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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by Guy on May 1, 2002, at 22:41:52
There is so much conflicting info about the benzos.... I have had debilitating anxiety (GAD and insomnia)for about five years and tried every AD in the book, all to no avail. The AD's usually made me worse. Now I'm wondering if clonazepam is the way to go. Some people say it's great while others warn it will take me down the road to hell. Who is one to believe?? It seems to me that most of the problems are reported by those who decide to quit the drug, rather than by those who continue treatment. Is this an accurate perception? My biggest fear is having the drug poop out and then being faced with a horrific withdrawal syndrome. I'm wondering if those who take the drug long-term do so for the continuing anti-anxiety effect, or just because they don't want to deal with the withdrawal symptoms. I'd love to get some relief, but I don't want to trade in my current problems for even bigger ones in the future. Any advice would be greatly appreciated.
Posted by judy1 on May 1, 2002, at 23:10:16
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
I've taken 6mg/day of klonopin for over 4 years. I've stopped twice with careful tapering and had some insomnia and anxiety which gradually ended. I take it for panic disorder (which occasionally remits), and it essentially cures my panic attacks. I have no side-effects and I definitely think it's worth a try. Best of luck- Judy
Posted by n0matter on May 1, 2002, at 23:20:19
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
I took ativan for 4 years, 1mg, 3x/day then switched to klonopin, which is basically the same thing as ativan but with a longer half-life. They've served me well, I admit, but the problem with these drugs is that they're VERY addictive. And, when you finally decide you're ready to wean yourself off of them, if that ever even happens, the withdrawals are of such an intensity that it feels like your anxiety returns twice as powerful as before you started taking anything to control it. And then there's no way of telling, once the withdrawals are over with, whether or not you'll have kicked the anxiety. I strongly suggest alternative medication...something without addictive properties, like neurontin.
Posted by Alan on May 1, 2002, at 23:26:20
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
I've been on BZD's long term and the strident anti-benzo lobby has been at it for years with their moralising and politicising about a contolled substance. ALL of the medical evidence says that BZD's are some of the safest drugs in the world of Psychotropics...even more successfully prescribed overall for anxiety disorders than any commercially driven AD (wonder why you were never offered them on an equal footing with the ssri's?).
BZD monotherapy is safe for the vast majority of the population. Please read these links and you'll be able to decide for yourself:
http://bearpaw8.tripod.com/pd.html
and
http://panicdisorder.about.com/library/weekly/aa031997.htm
and
http://www.psykmott-ntorg.a.se/benzoart.html
and finally,
http://earthops.org/panic-disorder1.html (long)
Generally, there is no better medicine for the contol of anxiety (chronic) than the BZD's. I went through years of the latest comercially driven AD and had to take a BZD with it anyway. Once at the proper theraputic dose, you'll wonder why they were never offered in the first place. Generally it takes seeing a pdoc that understands and specialises in the treatment of the anxiety disorders who understands these meds and how to use them and help you decide which of them are best for you through clinical trials with each.I take 1 MG daily of klonopin (but up to 3 MG's is not uncommon) and augment with Ativan PRN for breakthrough panic. These drugs really gave me my life back with FULL relief if my symptoms.
I think you'll have a lot to digest from the links I've given you. Unfortunately there is so much MISinformation out there about these safe drugs that many patients and doctors are scaremongered by all the anti-benzo myths and sites out there without having read the actual facts and evidence about these meds.
Good luck!
Alan
Posted by Alan on May 2, 2002, at 0:43:40
In reply to STAY AWAY FROM BENZOS..., posted by n0matter on May 1, 2002, at 23:20:19
> I took ativan for 4 years, 1mg, 3x/day then switched to klonopin, which is basically the same thing as ativan but with a longer half-life.
They are certainly in the same class chemically but different people react differently to them. Klonopin may work for GAD but not so well for PD - xanax is better for that and so on. So I wouldn't say this statement is accurate.
>They've served me well, I admit, but the problem with these drugs is that they're VERY addictive.
This is not the proper terminology when referring to BZD's. Medically dependent is correct for a medical condition. Tolerance and dependence DOES NOT = "addiction". I have posted a link about the distinction too. Please read and understand the distinction above. It is probably the most important one to understand about these medications - and the LEAST understood by patients and many doctors alike.
>And, when you finally decide you're ready to wean yourself off of them, if that ever even happens, the withdrawals are of such an intensity that it feels like your anxiety returns twice as powerful as before you started taking anything to control it.
This rarely happens except for a small subset of the population and can be countered with a longer acting BZD, slower taper, adding neuontin, or a calcium channel blocker - so there's always a way out if you are the exception and if the tapering is done slowly and methodically enough. Besides, the type of side effect described is relatively rare. The tapering is at least controlable unlike the discontinuation syndromes reported more and more on these bboards with the ssri's (which the manufacturers witheld info. about) and they aren't even classified as building tolerance and withdrawl.
>And then there's no way of telling, once the withdrawals are over with, whether or not you'll have kicked the anxiety.
That's why you keep taking them - to treat the symptoms of chronic anxiety. BZD's, ssri's - as a matter of fact, no medicine "cures" disease (except perhaps antibiotics), they only treat symptoms.
>I strongly suggest alternative medication...something without addictive properties, like neurontin.
The irony of this statement is that there are discontinuation syndromes with ALL psychotropic drugs for an unlucky subset of the population. This phenomenon is not exlusive to BZD's as implied.
So this is part of the misunderstanding of this class of medications that is out there. Not to say that this individual didn't have a bad experience with them. But one must go to a specialist who knows how to diagnose, treat, and follow up using BZD's for anxiety disorders - preferably a specialist who knows the anxiety disorders well.
PLEASE read the links I've posted above.
Alan
Posted by jay on May 2, 2002, at 2:34:20
In reply to Re: STAY AWAY FROM BENZOS... » n0matter, posted by Alan on May 2, 2002, at 0:43:40
Posted by Guy on May 2, 2002, at 8:57:42
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
Nomatter, I certainly won't question the pain you have suffered...I know first hand how nasty this disorder can be. However, your statement does seem to confirm my perception that most complaints with the benzos have to do with discontinuation rather than continuation. I have suffered so much over the past years that I really don't care if I have to take the med for the rest of my life. In other words, addiction, dependancy or whatever you want to call it, is not a concern for me. I am more concerned about the drug continuing to be effective in the long-term. I think most others who are severely ill with chronic anxiety feel the same way. Who wants to be suicidal every day???
Posted by rickoshay on May 2, 2002, at 9:41:32
In reply to Re: Long-term Clonazepam, posted by Guy on May 2, 2002, at 8:57:42
All i can say Guy is "amen!"
Posted by Spongemomsquarepants on May 2, 2002, at 10:01:17
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
Hi,
I have been on Klonopin for 8-9 years now and I have only had to increase the dosage 1/2 mg in that time period. It works well for my anxiety. Everyone is different.
Viki
Posted by n0matter on May 2, 2002, at 10:59:41
In reply to Re: Long-term Clonazepam, posted by Spongemomsquarepants on May 2, 2002, at 10:01:17
I'm the first to admit I'm not as book-smart on this subject as Alan. But my own personal experiences have left me very anti-benzos. I believe I was improperly diagnosed and mistreated years ago and am currently benzo-dependent because of this. I constantly struggle against the idea of having to take these for the rest of my life. It's very self-defeating. And, while I agree with Alan re: the fact that these drugs don't CURE an affliction but merely help in controlling the symptoms, I do believe that the purpose intended in alleviating these symptoms is to allow us to root out the cause of our condition and resolve it. There was a time when the majority of us didn't have our depression, anxiety, OCD, etc. I was always under the impression that the ultimate and most favorable of scenarios involved us rediscovering that time and that way of thinking. Not finding a pill that masks our problems and being content with taking it for the rest of our lives. But to each his own, I suppose. Tony, thank you for the links, I WILL check them out. And good luck to everyone else.
Posted by tina on May 2, 2002, at 13:15:20
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
Been taking it for 12 + years dude and I'm still taking it. No abuse. Just 1 mg per day, that's it. Never had to increase and it takes the edge of the anxiety. As to anything more longterm than 12 years,,,,,can't say. I just know it's been the one med that has never let me down.
Posted by crepuscular on May 2, 2002, at 14:12:03
In reply to STAY AWAY FROM BENZOS..., posted by n0matter on May 1, 2002, at 23:20:19
Jeez, kicking high-dose Neurontin is no fun either. missed almost a week of sleep.
Posted by Alan on May 2, 2002, at 14:42:49
In reply to They're just my personal opinions, guys..., posted by n0matter on May 2, 2002, at 10:59:41
> I believe I was improperly diagnosed and mistreated years ago and am currently benzo-dependent because of this. I constantly struggle against the idea of having to take these for the rest of my life. It's very self-defeating. And, while I agree with Alan re: the fact that these drugs don't CURE an affliction but merely help in controlling the symptoms, I do believe that the purpose intended in alleviating these symptoms is to allow us to root out the cause of our condition and resolve it. There was a time when the majority of us didn't have our depression, anxiety, OCD, etc. I was always under the impression that the ultimate and most favorable of scenarios involved us rediscovering that time and that way of thinking. Not finding a pill that masks our problems and being content with taking it for the rest of our lives.
_______________________________________________Perhaps it's the misprescribing and mismanagement at fault, not the drug itself as you say. It takes a great amount of knowledge to know when to prescribe these meds and effort in follow up continuing to manage them..
But I guess the question then becomes after you are finally through discontinuing it, what is the strategy for managing one's own anxiety? Actually, BZD's ARE used short term while one can get their head screwed on straight to be able to sort things out enabling them to go through therapy, whatever, to get to some roots of the problem, practice CBT and the like.
Unfortunately for a lot of us, the disorder/disease is biologically or familial based and trying to go off BZD's is the eqivalent of trying to go off insulin for diabetes, etc. So the return of symptoms is practically guaranteed (along with the hassle of withdrawing) so one is better off staying on the med in the first place.
Alan
Posted by Squiggles on May 2, 2002, at 16:52:17
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
Hi Guy,
I found that with Xanax, tolerance built over
the years, and the results were very distressing;
mostly unexplained panic attacks. Those stopped
once I was weaned off.The clonazepam on the other hand, was a
different experience. After 5-7 years, I began
to feel strange effects, and my doctor doubled it.I think that with clonazepam you can go for a long
time on the same dose; not the case with Xanax.Squiggles
Posted by Dr. Bob on May 2, 2002, at 17:01:24
In reply to Re: Long-term Clonazepam » Guy, posted by Alan on May 1, 2002, at 23:26:20
> Please read these links and you'll be able to decide for yourself:
>
> http://bearpaw8.tripod.com/pd.html
>
> and
>
> http://panicdisorder.about.com/library/weekly/aa031997.htm
>
> and
>
> http://www.psykmott-ntorg.a.se/benzoart.html
>
> and finally,
>
> http://earthops.org/panic-disorder1.html (long)Hey, would you be interested in putting together a folder of "bookmarks" (links) on benzodiazepines for Psycho-Babble Tips?
http://groups.yahoo.com/group/psycho-babble-tips/links
Bob
Posted by johnj on May 2, 2002, at 17:06:55
In reply to Re: tips on benzodiazepines?, posted by Dr. Bob on May 2, 2002, at 17:01:24
other than benzo's?
Thanks
John
Posted by Guy on May 2, 2002, at 18:50:38
In reply to Long-term Clonazepam, posted by Guy on May 1, 2002, at 22:41:52
I have suffered from anxiety all of my life, but I just didn't know it! I thought that that is what life is like. Now, after a major melt-down, I look back and realize that so many things in my past can be attributed to the anxiety. In other words, my nervous system has been out of kilter right from the very beginning. For people like me there is no real (med free) recovery. If benzos can help, then why no go for it? What good is it to be "med-free" if it means constant suffering? To Nomatter: I notice that you are on a low dose of clonazepam. Have you ever considered increasing the dose to give yourself some relief? Perhaps you are yearning for something that doesn't really exist.
Posted by beetle on May 2, 2002, at 21:18:08
In reply to Re: Long-term Clonazepam, posted by Guy on May 2, 2002, at 18:50:38
I say go for it. I have tried it all in the past 2 years to control my anxiety....several SSRIs, Tri-cyclics, Neurontin, Gabitril, Seroquel, Buspar, Depakote....you name it (I also have depression, but that is under control with Celexa). I had a crash about 4 weeks ago and went to see my doctor. she said it was to try something else (Klonopin), since nothing else has been very effective. I take 1.5mg/day, and I have had a heavy burden lifted from my shoulders. Good luck my friend, something is bound to work. By the way, does anyone know if you need to take the Klonopin in divided doses, or can you take it all at once? I've heard clonazepam has a long half life.
Posted by Alan on May 2, 2002, at 21:35:16
In reply to Re: tips on benzodiazepines?, posted by Dr. Bob on May 2, 2002, at 17:01:24
> > Please read these links and you'll be able to decide for yourself:
> >
> > http://bearpaw8.tripod.com/pd.html
> >
> > and
> >
> > http://panicdisorder.about.com/library/weekly/aa031997.htm
> >
> > and
> >
> > http://www.psykmott-ntorg.a.se/benzoart.html
> >
> > and finally,
> >
> > http://earthops.org/panic-disorder1.html (long)
>
> Hey, would you be interested in putting together a folder of "bookmarks" (links) on benzodiazepines for Psycho-Babble Tips?
>
> http://groups.yahoo.com/group/psycho-babble-tips/links
>
> Bob
************************************************Sure but I'm not sure how to do it. I get to the yahoo site and register and then what? Give all the links about bzd's that have their own addresses so that I can then post one link to yahoo on the PSYBABBLE board instead of listing so many of them?
Alan
Posted by Rathrbfishn on May 2, 2002, at 23:11:24
In reply to Re: tips on benzodiazepines?, posted by Dr. Bob on May 2, 2002, at 17:01:24
Hey Alan, I second dr.bob's thoughts. You know what your talking about and you know it. You may remember me as Okieman on another BB. I'm doing fine with the xanax, decided to quit all the other psych drug trials(there weren't many left) and just stick with what has worked for so many years. Glad to see you posting your info here. You have a lot to offer. Carry on, I'll jump in from time to time if things get too thick, though I know you don't really need the help.
Posted by Rathrbfishn on May 2, 2002, at 23:52:12
In reply to Re: Long-term Clonazepam, posted by beetle on May 2, 2002, at 21:18:08
beetle, I'm surprised that your doc didn't advice you on how she wants you to take the klonopin. I would give her a call and ask, if it's not spelled out on the script bottle. Proper dosage timing is pretty important, for a variety of reasons. Ultimately, you will probably have to experiment a little with your doc's guidance to find the optimum dosage regiment.
Posted by Dr. Bob on May 3, 2002, at 9:47:22
In reply to Re: tips on benzodiazepines? » Dr. Bob, posted by Alan on May 2, 2002, at 21:35:16
> > Hey, would you be interested in putting together a folder of "bookmarks" (links) on benzodiazepines for Psycho-Babble Tips?
> >
> > http://groups.yahoo.com/group/psycho-babble-tips/links
>
> Sure but I'm not sure how to do it. I get to the yahoo site and register and then what? Give all the links about bzd's that have their own addresses so that I can then post one link to yahoo on the PSYBABBLE board instead of listing so many of them?Right. Plus then I can just keep it listed at the top of the main page here. If you register, though, please also email me directly, I'm super-behind with registration requests, most of which I think are unintended, but that way I'll know to approve yours right away.
Bob
Posted by Alan on May 3, 2002, at 14:25:59
In reply to Re: tips on benzodiazepines? » Alan, posted by Dr. Bob on May 3, 2002, at 9:47:22
> > > Hey, would you be interested in putting together a folder of "bookmarks" (links) on benzodiazepines for Psycho-Babble Tips?
> > >
> > > http://groups.yahoo.com/group/psycho-babble-tips/links
> >
> > Sure but I'm not sure how to do it. I get to the yahoo site and register and then what? Give all the links about bzd's that have their own addresses so that I can then post one link to yahoo on the PSYBABBLE board instead of listing so many of them?
>
> Right. Plus then I can just keep it listed at the top of the main page here. If you register, though, please also email me directly, I'm super-behind with registration requests, most of which I think are unintended, but that way I'll know to approve yours right away.
>
> BobOK. But give me a couple of days to get them together .....
Thanks for asking
Alan
Posted by beardedlady on May 7, 2002, at 13:20:57
In reply to They're just my personal opinions, guys..., posted by n0matter on May 2, 2002, at 10:59:41
>...I constantly struggle against the idea of having to take these for the rest of my life. It's very self-defeating. ...I do believe >>that the purpose intended in alleviating these symptoms is to allow us to root out the cause of our condition and resolve it. >>There was a time when the majority of us didn't have our depression, anxiety, OCD, etc. I was always under the impression >that the ultimate and most favorable of scenarios involved us rediscovering that time and that way of thinking. Not finding a >pill that masks our problems and being content with taking it for the rest of our lives.
--------I don't know a person on meds who doesn't struggle with this very problem. I slept well for 35 years. I had a child, and once she stopped nursing, I stopped sleeping. I haven't been able to sleep without medication for almost four years. I long for the day I can return to my old, unSerzoned, unSonataed self.
But guess what: I probably won't. Who knows why our bodies and our brains go through the changes they go through? But sometimes there are no answers. And even when there are, well, read on.
My father has asthma and diabetes. He smoked 3 packs of Kools a day for almost thirty years. When he quit, he got asthma. The inhalers he takes to relieve his symptoms aren't temporary until they find a cause and cure for his asthma. They are permanent symptom relievers. That's all he can do.
My sister has asthma, allergies, and reflux. She is on medications to relieve the symptoms of each. But they are not standbys until the causes have been discovered. There is no miracle that happens once such a cause is revealed. She is simply a person allergic to mold and dust who has an inherited digestive disorder that runs in my family, and she has to take meds to relieve her symptoms. Period.
When it comes to disorders of the brain, people think a different rule applies. Once they find the cause (a death in the family, say, or the stress of protecting sleep while nursing), they expect the disorder to just go away or expect to be able to reason it away or remove it with therapy or cognitive thinking. But it's not likely to happen.
Being healthy does not mean being medicine free! It means managing your illness AND, most important, accepting that you may never be medicine free! It may sound like a catch 22, but ridding yourself of med shackles often can't occur until you've become comfortable with the notion that you are shackled to meds.
You find benzos evil because you are dependent upon them for symptom relief. But part of getting better will require you to change your outlook and see the things that ease your pain, your brain, as gifts.
beardy : )>
This is the end of the thread.
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