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Benzos When/why/what do psychiatrists prescribe the atypicals - not the big 3 (val,kpin,xan)

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polysubstancer

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Jan 6, 2012
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When/why/what do psychiatrists prescribe the EXOTICS - not the big 3 (val,kpin,xan)

As a patient, I have rxed xanax for anxiety/panic attacks, kpin for gad and mood stabilization, and diazepam for neurological (nerve damage, small seizures). ativan and kpin are often substituted but what about the others....

all those heavy duty ones, ive heard people mention oxazepam, temazpam, halcion, etc.....but ive never been rxed those or asked to try when kpin became less efective or i wanted something else, like when do psychs move away from the main 4 (above), like what do they treat differently or react differently, why would they switch like for what symptoms, and what are the main differences from the big 4 (i know for instance some are hypnotic to the point of trippin) but idk,

just wanted to understand the application of benzos in psychiatry
 
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polysubstancer said:
As a patient, I have rxed xanax for anxiety/panic attacks, kpin for gad and mood stabilization, and diazepam for neurological (nerve damage, small seizures). ativan and kpin are often substituted but what about the others....

all those heavy duty ones, ive heard people mention oxazepam, temazpam, halcion, etc.....but ive never been rxed those or asked to try when kpin became less efective or i wanted something else, like when do psychs move away from the main 4 (above), like what do they treat differently or react differently, why would they switch like for what symptoms, and what are the main differences from the big 4 (i know for instance some are hypnotic to the point of trippin) but idk,

just wanted to understand the application of benzos in psychiatry
Click to expand...

Because none of these medications are appropriate for the treatment of anxiety. Triazolam (Halcion) and temazepam (Restoril) are both labelled for the treatment of insomnia and have very short half-lives, are known for their complex drug interactions, and frequent allergic reactions. Therefore, they are used infrequently by physicians, especially now that medications such as Ambien and Lunesta are available. Oxazepam (Serax) is labelled for the use of alcohol withdrawal.
 
Diazepam is also used as a muscle relaxant.

Lorazepam is used as an anti-nausea agent (it is actually quite effective at this).

I'm sure there are many others. Diazepam is used for something like 100 things besides anxiety treatment.
 
When my best friend died (at 19 head bashed on the concrete) I was fucked up and very unstable. I was given clonazepam for general anxiety and alprazolam for panick attacks. After a while I was asked to decide between alprazolam or clonazepam so they gave me clonazepam now Im on 4mg a day and it doesnt do shit anymore (since 04).

Around 08 or 09 since the clonazepam wasn't doing much I asked for alprazolam and my psychiatrist was ready to kick me out saying it was addictive and i was a drug seeker, same thing when I needed a muscle relaxant he gave me a prescription for Soma/carisoprodol but they dont make it anymore in Canada he gave me Baclofen which I threw up all day every day I took it. I went and asked for meprobamate which is the main metabolite of Soma, he reacted the same as with alprozalam, saying it was too addictive and I was a drug seeker.

Back home (somewhere in the balkans) other than diazepam and phenobarbital they give bromazepam a lot for mild cases of anxiety (my grandma and ant take 3-6mg bromazepam when needed), they also give midazolam but thats for insomnia.
 
I thought that they discontinued halcion? Also something interesting that I read, probably here on bluelight, that pertains to clonazepam, is that it attaches to both GABA A and B. is that correct? And if that were true, than would that make clonazepam a good detox tool for GHB since I believe they attach to GABA B too?

Anyway, I'm pretty sure that those other benzo's like halcion, flunitrazepam and midazolam are used mostly for sleep. I know they also use midazolam along with fentanyl for anesthesia in some hospitals. My dad had his septum operated on (coke head!) and on the discharge paper it told the array of drugs he was given for anesthesia which included midazolam,fentanyl, and shockingly (to me at least) cocaine.
 
OP, so you are aware, "atypicals" is a name commonly associated with the new class of antipsychotics deemed atypical antipsychotics (differentiating them from typical antipsychotics such as chlorpromazine).

If it wouldn't be too much of a bother, would you mind rephrasing the title just to clarify?

Regarding your inquiry, some other uses include inducing amnesia (such as during procedures that require conscious sedation) and alcohol or other GABAergic withdrawal. There are loads of benzodiazepines with different efficacies for the various indications - some are great for sleep but not as useful myorelaxants, some are good for anxiety but less useful for seizures, etc.

Typically, the potent and short-acting benzos such as midazolam are used for their amnestic effects and conversely, less-potent and longer-acting ones such as chlordiazepoxide are used for alcohol/other sedative withdrawal or detox.
 
I dont get how they do it and every little thing is drug seeking. Panic and extreme anxiety they gave me Clonazepam instead of xanax even tho that is really for straight up panic. seroquel which is for psychotic symptoms but for sleep and not a different benzodiazepine for sleep i dont get them and they wanted to use ssri's whole time but that is for LONG term me i was really just having panic and nervousness no ssri is going to subdue that they are sometimes full of shit if you ask me.
 
Clonazepam is growing more and more popular as the benzo of choice esp. for GAD because it is a relatively simple benzo with a predictably long half-life that happens to be quite potent, and not too hypnotic. It is the Valium of the 2010's. Speaking of Valium, diazepam is still used because it is so tried and true and is fairly predictable as well. It is a great taper benzo because of the myriad of long half-life metabolites. Alprazolam is a frequent choice for panic and often GAD as well because of its potency and "tried and true" nature as well. It is a hard hitting, anxiolytic and anti-panic benzo that gets the job done. Lorazepam is kind of looked at differently from doc to doc, and in my opinion under-rated as far as benzos go. It is rather subtle, and also has some good hypnotic properties to it, not short-acting, not really long-acting. It is used for GAD and panic. It is often viewed as an effective, but less abusable benzo which isn't necessarily true, but this wins the doctor's choice.

Some of the more unpopular benzos include chlordiazepoxide (Librium), which is just like diazepam. It is rarely rx'd outside of detox, but just because it is unpopular. It was the first benzo to hit the market. Clorazepate (Tranxene) is not so predictable from what I recall. Oxazepam (Serax) is a light benzo, not often bothered with. All three of these are not exclusively hypnotic, but really more suitable for general anxiety however they just aren't popular. I think it comes down to the fact that they weren't marketed as heavily as the other benzos when they came out, and aren't so "tried and true". Other benzos, docs steer clear of because of their reputation. Triazolam (Halcion) and temazepam (Restoril) are very iffy in a lot of docs' eyes, but are good hypnotics. Z-drugs were so heavily marketed, and the hypnotic benzos were demonized, and a lot of docs have no trouble rx'ing z-drugs but have issues with benzos, even though they are so close to being benzos themselves. I hope I helped some. When it comes down to it, it is all or was in a lot of cases marketing and propaganda. I have pharmaceutical company managers and reps in my family.
 
yes, i know atypical is for antipsychs, i just meant atypical in the literal form, ill try to change it just for u tho cuz im that kinda guy, just a nicce fuckin guy :)

neway, thanks for all the feedback, i had NO idea the "atypical" (just fuckin wit u lol jk), i had no clue the uncommon and irregular benzos are prescribed for such reasons or that they had allergic reactions, afaik, benzos are like the safest med there is, guess it just depends on which one

so basically the unusual benzos arent prescribed for usual issues (of anxiety and what not), but in instances where the other properties of the benzos are stronger, like amnesia or hypnotics as opposed to anxiolytic or seizing


interesting, ill stick with xanax for the most short lived fun, kpins for an all day relax, and valium to loosen up

btw, on a side note unrelated to all of this, i quit smokin today and benzos are known to cause them to metabolize faster, so my benzo use, tho its infrequent should be more noticable

thx again and continue to teach me if u wish

PS can anyon else provide info on kpins serotonergic properties, very hard to find info on it but its out there
 
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Alex000 said:
Clonazepam is growing more and more popular as the benzo of choice esp. for GAD because it is a relatively simple benzo with a predictably long half-life that happens to be quite potent, and not too hypnotic. It is the Valium of the 2010's.
Click to expand...

kpins are #1 as far as medicinal and therapeutic value, not so much recreationally as like xanax, but kpins ARE the best, like the valiums of the 2010s as u sed
 
I don't know I find lorazepam to be kind of shitty IMO, it's like a wierd mix of xanax and ambien. Clonazepam is great for GAD, even at low dosages, and is just as good as Xanax if you don't take it regularly, or take a higher ammount. Curiously enough though, I always found that Xanax provided consistent anxiety relieve for a real long time at the same dose. Over the summer I went away for a month to a farm and bought enough Xanax to last me the whole time, as long as I took only one mg a day. Shockingly my tolerance didn't skyrocket and I got a buzz off of them to the very end. It seems that if you dose Xanax throughout the day, like I've done in the past, that's when the tolerance skyrockets. I would go from taking one mg in the morning and another mg throughout the course of the day for about two weeks, and then I'd have to double that ammount two weeks later to get the same effect. That continued until I was taking three bars to the face first thing in the morning, and I was NOT even getting that stoned off of it, soon after I went to detox.
 
In australia I have been prescribed:

Clonazepam, Temazepam, Alprazolam, Diazepam, Nitrazepam, Oxazepam, Lorazepam, Flunitrazepam, Triazolam.

For panic disorder, sleep disorder and chronic anxiety.
 
I picked up a halcion script the other day, and i had to go to like 4 pharmacists, none of them had it and each was amazed I had a script for it...

Had to order it in, pharmacist was like I haven't seen a script for this in years.
 
DexterMeth said:
Clonazepam can also subsequently be used to treat epilepsy it.
Click to expand...

This is actually the only indication for it in the UK I think, it is not used for anxiety disorders over here, we usually stick to good old diazepam.
 
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