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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Brad323 on February 11, 2004, at 3:01:19
After reading quite a few of the posts on this site I went to see a very expensive anxiety doctor here, needless to say he ONLY wanted to put me on Zoloft and laughed at my request to try a very small dose of Klonopin! Anyways, I was looking for a good anxiety doctor in the Los Angeles area who maybe would be a little more receptive to trying different things, don't need to go broke just trying to get help ya know!
Thank you
Posted by Chairman_MAO on February 11, 2004, at 9:58:18
In reply to Klonopin for SP, posted by Brad323 on February 11, 2004, at 3:01:19
I've had much more luck getting controlled substances from foreign-trained doctors (notably older, eastern european ones) for anxiety and ADD, since they don't have absurd views about drug addiction and view benzodiazepines as just another therapeutic agent.
Posted by KellyD on February 11, 2004, at 15:19:22
In reply to Klonopin for SP, posted by Brad323 on February 11, 2004, at 3:01:19
No, you don't need to go broke getting help, but you may need to try and find a new doc.
I have found that when a Dr. is reluctant to adament in not using benzo's, pleading your case, be it by any good and valid means, isn't going to sway their plan of treatment.
Have you actually tried AD's to see if they would work for you? Some people do have good results in using AD's for anxiety and it is generally the first line treatment tried. As you probably know, anxiety can be comorbid with depressive states.
Posted by Chairman_MAO on February 11, 2004, at 17:42:27
In reply to Klonopin for SP, posted by Brad323 on February 11, 2004, at 3:01:19
It really is best to only rely on benzos if you have to for one reason or another. It may sound absurd to you, but taking a drug such as an SSRI, Serzone, or Remeron which doesn't work as well as a benzo does will allow you to more easily develop non-med coping skills. It's a fact that people who go on antidepressants for anxiety disorders have a decent chance of having significantly reduced anxiety when they go off of them whereas people on benzos almost always have a return of their original anxiety _on top of_ the post-acute withdrawl symptoms which may last for months.
Don't waste too much time with antidepressants, though. If they don't work, Klonopin is a clearly indicated and excellent treatment.
Posted by Kon on February 11, 2004, at 21:08:07
In reply to Re: Klonopin for SP » Brad323, posted by Chairman_MAO on February 11, 2004, at 17:42:27
> It may sound absurd to you, but taking a drug such as an SSRI, Serzone, or Remeron which doesn't work as well as a benzo does will allow you to more easily develop non-med coping skills. It's a fact that people who go on antidepressants for anxiety disorders have a decent chance of having significantly reduced anxiety when they go off of them whereas people on benzos almost always have a return of their original anxiety _on top of_ the post-acute withdrawl symptoms which may last for months.
Can you provide any references for this? I would be very interested in reading this because I have never come across this argument in any of the literature I've looked at. Almost all the literature I've looked at suggests a return of anxiety and/or withdrawl upon stopping the drug, whether that drug is an SSRI or benzo. In fact, the one study that suggested continued benefit after discontinuing the drug was a benzo (clonazepam). I can provide the reference if interested.
Also data from the UK and other European countries suggest problems with withdrawl are worst with SSRIs than with benzos. I can provide links if you're interested. Is this your own personel experience or is it based on any literature that I may not have come across?
Thanks.
Posted by Chairman_MAO on February 11, 2004, at 22:29:44
In reply to Re: Klonopin for SP-Brad323,, posted by Kon on February 11, 2004, at 21:08:07
This is based upon stuff I read approximately 1-3 years ago, and my memory may be incorrect. I was having a discussion about this very topic with my therapist before I came across this post, and she agreed with me. I wish I still had access to the textbook where I read this in as well as a medical library. :(
My personal experience also bears this out, but that is meaningless on a larger scale. I'd like to read your references, and would be interested to hear what other people think.
My trazodone is kicking in, along with its nausea, so we'll pick this up tomorrow.
Posted by HenryO on February 12, 2004, at 2:19:27
In reply to Re: Klonopin for SP-Brad323, » Kon, posted by Chairman_MAO on February 11, 2004, at 22:29:44
Hey Brad, I think Klonipin is great stuff. It doesn't buzz me. I don't need it everyday. I haven't had to take increasing amounts of it. AND it has worked great on my anxiety. I guess if people want to abuse drugs it might be one they'd choose, but you'd have to take way more than 5-10mgs to feel anything that a junky would enjoy. I am a Klonipin fan.
Posted by Kon on February 12, 2004, at 19:42:57
In reply to Re: Klonopin for SP-Brad323, » Kon, posted by Chairman_MAO on February 11, 2004, at 22:29:44
>I'd like to read your references, and would be interested to hear what other people think.
Withdrawl following SSRI discontinuation has been reported to be worst than benzos both in the UK and other European countries. Most of the drugs that cause most withdrawl problems seem to be SSRIs:
www.socialaudit.org.uk/4390EU61.htm
www.socialaudit.org.uk/43800047.htm
Wrt the study using clonazepam that suggests continued long-term benefit for SAD following short-term therapy:
--------------------------------------------------
J Nerv Ment Dis. 1996 Dec;184(12):731-8.A 2-year follow-up of social phobia. Status after a brief medication trial.
Sutherland SM, Tupler LA, Colket JT, Davidson JR.
Although social phobia is thought to be a chronic disorder, little is known about its long-term course in patients who engage in brief treatment studies. We, therefore, conducted a follow-up study of social phobics who had participated in a brief, placebo-controlled treatment trial of clonazepam. Of the original 75 subjects, 56 were assessed through telephone interview and self-report questionnaires that evaluated current social phobia symptoms. Information was also gathered about treatment received in the 2-year interval since the initial pharmacotherapy trial. The group as a whole showed maintenance of the gains acquired during initial treatment. On a number of symptom scales, subjects initially treated with clonazepam exhibited significantly less severe scores compared with placebo subjects. This study provides evidence of long-term benefit for social phobics when treated with a brief medication trial.
--------------------------------------------------I've never come across a similar study showing such long-term benefits with SSRIs. In fact, most SSRIS studies recommmend long-term treatment because of return of anxiety. Of course, others argue that these may also be symptoms of withdrawl.
This is the end of the thread.
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