Psycho-Babble Medication Thread 86854

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

Please help any happy ativan users out there

Posted by gilbert on December 13, 2001, at 21:33:49

I was recently tapered off xanax due to the short half life was driving me nuts. The doc gives me klonopin and it makes me impotent.....so today he gives me a script for .5mg ativan bid. This dose seems low. I was on on 2mg xanax. He says ativan is stronger so I should need less. Question ...does ativan work, and what do you think a proper dose would be considering I was on 2mg xanax per day.

Thanks,

Gil

 

Re: Please help any happy ativan users out there gilbert

Posted by janejj on December 13, 2001, at 22:19:09

In reply to Please help any happy ativan users out there , posted by gilbert on December 13, 2001, at 21:33:49

Hi,

I use Ativan 1mg before bed and when needed, seems to work just fine for me. I think I read somewhere that its less damaging on the liver than other benzo's and its prescribed to children.

Good Luck
Jane


I was recently tapered off xanax due to the short half life was driving me nuts. The doc gives me klonopin and it makes me impotent.....so today he gives me a script for .5mg ativan bid. This dose seems low. I was on on 2mg xanax. He says ativan is stronger so I should need less. Question ...does ativan work, and what do you think a proper dose would be considering I was on 2mg xanax per day.
>
> Thanks,
>
> Gil

 

Re: Please help any happy ativan users out there

Posted by dreamer on December 13, 2001, at 23:19:53

In reply to Re: Please help any happy ativan users out there gilbert, posted by janejj on December 13, 2001, at 22:19:09

> Hi,
>
> I use Ativan 1mg before bed and when needed, seems to work just fine for me. I think I read somewhere that its less damaging on the liver than other benzo's and its prescribed to children.
>
> Good Luck
> Jane
>
>
> I was recently tapered off xanax due to the short half life was driving me nuts. The doc gives me klonopin and it makes me impotent.....so today he gives me a script for .5mg ativan bid. This dose seems low. I was on on 2mg xanax. He says ativan is stronger so I should need less. Question ...does ativan work, and what do you think a proper dose would be considering I was on 2mg xanax per day.
> >
> > Thanks,
> >
> > Gil

I take 1mg when needed as sedative or going out for panic, 2mg if I can't sleep......not everyday bout twice a week.

 

Re: switching from Xanax to Ativan gilbert

Posted by Elizabeth on December 14, 2001, at 13:29:04

In reply to Please help any happy ativan users out there , posted by gilbert on December 13, 2001, at 21:33:49

> I was recently tapered off xanax due to the short half life was driving me nuts. The doc gives me klonopin and it makes me impotent.....so today he gives me a script for .5mg ativan bid. This dose seems low. I was on on 2mg xanax. He says ativan is stronger so I should need less.

Ativan is less potent than Xanax or Klonopin. Xanax is the most potent of the three. So the equivalent dose of Ativan will be *higher* than the dose of Xanax that you had been taking, not lower (this is what "potency" means). However, you won't need to take it as many times a day -- I think most people who take Ativan on a regular basis take it three times a day or so.

-elizabeth

 

Re:nocturnal panics

Posted by gilbert on December 15, 2001, at 16:09:09

In reply to Re: switching from Xanax to Ativan gilbert, posted by Elizabeth on December 14, 2001, at 13:29:04

So much for going off xanax. I may have to resign myself that this is a life med. Does anyone else experience nocturnal panics. I wake up....I can remember my dream vividly and my heart is racing and I am sweaty. The more I think about it the more it happens. It only occurs after a dream and when I wake up.....soooo strange. Tonight I am going to try to bomb it with xanax at bedtime and see If I can avoid the whole mess. Weird I no longer have panics during the day but now they creep out in my sleep instead. Doctor said it was not sleep apnea if I remember my dreams and the wife says I don't even snore. This morning it hit at 640 a.m I was able to do some diaphramtic breathing to avoid the bounding pulse but I was scared to even move my foot for fear my heart would take off. I was to the cardio doc last year everything normal, I run 30 miles per week plus if it were my heart why only at the same time every night....sooo strange.....anyone else have this happen.

Gil

 

Re: nocturnal panics gilbert

Posted by Elizabeth on December 15, 2001, at 20:05:58

In reply to Re:nocturnal panics, posted by gilbert on December 15, 2001, at 16:09:09

> So much for going off xanax. I may have to resign myself that this is a life med. Does anyone else experience nocturnal panics.

Yes, I do sometimes. This is common in panic disorder. It's like I wake up already panicking. But perhaps of interest, mine *don't* occur during dreams. MAOIs did stop the nocturnal attacks as well as the waking ones. Too early to know if Effexor will help yet. Desipramine did *not* help much, if at all, with daytime or nocturnal panics.

Something that might help you would be to take Klonopin at bedtime. It's longer-acting than Xanax so it can hold you through the night where Xanax may not.

BTW: you don't have to take Xanax forever if you don't want to -- the way to get off it is to switch to a longer-acting med (e.g., Klonopin) and then taper off that *very* gradually. But panic disorder is often a lifelong thing, and if you stop the Xanax without replacing it with something else (like an antidepressant) that might help, you shouldn't be surprised if the panics return.

-elizabeth

 

Re: .thanks Elizabeth..mood stabilizers and panic

Posted by gilbert on December 15, 2001, at 23:11:03

In reply to Re: nocturnal panics gilbert, posted by Elizabeth on December 15, 2001, at 20:05:58

I found the ativan too weak even at 1.5 the dosage of xanax and klonopin makes me a Eunich....did I spell that right, it actually has more side effects sexually than prozac. The doc is talking about mood stabilizers.....kind of makes me wonder I show no signs of even having bi-polar II. I think I am better off in the long run as far as side effects go on xanax than an anti convulsant. I am very gun shy to medicate what has been life long panic with agoraphobia with anti-pychotics or stabilizers. I have always been a very typical panic disorder patient. He thinks because I did not do well on the ssri's we should be able to sub the xanax with depakote or lithium...I don't get it...I think he would have me on anything but a benzo. Any comment would be helpfull

 

Re: .thanks Elizabeth..mood stabilizers and panic

Posted by Alan on December 16, 2001, at 11:45:03

In reply to Re: .thanks Elizabeth..mood stabilizers and panic, posted by gilbert on December 15, 2001, at 23:11:03

> I found the ativan too weak even at 1.5 the dosage of xanax and klonopin makes me a Eunich....did I spell that right, it actually has more side effects sexually than prozac. The doc is talking about mood stabilizers.....kind of makes me wonder I show no signs of even having bi-polar II. I think I am better off in the long run as far as side effects go on xanax than an anti convulsant. I am very gun shy to medicate what has been life long panic with agoraphobia with anti-pychotics or stabilizers. I have always been a very typical panic disorder patient. He thinks because I did not do well on the ssri's we should be able to sub the xanax with depakote or lithium...I don't get it...I think he would have me on anything but a benzo. Any comment would be helpfull
*********************************************

It's called Benzophobia. Taking one off of a type of med BZD's in your case after not already trying the others available and in higher, theraputic doses is irresponsible in the extreme in my opinion. I know that the NHS uniformly discourages their usage but private care does not. Are you in a position to seek out a private doc that isn't under political or moral pressure to give you the care that you deserve? If not, ask to try Ativan at theraputic doses up to 4 -5 MGs and xanax at a decent dose and valium, and other BZD's. The anti-benzo zealotry is effecting you directly and you should at least have a go of these extremely useful meds before going on to others. Xanax is especially helpful in PD with nocturnal panic. Neurontin, a mood stabiliser could be used as a maintinence dose and xanax on to of that to get you through the night and not awake early. Or perhaps the higher dose of xanax would do that alone altogether.

Alan

 

mood stabilizers gilbert

Posted by Elizabeth on December 16, 2001, at 12:12:39

In reply to Re: .thanks Elizabeth..mood stabilizers and panic, posted by gilbert on December 15, 2001, at 23:11:03

I'm dubious about the mood stabilizer idea, but maybe your doctor sees some symptom in you that you don't notice, or that you don't recognize as potentially responsive to mood stabilizers. Ask -- you deserve a reason why you should try this stuff. Some anticonvulsants (Depakote, Neurontin) may be helpful for panic disorder, but lithium certainly isn't (did he explicitly mention lithium, BTW?). It really does sound like he's just being benzophobic and will use any excuse to get you off a benzo.

What happened when you took ADs, and which ones did you try? Also which benzos have you tried, exactly, and in what doses?

This is looking ahead, but when you've got the panic attacks under control, if you still have problems with agoraphobia then it would probably be a good idea to get involved in cognitive-behavioral therapy for it. Once the panic is gone, CBT should help with the phobic avoidance.

That's weird about the sexual dysfunction from benzos, but who knows? These meds have such varied effects on people. Believe it or not, I experienced only one benzo withdrawal symptom ever, and it was vomiting! Not exactly your standard benzo withdrawal, and for several days I couldn't figure out what it was. Then I took some Klonopin and it stopped!

(It's "eunuch," BTW. :-) )

-elizabeth

 

Re: Elizabeth and Alan

Posted by gilbert on December 16, 2001, at 16:07:58

In reply to mood stabilizers gilbert, posted by Elizabeth on December 16, 2001, at 12:12:39

I had my panic under control for 2 years on xanax at 2mg per day. I have had trouble getting a higher dose that that. That has by far been my best med. The AD's seem to make me nervous....not manic I still would sleep and they gave me severe anorgasmia. The tricyclics always gave me weird heart effects so I never tried them for very long. I am a bit hyper vigilant about my heart. a tad hypochondriac. My anxiety is usually centerd around health issues and dying. I was able to do many things on the xanax like drive across the Mackinaw bridge and other phobias like visiting friends in the hospital were all possible. I have put myself under some pressure to try different AD's because I am a long time AA member but I think that masochistic phase of my therapy is over. I am sober I just need xanax to function. I really have never exhibitied any signs of even slight mania maybe a little depression and certainly some ocd but not mania. I have been with my wife for 20 years she says I have panic and some ocd so does my therapist he diagnosed me as the same......but the doc thinks that I will be on like 20mg xanax 10 years from now. I only take 2 mg now but could probably do better on 3 to 4 mg. That's it in a nut shell.....the ocd seems to almost always be health isuuees driven by anxiety over my mortality.

There How much do I owe you guys for theat last session.

I am very reluctant to go to his psychiatrist due to the fact it seems the mood stabilzers and anti-pyschotics are being handed out like candy. Am i wrong is xanax pretty harless compared to alot of those other drugs.

Gil

 

Re: Elizabeth and Alan gilbert

Posted by Alan on December 16, 2001, at 20:02:19

In reply to Re: Elizabeth and Alan, posted by gilbert on December 16, 2001, at 16:07:58

> I had my panic under control for 2 years on xanax at 2mg per day. I have had trouble getting a higher dose that that. That has by far been my best med. ...I have been with my wife for 20 years she says I have panic and some ocd so does my therapist he diagnosed me as the same......but the doc thinks that I will be on like 20mg xanax 10 years from now. I only take 2 mg now but could probably do better on 3 to 4 mg. > Gil
*******************************************

This is very sad commentary on your docs competency or the system or something. To be just a MG or two short of relieveing you suffering is in my estimation unconscionable. Especially instilling the fear of ending up taking 20 MGs someday shows such incompetency of the understanding of the drug that it's outrageous. This almost never happens. You need to find a dose of a BZD that works...or find a new doc.
Period. You don't take it to get "high", correct? You take it to feel normal again. You've been burdened with additional anxiety about taking the very med that YOU say helps you. You're the boss. Tell your doc what you need and if they say no ask why. If they give you the escallating dose line, find a doc that will listen and knows what the hell they're talking about. Sheesh! Such incompetency is staggering - not to mention beyond frustration for yourself....

Best,

Alan

 

Panic can just be panic!

Posted by spike4848 on December 16, 2001, at 21:17:15

In reply to Re: Elizabeth and Alan gilbert, posted by Alan on December 16, 2001, at 20:02:19

Gilbert,

A new evolving trending in psychiatry is to re-label behavior as being, "in the bipolar spectrum." I think now people have classified Bipolar types I,I and 1/2, II, III, IV and V. But some times people may just have panic or shyness or aggressiveness, they are not bipolar X or XII. More important than diagnotic labels ....which are for doctors ... is how YOU feel. If xanax if effective, use it and find a doctor that will prescribe it.

I have seen way too many panic patients under treated, mainly with ssri's and tca's alone. Granted, some do well with ssri's and tca's, but many people actually feel worst-even after the initial stimulation period in the beginning. Many panic patients do extremely well with benzodiazapines alone. And not only do they not increase their dose, most patient take a stable dose for years.... and try to taper off the benzo periodically.

Spike

 

panic treatment (or mistreatment) gilbert

Posted by Elizabeth on December 16, 2001, at 22:49:22

In reply to Re: Elizabeth and Alan, posted by gilbert on December 16, 2001, at 16:07:58

> The AD's seem to make me nervous....not manic I still would sleep and they gave me severe anorgasmia. The tricyclics always gave me weird heart effects so I never tried them for very long. I am a bit hyper vigilant about my heart. a tad hypochondriac. My anxiety is usually centerd around health issues and dying.

This is all typical of panic disorder. People with PD tend to get jittery on antidepressants, especially SSRIs, and to be hypersensitive to side effects (such as the tachycardia and palpitations which can often occur on TCAs). The initial nervousness goes away with time, but people being treated for PD with antidepressants often need to start at a very low dose and increase it very gradually.

> I have put myself under some pressure to try different AD's because I am a long time AA member but I think that masochistic phase of my therapy is over. I am sober I just need xanax to function.

Hey, you don't need to convince me -- I believe you. A lot of people with anxiety disorders self-medicate with alcohol. It's nothing that you should have to feel ashamed of, nor should it prevent you from getting effective treatment.

> the doc thinks that I will be on like 20mg xanax 10 years from now.

The doc needs to do some reading. All the evidence that's out there shows that people taking benzos for panic do not develop tolerance.

> I am very reluctant to go to his psychiatrist due to the fact it seems the mood stabilzers and anti-pyschotics are being handed out like candy. Am i wrong is xanax pretty harless compared to alot of those other drugs.

It's certainly much more tolerable. This doctor owes you an explanation for why he wants you to try to go off the Xanax and go on anticonvulsants or whatever.

Spike has a good point, that "soft bipolar disorder" is a trendy diagnosis while panic is not. But the bottom line is what works. If Xanax is working for you and you're tolerating it well, then that's probably what you should be on.

You might dig up some articles showing that panic patients don't abuse benzos or grow tolerant to them, and show the citations to your doctor. He seems to be misinformed.

-elizabeth

 

Re: klonopin side effects

Posted by gilbert on December 17, 2001, at 16:23:26

In reply to panic treatment (or mistreatment) gilbert, posted by Elizabeth on December 16, 2001, at 22:49:22

Is it possible to attenuate to klonopin's side effect.....for me the sexual side effect is not comletely unbearable and the med is certainly smoother than multi dosing xanax when I have taken it I have never stayed on it for more than 2 weeks. Is there anyone out there who had mild to moderate sexual side effects that went away after a couple of weeks. I am also not completely sure this side effect is not pyschosymatic......because no one else seems to experience what I have in the way of mild impotence from klonopin at 1.5mg per day.

Gil

Gil

 

Re: klonopin side effects

Posted by Thrud on December 20, 2001, at 7:12:53

In reply to Re: klonopin side effects, posted by gilbert on December 17, 2001, at 16:23:26

Hi Gil,

I can tell you for sure that sexual side effects differ amongst the different benzos. I've only tried two of them: Xanax and Valium. I found the sexual dysfunction of 10mg of Valium to be considerably greater than 3mg of Xanax, even though this is supposed to be equivalent in anxiolytic potency to 30mg of Valium.

I have not tried Klonopin, but you are certainly not the first to complain about sexual side effects with it. As for will it go away in time, I cannot answer that one. I have been on 3mg of Xanax for about six months but I started taking it almost immediately in conjunction with Lamictal because Lamictal could not control my anxiety. I currently also have sexual side effect problems with this combo but I can't say which med (maybe both?) is to blame. It has not gone away yet and doesn't seem like it is going to: it has been too stable.

There is a thread not too far above where I discuss with Rick about using small amounts of Selegiline to improve sexual function while on other meds. He has done extensive research on the topic and based on the evidence I am going to try it myself. Perhaps you should consider it also.

I know what it is like to have a benzophobe doctor. My PCP says he very rarely prescribes them and says that my being on 200mg of Lamictal and 3mg Xanax per day is a, "shit load of medication". Of course I felt simultaneously ashamed and angry, but I have a very good pdoc. He believes that the pendulum has swung too far against benzos and has no hesitation in prescribing me Xanax. Like most PD users, I never use more than what keeps me comfortable and he knows that. My advice to you: I had to go through quite a few pdocs before I found one who made himself part of a team with me rather than one who simply demanded conformity. It is a hassle but once you find your match you will find the effort well worth it.

All the best on what is always a difficult road.

Thrud

> Is it possible to attenuate to klonopin's side effect.....for me the sexual side effect is not comletely unbearable and the med is certainly smoother than multi dosing xanax when I have taken it I have never stayed on it for more than 2 weeks. Is there anyone out there who had mild to moderate sexual side effects that went away after a couple of weeks. I am also not completely sure this side effect is not pyschosymatic......because no one else seems to experience what I have in the way of mild impotence from klonopin at 1.5mg per day.
>
> Gil
>
> Gil


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