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I've had a problem with benzodiazapines since my early twenties when I was prescribed xanax to manage panic attacks.  That was a terrible time, and coming off it was excrutiating.  Then I was prescribed klonopin, which I didn't take often because it made me so tired, but I quicly learned that a small dose made me fearless, which was addictive for someone so fearful.  After that, I was hooked.  It was remarkably easy to obtain prescriptions for it with a diagnosis of schizophrnia.  At age 27 (now), after all the problems my addiction caused me over the years, I decided to be honest with my new doctors that I believed I have addictive tendencies.  Subsequently, my psychiatrist refuses to prescribe me any benzodiazapines.

Granted, this is, to an extent, what I wanted; however, the anxiety, tooth grinding, and incessant ruminating thoughts quickly returned and I became desperate for relief.  I recently obtained a small amount of low-dose xanax, which I took in no time.  Of course, it felt wonderful to feel that relief, but the inevitable come-down is looming, and it's terrifying.

I have a question: I have a psychiatrist appointment later this month, and I'd like to ask for gabapentin (neurontin) to ease this anxiety.  It's technically non-narcotic, and used off-label for anxiety, and from testimonials I've read, tends to be effective for this purpose.  Do you think I should ask about it, and do you think it will be effective, or futile to ask?

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First, I wouldn't look at this like a typical "addiction." It sounds like benzos give you an actual therapeutic benefit. You're not trying to get high from them. You're just trying to feel normal, right? There's nothing worse than extreme panic/ anxiety. I have a prescription for gabapentin, and honestly, it doesn't come close to the effectiveness of benzos. I don't see why your doctor would have any problem prescribing you gabapentin. There is absolutely no risk of abuse with that drug. It's worth a try. There's also Buspar (buspirone) for anxiety, but it doesn't work for a lot of people. But it might work for you and it's something else to consider.

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1 hour ago, DopamineSick said:

First, I wouldn't look at this like a typical "addiction." It sounds like benzos give you an actual therapeutic benefit. You're not trying to get high from them. You're just trying to feel normal, right? There's nothing worse than extreme panic/ anxiety. I have a prescription for gabapentin, and honestly, it doesn't come close to the effectiveness of benzos. I don't see why your doctor would have any problem prescribing you gabapentin. There is absolutely no risk of abuse with that drug. It's worth a try. There's also Buspar (buspirone) for anxiety, but it doesn't work for a lot of people. But it might work for you and it's something else to consider.

Well, I've read that some have abused it, and they're thinking of making it a scheduled drug, although it's not currently.  My pdoc is weird about prescribing too many drugs at once, and I don't want to be on too many at once, but I think it's a necessity to get this under control.  I will definitely get ask!  Thanks so much!

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2 minutes ago, catchme said:

Well, I've read that some have abused it, and they're thinking of making it a scheduled drug, although it's not currently.  My pdoc is weird about prescribing too many drugs at once, and I don't want to be on too many at once, but I think it's a necessity to get this under control.  I will definitely get ask!  Thanks so much!

Benzos are classified as schedule IV.

Yes, some people definitely abuse benzos, but most of those people are just looking for a buzz and do not have an anxiety disorder. I have a prescription for klonopin. I try to take it as little as possible. When I take it, I feel better, but not "high." I don't necessarily like to take it. I only take it because of unbearable anxiety. I'm assuming you're the same way. There's a difference between "addiction" and "dependence." Unfortunately, if you take too high of a dose on a daily basis, you will become physically dependent. A lot of people with severe anxiety do become dependent on benzos simply because nothing else works well enough for their anxiety. However, I wouldn't call them "addicts" or "drug seekers."

There is a way to take benzos that doesn't lead to physical dependence. Some people only take them when they really need them - like for panic attacks. Daily use is obviously something you want to try to avoid, if possible.

But even with daily use, if you take a small enough dose, you might not develop physical dependence at all. For example, I took 0.5 mg of xanax daily for about two years and had no problems stopping cold turkey.

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6 minutes ago, DopamineSick said:

Benzos are classified as schedule IV.

Yes, some people definitely abuse benzos, but most of those people are just looking for a buzz and do not have an anxiety disorder. I have a prescription for klonopin. I try to take it as little as possible. When I take it, I feel better, but not "high." I don't necessarily like to take it. I only take it because of unbearable anxiety. I'm assuming you're the same way. There's a difference between "addiction" and "dependence." Unfortunately, if you take too high of a dose on a daily basis, you will become physically dependent. A lot of people with severe anxiety do become dependent on benzos simply because nothing else works well enough for their anxiety. However, I wouldn't call them "addicts" or "drug seekers."

There is a way to take benzos that doesn't lead to physical dependence. Some people only take them when they really need them - like for panic attacks. Daily use is obviously something you want to try to avoid, if possible.

But even with daily use, if you take a small enough dose, you might not develop physical dependence at all. For example, I took 0.5 mg of xanax daily for about two years and had no problems stopping cold turkey.

I was referring to gabapentin, not benzodiazapines.

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Yes gabapentin has some abuse potential. Yes a number of people abuse it. No, it's nowhere near as bad as benzos. Yes, it's enough abuse potential that a number of people think it should be in Schedule V alongside pregabalin, but that isn't that much. Honestly I don't think many providers are even aware of the fact that gabapentin has much abuse potential, I only know about it from hanging out in pharmacist forums and on Figure 1, and it was not described as or considered common knowledge at all in either of those places.

You have other alternatives you know - SSRI/SNRIs, Buspar, etc.

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Posted (edited)

I take benzos and not daily.  I do not take them to feel high but to help stressful situations become manageable.  I do have issues with being stress "sensitive."  I do feel I overreact, and perceive situations as triggering when I shouldn't.  I fight avoidance.  The choice to take a benzo to manage this is tricky because you do want to desensitize yourself to day-to-day situations that shouldn't be too difficult.  Calling it "addiction" is difficult when it is done to just feel normal instead of high.  I think I develop a slight dependence to klonopin though I can never get above 1mg even in hair pulling situations.  It makes me terribly sleepy.  I take lorazepam and I also try to avoid taking it daily.  I find as I get used to a situation I don't need it.

I tried Gabapentin and just found it did nothing and even maybe caused depression, and thus anxiety.

 

 

Edited by wookie

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Posted (edited)
On 3/2/2017 at 10:25 AM, catchme said:

  I have a question: I have a psychiatrist appointment later this month, and I'd like to ask for gabapentin (neurontin) to ease this anxiety.  It's technically non-narcotic, and used off-label for anxiety, and from testimonials I've read, tends to be effective for this purpose.  Do you think I should ask about it, and do you think it will be effective, or futile to ask?

I think the gabapentin would at least be worth a try.....Also, as others have said, Buspar is another option--it does help some people.

Like @JustNuts mentioned, an SSRI or SNRI might be worth a shot, too.....However, in general, they do take at least a few weeks to really kick in for most people.

Edited by CrazyRedhead

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Also low dose antipsychotics....but I'd save them for last line 

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42 minutes ago, Iceberg said:

Also low dose antipsychotics....but I'd save them for last line 

Yep, they're the big guns.

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On 3/4/2017 at 11:35 AM, CrazyRedhead said:

I think the gabapentin would at least be worth a try.....Also, as others have said, Buspar is another option--it does help some people.

Like @JustNuts mentioned, an SSRI or SNRI might be worth a shot, too.....However, in general, they do take at least a few weeks to really kick in for most people.

It's worth mentioning that gabapentin requires some time and titration as well.

On 3/4/2017 at 1:55 PM, Iceberg said:

Also low dose antipsychotics....but I'd save them for last line 

Oh dear, I completely forgot about those (probably because I always responded so poorly to most of the atypicals)... I think I need to refresh my memory on this again, maybe it's time to reread Stahl's textbook.

On 3/4/2017 at 2:37 PM, CrazyRedhead said:

Yep, they're the big guns.

They're used more commonly than you'd expect (depending on the prescribing doctor's preferences of course).

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Posted (edited)
On 3/5/2017 at 9:04 PM, JustNuts said:

They're used more commonly than you'd expect (depending on the prescribing doctor's preferences of course).

Yes, my pdoc prescribes anti-psychotics for anxiety and sleep, too....... I have to take Thorazine for anxiety, and I am really not thrilled about it, even though my dose is probably considered in the low range.

It makes me feel "snowed" and very foggy, so I take my entire dose at bedtime.......It helps my sleep, though, so it's not all bad....If I don't get at least 7 hours sleep, all my crazy just gets worse.

My pdoc tried me on Seroquel for anxiety, too......It worked for that, but caused me to gain a lot of weight......I have found that the Thorazine is more weight neutral for me, so we decided on that one for now.

Edited by CrazyRedhead

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how often do you take the thorazine. For me to be covered all day I have to take it at least every 4-6 hours,,,,400mg a day isn't what id consider low...or is it just a prn?

Also, stelazine actually has "short -term"  anxiety approval

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For me trilafon didn't do much...it didn't hit anxiety or irritability. Stelazine is some "strong shit" (words of a pdoc)...I've heard it's great for anxiety and psychosis but comes with pretty hefty side effects...weirdly trilafon had no side effects...but not really any effects at all actually 

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Posted (edited)
10 hours ago, Iceberg said:

how often do you take the thorazine. For me to be covered all day I have to take it at least every 4-6 hours,,,,400mg a day isn't what id consider low...or is it just a prn?

Also, stelazine actually has "short -term"  anxiety approval

I take my 100mg thorazine once a day at bedtime, it's not a prn for me....It has a fairly long biological half life of about 30 hours, which covers me pretty well throughout the next day:

https://en.wikipedia.org/wiki/Chlorpromazine

Never tried stelazine, but after investigating, found it's biological half life varies between 10-20 hours--significantly shorter than thorazine:

https://en.wikipedia.org/wiki/Trifluoperazine

 

Edited by CrazyRedhead

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@CrazyRedheadOH- ok then that is low but its what I do too basically. 50-100 if I cant sleep,,,if I need it during the day I Do 25 every 4-6 hr so it ends up being about 200 a day, would never recommend that for anxiety though. When I was on it for anxiety it was !00 hs and 25 am. And yes stelazine is shorter, its dosed twice a day usually...typically one or two mgs for anxiety

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2 hours ago, Iceberg said:

@CrazyRedheadOH- ok then that is low but its what I do too basically. 50-100 if I cant sleep,,,if I need it during the day I Do 25 every 4-6 hr so it ends up being about 200 a day, would never recommend that for anxiety though. 

Thorazine was the drug of last resort for my anxiety and sleep, because pdoc would not increase my Klonopin dose, and the Trazodone didn't work well enough on it's own for sleep.

I find that taking the 100mg at bedtime will cover me throughout the next day.....I may have to increase dose, or change to a different med, at a later point, but for now it's working okay.

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Gabbys are a very good alternative to benzos, I've seen so first hand. I suggest you do ask it's helpful and not as strong. And I guarantee you won't run out as the prescription has such a high quantity. 

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Thank you guys for the suggestions and support.  I am currently taking 5mg Abilify and 10mg Celexa, which does help, but it still gets very bad sometimes, especially when I have the EPS from Abilify.  That gives me a lot of anxiety.  I've also been on Buspar, but had to go off because it gave me orthostatic hypotension.  I will ask about the gabapentin next time I see her and hopefully she will understand just how bad the problem is.

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I have severe SAD, GAD, and PTSD. I'm currently early in month four of withdrawal from 4mg of klonopin daily for 16 years.  Had to cold turkey due to six weeks of inpatient rehab for alcoholism. 

Due to my addiction issues I'm no longer prescribed klonopin. From what I know the first line for anxiety is a MAOI such as Nardil. It is the gold standard. It works on multiple neurotransmitters as well as GABA. I'm only 10 days in so it hasn't kicked in yet although I've felt relief at times early on. 

I'm on: Nardil 60mg, Clonidine .2 x 3, Propranolol 20mg x3, Trileptal 300mg x 2, Neurontin 300mg x 4, Seroquel 25mg x 1 (sleep). 

Try Lyrica or Neurontin.  With Neurontin use at least 1200mg a day.  Clonidine acts on neurepinephrine and does a nice job although it makes you sleepy for 15 minutes after you take it. A beta blocker stops physical anxiety symptoms. Trileptal is for benzo withdrawal and I'll stop it soon. 

I think SSRI / SNRI drugs are not effective for anxiety and have terrible side effects. That was my experience. 

Edited by AtlantaPhobic

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I can relate to what you're saying.

Ativan and Xanax make me feel so much more in control.

That's why I never take them unless of a panic attack.

The SSRIs do eventually work for anxiety, it just takes some time.  Beginning is usually worse anxiety.

Edited by BrianOCD

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