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Fave PRN? Xanax, Valium, Ativan, or Klonopin, etc?


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What do you think is the best Emergency PRN med for short/intermittent episodes of anxiety? I initially tried a couple of non-benzos Hydroxyzine (antihistamine) which did nothing...and Oxazapam (did very little and took over an hour to notice any effect). Valium worked pretty well in the past, but the effects are too long lasting (would wake up groggy).

I would only take it 1-2x per Month (for emergency/anxious distress) in order to avoid tolerance. I'm wondering what your favorite med is for this purpose? Something that works quickly, and doesn't last like 12 hours. Also, how many times per week can you take a low dose without developing any tolerance?

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I haven't built up a strong tolerance to Klonopin. I take it twice/day, as it does wear off after about 5 hours. I used to take it at night so it would already be in my system when I woke up, as I was having anxiety attacks upon waking. I take 2 mgs. If I'm having a really bad day, i.e. my cat died last week, I might take an extra when I feel an anxiety attack coming on. It tends to work in about a half hour, sometimes 25 minutes, but you're not going to find anything that works faster than that aside from the sublingual tabs that dissolve in your mouth, which I've never been given, despite raging anxiety attacks that come out of nowhere. I think docs are afraid of people abusing it. 

Also, Klonopin doesn't make me sleepy or help me sleep at all. I've taken 4mgs to try to get some sleep, and all I did was calmly play Halo. :D

Edited by heilmania
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I use xanax ODT (the disintegrating kind, works in seconds), but I don't use it often.  I also take klonopin ODT, but on a schedule so it doesn't reduce any anxiety like xanax does.  It is a maintenance level.  Does nothing for me as an as needed med.

I wouldn't call xanax my favorite because it is the only thing I have.  But it does work when I need it.

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eeny meeny miny moe...

Xanax is the winner.. I did not do well on Klonopin. It gave me a stuffy nose and I felt very off , it didn't even really take care of the anxiety. Xanax works somehow, if I am really bad..it feels like it takes forever to work but then give it a few minutes, my eyelids get heavy and I feel this wave like you do with a buzz or if you drank. I keep mine on me everywhere I go. It is security buddy. He makes me feel safe.

 

Edited by KnickNak
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I've tried all the benzos available in the US except midazolam, and I think Xanax is my favorite, especially Niravam (the ODT version of Xanax). I'm very benzo resistant, so I have to take 2-6 mg for it to do anything, but ever since starting Parnate, I have hardly had to take Xanax at all.

I don't do well on Klonopin when taken regularly. I tend to get very depressed when I'm on it.

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Thank you for the awesome feedback everyone!! Seems Xanax is the winner (it's actually what my pdoc RX'd) I'm not one to take benzos often. With depression, the last thing I need is to take something that will make me more depressed/groggy/stuffy or cause immediate/abrupt withdrawal effects (like acute sweating & panic)

Is it true that all of these Benzos also act as Muscle relaxers? (i.e. take care of physical symptoms of anxiety like tensing stomach, fast heartbeat, choking feeling in chest, etc)

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3 minutes ago, cloudmonger said:

Thank you for the awesome feedback everyone!! Seems Xanax is the winner (it's actually what my pdoc RX'd) I'm not one to take benzos often. With depression, the last thing I need is to take something that will make me more depressed/groggy/stuffy or cause immediate/abrupt withdrawal effects (like acute sweating & panic)

Is it true that all of these Benzos also act as Muscle relaxers? (i.e. take care of physical symptoms of anxiety like tensing stomach, fast heartbeat, choking feeling in chest, etc)

I wouldn't say they're muscle relaxers, but they'll take care of the physical symptoms associated with the anxiety, in my experience.

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I have had very little Xanax, a fair amount of Ativan, and a lot of Valium. I've never had klonopin. Xanax definitely worked, but maybe too well. Ativan didn't do much for me, to be honest. Valium works reasonably well for me. My pdoc would be horrified if he knew I had it. But if it was going to kill me, it would have done so long ago. It works quickly and pretty effectively. It also helps relax my muscles a bit. My anxiety has been really high lately, so I've been gobbling an unusually large amount. Normally, I rarely take it. 

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14 minutes ago, heilmania said:

I wouldn't say they're muscle relaxers, but they'll take care of the physical symptoms associated with the anxiety, in my experience.

They're not as good, but they're the next best thing. They're definitely not going to work as effectively as baclofen or soma, but in my experience, they close to flexiril. Some people have good results with flexiril, but I don't. Methocarbamol is another one that doesn't work well for me. soma is great if you need Sleep, otherwise I'd go with baclofen. 

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39 minutes ago, Flash said:

Some people have good results with flexiril

Flexeril helps me.  But not with anxiety, but maybe indirectly?  For me it loosens up my muscles, but only when I take it and lay down to fall asleep.  Otherwise it kind of works against me and gives me a headache, with no (or barely felt) muscle relaxation.

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I "feel" Xanax but its a too much too short of a time thing.  I had a long talk with PDoc about it and he said the "Rush" with Xanax is why he doesn't like prescribing it.  Its appealing to a lot of patients in a not good way.  My experience is with the right dose of Valium it works fast and lasts long enough to break up the anxiety.   Xanax is like it busts up the anxiety like a punch to the face but when you get up your back in the fight.   *Really don't like it.

Valium in a large dose can dope me up.  Finding the lowest amount that works for everything is a trial.   And I learned that the dose I took years ago was too much when I restarted using it.   *Fell asleep on the couch and freaked out people.   I only do benzos prn just for what its worth.

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  • 4 months later...

As others have mentioned, I think Xanax is the best PRN benzo to take in the situation you described. It will quickly relieve your anxiety without lingering around for the rest of the day like Klonopin or Valium might due to their longer half-lives. 

If you are only taking it 1-2x per month, Xanax might just work perfectly. Taking it more than twice per week, however, might cause tolerance and psychological dependence to occur. If you want to use it strictly PRN, try taking it as little as possible, and the lowest dose possible when you do take it. A little Xanax can surprisingly go a long way (0.25-0.5 has stopped a panic attack for me in the past without leaving me feeling high or doped up). Whereas Valium, in my experience, the dosage I need to relieve my anxiety acutely causes more drowsiness than it does help my anxiety. I would rather be anxious than in a daze and feeling tired/sluggish 

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  • 2 weeks later...

I took klonz for anxiety PRN for a while and it helped a lot, but took longer to kick in. I tried a few of my mom's xanax on occasion, and that kicked in within 15 minutes and helped even more. My pdoc won't give me xanax though, she says it isn't for maintenance of anxiety, and it can become addicting. 

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