Benzo tolerance.....is it common?

[quiet storm]

Hi all,

New to this forum and new to anxiety issues. Ive been dealing with some bad anxiety the last couple of months. Started out on Ativan but switched to clonazepam a couple days ago because it is longer acting. I started back an Cymbalta a couple weeks and have taken it in the past for depression. I'm hoping it kicks in sooner later and helps with this anxiety. I'm new to benzos. And they scare the crap out of me. But they do work. Very well. My question is on tolerance to these meds. Is it almost a given that if you take these often enough that you will eventually have to increase the dose to get the same anti anxiety effect? Or can you go for a very long time at the same dose? I'm really hoping I wont be on this stuff for more than a few months. But I'm finding that I need to take it every day and tolerance worries me. Any thoughts or experiences would be appreciated. I know it may be one of those everybody is different questions. I'm currently taking .5mg clonazepam twice a day. Thanks!

[alankay]

That's a contentious question. Many authorities say the anxiolytics(anti anxiety) effect often(not always) holds but the hypnotic(sleep inducing) does fade.
I have a .pdf written by a psychiatrist discussing this subject and more. Bottom line if the anxiety is severe, debilating or causes unreasonable distress/discomfort a benzo should be tried to see if it can do what they usually do. Some do not like them. The majority get anxiety relief. Only way to know is by time but there is indeed a number of docs who report patients stable on a given dose long term. Dr. Ashton in the UK would disagree but that's another discussion.
Anyway patients that respect the meds often stay at the same dose but not all. You really only need to worry about effects on memory, etc , at higher doses than what you are taking. Stay on the AD too. It will help be less anxious over time. Of course some will diagree on this and of course tolerance to any drug can develop.......but it is not certain with benzos any way. Sorry Dr. Ashton. PM me any time. Alankay

[quiet storm]

Appreciate the quick response. Yeah, I definitely have a healthy respect for these meds. Do you know where or how I can see that pdf? Id be interested in reading that.

[alankay]

http://www.ama.lu/docs/Psytimes_part1.pdf

[alankay]

I've read them all and reread them. I don't want to get started. LOL :) ALankay

[alankay]

http://www.currentpsychiatry.com/fileadmin/cp_archive/pdf/1104/1104CP_Bostwick.pdf
I get a kick out the graphic on this one. I've been the dude in the water(years ago). :) Alankay

[alankay]

I can dig up more maybe but what you should(IMHO) do is compile in your mind some data and come to a conclusion on modest, prudent use of benzos. Ignore either extreme. These meds have been out since 1960(librium) and are still on the market for many other things besides just anxiety. Used properly, like many things, they are fine and have their place. I can't say I like it but that's how I see it as well as others. PM me any time. Alankay

[quiet storm]

Thanks for the info and your help, alan!

[alankay]

My pleasure. Alankay

[Ahlstrom]

I used to take them often for a month after a real bad event in my life. They do work great as you said. You will begin to feel less effect when you take them, but you should only take the, when having a panic attack. Even .25mg should knock you down good if you're having a panic attack. Other than that they don't seem to do much

[quiet storm]

My problem is I'm probably not taking them like I should and I'm still dealing with anxiety. I've been trying to get by on the smallest dosages possible and its probably not enough. I'm so scared of getting hooked on these things that I'm probably not taking them like I should. I seem to be caught in some panic cycle where early afternoon I'm ready to have a full blown panic attack. Shortness of breath, dizziness, palpitations. Feeling like I just have to get up and get out of the building. And go where? It doesn't matter, I just have to MOVE. Whats also weird is my anxiety seems to be worse after meals. What the hell is that all about?

I quit taking the Cymbalta last weekend because after going up to 60mg for all last week I didn't hardly sleep at all. It's not that I don't want to take it but I just cannot deal with insomnia. When I was on years ago it did the same thing. Hardcore insomnia and I ended up taking lunesta for two years. Im NOT getting back on lunesta. So if I'm going to get back on Cymbalta a solution for sleep is going to need to be found. I thought about trying Zoloft but I see it can be rather activating as well and insomnia is listed as one of its biggest side effect. Thinking about maybe asking to get back on remeron and see if I can do Cymbalta at same time. Maybe the remeron sedation can counteract the Cymbalta insomnia enough to get a decent nights rest.