[akaky]

I'm currently being treated for generalized anxiety (with a strong undercurrent of social anxiety) and am taking Celexa, with .5mg of Klonipin as needed.

In my last couple sessions with my psychiatrist, he has recommended that I take the Klonipin regularly (2x a day) with no real endpoint in sight. I'm very frightened by this idea, and my research indicates that Klonipin prolly shouldn't be used for long-term.

I want to try other things before I use this sledgehammer. I know a little about buspar (my doc thinks it's not very effective), and I'd rather try something like this first.

What're people's experiences with buspar and other non-benzos?

akaky

[apislily]

I am also wary about benzodiazepines. I took buspar for a few while, but I felt no effect. I've heard that it's pretty weak, especially on its own, but works better when paired with an SSRI (but I have no citation for that...it's just what I read somewhere.)

I've taken hydroxyzine (a prescription antihistamine) for anxiety and it worked okay, but it made me pretty sleepy.

Good luck finding something that works for you.

-apislily

[bptoo]

Hi akaky,

BuSpar was one of the first meds I tried for anxiety, and it had absolutely no effect on my symptoms. My current Psych calls it the "Worlds Most Expensive Placibo", and I agree with him. I've been taking .5mg of Klonopin 2x daily for over 3 years and it works great. I take regular breaks from it in hopes that it will help detox my system, and I have no withdrawals. But I do know that the med is extremely addictive. But I have heard of BuSpar working for some people, you may be one of those people. This is just my experience with it.

There are a lot of meds besides benzos that work well against anxiety. Some of the SSRI's are Lexapro, Celexa, Paxil, Serzone, Zoloft. Some of the the TCA's are Anafranil, Elavil, Pamelor, Sinequan. Hopefully Cam (our resident Pharmacist) will read this and give you some ideas for things to suggest to your doctor.

I wish you luck with whatever you try, and I hope you'll let us know how it works out.

Take care,
Greg

[Genevieve]

Another option is to try something to address the physical side of it, like a beta blocker. Not for everyone, but I've been taking propranalol, and it's helped me a lot.

Hope that helps.

[CamW]

akaky - Benzodiazepines like Klonopin™ (Rivotril™ - clonazepam) were unfairly given a very bad rap by the media in the 1970s and 1980s; its addictive properties were vastly overstated. A similar situation exists at this moment with SSRIs and suicide; not to mention SSRIs and children. I am not going to get into this second media "fallacy" at the moment,
although it is interesting to note that the backlash against these two classes of medication arise, at least in part, from an effect common to both classes of drugs.

Both benzodiazepines and SSRIs can cause withdrawl syndromes upon discontinuing the drugs after taking them for a relatively longer periods of time (ie. longer than a month in most instances, but this is not a hard and fast rule). The discontiuation (withdrawl) syndrome seen with the benzos can cause more serious health consequences than is seen with the SSRIs, but when managed correctly one can be weaned from even high-dose, long-term benzodiazepine therapy with little discomfort. When I say high dose I am referring to, for example, people who are taking daily doses of more than 4mg to 6mg of Rivotril ..... er, Klonopin (damn U.S. drug names).

Okay, now my "benzo mantra"!. When used properly (ie. as prescribed), especially in low doses, are extremely safe and effective. It has been my clinical experience, and that of most of the psychiatrists that I know who specialize in treating anxiety disorders, that people who use benzodiazepines as maintenance medication to treat excessive chronic anxiety will not, in a vast majority of cases, become addicted to these medications. A caveat to this is that when one begins to use the benzodiazepine more often and/or at ever increasing doses against doctors orders, problems will arise.

When the benzo becomes a crutch, a way to escape problems, or as a recreational binge drug, then yes, a psychological addiction to the drug becomes a definite reality. Daily dosages begin to escalate and drug-seeking behavior, with it's lying and deception starts occupying most of one's time. As a community pharmacist for over 20 years, I have heard every excuse imaginable (and some that are unimaginable) by the poor soul who has needs there benzo refill significantly early.

Now, I am not talking about having to take an extra Klonopin every now and then when a stressful situation arises or the anxiety breaks through for no apparent reason. I will always fill a prescription up to a week early on a monthly fill, as long as someone is honest to me about having to take the occasional extra tablet. No reasonable psychiatrist would see a problem with this. If a person is consistently a week early in asking for a refill every month, then the alarm bells go off in my head ('cause then I can't hear the voices very well .... sorry, bad joke ).

Another theory of mine (for which I have no scientific proof) regarding why people may increase their benzo dose is that as the body adjusts to the drug and, while the actual anxiolytic (ie. anti-anxiety) effects are maintained, the psychomotor effects do fade. The psychomotor effects include incoordination (eg. stumbling) and that feeling of excessive muscular relaxation, where the body feels like a bag of Jello™. Many people think that these feelings are part of the benzos anxiolytic activity, so when the psychomotor side effects disappear some people increase the dose to get the effect back, not realizing that the drug is still controlling the anxiety.

As for Buspar™ (buspirone), I have found that it does seem to either work or not. For me, there doesn't seem to be any middle ground with this drug. I have several theories of why this may be, but I won't go into them here. I will just say that it can take up to 2 months to get a decent anxiolytic effect from the Buspar, and a lot of people give up on it long before then. Also, Buspar does not have the psychomotor effects that the benzos do, so people who equate theses effects with anxiolytic activity and have taken benzos for anxiety in the past may feel that the Buspar doesn't work when it actually is.

My very good buddy, bptoo, is a classic example of someone who has taken benzodiazepines for years for the anxiety of bipolar disorder and, like me, has an addictive personality (hope I'm not giving away any secrets, beep) has not become addicted to Klonopin, nor has the drug any appeal as a recreational diversion. To tell you the truth, I was worried when bptoo started Klonopin, as I thought that I'd have to do an "intervention". Quite frankly bptoo helped me understand the activity of benzodiazepines and convinced me that the media's coverage of the drug's effects is on par with that of "Reefer Madness".

I hope that this long rambling rant is of some help to you. - Cam

[Butterfly_Faerie]

I've taken Lorazepam and clonazepam as needed only. Because tranqulizers can be addicting.
For me however is that the last time I took ativan I had to stop because it as over-powering and I was acting like a drunk ect.. slurring my words, had bad adverse reactions even on the smallest dose.

It did help me in the past, but I found antidepressants worked better for me in terms of GAD which I do suffer from as well. I am now currently on remeron, which isn't an SSRI but it has helped me out greatly.

All medication is different for everyone, sometimes you will have to try a couple different ones before you find the right now. Zoloft worked for me for 8 yrs and it just quit on me, after that I tried celexa, had a terrible time on that so went medication free for a bit to see how I was with the help of my psychiarist, crashed after 3 days and went onto remeron.

[startingrtnow]

I took valium for 9 months and when trying to come off of it I had to go to rehab b/c my body had become addicted. STAY AWAY FROM THE BENZOS!! The hell that it put me through I can't explain. I rather deal with the anxiety and social phobia (both of which I have as well). I started taking 2mgs a day, and the doctor kept uping the dose until I was at 30mgs a day. Of course I wasn't anxious, I was nothing!! BBLLAAHHH! The pain and rebound anxiety was unbearable. I just quit Buspar and had no benefit. In fact, over the years and the 8 or so different meds I've been on and off, I've decided that they don't help. Not a one has ever brought me back to normal, and the side effects have all been unpleasant. I'm med free now and doing the Linden Method which surprisingly enough makes perfect sense and is working. Research it and give it a try. GET OFF THE MEDS! It will never get better if you keep covering up the probleml; face the problem with an attitude of "I can get better". Hope this helps and good luck.

[Butterfly_Faerie]

I think it's up to your doctor and you I don't think anyone should tell someone not to take something because they had a bad expiereince. I've benefited from Benzos, and i've had a hard time on them. Some meds will work differently for others. You can't keep taking them non-stop because they are highly addictive, but if only taken as needed then that is a different story.

Do what works for you, but keep your doctor posted if something doesn't seem right.... always keep your doctor posted.

[startingrtnow]

Whatever works do it; if it helps you get your life back. I do want to state however that while at the Mount Regis Center (my body was having such adverse reactions to coming off the benzo's it was decide to go to rehab so I could have constant monitoring) there were more people in there for benzo addiction than for any other drug, any! (minus alcohol of course which acts on the brain the same way benzos do). They told me benzo withdrawel was as bad or in some cases worse than heroin withdrawel. Is it ok to take heroin just because it makes you feel better for a while? It's just masking reality. I'm not telling any one to do anything, I'm just making suggestions from my experiences. My suggestion is DONT TAKE BENZOS because its like crossing the highway with without looking both ways. Your taking a gamble. Now if you are convinced that you are going to HAVE to be on meds for the rest of your life than, valium will take away your anxiety. But if you try to get off of it it will come back 5 fold or more, depending on how long you have been on it and how your body reacts to it. Every ones different. I'm struggling with my health (anxiety) but its my struggle not the medications.

[Butterfly_Faerie]

Benzos aren't meant to take for a long period of time. Anxiety will not go away with a pill. Yes it helps with the symptoms, but only you as a person with the help of therapy can be rid of anxiety.

Benzo's shouldn't usually be taken for a long period of time because they are highly addictive. One benzo worked for me and I only took it for a short amount of time and when needed, the second time I was on benzo, I think it was ativan I had a bad reaction to it therefore had to get off of it.

Everyone will have a different reactions with some medications, what does work for them wont work for others.

I wasn't knocking you startingrtnow by any means... Just wanted to say that no one can tell someone NOT too take anything, because we aren't doctors, we can only share what expierences we've been through.

I've benefited from tranqulizers, and I haven't benefited from there.

It's different for everyone, clonazepam worked for me, but lorazepam didn't.

I'm not taking any bezo's now and perfer not too because of my adverse reaction to lorazepam, turned me off.

[bptoo]

You make a good point sundance, we should be careful not to tell anyone what to take or not to take. What may not work for one might be a life-saver for another. I have taken Klonopin long term and they have worked out very well for me. But as I said earlier, I make sure to take breaks from them to lower my chance of becoming addicted. My therapy also helps greatly in helping me develop the tools I need to combat anxiety. Thanks for sharing your thoughts.

Greg

[Fred23]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Okay, now my "benzo mantra"!. When used properly (ie. as prescribed), especially in low doses, are extremely safe and effective. It has been my clinical experience, and that of most of the psychiatrists that I know who specialize in treating anxiety disorders, that people who use benzodiazepines as maintenance medication to treat excessive chronic anxiety will not, in a vast majority of cases, become addicted to these medications.

</div></font></blockquote><font class="post">If we feel that we are that type of person, what is the best way to convey that?

Due to this issue, my GP has referred me to a psychiatrist for my chronic anxiety. The actual appointment isn't for two months, and I'm wondering how to as quickly as possible establish that I believe that benzos are "enough" and don't want to go down the SSRI path.

[kimmydawn]

akaky,

welcome. i can only speak from personal experience.

i took xanax for 7 yrs. when i went off my meds on my own, i just woke up one day and didn't take them. however, when i felt like my body need a xanax, i took it over the next few months. i think that's why i never had withdrawal, etc. i never abused my meds and i think that's they key. my dr told me there's a huge difference between use and abuse. when you abuse you can quickly become addicted. when you use, your body may become physically dependent, but you wean off.

since i went off the xanax, i've been prescribed valium and now klonopin. i've never had a problem with not taking them, after taking them regularly for periods of time. again, this is personal experience. it seems to me if your concerned about addiction, that you more than like won't abuse.

i can also say my dr wanted me to take them regularly to "trick my brain" into not having panic. i was having regular panic and he wanted to keep in away long enough for my brain to break the pattern. it worked!

this is the story of a long time benzo user. i never abused and had no problems. i still, when i need to, occasionaly take klonopin.

kd

[CamW]

Fred - Further to my last post, it has been my clinical experience that the SSRI antidepressants are much safer and more effective for a vast majority of anxiety disorders than are benzodiazepines over the long term. In most cases, benzos should be used short-term, and then only to augment an antidepressant.

In some disorders (eg. bipolar disorder or panic disorder) benzodiazepines may need to be taken on a chronic basis, but again, only as an adjunct (ie augmenting agent) to a primary medication, whether that primary medication is a mood stabilizer or anitdepressant.

It has been my experience that SSRIs are far more effective and safe than benzodiazepines in the treatment of chronic anxiety. Benzodiazepines only mask the symptoms of anxiety, whereas SSRIs will alleviate the symptoms of chronic anxiety. Also, using SSRIs for chronic anxiety allow one to lead a better quality of life of life, if only from the standpoint of comparing side effect profiles.

I hope that this is of some help. - Cam

[Fred23]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Fred -
It has been my experience that SSRIs are far more effective and safe than benzodiazepines in the treatment of chronic anxiety. Benzodiazepines only mask the symptoms of anxiety, whereas SSRIs will alleviate the symptoms of chronic anxiety. Also, using SSRIs for chronic anxiety allow one to lead a better quality of life of life, if only from the standpoint of comparing side effect profiles.

</div></font></blockquote><font class="post">
It seems that it is becoming more well known that ADs do have side effect and discontinuation issues, as bad or worse than the benzodiazepines. Even doctor-level material like http://www.medscape.com/viewprogram/2546_pnt "Optimizing Efficacy and Tolerability of Antidepressant Therapy: Does Selectivity of Action Matter?" admits that "side effects compliance".

It may be that those who benefit from ADs have both anxiety and depression, and that the benefits outweigh the side effects.