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Re: When are benzos justified? » detroitpistons

Posted by yxibow on January 4, 2006, at 16:05:20

In reply to When are benzos justified?, posted by detroitpistons on January 3, 2006, at 15:21:05

> I've been thinking about starting Klonopin, but I just wanted some feedback from other benzo users. I take small amounts of Xanax and I can feel better by taking as little as .25mg. However, it can make me depressed and lethargic.

Depression and lethargy are common side effects of all benzodiazepines. Xanax is generally prescribed for more short term anxiety although there are people who have taken your dose for years, it is quite often prescribed for tinnitus.
That you "feel better" is its intention -- Xanax has a more immediate gratification than Klonopin in general.

>
> I'm on Effexor XR 225 mg, and it has not totally relieved me of anxiety, although it picked me up out of a depressive episode. I'm familiar with the pro-benzo vs anti-benzo debate.

Yes, there are various camps. For me, I believe that if someone is not born with a physical addiction problem, and tapers on and off of them properly, there shouldn't be an issue. They were and still are the safest psychiatric drugs out there.

I guess what I'm trying to get at is this: How bad does anxiety have to be in order to justify taking a benzo? I realize this is a very difficult question to answer, but I just wanted to hear some other people's thoughts.

That's a very individual matter. You can have ****-kicking, crying, awful anxiety. I would say that's a highly likely situation for a benzodiazepine. You can have specific fear situations for PRN (as needed) social anxiety, fear of elevators, airplanes, herds of rhinoceroses [sorry, just thought I'd put some humour in], and you might carry a little Xanax or Valium along.

>
> I can generally function without a benzo (or even an AD for that matter)...I can leave the house, go to work, be in social settings with people I don't know (although rarely comfortably).

Sounds fairly "normal" as they say. But normal to one is not normal to another, and I really hate that concept. But you already can leave the house -- no agoraphobia, go to work -- no more anxiety than the next person who is hiding it far too well when their boss yells at them, or be in uncomfortable social situations -- not too high of a social anxiety disorder.

In short, I can get along with life, but I never feel quite right. I feel like everything is forced. I feel like I'm operating at 75%.

We're all operating at 75 or 80%. As they say, if you can get the job done 80% of the time, you're probably doing just fine and if you have a boss otherwise he's anal retentive.

I probably wouldn't regard my anxiety as severe (not agoraphobic, for example), but I do think it interferes with my life and prevents me from being all I can be.

If you do believe though that you have some social anxiety, a small amount of PRN benzodiazepine might be of some benefit. There's no shame in a little help, and it doesn't have the hangover that we all get when we have a drink to basically get over that hump -- that's primarily why people drink in bars.

>
> Where is the line? When is taking a benzo justified? I've always been scared to overmedicate myself. In fact, it took me a good amount of pain and suffering before I broke down and tried an AD. I've never liked the idea of taking 1 psych drug, much less 2 or 3.

I've never liked the idea that I have to take medication, but it is a cost-benefit analysis. If your life is such that you feel it is deteriorating in quality, why force yourself to "tough it out" when a medication may bring some hope and promise. Of course, it has to be weighed against side effects. These come with all medicines -- there is nearly no medicine yet that is so clean that it doesnt do anything but what it does (even aspirin.)


Sometimes I feel like I'm "cheating," like the only people who should really be on meds are the ones who can't get out of bed in the morning, can't leave the house, can't go to work, etc.

Those are people with severe depression and severe social anxiety, or schizophreniform and bipolar disorders. But there are other equally valid reasons for medications that don't have to be earth shattering.

>
> Can anyone relate to this sort of "psych med reckoning" I'm going through?

Yes -- its called ordinary common sense, rationalizing, and what in medical terms is called "informed consent". You are told what a drug does, its side effects, you consider what it could be on it, or not on it, and you make your decisions from there. And they are your decisions and yours only. And nobody can fault you for them. Its your life. Even for the most severe disorders. Although I would say if you are in a state where you are in immediate danger of harming yourself or others, the choice whether to medicate becomes more of a societal decision than purely your own, whether you like that idea or not.

>
> And back to the original point, any thoughts from benzo/Klonopin users? The first and only psych med I took that worked was Effexor, and it seemed like a godsend at the time (for both anxiety and depression). Now I tried it again, and it just doesn't seem to be working as well on the anxiety. I think my condition(s) may have worsened over the past couple of years, and quite frankly, it feels like the meds may have contributed to that (e.g. caused a permanent change in brain chemistry--which I know sounds very paranoid).

Its possible that medications may cause a change in brain chemistry but not to be a company shill, a typical drug takes up to 10 years to come to market (save for fast track medications like antivirals and vaccines.) Compounds have to be tested extensively on animals before they are even put inside a human. Then so-called "healthy" people are given them just to see what happens. Then there are stage II and stage III trials involving tens to thousands of people around the world, until finally the FDA approves a medication.

Now, back to the Effexor -- in me personally it would only serve as an antidepressant, and a bad one at that, compared to Cymbalta, in terms of jumpiness. It seems to me that most all SSRIs and SSNRIs either work for depression (mostly) or anxiety (sometimes) but not both, in me.

But as you were saying, you are trying it again.. body chemistry can change in a couple of years -- its not just affected by internal change, but life changes, psychological factors which in turn change the chemistry in your brain. Talk therapy is as much a brain chemistry changer for some conditions as a medication (or in combination).

Hope that helps put things in perspective. And never feel ashamed that you "have" or "need" to take a medication. Many people have to take drugs for a variety of things and the person in the cubicle next to you may be happy go lucky and so cheerful its nauseating but they may have a terminal illness you never heard about.

So, do you take a benzodiazepine or not. Well, sometimes they're prescribed along with SSRIs and SSNRIs/SNRIs (like Effexor) for a period of time until the anxiety mitigating factor of the drug kicks in as well as the antidepressant effects. And sometimes for a whole host of reasons that I mentioned above. To just take one because it well, makes you feel good -- maybe that's justified too. Its all relative.

There's the obvious factor of benzodiazepines that some day one will become acclimatized (used to) one -- it still may not matter, because it still may be providing relief, you just dont feel the "immediate" kick. Some claim they're addictive. I personally call them habituating. That has to be watched too. If you're taking 1mg of Klonopin and suddenly in a few weeks you're up to 10mg, that is a sure sign of habituation (not to mention a strain on the liver).

So, hope that helps

Tidings

 

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poster:yxibow thread:594786
URL: http://www.dr-bob.org/babble/20051231/msgs/595217.html