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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by magnox on April 16, 2009, at 18:20:45
Would it be possible to get clonazepam for anxiety, psychosomatic? conditions off label on the NHS. It is only approved for seizuires here. Would it be possible, and enough tablets for a proper taper?
Posted by sowhysosad on April 16, 2009, at 19:57:02
In reply to how to get rivotril off label on the NHS, posted by magnox on April 16, 2009, at 18:20:45
Looks like it's easy enough to get online without a prescription, but I don't know what the legalities are with regard to importing it.
If you're currently dependent on clonazepam and hoping to quit benzos entirely, the preferred method is to switch to diazepam then taper. Its long half life allows you to drop the dose gently without getting withdrawal effects. A sympathetic GP might prescribe a couple of weeks' worth of diazepam, particularly one who specialises in drug dependency. Or perhaps they could refer you to a specialist centre.
But in terms of getting a benzo (particularly an off-label one) prescribed long-term for anxiety, it'll almost certainly be a non-starter. The NHS is VERY paranoid about the risk of dependency from benzos.
Posted by magnox on April 16, 2009, at 20:07:10
In reply to Re: how to get rivotril off label on the NHS » magnox, posted by sowhysosad on April 16, 2009, at 19:57:02
no i'm not dependant on this. this is totally ironic, alot of doctors in the 80s pepetuated the benzodiazepine addiction scandal of the 80s. i do find bromazepam and clonazepam useful, and if it came to it later in life and I needed it to keep a job due to a health problem i'm hoping the gps see sense, otherwise i will go private.
Posted by sowhysosad on April 16, 2009, at 20:59:50
In reply to Re: how to get rivotril off label on the NHS, posted by magnox on April 16, 2009, at 20:07:10
Yeah, perhaps going private would be a better option.
I read earlier that the whole NHS ban on benzos was down to one guy's negative experience which prompted a campaign on "That's Life".
If that's the case, it's another example of the ill-informed, science-free media setting the country's health agenda. Just as ludicrous as the MMR autism bollocks that's caused a huge rise in measles cases.
Posted by rvanson on April 17, 2009, at 3:40:40
In reply to how to get rivotril off label on the NHS, posted by magnox on April 16, 2009, at 18:20:45
> Would it be possible to get clonazepam for anxiety, psychosomatic? conditions off label on the NHS. It is only approved for seizuires here. Would it be possible, and enough tablets for a proper taper?
Benzos are advertized all over the net but they are not cheap without a script, and are probably illegal to order in many countries.
BTW, the doctors here in the USA are becoming anti-benzo too, prescribing expensive anti-psychotics in their place to many a
persons detriment.Back in the 80's they were handing out Xanax like it was candy.
FYI, lots of these new neoroleptic drugs can increase sugar diabetes and cholesterol levels and the lawsuits are already out there.
Posted by metric on April 17, 2009, at 15:38:30
In reply to Re: how to get rivotril off label on the NHS » magnox, posted by sowhysosad on April 16, 2009, at 19:57:02
> But in terms of getting a benzo (particularly an off-label one) prescribed long-term for anxiety, it'll almost certainly be a non-starter. The NHS is VERY paranoid about the risk of dependency from benzos.
I've never understood why such a fuss is made over benzodiazepine dependency. Almost any drug is capable of inducing some form of physical dependency if taken for long enough; benzos are hardly unique in that respect.
Withdrawal can be completely avoided by either remaining on the drug or tapering slowly. There won't be any withdrawal if the taper is done slowly enough.
Also, benzodiazepines are the only anxiolytics that are prescribed. SSRIs are not useful as anxiolytics, not least because they increase anxiety (not exactly characteristic of an anxiolytic), but because they have so many other side-effects. Benzodiazepines are the safest drugs used in psychiatry, if not all of medicine.
Posted by metric on April 17, 2009, at 15:46:11
In reply to Re: how to get rivotril off label on the NHS, posted by rvanson on April 17, 2009, at 3:40:40
> FYI, lots of these new neoroleptic drugs can increase sugar diabetes and cholesterol levels and the lawsuits are already out there.
They're also intrinsically neurotoxic.
Posted by jms600 on April 17, 2009, at 16:37:31
In reply to how to get rivotril off label on the NHS, posted by magnox on April 16, 2009, at 18:20:45
I guess if you get a reasonably good psychiatrist on the NHS he may prescribe clonazepam for you off label - as they do with atypical antipsychotics for anxiety issues. I think it's unlikely that your GP would prescribe it as it's not licensed for anxiety.
Agreed with the other posters here, any doctor is going to be a little difficult over this as your asking for benzos - and ones only licensed for epilepsy at that.
I bought some diazepam over the net a couple of years back and had no trouble getting that into the country at all. Maybe I was just lucky. If you do buy over the internet go for the official branded tablets. Who knows what some unscrupulous w**kers are putting in so called generic drugs from foreign pharmacies.
> Would it be possible to get clonazepam for anxiety, psychosomatic? conditions off label on the NHS. It is only approved for seizuires here. Would it be possible, and enough tablets for a proper taper?
Posted by sowhysosad on April 17, 2009, at 17:02:18
In reply to Re: how to get rivotril off label on the NHS, posted by metric on April 17, 2009, at 15:38:30
> I've never understood why such a fuss is made over benzodiazepine dependency. Almost any drug is capable of inducing some form of physical dependency if taken for long enough; benzos are hardly unique in that respect.
Supposedly the withdrawal and rebound effects of benzos can be particularly unpleasant compared to other psych drugs and it's easy to quickly build tolerance but, you're right, it does seem to be a storm in a teacup.
> Also, benzodiazepines are the only anxiolytics that are prescribed. SSRIs are not useful as anxiolytics, not least because they increase anxiety (not exactly characteristic of an anxiolytic), but because they have so many other side-effects. Benzodiazepines are the safest drugs used in psychiatry, if not all of medicine.
I'm not so sure about that. Many people find SSRI's helpful for anxiety (albeit after some initial start-up anxiety perhaps), and sedating tricyclics and tetracyclics can be good for anxiety too.
Posted by metric on April 18, 2009, at 13:26:22
In reply to Re: how to get rivotril off label on the NHS, posted by sowhysosad on April 17, 2009, at 17:02:18
> I'm not so sure about that. Many people find SSRI's helpful for anxiety (albeit after some initial start-up anxiety perhaps), and sedating tricyclics and tetracyclics can be good for anxiety too.
Many people find amphetamine (and other stimulants) helpful for anxiety too, but I wouldn't call it an anxiolytic. Would you?
Even in someone who has taken an SSRI chronically, taking a higher dose to suppress anxiety acutely is more likely to increase than decrease their level of anxiety. I think that for a drug to properly be called an anxiolytic, it should reliably and dose-dependently suppress anxiety when administered acutely. SSRIs don't do that. Antidepressants are also plagued with so many side-effects that their weak and unpredictable effect on anxiety is difficult to justify in many anxious individuals.
Posted by West on April 18, 2009, at 17:48:06
In reply to Re: how to get rivotril off label on the NHS, posted by sowhysosad on April 17, 2009, at 17:02:18
Go and see a psychiatrist who works privately, probably in london. Also lyrica is approved for GAD here in the uk.
Posted by yxibow on April 19, 2009, at 1:10:02
In reply to Re: how to get rivotril off label on the NHS, posted by rvanson on April 17, 2009, at 3:40:40
> > Would it be possible to get clonazepam for anxiety, psychosomatic? conditions off label on the NHS. It is only approved for seizuires here. Would it be possible, and enough tablets for a proper taper?
>
> Benzos are advertized all over the net but they are not cheap without a script, and are probably illegal to order in many countries.
>
> BTW, the doctors here in the USA are becoming anti-benzo too, prescribing expensive anti-psychotics in their place to many a
> persons detriment.I would say that's overly generalized. I think doctors here are being prudent about the use of benzodiazepines and their long term consequences, of which I know yet I'm stuck in a catch-22 because actually, they're still necessary.
Mainly, it is the DEA who, as well as the state boards, gives a doctor their ability to practice medication, who is breathing down the backs of doctors.
There is some justification in this -- there are doctors who have almost absentmindedly handed out things like Oxycontin and the like to patients without really watching what is going on. And to their detriment, some have lost their license, which is their ability to exist in their trade, after all.
I'm not saying that I am in love with what the DEA believes on everything -- I'm just pointing out other reasons.
At least I know my doctor still prescribes, but with this in mind.
Also pharmacies when they see high amounts on prescriptions often pay a call to doctors to have a justification (a diagnostic code) on file, so they don't lose their pharmacy license.
As for doctors who don't prescribe them at all when there is a perfectly good reason, especially small PRN doses, well -- yes, I think that's going extreme. And maybe that is what you're referring to.
As for the use of Seroquel for anxiety, I can say that tough anxiety, though I don't like it, sometimes has its justifications.
But APs aren't something just for everything and I would also agree completely with that.
-- tidings
Jay
Posted by metric on April 19, 2009, at 12:24:48
In reply to Re: how to get rivotril off label on the NHS » rvanson, posted by yxibow on April 19, 2009, at 1:10:02
> > > Would it be possible to get clonazepam for anxiety, psychosomatic? conditions off label on the NHS. It is only approved for seizuires here. Would it be possible, and enough tablets for a proper taper?
> >
> > Benzos are advertized all over the net but they are not cheap without a script, and are probably illegal to order in many countries.
> >
> > BTW, the doctors here in the USA are becoming anti-benzo too, prescribing expensive anti-psychotics in their place to many a
> > persons detriment.
>
> I would say that's overly generalized. I think doctors here are being prudent about the use of benzodiazepines and their long term consequences, of which I know yet I'm stuck in a catch-22 because actually, they're still necessary.
>
> Mainly, it is the DEA who, as well as the state boards, gives a doctor their ability to practice medication, who is breathing down the backs of doctors.
>
> There is some justification in this -- there are doctors who have almost absentmindedly handed out things like Oxycontin and the like to patients without really watching what is going on. And to their detriment, some have lost their license, which is their ability to exist in their trade, after all.
>
> I'm not saying that I am in love with what the DEA believes on everything -- I'm just pointing out other reasons.
>
> At least I know my doctor still prescribes, but with this in mind.
>
> Also pharmacies when they see high amounts on prescriptions often pay a call to doctors to have a justification (a diagnostic code) on file, so they don't lose their pharmacy license.
>
> As for doctors who don't prescribe them at all when there is a perfectly good reason, especially small PRN doses, well -- yes, I think that's going extreme. And maybe that is what you're referring to.
>
> As for the use of Seroquel for anxiety, I can say that tough anxiety, though I don't like it, sometimes has its justifications.
>
> But APs aren't something just for everything and I would also agree completely with that.
Benzodiazepinse are among the top selling prescription drugs in the United States. They aren't at all hard to obtain.
This is the end of the thread.
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