Benzodiazepines for panic and anxiety

[mike h]

I am 39 years old have had panic and anxiety disorder since I was 12 and in my late 20's became agoraphobic because my panic attack seemed to hit me everytime I left home. I started taking benzodiazepines when I was 27, only took them as needed or when I was going somewhere, I didn't ever take more than 60 pills, one prescription, in a years time. Recently I went to my dr and he talked me into tryin ssri's, first zoloft then paxil cr, these medication are not right for me, they increased my panic and anxiety 100% after just 1 week of use and I was taken off of them. I woke up and was drenched with sweat after the 7th day and it was like someone turned a light switch on in my head, I couldn't sit still couldn't concentrate and my heart was racing at a whopping 147 beats per min for more than 2 hours, I was scared to death. My dr wants to try me on more ssri's but I refused, he also doesn't want me taking the benzodiazepines because of the risk of addiction. This is a new dr, my old dr retired, and he doesn't like to prescribe benzo's at all. Is there any danger of me getting addicted to using them this way, I think it is ridicules, I dont want to have to take anything everyday like ssri's. I only want to take them as needed. They dont make me feel high or tired, just normal. I am affraid of being addicted to anything so I am very very cautious about how and when I take them, I cope with the anxiety the best I can and avoid taking it all together if I'm not planning on leaving home, being self employed makes that easy for me because I work at home.From what I read about ssri's they seem to me to be more addictive than they let on only they sugar coat it and use discontinuation syndrome instead of withdrawl symptoms. I have read so many horror story's and after my own experience with them I have no intension on ever trying them again. Thanks for any input, Mike H

[shoe]

mike, many doctors and psychiatrists are a bit hesitant about prescribing benzos because for some people they can be addictive. Most of the people with anxiety that I've talked to who take benzo's have told me they've never gotten addicted to them though. The people who are really at risk are people who have a history of drug addiction.

Some doctors will actually prescribe benzodiazepines on a daily basis, but you'll find more prescribing it on an as-needed basis or not at all. SSRI's seem to be the drugs of choice for treating anxiety, even though the risks with them are often just as bad. You're not likely to get addicted to SSRI's but you will become dependent on them and will have to taper off them slowly to avoid withdrawal problems. Benzos are supposedly harder to get off if you've taken them on a daily basis for a long period of time.

Anyway, the highest risk for addiction of benzos is if you are taking it daily for a period of time like weeks or months, rather than on an as-needed basis.

There are a few good medication info resources in the Resources section where you might find more info.

If you do decide to go on benzos, you might as well seek out a new dr, one who's more open to helping you the way that works best for you.

[Bridgie]

Mike, I could swear I wrote that myself! You sound just like me. I don't want to take any of the SSRi's anymore, they just don't work for this anxiety problem. But I have a prescription for Clonazapam, and It hink that's a benzo. And I take it just like you, on an as needed basis, and never have had a problem with it, but it's the best thing for anxiety!

Welcome to the forum!

[babycristy]

Hi Mike. I understand your worry about getting on medications on a daily basis. I am only 19 and am scared of getting on meds so I refused to take Paxil when my dr prescribed it. Maybe you can try some type of talking therapy instead. You can also look into herbal pills. The are not as immediate as drugs but in the long term I heard they are not addictive and can reduce your anxiety.

[Maggie May]

I have taken Ativan as a maintenance medication (daily) for several years now. Since I was first diagnosed, in 2000, I have tried about 14 other medications in the categories of SSRIs, beta-blockers, tricyclics, and anti-psychotics in that time, one at a time, trying to find something that will work that isn't a benzo. Like almost everyone with anxiety, I don't want to be addicted to anything, and I'd rather not take Ativan and I take as little as I can, as infrequently as I can. The amount I take is just enough so that I can eat, sleep, and do my schoolwork, about 3 milligrams a day.

Through changing jobs and moving, etc, I have had lots of psychiatrists, and some of them just categorically will not prescribe benzos as a maintenance medication. Either they have had bad experiences with patients becoming addicted, or people who were already addicted coming to them, or they got sued, who knows. It's okay for them to choose not to, they shouldn't prescribe something if they aren't comfortable with it.

But that doesn't mean you should stop taking your 60 pills a year. That's such a tiny amount, I'm surprised your doctor is so insistent about it. My advice is to find a doctor who is comfortable with it. No hard feelings, no crime, no foul. One of the signs of addiction is needing more and more in a short amount of time, not just habituation. So if your new doctor has your chart from your old doctor, he/she can see for themselves that you have not had to take more and more and more over time. It's an awful feeling when a doctor makes you feel like you're a junkie and shouldn't take something that is helping you function normally. I get that vibe from pharmacists too, sometimes. It just comes with the territory.

If you're able to see a different doctor, you might say, "I was seeing my old doctor for blank number of years, and I have been taking blank medication for blank years at blank dose and I'm looking for a doctor that is comfortable prescribing this."

Under most circumstances, I think it's okay to try some new medications. But you had a terrible reaction, I'm so sorry to hear how bad you were feeling. I've been there and hated it. I'm still "auditioning" (as I call it :)) new medications, but I always work very closely with my doctor. We make a plan, I start out with the lowest possible dose, broken into smaller doses, if the pill is scored and can be cut in half or quarters, and I start tapering up extremely slowly. If I get a bad reaction, I stop or taper back down. Like most people, I can't afford to miss so much work or school because of bad reactions. Benzos can be invaluable when you have a bad reaction to another med, the benzos can calm you down when that happens.

So trying out every single medication is a long process, but I am adamant about trying every single medication that is out there before I resign myself to just taking Ativan forever. I have also had good results with CBT and 30 minutes of aerobic exercise a day.

A note about herbal remedies - they can have just as many side effects as prescription meds, and they can have drug reactions with other meds, so work out a plan with your doctor if you want to try some of the herbal stuff. I believe St. John's Wort makes the birth control pill less efffective, not a problem for you since you're male, ;) just an example of the reason to use caution in general.

Good luck to you and keep us posted!

Maggie

[shoe]

MaggieMay,

wow, 14 different medications? You're like a veteran hehe. I have tried an SSRI a multiple reuptake inhibitor (Effexor), a beta blocker, and 3 different benzo's before finally settling on the one I'm taking now (clonazpeam). I've also taken SAM-e and 5-HTP. So hmm.. I guess a total of 8 different things I've tried! You're up on me by 6 :P I've had various levels of initial success on each thing but also eventual failures on most - except the benzos and SAM-e.

Anyway.. what you say about it being okay for psychiatrists to not prescribe something if they don't feel comfortable doing so makes me wonder if most of us should put the psychiatrists through a 'screening' process before wasting valuable money on seeing them. Its ridiculous that they should prescribe what they feel 'safe' with or what currently is the most promoted drug for treating the disorders, rather than to take into account their patient's needs. I've even dealt with psychiatrists that obviously did not do research on the medication they prescribe, and basically went off what the pamphlets or prescribinig materials or colleagues or even drug companies say. Pharmacists seem to know more about the drugs sometimes.

Also, something that gets confused by them is the concepts of 'addiction' versus 'dependence'. Nearly any drug prescribed for anxiety will make you dependent on it if you take it long enough. Addiction is about a compulsion to do something regardless of consequences. Its more a behavioral thing then a physical or biological thing.

For me, the SSRI's and benzos both gave me some kind of dependence on them but I've never taken benzos out of addiction.

[pelliott]

Hello,

I think this topic is great!! I went through hell and back with SSRI's. They make your anxiety condition much worse and do not work. The drug industries that are making these drugs should all be in jail. From hallucinations to not being able to control your emotions, this stuff is toxic.

Maggie, by the end of your trials with SSRI's you will come to a dead end and find no solution. If you think about it, why do you have to go through so many medications? And through all this trial and error, your body is suffering from this poison.

Mike, I would find a doctor that is going to listen to your needs and not be scared of prescribing something you need to help you get through your daily life activities. Your 39 years old, you know your condition, and have been through this long enough not to let a doctor dictate what's in "his" best interest. Lose the doctor and find one who is compassionate with your anxiety disorder.

[Laura]

I to have been reluctant to take benzos because of the risk of addiction. I take Ativan on as needed basis and they work fine . I have been told by several Drs. & Pharmacists that taking it this way will not pose a problem for addiction. If I was taking them everyday several times a day then there would be a problem. Today for example , I am feeling extremely anxious !!!! and could take one but am trying to get through it on my own by trying to focus, keep busy, and talk to you !!! I do take Effexor and Celexa.

[pelliott]

Laura,

That's great that the effexor and celexa is working fine. I guess I was a little harsh with some of my statements above. I went through very hard experiances with these drugs. The conclusion I made about Benzo's is from six years of dealing with different medications for panic/anxiety attacks. There is no solution from both SSRI's or Benzo's but the Benzo's give me release from my condition. I have been on Benzo's for four years and have been on the same mg and dose the whole time. Most people will increase their dose over time because the effects will not be the same and sometimes addiction. The Benzo's do not mask my anxiety totally. When I take the medication it takes the edge off, but I still deal with the issues attributed to my condition with the ability to handle the task at hand. The key to taking this medication is to be open and come off the meds throughout the years to see if your anxieity is ok to handle without the Benzo's.

[shoe]

pelliot, SSRI's do work for some people, don't forget =) But I've had bad experiences with them myself so I pretty much stay away.

Laura, some psychiatrists will prescribe benzos on a daily basis, even a few times a day. It would result in dependence no doubt, but addiction is another thing altogether.

I am a bit wary about some issues with benzo long term use.. like if I stop taking clonazepam cold turkey after taking it on a consistent daily basis for a while, I run the risk of having seizures. But thats if I stop taking it abruptly.

Being my dumb self, I did do this - stopped taking it cold turkey, after having been on it on a daily basis for a month or so. I wound up being pretty shaky and anxious feeling for a few days because of that (but no seizures thankfully!). The experts say to taper off medications slowly, decreasing the dose and frequency bit by bit. I didn't do it, and learned my lesson hehe.