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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by McDaniel on October 12, 2000, at 20:54:27
It doesn't seem like Valium is too popular as an
anti-anxiety drug. It seems like xanax, ativan, klonopin
are heavily favored over it. Anyone know why? Also,
for those of you with success on xanax, ativan, or klonopin,
what doses did you have to take for success. I have very
serious generalized anxiety disorder which has not responded to
any of the AD's or even neurontin. Please help. Thank
you.
Posted by Greg on October 12, 2000, at 21:57:18
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
I've been taking Xanax for about 7 months and it has been very helpful for my anxiety. I have also taken Valium and while it makes me feel more relaxed that Xanax does (probably because Valium is primarily a muscle relaxant), the Xanax seems to last much longer. This is probably due to Valium having a much shorter half-life (6-8 hrs) than Xanax (6-20 hrs). Also Xanax binds readily to the GABA receptor which I believe (and I could be wrong) makes it more effective in the treatment of anxiety and panic. They are both benzos and there is a high probability of addiction and doses should be monitored closely. I generally take .5mg twice daily of the Xanax and it controls my anxiety pretty well most of the time.
I've never used Ativan or Klonopin so I can't help you there, sorry.
I hope this helps.
Peace,
Greg> It doesn't seem like Valium is too popular as an
> anti-anxiety drug. It seems like xanax, ativan, klonopin
> are heavily favored over it. Anyone know why? Also,
> for those of you with success on xanax, ativan, or klonopin,
> what doses did you have to take for success. I have very
> serious generalized anxiety disorder which has not responded to
> any of the AD's or even neurontin. Please help. Thank
> you.
Posted by JohnL on October 13, 2000, at 4:21:27
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
Go up the page to a post titled "Looking for the experts", David Newhouse, 10/12. Check out my repsonse his post. There are some very interesting statistics that might be of help to you.
John
Posted by coral on October 13, 2000, at 5:36:06
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
I use Librium for both generalized anxiety and panic attacks with good results. Good luck.
Posted by Cam W. on October 13, 2000, at 7:25:25
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
McDaniel - The difference between these benzodiazepines (Valium, Xanax, Klonopin, & Ativan) is there pharmacokinetic properties; differences in their absorption, distribution throughout the body, metabolism, and excretion. The main difference between benzos is their half-lifes (the time it takes for half of the drug to leave the body). The half-life of Valium (including it's active metabolites) is about 100 hours; whereas the others you mention have half-lifes of a day or less (except clonazepam - 20 to 80 hours).
Valium is basically the Prozac of of the benzos. It's long half-life prevents immediate withdrawl symptoms that are seen with some of the shorter acting benzos (esp. Xanax).
The more powerful (on a per milligram basis) benzos seem to work faster orally for anxiety, but the effect of Valium lasts longer (probably why it is used as a muscle relaxant).
For GAD, low doses of Effexor (eg 37.5mg Effexor XR daily) have worked in many people. The downside is that it may take 10 weeks to see any good improvement.
Hope this helps - Cam
Posted by Cindy W on October 13, 2000, at 10:07:49
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
> It doesn't seem like Valium is too popular as an
> anti-anxiety drug. It seems like xanax, ativan, klonopin
> are heavily favored over it. Anyone know why? Also,
> for those of you with success on xanax, ativan, or klonopin,
> what doses did you have to take for success. I have very
> serious generalized anxiety disorder which has not responded to
> any of the AD's or even neurontin. Please help. Thank
> you.McDaniel, have you tried Seroquel for anxiety? I've heard it is good for anxiety and am trying it now to sleep better and have clearer thoughts.
Posted by David Peterson on October 13, 2000, at 19:39:21
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
> It doesn't seem like Valium is too popular as an
> anti-anxiety drug. It seems like xanax, ativan, klonopin
> are heavily favored over it. Anyone know why? Also,
> for those of you with success on xanax, ativan, or klonopin,
> what doses did you have to take for success. I have very
> serious generalized anxiety disorder which has not responded to
> any of the AD's or even neurontin. Please help. Thank
> you.I have had good luck with Ativan AKA Lorazepam 1mg 3 times a day. I also Take St.John's Wort 3 times a Day. I can relax and sleep 8 hours a night now,
Posted by stjames on October 15, 2000, at 1:44:56
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
> It doesn't seem like Valium is too popular as an
> anti-anxiety drug.James here.....
Valium is one of the worst of the benzo's for making people sleepy.
That is why it is not used. It would be effective for panic disorder
but the dose would be at a point most would be asleep. It is also long acting,
so you are sleepy all the time. Xanax is unique in this respect, most report
it does not make them sleepy. Xanax is the most addictive, due partly to its short
action. I also find it different from other benzos and
more addictive. Atavin is generally less addictive, I take it, and it
is less powerful than Xanax. I find it to be just right. Atavin has
aprox. the same half-life and length of action as Xanax, to me Xanax
comes on faster. This is an advantage in stopping
a panic attack.For GAD a long action benzo makes sence. Take short acting benzos, requiring
several doses a day, and you will creating peaks and valleys in the
body level of benzo. During these valleys, which is usually right before
the next dose, you start feeling uneasy. If anxiety levels are static, you
don't notice the valleys till anxiety increases. A long acting benzo, Klonipin
is used alot for this, offers once a day dosing and long action, producing body levels that
are constant. The 24/7 treatment for GAD. It is also ez'er to get off a long acting
benzo than a short acting one. You have tried AD's and neurotin, so moving onto
benzos is justified. Klonipin would be my choice.James
Posted by stjames on October 15, 2000, at 2:06:19
In reply to Re: antianxiety meds, posted by stjames on October 15, 2000, at 1:44:56
One more thing, have you done any cognative thearpy,
like CBT ? Very effective for stuff like GAD.James
Posted by Snowie on October 15, 2000, at 7:09:58
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
McDaniel,
I agree with you. I want to get off Xanax, and I've heard that the less potent yet longer lasting Valium can make the weaning easier. However, my new pdoc (soon to be my ex-pdoc) said he doesn't prescribe Valium, but he does prescribe Xanax and Klonopin -- both of which are more potent than Valium. Go figure. On a positive note, I have responded very well to Neurontin for some strange reason. I have slowly been able to decrease my Xanax intake from 3 mg. to 1.5 mg. per day while on 300 mg. per day (100 mg. x 3) of Neurontin. I hope to increase that dose to eventually go off of Xanax.
Snowie
> It doesn't seem like Valium is too popular as an
> anti-anxiety drug. It seems like xanax, ativan, klonopin
> are heavily favored over it. Anyone know why? Also,
> for those of you with success on xanax, ativan, or klonopin,
> what doses did you have to take for success. I have very
> serious generalized anxiety disorder which has not responded to
> any of the AD's or even neurontin. Please help. Thank
> you.
Posted by McDaniel on October 15, 2000, at 14:20:52
In reply to Re: antianxiety meds, posted by stjames on October 15, 2000, at 1:44:56
Thanks everyone. James, any idea what dosage of Klonopin
may be a good target for my GAD? Also try to keep in mind that
I'd love to take it once a day and definitely no more
than twice a day. Thanks.
Posted by JohnM on October 15, 2000, at 14:52:52
In reply to antianxiety meds, posted by McDaniel on October 12, 2000, at 20:54:27
Valium is quite popular in Great Britain. I think its just trends. I've tried all four that you have
mentioned.Klonopin lasts the longest. It is very potent; I found I had to split a .5 milligram tablet into
quarters (or even eighths!) to avoid getting over sedated. The negative, I found was that it tended
to have somewhat of a slight depressive effect with me, but that could be just me. Klonopin is
considered an anti-panic (anti-confusion) medicine. A good medicine!Xanax probably has the best all-around effect: anti-panic, anti-anxiety, and helps with depression.
The downside is that it is short acting and can develop what I call a "craving effect" which can
interfere with the daily flow of one's life. I wouldn't recommend it, or would recommend it for a
brief period of time (2 months) with a switch to another benzo, say Klonopin (remember to split
the tablets into quarters or eighths if necessary).Ativan is rather unremarkable. Short-acting and moderately powerful. Not a bad medicine to try!
Valium is my favorite. Long-acting and moderately powerful. It is not known for anti-panic effect
though, but some focused cognitive or rational-emotive therapy can do wonders with that! See
the web site rebt.org Good Luck!
Posted by stjames on October 17, 2000, at 16:50:17
In reply to Re: antianxiety meds, posted by McDaniel on October 15, 2000, at 14:20:52
> Thanks everyone. James, any idea what dosage of Klonopin
> may be a good target for my GAD? Also try to keep in mind that
> I'd love to take it once a day and definitely no more
> than twice a day. Thanks.james here....
The PDR states 1 mg a day, which can be divided.
YMMVjames
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