On Clonazepam(Rivotril) and Valium Should I transfer to Xanax(Alprazolam)? +methadone

[BennyZoMGS]

Hey,
I've had panic attacks and been an former opiate user which now I've been on methadone for about 3-4 years and am going down. My psychiatrist when i was at over 100mgs of methadone had me on an SSRI 20 mgs citalopram, then for my insomnia tried introducing trazodone or mirtazepine, which both gave me dizziness when getting up the next day or being too groggy then when i'd take my valium(generic at the time) I'd fall asleep during the day instead of just takign away my panic attacks. I also had ADHD which he put me on ritalin. I myself stopped taking the ritalin over the last year, I'm coming down from my methadone (at 58mgs now) and instead i learned that the valium 10Mgs at night would work better for sleep then any of the sleep meds he gave me i basically stopped my ssri also he claimed i had GAD butmy life got busy and i told him its just panic attacks i'm not constantly worried but i do get attacks big ones 2-3 times a day. so now After getting of all those i seen him this last week, and i told him that I'm just on the Valium an Id want it to be brand name (which by the way makes a huuuuuge difference) and then i told him in my past my doctor for 17 yrs when i was 17 and first got panic attacks (12 years ago he put me on alprazolam can't remember the dose) then sadly he died of caner RIP. i went to another doctor he gave me 2 2mgs of clonazepams twice daily when needed. I told him all of this and his answer was to try to tweak the valium in the day that's making me fall asleep to 7.5mgs and i'm like no ive split pills 5 doesn't do a dent 10 puts me out 7.5 puts me out also. i finally got him to give me clonazepam and asked for brand name as of valium. Now i told him to give me 2 mgs cause i was on 1 mg from my last local med center and it only worked for one panic attack when somedays i get one others i get 3-4 (from weaknesses of weak - strong, weak .5 will do it strong i need 1mg of Klonipin(clonazepam). now I'm wondering I see him in 5 weeks, should i change from clonazepam 2 .5's and valium 10mgs(for insomnia at night) and ask for a higher dose of clonazepam like 2 mgs or 1.5 instead of 1. Or should i tell him it's not owrking out I should be on a benzo in the day time for my panic attacks that has a shorter halflife like a 2mg bar of xanax since I'm already taking valium everynight which has a long half life. Besides the half lifes . is it a good idea to switch from clonazepam to alprazolam with my valium (which will never change for sleep) or is clonazepam the better choice for having multiple panic attacks and i should just ask him to up it to 1.5 to 2 mgs instead of 1mg or 2 mgs of alprazolam? Please let me know your opinions, the main thing I'm asking is should i stick it out with the clonazepam (i heard if u take it everyday it will build up and with lesser amount u'll start feeling more of an effect cause of a longer halflife and build up) or should i change it to alprazolam cause of my 10mgs already having a long half life of valium. and if he only gives me 1mg of alprazolam will that be enough or should i say nevermind just keep me with the clonazepam and put me up a .5 or a mg. remember i am also on 58 mgs of methadone going down though about 3-5 mgs a month. let me know whats up sorry for the big thread need help with this. BTW my Psych is a D*CK.​

 

[Speed King]

Hey man. I'm going to try and give you my best opinion, from years of experience and I'm truthful and honest.

First, that is very great, that you are tapering down the methadone. Wonderful. Now on to your anxiety/sleep/panic attacks and what not.
If you currently have a understanding, compassionate psychotherapist, that is willing to deal with all that is you( I mean that as a compliment. I see a psych doc also) and provide you with real medicine that works, treat them like gold.
I am leading up to the switching and trying different medications.

You've been on methadone for 3-4 years and are tapering dosage down 3-5mg's a month. Great job again. Putting the work in. Very happy for you again.

Your old psychiatrist (when you were over 100mg of methadone) had tried you on 20mg citalopram. I was actually on that dose while on an amphetamine dose and the doctor cut it off, because I was manic. I loved how I felt, lol. At same time, doctor was trying trazadone or mitazepine, which left you with a bad side effect profile. I don't take them for basically the same reasons. Dizziness, being groggy when mixed with real medicine. It ended up knocking you out, instead of taking away panic attacks.
You mentioned having ADD/ADHD in which you were prescribed Ritalin. That's great that you were able to take yourself off that medicine. I hate Ritalin. Ritalin actually releases dopamine like cocaine.
Ritalin actually releases more dopamine then cocaine ( cocaine 50% and Ritalin 70% ) The only reason it's not as "popular" is due to the fact that it doesnt hit as quickly. I have felt like that song "Snowblind" by Black Sabbath. I have had a better Coke high off Ritalin.

Back to the story. You figured out that 10Mg Valim does the trick for sleep. Excellent.

You stopped your SSRI medication yourself. You are showing a lot of willpower. I am assuming that your current doctor figured and said that you had GAD( generalized anxiety disorder). You claimed that life got busy and you were having regular panic attacks. You mentioned that you(think) that you are not constantly worried, but it hits you hard, up to 2-3 times a day.

You tell your doctor that you're only taking Valium( which is much better then generic diazepam).

Your past doctor started you on alprazolam(Xanax) of an unknown strength (probably 1mg). I am sorry to hear your doctor passed away from cancer. I am a year in remission from Hodgkin's Lymphoma. I hold a special place in my heart for people that have been effected by cancer.

So your back at new psychologist and he gives you 2mg Clonazepam, twice daily, as needed. As far as your Valium goes, your doctor said to tweak your Valium dosage. You tried 5mg, 7.5 and knocked out at 10mg's. You don't like it due to the effects the different dosages have on you.

Finally, you got both name brand Clonazepam and Valium. You are or did ask doctor to put you on 2mg Clonazepam, because 1mg doesn't always cover it. Your attacks range from weak to strong/weak requiring different dosages. Sometimes .5 of Clonazepam will take care of it and others, 1mg is the minimum to take care of it.

Now you have an appointment with doctor in 5 weeks and you are wondering what to do. You mention using a short acting benzodiazepine during day as a possibility because of the long acting Valium at night.

Here are my honest recommendations based on experience. The first problem is with the 2mg Xanax bar. They hit hard and fast. That makes them easy to OD on when using methadone. Also, the withdrawals can give you seizures and kill, if done to quick. One way you can go, due to being established is with a slightly higher dosage of Clonazepam. Due to the panic attacks you have, you could go .5mg, 3 times for your daytime dosage. This way, if it's light anxiety, then .5 will do, but on the flip side, if it's worse, you can go 1mg-1.5mg real quick.

The minor, subjective issue with Clonazepam is that it's not going to kick in super fast. It will kick in quick enough, so it is a viable option for sure. Also, tolerance to properly used Clonazepam builds pretty slow. YMMV, but I stayed on 3mg/ day for eight years. Now, I understand you are not crazy about diazepam/Valium, but I have reciently just switched to it from Clonazepam. Right now, I take 10mg diazepam, 3 times a day, with a 30mg Temazepam capsule at bedtime. I understand how it can knock you out, however, first Diazepam is the benzo that has active metabolites that build up in your body over time. It has a few active metabolites including the main one desmethyldiazepam, Temazepam and Oxazepam. The half life of diazepam is 20-100 hours. The half life of desmethyldiazepam is 36-200hours. This makes it perfect for a taper. You mentioned that the doses kicked your rear and made you sleep. They make tablets starting at 2mg, followed by 5mg and 10mg. I'll use me as an example. I get a 30 day script with 90, 10mg pills. It would be unnecessary, but technically, I could get 180, 5mg pills, or even 450, 2mg pills. Point is, you could dial your Valium dose down as low as you want.
I just thought I'd point it out.

I hope my response wasn't too long, lol, but I thought I had a lot I could help with.
I'm Speed King. PM me anytime. I might send you a PM anyway. I like making friends with similar, smart people.

 

[neversickanymore]

DS > bdd