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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 daizy on May 14, 2003, at 9:24:20
opinions please? Im starting to think so.......
Posted by JackT on May 14, 2003, at 12:03:34
In reply to Benzo's best drug for anxiety?, posted by daizy on May 14, 2003, at 9:24:20
> opinions please? Im starting to think so.......
I have GAD and cannot find anything to work except benzo's. However, they leave me with short term memory loss, so I'm constantly looking for something different. I've tried the following with no success.
effexor
celexa
buspar
depakote
haldol
abilify
seroquel
remeron
serzone
atlenol
ritalinThe years of anxiety have taken their toll on me causing me to be milding depressed (disinterested in life). I believe it is because I am low on dopamine and have to much norepinephrine.
I haven't tried the Maoi's or the tricyclics. I would also like to try Selegiline. I currently have a prescription for Wellbutrin, but I haven't taken any yet. Waiting for the right time and taking Xanax in the meantime.
JackT
Posted by mattdds on May 14, 2003, at 16:45:44
In reply to Re: Benzo's best drug for anxiety?, posted by JackT on May 14, 2003, at 12:03:34
Hi,
In my mind, there is no question that benzos are the best drug for anxiety. I have tried every other pharmacological treatment (besides MAOI's) out there for anxiety, and benzos blow anything else away. Particularly, Klonopin seems to be the best for me (out of the ones I've tried: Ativan=lorazepam, Valium=diazepam and Xanax=alprazolam).
For me, they are extremely specific, i.e. they do not sedate me or leave me chemically castrated, like the SSRI's. They target only my symptoms, and nothing else! I have NO side effects whatsoever! They are also intensely studied, with proven efficacy and safety.
Only downside is, expect to have a lifelong relationship with them, once you find out how good they work. I could probably taper off them and do fine, if I wanted to. But they have worked so well over two years, so why the heck would I want to? If for some reason, you need to get off them, simply use a very slow taper over a few months. This eliminates what is in my mind the ONLY downside of benzos.
Best,
Matt
Posted by Jack Smith on May 14, 2003, at 17:51:37
In reply to Re: Benzo's best drug for anxiety? » JackT, posted by mattdds on May 14, 2003, at 16:45:44
> Hi,
>
> In my mind, there is no question that benzos are the best drug for anxiety.When you say "anxiety" what do you mean? Panic? Or non-panic with physical symptoms? Or just some sort of worry?
What is your dose of Klonopin and how often? Do you use brand or generic? If generic, do you know which drug maker?
JACK
Posted by djmmm on May 14, 2003, at 18:38:18
In reply to Benzo's best drug for anxiety?, posted by daizy on May 14, 2003, at 9:24:20
> opinions please? Im starting to think so.......
I think it depends on the type of anxiety you have. When I was 15, I had Panic attacks, and Paxil worked well for that (at the time)
Most of my life I have had social phobia, and I have found only MAOIs work...well, Klonopin works, too.
In general, SSRIs work for panic, and OCD and general anxiety, and social phobia to an extent
Benzos, work wor a variety of anxiety symptoms (from panic to insomnia) If you are going to try a Benzo, ask you doc about a longer acting one like Klonopin or even Valium, try and stay away from xanax or ativan if you can, leave those as a last resort...they tend to bind more readily to benzo receptors thus causing more rebound effect--not too good for the ole brain, but very effective drugs non-the-less.
There is always Buspar... a lot of people love it
and atypical anti-anxiety meds like the various anti-epileptics that are used (Neurontin, etc.)
Posted by BobS. on May 14, 2003, at 19:52:34
In reply to Re: Benzo's best drug for anxiety?, posted by JackT on May 14, 2003, at 12:03:34
>>However, they leave me with short term memory >>loss, so I'm constantly looking for something >>different.
JackT.,
Can you elaborate on your memory experience and what dose of Xanax you take?I take Xanax and am not really sure if it affects me that way or not. However I am worried about my memory. I did a complete Medline search on benzo's and cognition(memory), but found very little. I also discussed it with my pdoc and he agrees there is little fundamental research on the memory issue, yet the common wisdom is benzo's screw up your memory.
Thanks for your help.
BobS.
Posted by mattdds on May 14, 2003, at 21:46:46
In reply to Re: Benzo's best drug for anxiety? » mattdds, posted by Jack Smith on May 14, 2003, at 17:51:37
>>When you say "anxiety" what do you mean? Panic? Or non-panic with physical symptoms? Or just some sort of worry?
>>What is your dose of Klonopin and how often? Do you use brand or generic? If generic, do you know which drug maker?
This is a good point. I should have been more specific. I think the research indicates that benzos are best for panic, GAD and sometimes social phobia. Perhaps they are not so useful for OCD or PTSD, as indicated by research and anecdotal reports here.
I have a pretty bad case of panic disorder, and that is my main "diagnosis". I also have a moderate case of social anxiety, and of course GAD. But I've found Klonopin to be effective across that whole spectrum. It completely shuts down spontaneous panic, takes the edge off of social situations (but I believe this should be used in conjunction with behavioral techniques that are pro-social, in order to get the best effects, especially in the socially phobic). It also kills the GAD.
You asked if it worked on the "worry" aspect of anxiety or just the physical "spontaneous" anxiety. The answer is: both! I just don't really worry much anymore, and I definitely never get spontaneous anxiety spells (of the more physiological sense).
I believe the manufacturer is Purepac, or something like that. It is a 0.5 mg tablet, pink in color. I doubt the manufacturer matters that much, because I used to take the Roche brand name, but now my insurance only pays for generics, and it seems to work the same. This is 2 years after starting, I still get the same panic-blocking and anti-GAD-worry effect.
My dose was originally 0.5 mg / day, and that was enough to block panic and GAD. I did have some residual derealization / depersonalization and have titrated up to 1.5 - 2.0, (1 mg in the AM, 0.5 - 1.0 in the PM). I should emphasize that 0.5 works as well as it did 2 years ago, my pdoc just felt that it would get rid of depersonalization / derealization at a higher dose. I have not had any tolerance, almost 2 years into this. I have had tolerance to the side-effects. To me this is the beauty of benzos, differential tolerance. In other words, you get used to the sedation, clumsiness, and memory effects, but tolerance does not typically build to the panic-blocking and anxiolytic effects. I think this is pretty well documented in the literature, and has certainly been my experience.
Regards,
Matt
Posted by jerrympls on May 14, 2003, at 22:54:14
In reply to Jack - benzos effective for *almost* all anxiety, posted by mattdds on May 14, 2003, at 21:46:46
Benzos have been the ONLY meds that have effectively help treat my anxiety. I'm major depression w/ GAD - mostly anticipatory - not so much social phobia. Anyway, I've been on Valium, Klonopin, Ativan, Cerax, Librium for anxiety and Halcion, restoril, and Dalmane for insomnia - all thoughout various times during the past 11 years (I'm 31 now). Anyway, no SSRI or any other add-on like Atarax (an antihistamine) or Benedryl. Ativan, Klonopin and Xanax have worked the best for me. I'm currently on Xanax .5 3x daily. Xanax also helps a little with my depressive symptoms--well actually it helps ALOT with my depressive symptoms. It doesn't cloud my mind - doesn't make me sleepy - doesn't make me crave more - doesn't cause memory problems (I think? haha) - basically it helps calms my overactive biological anxiety circuits and help ease anticipatory anxiety and catastrophic thinking.
I wrote in another post that I think I'm lucky because when I've gone off of a benzo I've NEVER had withdrawl of any kinda - minus a little rebound anxiety.
My experience w/ Doctor's: I've seen about 8 different psychiatrists over the past 11 years and here's how some of them stacked up on attitudes towards benzos for anxiety:
--One doc treated my depression with ONLY xanax for a while and said it was a great medication and had anti-depressant properties. He was a great doc - willing to work with me to find anything that worked. We eventually switched to a "new" SSRI (Luvox) when it came out which helped some...yada yada yada...
--Another doc would make excuses for not prescribing them like "I'll lose my license..."
--One doc was so incredibly, horrifyingly without compassion, that when I called her on route to the hospital because I was having a severe panic attack she said: "Oh you're not having a panic attack - take a hot bath or go for a walk and if you need to you can take Benedryl." After which she hung up on me. Prior to this, during our first appt. she basically told me that I was - or would be an addict. Why? To this day I have no clue. She had full access to my medical records - none of which had ever indicated any problems abusin ANY substance. Found out later that she routinely gossiped about her patients to other patients and doctors in the clinic. She wasn't employeed for too long.
--One Doc was pretty good and I really liked him. However, during outpatient visits he would readily have a prescription almost already written out for 2 months worth of Adderall (an amphetamine) but would NOT budge on EVER prescribing benzos giving this excuse: "All benzos are basically alcohol in a pill and EVERYONE gets SEVERELY addicted to them, then I have to take up my time trying to get them off of them. You'll get addicted and I don't want to have to take the time to get you off them." After which he handed me my 2 month supply of Adderall. I was completely speechless and didn't see him again after that.
--FInally I saw a an experienced and confident psychiatrist at a major Big Ten University hospital. He was/is also involved in research for new depression and anxiety meds. He has had no problem prescribing benzos and goes by the "If we can find something that works - then we'll go with it. The goal is to get you better." He listens to me and even encourages me to do my own research and actually READS stuff I find and bring in to him during my appointments.
The only meds I have ever had terrible withdrawl were/are the SSRIs.
Sure, some people do have problems with addiction and yes, they have terrible withdrawl as well - but no one ever stands up for the majority (in my opinion) of anxiety sufferers out there who benefits soley from meds like Xanax, Klonopin, etc. Over the past 11 years in and out of hosptials, support groups, therapists, etc - I have talkedd with many people and I would say 98% of them never abused these meds and many are only able to work, be social, and participate in LIFE due to the help of benzos.
Both my parents are alcoholics and I've never, never, ever had problems with addiction - abuse - or ANy substance. I do not drug seek, I do not buy meds illegally - none of that.
Sorry for the long winded post - but I just wanted to share my experiences and opinions on this matter.
Thanks for reading - and good luck!
Jerry
Posted by Viridis on May 15, 2003, at 1:53:50
In reply to Re: Jack - benzos effective for *almost* all anxie, posted by jerrympls on May 14, 2003, at 22:54:14
My experience is essentially the same as that of MattDDS -- benzos work extremely well for panic and generalized anxiety, the side effects were minimal and wore off very quickly, and I'd recommend these drugs highly. I take 1 mg Klonopin daily, and Xanax when I need it (typically 0.25-0.50 mg, sometimes a few times a week, sometimes not at all for a week or two). I haven't had to increase the dose so far, after almost two years, and I find Klonopin and Xanax "self-limiting" in that if I take more than what works, they just make me sleepy -- I have no inclination to abuse them, and doubt that I could (I'd just fall asleep).
I had all sorts of problems with the antidepressants I've tried (SSRIs, Wellbutrin, etc.), even after long-term use with some. I do take Adderall for ADD as well, and I find it calming/focusing, but Klonopin (clonazepam )is my main-line med for anxiety and depression.
I take the Teva brand generics; once I changed pharmacies and got the pink clonazepam, and found it noticeably inferior to the Teva brand. But that could just be me.
Posted by JackT on May 15, 2003, at 11:07:01
In reply to Re: Benzo's best drug for anxiety?, posted by BobS. on May 14, 2003, at 19:52:34
BobS,
I take very little Xanax at night and the effect lasts well into the next day for me. It begins to wear off in mid-afternoon. I am micro sensitive to medications and assume I metabolize them very slowly. I'm not sure of the dosage (bottle at home), but I even split the pill at night before taking.
A better description of my memory problem when taking the benzos is the problem with recalling the proper words in a conversation. I can't remember names and other information I would normally recall without difficultly. This effect wears off and is not permanent, just a side-effect. Some even say that this effect will go away in a couple of weeks. I've just never taken it consistenly enough to get past a 2-3 week regimen. For example, I don't need a benzo on the week-ends and some days during the week I skip a day or two.
Only problem with this side-effect is that I get very anxious when I'm talking to someone and can't remember some key fact or name. I'm always saying "it's on the tip of my tongue". This recall problem causes my brain to work extra hard and triggers more anxiety.
Other than that, the benzos work fine for me and at very small dosages.
Posted by judy1 on May 16, 2003, at 13:16:01
In reply to Benzo's best drug for anxiety?, posted by daizy on May 14, 2003, at 9:24:20
without a doubt, they have been used for 40? years with little or no side-effects for the treatment of anxiety disorders. I've been off and on xanax and klonopin for panic disorder for 5 years (it waxes and wanes for me) and get instant relief. take care, judy
Posted by BobS. on May 18, 2003, at 18:15:30
In reply to Re: Benzo's best drug for anxiety? » BobS., posted by JackT on May 15, 2003, at 11:07:01
Posted by Ellie's Mom on May 19, 2003, at 10:36:25
In reply to Benzo's best drug for anxiety?, posted by daizy on May 14, 2003, at 9:24:20
> opinions please? Im starting to think so.......
I've found Xanax to be a miracle drug for ACUTE panic or anxiety. I would never take it around the clock. Currently I take it at night more often, and I'm careful to not make it a habit.
Good luck to you.
This is the end of the thread.
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