DammitJanet Posted January 13, 2019 Share Posted January 13, 2019 Pdoc let me have it 5 years ago, said under condition she’d never raise the dose (1mg). Well, tolerance has built...I’m having withdrawals every day all day...need to switch. I know both diazepam and clonazepam have both caused my depression to worsen, but at this point, not sure what else to do. What are the benefits to each of these if anyone has an opinion? i see her next Monday and need to be decided so I can be as assertive and assured as possible. I think when I tried diazepam it may have negated the benefits of vyvanse, not totally positive. Guess I’ll try it once more tomorrow since I have a bunch left. I’m terrified she’s gonna force Ativan which makes me really feel moody. Link to comment Share on other sites More sharing options...
Wonderful.Cheese Posted January 14, 2019 Share Posted January 14, 2019 Darn. I'm sorry you are in such a bad situation. Would you feel comfortable asking your pdoc gently for an increase in xanax ? Just to see if she will do that? The worst she can say is no, right? If not, personally I prefer Klonopin. I've never even had to try anything else except Ativan while IP. I credit Klonopin for saving my life big time. I can't leave the house without it. I become agoraphobic. I can't drive or anything. But ymmv. You and your Dr will have to decide how to proceed. Good luck. I'll be thinking of you. 1 Link to comment Share on other sites More sharing options...
CeremonyNewOrder Posted January 14, 2019 Share Posted January 14, 2019 My HMO just banned prescribing Xanax. Routine use of benzos also makes me depressed and I build up a tolerance pretty fast thus I never use them. When you see your pdoc, I would try to either tinker with your current meds or add something for anxiety. I know some people have to have a benzo and are responsible consumers but I personally find the right AD or AAP to work better than benzos. 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 2 minutes ago, Wonderful.Cheese said: Darn. I'm sorry you are in such a bad situation. Would you feel comfortable asking your pdoc gently for an increase in xanax ? Just to see if she will do that? The worst she can say is no, right? If not, personally I prefer Klonopin. I've never even had to try anything else except Ativan while IP. I credit Klonopin for saving my life big time. I can't leave the house without it. I become agoraphobic. I can't drive or anything. But ymmv. You and your Dr will have to decide how to proceed. Good luck. I'll be thinking of you. Thanks. I may just try clonazepam for awhile then until my depression crisis is over Link to comment Share on other sites More sharing options...
Wonderful.Cheese Posted January 14, 2019 Share Posted January 14, 2019 1 minute ago, DammitJanet said: Thanks. I may just try clonazepam for awhile then until my depression crisis is over I hope it helps you! 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 (edited) 30 minutes ago, CeremonyNewOrder said: My HMO just banned prescribing Xanax. Routine use of benzos also makes me depressed and I build up a tolerance pretty fast thus I never use them. When you see your pdoc, I would try to either tinker with your current meds or add something for anxiety. I know some people have to have a benzo and are responsible consumers but I personally find the right AD or AAP to work better than benzos. I build tolerance very slowly, and not ready to ditch benzos yet. I’m already on lots of meds and don’t want to add to it. I refuse any weight gainers too, so I’m pretty limited. Thanks for your ideas. Ps. I’m also entering menopause which vastly increases mood shifts, anxiety and insomnia. I don’t feel now is the time to put myself through even more distress. Edited January 14, 2019 by DammitJanet Link to comment Share on other sites More sharing options...
mikl_pls Posted January 14, 2019 Share Posted January 14, 2019 Have you tried Librium or Tranxene? Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 4 hours ago, mikl_pls said: Have you tried Librium or Tranxene? My doc is an old fogie. She doesn’t do anything outside of old standard protocol. I’ve never heard of tranxene. I will ask her though what she thinks. Thanks. Link to comment Share on other sites More sharing options...
CrazyRedhead Posted January 14, 2019 Share Posted January 14, 2019 (edited) 13 hours ago, DammitJanet said: Thanks. I may just try clonazepam for awhile then until my depression crisis is over Sounds like a decent idea to me....Clonazepam is as potent as Xanax, but it stays in your system longer. Edited January 14, 2019 by CrazyRedhead 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 7 minutes ago, CrazyRedhead said: Sounds like a decent idea to me....Clonazepam is as potent as Xanax, but it stays in your system longer. Do you happen to know how long diazepam stays for? Link to comment Share on other sites More sharing options...
CrazyRedhead Posted January 14, 2019 Share Posted January 14, 2019 (edited) 18 minutes ago, DammitJanet said: Do you happen to know how long diazepam stays for? I'm finding slightly different answers when I looked this up, but diazepam has a longer half life than clonazepam or Xanax, of that I'm sure. However, even though diazepam is longer acting, it is a much weaker benzo than clonazepam or Xanax. For example, to equal 1mg of clonazepam or Xanax, you would need 20mg of diazepam. Edited January 14, 2019 by CrazyRedhead 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 2 minutes ago, CrazyRedhead said: I'm finding slightly different answers when I looked this up, but diazepam has a much longer half life than clonazepam, of that I'm sure. However, even though diazepam is longer acting, it is a much weaker benzo than clonazepam or xanax. For example, to equal 1mg of clonazepam or Xanax, you would need 20mg of diazepam. I need a new Pdoc I think...when she let me try diazepam to equate 1mg of Xanax, she only scripted me 5 mg 2x a day...the biggest thing that keeps me with her is the amount of input she allows from me and I’m scared I won’t be able to find another doctor to prescribe a stimulant and benzo again. I’m gonna call around today I think. Thanks for helping me again. Link to comment Share on other sites More sharing options...
CrazyRedhead Posted January 14, 2019 Share Posted January 14, 2019 1 minute ago, DammitJanet said: I need a new Pdoc I think...when she let me try diazepam to equate 1mg of Xanax, she only scripted me 5 mg 2x a day...the biggest thing that keeps me with her is the amount of input she allows from me and I’m scared I won’t be able to find another doctor to prescribe a stimulant and benzo again. I’m gonna call around today I think. Thanks for helping me again. Do you think she would let you try clonazepam?....That would be a much easier switch, since 1mg Xanax = 1mg clonazepam. Wishing you good luck in your search for new doc, if that's what you decide to do..... Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 (edited) 13 minutes ago, CrazyRedhead said: Do you think she would let you try clonazepam?....That would be a much easier switch, since 1mg Xanax = 1mg clonazepam. Wishing you good luck in your search for new doc, if that's what you decide to do..... Yeah, pretty sure she would. I’ve told her in the past that I’ve gotten very depressed on it in the past, which is when I begged for Xanax. Why she said ok, but I’ll never increase the dose for ya. And thanks! Edited January 14, 2019 by DammitJanet Link to comment Share on other sites More sharing options...
CrazyRedhead Posted January 14, 2019 Share Posted January 14, 2019 (edited) 8 minutes ago, DammitJanet said: Yeah, pretty sure she would. I’ve told her in the past that I’ve gotten very depressed on it in the past, which is when I begged for Xanax. Why she said ok, but I’ll never increase the dose for ya. And thanks! Also, a warning about finding a new doc: Realize that a different pdoc may or may not feel the same about benzos, or prescribing a benzo and stimulant together. Edited January 14, 2019 by CrazyRedhead 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 4 minutes ago, CrazyRedhead said: Also, a warning about finding a new doc: Realize that a different pdoc may or may not feel the same about benzos, or prescribing a benzo and stimulant together. Yeah. I mentioned that above. My biggest fear for switching docs. I’m just gonna do a consult with another psychiatrist and see what they say. Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 God even though I just woke 4 hours ago, I’m seriously anxious right now! I mean shallow breath and all. Link to comment Share on other sites More sharing options...
mikl_pls Posted January 14, 2019 Share Posted January 14, 2019 1 hour ago, CrazyRedhead said: Do you think she would let you try clonazepam?....That would be a much easier switch, since 1mg Xanax = 1mg clonazepam. Wishing you good luck in your search for new doc, if that's what you decide to do..... Klonopin is actually twice as potent as Xanax, so 0.5 mg Klonopin = 1 mg Xanax. I think Klonopin would be a good idea barring that it doesn't worsen her depression. If not, Librium and Tranxene are good options. Librium is the first benzo to be invented and is SUPER long-acting. Not very potent though. A 25 mg capsule = about 0.75 mg Xanax, but you can take up to 100 mg Librium per day which is about 3 mg Xanax. Its active metabolite is desmethyldiazepam which is a partial agonist at the GABAA benzodiazepine receptor so it's not as harsh. Your pdoc may really go for that. Tranxene is another oldie but a goodie. It's another long-acting benzo. It's more potent than Librium for sure! It's nice, very smooth as its active metabolite is the same as Librium's, desmethyldiazepam. 15 mg = 1 mg Xanax, and you can take up to 60-90 mg/day depending (4-6 mg Xanax). Do be sure to mention that Its active metabolite, desmethyldiazepam, is a partial agonist at the GABAA benzodiazepine receptor, so it's not quite as harsh. Your pdoc may really go for that... 1 Link to comment Share on other sites More sharing options...
looking for answers Posted January 14, 2019 Share Posted January 14, 2019 15 hours ago, DammitJanet said: Pdoc let me have it 5 years ago, said under condition she’d never raise the dose (1mg). Well, tolerance has built...I’m having withdrawals every day all day...need to switch. I know both diazepam and clonazepam have both caused my depression to worsen, but at this point, not sure what else to do. What are the benefits to each of these if anyone has an opinion? i see her next Monday and need to be decided so I can be as assertive and assured as possible. I think when I tried diazepam it may have negated the benefits of vyvanse, not totally positive. Guess I’ll try it once more tomorrow since I have a bunch left. I’m terrified she’s gonna force Ativan which makes me really feel moody. SOrry to hear that the xanax has pooped out on you. Im sorry i didnt read all the replies. So just gonna tell you my experience as it relates to you. I have been on some benzo for god since i was 17 and im 34 now. Ive been on xanax, ativan, clonazapem, valium. Each has their own "feel" mechanism of action. I truly think xanax was the most effective, but didnt last long enough, xanax XR was great. For me xanax-kicked in quick, worked great, didnt last long enough valium-groggy, not the best overall anxiety relief, but it was a long time ago TBH Xanax XR-potent shit, and lasted long, almost too long. Clonazapem-Switched to this when i was horrid. to give longer relief, i went from doing most benzos 1 x day at a low dose to this 2x day at 1mg. It worked pretty good initially, but quick tolerance. ive weaned back to 1x day. Then only at night to assist with sleep. Ill be honest i dont feel a thing on it. That happened pretty quick for me What helped my anxiety more than anything was stimulants, especially vyvanse. My anxiety was crippling. 2 Link to comment Share on other sites More sharing options...
mikl_pls Posted January 14, 2019 Share Posted January 14, 2019 There's also Serax (oxazepam). It's a short-acting stimulant, but it's very good for anxious depression. It's an active metabolite of Valium, and produces no active metabolites itself, so it's very, very clean. It does take a little while to take effect, but once it does, it's very soothing and has a bit of an antidepressant effect for me. 30 mg = 1 mg Xanax, and you can take up to 120 mg/day (4 mg Xanax). I would take Serax too if my pdoc would let me have two different benzos. 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 3 minutes ago, mikl_pls said: Klonopin is actually twice as potent as Xanax, so 0.5 mg Klonopin = 1 mg Xanax. I think Klonopin would be a good idea barring that it doesn't worsen her depression. If not, Librium and Tranxene are good options. Librium is the first benzo to be invented and is SUPER long-acting. Not very potent though. A 25 mg capsule = about 0.75 mg Xanax, but you can take up to 100 mg Librium per day which is about 3 mg Xanax. Its active metabolite is desmethyldiazepam which is a partial agonist at the GABAA benzodiazepine receptor so it's not as harsh. Your pdoc may really go for that. Tranxene is another oldie but a goodie. It's another long-acting benzo. It's more potent than Librium for sure! It's nice, very smooth as its active metabolite is the same as Librium's, desmethyldiazepam. 15 mg = 1 mg Xanax, and you can take up to 60-90 mg/day depending (4-6 mg Xanax). Do be sure to mention that Its active metabolite, desmethyldiazepam, is a partial agonist at the GABAA benzodiazepine receptor, so it's not quite as harsh. Your pdoc may really go for that... Thanks for all that info Michael! I’m gonna give that a shot with her. 1 Link to comment Share on other sites More sharing options...
looking for answers Posted January 14, 2019 Share Posted January 14, 2019 if you like xanax, and its "feel" and are comfortable with your doc, i suggst 1mg Xanax XR Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 One other key thing that worries me is the benzo being so strong that it negates the entire effect of the vyvanse. 1 minute ago, looking for answers said: if you like xanax, and its "feel" and are comfortable with your doc, i suggst 1mg Xanax XR Thanks. Is it in any way more potent than 1mg ir? Cause 1mg is now a very minimal effect. Link to comment Share on other sites More sharing options...
looking for answers Posted January 14, 2019 Share Posted January 14, 2019 Just now, DammitJanet said: One other key thing that worries me is the benzo being so strong that it negates the entire effect of the vyvanse. can always try a small jump up and see what happens, can always cut back. or switch meds after trying that. May be better to dance with the devil you know 1 Link to comment Share on other sites More sharing options...
mikl_pls Posted January 14, 2019 Share Posted January 14, 2019 14 minutes ago, DammitJanet said: One other key thing that worries me is the benzo being so strong that it negates the entire effect of the vyvanse. Thanks. Is it in any way more potent than 1mg ir? Cause 1mg is now a very minimal effect. Xanax XR to me is far, far, far weaker. 1 Link to comment Share on other sites More sharing options...
looking for answers Posted January 14, 2019 Share Posted January 14, 2019 (edited) 16 minutes ago, DammitJanet said: One other key thing that worries me is the benzo being so strong that it negates the entire effect of the vyvanse. Thanks. Is it in any way more potent than 1mg ir? Cause 1mg is now a very minimal effect. no, its the same, just lasts longer. I just assumed you were on 0.5mg. Id just bump up 0.5mg 1 minute ago, mikl_pls said: Xanax XR to me is far, far, far weaker. see to me, it was stronger, or at least the same Edited January 14, 2019 by looking for answers 1 Link to comment Share on other sites More sharing options...
mikl_pls Posted January 14, 2019 Share Posted January 14, 2019 2 minutes ago, looking for answers said: no, its the same, just lasts longer. I just assumed you were on 0.5mg. Id just bump up 0.5mg Have you taken Xanax XR @looking for answers? Link to comment Share on other sites More sharing options...
looking for answers Posted January 14, 2019 Share Posted January 14, 2019 Just now, mikl_pls said: Have you taken Xanax XR @looking for answers? I have. Like I said for me. It was very effective . It was as strong or stronger than ir. And lasted very very very very long Link to comment Share on other sites More sharing options...
mikl_pls Posted January 14, 2019 Share Posted January 14, 2019 Just now, looking for answers said: I have. Like I said for me. It was very effective . It was as strong or stronger than ir. And lasted very very very very long Wow. Must just be me then. Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 See... just took 10 of the diazepam I have leftover... and I’m still having the shallow breathing, and it indeed making it feel as though I have no stimulant in me. Sigh. This has GOT to be hormone related. Ordered progesterone from amazon. Maybe when I see my new gp next week I’ll ask for a lung workup. Link to comment Share on other sites More sharing options...
looking for answers Posted January 14, 2019 Share Posted January 14, 2019 1 minute ago, mikl_pls said: Wow. Must just be me then. Always that Ymmv plus what other meds your on at the time Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 2 hours ago, mikl_pls said: Xanax XR to me is far, far, far weaker. Which of all the other benzos you mentioned would be the least sedating do you think? i just took 10mg of left over diazepam and I’m sooooo sleepy! It’s like I didn’t take vyvanse at all. Thats why I like Xanax so much is it works so well without putting me to sleep. Link to comment Share on other sites More sharing options...
mikl_pls Posted January 14, 2019 Share Posted January 14, 2019 1 hour ago, DammitJanet said: Which of all the other benzos you mentioned would be the least sedating do you think? i just took 10mg of left over diazepam and I’m sooooo sleepy! It’s like I didn’t take vyvanse at all. Thats why I like Xanax so much is it works so well without putting me to sleep. Probably Librium or Tranxene since they are partial agonists of the benzodiazepine site of the GABAA receptor. That's just a guess. 7.5 mg Tranxene = 0.5 mg Xanax = 10-25 mg Librium (which are capsules so you can't split them) So 15 mg Tranxene = 1 mg Xanax = 20-50 mg Librium. 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 14, 2019 Author Share Posted January 14, 2019 Just now, mikl_pls said: Probably Librium or Tranxene since they are partial agonists of the benzodiazepine site of the GABAA receptor. That's just a guess. 7.5 mg Tranxene = 0.5 mg Xanax = 10-25 mg Librium (which are capsules so you can't split them) So 15 mg Tranxene = 1 mg Xanax = 20-50 mg Librium. Thanks again! 1 Link to comment Share on other sites More sharing options...
notloki Posted January 15, 2019 Share Posted January 15, 2019 Tranxene made me comfortable but not sleepy and did not sedate me. It's long acting due to the very long half life. Link to comment Share on other sites More sharing options...
Iceberg Posted January 15, 2019 Share Posted January 15, 2019 On January 14, 2019 at 11:12 AM, mikl_pls said: Wow. Must just be me then. Not just you... I take 2 mg Xr during rough patches and still that's iffy Link to comment Share on other sites More sharing options...
mikl_pls Posted January 16, 2019 Share Posted January 16, 2019 Librium and Tranxene both have the same active metabolite, which is largely responsible for their pharmacological effects: nordazepam AKA nordiazepam or desmethyldiazepam. Link to comment Share on other sites More sharing options...
l'appel du vide Posted January 16, 2019 Share Posted January 16, 2019 Klonopin has treated me well for 6 years. Never gained a tolerance to the anti-anxiety or anti-panic effects, just the sedation and loopiness. 0.25mg twice a day is enough to keep my agoraphobia away. Higher doses definitely have a negative effect on my mood....but you have to find a balance. Since Klonopin has such a long half life you'll feel very stable, you won't wake up in withdrawal or anything. I have skipped doses on accident and not noticed. 1 Link to comment Share on other sites More sharing options...
DammitJanet Posted January 16, 2019 Author Share Posted January 16, 2019 2 hours ago, l'appel du vide said: Klonopin has treated me well for 6 years. Never gained a tolerance to the anti-anxiety or anti-panic effects, just the sedation and loopiness. 0.25mg twice a day is enough to keep my agoraphobia away. Higher doses definitely have a negative effect on my mood....but you have to find a balance. Since Klonopin has such a long half life you'll feel very stable, you won't wake up in withdrawal or anything. I have skipped doses on accident and not noticed. Yeah I’ve been on klonopin and it was too sedating for me even at low dose I felt too drugged. For now I’ve decided to try diazepam again for a bit. Thanks for your response! Link to comment Share on other sites More sharing options...
Persona_Is_Life Posted January 25, 2019 Share Posted January 25, 2019 I noticed no one here has mentioned Ativan. It might be another option! 1 Link to comment Share on other sites More sharing options...
notloki Posted January 25, 2019 Share Posted January 25, 2019 Yes, Ativan is just as fast, coming on, as Xanax. I take it for breakthrough anxiety as needed and take 1 mg Klonopin every day. I prefer Ativan to Xanax. Ativan is very useful, I use it for sleeping if I am out of Lunesta, anxiety, prophylaxis against seizures or to break a seizure, and it has some GI settling and calming effects. It does not have the kick of Xanax but it controls anxiety just as quickly. I've grown used to the sedating effects so I don't notice anything taking 1 mg, except my anxiety going away. Link to comment Share on other sites More sharing options...
DammitJanet Posted January 25, 2019 Author Share Posted January 25, 2019 (edited) 8 hours ago, Persona_Is_Life said: I noticed no one here has mentioned Ativan. It might be another option! Unfortunately, that one also messes with my mood. I’ve decided to stay with Xanax for now. Thanks for the idea though! Edited January 25, 2019 by DammitJanet Link to comment Share on other sites More sharing options...
Bigtimer Posted September 2, 2019 Share Posted September 2, 2019 @DammitJanet can I ask why your doc is so anti benzo? Is it because you are on a stimulant? Link to comment Share on other sites More sharing options...
DammitJanet Posted September 2, 2019 Author Share Posted September 2, 2019 19 hours ago, Bigtimer said: @DammitJanet can I ask why your doc is so anti benzo? Is it because you are on a stimulant? This is from January. My doc isn’t anti-benzo. Like I said she warned me from the beginning she’d never increase xanax past 1mg. I knew that going in. I’m now on 1.5. If my doc were anti-benzo, I wouldn’t be able to explain why. Docs all have their things. Link to comment Share on other sites More sharing options...
Bigtimer Posted September 2, 2019 Share Posted September 2, 2019 Yeah...do you think she’d go higher? and can I ask, what feeling do you get from taking your xanax? If you can be really specific I’d appreciate it..thanks Link to comment Share on other sites More sharing options...
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