![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
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Posted by viridis on October 20, 2002, at 0:06:43
In reply to My Klonopin (Clonazepam) isnt working at all!!!!!, posted by Jefff on October 19, 2002, at 17:47:17
Jeff,
Xanax is an excellent drug, and if that's what works for you then you just have to find a doctor who understands that. I know you're limited in your treatment options, but somehow you have to get someone who's intelligent enough to prescribe what you need. Many doctors are leery of Xanax (it's supposedly "addictive", blah blah blah) so, you need to go in and clearly, rationally explain that you've tried various options, and this is what establishes mental stablility for you.
A couple of suggestions: don't give any hint that you like it, only that it stabilizes your mood and makes you feel normal (which is how it should work anyway). Also, use the generic name alprazolam (pronounced "al-pra- zo-lam", with the stress on "pra") rather than Xanax, and try to sound as clinical (= matter-of fact) as possible; i.e., this medication helps me function optimally, no more.
I'm not suggesting any tricks; it's just that doctors are so wary of Xanax that you have to be especially careful to present your case in a very factual, non-emotional way. Xanax is an excellent med that's gotten a bad reputation because a tiny minority of people abuse it.
I take Xanax, among other things, and once asked my psychiatrist if (should I move etc.) I would have trouble getting another pdoc to replicate his treatment regime (which has been excellent). He went down the list: Neurontin, no problem; Klonopin, should be fine, dose is low; Adderall, probably OK, dose is low and ADD diagnosis is established; and then Xanax... this is the tricky one. He thinks it's a great med for some people (like me), but told me straight out that if you ask most doctors for Xanax, they'll peg you as a drug-seeker. So, he advised caution in requesting this drug, although in my case, my history supports its use (and I only use it occasionally). That's why I recommend the strategy above.
BTW -- I imagine you could get Xanax on-line, but try your best to get a legitimate prescription from a real doctor. You have to search to get a pdoc who really understands you and will do what's best. Don't give up! There are good ones out there, even if you have to fight for appropriate treatment.
Posted by Jefff on October 20, 2002, at 3:29:31
In reply to Re: My Klonopin (Clonazepam) isnt working at all!!!!! » Jefff, posted by Alan on October 19, 2002, at 23:02:14
"> Can you expand on why you are not prescribed xanax if that's what works for you? Klonopin is well known for causing irritibility and even depression and rage in a sizeable segment of the population taking dosages high enough for their situation.....it's all side effect.
> Is your doctor a benzophobe or do they not realise that different bzds cause different reactions to differing individuals, or do you have a history of D/Abuse or.....?
> Curious,
> Alan"Alan,
Ill have to start my long winded answer by saying that I have in my lifetime done recreational drugs (hate alcohol though) but no, I have no history of drug abuse. OK, I do still smoke too much pot- which I dont tell my psych. about as I dont want him to all of a sudden attribute all of my problems to pot use.
When I began going for therapy in 95 (weekly with a social worker) I was adamant about not taking any medications as I didnt think meds were going to cure my severe emotional problems. But a severe depressive episode and the strong suggestion from my therapist in 96 quickly changed my mind about that and I allowed the psychiatrist at the place (they call it a guidance center) to put me on Prozac. It got me out of the severity of the irrational depression (I was crazily convinced and literally suicidal once again over my belief that I was going bald- which btw I wasnt) but Ive always been depressed even before and still after that. I stopped taking the Prozac about two or so years later as it wasnt doing anything at all and I was still hoping my weekly therapy was going to help (It didnt). Then in 12/99 I asked the Psych to put me on Paxil which Ive been on ever since. Its been useless.
So...after going out of my mind (particularly severely so in the past few months) with anxiety, rage, depression and just internal angst I did some net research last month, found this site, and learned that Benzos are what I need. My shrink appointent wasnt for another few weeks so my roomate was able to get me some Xanax from someone- about 1.5mg a day for about four days and as I said it totally normalized me. Yes, I felt a bit dopey but it was the calming, anti anger, anti anxiety, anti racing thought properties that made me so thrilled with it.
And then when my shrink appt. came I explained to him that Id been doing a lot of research on the net and that I had concluded that I needed Benzos (and I didnt tell him I had sampled the Xanax although now I think I should have). Anyway he immediately launched into how they are soooooooo addictive, blah, blah blah. He didnt give a crap about what I had to say about what Id read. I got to the point to where I got totally furious and irrate with him and started balling him out for having no problem pumping me full of paxil for three years (which he denies/miniizes the withdrawal of that) when he knows damn well that Ive been imprisoned in my house due to severe anxiety etc for seven years now and he can obviously see that the Paxil wasnt doing crap for me.... and yet when I finally opened my mouth and ask for what I believe/knew would help he gave me hell over it and was going to allow me to suffer rather than give it to me.
He absolutely refused to give me the Xanax claiming that it would only work for a short period, then make me feel worse when I came down and all this other crap. I honestly wasnt really even listening as I wanted to strangle him at that moment.
I cant believe he finally even gave in and gave me the Clonazepam, and im sure he only did that because I was making such an issue (of him being so oblivious and incompetent---although I didnt use that word).
Nedless to say Ive had it with him so I made my next medical appointment with the only other person there (a nurse practitioner). I really doubt that she's going to be any different and I doubt Ill get the Xanax from her either.
Jeff
Posted by Jefff on October 20, 2002, at 4:08:54
In reply to Re: My Klonopin (Clonazepam) isnt working at all!! » Jefff, posted by viridis on October 20, 2002, at 0:06:43
Howdy,
Actually I ended up calling the Nassau County Medical Center on thursday (I live in Long Island, NY) and after a nice lengthy converstion with an intake nurse (from the out patient mental health clinic) I luckily learned that their shrinks dont ever prescribe benzos (according to her there are so many better, newer, non addictive meds such as buspar,and wellbutrin and blah, blah, blah that they dont need Xanax). Is this just a New York thing??
Well at least I found that out before I stopped going to the place Im currently going to, otherwise Id have been totally screwed.
Thanks for the tips too btw. My next step is to see the nurse practitioner on nov 8th and plead my case to her. Its really hard for me to remain calm and non emotional though if Im getting the deaf ear treatment, but Ill try. I really hope she'll be differnet but I remain entirely cynical until I see.
How could they deny me something (legal meds) that will help me when they know Ive never in the past seven years Ive been going to this place asked for any other meds? It kills me to know that they could so easily provide me with some relief after all the years Ive suffered, yet they refuse because I may become "addicted"?
Well, which one is worse? Living my life in sheer misery or being "addicted" to something that will help me "live"?
Thanks again for listening,,
Jeff
"> Jeff,
>
> Xanax is an excellent drug, and if that's what works for you then you just have to find a doctor who understands that. I know you're limited in your treatment options, but somehow you have to get someone who's intelligent enough to prescribe what you need. Many doctors are leery of Xanax (it's supposedly "addictive", blah blah blah) so, you need to go in and clearly, rationally explain that you've tried various options, and this is what establishes mental stablility for you.
>
> A couple of suggestions: don't give any hint that you like it, only that it stabilizes your mood and makes you feel normal (which is how it should work anyway). Also, use the generic name alprazolam (pronounced "al-pra- zo-lam", with the stress on "pra") rather than Xanax, and try to sound as clinical (= matter-of fact) as possible; i.e., this medication helps me function optimally, no more.
>
> I'm not suggesting any tricks; it's just that doctors are so wary of Xanax that you have to be especially careful to present your case in a very factual, non-emotional way. Xanax is an excellent med that's gotten a bad reputation because a tiny minority of people abuse it.
>
> I take Xanax, among other things, and once asked my psychiatrist if (should I move etc.) I would have trouble getting another pdoc to replicate his treatment regime (which has been excellent). He went down the list: Neurontin, no problem; Klonopin, should be fine, dose is low; Adderall, probably OK, dose is low and ADD diagnosis is established; and then Xanax... this is the tricky one. He thinks it's a great med for some people (like me), but told me straight out that if you ask most doctors for Xanax, they'll peg you as a drug-seeker. So, he advised caution in requesting this drug, although in my case, my history supports its use (and I only use it occasionally). That's why I recommend the strategy above.
>
> BTW -- I imagine you could get Xanax on-line, but try your best to get a legitimate prescription from a real doctor. You have to search to get a pdoc who really understands you and will do what's best. Don't give up! There are good ones out there, even if you have to fight for appropriate treatment."
Posted by Dinah on October 20, 2002, at 8:39:55
In reply to Re: Klonopin isn't working well enough. » Dinah, posted by Simcha on October 19, 2002, at 19:22:27
Thanks Alan. I think the 2 1/2 mg that I've been authorized to use will be enough to ride this out, perhaps not comfortably, but I'll make it.
Hi Simcha, I think I'm in a downswing of my cyclothymia with a lot of agitation and tons of anger (more than anxiety) thrown in. And I just don't find klonopin works as well for anger. If I can ride it out I'll be ok I think. That's the up side of cyclothymia. Whatever it is won't last long.
Posted by Alan on October 20, 2002, at 12:18:15
In reply to Re: My Klonopin (Clonazepam) isnt working Alan, posted by Jefff on October 20, 2002, at 3:29:31
> "> Can you expand on why you are not prescribed xanax if that's what works for you? Klonopin is well known for causing irritibility and even depression and rage in a sizeable segment of the population taking dosages high enough for their situation.....it's all side effect.
> > Is your doctor a benzophobe or do they not realise that different bzds cause different reactions to differing individuals, or do you have a history of D/Abuse or.....?
> > Curious,
> > Alan"
>
> Alan,
> Ill have to start my long winded answer by saying that I have in my lifetime done recreational drugs (hate alcohol though) but no, I have no history of drug abuse. OK, I do still smoke too much pot- which I dont tell my psych. about as I dont want him to all of a sudden attribute all of my problems to pot use.
> When I began going for therapy in 95 (weekly with a social worker) I was adamant about not taking any medications as I didnt think meds were going to cure my severe emotional problems. But a severe depressive episode and the strong suggestion from my therapist in 96 quickly changed my mind about that and I allowed the psychiatrist at the place (they call it a guidance center) to put me on Prozac. It got me out of the severity of the irrational depression (I was crazily convinced and literally suicidal once again over my belief that I was going bald- which btw I wasnt) but Ive always been depressed even before and still after that. I stopped taking the Prozac about two or so years later as it wasnt doing anything at all and I was still hoping my weekly therapy was going to help (It didnt). Then in 12/99 I asked the Psych to put me on Paxil which Ive been on ever since. Its been useless.
> So...after going out of my mind (particularly severely so in the past few months) with anxiety, rage, depression and just internal angst I did some net research last month, found this site, and learned that Benzos are what I need. My shrink appointent wasnt for another few weeks so my roomate was able to get me some Xanax from someone- about 1.5mg a day for about four days and as I said it totally normalized me. Yes, I felt a bit dopey but it was the calming, anti anger, anti anxiety, anti racing thought properties that made me so thrilled with it.
> And then when my shrink appt. came I explained to him that Id been doing a lot of research on the net and that I had concluded that I needed Benzos (and I didnt tell him I had sampled the Xanax although now I think I should have). Anyway he immediately launched into how they are soooooooo addictive, blah, blah blah. He didnt give a crap about what I had to say about what Id read. I got to the point to where I got totally furious and irrate with him and started balling him out for having no problem pumping me full of paxil for three years (which he denies/miniizes the withdrawal of that) when he knows damn well that Ive been imprisoned in my house due to severe anxiety etc for seven years now and he can obviously see that the Paxil wasnt doing crap for me.... and yet when I finally opened my mouth and ask for what I believe/knew would help he gave me hell over it and was going to allow me to suffer rather than give it to me.
> He absolutely refused to give me the Xanax claiming that it would only work for a short period, then make me feel worse when I came down and all this other crap. I honestly wasnt really even listening as I wanted to strangle him at that moment.
> I cant believe he finally even gave in and gave me the Clonazepam, and im sure he only did that because I was making such an issue (of him being so oblivious and incompetent---although I didnt use that word).
> Nedless to say Ive had it with him so I made my next medical appointment with the only other person there (a nurse practitioner). I really doubt that she's going to be any different and I doubt Ill get the Xanax from her either.
> Jeff
>
================================================First, show your new doc this article (the commonly accepted dictinction made by all physicians that know their stuff when it comes to treating anxiety disorders):
http://panicdisorder.about.com/library/weekly/aa031997.htm
Stable dependencey is not the same as addiction as they have no clue about. (What happens when many try to discontinue paxil for instance?)
Then ask them if they had ever heard of klon. exacerbating irritibility and depression.
Then ask them if they have ever heard of the World Health Organisation (the least commercially driven organisation on the planet when it comes to evaluting the commercially driven AD's and other meds in general).
Then ask them if they know of their findings in their review of 40+ years of studies on bzs known as "The Rational Use of Benzodiazapines" concluding that bzds in monotherapy are safe in short AND long term therapy.
If any doctor can't answer these basic questions or do not understand these basic concepts, fire them immediately and get a secon or even third opinion. I've heard of some docs giving their patients limited supply (to start) of bzds to see how they do but not to let them try it is absurd.
The final question you probably have to ask yourself is this:
Why are you consistently smoking pot? This, as alchohol, is usually used most of the time, in the way that you describe it, for self medication. If you finally did find a doc that you felt safe admitting this to, they would still have a hard time justifying prescriptins of a bzd...but then again, if there is some way of convincing yourself AND them that you are not gong to smoke pot while at the same time taking xanax they my at least be inclined to listen.
Smoking pot to physicians is "drug-seeking behaivour" and almost immediately disqualifies you for xanax because of your penchant to seek highs. In their minds, "potential for abuse goes way up".
That's not to say that you want to , with the help of an open minded doc that you are willing to be monitored as to your quit seeking this high, and substitute the xanax or ativan or whatever for the pot.
It seems entirely up to you if you are serious about confronting these issues.
Rehabilitate off of the pot first, prove that to your doctor, and hope that you have one compassionate enough to understand that you were self-medicating with pot.
Many AA members are successful at making the switch from the bazooka-like effect of alcohol to the lazer-like effect of bzds to treat anxiety disorder (this is the diagnosis, yes?). Or is it depression secondary to the overwhelming anxiety?
Alan
Posted by Squiggles on October 20, 2002, at 13:31:00
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Jefff, posted by Alan on October 20, 2002, at 12:18:15
For what it's worth, my experience with
benzos: Xanax with its short half-life
induced panic attacks and irritability,
phobias, fight or flight responses. I never
knew where these problems came from until
i studied the net.Klonopin (given just as long ago as Xanax
i.e., about 12 yrs.) presented with completely
different effects. I would say that they
were more somatic. After a number of years
of taking it, for example, if i missed one
i experienced something like a stroke, and
temperature fluctuations, as well as orthostatic
hypotension and gastrointestinal problems.I withdrew from X but got a stroke from K.
If i were a doctor and had to choose between
the two, would go with Klonopin. As serious
as the withdrawal is, IF you stay on it indefinitely,
there are far fewer perceptible side effects,
and NO anxiety or panic in between.
BTW:
I have a friend who has a dilemma with AD induced
anxiety, or maybe even endogenous, and it seems
that Serzone is proving to be a good anxiolytic
AD - this drug is post SSRI, so one hopes that
progress in psychiatry is a real possibility.Hope this helps a bit.
Squiggles
Posted by Alan on October 20, 2002, at 15:56:55
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Alan, posted by Squiggles on October 20, 2002, at 13:31:00
> For what it's worth, my experience with
> benzos: Xanax with its short half-life
> induced panic attacks and irritability,
> phobias, fight or flight responses. I never
> knew where these problems came from until
> i studied the net.Interesting. What exactly do you mean in your case? All of the news and research I've seen provide for just the opposite that I've ever seen...unless you had a "paradoxical" reaction which is not out of the question with any med.
>
> Klonopin (given just as long ago as Xanax
> i.e., about 12 yrs.) presented with completely
> different effects. I would say that they
> were more somatic. After a number of years
> of taking it, for example, if i missed one
> i experienced something like a stroke, and
> temperature fluctuations, as well as orthostatic
> hypotension and gastrointestinal problems.
>
> I withdrew from X but got a stroke from K.Sounds like bzds were not for you (to come off of anyway). Was there medical (MD) confirmation of a stroke directly causal to klonopin? I've never heard of that. The other symptoms I have heard of...especially if done too quickly or less likely if there weren't underlying symptoms that had developed while on klonopin.
>
> If i were a doctor and had to choose between
> the two, would go with Klonopin. As serious
> as the withdrawal is, IF you stay on it indefinitely,
> there are far fewer perceptible side effects,
> and NO anxiety or panic in between.
> BTW:
> I have a friend who has a dilemma with AD induced
> anxiety, or maybe even endogenous, and it seems
> that Serzone is proving to be a good anxiolytic
> AD - this drug is post SSRI, so one hopes that
> progress in psychiatry is a real possibility.
>
> Hope this helps a bit.
>
> SquigglesGenerally, a small segment of the population have these extreme difficulties during the withdrawal process. Sounds like this class didn't agree with you...or that your "sustained medical dependence" on Klonopin is essential in the treatment of your disorder?
By the way, AD induced anxiety for anxiety disorder dx'ed patients is the side effect most reported by patients with these disorders. That's why they are usually given bzds to take PRN simultaneously when alternatively, bzd monotherapy wouldn't have the plethora of other side effects associated with the latest and greatest commercially driven AD.
Alan
Posted by Squiggles on October 20, 2002, at 16:15:47
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Squiggles, posted by Alan on October 20, 2002, at 15:56:55
Alan,
I just can't talk to you. You sound like
a pharm rep, and where I try to be helpful
and candid, you sound like a real pain in
the *ss.Squiggles
Posted by Lou Pilder on October 20, 2002, at 16:27:37
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Alan, posted by Squiggles on October 20, 2002, at 16:15:47
Sqiggles,
Lou hear...
I have been reading your posts and I am wondering if you have any more infomation about X and K that you havn't shared with us yet. I recognise that you have an extensive knowlege from working with people trying to withdrawal from BZs and I am wondering if you have any new infomation to share with us, perhaps, from Canada?
Lou
Posted by Squiggles on October 20, 2002, at 16:54:01
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Squiggles, posted by Lou Pilder on October 20, 2002, at 16:27:37
Hi Lou,
Long time no here - well i guess Alan shouldn't
compete with your bedside manner :-)I would be happy to share my news. I am happily
off XANAX for 3 yrs now and no longer have the
daily panic attacks I used to. You can't imagine
how happy i am.As for the Rivotril (Klonopin) - after a year
and a half of trying to get off 1.0 mg, i arrived
at a state which had the following symptoms:- myoclonic seizure experienced the year before
(and so pronounced by an emergency doctor) became
more intense. Sitting at the computer, i felt
large electric cables crawling up my spine/head
area. They proceeded towards one side of the head
then the other. They then seemed to pick up
electric force. After that I felt an axe like
slam on the back of the centre head. My head
felt as if it was on fire.After that, i lost memory for a while, but i did
call my husband. After that, i was unable to walk
steady, my blood pressure seemed to go up and down,
I had horrible pain in the head, trouble breathing,
my pupils were fixed tiny and stayed there, and
i had the strange experience of falling asleep while
standing. My sleep cycles were completely off, and
when i did wake up i felt very sick and nauseous.
I had very deep emotional depression and physically
I felt very immobile.It took a month to recover. The worst part, was
that i was not able to place my head on the pillow
as it hurt too much. My mother was very concerned
and may have shared my thoughts that i was dying.My dr. on the phone said no, it was not hemmorrhage,
no it did not sound like stroke, no it did not sound
like seizure... it was withdrawal.Well, i am not a doctor, but from what i read on
every addiction book this was a stroke/seizure of
a type maybe specific to K.It has now been a year and the waves of withdrawal
took a while to subside but i am stabilizing.I don't know if many people went through that
at the Benzo group - i was so upset I called them
all Scientologists.I had to reinstate the entire dose and some.
That was the bone of bitter contention at the
Benzo group - i insisted that people not be let
go so far as i did. I think it is dangerous.
And, perhaps my doctor knew something but let
me try -- i.e. that i should not have gotten off
Klonopin.
Questions: What was it? If not a seizure or stroke?Why was it so hard to come off such a small dose?
Why did i get prescribed on this in the first place?
Do i need it or am i just addicted?
Why was I not sent to a detox centre?
_______________
Well, that's my story.
Squiggles
Posted by Alan on October 20, 2002, at 16:54:36
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Alan, posted by Squiggles on October 20, 2002, at 16:15:47
> Alan,
>
> I just can't talk to you. You sound like
> a pharm rep, and where I try to be helpful
> and candid, you sound like a real pain in
> the *ss.
>
> Squiggles
============================================
Pardon me. The post I replied to in a civil manner was addressed to me - from you. Sorry if I misunderstood. Perhaps you meant it directed to someone else.My initial reply was based on my own experience of taking all of the bzds and just about every other med for the last 20 years.
I do not believe that the information I supplied or asked about was anything but based on my own experience of my reading of the anecdotal plus medical evidence.
Alan
Posted by Squiggles on October 20, 2002, at 17:06:11
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Squiggles, posted by Alan on October 20, 2002, at 16:54:36
If you took so many benzos for so long,
and yet your experience is so different,
there must be a reason. We must differ
somehow - maybe another drug, maybe the heat;
i don't know. I wrote my whole story to
Lou. I do feel lucky to be alive.Squiggles
Posted by Lou Pilder on October 20, 2002, at 17:11:24
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Lou Pilder, posted by Squiggles on October 20, 2002, at 16:54:01
Squiggles,
I have heard of similar withdrawal episodes from others. A man emailed me a few months ago with the same thing, on K, that you are describing and he was down to a fraction of a mg and could not go to zero without experiancing what you have described. He was on K for 10 years.
I am gad that you are better. I hope to hear from you again,
Lou
Posted by Squiggles on October 20, 2002, at 17:46:50
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Squiggles, posted by Lou Pilder on October 20, 2002, at 17:11:24
Thank you Lou;
Then it's K-specific; i think i saw a couple
of papers on this - maybe a new syndrome.I appreciate the company even though it was
a bad experience, and i do recall you were
there with some kind words.Take care and make this known.
Squiggles
Posted by Alan on October 20, 2002, at 19:31:11
In reply to Re: My Klonopin (Clonazepam) isnt working Alan » Alan, posted by Squiggles on October 20, 2002, at 17:06:11
> If you took so many benzos for so long,
> and yet your experience is so different,
> there must be a reason. We must differ
> somehow - maybe another drug, maybe the heat;
> i don't know. I wrote my whole story to
> Lou. I do feel lucky to be alive.
>
> Squiggles
===========================================
I'm sure that you do. And there is a segment of the population that have bad reactions to drugs of all sorts and are stuck by lightning it seems when it comes to being hit with a confluence of events that are difficult at best to tease out.But this gets back to the essential complaint that I have about relating these types of unfortunate stories....and the notion that contradictions to those stories are only that of drug reps or phar. houses (of which I am neither).
And that is:
One can not logically extrapolate or generalise for an entire population about any medication risk based on their own personal experience. It's a generally and widely accepted axiom in the world of science and medicine.
The anti-benzo movement is quite skilled at doing this and the www.benzo.org site is a leader in advancing their scare tactics in this regard...especially now that they have the opportunity to use the www and reach millions to spread their unsubstantiated half-truths for moral and especially political purposes (to effect NHC systems, prescribing patterns, lawsuits, etc).
Serious physicians treating and specialising in the anxiety disorders that may take a short visit to these websites and a couple other like them may be laughing at the mere glance of such psudeo science but what's troubling is that many are unaware of the influence that typically med phobic anxiety sufferers are reacting to these website's exaggerated statement of risk, therefore believeing that bzds are not an option to ask their physician about.
PS. Actually I've been comlimented many times for my bedside manner. I'm hopefully a diplomat of some stripe to some people.
That is why I feel obligated to correct misunderstandings about bzds that are out there in the ether somewhere - most especially about the extrapolating part.
Otherwise, at the risk of peoples well being, their jobs and family risk being unnecessarily being put into "detox" centers simply because they show a "level and sustained medical dependence" on a medication that they are doing well on.
Benzophobia is to psychiatry what Opiodphobia is to pain management.
It's slowly evolving but has a long was to go based on the half-truths and psudeo science I see on these tabloid sites.
Again, this is not to say that a population of all kinds of folks do not have bad reactions to all kinds of drugs. But to place the barrier of stigma and guilt between the already crowded relationship between patient and doctor where commercial interests are already intruding to such a breathtaking degree through their promotion of AD's over the less profitable but more effective bzds is one of the biggest problems facing psychiatry today IMO.
Otherwise, where has the patient's freedom to choose treatment about their anxiety disorder gone?
End of rant.
Alan
Posted by Squiggles on October 20, 2002, at 19:53:02
In reply to Re: My Klonopin (Clonazepam) isnt working » Squiggles, posted by Alan on October 20, 2002, at 19:31:11
Alan,
I appreciate your posts very much. I love
reading them because they are thoughtful,
informed, and caring. I think you are a
nice person. I was only teasing about bedside
manner (chacun a son gout):-).You may be right about some aspects of
the benzo group. There are many people
who have experienced severe withdrawal symptoms
and as I have told you before, just about every
medical text i have read on addiction, puts
the benzos along side (though not as severe)
the barbituates, for withdrawal severity.
Seizures after long use is not uncommon and
can be fatal.As for my case, i admit that i have had my
sceptical moments. I have wondered if perhaps
the lithium was not the culprit. My dr. lowered
my thyroxine med. about 40% and kept the lithium
at the same level about 3 years before this
stroke thing happened. It could have been the
lithium that gave me this cerebral event.
It could have been drug displacement with the
Klonopin coming off and the lithium kicking in.
Or it could have just been the Klonopin withdrawal--at
least that is what my doctor said.So, you are correct in saying that each case is
complex and many other factors come into play.
For example during the summer that happened, we had
the hottest summer on record - maybe it was a heat stroke.But remember, my doctor said it was withdrawal.
Frankly, I don't know. What is really disturbing
is that nobody knows, and nobody checked the inside
of my brain. I am little worried about these issues.As for scaring people off benzos - i really believe
that benzos, if given with adequate supervision can
do a tremendous amount of good. But that can be
said of not just benzos, but any drug, and any
medical treatment. Famous last words!Squiggles
Posted by Alan on October 20, 2002, at 20:15:55
In reply to Re: My Klonopin (Clonazepam) isnt working » Alan, posted by Squiggles on October 20, 2002, at 19:53:02
> You may be right about some aspects of
> the benzo group. There are many people
> who have experienced severe withdrawal symptoms
> and as I have told you before, just about every
> medical text i have read on addiction, puts
> the benzos along side (though not as severe)
> the barbituates, for withdrawal severity.
> Seizures after long use is not uncommon and
> can be fatal.
==============================================Well, withdrawal severity is not the same as withdrawal commonality. And that's the distinction that needs to be made vis-a-vis the inflammitory rhetoric surrounding the lumping of narcotics and bzds when concerning withdrawal....especially viewed through the prism of texts on "addiction".
I certainly wouldn't want to be prescribed to and managed by an addictionologist where the whole world would seem to be a stage for case after case of "addiction". There are few addictionologists that even make the distinction between "addiction" and appropriate sustained levels of "medical dependence". And that's where the problem lies. Docs looking for problems where they do not lie.
The fact of the matter is that the vast majority of those "addicts" that are using bzds are not using them alone but to get from high ot high from one illegal substance (or alcohol) to another as sort of a buffer. Of course there are going to be narcotic-type withdrawals for those that are poly-drug abusers or have such high dosages to begin with or most importantly have a predisposition for drug-seeking behaivor.
Unfortunately addictionologists will look first at the drug and not at the patient's attitude towards a drug as the genesis of the problem.
Most don't go out seeking highs - at least the type of hard core addicts that I'm speaking of - and that's what makes them different from you and me. Same with opioids for pain. Why do we discriminate between physical and psychic pain? It's so deeply rooted culturally speaking that grandma or mum aren't given enough pain medication for fear of being addicted just for the sake of being addicted! Where does that rationale come from? How is that compassionate?
We treat them more humanely these days I hope but why is the use of bzds to treat psychic pain so demonised and such a moral issue for folks? Because people may become medically dependant on them. To withold them as anything other than an eqivalent for treating the anxiety disorders borders on Calvinism.
No, it is Calvinism.
Alan
Posted by viridis on October 20, 2002, at 20:49:01
In reply to Re: My Klonopin (Clonazepam) isnt working » Squiggles, posted by Alan on October 20, 2002, at 20:15:55
I agree with Alan. Benzos have helped me tremendously, with essentially no side effects and no need for any increase in dosage. The various ADs I've tried have had terrible side effects and have increased my anxiety, even at very low doses, and for me these effects don't disappear with time. I know others who have done extremely well on Prozac, Celexa, etc., so I'm sure these are great meds for some people. However, I no longer have any patience with doctors who push these drugs on me when I tell them of my experiences, and my positive reaction to benzos. Fortunately, I now have a totally non-benzophobic psychiatrist who quickly realized that benzos were appropriate meds for me, and that SSRIs and Wellbutrin were not.
I haven't tried to withdraw from benzos (and don't have any plans to in the near future). My psychiatrist was very straightforward in telling me that medical dependency was likely to develop, just as it does with various ADs, blood pressure meds, insulin, etc. According to him, supervised withdrawal from benzos by slow taper is quite routine and is not a problem for most people. However, he seems most concerned that I continue to take benzos, because of their proven record of safety, my very positive reaction to relatively low doses, and the damage that long-term anxiety does to one's mental and physical health.
The whole benzo argument seems silly to me. Treatment for for anxiety should be like treatment for any other medical condition. Certain meds are appropriate for some people, not for others. So, find out whether benzos work for you, or whether ADs would be better, and then follow the best treatment plan. If you run into foolish doctors who insist that "one med fits all", or "benzos are addictive", then move on until you find a doctor who listens to what you say and is comfortable with prescribing the best treatment.
Posted by Squiggles on October 20, 2002, at 20:59:08
In reply to Re: My Klonopin (Clonazepam) isnt working » Squiggles, posted by Alan on October 20, 2002, at 20:15:55
Alan,
[I find this set up an exercise in memory];
anyway;"Withdrawal severity is not the same as withdrawal
commonality"--granted--because medical prescription
is administered indefinitely, and in my case (K)
for the rest of my life. It is a tautology in these
circumstances that the patient will not experience
withdrawal severity, unless the doctor fails to raise
the dose. That is what happened to me with Xanax
and how I found out. The nature of the drug plays
a role as well. It is not the case with Klonopin as this
drug may take 7 yrs to up the level before tolerance
is reached. Don't ask me why - i am not a pharmacologist.As for benzo addicts who take the drug possibly because
they are coke addicts or need something to bring them down
(street drug addiction), i would be very surprised if
the principles of addiction on the body is any different
here than for a CEO who drives a Porsche.Regarding psychic pain, i disagree with you - there is
compassion here. Doctors DO prescribe anxiolytics
for anxiety, which is a psychic pain; as well as
post traumatic disorder and maybe even the agitation that
can accompany deep grief.Squiggles
Posted by Squiggles on October 20, 2002, at 21:04:55
In reply to Re: My Klonopin (Clonazepam) isnt working, posted by viridis on October 20, 2002, at 20:49:01
I think that each person should choose
the drug that she or he feels comfortable
with. And i think you have a considerate
doctor to work with you.I am not sure for how long benzos will
work their magic without deliterious side
effects. Personally, Xanax destroyed my
life plans and projects--however, it is
conceivable that had I raised the dose
this may not have happened.Again, with Klonopin (raised a couple of times
in 15 yrs) the same was not the case. And
who knows, maybe the type and half-life of the
benzo will make a difference.You are also correct in bringing up the many
side effects of the ADs and the trials and
tribulations one has to go through to get the
right fit. I know from my friend, who finally
after 15 years and some 25 different drug
samples and experiences, has finally hit on
something that doesn't turn him into Mr. Hyde.So, i am glad for you and i hope the effect
continues.Squiggles
Posted by viridis on October 20, 2002, at 21:29:14
In reply to Re: My Klonopin (Clonazepam) isnt working » viridis, posted by Squiggles on October 20, 2002, at 21:04:55
Hi Squiggles,
Thank you for the vote of confidence, and I'm really sorry to hear about the problems you had with benzos. They seem rather unusual, but it just goes to show how much individual variation there is in response to medications.
Klonopin is my mainstay -- I only take Xanax occasionally, for very stressful situations, so I'm not dependent on it, just K. Who knows how I'll feel in a few years. For now, I just feel consistently normal and enthusiastic about life, for the first time in decades. And I am very lucky to have an informed, sympathetic pdoc who really listens to what I tell him and is open to a wide variety of treatment options.
Thanks again, and all the best to you.
Viridis
Posted by Squiggles on October 20, 2002, at 21:35:57
In reply to Re: My Klonopin (Clonazepam) isnt working, posted by viridis on October 20, 2002, at 21:29:14
Viridis,
I really don't think you will have problems
with Klonopin, as long as you stay on it.Had i listened to my doctor, and not tried to
get off it after 15 yrs. i would not have had
such problems. Unfortunately, i succumbed to
the enthusiasm of the benzo group--which has
many useful and informative testimonials. And
even there, variation between individuals
is great.One thing is certain--benzos are addicting.
But, so what? As long as you are taken off easy,
IF you have to be taken off.Squiggles
Posted by Alan on October 20, 2002, at 23:28:11
In reply to Re: My Klonopin (Clonazepam) isnt working » Alan, posted by Squiggles on October 20, 2002, at 20:59:08
>
> Regarding psychic pain, i disagree with you - there is
> compassion here. Doctors DO prescribe anxiolytics
> for anxiety, which is a psychic pain; as well as
> post traumatic disorder and maybe even the agitation that
> can accompany deep grief.
>
> Squiggles
========================================Long term is the exception - that was my impression from your part of the world.
Alan
Posted by Alan on October 20, 2002, at 23:41:44
In reply to Re: My Klonopin (Clonazepam) isnt working » viridis, posted by Squiggles on October 20, 2002, at 21:04:55
> I am not sure for how long benzos will
> work their magic without deliterious side
> effects. Personally, Xanax destroyed my
> life plans and projects--however, it is
> conceivable that had I raised the dose
> this may not have happened.
>
====================================Go ahead and call me an a** for saying so but this is not only a possibility in your case but the probable reason that xanax in general has gotten a bad name - needing dose adjustments or during start - up, many titrations ( the problem being not knowing how to manage it for most people).
Most go by some arbitrary set of guidelines that they can't increase to theraputic levels from an arbitrary starting point to begin with...and what makes it most tricky is the short half-life. Keeping up with dosages account for many a perceived problem I'm sure - especially considering the withdrawal symptom heightens the state of already unberable agintation in many cases.
Too bad there isn't a xanax extended release somewhere in order to combat the misperceptions out there when patients finally get to a theraputic dose, their underlying anxiety fluctuates, they need more, and all sorts of flags go up to the doc that dosage escalation is occuring.
The addictionologist is sure to interrupt at this point.
Alan
Posted by Squiggles on October 21, 2002, at 8:02:43
In reply to Re: My Klonopin (Clonazepam) isnt working » Squiggles, posted by Alan on October 20, 2002, at 23:28:11
If you mean they are prescribed long-term,
and that is the case we are discussing, as
a layman, i really think that is a mistake--not
only for benzos (though they particularly
addictive) but for all psychiatric drugs.
I suspect that the prophylactic business is
really a matter of expediency.Squiggles
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