![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by hildi on August 21, 2002, at 17:51:01
I have been reading many posts about benzos and am interested in trying benzos alone-to give my body a much needed break from the AD's which give me too much increased anxiety and other cruddy feelings.
I have major anxiety d/o and depression.
Would xanax be the 'best' benzo for this, or would it really depend on the person? I have read posts that mentioned xanax as being one benzo with AD effects. And I have read other posts that mentioned klonopin causing increased depression for some. Is xanax really that 'special'?I am getting ativan and klonopin soon, would that be as good as xanax?
I just tried valium and hated it!
Hildi
Posted by Squiggles on August 21, 2002, at 19:19:47
In reply to benzo monotherapy-Advice please you benzo users!, posted by hildi on August 21, 2002, at 17:51:01
Hi,
In my knowledge benzos as a whole are used
for anxiety and anxiety related conditions,
as well as anti-convulsions in epileptoid
conditions. If you have depression that is
concurrent with anxiety, the benzos will work
on the anxiety. But like all depressants,
they may make you more depressed. Personally,
i don't think they are the best drug for
depression.Squiggles
Posted by joy on August 21, 2002, at 21:02:35
In reply to benzo monotherapy-Advice please you benzo users!, posted by hildi on August 21, 2002, at 17:51:01
I used to be on SSRIs but now take Xanax only which is good for anxiety and insomnia. The benzos are not that great for depression. My pdoc says Klonopin tends towards depressing its user so he prescribes Xanax [generic which is alazopram] and it works well for me. I usually take .5 at night as my anxiety is much better. I have no side effects as I did with the antidepressants, however, I am no longer depressed much. I am out of the black hole so I just use Alazopram [Xanax]. It's best for anxiety for many people.
Joy
Posted by alan on August 21, 2002, at 22:54:44
In reply to benzo monotherapy-Advice please you benzo users!, posted by hildi on August 21, 2002, at 17:51:01
> I have been reading many posts about benzos and am interested in trying benzos alone-to give my body a much needed break from the AD's which give me too much increased anxiety and other cruddy feelings.
> I have major anxiety d/o and depression.
> Would xanax be the 'best' benzo for this, or would it really depend on the person? I have read posts that mentioned xanax as being one benzo with AD effects. And I have read other posts that mentioned klonopin causing increased depression for some. Is xanax really that 'special'?
>
> I am getting ativan and klonopin soon, would that be as good as xanax?
> I just tried valium and hated it!
> Hildi
-------------------------------------------
I had to go through a period dechiphering whether the depression or the anxiety was primary. After countless trials with 3 different docs, I finally told the one I'm with now "if you were always battling relentless anxiety, you'd be depressed too!".That's all he had to hear. I experimented with all of the bzd's until I found a combo that worked - Klon maintainence and ativan PRN (or xanax PRN if you wanted to try that instead of ativan).
The dosages fluctuate with the waxing and waning of my anxiety levels so if I get above 2 MG klon I get some of the depressed feeling from it. But that isn't that common. I then lower my klon dose and add ativan in along as part of the maintenence schedule and that seems to take away the hints of depression.
Anxiety definitely causes a hopelessness and depressed feeling - sometimes it takes awhile to figure out which one is driving which.
Alan
-----------------------------------
bzds to try in mono or combination:
xanax and ativan - shorter half-life
klonopin and tranxene - longer half-lifeCombine a long (maintainence) with a short (PRN).
Posted by Ritch on August 22, 2002, at 1:24:42
In reply to benzo monotherapy-Advice please you benzo users!, posted by hildi on August 21, 2002, at 17:51:01
> I have been reading many posts about benzos and am interested in trying benzos alone-to give my body a much needed break from the AD's which give me too much increased anxiety and other cruddy feelings.
> I have major anxiety d/o and depression.
> Would xanax be the 'best' benzo for this, or would it really depend on the person? I have read posts that mentioned xanax as being one benzo with AD effects. And I have read other posts that mentioned klonopin causing increased depression for some. Is xanax really that 'special'?
>
> I am getting ativan and klonopin soon, would that be as good as xanax?
> I just tried valium and hated it!
> Hildi
Hildi,I was on Valium in the past and it definitely worsened depressive feelings. Klonopin was just a *little* depressogenic. Ativan had a slight mood elevating effect, Xanax had an increased mood elevating effect. I would suggest a low-dose of Ativan because of its longer half-life (as opposed to Xanax). I think you might be able to get by on a twice-daily dosing of low-dose Ativan as maintenance. Also, Ativan has less potential of drug-drug interactions than the others, and clears your body without much work on the part of your liver.
Mitch
Posted by hildi on August 22, 2002, at 11:15:23
In reply to Re: benzo monotherapy-Advice please you benzo users! » hildi, posted by Ritch on August 22, 2002, at 1:24:42
Posted by viridis on August 23, 2002, at 23:23:03
In reply to Thanks All for Replies-Need all help I can get! (nm), posted by hildi on August 22, 2002, at 11:15:23
Just my 2 cents: After many years of trying to deal with anxiety, panic attacks, and serious depression through various kinds of therapy, SSRIs, Wellbutrin, other drugs, herbs and various dietary supplements, lifestyle changes etc. (with limited and short-lived success at best and awful side effects at worst) I found a very skilled and intuitive psychiatrist. He immediately prescribed Klonopin daily, with Xanax PRN, and the relief was dramatic. Clearly (for me) the anxiety was primary, the depression secondary or at least aggravated by the anxiety.
We later added a small dose of Adderall to deal with possible mild ADD, and this pretty much cleared up the remaining low-level depression as well. I'm also taking Neurontin to help maintain stability, but really, I think Klonopin (clonazepam) is the key, with Adderall acting synergistically on the depression/ADD side of things.
So far, I've had no need or desire to increase beyond 1 mg Klonopin/day, and take the Xanax only occasionally for breakthrough anxiety. The initial bzd side effects (clumsiness, sleepiness, short-term memory loss) were mild and subsided in about a week. The increase in quality of life and overall performance offsets any concerns I have about long-term bzd therapy, and my pdoc seems quite comfortable with keeping me on this class of drugs indefinitely.
Posted by hiba on August 24, 2002, at 4:02:52
In reply to Re: benzo monotherapy-Advice please you benzo users! » hildi, posted by Ritch on August 22, 2002, at 1:24:42
Dear Ritch,
You are right to some extent. But klonopin always shouldn't necessarily make depression worse, but like all anticonvulsants, it has got some mood stabilizing properties. I have experience. I don't argue, because I couldn't find considerable support to back it. But one thing is sure. If anxiety is making one person depressed, using klonopin alone can definitely keep him away from depression. Here klonopin can be used as a shield.Xanax is unique in this regard. In India high doses of xanax is being used to treat major depressives because xanax can quickly elevate mood whereas an ideal antidepressant takes ten to twenty days for a slight elevation. But using high doses of xanax will have its own problems. Still sometimes it is the only way to overcome hellish depression.
HIBA
Posted by hildi on August 25, 2002, at 14:13:46
In reply to Re: Thanks All for Replies-Need all help I can get, posted by viridis on August 23, 2002, at 23:23:03
> Just my 2 cents: After many years of trying to deal with anxiety, panic attacks, and serious depression through various kinds of therapy, SSRIs, Wellbutrin, other drugs, herbs and various dietary supplements, lifestyle changes etc. (with limited and short-lived success at best and awful side effects at worst) I found a very skilled and intuitive psychiatrist. He immediately prescribed Klonopin daily, with Xanax PRN, and the relief was dramatic. Clearly (for me) the anxiety was primary, the depression secondary or at least aggravated by the anxiety.
>
> We later added a small dose of Adderall to deal with possible mild ADD, and this pretty much cleared up the remaining low-level depression as well. I'm also taking Neurontin to help maintain stability, but really, I think Klonopin (clonazepam) is the key, with Adderall acting synergistically on the depression/ADD side of things.
>
> So far, I've had no need or desire to increase beyond 1 mg Klonopin/day, and take the Xanax only occasionally for breakthrough anxiety. The initial bzd side effects (clumsiness, sleepiness, short-term memory loss) were mild and subsided in about a week. The increase in quality of life and overall performance offsets any concerns I have about long-term bzd therapy, and my pdoc seems quite comfortable with keeping me on this class of drugs indefinitely.Hi. Thanks for the reply. I printed your reply as a reference because it seems to be hitting on key issues with me.
The more I am finding out from others, I believe that the anxiety may be causing much of my depression. I also believe I am ADD, too.
Have you tried, heard much about adafranil, Provigil, or modafinal for ADD? I am curious about these, or anything else that is mild and easy for me to obtain- my dr. won't prescribe a stimulant for me. He is very close-minded and really only wants me on an SSRI.
I am still awaiting my benzos in the mail and in the meantime I have been taking 25mg zoloft for anxiety/ depression relief (helps a little). I am having an especially hard time today and my moods are scary. I've been yelling alot, being mean, having racing thoughts, hyperness and am shaky, sweaty. I was thinking that maybe I have some sort of borderline personality d/o too, but then I read your post and realized i am especially anxious (besides my GAD I have much upheaval going on in my life right now) and maybe my anxiety is bringing all the rage and other feelings out.I sure hope the benzos help. I hate being me like this. I can't stand another day of acting or feeling like this.
I also want to try a stimulant. The neurontin also would be a good thing to try, but for now (limited funds and no insurance) I'll try the benzos and then add a stimulant.
Hildi
Posted by hildi on August 25, 2002, at 14:22:57
In reply to Re: benzo monotherapy-Advice please you benzo users!, posted by hiba on August 24, 2002, at 4:02:52
> Dear Ritch,
> You are right to some extent. But klonopin always shouldn't necessarily make depression worse, but like all anticonvulsants, it has got some mood stabilizing properties. I have experience. I don't argue, because I couldn't find considerable support to back it. But one thing is sure. If anxiety is making one person depressed, using klonopin alone can definitely keep him away from depression. Here klonopin can be used as a shield.
>
> Xanax is unique in this regard. In India high doses of xanax is being used to treat major depressives because xanax can quickly elevate mood whereas an ideal antidepressant takes ten to twenty days for a slight elevation. But using high doses of xanax will have its own problems. Still sometimes it is the only way to overcome hellish depression.
> HIBAHi HIBA. I think Ritch really was emphasizing more on the Valium causing depression, rather than the Klonopin. However, I have read other posts that agreed with what Ritch said, and 'higher' levels of Klonopin can increase depression in some individuals. The valium was not what I expected and I am eager to try the Klonopin and Ativan that I should be getting soon.
I also would like to give Xanax a try. There have been alot of good posts on it's effectiveness for anxiety/depression.One of the things that intrigues me about the klonopin is it's supposed mood stabilizing abilities. I hope that this is true because my anxiety, anger, and hypomania is all over the place. I can't stand this.
Hildi
Posted by viridis on August 25, 2002, at 16:34:19
In reply to adderal and other questions » viridis, posted by hildi on August 25, 2002, at 14:13:46
Hi Hildi,
Your situation sounds very similar to mine. I went through several doctors who insisted that SSRIs (or Wellbutrin) were the way to go. I used Prozac for extended periods (several months) at various times. In each case, I would experience severe anxiety for several weeks, which eventually turned into a sort of wired, yet emotionally blunt state of mind in which I really didn't enjoy or care about anything and could rarely sleep properly. This was the case at any dose I tried (even as low as 10 mg/day).
I was prescribed short-term Xanax a few times when my anxiety really went through the roof, and it helped tremendously (especially for sleep). However, the doctor who prescribed it was afraid of "addiction" and so wouldn't allow extended use.
When I finally found my current pdoc (after my bad experience with Wellbutrin), he did try very low-dose Zoloft (starting at 12.5 mg/day) a few weeks after initiating the Klonopin/occasional Xanax plan. I had a reaction that sounds much like yours: drastic mood changes, unpredictable anger (uncharacteristic for me), shakiness, etc. After about a week of this, I called the dr. and told him I'd have to stop taking it. He said yes, stop -- this isn't the drug for you. We later discussed this more, and I asked about the possible significance of my reaction to Zoloft. His response was simply that different people react differently, and that I didn't seem like a good candidate for further SSRI experiments. So, I haven't tried any since.
I had been tentatively diagnosed with ADD a couple of times before by therapists, and was intending to bring this up, but he beat me to it by suggesting the possibility of psychostimulants (after some fairly detailed questioning about ADD-type symptoms and history). He gave me some samples of Provigil (=modafinil), and said this was the mildest of the pstims. I tried the Provigil for a few weeks, and it was OK -- stimulating, not particularly anxiogenic, but not really much help with the focus problems.
When I told my pdoc this, he wasn't too surprised, and said that in his experience Provigil is kind of hit-or-miss, although it can be good for some. So, we tried Adderall (5-10 mg/day) and that made a big difference. I was able to concentrate better, my mood improved (I was still experiencing transient depression, although nothing like pre-Kolonopin), and I generally felt more enthusiastic. This was a few months ago (I started the Klonopin about a year ago) and I still get the same effects at the same doses. I do skip the Adderall for a day or so here and there with no problem.
The Neurontin was added somewhere in the middle of this. I'm not sure it does a whole lot, but my pdoc feels that it probably adds some background stability. Since I've had no side effects (except mild euphoria the first couple of times I took it) I'm sticking with it for now. Again, though, I think the Klonopin is the key player, with the Adderall further improving mood and concentration, and a bit of Xanax now and then for especially stressful situations.
I'm pretty happy with this mix, and everything except the Neurontin is available as generic, so it's a relatively inexpensive way to go.
Hope this helps, and good luck!
Posted by hiba on August 26, 2002, at 0:23:12
In reply to klonopin and depression/anxiety/hypomania? » hiba, posted by hildi on August 25, 2002, at 14:22:57
Dear Hildi,
My diagnosis with major depression is at least ten years old. Since then I couldn't stay off medications. I have been on ten different antidepressants, and I must admit all of them worked for me. But prior to taking prozac which was (and I doubt still) hailed as a wonder drug, I was on klonopin for eighteen months without any problem and it is a record in my life. It is the best one I took in my ten years of hellish life with depression. Klonopin very effectively stabilized my mood and kept away anxiety and other obsessive worries which is the major cause of my depression. You will probably ask me why I quit it. The reason: klonopin is not available in the locality where I am staying now, and a benzophobic psychiatrist put me on prozac which has done enough damage to my sexuality. I have travelled far enough, that a return to klonopin is very unlikely although I wish I could.
Klonopin is a very potent anticonvulsant and like tegretol and depakote it should have some mood stabilizing properties(I guess). Its use in depression is still controversial, because there is not enough data to support. All I can say is,it helped me. Helped me tremendously. But it should not necessarily help you as it did to me.At the same time Xanax's antidepressant properties have been proven. So use your common sense and do the right thing. That is all I can say.
Good luck to you Hildi
HIBA
Posted by noelle on August 26, 2002, at 22:56:22
In reply to Re: adderal and other questions, posted by viridis on August 25, 2002, at 16:34:19
Hildi,
I've seen klonopin mentioned so much, I'm currently on Neurontin and I've tried going back to Adderall again. I was just wondering how this medication helps you and what are the effects, I'm assuming its an anti-axiety, but not an AD?
Just wondering
Posted by hiba on August 26, 2002, at 23:55:42
In reply to Re: adderal and other questions-Hildi, posted by noelle on August 26, 2002, at 22:56:22
Dear Noelle,
When anxiety is a prominent factor in depression klonopin and similar kind of benzos can be used as a shield to protect yourself from depression. Anxiety and obsessive worries can cause depression, and using klonopin on regular basis can prevent this, because klonopin is an excellent anxiolytic and has proven anti-obsessive properties. But once the depression takes dominance, using it alone can't bring the complete relief and an antidepressant is often recommended. After the remission of depression, there is a chance of relapse in most patients and here is where I emphasize on the effectiveness of klonopin in keeping away that relapse. It is always better to be stabilized than to succumb in another episode of depression.It is better to depend on benzos than hard antidepressants. Benzos have fewer and lesser side effects and are much safer than antidepressants.
Take care
HIBA
Posted by Hildi on August 27, 2002, at 12:13:48
In reply to Re: adderal and other questions-Hildi, posted by noelle on August 26, 2002, at 22:56:22
> Hildi,
> I've seen klonopin mentioned so much, I'm currently on Neurontin and I've tried going back to Adderall again. I was just wondering how this medication helps you and what are the effects, I'm assuming its an anti-axiety, but not an AD?
> Just wonderingI am not sure if you are meaning the adderal or the klonopin. I have not tried either yet. And neither is 'officially' an a/d. Adderall interests me because it can help those with ADD, and the klonopin is going to be for my insanely, over the top anxiety.
Now, some use adderal in conjuction with other meds and it helps them with their anxiety, too. It's funny, but for some people stimulants may be calming and helps with focus. That is what I am interested in, for me, and I am going to TRY to get my dr. to let me try it.
Posted by noelle on August 28, 2002, at 15:25:09
In reply to Re: adderal and other questions- » noelle, posted by Hildi on August 27, 2002, at 12:13:48
Hildi,
I was speaking about Klonopin, I just wondered what the classification was. If you have anxiety you might want to be careful of stims. Adderall is what put me over the top in terms of axiety and depression. In fact I had to stop taking it and get on Neurontin. I am trying to add adderal back in because I too suffer for the ADD but nothing is worse then feeling intense anxiety all the time.
Posted by viridis on August 28, 2002, at 21:30:15
In reply to Re: adderal and other questions-Hildi, posted by noelle on August 28, 2002, at 15:25:09
It's interesting how people's responses to these drugs vary -- I find low doses of Adderall (5-10 mg) actually reduce anxiety and make me feel more focused and motivated. However, I didn't start Adderall until I had been using Klonopin (1 mg/day) regularly for several months, and my anxiety and panic attacks had subsided. I've almost always taken Adderall with Klonopin in place, so I don't know what would have happened with Adderall by itself. The two (for me) seem to have a special synergy, and I've seen this expressed by others on this board in past.
For someone with severe anxiety, Adderall (or other stimulants) alone might be risky. The strategy my pdoc used -- first stabilize the anxiety with benzos, then start adding more activating drugs cautiously, starting with very low doses -- seems like a sensible one. And, it might make sense to try a "milder" pstim like modafinil or adrafinil first, since some ADD types seem to respond very well. Although modafinil (= Provigil ) wasn't great for me, that doesn't mean it wouldn't work for others -- some people find it very effective. It might even be worth trying Wellbutrin (quite stimulating) once benzo stabilization has been achieved. WB freaked me out at standard doses and was just irritating at low doses, but again, some do well with it, and it should be easy to get a trial prescription.
So, my advice (based only on my experience) would be to get the anxiety under control first (preferably with a bzd such as Klonopin), then see if your dr. will let you try low doses of more stimulating meds. Here at least (US) it seems like free samples of Provigil, Wellbutrin etc. are widely available, and you might just luck out and find that one of these does the trick for ADD. If they don't, then at least your dr. knows that you made a sincere try with less controversial pstims than the amphetamines (Adderall & co.), and might be more willing to try these next.
I suspect you'll find that the relief the benzos provide is so great that you'll be willing and able to gradually try augmentation with pstims etc. to achieve the optimal balance.
Posted by hildi on August 28, 2002, at 22:06:06
In reply to Re: adderal and other questions-Hildi, posted by noelle on August 28, 2002, at 15:25:09
> Hildi,
> I was speaking about Klonopin, I just wondered what the classification was. If you have anxiety you might want to be careful of stims. Adderall is what put me over the top in terms of axiety and depression. In fact I had to stop taking it and get on Neurontin. I am trying to add adderal back in because I too suffer for the ADD but nothing is worse then feeling intense anxiety all the time.Hi Noelle. You've got that right! That is how I've been most of the time lately-major anxiety all of the time. My anxiety d/o is beyond belief. I have been taking SSRI's for many years for the anxiety and my depression, and they have helped my anxiety, but the ad's also make me feel sick and unfocused, also sort of 'manic'with racing thoughts and more anxiety, but of a different sort.
I have been very sick lately. My meds stopped working (too many side effects and not enough relief) then my doc tried me on various other ad meds which didn't work. So all summer my mind and body have been on an emotional and physical roller coaster. It's really been a rough summer.
After many 'battles' with my doc over different meds, I got so frustrated that I ordered some anxiety meds for myself (Klonopin and Ativan).
I'm starting Klonopin tonight. It is a benzo and there is much posted on PB about this anti-anxiety med. Klonopin is said to also have mood stabilizing properties. Many people have success on this med alone, or in conjuction with other anxiety meds or ad's.
Klonopin, Ativan, and Xanax are the three anxiety meds I have been waiting anxiously to try, and if they help with the my anxiety d/o as much as I hope then I was thinking of adding a mild stimulant such as adderal.
You mentioned the increased anxiety on the stimulant. Well, that makes sense and I bet I would feel that way too from a stimulant alone, but I wouldn't take it alone. I know I would freak! Words cannot explain how bad my anxiety is. It's out of this world. I know I have to focus on the anxiety first. The stimulant, if I added later, would be only for the focus.
I am so sick of ad's and I really want to try another way.
How is the neurontin working for you? Have you, or are you going to add the adderal to this? I would be interested to know if the neurontin is enough to keep the anxiety away.
Hildi
Posted by hildi on August 28, 2002, at 22:10:32
In reply to Re: adderal and other questions-Noelle/Hildi, posted by viridis on August 28, 2002, at 21:30:15
Posted by hildi on August 29, 2002, at 13:20:43
In reply to Re: adderal and other questions-Noelle/Hildi, posted by viridis on August 28, 2002, at 21:30:15
Hi. Thanks for the last reply. I had such anxiety last night I couldn't really type, so I just printed out your post and read it later.
What you posted pretty much confirmed what I had thought about the stims affecting anxiety, and to add them later- I had just replied to Noelle's post on the same subject before reading yours.
Her anxiety increased on just the stim alone- I know that would be a big mistake for me to not also have an anxiety med.
I will definately wait a little while before trying a stim, get the anxiety under control first.
You mentioned that adderal is in a different class of stims that adafranil and modafranil, and that the ladder two are more mild. Mild sounds good.
I would guess then that dexedrine is also an amphet, but how about ritalin? Same thing?Also, do you take your Klonopin in the PM?
I'm wondering about that, since some people take a shorter acting benzo with a longer acting one, and I don't when to take which!
Hildi
Posted by viridis on August 30, 2002, at 2:38:59
In reply to Re: adderal and other questions- » viridis, posted by hildi on August 29, 2002, at 13:20:43
Hi Hildi,
My dosing schedule of Klonopin (clonazepam) has changed quite a bit. Initially, my pdoc prescribed 1 mg to be taken at bedtime. The half-life is supposed to be long enough to last through the next day, but for me, it wore off by about mid-morning. This wasn't much help; I have a pretty demanding job that involves long hours, lots of interaction with people, public speaking, and dealing with diverse and unexpected situations. So, I changed the dosing to 0.25 mg 4X/day, in part because initially (first week or two) Klonopin did have some side effects -- sleepiness, lack of coordination, and forgetfulness -- and I didn't want a big dose all at once. I found myself using Xanax (alprazolam) quite a bit during this time to further reduce anxiety. I mentioned my change in dosing to my pdoc, and he said this was fine as long as it worked and I was comfortable with it. He also commented that this several-times-a-day dosing schedule is popular with some prescribers.
As I got used to Klonopin, I quickly changed to 0.5 mg 2X/day (morning and afternoon). That was better. Now, I just take 1 mg in the morning, along with 5 mg Adderall at the same time. I often take another 5 mg Adderall later in the day, but have never exceeded 1 mg/day Klonopin.
I still take Xanax occasionally, 0.25-0.5 mg, but just for especially stressful situations. I take it rarely enough that I can still feel its anti-anxiety effects coming on, especially if I dissolve it under my tongue (very bitter, though). In contrast, I don't "feel" anything from Klonopin, just a relief of anxiety and tension that lasts all day. By the way, I gather that Ativan (lorazepam) can be used in a similar way to Xanax, although I've never tried it.
I also take Neurontin, 400 mg 3X/day. As I mentioned earlier, I'm not sure it does much, but my pdoc recommends that I stay with it because he suspects it adds a subtle level of stability. For me, it has no discernable side effects.
Re: stimulants: I've just used Adderall. It's an amphetamine (Adderall is a combination of several amphetamine salts; dexedrine is another example of an amphetamine). Ritalin (methylphenidate) is closely related to the amphetamine group of drugs (I've never tried Ritalin, although my pdoc initially suggested this as an alternative if Adderall wasn't effective). This group of drugs is generally considered "strong" and has abuse potential for some, so is tightly regulated, at least here in the US. This is why doctors are cautious in prescribing these drugs -- the prescriptions are filed with state and federal regulatory agencies, they're subject to audits etc., these drugs have street value, and they're wary of drug abusers. In contrast, modafinil (Provigil) belongs to a different, much newer class of stimulants, and is much less closely regulated. Adrafinil was developed in France and is the "parent' drug of modafinil, but isn't available in North America. Free samples of Provigil are easily available, but you'd never (at least in the US or Canada) be able to get a trial sample of Adderall, Ritalin, etc. Ironically, Adderall and Ritalin (generally considered most effective for ADD) are prescribed much more freely to children with ADD than to adults with the same condition.
My pdoc considers Provigil a "mild" stimulant (of course, it depends in part on what dose you take, just as with amphetamines). He isn't subject to close scrutiny when he prescribes it, so it isn't surprising that he tried it first, especially since it's very effective for certain people. It wasn't the best for me, but it didn't cause any problems and is certainly worth trying.
I get the impression that you're in a different country. This is partly because you're able to order benzos by mail, something that I don't think would be possible (at least legally) here. Wherever you are, I suspect that your doctor is subject to closer scrutiny when prescribing amphetamine stimulants like Adderall than with modafinil etc. So again (and it looks like you agree) Adderall or Ritalin might be something to gradually build up to if necessary, once the anxiety is tamed and you've tried other stimulants that your doctor is more comfortable with. Asking for Adderall or Ritalin right off the bat makes a lot of doctors suspicious (and by the way, so does asking for Xanax, which at least in the US is considered much more subject to abuse than Klonopin and some other benzos, whether it really is or not)
Just a couple of other questions/comments: First, it sounds like you're trying the benzos on your own (unless I misunderstood). Does your doctor know this? He or she really should be aware of the medications you're taking, and it would be best to get the benzo prescription(s) from your doctor if possible, or change doctors if necessary. Again, I may have totally misunderstood, but I got the impression that you ordered the benzos independently.
Second, you mentioned earlier that your doctor is very insistent on SSRIs. These work wonderfully for some (I know several people whose lives have been dramatically improved by Prozac, Paxil, Celexa, etc.) but for others of us they're just awful. I'm one of the latter, and would never touch an SSRI again. Some doctors simply refuse to accept that this class of drugs isn't effective for everyone, prescribe them to anyone who complains of depression or anxiety, and continue to push them even when the patient reports serious side effects after weeks of use. It took me many years and several doctors before I found one who actually understands how to treat me effectively (without SSRIs), and with whom I can actively discuss my treatment. So, if you're not happy with your current doctor, or don't feel they're communicating with you properly, it's definitely worth trying others. There are good ones out there; it may just take some searching.
Best of luck!
This is the end of the thread.
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