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Is my psychiatrist nuts?


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Hi there!

I have been experiencing both anxiety and severe anxiety-attacks for several months now after a few months on the wrong epilepsy medication. A long story that I won't get into...

Now I have begun therapy twice a week to cope with and get rid of my anxiety, and as a part of this my psychiatrist has found it useful for me to stop taking Valium, or any other benzo for that matter. I have no objections to this, since I have been feeling a bit tired and "foggy" and want to get off pills. (Except for the 1200 mg of Tegretol I have to take to keep the epilepsy at bay...)

But his method is absolutely contrary to every piece of advice I have found anywhere. He wants me to switch from Valium to Xanor (The Norwegian version of Xanax.) And he even meant I should be taking the same amount. 15mg of Xanor per day!!! Is he nuts or is there any sense in this at all?

Have the best day you possibley can!

H.

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the equivalency charts don't work for me but apparently they do for others. putting that aside, how much valium you were on? 15 mg xanax seems a lot if they want to get you off benzos! [edit -- unless the norwegian version is really different?]

and as far as getting off them, the tapering method (see sticky) is working for me -- i switched from a shorter (xanax) to longer (klonopin) to longest (valium) acting benzo, and i'm finally able to taper (i've gone from 30 to 27.5 to 25mg valium in one week, yay.) but to switch to xanax seems to go against what i've heard? someone else please jump in.

glad you checked in here, gotta get reality checks. good luck and aloha.

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the newer med is a little less groggy producing and they say not as addictive over the long hall,but do drug company c.e.o.s care about anything other than thier bottom line and obsessive wealth ?  In my system zanex isn't as physical as valium,as for your doctors idea who knows ? maybe try one or two to see if it's less physical and takes the edge off.

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I have been on a fairly low dose, 3 x 5mg of Valium, some days 4 x 5mg.

unless xanor is really a different animal than xanax, it sounds like 15 mg of it is not a way to cut back on benzos, either in terms of dosage or type.

but that's just taken in isolation. given your other meds, i can't give a reliable opinion at all. there's others here who know way more. perhaps the cocktails section?

i can, however, offer my best wishes, and understanding that anxiety is hard enough without anxiety about meds. you'll find what works for you, and my thoughts are with you that it will be soon.

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This is from the main Crazy Meds page on benzos:

http://www.crazymeds.us/benzo.html

Here are the dosage equivalents of benzodiazepines: 1mg Ativan = 0.5mg Klonopin = 25mg Librium = 15mg Tranxene = 10mg Valium = 0.5mg Xanax. If you need to suddenly switch from one to another because of a sudden bad reaction you're pretty much OK swapping any benzodiazepine for any other in case of emergency. Unless you've been taking Xanax for long enough to become dependent upon it. Then you're hosed. Xanax requires Xanax for discontinuation. You can try switching between brand and generic and that's it.

According to this, 10 mg of Valium = .5 mg Xanax. Are you perhaps taking 1.5 mg of Xanax (not 15)? That would make a little more sense (but not entirely). Unless, of course, Xanor is a different formulation than Xanax.

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I don't know why someone would switch from valium to Xanax in an attempt to decrease one's dependency on the benzodiazepine.

It's usually the other way around. What your doc wants, doesn't seem to make any sense (to me, and others).

My intuition tells me that you are better of with another doctor. Even if he meant 1.5 mg of Xanax instead of 15.

Taking 15 mg of Xanax is -figuratively speaking- like taking heroin.

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I take 2mg of ativan with my schedule meds at 9am, 6pm and 10pm and get 2 PRNs during the day with an 8 hour time span of another 2mg each.  That totals 8mg throughout the day I am allowed.

9pm 200mg dopamax,2mg ativan

PRN if needed by 2pm

6pm 200mg dopamax, 2mg ativan

PRN if needed by 8pm

10-11pm 600mg of seroquel. 2mg ativan

dx 296.6x, ocd, gad

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I don't know why someone would switch from valium to Xanax in an attempt to decrease one's dependency on the benzodiazepine.

It's usually the other way around. What your doc wants, doesn't seem to make any sense (to me, and others).

My intuition tells me that you are better of with another doctor. Even if he meant 1.5 mg of Xanax instead of 15.

Taking 15 mg of Xanax is -figuratively speaking- like taking heroin.

<{POST_SNAPBACK}>

Thanks for the replies!

I went to see my regular doc today, and she agrees with me that switching to Xanor/Xanax is basically a bad idea since I'm trying to get off benzos. I will confront my psychiatrist on monday when I have my next session with him, and then we'll see.

Switching to another psychiatrist/psychologist is not really an option for me, since we seem to have a shortage of them in this otherwise "nice to be sick in"-country. (Due to a good healthcare system we never pay more than about $250 per year for medication, other treatment and visits to any doc...) There are therapists working privately, but they charge way too much for me to afford, and even they have waiting lists up to a year! That just won't do!

So I'll stick to the Valium for the time being, and figure out were to go from there on Monday.

Have a good week-end!

H.

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Socialized health care sucks.

It's nice that things are cheap.

But I think that the problems are usually worse, like a more limited selection of meds, waiting lists, less freedom to choose your own doctor etc.

<{POST_SNAPBACK}>

Not to start a debate on socialized vs private health care, but I have to say the benefits clearly weigh up for the downsides. I am free to choose whatever doc I want, whatever meds I want and usually whatever specialist I want. There is a shortage of psychiatrists but that is about it. I have been too sick to work now for close to three years due to a busted balance nerve, and I have never once had to worry about the financial aspect of anything. And now I have been granted financial aid until the end of 2007 to get back to work, including medical help, re-education and even travel money. Not too bad really!

And you are free to sign a private health care insurance, if you really want to.

Take care!

H.

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How the heck do you guys get doctors to prescribe all those benzos for you?

I have been stable on the same dose of Klonopin off and on for 9 years. I find it VERY difficult to get a doctor to keep this maintenance going for me. They are all scared to death of getting in trouble for prescribing it. And scared you will be addicted. I'd rather be "addicted" to a benzo than dead! I never abuse it.

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  • 2 weeks later...

I went back and confronted my psychiatrist with what info I had gathered from the net, and he seemed a bit surprised. The reason is that psychiatrists in Norway are told not to prescribe benzos at all, so he knew very little about any of them. (I've gotten my Valiums from my regular doc...)

He still wants me to taper off the benzos, but I'm having trouble managing on lower doses. Anxiety sucks!!! Panic attacks are even worse!

Take care!

H.

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hey st.helge, i just replied to your other post, just wanted to reiterate that there's something wrong with this tapering idea if you don't have other tools or don't feel better. i know you know this. just....supporting you. aloha!

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I went back and confronted my psychiatrist with what info I had gathered from the net, and he seemed a bit surprised. The reason is that psychiatrists in Norway are told not to prescribe benzos at all, so he knew very little about any of them. (I've gotten my Valiums from my regular doc...)

He still wants me to taper off the benzos, but I'm having trouble managing on lower doses. Anxiety sucks!!! Panic attacks are even worse!

Take care!

H.

<{POST_SNAPBACK}>

I certainly do not wish to insult any Norwegians, but this is CRAZY ! And with UK doctors, they come with their own problems. Any other countries where docs have weird/less than competent practices ?

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I certainly do not wish to insult any Norwegians, but this is CRAZY ! And with UK doctors, they come with their own problems. Any other countries where docs have weird/less than competent practices ?

<{POST_SNAPBACK}>

Hi!

It is not that I'm insulted in any way, but I feel like I should defend the Norwegian psychiatrists a little bit.

Here is what I think the problem is! Benzos are addictive, and this is a fact that has been known for quite some time. The government decided several years ago that addictive was bad, and tried to put a lid on the use of most addictive medication. For this reason the psychiatrists are given instructions to not prescribe benzos, and therefore have little knowledge of them. They have at least 7 years of university studies behind them before they graduate, so I don't think that there is any problem with the competence. But if the government says that they shouldn't prescribe, it is very little they can do about it. On the other hand a regular doc is more likely to prescribe benzos as this "rule" does not apply to them. Weird, but not too surprising knowing how official bureaucracy can work... The fact that SSRI's can be just as addictive has not resultet in the same banning, so most pdocs are more than willing to prescribe those. Regular docs on the other hand are not too happy to do the same.

Did this make any sense to anyone but me? A bit zonked as the valium and tegretol kicked in at the same time...

Take care!

H.

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Here is what I think the problem is! Benzos are addictive, and this is a fact that has been known for quite some time. The government decided several years ago that addictive was bad, and tried to put a lid on the use of most addictive medication. For this reason the psychiatrists are given instructions to not prescribe benzos, and therefore have little knowledge of them.

<{POST_SNAPBACK}>

Regardless, it's close to malpractice for your dr. to tell you to take 15 mg xanax.  He has a copy of felleskatalogen (the Norwegian version of the PDR), or he should.  Did he actually write you a prescription?  I hope you have gotten this sorted out by now.

BTW, I was able to get in to see a pdoc in Lillestr

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Here is what I think the problem is! Benzos are addictive, and this is a fact that has been known for quite some time. The government decided several years ago that addictive was bad, and tried to put a lid on the use of most addictive medication. For this reason the psychiatrists are given instructions to not prescribe benzos, and therefore have little knowledge of them.

<{POST_SNAPBACK}>

Regardless, it's close to malpractice for your dr. to tell you to take 15 mg xanax.

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to answer the question, yes he's nuts.  i've never heard of anyone taking 15mg of xanax.  it's like taking 50mg of klonopin, you will forget what happened to you 30 seconds ago and people will think you need to go to the hospital.

maybe he didnt mean 15mg... if he did, its a dose that would be five times higher than the highest ive ever heard people taking, and believe me, they were pretty bad cases.

Hi there!

I have been experiencing both anxiety and severe anxiety-attacks for several months now after a few months on the wrong epilepsy medication. A long story that I won't get into...

Now I have begun therapy twice a week to cope with and get rid of my anxiety, and as a part of this my psychiatrist has found it useful for me to stop taking Valium, or any other benzo for that matter. I have no objections to this, since I have been feeling a bit tired and "foggy" and want to get off pills. (Except for the 1200 mg of Tegretol I have to take to keep the epilepsy at bay...)

But his method is absolutely contrary to every piece of advice I have found anywhere. He wants me to switch from Valium to Xanor (The Norwegian version of Xanax.) And he even meant I should be taking the same amount. 15mg of Xanor per day!!! Is he nuts or is there any sense in this at all?

Have the best day you possibley can!

H.

<{POST_SNAPBACK}>

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  • 4 weeks later...

Hi there!

I have been experiencing both anxiety and severe anxiety-attacks for several months now after a few months on the wrong epilepsy medication. A long story that I won't get into...

Now I have begun therapy twice a week to cope with and get rid of my anxiety, and as a part of this my psychiatrist has found it useful for me to stop taking Valium, or any other benzo for that matter. I have no objections to this, since I have been feeling a bit tired and "foggy" and want to get off pills. (Except for the 1200 mg of Tegretol I have to take to keep the epilepsy at bay...)

But his method is absolutely contrary to every piece of advice I have found anywhere. He wants me to switch from Valium to Xanor (The Norwegian version of Xanax.) And he even meant I should be taking the same amount. 15mg of Xanor per day!!! Is he nuts or is there any sense in this at all?

Have the best day you possibley can!

H.

<{POST_SNAPBACK}>

If it is .15 I could understand, but take it from me , been using benzos four 5 yrs plus. If it is 15 mg a day  of xanex thats like 30 1 mg. tabs of ativan which is not only illegal but you would probably be sleepping for a week. Think about it 15 mg.times 30 days in a month could never be prescribed. And if it is, let me know and I'll go to that doctor too .Impossible.

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Here's Steven Stahl's take on benzos:

http://www.psychiatrist.com/brainstorms/br6309.pdf

According to him, benzos are still the most used meds for anxiety and rightly so.

<{POST_SNAPBACK}>

If that doesn't work, try this:

Proc Natl Acad Sci U S A. 1986 Dec;83(23):9236-40. Related Articles, Links 

 

Purification of a benzodiazepine from bovine brain and detection of benzodiazepine-like immunoreactivity in human brain.

Sangameswaran L, Fales HM, Friedrich P, De Blas AL.

An endogenous brain substance that binds to the central-type benzodiazepine receptors with agonist properties is present in both rat and bovine brains. This substance has been purified to homogeneity from bovine brain by immunoaffinity chromatography on immobilized monoclonal anti-benzodiazepine antibody followed by gel filtration on Sephadex G-25 and two reversed-phase HPLC steps. The purified substance was characterized as the benzodiazepine N-desmethyldiazepam (nordiazepam). The techniques used for the identification were mass spectrometry, HPLC, spectrophotometry, benzodiazepine receptor binding, and immunological techniques. Benzodiazepine-like immunoreactivity was also found in all the human brains tested, including six brains that had been stored in paraffin since 1940, fifteen years before the first synthesis of benzodiazepines. These results show that benzodiazepine-like molecules of natural origin--and possibly benzodiazepines themselves--are present in human and other mammalian brains.

Nordiazepam is a metabolite of diazepam. More info ]here.

It's kind of old, I know.

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