anti depressant vs. benzo for anxiety

[relaxation001]

So... I cannot take any type of anti depressant as the side effects are horrible for me that never go away - just get worse. Last one landed me in the ER. So, Dr. has me on xanax. I hope I can keep this GP Dr. for a long, long time because I know a lot of Dr.'s would not do this. He does what is best for me and daily living. So I understand that benzos are addictive but so are AD's. And some of those AD's have horrible withdrawals. So why are some people so against choosing a benzo over an AD?? Same sort of taper to come off and AD's do stop working over time. Could be 5 years, could be 10. Same with the benzos.

 

[Rafayte]

You can take amytriptiline which is an antidepressant with sedative effects whose too helps you to sleep. For avoid the side effects start with a very low dose and get it up very slowly

 

[Keif' Richards]

So... I cannot take any type of anti depressant as the side effects are horrible for me that never go away - just get worse. Last one landed me in the ER. So, Dr. has me on xanax. I hope I can keep this GP Dr. for a long, long time because I know a lot of Dr.'s would not do this. He does what is best for me and daily living. So I understand that benzos are addictive but so are AD's. And some of those AD's have horrible withdrawals. So why are some people so against choosing a benzo over an AD?? Same sort of taper to come off and AD's do stop working over time. Could be 5 years, could be 10. Same with the benzos.

Why hello! I didn't see you standing there relaxation001. You snuck up on me. This time, you skate free... next time, I harvest your body for the exogenous Opioids it contains, as my understanding of biochemistry is such that this sort of thing is possible.

Now, down to business. Please be aware that throughout this explanation, I am in no way trying to patronize you. In fact, my knowledge of and experience with drugs is not something to be proud of (outside of application to HR principles yay! ). For your own good, I need to start by saying that your rationalization of BZD use is already leading you in a bad direction. I am assuming you've never been through a bout of BZD withdrawal, but correct me if I'm wrong. It is a nightmare hellscape in which no happiness, joy or relief may exist. It's very, very bad.

"Antidepressant" means whatever the prescribing doctor says it means. One could be prescribed 40mg Fluoxetine (Prozac)/day for erectile dysfunction. He's not taking an antidepressant, he's taking ED medication. My point is that there is a definite grey area and off-label prescribing is a hallmark of many antidepressants. I'm assuming you've been through SSRI withdrawal. SSRI withdrawal can be shitty, but it is a leisurely walk through the park compared to BZD withdrawal.

Cracks are already forming in your plans by the way. You say you really want to keep this prescriber because he writes you for Alprazolam (Xanax). The problem is that Benzodiazepines are not meant to be prescribed for long-term use outside of special circumstances. This isn't my opinion. Also, if we're using the same nomenclature, which I think we are, antidepressant medications are not addictive. BZD's and AD's are not even comparable.

In general when someone is prescribed BZD's for the first time, they realize everything they've been missing in life. They should say hi to that cute girl in the cube next to you. You're going to walk up to your boss who normally intimidates you and you're gonna tell him you want a raise. Your bills are all overdue? No sweat, you'll figure it all out, right? It's much like how new users of Amphetamine "realize who they truly are" after taking a pill. It's a major pitfall and I say this not to degrade you but to hopefully enlighten you:

Unlike certain other psychiatric drugs, the SSRI/SNRI drugs, usually require some time before noticeable effects present; at least a few days, but generally a couple of weeks. When you take a BZD, you are experiencing instantly, the full impact of that drug. It is exerting all of its effects until it wears off. You can probably understand why someone who has been attempting SSRI therapy with little success might discover Benzodiazepines to be their own personal wonder drug; that key that fits; that one attribute that they had been lacking their whole lives

BZD's are powerful sedatives/anxiolytics/muscle relaxers and more. They are highly addictive because they are highly effective at just what they claim to be. It's not a "maybe it will work, give it a shot" it's a "I have 90% confidence that this drug will arrest anxiety as soon as it is taken". They work well and much like how Opioids are the silver bullet that kills pain, Benzodiazepines are equally effective at halting anxiety.

First off, if this prescriber does care first and foremost about your health, he/she will not be prescribing you Benzodiazepines for very long. The clinical indications are clear and ~6 weeks of daily use is considered to be the maximum before cost begins to outweigh benefit.

I'll put it bluntly, on paper, everything you're saying makes sense, but if I may channel Freud, I think you might be referring to antidepressants as addictive in the hopes that you can rationalize taking Benzodiazepines. They really are not comparable. I do believe that someone who has never experienced withdrawal from drugs might thing SSRI withdrawal is "terrible", but in life, all things are relative.

There's not a lot of room for comparison. Benzodiazepines are not the "answer" in any genuine psychiatric practice, they are only part of an equation. The idea is that the sedatives might give the user the necessary time to collect themselves and engage in intensive therapy, because once the drugs run out, they're gone. I and everyone else here cares for you and can empathize with your situation. We don't want you to end up completely dependent upon BZD's and have your life struggle shift to the daily procurement of illicit Benzodiazepines.

I have rambled considerably, my apologies. Please, don't take BZD's, feel better and do no further work on yourself, otherwise, you've really just wasted time.

Most of this was totally subjective. Take it all with a grain of salt please guys.

 

[JustBlaze420]

Why hello! I didn't see you standing there relaxation001. You snuck up on me. This time, you skate free... next time, I harvest your body for the exogenous Opioids it contains, as my understanding of biochemistry is such that this sort of thing is possible.

Now, down to business. Please be aware that throughout this explanation, I am in no way trying to patronize you. In fact, my knowledge of and experience with drugs is not something to be proud of (outside of application to HR principles yay! ). For your own good, I need to start by saying that your rationalization of BZD use is already leading you in a bad direction. I am assuming you've never been through a bout of BZD withdrawal, but correct me if I'm wrong. It is a nightmare hellscape in which no happiness, joy or relief may exist. It's very, very bad.

"Antidepressant" means whatever the prescribing doctor says it means. One could be prescribed 40mg Fluoxetine (Prozac)/day for erectile dysfunction. He's not taking an antidepressant, he's taking ED medication. My point is that there is a definite grey area and off-label prescribing is a hallmark of many antidepressants. I'm assuming you've been through SSRI withdrawal. SSRI withdrawal can be shitty, but it is a leisurely walk through the park compared to BZD withdrawal.

Cracks are already forming in your plans by the way. You say you really want to keep this prescriber because he writes you for Alprazolam (Xanax). The problem is that Benzodiazepines are not meant to be prescribed for long-term use outside of special circumstances. This isn't my opinion. Also, if we're using the same nomenclature, which I think we are, antidepressant medications are not addictive. BZD's and AD's are not even comparable.

In general when someone is prescribed BZD's for the first time, they realize everything they've been missing in life. They should say hi to that cute girl in the cube next to you. You're going to walk up to your boss who normally intimidates you and you're gonna tell him you want a raise. Your bills are all overdue? No sweat, you'll figure it all out, right? It's much like how new users of Amphetamine "realize who they truly are" after taking a pill. It's a major pitfall and I say this not to degrade you but to hopefully enlighten you:

Unlike certain other psychiatric drugs, the SSRI/SNRI drugs, usually require some time before noticeable effects present; at least a few days, but generally a couple of weeks. When you take a BZD, you are experiencing instantly, the full impact of that drug. It is exerting all of its effects until it wears off. You can probably understand why someone who has been attempting SSRI therapy with little success might discover Benzodiazepines to be their own personal wonder drug; that key that fits; that one attribute that they had been lacking their whole lives

BZD's are powerful sedatives/anxiolytics/muscle relaxers and more. They are highly addictive because they are highly effective at just what they claim to be. It's not a "maybe it will work, give it a shot" it's a "I have 90% confidence that this drug will arrest anxiety as soon as it is taken". They work well and much like how Opioids are the silver bullet that kills pain, Benzodiazepines are equally effective at halting anxiety.

First off, if this prescriber does care first and foremost about your health, he/she will not be prescribing you Benzodiazepines for very long. The clinical indications are clear and ~6 weeks of daily use is considered to be the maximum before cost begins to outweigh benefit.

I'll put it bluntly, on paper, everything you're saying makes sense, but if I may channel Freud, I think you might be referring to antidepressants as addictive in the hopes that you can rationalize taking Benzodiazepines. They really are not comparable. I do believe that someone who has never experienced withdrawal from drugs might thing SSRI withdrawal is "terrible", but in life, all things are relative.

There's not a lot of room for comparison. Benzodiazepines are not the "answer" in any genuine psychiatric practice, they are only part of an equation. The idea is that the sedatives might give the user the necessary time to collect themselves and engage in intensive therapy, because once the drugs run out, they're gone. I and everyone else here cares for you and can empathize with your situation. We don't want you to end up completely dependent upon BZD's and have your life struggle shift to the daily procurement of illicit Benzodiazepines.

I have rambled considerably, my apologies. Please, don't take BZD's, feel better and do no further work on yourself, otherwise, you've really just wasted time.

Most of this was totally subjective. Take it all with a grain of salt please guys.

this post might of just inadvertently saved my life, thank you.

and to answer the op , proper diet and exercise is the only answer for people like us, it might be a hard grind but you gotta do it.

 

[zephyr]

^ That post is absolute gold!

 

[MrRoot]

Keif’s post is nearly better than zephyr’s ass which is much to say. It should be made made publicly available to some place so everyone can enjoy it (the post, not zephyr’s ass).

I would add to the post that BZDs could be useful when used for a short period of time while waiting for anti-depressants to start working properly.

 

[bindingaffinity]

For what it's worth, some other observations on non-benzodiazepine treatments as a long-term anxiety patient:
- fluoxetine is very mild and easy to taper off of. I've done it twice with no withdrawal symptoms, from 40mg/day all the way to 0 (stepping through 30, 20, and 10 on the way). If you're worried about discontinuation effects, venlafaxine and paroxetine are ones to avoid. However, none of the traditional antidepressants (with the possible exception of atypical ones like tianeptine) are addictive in the same psychological way that benzodiazepines can be.
- mirtazapine is a good alternative if you need a sedative/hypnotic. It has long-term anxiolytic effects like an SSRI. Some people such as myself are very sensitive to the sedative effects, so YMMV.
- talk therapy is actually really, really good. It takes time, and patience, and can take a lot of work to find a therapist and treatment modality that works for you. CBT is aces but I've been doing psychodynamic therapy for the past 2 years and it's been working great as well. Support groups could also be another great option if that appeals to you. From the literature I've read, exact therapeutic method doesn't make that much of a difference in generalized anxiety and depression, as long as the therapist is good and rapport between the patient and therapist is present. Meds can get you past the most incapacitating effects of anxiety and/or depression, but therapy actually gives you the tools to make positive changes in your life that break the cycles that increase and reinforce anxiety and depression.
- get enough sun, and see your primary care doctor for regular checkups. I have thyroid disease, and overly high or low levels of thyroid hormone can cause me to swing much more towards the excess anxiety or excess lethargy ends of the emotional pendulum. You'd also be surprised how much things like vitamin deficiency can affect mood and anxiety levels.

Upping the Care on Downers is an interesting recent review of the evidence for benzodiazepines and their alternatives.

 

[mal3volent]

First off, if this prescriber does care first and foremost about your health, he/she will not be prescribing you Benzodiazepines for very long.

Can you elaborate on this? You said to take it all with a grain of salt, so I was just wondering. Wouldn't it depend drastically on which benzo and the dosage?

 

[Rafayte]

I think alprazolam is the best drug for anxiety in a dose of 1-2mg followed by clonazepam 0'5-2mg. In antidepressants tianeptine is that more works for anxiety followed by tryciclics. Benzos are better for a instantly anxiolytic answer and for take it only one time a week maximum but to take daily better tianeptine 12'5mg three times a day or amytriptiline because of benzos taked daily during three weeks cause dependence while antidepressant cause a bit of dependence but are much less addictive