproductive.
For a couple weeks now I've really tried to nail down what my symptoms are (think about them, write them down), and the more I think about it, the more I realize that my quality of life could be a hell of a lot better, and that I could probably use the help of a benzo.
A couple of years ago, I'd go to a pdoc and I really didn't know what to tell him, because I didn't have a good grasp of my symptoms. Now I think I'm getting better at that. Either that, or I'm getting more symptoms.
Of late, my concentration has been very poor, I've just been really agitated and nervous and worried, especially in response to a stressor (obviously). I can be very irritable, although this has gotten better over the years. I rarely, if ever, feel pleasure (although I'm not in a state of depression currently). I sort of get a sense of dread about things instead of being positive. I get dull headaches. I sometimes get a weird sensation in my chest area, however, I usually don't get a rapid heartbeat. I chew the crap out of my cheek. I start sweating sometimes for no reason. Sometimes when I'm with people (e.g. when I go to lunch with people from work), I start to clam up and feel really panicky inside and start perspiring, even though I'm able to keep my composure. Relationships can become strained due to a lack of consistency in my mood (some people can't figure me out). My libido is very low (and this is the case even when I'm not taking AD's).
A few years ago, when I'd look at a list of symptoms for GAD or depression, for example, I would rationalize that because my symptoms didn't match exactly to the "textbook" cases and descriptions of those particular disorders, that I must not have them. For example, depression doesn't cause weight gain or weight loss in me, so I figured I must not be depressed....Now I see how ridiculous that is, and that my anx/dep can be completely unique to me and still be a clinical issue...Duh!
Anyways, thanks a lot, you guys are great!
Marc
Posted by MGOLDW on January 5, 2006, at 14:31:15
In reply to Re: When are benzos justified? » detroitpistons, posted by JohnKeats on January 5, 2006, at 12:19:56
Everyone talks about long term Bezo use. What is considered long term use? One month, one year, ten years?
Also, is there a significant difference between regular use or as needed use in terms as long term use?
Posted by detroitpistons on January 5, 2006, at 14:54:46
In reply to Re: When are benzos justified?, posted by MGOLDW on January 5, 2006, at 14:31:15
> Everyone talks about long term Bezo use. What is considered long term use? One month, one year, ten years?
> Also, is there a significant difference between regular use or as needed use in terms as long term use?I am considering Klonopin because I consider it to be better suited for maintenance than Xanax which is faster acting and has a much shorter half life. I think you can even get away with taking Klonopin just once a day, whereas you have to take Xanax 2 or 3 times a day. Xanax is better suited for panic attacks, although I'm no expert. At this point, I have no problem with the idea of taking Klonopin daily for an extended period of time. I've tried it before, so I know it would suit me better than Xanax...
Posted by ed_uk on January 5, 2006, at 15:01:30
In reply to Re: When are benzos justified?, posted by MGOLDW on January 5, 2006, at 14:31:15
Hi
>Everyone talks about long term Bezo use. What is considered long term use?
I consider benzo use to be long term when a person has taken a benzo on a daily (or almost daily) basis for more than 4 weeks.
Ed
Posted by James K on January 5, 2006, at 18:19:07
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
I take generic Klonopin (clonazepam)1 or 2 mgs a day. I've taken it off and on for years and not abused. Even though I've had serious alcohol problems. It's the only thing that helps me with the "brain fog" of chronic fatigue syndrome.
One thing I would point out is that I have been hospitalized several times in the past couple of years, and almost everyone with an addiction problem it is meth and xanax, or just xanax. So in my opinion based only on personal observation, klonopin is safer than xanax if potential addiction behavior is a fear.
A thing about habituation - If you take it everyday and get habituated to it, then forget to take it, You may feel like crap mentally and not realize why.
just chiming in,
James K
Posted by Glydin on January 5, 2006, at 19:31:42
In reply to Re: When are benzos justified?, posted by James K on January 5, 2006, at 18:19:07
I think there is alot of confusion and misinformation regarding how the word "addiction" is used when speaking of meds with addiction/abuse potential. I know a number of folks who believe any med with withdrawal symptoms or a discontinuation syndrome constitutes one is "addicted" if one experiences such.
Medical dependence is the legit approiate use of a chemical to treat symptoms.
Addiction is hallmarked by four characteristics: Psych-Social disruption, Drug seeking behavior, Inapproiate use, Tolerance.
Posted by yxibow on January 6, 2006, at 0:46:24
In reply to Re: When are benzos justified?, posted by MGOLDW on January 5, 2006, at 14:31:15
> Everyone talks about long term Bezo use. What is considered long term use? One month, one year, ten years?
> Also, is there a significant difference between regular use or as needed use in terms as long term use?There are people who have been on Librium since it came out in 1960 and Valium since it came out in 1963 with no habituation. Its inventor recently died at 97, if that gives any idea of the length of time psychiatric medications have been around. That is definately long term use.
The difference between regular use and as needed use is that after about a certain period of time, weeks to months (dependent on the benzodiazepine, there are more than 3 dozen though not all are approved in every country) one can and usually becomes habituated to it. At that point, it may still has clinical use, but if one wants to discontinue, it has to be gradual withdrawal or anything can happen from seizures to extreme anxiety, tremor, chills, and other typical signs of drug withdrawal.
Do not attempt to "cold turkey" a long term use of any benzodiazepine. I did for a variety of reasons (I thought it was starting to interfere cognitively and in other ways) although my so-called doctor at the time allowed an amount back again that wasn't enough, but that's neither here nor there. I still have occasional scalp spasms and back oddities from it.
That doesn't mean benzodiazepines don't have their place -- even with my experience, benzodiazepines are still the safest psychiatric medication and there will be those from the benzo.org.uk camp that will say otherwise, and I am not going to make slander for I once commented about it and it was not taken by Dr Bob in its context -- and one can respect their opinion if they wish.
As needed / PRN, is exactly that, when moderate to severe anxiety occurs, on a fortnight or once or twice or three times a week, or a few times a day here and there. The distinction is that tolerance is generally not built up and benzodiazepines with a more "immediate" action are generally used, like Ativan.
hope that clears that question
tidings
Posted by James K on January 6, 2006, at 8:22:35
In reply to Re: When are benzos justified?, posted by Glydin on January 5, 2006, at 19:31:42
> I think there is alot of confusion and misinformation regarding how the word "addiction" is used when speaking of meds with addiction/abuse potential.
---Was this directed at my post? I know the difference between medical dependence and addiction. I was attempting to point out that the young people around here take "bars" (xanax) by the handfuls, and they have high street value. I've never seen this with klonopin. I will try to be more precise in the future. I said it was only my opinion between the two medicines.
If you were just trying to give the gentleman more information, and I'm just feeling paranoid, let me apologize in advance. It's been a tense space around here. I'm already sorry.
>
> Medical dependence is the legit approiate use of a chemical to treat symptoms.
>
> Addiction is hallmarked by four characteristics: Psych-Social disruption, Drug seeking behavior, Inapproiate use, Tolerance.
Posted by Glydin on January 6, 2006, at 8:55:32
In reply to Re: When are benzos justified? » Glydin, posted by James K on January 6, 2006, at 8:22:35
> > I think there is alot of confusion and misinformation regarding how the word "addiction" is used when speaking of meds with addiction/abuse potential.
>
> ---Was this directed at my post? I know the difference between medical dependence and addiction.
No, No, a thousand times No..... I am very sorry it appeared that way to you. I posted that due to just a general opinion of mine. I have in the past, on this board, been told I was "addicted" due to my use of Klonopin. I am sensitive and prehaps in light of your post, I should not have even posted what I did. I did as we were discussing benzo's and addiction versus dependence.I know from your post you are very knowledgable of the difference. I don't think everyone is.
I hope you will accept my apologies.....
Posted by detroitpistons on January 6, 2006, at 9:07:04
In reply to Re: When are benzos justified? » James K, posted by Glydin on January 6, 2006, at 8:55:32
How long do you have to take Xanax (roughly) before you'll experience withdrawal? Assume 1 mg daily. Can I become dependent within a couple of weeks?
The reason I ask is because I've been taking it lately and my next pdoc apt isn't till the 11th.
Posted by MGOLDW on January 6, 2006, at 10:57:40
In reply to Re: When are benzos justified?, posted by detroitpistons on January 6, 2006, at 9:07:04
I am going to see a therapist today. This will be a first for me. I know the causes for my depresion and my anxiety. Do you guys think that I will benefit from therapy? or am I just waisting time and money?
Lexapro 10mg/day
Xanax .25mg as needed
Posted by detroitpistons on January 6, 2006, at 11:30:32
In reply to Re: When are benzos justified? One more question?, posted by MGOLDW on January 6, 2006, at 10:57:40
> I am going to see a therapist today. This will be a first for me. I know the causes for my depresion and my anxiety. Do you guys think that I will benefit from therapy? or am I just waisting time and money?
> Lexapro 10mg/day
> Xanax .25mg as needed
My view on therapy is that it can help anyone, regardless of how happy they are...My brother in law, who is one of the happiest, successful, most well grounded people I know, has gone to therapy and benefitted from it.When I was in therapy, I was in the middle of a pretty bad depressive episode, and it was really hard to talk, but I did feel better sometimes after leaving therapy. That good feeling, however, was pretty short lived...The next day I was still anxious and depressed. I didn't continue with the therapy because I moved to a different city, but I would like to start again just to sort out the types of issues that everybody has.
Basically, if you have insurance that will cover it (my insurance would cover 26 visits per year--copay is like 20 bucks per visit), and you have the time to go, you should try it, even if only for a couple of sessions. At least then you will know if therapy helps you. Also, the therapist/ psychologist may be able to recommend if other forms of therapy could be beneficial to you, based on your unique circumstances.
If you're paying completely out of pocket, then it's a bit more of a risky proposition, simply because your therapist may not even be the right one for you, and you could spend a lot of money just looking for the right one (just like with meds).
Again, if you have insurance, it can't hurt to try it.
Posted by vbAgent on January 6, 2006, at 11:35:37
In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05
Improving your quality of life doesn't need justification... ;-]
Weigh the benefits and risks. If it works, stick with it. Bear in mind that the therapeutic value of benzos are compromised by their abuse potential (but you already knew that).
Peace...
Posted by irishcatholic on January 6, 2006, at 11:46:06
In reply to Re: When are benzos justified? » detroitpistons, posted by Glydin on January 3, 2006, at 22:03:41
Great post! Excellent insight!
1 x 20 mg generic Proz + 2 x .5 mg generic Xanax per day has been a big help for me, over 2 yrs now. If it goes bad in the future, I'll have to deal with it, but for now I (and my pDoc) see no reason to mess with it. I call it an 80% solution. Took 2 years to get there in the first place because I got discouraged about all the failed drug trials we did.
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