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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Darrell on December 7, 1998, at 11:23:43
I'm thinking of asking my doctor for a prescription for
Valium or some other benzodiazepine. This is based on
several things. My symptoms are mainly a combination of
mild depression and anxiety--for years. I just don't feel
vital and "alive" most of the time. My social life is
non-existent, and there's just no joy in much of anything.
My work performance has not suffered too much, thankfully.
BTW, any form of anti-depressant or SSRI (incl. St. John's Wort)
in any dosage leaves me feeling like a zombie.Quite a few years ago, right before I started college, I
started taking Valium for several months. (I acquired these without
a prescription...it was a long time ago.) I seemed to be able to
stop taking them for a couple of days at a time with no
problems, and when I finally ran out, I didn't
notice any serious withdrawal effects. The remarkable
thing about this time in my life was that my energy and
concentration levels were higher than at any time in my
life. That semester, I made the dean's list with a 3.9
GPA. I never came close to that the rest of my college career.
I also drank less alcohol, and had at least some semblance of
a social life. That was a joyous and exciting time in my
life. Was this due solely to the newness of the college experience?My concerns about asking my family doctor to prescribe a benzo center
on whether he will take anything I say seriously, whether
what I experienced many years ago with Valium is repeatable,
and how sustainable a therapy like this is. I certainly didn't
notice any problems with short-term memory loss at the time.
I don't want to annihilate the rest of my life for the
sake of feeling better. Any thoughts?Thanks.
Posted by alan on December 7, 1998, at 12:29:51
In reply to ask my doc for benzos?, posted by Darrell on December 7, 1998, at 11:23:43
> I'm thinking of asking my doctor for a prescription for
> Valium or some other benzodiazepine. This is based on
> several things. My symptoms are mainly a combination of
> mild depression and anxiety--for years. I just don't feel
> vital and "alive" most of the time. My social life is
> non-existent, and there's just no joy in much of anything.
> My work performance has not suffered too much, thankfully.
> BTW, any form of anti-depressant or SSRI (incl. St. John's Wort)
> in any dosage leaves me feeling like a zombie.
> Quite a few years ago, right before I started college, I
> started taking Valium for several months. (I acquired these without
> a prescription...it was a long time ago.) I seemed to be able to
> stop taking them for a couple of days at a time with no
> problems, and when I finally ran out, I didn't
> notice any serious withdrawal effects. The remarkable
> thing about this time in my life was that my energy and
> concentration levels were higher than at any time in my
> life. That semester, I made the dean's list with a 3.9
> GPA. I never came close to that the rest of my college career.
> I also drank less alcohol, and had at least some semblance of
> a social life. That was a joyous and exciting time in my
> life. Was this due solely to the newness of the college experience?
> My concerns about asking my family doctor to prescribe a benzo center
> on whether he will take anything I say seriously, whether
> what I experienced many years ago with Valium is repeatable,
> and how sustainable a therapy like this is. I certainly didn't
> notice any problems with short-term memory loss at the time.
> I don't want to annihilate the rest of my life for the
> sake of feeling better. Any thoughts?
> Thanks.Personally, I think you should see a psychopharmacologist. If you just wanted to get thru a short, difficult bit of time, it wouldn't matter. But if there is any chance benzos will be your main or only psych med for some time, see someone you can trust to be expert. Many family docs see benzos as candy (more used to) or heroin; and the heroin camp (fairly numerous now) wish to protect themselves, as well as patients.
Posted by Toby on December 11, 1998, at 14:14:33
In reply to Re: ask my doc for benzos?, posted by alan on December 7, 1998, at 12:29:51
I agree with Alan that you should see a psychopharmacologist (and BTW I like this term; it seems as though it may help people feel more comfortable talking to others about it than saying they are seeing a psychiatrist). Go and relay your college experience, but don't automatically expect Valium, even though you have had difficulty with SSRI's before. There are other meds for anxiety and depression that don't exactly work like SSRI's and therefore may not give you the zombie feeling. Almost certainly the doc will want to explore those options before Valium. Some of those options are Effexor, Remeron, Serzone, Buspar and zyprexa. good luck.
Posted by betsy on December 13, 1998, at 19:33:22
In reply to Re: ask my doc for benzos?, posted by Toby on December 11, 1998, at 14:14:33
I think that an internist is competent to treat mild depression/anxiety, especially since you have responded to Valium before. It doesn't seem like that tough a case. Don't argue too much if your doctor wants to refer you to a psychiatrist, though.
You do run the risk of sounding like a "drug seeker," unfortunately. This depends a lot on your relationship with your doctor, I think. I personally don't think that requesting a benzo would be unreasonable, but it might sound better if you told your doctor that you have been experiencing anxiety and would like a prescription for it. Don't mention that you got the Valium without a prescription before! If your doctor suggests antidepressants, tell him which ones you tried and what effects they had on you. If he still wants you to try something else, go along with it - it may work, who knows?
Klonopin seems to be the most popular benzo today, BTW. I have found personally that Klonopin works well for me. It is also perceived (correctly or not) as being less prone to abuse.
I disagree that Zyprexa (an antipsychotic drug with a number of side effects that is quite sedating for many people) would be used before a benzo.
Good luck. I'd like to hear what happens.
Posted by Toby on December 14, 1998, at 11:06:38
In reply to Re: ask my doc for benzos?, posted by betsy on December 13, 1998, at 19:33:22
I would disagree with Betsy on only two points: one, don't start out a relationship with your physician by "not mentioning" that you got Valium without a prescription before college. If you don't have a big drug history otherwise, the doc shouldn't hold it against you in the big scheme of things. Doctors know that teenagers do things like that. And you'll look even more like a drug seeker if you don't mention it and somewhere down the line end up having to admit that "Valium worked once, so why not again?"
Two, in some people, Zyprexa in tiny doses like 2.5 mg has helped certain anxiety disorders. It wouldn't be a general first or second line medication for most people, but for some, yes. The mechanism appears to be along the same lines as how Mellaril in tiny doses has been given since the 60's to people with depressive anxiety and to geriatric patients with certain anxious emotional problems.
Posted by Betsy on December 15, 1998, at 19:32:27
In reply to Re: ask my doc for benzos?, posted by Toby on December 14, 1998, at 11:06:38
> I would disagree with Betsy on only two points: one, don't start out a relationship with your physician by "not mentioning" that you got Valium without a prescription before college. If you don't have a big drug history otherwise, the doc shouldn't hold it against you in the big scheme of things. Doctors know that teenagers do things like that. And you'll look even more like a drug seeker if you don't mention it and somewhere down the line end up having to admit that "Valium worked once, so why not again?"
In an ideal world, I'd agree with this. I think it depends on the doctor in question, but a person who has a drug history has an extremely good chance of being labelled as a drug seeker, regardless of whether there is any justification for this label. Yeah, the doctor _shouldn't_ hold it against you - but many doctors will anyway.
> Two, in some people, Zyprexa in tiny doses like 2.5 mg has helped certain anxiety disorders. It wouldn't be a general first or second line medication for most people, but for some, yes. The mechanism appears to be along the same lines as how Mellaril in tiny doses has been given since the 60's to people with depressive anxiety and to geriatric patients with certain anxious emotional problems.
I'm not saying it doesn't help, just that it's a poor first (or second) choice and probably falls well below benzos on most doctors' lists of things to try for mild depression/anxiety. Even low doses of Zyprexa can cause quite a few side effects for a lot of people. (Sedation, weight gain, and feeling "drugged" are very common.) It seems especially silly to try something like Zyprexa before trying a benzo (a class of drugs that have been effective before and are well-established antianxiety drugs) again. Remeron, Serzone, or BuSpar might be the next thing to try if a benzo doesn't help this time.
Posted by Matt on December 16, 1998, at 11:53:27
In reply to Re: ask my doc for benzos?, posted by Betsy on December 15, 1998, at 19:32:27
There is, unfortunately, a great deal of "benzophobia" out there. This is unfortunate, for these drugs are very safe (even when taken for long periods of time), and are quite effective on anxiety. If anxiety is an issue with you, and it impairs your normal functioning, I most certainly would look into trying klonopin (first, and before trying a brand new antipsychotic). This drug is thought by many to be more effective than Valium, and it is long-acting, as is Valium. I'd try to get the brand name (rather than generic clonazepam) for a couple reasons. First of all, the brand name doesn't cost much more than the generic. Second, and more important the brand name (in my experience and that of many others to whom I've talked) seems to work better than the generic.
I personally have found klonopin to help significantly with anxiety. I'm going off it now, but it really did help me through some difficult times. I'm very glad it was available to me (in the dosage I needed it, up to 2mg a day).
Best of luck
Matt
Posted by Peter on December 16, 1998, at 15:38:58
In reply to ask my doc for benzos?, posted by Darrell on December 7, 1998, at 11:23:43
Darrell,
So what did you decide to do? Or what action did you take,
and how did it go?
Peter
> I'm thinking of asking my doctor for a prescription for
> Valium or some other benzodiazepine. This is based on
> several things. My symptoms are mainly a combination of
> mild depression and anxiety--for years. I just don't feel
> vital and "alive" most of the time. My social life is
> non-existent, and there's just no joy in much of anything.
> My work performance has not suffered too much, thankfully.
> BTW, any form of anti-depressant or SSRI (incl. St. John's Wort)
> in any dosage leaves me feeling like a zombie.
> Quite a few years ago, right before I started college, I
> started taking Valium for several months. (I acquired these without
> a prescription...it was a long time ago.) I seemed to be able to
> stop taking them for a couple of days at a time with no
> problems, and when I finally ran out, I didn't
> notice any serious withdrawal effects. The remarkable
> thing about this time in my life was that my energy and
> concentration levels were higher than at any time in my
> life. That semester, I made the dean's list with a 3.9
> GPA. I never came close to that the rest of my college career.
> I also drank less alcohol, and had at least some semblance of
> a social life. That was a joyous and exciting time in my
> life. Was this due solely to the newness of the college experience?
> My concerns about asking my family doctor to prescribe a benzo center
> on whether he will take anything I say seriously, whether
> what I experienced many years ago with Valium is repeatable,
> and how sustainable a therapy like this is. I certainly didn't
> notice any problems with short-term memory loss at the time.
> I don't want to annihilate the rest of my life for the
> sake of feeling better. Any thoughts?
> Thanks.
Posted by Darrell on December 20, 1998, at 13:34:16
In reply to Re: ask my doc for benzos?, posted by Peter on December 16, 1998, at 15:38:58
> Darrell,
> So what did you decide to do? Or what action did you take,
> and how did it go?
> Peter
>Thanks for the thoughtful replies, all. I really appreciate the opinions. I haven't taken any action, so far. I'll post again and let you know how it goes. I guess my main concern is being perceived as irresponsible. But, with the advice you've given, I think I can deal with that.
/Darrell
This is the end of the thread.
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