Medication help

[temperancebrennan]

My doctor refuses to prescribe me with Diazepam, which has been the only thing that has worked in the past 6 years that I've been diagnosed with anxiety.

The other medications that I have tried so far have been:
Escitaloptam
Citalopram
Dolmatil sulpiride
Sertraline
Clomipromine
Fluoxetine
Propranolol

None of the above have worked & I'm about to break if my attacks keep happening. I'm at risk of losing my job if I can't find a way to control my attacks. I don't know what else to suggest to try seeing as my GP has no interest in helping me out.

[alankay]

Benzos have been villified in the UK by Heather Ashton MD who likely never had a panic attack. Funny thing is that liberal prescribing BY DOCS that LED to the over prescription problem and YOU'RE paying the price. I'm very sorry.
You could ask about gabapentin or pregabalin(non benzos, I'd see if he'd rx gabapentin first). But can you see a doc on the private side to run any psyche meds? You could also ask about serax(oxazepam) as it tends to be the least habit forming of the benzos.
I wish I could send you some valium as GP's over here are OK with modest amounts for occasional use. But that could be a problem.
As a UK resident can you seek treatment in France or Holland?? They are more realistic on the continent with judicious use of benzos I understand. Just explain you doc seems to be OK letting you suffer because of UK policies even though you have no history or abuse and do have serious anxiety. You also will be prevented from working by these policies and know from your contact on forums other countries rx them with caution for "as needed" use often when needed(as in your case). Best bet would seem to be paying the extra to see a doc on the private side. Sad. Tell them you have debilitating anxiety and need a rx just for occasional use.
You could also try atarax(Hydroxyzine) and old antihistamine with anti anxiety effects.
My heart hurts for you. PM me any time. Alankay

[temperancebrennan]

I was prescribed Venlafaxine today as I had to see another GP. The last few days have been filled with crippling panic attacks that caused even my teeth to hurt.

[alankay]

Let me ask how many times you've used diazepam and how much did it help at what dose, etc? Alankay

[temperancebrennan]

I used to use 1 x 2mg tablet if I was having an attack in work. The most I took was 3 x 2mg in 24 hours once when I was having a severe attack that lasted around 10 hours.

If I put it this way, I got 21 x 2mg tablets at the start of April & I have a half tablet left now. I don't think I'm at risk of dependency, but my doctors policy is to not prescribe it, so there's not much I can do :(

[alankay]

I just don't understand why that is as your high anxiety is a chronic issue(ongoing as opposed to a short term, acute anxiety) and that is when a doc will need to monitor so you use it properly and give you refills as long as you are using it with restraint. Along with that you should have talked with a therapist to see if a source can be found and addressed for the anxiety and a daily ssri be tried to lower you anxiety in general.
This is not an uncommon scenario with anxiety/panic suffers not matter what the doc says. If that is his policy it should be yours to find a doc that will treat your anxiety properly. No matter what the policy is there, there is a time and place for meds like valium to be prescribed and monitored. Why do they still have diazepam available then??? Surely not for epilepsy or muscle spasms(other meds for that). Seriously I'd find another doc as the amount you've used is small. I have had panic disorder since 1982 and although I have much less anxiety than back then I have had no issues when starting another doc(I've moved a few times and I've had docs move too) bring in the old rx bottle, explaining I have panic disorder(and some Social Anxiety) and use valium maybe once a month or so for dental appts., interviews, flights, meetings, large gatherings, etc and they are OK after I let them know I had been treated by a pdoc years ago and he told me this was how patients like me should and could use benzos(if CBT and a daily ssri doesn't control the anxiety/panic enough) . It's in my med records any way. I also take fluoxetine daily and propranol as needed for the social anxiety. The docs are like "I'm glad you've found a way you manage well" and they just rx the valium 2 maybe three times a year and encourage the daily prozac. They just mention to use it as little as needed and make sure you pay attention to how it effects you, etc. I feel for you. Another doc might be OK with this just tell them you get the attacks, you job is threatened and you know that you should use as little as possible and pay attention to how it effects you(some get drowsy and don't notice because they are not paying attention).
Clonidine(http://en.wikipedia.org/wiki/Clonidine) is another non benzo you could ask about as well. There musty be a solution for you out there. PM me any time.
Alankay

[temperancebrennan]

Its written on the reception there that they won't prescribe it to anyone. The other doctors in my area are all the same. I checked them out. Nowhere in the city centre will accept me because they go off postcode areas. It's daft.

I am still on the waiting list for therapy and CBT. I'm not sure how long it will be to see someone. They chased it up for me yesterday, or at least they said they did.

I have told them that I use the diazepam sparingly & only if it happens at work, but they're not listening to that & just keep repeating "our policy is to not prescribe them" and "it's only for short term use" etc.

I'm going to try the Venlafaxine & see if it makes any difference. If not, I may give up hope.

[alankay]

Is that just for diazepam or all benzodiazepines? Very similar drugs would be either prazepam or clorazepate. If that can be rx'ed you'd get similar relief. I used clorazepate for years and only use diazepam because it is much cheaper. Alankay

[temperancebrennan]

It's all benzos. They have a list & they're all mentioned on there. I asked about Buspirone, but was told that "no one prescribes that anymore" & wouldn't give me any information on it.
Quite frustrating. I'm hoping that the Venlafaxine will help (my friend who studies mental health recommended it too) but at the same time, I'm nervous that it will be just another waste of time & money like all the others were.

[alankay]

Well hell. All I can think of is mainly gabapentin but sure effexor has a good rep but if you ever need to stop it, do slow slowly. I do see others that post here in the UK get modest amounts of a benzo for serious anxiety and hope in time you can to if you need it. Alankay

[smurfychris]

Strange that you use fluoxetine Alan mate, was on that before the Mirtazipine, and found the latter much more effective, strange how each one effects each of us differently

[alankay]

Cause much of an appetite increase or not for you? Yep, a given AD might help tons with one and not much at with another patient. Alankay

[smurfychris]

Cause much of an appetite increase or not for you? Yep, a given AD might help tons with one and not much at with another patient. Alankay

I did notice slight increase in appetite with the mirt if I didn't have breakfast

[temperancebrennan]

I'm going to research private psychologists, CBT counsellors etc to see if I can find a good person in my local area. I can't really afford it, but I'd rather be poor & have a normal day to day life if it helps.

[alankay]

So just to be open you have no past history of real substance abuse(no I don't mean a few drinks with the gals on fri night, etc)? This is just a mystery to me. Alankay

[temperancebrennan]

I smoked weed sometimes when I was younger, but it wasn't a very frequent thing. Maybe a couple of times a month, but I've not done it in years. I drink on a weekend sometimes, but not often because my friends live in a different town to me now.

I've had a few personal problems since the age of 11. But my panic attacks & anxiety didn't start until I was 18/19. I was diagnosed at 19 by my GP after my first panic attack. Before that, I was told I had aura migraines & not anxiety.

[Ritch]

Venlafaxine is a very strong compound. Make sure you take it at the same time everyday, whatever you do..... do not miss a dose, it is not the same as others where it won't cause too many problems. In my personal experience if you miss a dose the next day is torture.

You can access therapies through anxiety uk, but you have to pay a £30 joining fee I believe. then the cost of therapy depends on your financial situation.

If you have not had any success with propranolol ask to see if you can try Nebivolol (most docs need to look this one up). it is what I use and works better for me than. I wish you all the best H

[alankay]

Well I'm glad you are not a substance abuser. They usually won't rx benzos to those who do but that's not you.
I still think overall it would be therapuetic for you to have a benzo on hand for tough times. There's little or no harm in the kind of use pattern that you would use it for. Alankay

[Ritch]

http://anxietyforum.net/forum/showthread.php?21046-Chapter-23-Anxiety-Depression-Adhd-Clinical-Natural-Medicine-Handbook

Under the Niacin heading it says

"Niacinamide (also known as nicotinamide) is a form of the B vitamin niacin (vitamin B3). Niacinamide has effects similar to benzodiazepines on the brain.3 Nicotinamide stimulates the gamma aminobutyric acid (GABA)–benzodiazepine receptor complex, which is an inhibitory neuron grouping, and by modulating these specific neurons, exerts a calming effect.4 Experiments designed to test the efficacy of nicotinamide and brain function demonstrate that GABA nerve receptors were less stimulated when nicotinamide was lacking in individuals, and that reintroduction of nicotinamide led to a calming effect on the GABA receptors.5 Based on this research, it is reasonable to assume that supplementation with nicotinamide may contribute to fewer or less-severe anxiety symptoms.

A friend of mine who has similar issues to myself/you has said that he had great results with magnesium and Niacin. Not 100% to work but worth a try? If you decide to buy the niacin get the no flush version.

These are the links he gave me. The slow release magnesium is not available in the UK yet so he orders from oversea's

http://www.medshopexpress.com/081989.html

http://www.lef.org/Vitamins-Suppleme...icotinate.html

[temperancebrennan]

Thank you. I will give that a try. I'm willing to try anything!