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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Phillipa on June 7, 2006, at 13:32:49
What do you do if you've been on benzos for over 30 yrs and the doc won't fill the Rx anymore wants antipsychotics instead and I'm not psychotic what of the withdrawal .Anyone know of a doc in Charlotte NC that prescribes Benzos? Oh I've never abused them always took less than prescribed. Thanks Love Phillipa
Posted by B2chica on June 7, 2006, at 13:39:49
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
kinda curious of why if benzo's been working for you for over 30 years why would they change? did he tell you why choosing AP instead? i mean for side effects alone, if the benzo is still working, why switch.
but just so you know AP have other helpful uses other than for psychosis. the zyprexa that i was on not only helped with depression but did WONDERS for my anxiety. maybe that's what they are thinking...but still. i would think if it ain't broke don't fix it...ya know?
yes i would think there certainly would be some withdrawal effects and to taper off very slowly...but...
sorry can't help you out with pdocs in that area...here's hoping you find one though!
b2c.
Posted by honeybee on June 7, 2006, at 14:13:27
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
Phillipa! That's horrible. Is he not willing to work with you at all? There doesn't seem to be a good reason for you to switch, if the benzos seem to be working, unless he has some solid rationale.
The antipsychotics seem to be helpful for some people, though, and lots of babblers seem to be on them. You'll have a good resource base to talk to. And this could be just the thing to help you!
hb
Posted by FredPotter on June 7, 2006, at 16:12:29
In reply to Re: What Do You Do If On Benzos Over 30yrs Doc Says, posted by honeybee on June 7, 2006, at 14:13:27
Hi Phillipa I've been on benzos for 42 years off and on and have been taken off them twice abruptly when in hospital. I try to tell them that addiction is hardly an issue after that many years. I also believe that anxiety is much more serious than a low-grade dependency on a harmless drug like a benzo
Fred
Posted by yxibow on June 7, 2006, at 17:16:36
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
> What do you do if you've been on benzos for over 30 yrs and the doc won't fill the Rx anymore wants antipsychotics instead and I'm not psychotic what of the withdrawal .Anyone know of a doc in Charlotte NC that prescribes Benzos? Oh I've never abused them always took less than prescribed. Thanks Love Phillipa
A lot of doctors are benzophobic -- and its obvious that you haven't abused them, I know you haven't. Be firm and upforward with your doctor -- its your body. Also mention the withdrawal -- which could change your psyche, be dramatic if you have to. Obviously since you're not particularly habituated at your dose you wouldnt withdraw much, but thats irrelevant. Taking an AP or any drug means informed consent about the actions and side effects of it and if you do not wish to consent, don't.
But when you look for a new doctor if you choose, and I dont know the area other than I've suggested to you some possible angles in the past -- just phrase it as an anxiety disorder -- the one thing you don't want to look as is "benzo shopping." That is a flagword for habituation. Which you don't have clearly.
Posted by blueberry on June 7, 2006, at 17:21:17
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
That's insane. If that is what is going to happen, you definitely need a new doc before your supply runs out.
I don't care what drug it is...benzo, antidepressant, mood stabilizer, whatever...30 years is a very long time. You can't undo 30 years in a slow taper of weeks or even months.
Docs are so ignorant sometimes. You want to talk about pysical dependence, horrific withdrawals, and permanent brain re-wiring, try an antipsychotic for a few years. It will make the physical dependence problems of benzos seem like candy in comparison.
Just economically speaking, benzos are dirt cheap. An antipsychotic is going to cost you about $6 to $10 a day.
I don't understand why he would want to change the valium. Certainly not out of conern for your wellbeing.
> What do you do if you've been on benzos for over 30 yrs and the doc won't fill the Rx anymore wants antipsychotics instead and I'm not psychotic what of the withdrawal .Anyone know of a doc in Charlotte NC that prescribes Benzos? Oh I've never abused them always took less than prescribed. Thanks Love Phillipa
Posted by valene on June 7, 2006, at 17:42:59
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
Phillipa, that is insane! Your doctor is a moron big time!
Tell him to call Dr. CARL SALZMAN, in Boston whom I consulted recently. He recommends I stay on the low dose xanax for the rest of my life or until I'm around 80! They are tons safer than any antipsychotic and he told me benzos are making a comeback. Please don't go off valium cold turkey as it can cause life threatening seizures as you already know. Here is DR. SALZMAN'S CREDENTIALS:CARL SALZMAN, MD is Professor of Psychiatry, Harvard Medical School. He has served as Chairman, American Psychiatric Association Benzodiazepine Task Force. He has been awarded the Elvin Semrad Award for Outstanding Teaching in Psychiatry at the Massachusetts Mental Health Center. In 1990, he was appointed the Asher Globus Visiting Professor of Psychiatry, Cornell University School of Medicine. He shared the Vestermark Award from the American Psychiatric Association for Outstanding Contribution to Psychiatric Education in 1990. In 1997 he was awarded the Heinz E. Lehmann Award from the New York State Department of Mental Hygiene for his contribution to psychiatric research. In 2003 Dr. Salzman was nationally recognized with a Teacher of the Year Award. He has also been on numerous editorial boards including The American Journal of Psychiatry. Dr. Salzman is the author of over 250 publications and 7 books. His latest book is Clinical Geriatric Psychopharmacology, 4th edition.
Tell your nutball doctor to call him! You are like me, same age, on safe low dose benzos, no alcohol, no drug seeking behavior, etc. etc. No Psychotics! I will say a prayer for you!
Love, Val
> What do you do if you've been on benzos for over 30 yrs and the doc won't fill the Rx anymore wants antipsychotics instead and I'm not psychotic what of the withdrawal .Anyone know of a doc in Charlotte NC that prescribes Benzos? Oh I've never abused them always took less than prescribed. Thanks Love Phillipa
Posted by FredPotter on June 7, 2006, at 17:49:13
In reply to Re: What Do You Do If On Benzos Over 30yrs Doc S » Phillipa, posted by valene on June 7, 2006, at 17:42:59
Incidentally I was put on 2.5 mg Zyprexa and it helped for a few days then pooped. By this time I had put on weight and lost control of my diabetes. After 2 months without Z I'm still not right
Posted by heaven help me on June 7, 2006, at 18:27:43
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
Phillipa,
I'm not psychotic, never have been (even checked it out with a post a while back :) But I AM on an antipsychotic becasue it is what seems to work for me. My ONLY complaint about it is that I still have Vertigo and it makes me wonder if THAT is a side effect. My PA says to keep waiting that one out as it is likely an ear infection that can take months to subside. So I'm waiting, and otherwise doing well on an AP
blessings
mary
Posted by RobertDavid on June 7, 2006, at 22:15:28
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
Phillipa:
You need a new doctor. That's nuts. I can't believe a doctor would think you can just STOP a benzo without a slow taper regarless of what med you would be changing to (unless it was another benzo). If the doctor is that off base with this decision, I would be very conserned about other ideas/decisions he/she has in mind.....
Posted by med_empowered on June 8, 2006, at 0:05:49
In reply to Re: What Do You Do If On Benzos Over 30yrs Doc Says » Phillipa, posted by RobertDavid on June 7, 2006, at 22:15:28
here's the thing: some docs hate benzos b/c they think of "addiction" and what not. Thats stupid. Yeah, there's some habituation, and there can be pretty pronounced withdrawal effects if the doc is stupid and does an abrupt taper (OR if the doc is heartless and withdraws a patient who needs benzos).
Long-term benzo use isn't the best thing ever, but it beats antipsychotics (yes, even the new ones) hands down. So...try to find a new doc. Yours appears to be uninformed, callous, or both.
Posted by zero on June 8, 2006, at 0:34:33
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
Phillipa,
Sounds like you've got a benzophobic doc'.
I'd look for a new one, an anxiety disorders specialist (a psychopharmacologist if possible).
It's not a nice position you're being put in (I've been put there too).
Good luck, and best wishes.
zero
Posted by cecilia on June 8, 2006, at 3:35:24
In reply to Re: What Do You Do If On Benzos Over 30yrs Doc Says » Phillipa, posted by RobertDavid on June 7, 2006, at 22:15:28
Your doctor has demonstated before that he's an idiot, Phillipa, but his latest actions make me wonder if he's getting pressure from some outside agency, either the insurance company, or the govt agency that deals with prescriptions for controlled substances, to cut down on his benzo prescriptions. I could be wrong, but I don't exactly have the impression that he has a lot of concern for your well being. Cecilia
Posted by SLS on June 8, 2006, at 6:10:01
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
> What do you do if you've been on benzos for over 30 yrs and the doc won't fill the Rx anymore wants antipsychotics instead and I'm not psychotic what of the withdrawal .Anyone know of a doc in Charlotte NC that prescribes Benzos? Oh I've never abused them always took less than prescribed. Thanks Love Phillipa
Perhaps you can negotiate with this doctor and agree to try the AP if he would agree to an extended taper schedule for discontinuing the benzo. Then you can begin your search for another doctor.
As others have suggested, an AP is just a molecule. It really isn't an antipsychotic or an antidepressant or a mood-stabilizer. It just is. It has certain properties that are useful for treating a variety of conditions. It might be helpful in treating yours. The risks of atypical APs to produce EPS and TD are real, but very small. For Seroquel, the risk is almost zero. Still, this is a decision that you must make understanding the risks versus benefits. I have tried every atypical AP except Clozaril in an effort to treat bipolar disorder. I currently take Abilify.
- Scott
Posted by Sobriquet Style on June 8, 2006, at 7:04:20
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
If you're functioning well, I wonder why the doctor is suggesting a medication change?
Personally speaking, when i'm doing good, I'll only see a psychiatirst once a year, every 6 months, just for a routine check up. Never change meds, although have come off them in the past or reduced dosages if things are that good.
Its usually when things have been really not good, that its time for a medication change.
Perhaps ask the doctor what is his rationale in withdrawing you from one medication on to another - what does he hope to achieve that you're not experiencing now from current treatment.
~
Posted by Tom Twilight on June 8, 2006, at 13:31:24
In reply to Re: What Do You Do If On Benzos Over 30yrs Doc Says » Phillipa, posted by Sobriquet Style on June 8, 2006, at 7:04:20
Hey Phillipa
Sorry your having such a hard time with your doc
I agree 100% with everyone else!Find a new Doc asap one that cares about you!
In the meantime here is a interesting study on Benzo usage
Lack of relationship between long-term use
of benzodiazepines and escalation to high dosages
by
Soumerai SB, Simoni-Wastila L, Singer C,
Mah C, Gao X, Salzman C, Ross-Degnan D.
Psychiatr Serv. 2003 Jul;54(7):1006-11ABSTRACT
OBJECTIVE: The objective of this study was to determine whether long-term benzodiazepine use is associated with dose escalation. METHOD:S: The authors examined changes in dose and the frequency of dose escalation among new and continuing (at least two years) recipients of benzodiazepines identified from a database containing drug-dispensing and health care use data for all New Jersey Medicaid patients for 39 months. Independent variables included age; Medicaid eligibility category; gender; race or ethnicity; neighborhood socioeconomic variables; chronic illnesses, such as schizophrenia, bipolar illness, panic disorder, and seizure disorder; and predominant benzodiazepine received. Logistic regression analyses were conducted to determine the association between the independent variables and escalation to a high dosage (at least 20 diazepam milligram equivalents [DMEs] per day for elderly patients and at least 40 DMEs per day for younger patients). RESULTS: A total of 2,440 patients were identified, comprising 460 new and 1,980 continuing recipients. Seventy-one percent of continuing recipients had a permanent disability. Among all groups of continuing recipients, the median daily dosage remained constant at 10 DMEs during two years of continuous use. No clinically or statistically significant changes in dosage were observed over time. The incidence of escalation to a high dosage was 1.6 percent. Subgroups with a higher risk of dose escalation included antidepressant recipients and patients who filled duplicate prescriptions for benzodiazepines at different pharmacies within seven days. Elderly and disabled persons had a lower risk of dose escalation than younger patients. CONCLUSION: The results of this study did not support the hypothesis that long-term use of benzodiazepines frequently results in notable dose escalation.Heres a link: http://biopsychiatry.com/benzoabdos.htm
Posted by FredPotter on June 8, 2006, at 18:48:41
In reply to Re: What Do You Do If On Benzos Over 30yrs Doc S » Phillipa, posted by zero on June 8, 2006, at 0:34:33
Has anybody any ideas about what I can do? I'm going to Canada then the UK for a month. I have a doctor here in NZ who happily prescribes a month's supply of Xanax every month or 2 weeks sometimes, but it's only 2mg per day. Which is more than enough sometimes and nowhere near enough when I'm going through anxious states. On a plane and in a foreign land I'll probably feel very anxious and need at least 2 month's supply in a month. Should I tell him and ask what can be done? I don't want to betray his trust and duplicate scripts etc. I gather that Hell will freeze over before a doctor will prescibe benzos in the UK. Perhaps Canada is more compassionate
Thanks
Fred
Posted by tizza on June 9, 2006, at 0:39:41
In reply to What Do You Do If On Benzos Over 30yrs Doc Says, posted by Phillipa on June 7, 2006, at 13:32:49
hey hon your new doc is being totally inconsiderate to your health. I hope he/she realises the implications of taking you off valium so fast, you need a really slow taper for that and if he doesn't acknowledge that then show him the dreaded HEATHER ASHTON web site at http://www.benzo.org.uk/profash.htm
for a proper taper so you can switch docs and still get a script refilled and find a new doc that isn't a benzophobe in the mean time. Good luck hon, Paul
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