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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by methinks on March 11, 2003, at 12:46:43
Greetings all,
I have lurked here for some time and finally decided to post. I am male, 51, and have a long history of depression and anxiety. I have taken numerous antidepressants over the years, but have eventually quit all of them due to intolerable side effects. I am currently taking Sam-e 400 mg/day and Ativan 1 mg/twice a day and have been doing well. However, I now cannot find a doctor (I have seen three general practitioners and one psychiatrist) who will prescribe the Ativan long term because it is a controlled substance and potentially addictive. They want to put me on Paxil or another SSRI which for me result in sexual dysfunction.
In the year or so that I have been reading posts here I have come across several posters who seem to be taking Ativan and other benzos on a long term basis, apparently successfully. I am wondering what one has to do to be prescribed Ativan long term? I live in Florida. Is the Controlled Substance Act somehow more strict here (due to state laws) than in other states? All this expensive doctor shopping and the threat of not being able to get a beneficial, affordable medication has significantly increased my anxiety which will soon drive me back into depression! Thanks to all who respond.
Posted by michael on March 11, 2003, at 13:21:38
In reply to Benzo Dilemma--What's the Deal?, posted by methinks on March 11, 2003, at 12:46:43
> Greetings all,
>
> I have lurked here for some time and finally decided to post. I am male, 51, and have a long history of depression and anxiety. I have taken numerous antidepressants over the years, but have eventually quit all of them due to intolerable side effects. I am currently taking Sam-e 400 mg/day and Ativan 1 mg/twice a day and have been doing well. However, I now cannot find a doctor (I have seen three general practitioners and one psychiatrist) who will prescribe the Ativan long term because it is a controlled substance and potentially addictive. They want to put me on Paxil or another SSRI which for me result in sexual dysfunction.
>
> In the year or so that I have been reading posts here I have come across several posters who seem to be taking Ativan and other benzos on a long term basis, apparently successfully. I am wondering what one has to do to be prescribed Ativan long term? I live in Florida. Is the Controlled Substance Act somehow more strict here (due to state laws) than in other states? All this expensive doctor shopping and the threat of not being able to get a beneficial, affordable medication has significantly increased my anxiety which will soon drive me back into depression! Thanks to all who respond.
My guess (just a guess) is you'll have more luck w/pdoc's... they'd be more likely to have experience prescribing benzo's on a long term basis, than a gp (and therefore be more comfortable with the concept)?When looking for a new pdoc, "interview" them - have some questions that you want to ask. Among them - "Have you had success treating anxiety with benzos...?" (or something to that effect).
From his response, you can get a feel as to whether of not he's an anti-benzo doc, or if he's comfortable with them.
You can add that you have anxiety & depression, and have been successfullly treating it with ativan & sam-e - and that you would like to continue with this regimen. Particularly given that you suffer unacceptable side effects from the ssri's...
No great insights here, but at least an idea or two...? good luck.
michael
Posted by Jaynee on March 11, 2003, at 14:24:30
In reply to Re: Benzo Dilemma--What's the Deal?, posted by michael on March 11, 2003, at 13:21:38
I will probably get crap for posting this, but so be it.
First it is my experience that a pdoc's prescribe a benzo more easily than a GP.
Second, there are doc's that will prescribe benzo's very easily. I have a girlfriend who is a social worker who works in the welfare office, and it is very well known in that office who the doc's are that all the clients go to, to get their drugs of choice. I'm not encouraging this, I am just letting you know how it works.
With some creative asking "around", it shouldn't be to hard to find a doc that isn't benzo phobic.
Good luck.
Posted by Krissy P on March 11, 2003, at 14:25:39
In reply to Benzo Dilemma--What's the Deal?, posted by methinks on March 11, 2003, at 12:46:43
Greetings, I hear your dilemma.
Hi,
>>you ask, I am wondering what one has to do to be prescribed Ativan long term?
In my opinion,It depends on the doc, tell a good doc your symptoms and what you have heard, read, etc.-it depends on the doc.You ask>>I live in Florida. Is the Controlled Substance Act somehow more strict here (due to state laws) than in other states?
I live in California and they are strict here also-remember the First Do No Harm oath, all states and docs are different whether you live in Africa or Canada, AND docs are quite hesitant to prescribe benzos becasue of their addictive properties-there is so much to be said on that though. I am on Klonopin and I use it responsibly, and it does wonders.
Keep posting. Hope this helped.
Kristen
==================================================================================================Try to find a good doc, keep persisting, be patient, and hang in there-it all pays off-trust me:-)
Kristen
================================================================================================== All this expensive doctor shopping and the threat of not being able to get a beneficial, affordable medication has significantly increased my anxiety which will soon drive me back into depression! Thanks to all who respond.
> Greetings all,
>
> I have lurked here for some time and finally decided to post. I am male, 51, and have a long history of depression and anxiety. I have taken numerous antidepressants over the years, but have eventually quit all of them due to intolerable side effects. I am currently taking Sam-e 400 mg/day and Ativan 1 mg/twice a day and have been doing well. However, I now cannot find a doctor (I have seen three general practitioners and one psychiatrist) who will prescribe the Ativan long term because it is a controlled substance and potentially addictive. They want to put me on Paxil or another SSRI which for me result in sexual dysfunction.
>
> In the year or so that I have been reading posts here I have come across several posters who seem to be taking Ativan and other benzos on a long term basis, apparently successfully. I am wondering what one has to do to be prescribed Ativan long term? I live in Florida. Is the Controlled Substance Act somehow more strict here (due to state laws) than in other states? All this expensive doctor shopping and the threat of not being able to get a beneficial, affordable medication has significantly increased my anxiety which will soon drive me back into depression! Thanks to all who respond.
Posted by fachad on March 11, 2003, at 21:05:47
In reply to Benzo Dilemma--What's the Deal?, posted by methinks on March 11, 2003, at 12:46:43
Pdocs are much more likely to be comfortable writing indefinitely for BZDs.
I think there are several reasons why this problem exists. I've written a few posts detailing some of the factors that I believe led to this situation. I think they shed some light on why some docs are reluctant to RX for controlled substances.
The Controlled Substance Catch-22:
http://www.dr-bob.org/babble/20020416/msgs/103521.html
Ritalin is not marketed as AD:
http://www.dr-bob.org/babble/20020307/msgs/97442.html
Marketing Hype and Specificity of Drug Treatments:
http://www.dr-bob.org/babble/20020408/msgs/103154.html
Posted by viridis on March 12, 2003, at 1:20:34
In reply to Re: Benzo Dilemma--What's the Deal?, posted by fachad on March 11, 2003, at 21:05:47
Benzos are not addictive for the vast majority of anxiety patients. They often cause dependency, just as most ADs do. "Addiction" is a strong term that is greatly overused, as has been disussed here a lot lately -- addiction involves loss of control over dosage, craving, negative effects on your life, etc.
I wish people (including doctors) would stop tossing this term around so casually; strange how it's only used for medications that are off-patent (= available as generics).
Considering that benzos have been rated as some of the safest psychiatric meds for long-term use by the very conservative World Health Organization, it's shocking that so many doctors naively cling to benzophobic attitudes. Fortunately, some will still prescribe these (generally quite benign) meds -- you just have to search around a bit.
This is the end of the thread.
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