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Suggestions for Alternate medications for Anxiety and Depression


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I have been taking one form or another of benzo (xanax xr, valium, Klonopin)  for the last ten years. 1 mg 3 times a day along with an SSRI of a medium dose. SSRI's alone cause my anxiety to skyrocket. Making me unable to leave the house. Which is The reason I HAVE to take 3 mg of a benzo a day. The laws in Ohio have changed to where Dr's. are afraid to prescribe any sort of benzo at a "high" dose for an extended period time. I quit taking everything last year around October and it was hell. I will never try that again. So,  I Started .5 Klonopin twice a day with 40 mg of Celexa with 100 mg of Seroquel and it does not work, at the end of the day (around 5 pm) my anxiety comes back full on which forces me to take another .5 mg that day. Meaning I am without a benzo for the last 10 days or so of the month. Which in turn, brings on the withdrawal and means I can not work, for fear I won't be able to maintain a schedule and show up everyday. I have not been able to work for a year. Also, nothing has worked as well as the 3mg of Klonopin a day with 40mg of Celexa. It's just, no one in Ohio will prescribe 3 mg a day.

 

This is the worst it has been for me. I was wondering if anyone else has had close to the same experience and what they did to get help or if nothing helped. Either/or. Just looking for some advice. Sorry if the post is a little all over the place, still getting withdrawal from benzo's and I can't concentrate to well. Thank you for reading.

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What is it you want answered by us? Or just list every med that could possibly help?

 

You really haven't tried very many meds. Work with your pdoc. Maybe print out what you wrote above to show your pdoc, because I am a little confused. She will probably have a better idea of what you mean.

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You could try gabapentin or a higher dose of seroquel. But in my experience klonopin is the most helpful for my anxiety. I take 1.5 mg a day. 0.5 AM then 1 mg at bedtime. I do not think you taking 0.5 mg three times daily is a high dose. But I'm no dr. I was taking 3 mg a day too at one point but with a lot of therapy was able to cut my dose in half. So I also suggest you get a good therapist to help your anxiety. I have been in therapy since I was 13 or so. I'm 31 now. So it can take a while for you to find the right kind of therapy and the right actual therapist.

Oh and it's best to be honest about you taking more klonopin than prescribed to your current pdoc.

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What is it you want answered by us? Or just list every med that could possibly help?

 

You really haven't tried very many meds. Work with your pdoc. Maybe print out what you wrote above to show your pdoc, because I am a little confused. She will probably have a better idea of what you mea

The meds  I have tried are, Paxil CR, Zoloft, Lexapro, and Prozac. They help with depression, but make my anxiety worse. I have also tried Cymbalta, and Effexor XR  and Geodon, all three made me a bit suicidal. I have been on a semi constant dose of xanax/klonopin 1mg 3 times a day for ten years along with 1 of the above SSRI's.

 

I am now forced to take .5 mg twice a day because no one in Ohio wants to prescribe 3 doses a day of any benzo. So, I am trying 40mg of Celexa, with 100mg of Seroquel and .5 Klonopin twice a day and I can not make it through a single full day without taking an extra .5 or splitting that .5 in two. Leaving me short at the end of the month.

 

I am wondering if anyone has had anything similar (taking a benzo for yrs., and then lowering the dose), and what it is that they tried. Even if it helped them or not. I am looking for something, anything to help that I can suggest when I see my Dr.

 

Sorry if my post wasn't too clear.

Edited by dargis49
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You could try gabapentin or a higher dose of seroquel. But in my experience klonopin is the most helpful for my anxiety. I take 1.5 mg a day. 0.5 AM then 1 mg at bedtime. I do not think you taking 0.5 mg three times daily is a high dose. But I'm no dr. I was taking 3 mg a day too at one point but with a lot of therapy was able to cut my dose in half. So I also suggest you get a good therapist to help your anxiety. I have been in therapy since I was 13 or so. I'm 31 now. So it can take a while for you to find the right kind of therapy and the right actual therapist.

Oh and it's best to be honest about you taking more klonopin than prescribed to your current pdoc.

 

 

I have been 100% honest with my dr's.I also see a therapist once a week. they know I have taken extra during each day. They don't seem to care if I cant make it through the day and month  They flat out refuse to give me an extra .5 a day. Something happened in the last six months here in Oho where they will not give "high" doses of any benzo. So it's anxiety with a little withdrawal for 4-5 hours a day and not take the extra .5, or not leave my house for a week at the end of the month when I do take them. I'm screwed either way.

 

I will look up gabapentin.

 

Basically this is what I was hoping for with my post. suggestions for non-benzo solutions to treat constant anxiety that people have tried.

 

EDIT: is that what you are diagnosed with and currently taking in your signature?

Edited by dargis49
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Are you doing therapy with tdoc to help increase your self management skills when the anxiety shows up?

 

Sometimes a benzo is the only tool that works, and sometimes, especially as you grow to feel more solid in your skills, there are many other things you can try to help reduce the anxiety to a manageable level.

 

Using a combination of meds and self management, I was able to switch from 6+ mg of lorazepam per day to 3 mg of klonipin per day and then taper off to nothing. I haven't had any benzos in four years, though my dentist is STRONGLY advocating I let her give me a prescription for valium before I come back for anything more than an exam.

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Are you doing therapy with tdoc to help increase your self management skills when the anxiety shows up?

 

Sometimes a benzo is the only tool that works, and sometimes, especially as you grow to feel more solid in your skills, there are many other things you can try to help reduce the anxiety to a manageable level.

 

Using a combination of meds and self management, I was able to switch from 6+ mg of lorazepam per day to 3 mg of klonipin per day and then taper off to nothing. I haven't had any benzos in four years, though my dentist is STRONGLY advocating I let her give me a prescription for valium before I come back for anything more than an exam.

Yes I am doing self management skills with my therapist. So far benzo's are the only thing that controls my anxiety and, in turn helps with my depression a great deal. It makes me feel normal. Like I used to feel before I had any issues with depression and anxiety. Hearing you went form 6mg of ativan to 3mg of klonopin gives me a little hope.

 

I don't know many people who struggle with anxiety as bad as I do. It seems SSRI's are the over-prescribed drug where I am from. Almost everyone I know is on or has been on an SSRI. Benzo's are seriously hard to get prescribed in Ohio.  With my forced lower dose of klnopin, I am struggling to get through sometimes a day let alone the month. My current cocktail is not working.

 

Thanks for the reply.

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Oh good. Yes signatures can be helpful.

And I hope you find a solution to your anxiety problems. I know in my area when pdoc's are reluctant to prescribe benzo's they go straight to gabapentin (also know as neurontin). I've never tried it. Another one I just thought of is hydroxyzine. Or Vistaril. That is a non benzo that works for some people's anxiety. It helped mine a bit but luckily I was prescribed to be put back on klonopin.

Good luck!

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Yeah, I've heard of Vistaril. Haven't heard anything about neutronin until I visited this site. I could see how a nerve med may help anxiety. But like you said, you had, or got, to go back to Klonopin. Xanax "works" but it's half life is too short. It really only helps when you feel that attack about to come on. I've tried the 3 .5mg kpins a day, but it doesn't work as effectively as 1mg. That .5 makes an enormous difference for me. Don't know why.

 

My issue now is I am hopping from one psych to another trying to get my meds the way  I have been getting them for the last nine years. I bring them prescription histories going back 6 yrs from my pharmacist. They look at it and throw it aside. My last family doc looked at my history, gave me 2 .5's a day for a month, and then cut me off. Knowing I was going to go through horrible withdrawal.

 

Got kind of off topic, my bad. But, thanks for the suggestions. I'll bring some of this stuff up when I see my new psych doc Wed. Also am going to try Abilify. See how that works.

Edited by dargis49
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My issue now is I am hopping from one psych to another trying to get my meds the way  I have been getting them for the last nine years. I bring them prescription histories going back 6 yrs from my pharmacist. They look at it and throw it aside. My last family doc looked at my history, gave me 2 .5's a day for a month, and then cut me off. Knowing I was going to go through horrible withdrawal.

 

I'm sorry you're having trouble finding a good cocktail.

 

Doc hopping will not get you benzos. In fact, it will just make it harder to get anyone to prescribe them to you at all. There is (rightly or wrongly) a lot of fear of abuse, which for docs leads to fear of lawsuits (especially gdocs). Docs new to you will be unlikely, generally, to prescribe higher doses of klonopin. You need time to develop a relationship for the doc to trust you are not abusing the med. 

 

Mostly, you need to take your meds as rx'd. If it's not working, tell your pdoc that - but do what they say; let them do their job. Benzos work well for anxiety, but they're not the only option and clearly you need more than a low dose. Sounds like time to try a different class of meds before returning to higher doses of abusable drugs. Withdrawals suck. You have other options.

 

Good luck with the pdoc on Wednesday. Let us know how it goes!

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Geek hit the nail right on the head. Doctors are going to be very reluctant to prescribe you more benzos if you keep jumping from one doctor to another to get them. That is called doctor shopping and is a real concern  among medical professionals.

 

In my experience, Abilify is not a good med for anxiety. In fact, it is known to increase anxiety in some people. In my case, the anxiety was like I was going out of my mind but it abated somewhat after my dose got above 10 mg.

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My issue now is I am hopping from one psych to another trying to get my meds the way  I have been getting them for the last nine years. I bring them prescription histories going back 6 yrs from my pharmacist. They look at it and throw it aside. My last family doc looked at my history, gave me 2 .5's a day for a month, and then cut me off. Knowing I was going to go through horrible withdrawal.

 

I'm sorry you're having trouble finding a good cocktail.

 

Doc hopping will not get you benzos. In fact, it will just make it harder to get anyone to prescribe them to you at all. There is (rightly or wrongly) a lot of fear of abuse, which for docs leads to fear of lawsuits (especially gdocs). Docs new to you will be unlikely, generally, to prescribe higher doses of klonopin. You need time to develop a relationship for the doc to trust you are not abusing the med. 

 

Mostly, you need to take your meds as rx'd. If it's not working, tell your pdoc that - but do what they say; let them do their job. Benzos work well for anxiety, but they're not the only option and clearly you need more than a low dose. Sounds like time to try a different class of meds before returning to higher doses of abusable drugs. Withdrawals suck. You have other options.

 

Good luck with the pdoc on Wednesday. Let us know how it goes!

 

Thanks. I know doc hopping is BAD. I agree you have to build trust with your doctor. Problem Iv'e been jobless coming up on 1 yr. and I may (I am) be trying to hard to find a dr that will prescribe me what I feel I need function on a day to day basis. But, when I walk in pay, and then talk and they say "we do not prescribe "high" doses of Benzodiazepines" no matter what, I have to try another one.

 

I've been trying to get back with the one dr that helped me most. Only problem, she doesn't take medicaid and she's $150 an hour.

 

Thanks for your response though. I do appreciate everyone on here who has given suggestions.

Edited by dargis49
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Geek hit the nail right on the head. Doctors are going to be very reluctant to prescribe you more benzos if you keep jumping from one doctor to another to get them. That is called doctor shopping and is a real concern  among medical professionals.

 

In my experience, Abilify is not a good med for anxiety. In fact, it is known to increase anxiety in some people. In my case, the anxiety was like I was going out of my mind but it abated somewhat after my dose got above 10 mg.

I agree. Thanks for chiming in on the Abilfy. I may try it, may not. We'll see.

Thanks again everyone.

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Yeah don't Doc shop.  They probably catch on and then your going on to the don't prescribe anything list.  Find a good doctor and talk specifically about what has worked in the past.   How the current mix is not working and then see what the doctor can find for you.   Keep going back until you both find something that works.   There is a growing faction that thinks anything from a pharmacy is evil and we should let nature fix us.   Therapy is probably half the answer for a lot of people and for some thats all they need.  For the rest you need to do the meds thing and find the meds that work.   Who prescribes?   Your Gdoc or your Pdoc?   I think the GDoc is  a good choice if you take meds for other health problems.  

 

Good luck

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Yeah don't Doc shop. They probably catch on and then your going on to the don't prescribe anything list. Find a good doctor and talk specifically about what has worked in the past. How the current mix is not working and then see what the doctor can find for you. Keep going back until you both find something that works. There is a growing faction that thinks anything from a pharmacy is evil and we should let nature fix us. Therapy is probably half the answer for a lot of people and for some thats all they need. For the rest you need to do the meds thing and find the meds that work. Who prescribes? Your Gdoc or your Pdoc? I think the GDoc is a good choice if you take meds for other health problems.

Good luck

 I know my gdoc won't prescribe anything, so I wont be going back. Going back to my gdoc I went to when I was a teenager. So a pdoc will prescribe my meds.

 

Thanks.

Edited by dargis49
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Well, the visit to my new pdoc went as planned. No increase in klonopin. Staying on 40mg Celexa, .5mg klonopin 2x a day, and switched from 100mg of Seroquel to 2mg of Abilify. No change noticed so far. Going back to see him after 2 weeks.

 

Any suggestions or tips on how I can convince him that I need klonopin3x a day? I'm extremely frustrated.

 

Thanks.

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It's definitely understandable to feel frustrated when you have something that works and it's hard to get enough access to it.

 

My suggestions?

 

Build an honest relationship with your new practitioner.

 

This takes time.

 

Let them see over time that you are both responsible with the medications you have access to (including NOT obtaining multiple prescriptions from different doctors for similar drugs), and also that the medications you currently are prescribed are helping but not as much as you would like.

 

Work your ass off with a therapist (tdoc) to help manage your symptoms. This will offer evidence that you are doing EVERYTHING IN YOUR POWER to make it better and that you are using all available resources to help manage symptoms. Ask your tdoc to consult with your pdoc about the level of symptoms you are experiencing, your progress in therapy, and observations about levels of anxiety.

 

If your symptoms still aren't managed well after all these things done diligently over a period of many, many months (minimum of 6 months, probably more) you should have enough credibility with your new pdoc to request an increase in dose.

 

PS...

 

 

Hearing you went form 6mg of ativan to 3mg of klonopin gives me a little hope.

You missed the part where I said, "Then I tapered off to nothing." I haven't used any kind of benzo in 4 years and for the most part my anxiety is manageable with non-pharmaceutical interventions.

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