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Re: Chronic benzos, mood + memory. Hoover + exper

Posted by mattdds on April 17, 2009, at 19:50:45

In reply to Re: Chronic benzos, mood + memory. Hoover + experts? mattdds, posted by Larry Hoover on April 17, 2009, at 17:15:26

Larry, you're a gentleman and a scholar! Thanks for writing back.

> I well recall your going to war, Matt. I prayed for you many times. Going in theatre with an anxiety disorder seemed pretty courageous to me. Then more schooling and a residency? Sheesh! Way to go, dude!

Honestly, I didn't have it so bad in Iraq. There were a few close calls (indirect fire) but I held up better than I thought. Thank you for your thoughts and prayers!

The mil p-docs even sent me off with a bucket of Klonopin (the only time they were liberal with benzos). Insane who they'll send these days.

I am very fortunate to be back in one piece. Better people than me have not been so fortunate. I did come back with a life experience that few get (or want). I'm not a true believer in the war by any means, but it did build character. I complain a lot less about things back home now.

Yeah, I got out of the quacksilber business and am heading into my second year in OMFS. I don't know why I do this to myself. I do enjoy the work though - it can be very gratifying, and I'm learning tons.

> I got news for you. You're aging. No faster and no slower than the rest of us, though. I'm more concerned that a high stress lifestyle might be cumulatively burdensome. I'm big on coping strategies such as regular sleep, exercise, good nutrition, social supports, indulging in hobbies.

Yeah, you ain't kidding. I feel it big time too. You're absolutely right about the multifaceted approach. With my life choices (i.e. the OMFS residency), all those luxuries like eating food that isn't out of a vending machine and sleeping are not often options.

I seriously considered dropping out during my general / vascular surgery rotation - rounds at 5:30 am, 18-20 very ill vascular patients on the ward, an attending with an ego bigger than...I can't think of anything that big at the moment. Getting out at 10 pm. I truly feel sorry for general surgeons.

Life is good for now, I'm on anesthesia for 2 more months and getting out early and even eating well and exercising. People are happier in that line of work that gets passed on to me. I met my wife and daughter again too! Turns out they're fascinating people!

> So, why is it you're cutting back on the clonazepam? Not enough risk in your life? <teasing, but seriously teasing>

Probably the same reason I chose to take on the residency - overestimating myself and my capacity to cope and continuing to neglect myself (it will pay off eventually... right?).

I'm tapering because my oh-so-caring doc reminded me that I'm a resident surgeon who takes a benzo and that I should take an SSRI and propranolol like all the rest of the good little surgeons do. I was frustrated and baffled, but I took that chance to do a trial taper and it hasn't been as bad as I thought. I'm taking it SLOW, and refuse to feel any withdrawal.

Clonazepam has been a lifesaver over these difficult years, but I love the idea of not being dependent on psychiatrists - I really have gotten fed up with the federal health care system. The good patient-oriented psychiatrists are the exception rather than the rule in my experience. There is far too much cover your a$$ mentality at the expense of the patient. Probably due to the high demand for mental health care in the military, very little thought appears to go into their treatment plans. For anxiety, It's pretty much SSRI or suffering.

> I would describe medication for mental illness as generally being an incomplete treatment.

Couldn't agree more here. As I have gotten older, I've lost a lot of my initial enthusiasm in meds and conventional psych treatments. I could go on about how modern psychiatry hinders a more thorough approach, but that's for another forum. The bottom line is that if you want to get better, you really need to be very proactive with your health, because nobody else will.

> Well, you got me looking. Phase III clinical trials (one for GAD, one for depression) have wound up for Pexacerfont, a CRF-1 antagonist drug. They only recruited females, though. Nothing published yet.

> And there is another one called antalarmin. Doesn't work well as a standalone drug, apparently. If they could come up with a CRF-2g antagonist, that might be great, as those receptors are only in the amygdala.

The name is a bit smarmy - antalarmin? However, I like that these are still being investigated. I hate my amygdala, by the way.

> Good to see you, Matt.

Likewise, Lar. You're a huge intellectual asset here. People who post here, including me, are very fortunate to "have" you.

So now that I vented to you, what have you been up to these days?





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