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Re: correct dose benzos

Posted by viridis on September 6, 2002, at 2:28:37

In reply to Re: correct dose benzos » viridis, posted by hildi on September 5, 2002, at 17:13:19

Hi Hildi,

It's great to hear that the Klonopin is helping. My pdoc basically let me work out my own dosing schedule, since everyone reacts differently. He even offered to increase the dose if necessary, because 1 mg is considered low for panic disorder, which I experience episodically, along with frequent anxiety, mild ADD, and depression, which can be severe. Luckily for me, 1 mg/day of K turned out to be just right, so I've stayed at that dose. I feel no side effects from taking all in the AM, but it did take a while to work up to that. At first it made me a bit sleepy, uncoordinated, and forgetful, which is why I started with divided doses throughout the day. I do think your system gets used to it (I no longer even notice it), so just go slow and find the best schedule for you.

There are some reports of abuse of Klonopin, but I can't imagine how -- I've never had any high from it. I do feel the Xanax (probably because I take it so infrequently), but it's just a rapid relief of anxiety, no buzz. If I go over about 0.5 mg, I just want to sleep. I have no experience with Ativan, so can't comment there. Many years ago, I tried Valium, but it just made me feel "drunk" (not in a good way, just stupid and drowsy). In fairness, though, I never gave Valium a real try, but I do think different benzos can have different effects, so you have to find the best one(s) for you by trial and error. Xanax is excellent for me for quick relief, but one of the hardest to convince many doctors to prescribe since it's supposedly "addictive".

If the SSRI seems to be helping I wouldn't change it for now. I can't stand that class of drugs, but as I've mentioned, they're great for many people, just not me.

I have no problem with fish oil (just use the cheap Costco brand), but I have a cast-iron stomach and almost nothing makes me nauseous. Flaxseed oil is a good one too (contains omega-3 precursors), and works well in salad dressings etc. -- just don't cook with it, since heat destroys the beneficial effects. Or, just take capsules. If you're sensitive to oils, I suggest you try small amounts and work up gradually, as with any other new substance.

Re: pstims: maybe you could see if you can pry a free sample of Provigil (modafinil) out of your doctor. The company that bought the rights is really pushing it, and my impression is that free samples are readily available, although the prescriptions are incredibly expensive. It was OK, but not the best for me. Some on this board swear by Adrafinil ("parent" drug of Provigil, not available in the US), but apparently there's a slight risk of liver damage, so I'd be careful if you decide to try it. Adderall has been great for me, but it is hard to get unenlightened doctors to prescribe it -- they're scared of amphetamines because they're Schedule II (=highly controlled) in the US, and a small segment of users abuse these drugs -- inconceivable to me, but I guess it does happen occasionally.

Are you seeing a GP, or a psychiatrist? I never got real relief until I went to a psychiatrist (and I've seen more than one -- some are terrible). My current psychiatrist is great and trusts my judgement, within limits. In general, I think that psychiatrists/psychopharmacologists are much more willing than GPs to try different, sometimes controversial treatments.

My GP would never prescribe an amphetamine (or even a benzo!). He's a nice guy but is totally hamstrung by HMO prescribing requirements and fear of anything the slightest bit controversial. His response to my anxiety/depression problems was that I'd have to go through several weeks each of ALL of the standard ADs, and when I said (after trying several) that they increased my anxiety and caused other side effects, he claimed that this must be in my imagination (because these drugs supposedly can't cause side effects). He further suggested that I needed therapy (ironic, since previous therapists had told me that I was very grounded and obviously had a real chemical imbalance). He seemed to know almost nothing about anxiety, depression, or even the basic mechanisms of action of these drugs, nor had he even read the package inserts for the standard ADs he prescribes every day. So, I went to a psychiatrist and finally got appropriate treatment.

My advice is:

1) If you're being treated by a GP, see a psychiatrist/psychopharmacologist if you can possibly afford it;

2) Regardless of what kind of doctor you're seeing, if the treatment isn't working and/or you don't have a good rapport with them, then see another (and another, and another...until you find the right one) There's a huge range of quality, empathy, and willingness to experiment out there, so don't settle for anything less than the best. You deserve it!

All the best,

Viridis


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poster:viridis thread:118149
URL: http://www.dr-bob.org/babble/20020829/msgs/118981.html