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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by krybrahaha78 on March 9, 2005, at 20:35:30
it always seems that the first choice of a benzo if a doc is gonna prescribe one is almost always Klonopin, has anyone else noticed this? When i first started seeing my P-doc, that was his first choice, now my family doctor prescribed it to me. Is Klonopin just that more superior than the others or something?
Posted by Colleen D. on March 9, 2005, at 20:42:12
In reply to why is klonopin always first choice for benzo, posted by krybrahaha78 on March 9, 2005, at 20:35:30
by MICHAEL F. GLIATTO, M.D.
Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvaniathat says:
"Use of benzodiazepines in therapeutic dosages does not lead to abuse, and addiction is rare. The benzodiazepines most likely to be abused are those that are rapidly absorbed such as diazepam, lorazepam (Ativan) and alprazolam (Xanax). Alprazolam should be prescribed only for patients with panic disorder. When abused, benzodiazepines are usually abused with other substances, particularly opiates. The patients most likely to abuse benzodiazepines are those who have a previous history of alcohol or drug abuse, and those with a personality disorder."
Here's a link:
http://www.aafp.org/afp/20001001/1591.htmlSo I guess it makes sense. Klonopin is less risky for the doc to prescribe!?!
Colleen
Posted by med_empowered on March 9, 2005, at 20:53:19
In reply to I just read an article on GAD... » krybrahaha78, posted by Colleen D. on March 9, 2005, at 20:42:12
hey! Well, there is the whole problem with "abuse" of benzos, especially short-acting ones. (Just from what I've seen, some people who "abuse" benzos are actually just trying to get relief from severe, debilitating anxiety--with benzos that have short half-lives, there seems to be an additional problem with the drug wearing off quickly). In addition, drugs wax and wane in terms of popularity among docs, and this is definitely true of the benzos. For a long time, Valium was the undisputed benzo champion; then came Xanax and Ativan, which for a while dominated the field. Now, psychiatrists have switched back into MANAGING chronic anxiety rather than TREATING EXTREME EPISODES. So, now, shrinks will RX Klonopin at fixed rates for daily use instead of RX'ing a bottle of Ativan for "as needed" use. Klonopin is also a good choice because there isn't much drug-induced euphoria (Xanax has a reputation for this), its CHEAP (developed in the 1970s for seizures, so its available as a generic), and the sedative effects seem to wear off quickly, so there may be less drug-induced impairment. From a personal perspective, Klonopin is also great b/c it provides long-lasting relief of the first rumblings of mania (racing thoughts, increased anxiety, etc.). Other benzos can also do this, but they tend not to last very long so re-dosing is a problem. Also, since Klonopin only has to be taken 2-3 X daily, its easier to remember to take it, so you don't have those "where the hell is my xanax!?!?" moments.
Posted by krybrahaha78 on March 9, 2005, at 21:04:13
In reply to Re: I just read an article on GAD..., posted by med_empowered on March 9, 2005, at 20:53:19
i agree. Klonopin is an awesome drug, i prefer Tranxene though, but klonopin works. I only take it as needed though.
Posted by Phillipa on March 9, 2005, at 22:20:31
In reply to Re: I just read an article on GAD..., posted by krybrahaha78 on March 9, 2005, at 21:04:13
I really don't think thats true in all cases. I've been on xanax, ativan, valium, and klonopin. I never abused the short-acting benzos, I usually made the pdoc mad cause I wouldn't take higher doses. I like my 2x daily dose of valium. It does the trick for me. Klonopin made me feel stupid. Fondly, Phillipa
Posted by med_empowered on March 9, 2005, at 23:21:26
In reply to Re: I just read an article on GAD..., posted by Phillipa on March 9, 2005, at 22:20:31
Hey! I didn't mean to imply that ALL or even MOST people on short-acting benzos "abuse" them. Overall, benzos have gotten a bad rep for abuse that is totally out-of-line with the real rates of abuse and ignores the therapeutic potential of benzos. However, when benzo abuse occurs, it seems to happen more often with short-acting ones--especially xanax--than with longer-acting ones. That said, I'd kind of like to know what constitutes "abuse" of benzos and other RX drugs. If a person has extreme anxiety and can't leave their house, and takes an extra xanax or two so they can go out the door to work, is that considered "abuse" ? (if so, WHY?) Obviously, if someone grinds up huge amounts of their RX'd benzo and snorts it (more common with stimulants, but I've seen it happen with benzos), that is abuse.
Posted by partlycloudy on March 10, 2005, at 10:58:50
In reply to Re: I just read an article on GAD..., posted by med_empowered on March 9, 2005, at 23:21:26
Hi, I'm on a low dose of Cymbalta (30mg) due to its effect on my blood pressure. My anxiety is omnipresent (I have a call in to p-doc) and don't care for the .5mg of xanax I've been prescribed because when that stuff wears off, you better have another pill handy or it's misery. As it is the xanax gives me about 3 hours of relief and then I'm back where I started. I am a non-active alcoholic and so abuse issues are always a concern to me. Having one addiction is enough, thank you! We've tried Vistaril and Buspar, with no success.
Is it likely my p-doc would go for Klonopin for my GAD?
pc
Posted by gadman on March 10, 2005, at 10:59:53
In reply to Re: I just read an article on GAD..., posted by med_empowered on March 9, 2005, at 23:21:26
I personally have a history of alcohol abuse and was extremely worried when the Doc prescribed Xanax for my Anxiety attacks.
I was so fearful I might get hooked, I use to wait Til night just to take it it feel relief. I would be counting the hours before bed time....
To be honest with you, I never found Xanax to be "buzzing" and I never had any desire to abuse it.
Since my Effexor kicked in, I have not had a need to take it during the day, and have never had the desire. I still take a small amount at night, for sleep...
So, I am not sure why people make-over Xanax so much in the abuse arena.
gadman
Posted by ed_uk on March 10, 2005, at 11:11:56
In reply to Re: I just read an article on GAD..., posted by gadman on March 10, 2005, at 10:59:53
Hello,
IMO, benzos are very boring compared with alcohol.
Ed.
Posted by invisiblemanpa on March 10, 2005, at 11:31:19
In reply to Re: I just read an article on GAD..., posted by med_empowered on March 9, 2005, at 20:53:19
You are all absolutely right.......I loved the quick fix and almost alcohol feel of Xanax.....I admitted myself into the drug ward to get it out of my system when I realized what it was doing to me...and ativan...helped....but wore off to quickly and I was always waiting...counting the hours.....Klonopin.....has been great......I feel no need to take more....often hold off on taking the first dose....it IS a much smother and safer ride........for those of us with severe anxiety....short term...there is nothing wrong with Xanax...as it does work great......
E
Posted by FredPotter on March 10, 2005, at 13:59:30
In reply to Re: I just read an article on GAD..., posted by gadman on March 10, 2005, at 10:59:53
Nor me. I don't get a buzz. As I see it, if you get hooked on Xanax it doesn't really matter anyway as it doesn't do you any harm. Getting hooked on alcohol is a different matter
Posted by partlycloudy on March 10, 2005, at 14:58:17
In reply to Re: I just read an article on GAD... » gadman, posted by FredPotter on March 10, 2005, at 13:59:30
Well, in the midst of this discussion my p-doc has called in a prescription for Klonopin for my GAD since I whined about Xanax helping with panic attacks but not the day-long anxiety I experience.
I liked Effexor for my depression and anxiety; I was on it for about a year, but it eventually raised my blood pressure. We then switched to Cymbalta, and after getting up to 90mg/day, the BP went up again, so I'm down to 30mg/day, which left my anxiety blaring away.
pc
Posted by gadman on March 10, 2005, at 15:09:46
In reply to Re: I just read an article on GAD..., posted by partlycloudy on March 10, 2005, at 14:58:17
Yep... I tried Cymbalta and it did not work near as well as Effexor.
Posted by invisiblemanpa on March 10, 2005, at 15:27:14
In reply to Re: I just read an article on GAD... » partlycloudy, posted by gadman on March 10, 2005, at 15:09:46
I agree......I did tried Cymbalta for a month and was not happy at all...I did have some success with Effexor for about a year.....and as far as the benzos work....yes they are addicting, so is Effexor...so are many other meds...I think they have gotten a bum rap...recently during a forced switch of psy docs because of insurance bs, I had to try three different drs. to finally find one that did not care about using benzos..to a point of course...he said he only wanted his patient to feel better and to be able to function....so I really think it depends on the individual and the meds...some people can take xanax for years and stay on the same dose....I maybe could of, but going through a bitter divorce, loosing the shirt off of my back, then my career...well kinda pushed me over the edge........early on xanax really helped me with socail anxiety......but the klonopin helps great to.....
e
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