Aynone on anxiety meds: some questions

In My Humble Opinion
1

So my doctor put me on klonopin. I hated it. It made me dizzy and nauseated and so tired that I couldn’t do anything. I was miserable all the time. So I went back the other day for a follow-up and he seemed really confused about the whole thing. His reaction to my demanding that he take me off klonopin (because asking didn’t work and I wasn’t going to leave there with another klonopin prescription) was to suggest taking me off anxiety meds entirely. Bad idea, I said. Can’t you just give me something else? He stared at me. “… like what?” “I don’t know, there are a million different things out there.” I had researched, but the only one I could come up with at the time was xanax. But he was all “I don’t like xanax” and that was that. So he put me on ativan. Which… is worse. With the klonopin, I was at least semi-functional. I could take my zombie ass to the grocery store in the evening, do adoption events which involved mostly sitting down, stuff like that. On the Ativan, all I can do is sleep or lie around feeling miserable. It’s horrible.

But… not every medication can be like this, right? Lots of people with anxiety disorders can function with their medication. So I want to know
What are you on?
How bad are the side effects?
Does it fog up your brain? Make you too tired to work?
Do you take it as-needed or just every day?
Do you find it helps?
And anything else you can think of. I just need a better handle on what’s out there next time I see this guy.

2

It’s my understanding that klonopin is one of the anti anxiety medications that has the least amount of “fogginess” associated with it.
I take a medication that initially made me feel very loopy and tired. I felt barely able to function and considered going off of it. But, it works to alleviate my issues, and, so I stuck it out. By a month in, I no longer experienced the side effects. Could you give it some time? Especially if it’s working to alleviate your anxiety. The tiredness and fogginess may dissipate and/or disappear altogether.

3

Ditto this. It’s always harder in the beginning. Do you take it at night? The best anxiety med for me is Risperdal, just a small amount before bed because it’s powerful stuff. Then I take Atavan as needed, maybe once or twice a month.

I think it’s weird your doctor didn’t give you options. Is this a GP? I don’t trust GPs to prescribe psychotropics. You need a good shrink.

4

Sorry - I said Atavan, I meant Xanax.

5

I’ve recently been put on anti-anxiety medication (citalopram), and it took a few weeks for the dizziness to fade. I didn’t get nausea, but a friend who’s also on it did, and it took a few weeks for it to fade in his case. You should give it at least a month before deciding it’s unbearable.

6

I’ve been on the four most popular benzos for anxiety at some time or another. I would rank their effectiveness in order as Xanax, Valium, Klonopin, Ativan.

I hopped from one to another because I was finding them not nearly as effective as I wanted them to be, luckily I finally landed on Xanax and there is no reason to look back, because it works great.

Everyone responds to these meds differently so your order could well be very different from mine. I have to take mine as needed basically because Xanax works for the shortest amount of time out of those four, so I have to pick and choose the times when I really need it.

As for the side effects, I never really got any of the ones you describe. Maybe a little light headedness sometimes, but nothing all that bad. If the drugs are hurting you that much then it’s reasonable to assume that any of those in that drug class would carry these side effects for you. Hopefully not and it’s still worth a try to find the drug that truly works for you. You may need to try something entirely different though, like say Paxil, which has to build up in your system over time but can work very well for anxiety.

7

One reason a lot of docs don’t like to prescribe Xanax is because it has a short half life and therefore it is regarded as easier to abuse in comparison to klonopin. In many cases, benzos like Xanax and klonopin are meant to be short term treatments for anxiety to make it tolerable while waiting for the SSRI or therapy to help, not something you stay on forever.
I agree with the suggestion to see if you can get a referral to a psychiatrist, if you’re getting these meds from a primary care doc (which is what it sounds like - sounds like the doc isn’t very comfortable treating anxiety, or I’d expect he would have had more ideas about what else you can try).

8

The general rule is: Xanax is the “strongest” in that it hits you fastest. Klonopin is in the middle. Ativan is less so. YMMV. Valium isn’t prescribed much anymore but it stays with you for a long, long time.

Yeah, I don’t recommend taking benzos on a daily basis. Withdrawal from them is bad. Something like an SSRI might help, paired with a benzo if you have an attack or expect to be in a high-anxiety situation.

Risperdal: it’s an antipsychotic technically, if that turns you off. You don’t need to be psychotic to have a good reason to take it. I got off it precisely because it caused fogginess and didn’t want to fall asleep at the wheel. Although maybe olive’s before bed thing might be a good idea; it’s been at least 10 years so I don’t remember what I did.

ETA: didn’t see CyclopticXander’s line about comparative effectiveness, but we sad similar things. Whew.

9

I was on Paxil for about two weeks ten years ago. It was enough to convince me to stop taking psychiatric drugs in general, and realize I am not a good candidate for addiction to psychoactive drugs.

It pretty much shut my sense of urgency if not my sense of time. I didn’t remember to eat; I couldn’t keep a schedule. Anti-anxiety? OK, sure; I’d say, anti-functionality in general.

And of course it’s an SSRI, so sexual response is altered. That’s it’s own level of weird.
(If a drug makes you anti-orgasmic, don’t try masturbating to orgasm just to see if you can. Ow. I think I tore something. Really.)

10

Thirded that you find a shrink. Or if this doc is already a shrink and he’s asking you for advice about meds, you should go find a different shrink post-haste. A psychiatrist is all about these kinds of meds, and you absolutely want someone who knows what they’re doing. Not that all shrinks are good shrinks; be prepared to shop around.

11

What are you on? Currently, Xanax plus an anti-depressant.

How bad are the side effects? Zero. None. Nada. It is the ONLY anti-anxiety med that has worked for me and it has worked for over 20 years.

Does it fog up your brain? Make you too tired to work? No.

Do you take it as-needed or just every day? Both. Right now I’m back in the everyday groove, but I’m going through a particularly bad spell and it helps SO much.

Do you find it helps? Abso-fucking-lutely.

P.S. I was prescribed Klonopin after having a minor manic episode a couple of years ago. It helped at the time but I will tell you that trying to get off that medication was the WORST experience I have EVER had in my life. It was hell on earth. I would caution anyone that is on it to make sure that their psychiatrist prescribe a very, very slow withdrawal period if they even want to attempt that one.

P.P.S. Valium doesn’t do a thing for me!

12

So you can come off the Xanax with no real withdrawal problems?

13

There are always exceptions, but the problem is there are risks as well, for every success story with Xanax there are unfortunately many other poor outcomes. For too many people the more likely outcome is going from an anxiety disorder to an anxiety disorder and a substance abuse problem.

The reason that longer lasting benzoes are generally prescribed is to make its use ‘flatter’ and less directly connected to whatever stressors are increasing anxiety Taking a pill as one approaches a panic attack or stressful situation unfortunately tends to act as a strong cognitive reinforcer, making that issue more fearful and more important to avoid over time.

14

That is temporary. You will find you will need more and more for the same relief. I went from .75mg per day to 7mg per day in two years. It was a holy bitch to detox from.

15

Yes this is what I am thinking too. Aren’t benzos typically used for short-term bouts of anxiety? Using them daily for extended periods of time would seem to be ill-advised due to the dependence risk they pose-especially a shorter-lasting one like Xanax.

16

I think it would have been a bitch if I had followed my doctor’s advice and just quit cold-turkey. My fears about withdrawal were dismissed, but I don’t fool around. After almost a year of tapering (yes, I know that sounds like a crazy long time, but it’s flown by uneventfully), I’m off the stuff safe and sound. Maybe the doctor was right all along and I didn’t need to be so cautious, but why take chances?

Some doctors probably don’t think it’s a big deal to get addicted to klonopin since it’s pretty tame as far as side-effects go. But addiction is still addiction. Being addicted to anything can ruin your life.

17

I’ve taken Xanax, Klonopin, Ativan, and Valium. By a slim margin, Ativan works best for me. I’ve never experienced more than mild fogginess as a side effect and only then when I took it without probably needing it.

Wanted to let you in on something completely different from benzos that does me a lot of good. There is an antihistamine called hydroxyzizine, a.k.a. "Atarax, that has an off-label use for anxiety. It works for me. Could be worth looking into.

Best of luck.

18

Thanks for the info and suggestions, guys. This is indeed a psychiatrist and not a GP who is prescribing these meds. I’m not a big fan of his and am trying to find somebody better. I’m also on celexa and it seems to be helping a bit. I still get panic attacks at work and at night and have this little jingly thing I carry to keep from scratching compulsively (which has gotten a LOT better than it was). I’ll keep on with the ativan for a while (have tried atarax- my roommate was prescribed it and didn’t take much of it, so I used it in moments of desperation. It didn’t seem to have much of an effect)

I’m just frustrated and would like to be fixed now, please.

19

Klonopin survivor here.

It worked very well for me, for some length of time.

Until it didn’t.

The benzodiazepines, as a whole class, are DRUGS FROM HELL. Apparently, more doctors are gradually beginning to learn that. They work very nicely, make you feel much better, and then when you aren’t looking THEY SNARE YOU. Here’s a web site that all benzo users should see. Dr. Heather Ashton, whose paper on benzo withdrawal is posted there, ran a benzo detox clinic for a dozen years or so.

By most accounts I’ve read, benzos are best used (if at all) only for very short periods of time, or for very occasional use as needed. They may be very helpful when used that way. But with on-going regular use, people tend to get habituated quickly, so that it takes more and more, as Fear Itself noted several posts above. And you get physically dependent on it. It can be a REAL FCKING BITCH to quit – some say it’s tougher to kick than heroin. I personally don’t have the experience to make that comparison, but I can testify to this: Klonopin withdrawal is a REAL BITCH FER SURE!

And here’s what’s worse: For some people, for unknown reasons, the withdrawal symptoms (which are nasty) can persist for months or years! In my own case, it took 14 - 16 really awful months, and even after that I didn’t really feel quite right.

Xanax is said to be faster-acting, faster-wearing-off, for short-term action only (like, all within a few hours). And if you use it regularly for sustained effect, it is said to be much more horribly addicting than even Klonopin. The general rule seems to be: The shorter the half-life (Xanax is very short), the worse. Valium, in contrast, has a much longer half-life and is reputed to be the least addictive – but it has its own problems, for some users.

For people with REALLY serious anxiety problems, panic attacks, and the like, I don’t know what to tell you (and your doctor doesn’t really know either). Benzos, for all the short-term good they might do for some people, in the longer run they are one [del]cure[/del] curse that’s seriously worse than the disease.

20

If they’re knocking you out…maybe you don’t need them?

Or maybe you could do with citalopram or something. Not benzos.