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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 76 to 100 of 119. Go back in thread:
Posted by Dr. Bob on January 3, 2003, at 22:15:58
In reply to In defence of Syringachalet and civility » johnj, posted by bluedog on January 3, 2003, at 19:27:24
> I can guess you have never had a panic attack or a major depressive episode by your statements.
> I just plain disagree with what you said. It would help if you would not be so vauge about what you do. Since you are a nurse, and have experiences, I am shocked at how you feel.
>
> johnj> I feel compelled to refer you to a post recently made by Simcha in this same thread.
>
> http://www.dr-bob.org/babble/20021223/msgs/133772.htmlThat was to john7219, not johnj...
> John you are making assumptions about other posters... Can you please try to be a bit more civil in your posts.
>
> It saddens me that in her last post Syringachalet felt compelled to advise that she would no longer be contributing to this topic because I truly value her views just like I value the views of other posters on this board.
>
> bluedogBut I agree. Please be civil even if you think someone's wrong.
----
> your lack of self disclosure in that post (and others) makes me feel "talked down to".
> Had you personalized your message he, I and possibly others would have been able to better relate to your message.> I'm not judging you. I'm telling you the feeling tone *I* and possibly others may get from reading your posts. You don't have to bore others or repeat your history to personalize your messages.
>
> ZeeZeePersonalizing a message means disclosing more? Thanks for trying to use "I-statements", but please also be careful not to pressure others.
----
> Perhaps you havent had the time or the interest to read any of my past postings.
>
> syringachaletThanks for responding civilly!
Bob
Posted by harry b. on January 3, 2003, at 23:55:54
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » micky301, posted by Mr.Scott on January 3, 2003, at 0:58:36
Somewhere back in the '80's I began taking amitriptyline for panic attacks. I had been having the PA for years but they were getting worse. I did not even know what they were. I could 'feel' them coming on & I got so that I would drive quickly to the hospital & just sit in my truck, sometimes for hours, sometimes all night, wrestling with the PA & the fear. I never went into the hospital, just sat there, outside. It gave me a bit of comfort.
I finally went to a doc about them & began taking amitriptyline. The PA became more mild & less frequent. OK. Now I knew what I was dealing with.
Unfortunately the amitrip began causing severe 'restless leg' problems. At the same time I began having facial tics. My doc gave me Klonopin.
The K stopped the PA dead in their tracks, I have not had a bad one since. It also helped with the facial tics & there were no more 'restless leg' problems.
My current dosage is 3mg/day. I've been on dosages as high as 6mg/day. My actual daily dose varies. Sometimes only 1mg, sometimes 5mg if I'm feeling too intense.
The K, even at 5mg, no longer puts me to sleep. It would probably take double that amount.
Am I 'addicted'? Er, ah, yes. My Pdoc would like me to quit but I'm afraid of the PA.
I guess the worst thing is the 'dumbing down' effect. I can live with an addiction, if it helps me, but I really do not like having a brain that works at half capacity & in slow motion.
harry b.
Posted by HIBA on January 4, 2003, at 0:03:20
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER, posted by micky301 on January 2, 2003, at 23:57:23
BENZODIAZEPINES ARE NOT THE ANSWER
So, what is the answer then ?Those who make such statements have a responsibility to reveal their answers. If you have an answer to all those debilitating psychiatric disorders, If you have an answer to anxiety disorders other than benzodiazepines, please come forward with those unique answers. Antidepressants, CBT ....there could be many answers but none of them exactly match to anxiety disorders. Benzos are not made in heaven, but since we have no effective alternatives, benzos and benzo lovers will survive and exist.
About insulin: Insulin can cause hypoglycemia which is fatal by all means. But if used properly it is a life-saving medication. Pencillin saved millions, but killed some patients too. Even now, penicillin allergy is fatal if immediate medical intervention is failed.But benzos are absolutely safe, much safer than insulin and penicillin. They haven't killed even a single soul in my knowledge, even after intentional overdosing. I have seen a patient who survived after overdosing himself with nitrazepam 1500 mg.(1000 times higher than the normal dose) I can never be that sure in the case of any other medications other than other benzos.
HIBA
Posted by viridis on January 4, 2003, at 3:22:43
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER, posted by syringachalet on January 3, 2003, at 11:24:39
I didn't take offense at Syringachalet's post (although I will quibble with a couple of details), and I always seem to be on here advocating benzos for those who need them. My interpretation of her (his?) message was that there's often more to achieving mental stability and satisfaction than just pills, and I think that this is a very reasonable view. For some people, benzos (and other psychiatric drugs) provide a much-needed break from an intolerable state of mind, and the most fortunate ones are then able to make behavioral/lifestyle changes that alleviate the need for drugs. This takes dedication and willpower, and if you can do it, great.
Unfortunately, some of us (like me) really do need the meds on a long-term basis, and I don't think Syringachalet was denying this.
I guess the main statement that I disagree with is the following:
"Meds are a simply tools to help you help
yourself. No different than therapy, reading
self-help books, or hyponosis..."Meds ARE different if you've already made a real effort with therapy, self-help books, hypnosis etc. and your brain still just won't cooperate. For people in this category (like me) meds are a necessity, maybe for life. But this doesn't mean you shouldn't do everything else you can to improve your life too, and the meds can make this possible. They've certainly helped greatly for me, although things aren't perfect (but I'm working on it...).
Overall, I think Syringachalet's message was sincere and made some very valid points -- you have to do all you can to take control of your mind and your life. For many of us, we have to stay with the meds in order to be able to do this long-term, but the meds alone aren't likely to fix everything.
Posted by Ritch on January 4, 2003, at 9:37:18
In reply to Re: BENZODIAZEPINES , posted by harry b. on January 3, 2003, at 23:55:54
> Somewhere back in the '80's I began taking amitriptyline for panic attacks. I had been having the PA for years but they were getting worse. I did not even know what they were. I could 'feel' them coming on & I got so that I would drive quickly to the hospital & just sit in my truck, sometimes for hours, sometimes all night, wrestling with the PA & the fear. I never went into the hospital, just sat there, outside. It gave me a bit of comfort.
>
> I finally went to a doc about them & began taking amitriptyline. The PA became more mild & less frequent. OK. Now I knew what I was dealing with.
>
> Unfortunately the amitrip began causing severe 'restless leg' problems. At the same time I began having facial tics. My doc gave me Klonopin.
>
> The K stopped the PA dead in their tracks, I have not had a bad one since. It also helped with the facial tics & there were no more 'restless leg' problems.
>
> My current dosage is 3mg/day. I've been on dosages as high as 6mg/day. My actual daily dose varies. Sometimes only 1mg, sometimes 5mg if I'm feeling too intense.
>
> The K, even at 5mg, no longer puts me to sleep. It would probably take double that amount.
>
> Am I 'addicted'? Er, ah, yes. My Pdoc would like me to quit but I'm afraid of the PA.
>
> I guess the worst thing is the 'dumbing down' effect. I can live with an addiction, if it helps me, but I really do not like having a brain that works at half capacity & in slow motion.
>
> harry b.Hi, are you still taking amitriptyline with your clonazepam? Have you tried any of the SSRI's with clonazepam like Paxil or Zoloft, i.e? If so, have they allowed you to reduce your dosage of K? What does your pdoc want to do as an alternative to clonazepam if you quit it? Sorry for the questions, but am just wondering what your doctor's reasoning is on this issue.. Mitch
Posted by ZeeZee on January 4, 2003, at 10:15:40
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » syringachalet, posted by viridis on January 4, 2003, at 3:22:43
>Myinterpretation of her (his?) message was that there's often more to achieving mental stability and satisfaction than just pills, and I think that this is a very reasonable view.
>Overall, I think Syringachalet's message was sincere and made some very valid points -- you have to do all you can to take control of your mind and your life.Herein lies the problem. I doubt there are too many of us on this board who haven't already spent thousands of dollars trying to take control of our mind and life with thousands of hours and dollars of therapy, books, tapes, supplements, exercise, nutritional changes and the parade of medications that either didn't work, made us worse or inflicted intolerable side effects.
I have, and it sounds as if you too have gone this route, learning from it all that without the right medication all of our efforts are in fact fruitless.
When years ago I first found relief from the right AD after years (actually a life time) of struggling, I was immediately hit by how pitiful it was that I had suffered for so very long while silently questioning "my efforts" and blaming myself for my lack of progress.
The obese who have been stuggling with their weight for years already know to eat less and exercise more.
Right now benzo's are all I have.
Posted by syringachalet on January 4, 2003, at 11:36:26
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER, posted by ZeeZee on January 4, 2003, at 10:15:40
ZeeZee,
I know that for most of us our meds are that
'one life perserver' that when it seems that so many other things are not working in our lives we know what to expect from our meds.(or at least most of the time)I also have seen people be able to do things in their lives that noone else thought they could do. Was it because of the meds.. or just a combo of lots of things?
I will probably never run a 10K marathon nor will I ever travel to see the Panama Canal because of my mobility chair. For those who have already or may do these activities someday, I am in awe.
Each of us has our own strengths and limitations. If taking any medication for the rest of our lives helps us to have what WE consider a better life than we should do so. The key is having a doctor who will work with you to maintain your independence and good health for as long as possible.
As we all age, we will also be subject to all the 'normal' maladies that everyone else has
as the body ages; all will need to be figured into the whole person.I try to live for and enjoy today and keep hope for my future. I cant share the details of my personal past with my patients because it is not etchical and would interfer with the nurse-patient theraputic relationship.
Sometimes its hard to leave that N-P realtionship behind and just chat with others as friends.
There too are also vulnerabliity issues that that 'professional distance' provides.Maybe I will make ONE New Years resolution:
To find a few honest but supportive person that I can let that vulernablity down and just be me..
Still thinking about it.... :)
syringachalet
Posted by ZeeZee on January 4, 2003, at 11:50:21
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER, posted by syringachalet on January 4, 2003, at 11:36:26
>To find a few honest but supportive person that
I can let that vulernablity down and just be me..Yes, I hope you will find this as well, and maybe in the future with us.
Take Care
Posted by viridis on January 4, 2003, at 12:21:21
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER, posted by ZeeZee on January 4, 2003, at 10:15:40
Hi ZeeZee,
I don't disagree with most of what you say, and couldn't count all the times people have said things to me like "stop stressing so much", "think positive", "just do something to take your mind off it and you'll cheer up" etc. etc etc. Or recommended some book that would magically change my outlook on life. Or some vitamin, or exercise ... you know the routine.
And then you take a series of meds that don't help and/or make you feel worse, and the doctors act like it's your fault, don't believe you're really having side effects, or say you need therapy. But the therapy doesn't really help either.
So finally you find some drug or combo that actually does work, and then well-meaning people say "you don't need pills to be happy".
It's incredibly frustrating, and yes, I've definitely been there. I doubt I'd be able to function consistently without the right meds, and it's taken years for me to realize and accept this.
My point was that if you do get stabilized with appropriate medication, things don't have to just sort of stop there. You can allow yourself to do things that weren't possible before, you can try things that you were afraid to try before, and so on. And maybe some of the exercise, lifestyle changes, etc. will work in conjunction with your meds to help keep you stable and happy.
I guess that's what I took from Syringalet's message, and it seemed pretty positive to me. But I completely understand your frustration, and I agree that blaming yourself for not being able to live without medication, or letting other people blame you, is futile and damaging.
I'm glad to hear that you've finally found meds that work and (I assume) a doctor who understands your situation.
All the best,
Viridis
Posted by ZeeZee on January 4, 2003, at 12:28:44
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » ZeeZee, posted by viridis on January 4, 2003, at 12:21:21
Thanks for the response.
Actually I haven't yet found the right med's. I'm still searching and benzo's are there in the meantime.
Thanks
Posted by harry b. on January 4, 2003, at 15:59:15
In reply to Re: BENZODIAZEPINES » harry b., posted by Ritch on January 4, 2003, at 9:37:18
>
> Hi, are you still taking amitriptyline with your clonazepam? Have you tried any of the SSRI's with clonazepam like Paxil or Zoloft, i.e? If so, have they allowed you to reduce your dosage of K? What does your pdoc want to do as an alternative to clonazepam if you quit it? Sorry for the questions, but am just wondering what your doctor's reasoning is on this issue.. Mitch>Hi Mitch,
No, am not taking the amitrip. I do take Parnate, 80mg/day, for depression. My Pdoc's reasoning is that the P should deal with the PA, but I'm unsure of that & damned afraid to find out. Also, I don't think the P would control the facial tics.I have gone through most of the AD meds available, including the SSRIs. They were no help. I had to virtually plead with my doc to begin treatment with a MAOI, as a lot of docs are reluctant to prescribe them now.
Take care,
hb
Posted by Dr. Bob on January 4, 2003, at 16:11:06
In reply to Re: please be civil » utopizen, posted by Dr. Bob on December 30, 2002, at 16:59:12
> PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration
Here's a link:
http://www.dr-bob.org/babble/admin/20021128/msgs/8731.html
Bob
Posted by tancu on January 4, 2003, at 19:29:06
In reply to Re: Follow-ups regarding posting policies, posted by Dr. Bob on January 4, 2003, at 16:11:06
Hi John. There is certainly a lot of very reasonable, if not profound, insight offerred up here. I expect that you were just exagerating your point when you made the statement about a yr-long coke/heroin binge. I'm sure you realize that such a binge would be impossible, and I hope you will at least consider the possibility that your use of a .25mg of klonipin each evening is hardly comparable to coke and heroin addiction. Perhaps you are being too hard on yourself. Consider this--a 1/4mg of "dust" can settle atop a gold coin in a day. Is the coin now worth less? Can it's luster not be easily restored?
Posted by micky301 on January 4, 2003, at 20:52:25
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » micky301, posted by HIBA on January 4, 2003, at 0:03:20
You are right, there I do not have the answer and If I did I would be happy to give it to you all. I am here to give my viewpoint, and it appeared as though by coincidence mostly everyone here had very little difficulty handling benzo's. I just had to point out that It so happens that my body could not figure itself out after the chemicals in benzodiazepines took hold.
I myself am currently on .5mg of K , 1000mg Fish Oil, Flaxseed oil, and Estradiol.
I will be adding the MAOI Nardil this coming Monday because that is the only drug that has the consistency of good results I am looking for.
Can you explain to me why so many doctors hesitate to prescribe benzos anymore, ive been to a total of 5 pdocs and only one had a favorable attitude towards benzos. Im no doctor, i dont have the answer, but i would hope people with MD's attached to their names do.
Posted by Ritch on January 4, 2003, at 21:43:51
In reply to Re: BENZODIAZEPINES » Ritch, posted by harry b. on January 4, 2003, at 15:59:15
> >
> > Hi, are you still taking amitriptyline with your clonazepam? Have you tried any of the SSRI's with clonazepam like Paxil or Zoloft, i.e? If so, have they allowed you to reduce your dosage of K? What does your pdoc want to do as an alternative to clonazepam if you quit it? Sorry for the questions, but am just wondering what your doctor's reasoning is on this issue.. Mitch>
>
> Hi Mitch,
> No, am not taking the amitrip. I do take Parnate, 80mg/day, for depression. My Pdoc's reasoning is that the P should deal with the PA, but I'm unsure of that & damned afraid to find out. Also, I don't think the P would control the facial tics.
>
> I have gone through most of the AD meds available, including the SSRIs. They were no help. I had to virtually plead with my doc to begin treatment with a MAOI, as a lot of docs are reluctant to prescribe them now.
>
> Take care,
> hb
>
>Harry, thanks for responding. My pdoc is reticent to prescribe MAOI's. I am hestitant to take them because of Blood pressure concerns. I suppose I should consider myself fortunate to be panic free (spontaneous panic anyhow) with low dose Klonopin. I have "wigged out" in the recent past and needed 1.5mg of K./day for a few weeks, but I seem to get by OK now on .25-.5mg/day with Depakote and a little Effexor. stay well, Mitch
Posted by harry b. on January 5, 2003, at 0:36:19
In reply to Re: BENZODIAZEPINES » harry b., posted by Ritch on January 4, 2003, at 21:43:51
<<My pdoc is reticent to prescribe MAOI's. I am hestitant to take them because of Blood pressure concerns.>>
Rich,
I had the same concerns about MAOIs & BP (see my post). Docs, especially the younger ones, are very reluctant to prescribe the older MAOIs. To date (2yrs+) I have had no BP problems & no hypertensive crisis. The diet is not that restrictive & I've found that I can eat most of the prohibited items in small quantities without consequence. ******I'm NOT advising anyone to do this***** I do stay away from a few foods totally because of what I've read.Your K dosage is low. You should have no problem if you need to stop using it.
Good Luck & Have a Great New Year
hb
Posted by HIBA on January 5, 2003, at 0:51:32
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » HIBA, posted by micky301 on January 4, 2003, at 20:52:25
Hello Micky,
Thanks for your response. The reason why docs still hestitate to deal freely with benzos:
It is upto docs to chose the right medication for the right patient. Some doc see benzos much problematic than antidepressants because of their potential for abuse and dependence, while some are more rational to assess the benefit versus risks ratio and try the benzo route at first. Older antidepressants and newer ones have found to be effective in anxiety disorders,(though not as benzos) but the cost is too high. Whatever pdocs say to you, antidepressants are a life sentence if your disorder is of a chronic nature. That is my experience. Benzos can also be the same, but with a huge difference in the side effect and safety profile. In the case of an overanxious patient, docs usuallly try antidepressant route first hoping that the drug can be withdrawan easily, only to see the same patient a couple of months later in a more disturbed and disorganized state. Then the blame goes to underlying disorders and the possibility of antidepressant induced psychological dependence is conveniently being ignored or unnoticed. Anxiety is often chronic and antidepressants can be a life sentence to such patients, with all those horrible side effects such as memory loss, sexual dysfunction etc. But still some docs vehemently relying on these kind of medications with a frivolous belief that on a bright sunny day before the flood, they can free all their overanxious patients from these chemicals. But if you are unfortunate enough to be categorized in the chronic section, believe me,freedom from medications is not only an illusion, but can be quite unwise also.
So when a long-term therapy is needed, it is wise to chose the safest route. Though not innocuous, benzos are much superior to antidepressants in their safety profiles. They are safer than medicines like aspirin and penicillin. Even decades after their introduction, the controversy over benzos is roughly concentrated on their potential for abuse and dependence. Nothing more to blame. Benzophobics are frequently echoing the same thing. Dependence and withdrawal. That's all. But can't we accept a slight medical dependence in order to function normally? Can't we accept benzo dependence much favourable than a much problematic antidepressant dependence?
HIBA
Posted by FredPotter on January 5, 2003, at 14:28:45
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » syringachalet, posted by johnj on January 3, 2003, at 15:24:03
"only you can cure you" reminds me of when I was very ill and unable to help myself. My health worker turned up because I'd failed to turn up to an appointment. She said, "I can help you but I can't rescue you". I sighed and thought, "quoting from a behaviourist book isn't going to help".
Posted by johnj on January 5, 2003, at 15:58:07
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER, posted by FredPotter on January 5, 2003, at 14:28:45
8
Posted by comftnumb on January 5, 2003, at 23:47:44
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » micky301, posted by HIBA on January 5, 2003, at 0:51:32
Ever since I started taking 2mg Klonopin a day in late October my libido has been very low. I have blamed this on a prohormone (1-AD) I started taking at the same time as Klonopin. One of the side effects of 1-AD is decreased libido. However, this side-effect disappears once you stop taking the prohormone.
I stopped taking 1-AD 6 weeks ago but my libido is still shit. I can still perform sexually but the level of arousal is extremely low. I'm starting to think that Klonopin may be playing a role.
Has anyone else experienced low libido on Klonopin. It doesn't seem to be a listed side-effect, so I have been reluctant to mention this to my psychiatrist as of yet.
I can't come up with any other explanation as to why my libido has decreased so much. Thanks in advance!!!
Posted by Mr.Scott on January 5, 2003, at 23:52:31
In reply to Re: Can Klonopin or other benzo cause libido loss?, posted by comftnumb on January 5, 2003, at 23:47:44
Yes it can definately lower libido. Maybe you could try lowering the dose a smidge and see if things improve.
Also it can cause weight gain which you rarely hear about either.
It's still an imperfect world.
Posted by HIBA on January 6, 2003, at 22:48:13
In reply to Re: Can Klonopin or other benzo cause libido loss?, posted by comftnumb on January 5, 2003, at 23:47:44
This is a rare side effect of klonopin. Excessive sedation could be the reason. In such cases, lowering the dosage will help. If sedation is no more needed switching to librium will often solve the problem. Tranxene is another option.
While I was on klonopin, there was no problem with libido on a low dosage (1 mg a day). When I made an increase I had some problems with libido, which resolved over time. (As we know tolerance to the sedative effects often occur and I think that made the difference). Benzodiazepines have no direct adverse effects on sexual function, but the excessive sedation will always dampen libido. Fine tuning of dosage will usually restore the normal desire. Good luck,
HIBA
Posted by Joanie on January 7, 2003, at 13:36:07
In reply to Re: Can Klonopin or other benzo cause libido loss?, posted by comftnumb on January 5, 2003, at 23:47:44
Yes! Yes! Yes! It makes me numb like you and have a total lack of desire. I've noticed if I don't use it for a few days, I have a little desire starting to come back to me.
Posted by worrier on January 11, 2003, at 19:15:35
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » micky301, posted by HIBA on January 5, 2003, at 0:51:32
Just wanted to say that I think you summed things up quite well. I am curious as to why the whole benzo topic gets everyone so emotional. I thought we were here to help each other if we can or at least support each other. I'm sure benzos are not the answer for everyone. I am equally sure they are the answer for some. I happen to be one who has been saved by them. SSRIs brought me to the point of considering suicide and absolutely knowing I would either die or go completely insane. But I would never tell anyone that SSRIs are not the answer. The answer is whatever you as a unique individual can find to get you through. I wish I didn't need any meds, but I most obviously do and think I probably always will. Many of us probably fall into that category. Let's not judge each other based on how our brains respond to a particular chemical. Best wishes to all, worrier.
Posted by irwind on January 22, 2004, at 22:59:29
In reply to Re: BENZODIAZEPINES ARE NOT THE ANSWER » HIBA, posted by worrier on January 11, 2003, at 19:15:35
Is it ok for some one to take benzos for life. do you know of any one who is doing it. i consider the analagy of insulin dependence as in the case of diabetese. i am considering benzos for anxiety and insomnia. there are so many benzos and what is the best worst when it comes to the issue of developing tolerance.
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