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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 U2MN on July 14, 2010, at 16:20:41
I've been on everything.. Every SSRI, SNRI, an antipsychotic here and there, MAOIs... Horrible side effects including problems with my kidneys, I had the same PDOC for 5 years... He was great and understanding. Oh.. diganosis: Panic disorder/generalized anxiety disorder and OCD. About two years ago we discussed (at length) what to try next. We took an unconventional approach and decided to go with the following cocktail:
Namenda 10 MGs twice daily and Diazepam 5 MGs three times daily. Worked like a charm. I've been nice and stable for two years now.
A few months ago, my PDOC decides to retire. Of course, there is a shortage and they tell me I likely can't stay with the clinic (it's a co'op situation... you have to have their insurance...) Anyway, long story short, they end up letting me stay and toss me off to a different PDOC. First meeting is fine... I don't really "like" him that much, but I just figure it's because I'm so used to my previous doc and liked him a lot. Appointment goes fine. No changes.
Come in for my 6 month check-up today... Everything is still fine. No changes. I'm good as can be. The PDOC advises me that next year he wants to taper me off the diazepam, and then proceeds to spout off the typical text book stuff about addiction (there is a difference between addiction and dependence... I realize I am dependent on the medication.) I have never abused my medications and have no history of substance abuse... ever. I was shocked. For the first time in several years I feel normal. My career is going well, I'm side-effect free, and I'm doing great. I've been on this regiment for slightly over two years. Needless to say... I'm really peeved.
I explained my position (the best I could... I was shocked.) So now what? I have another appointment with him in 6 months and I'm good for medication. I'm angry though. I don't want to change anything. Why fix what isn't broken? I understand that benzo addiction is a real problem for some people, but why do PDOCs ignore the clinical research? Tolerance rapidly develops to the sedative effects of the drug, but does NOT develop to the anxiolytic effects. I haven't had to increase my dose or anything. The benzophobia is distressing, because there are people (like me) who benefit and do well on them daily with no issues.
I don't know what to do. It's hard to get in with a new PDOC, but I feel like that is really my only option. Any suggestions? I'm afraid of making appointments and getting the same response from every PDOC I interview. What questions do I ask when I interview them? All they would have to do is bother to actually read my entire medical history, and then it would become clear why we chose this course of treatment in the first place...
Sorry about the rant...
Thoughts?
Posted by Phillipa on July 14, 2010, at 16:59:55
In reply to Really Upset w/PDOC- Advice needed, posted by U2MN on July 14, 2010, at 16:20:41
You have every right to be upset. I found myself in a similar situation a few years ago with benzos. As been on for over 40 years no abuse either. Actually I take less than prescibed. I still ask for same amount as afraid someone will try the same thing. So have a supply. And my pdoc is in 70's. My suggestion is if you have a way to contact your old pdoc and maybe he could explain to new doc that you are a responsible patient and this has worked well. And please continue same with my old patient. And like me you can't just call say hey you use benzos. What I have found here is the free clinics do still prescribe them. Good luck to you. Phillipa
Posted by Christ_empowered on July 14, 2010, at 19:25:27
In reply to Really Upset w/PDOC- Advice needed, posted by U2MN on July 14, 2010, at 16:20:41
even if you have to pay cash, its worth it for your health. I cannot believe a new doc decided to taper a low dose of a benzo just b/c it *might* cause problems. That's ridiculous. I've actually abused benzos, and then after I'd been clean for a couple years my doc decided to let me try Klonopin (a dose equivalent to 40mgs of valium, btw). No problems, no abuse.
You need a new doctor.
Posted by emmanuel98 on July 14, 2010, at 19:53:35
In reply to Really Upset w/PDOC- Advice needed, posted by U2MN on July 14, 2010, at 16:20:41
Well, it's a year away, so maybe over that time, you can convince him otherwise. But I will add that I had a friend who was on xanax for years after having a couple of panic attacks. When she tried to go off it, she went through a year-long horrible withdrawal. She never abused it, but was physically dependent anyway.
Posted by U2MN on July 14, 2010, at 20:02:31
In reply to Re: Really Upset w/PDOC- Advice needed, posted by emmanuel98 on July 14, 2010, at 19:53:35
> Well, it's a year away, so maybe over that time, you can convince him otherwise. But I will add that I had a friend who was on xanax for years after having a couple of panic attacks. When she tried to go off it, she went through a year-long horrible withdrawal. She never abused it, but was physically dependent anyway.
I am aware of being medically dependent on it. I also know that with a correct very slow taper, you can ease some of the discomfort. My whole point is that my current regiment actually works for me. If there was something that I hadn't already tried, that would be a different story. It was a very carefully calculated decision between myself and my previous PDOC. I did not take it lightly by any means. I know Xanax is very effective, but I won't touch it. Did your friend take a year or so to taper? We specifically chose diazepam, because it is easier to taper... But if I'm doing well on it, I just don't see the need to change anything. It's not a year away actually... by next year I meant January, 2011.
Posted by Phillipa on July 14, 2010, at 21:23:45
In reply to Re: Really Upset w/PDOC- Advice needed/ emmanuel98, posted by U2MN on July 14, 2010, at 20:02:31
Stick with your current regime. As my pdoc also says "If it ain't broken don't need fixing". So I totally relate to you. Phillipa ps I also can just stop xanax with cross over to higher valium dose have done it before.
Posted by ron1953 on July 15, 2010, at 10:03:42
In reply to Very upset with PDOC - Need a little advice, posted by U2MN on July 14, 2010, at 16:02:30
Having been addicted to a benzo (Klonopin) for 7 years, and learning a lot about that addiction during my final withdrawal (I couldn't sleep for several days, so I had a lot of time to do research), I do have concerns about that class of drugs, but not benzophobia.
The one thing that I discovered (in arrears, unfortunately), and want to point out, is that withdrawal symptoms can actually appear BETWEEN DOSES, not just after a prolonged absence of the drug (which is WAY worse). What feels like anxiety between doses may actually be withdrawal. Looking back, I realize I was on a daily roller coaster ride, and didn't know it was being CAUSED by the drug. My doc didn't have a clue, so I applaud yours for being aware of the problems with benzos. For more excellent info, check out http://benzo.org.uk/
BUT.... you do seem to be doing well on your current regimen, and I can see why you might feel that if it ain't broke, don't fix it. In that case, you'll probably want to find a new doc, which I know is a real pain.
Posted by sigismund on July 15, 2010, at 10:03:42
In reply to Re: Very upset with PDOC - Need a little advice, posted by ron1953 on July 14, 2010, at 22:34:07
>withdrawal symptoms can actually appear BETWEEN DOSES, not just after a prolonged absence of the drug (which is WAY worse). What feels like anxiety between doses may actually be withdrawal. Looking back, I realize I was on a daily roller coaster ride, and didn't know it was being CAUSED by the drug.
Of course, you're quite right, why do I think this sounds ironical, how do I stop that, I do what I can, I mean what I say :)
Posted by sigismund on July 15, 2010, at 10:03:43
In reply to Very upset with PDOC - Need a little advice, posted by U2MN on July 14, 2010, at 16:02:30
My psychiatrist said to me about psychs and people who were habituated to benzos
'Sometimes they take them off them and then they're in a terrible state. If they have any sense they put them back on their dose'
because he sees benzo habituation as completely unspecial and relatively benign on the spectrum of evils he has to deal with? Unhelped by certain interventions?
We can agree that life, humanity anyway, is a mistake. He says he finds it fascinating.
Posted by g_g_g_unit on July 16, 2010, at 2:44:16
In reply to Re: Really Upset w/PDOC- Advice needed/ emmanuel98, posted by U2MN on July 14, 2010, at 20:02:31
i'm really sorry, i don't have anything useful to add regarding your predicament, but i'm curious about the fact that you've managed to stay on Namenda for so long. there's no real long-term accounts on here - most people end up ditching it due to intolerable/weird side-effects (dissociation, brain fog, etc.). have you found it to be a useful mainstay in combating OCD?
Posted by g_g_g_unit on July 16, 2010, at 7:18:12
In reply to Re: Really Upset w/PDOC- Advice needed/ emmanuel98, posted by g_g_g_unit on July 16, 2010, at 2:44:16
Posted by bearfan on July 24, 2010, at 22:24:25
In reply to Really Upset w/PDOC- Advice needed, posted by U2MN on July 14, 2010, at 16:20:41
My advice would be maybe explain that you tried to go off benzos before and started to relapse with symptoms. Pdocs that use beznos tend to like to use klonopin more, so if you haven't tried that, that could be an option. I do think its kind of weird that you take Diazepam 3x a day. That is one of the longer lasting benzos (84 hour half life I think) so I think you should be able to take that just once a day (say 15mg at night) and have no difference in relief. It sounds like Pdoc is just doing his job (there must be a certain population that does better off benzos or something like buspar).
This is the end of the thread.
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