Should Valium be presribed for anxiety?

[Irony XR]

UHH....Anyone who said they shouldn't be prescribed for anxiety, shut up. Give me two good reasons or at Least one reason why they shouldn't prescribed to those with anxiety? What if the patient likes this method of treatment better? Natural remedies for anxiety are pretty stupid. This is why I am quoting the person above me. 90 5mg Valium for a month wouldn't even be enough for me. I am sorry to the poster who cannot find a doctor who will prescribe anxiety medication that will work. I get so sick of doctors thinking just because one needs benzodiazepines at higher dosages then maybe their normal patients, they assume drug abuse. That is the dumbest shit I ever heard. It's like saying cancer patients take Morphine/Vicodin/Hydromorphone to abuse and not take for pain. Fucking cut people slack. I have never heard of anyone abusing benzodiazepines after being on them for a long time, nor have I heard of abuse period, but abuse to everyone seems to be if they need more pills and take them then prescribed which is dumb as fuck. UGH.

It's not about abuse. Benzos are safe if you're speaking about toxicity, but there are other issues to take into consideration. You want a reason? Here's one: tolerance withdrawal. It's a phenomenon when a patient experiences withdrawal symptoms because the body has acclimated to the current dose and needs more. That's right, you can go into Valium w/d just from regular use.

Withdrawal symptoms can occur while on a stable dose of benzodiazepines due to the "tolerance withdrawal" phenomenon, where the body experiences "withdrawal effects" and craves increasing doses to feel normal which can lead to dosage escalation, but most often withdrawal symptoms occur during dosage reduction. Onset of the withdrawal syndrome from long half-life benzodiazepines might be delayed for up to 3 weeks, although withdrawal symptoms from short-acting benzodiazepines often presents early, usually within 24–48 hours.[20] Withdrawal symptoms from benzodiazepines or opioids occur after infusions are withdrawn are common among pediatric intensive care patients. The risk of this syndrome developing is increased by total duration of infusion treatment and the total dose given.[21]

For pain patients, if they cease taking their pain meds they will experience severe discomfort for two weeks at the most, after which their pain levels will return to their pre-medication days. Moreover, there's no risk of death with opiate withdrawal, no matter how much you may feel that you're dying. If you stop large doses of benzodiazepines cold turkey you will likely experience seizures; extreme, crippling anxiety; and potentially death. This is corroborated both by medical journals and my personal experience of having a seizure and being hospitalized during a doctor-supervised five-month taper using clonazepam. Even if you taper over the course of months you will continue to have severe psychological symptoms persist many months after cessation of use. For somebody with an existing anxiety condition, this combination is deadly both emotionally and physically.

The problems with benzodiazepines isn't what happens when you take them, it's what happens when you start experiencing side effects such as tolerance withdrawal or want to get off the meds. Many benzo patients only find out how much of a hold the drug has on them once they try to quit and find it impossible. Do you know of any other drug which has people reporting lasting effects of withdrawal for several years after they stop taking it?

Check out a benzo support forum one day. After a quick google search I found benzowithdrawal.com, here's some threads taken from their first two pages of the "2 years + off of benzos" forum.

• 30 months off. Still so ill. Very hopeless
• 2 years off,still struggling.
• 24.5 months out still suffering
• symptons mental/phyiscal after eating still at 2 yrs off?
• 23 months off and very slowly recovering along with setbacks
• I am feelin worse than ever at 26 months off!
• Why R my symtoms getting worse instead of better at 25 months benzo free?

Do benzos hold a place in modern medicine? Of course. They are the magic cure for anxiety disorders. Unfortunately, its use comes with some pretty hefty sacrifices. I doubt that most people realize what they're getting themselves into when their doc offers them Xanax or Valium or K-pins. All they know is that they trust their doctor and that the pill makes all their problems melt away and their life worth living.

So, having read all of the above do you care to re-evaluate your positions?

 

[Cane2theLeft]

^ excellent post.

One thing I wasn't thinking about earlier is the duration of Post-Acute Withdrawals upon cessation of benzodiazepines after long term use (even therapeutic). These can last from months to YEARS whereas PAWS from even long term opioid, alcohol and other drug use rarely lasts more than a few months and for many is limited to a few weeks of relatively severe symptoms.

 

[baldheadedbull]

So, having read all of the above do you care to re-evaluate your positions?

I've been on Kpin for almost 9 years daily but have kept my dose at 0.50mg daily and I have not experienced interdose withdrawal or tolerance withdrawal but I'm sure my body is dependent even taking such a small dose. If I ever come off of it I'll probably just taper it slowly using a compunding pharmacy or valium crossover.

Withdrawal is a variable thing and some people seem to have nightmare experiences while others seem to be able to taper off easily. It's not a given that everyone will experience horrific withdrawal but it is a risk. Also, keep in mind that anyone who is being prescribed a benzodiazepine almost certainly has some type of psycholocial problems (anxiety, depression, ocd, etc.) and the relapse of those psych problems may be partially responsible for the increasing symptoms upon discontinuation. It seems only a minority suffer from protracted withdrawal even though that is a risk.

Benzodiazepines always seem to stir up a good debate and even doctors seem to have conflicting views when it comes to benzo prescribing methods. I do think they carry significant risks of dependence/withdrawal but I was so bad off beforehand that I was willing to take the risk.

You said you experieced a seizure from Kpin even with a slow taper? That's scary!

 

[Cane2theLeft]

^ what we've been discussing (the worst-case scenarios) are certainly not inevitabilities but all I'm trying to say to people is 'if this is the risk, is this worth going down that road?'

That's something only an individual can answer and even then... might THINK it's worth it until/unless they experience a seizure, 2 years or horrible PAWS, etc.

 

[baldheadedbull]

That's something only an individual can answer and even then... might THINK it's worth it until/unless they experience a seizure, 2 years or horrible PAWS, etc.

Those are certainly things to be concerned about and personally I worry more about the PAWS than the seizure risk just because of how long it can last.

 

[Cane2theLeft]

^ right and with your doses, the seizure risk is far lower than people who are taking 6x + what you are or more (which is relatively common in people taking it for as long as you have or even much less).

 

[Escapedysphoria]

If you're going to take a daily benzodiazepine I believe you're better off using a longer acting benzo such as diazepam or clonazepam. You don't have to redose constantly (like you do with alprazolam, which I was prescribed for months and I constantly found myself having interdose withdrawals even with the xanax xr it was hell). I am now currently on 10mg diazepam which works much better for my severe anxiety disorder, it is rapid acting yet lasts through out the day. In the long run benzo dependency has made my anxiety much worse than ever before I feel like I can't live normally without them.

 

[baldheadedbull]

I've cut my dose in half before and only taken 0.25mg per day and I did feel some withdrawal symptoms (insomnia, tinnitus, weight loss, increased anxiety, etc.) even taking such a small amount. If I could find a good med to replace it with I'd be tapering today. Lyrica is one that I'm going to talk to my doctor about but it has depedence issues too unfortunately. Opiates have always helped my anxiety but I don't think doctors will even prescribe it for anxiety.

 

[baldheadedbull]

In the long run benzo dependency has made my anxiety much worse than ever before I feel like I can't live normally without them.

I'm sorry to hear that and I understand how bad anxiety can mess with your life. Have you tried any other meds that have been helpful?

 

[Escapedysphoria]

I'm sorry to hear that and I understand how bad anxiety can mess with your life. Have you tried any other meds that have been helpful?

I haven't tried any other meds yet, but I would like to give Lyrica a shot at helping me out, but unfortunately Lyrica is not approved for anxiety disorders in the US yet

 

[Cane2theLeft]

^ that hardly matters. A SUBSTANTIAL amount of prescribing is done off-label here. Whether the doctor will be amenable to such is likely affected by how familiar they are with lyrica's usefulness for anxiety.

 

[K'd-OUT-in-AZ]

I haven't tried any other meds yet, but I would like to give Lyrica a shot at helping me out, but unfortunately Lyrica is not approved for anxiety disorders in the US yet

Doesn't mean that a doctor won't prescribe you it for anxiety. My doctor was in fact the one who brought it up to me for my anxiety disorder. I'm sure if you ask your doctor about it he will be willing to try it if he is aware of its anti-anxiety effects, in which many doctors are becoming more and more aware of. It is a better choice than benzodiazepines in my opinion, although it does carry the same tolerance issues. But far less addicting. From one report I read 450mg was shown to be just as effective as 1.5mg alprazolam.

 

[Irony XR]

I've been on Kpin for almost 9 years daily but have kept my dose at 0.50mg daily and I have not experienced interdose withdrawal or tolerance withdrawal but I'm sure my body is dependent even taking such a small dose. If I ever come off of it I'll probably just taper it slowly using a compunding pharmacy or valium crossover.

Withdrawal is a variable thing and some people seem to have nightmare experiences while others seem to be able to taper off easily. It's not a given that everyone will experience horrific withdrawal but it is a risk. Also, keep in mind that anyone who is being prescribed a benzodiazepine almost certainly has some type of psycholocial problems (anxiety, depression, ocd, etc.) and the relapse of those psych problems may be partially responsible for the increasing symptoms upon discontinuation. It seems only a minority suffer from protracted withdrawal even though that is a risk.

Benzodiazepines always seem to stir up a good debate and even doctors seem to have conflicting views when it comes to benzo prescribing methods. I do think they carry significant risks of dependence/withdrawal but I was so bad off beforehand that I was willing to take the risk.

You said you experieced a seizure from Kpin even with a slow taper? That's scary!

I'm glad that Klonopin is working for you. It worked for me too; I concede that it's an amazing anti-anxiety drug. I think that as long as you stay at your 0.5mg/day dose you'll be fine, but many people can't remain at the same, low dose over years, likely due to a combination of emotional and physical factors. Their tolerance goes up and the doc ups the dose. Once they do that once they've entered into a comfortable cycle. A doctor who knows little about benzodiazepine pharmacology + anxiety disorder patient is how you end up with Jane Doe taking clonazepam 12mg b.i.d + xanax 4mg prn.

I loved benzos when I started them, but I had a hell of a time getting off them. The internet tells me that my story isn't unique. I'm just concerned about how many people try a sample blister pack of Xanax, tell the doc that it fixes everything and after a brief disclaimer about how it might be habit-forming and make them drowsy they get themselves a script. Nobody tells them that habit-forming, for some, means withdrawal consisting of months of not being able to go out of your house.

I look forward to your well thought out, reasoned posts. I also hope that .5mg/day of clonazepam continues to be effective for you. Just out of curiousity, how effective is your daily dose compared to when you first started? And what specifically are you taking it for, if that's not too personal?

P.S. I was on Wellbutrin on the time (albeit a low dose) so I imagine it lowered the seizure threshold. I was lucky enough to have a seizure during my 30min weekly appointment with the doc! Talk about excellent timing.

 

[Pegasus]

...Just watch out for weight gain with Lyrica! It's pretty common...

 

[baldheadedbull]

Just out of curiousity, how effective is your daily dose compared to when you first started? And what specifically are you taking it for, if that's not too personal?

P.S. I was on Wellbutrin on the time (albeit a low dose) so I imagine it lowered the seizure threshold. I was lucky enough to have a seizure during my 30min weekly appointment with the doc! Talk about excellent timing.

I'm suprised your doctor or pharmicist didn't warn your about taking Wellbutrin during benzo withdrawal! I'm sorry that happened to you but I'm not suprised (like you said they both increase your seizure risk). That had to be a crazy experience in the doctors office! Did you have any history of seizures or was that your first one?

I think 0.50mg kpin is just as effective for my anxiety today as it was when I first started taking it almost a decade ago. My original prescribed dose was 1mg but it was too much and I felt sluggish so I slowly lowered it down to 0.50mg. I rarely take an extra 0.25mg if I need it.

The effects of Klonopin are subtle and it no longer makes me feel drowsy or tired but it still helps calm my anxiety/panic. I've been officially diagnosed with adhd, panic disorder, GAD, and social anxiety disorder. I've tried a bunch of meds but nothing worked very well for me and caused a lot of side effects. I hate having to take a medication everyday but it helps me enough that It's worth it.

I've never been one to look for for a "quick fix" and I've spent a lot of time in therapy before ever starting meds. Even my anti-medication counselor who preached "skills not pills" suggested I stay on Klonopin. Anxiety/panic is pretty bad in my family and I've got relatives with agoraphobia but I refuse to let it destroy my life.

Panic and anxiety is really hard to eplain to people and it differs in severity. For me it's more physcial than mental. I can be sitting in a chair relaxing and all of a sudden my heart feels like it's beating out of my chest and I feel like I'm going to die. "Fight or flight" kicks in and I feel like I have to get up and start moving around and usually it takes 15-20 min for me to calm down. When this happens and I'm at work or I'm on the highway in traffic I know I have to just sit there and that's really tough because nobody even knows how bad I'm freaking out inside. I pop the kpin and I know it will kick in about 30-45min later and while I'm waiting for it to kick in I'll pinch my arm real hard so that my brian will focus on that and not my panic/anxiety. It's a rough ride but kpin reduces the frequency of my painc attacks.

 

[RobotRipping]

fuck I wrote a well thought out reply and lost it; but in essence, valium should not be used as a long term solution to anxiety (and certainly not on an as needed basis). I am agoraphobic and fucking plain crazy going through withdrawal. It doesn't matter how you go about it, if you have constant benzos in your system you will become dependent and either way you will have to taper (not fun at all) or just jump off them (dangerous and terrifying).

I had 6 grams of phenazepam, tons of lorazepam, valium and clonazepam and planned to be on benzos for life or kill myself when I ran out. Needless to say that plan was stupid and I fucked everything up and i've gotten clean from benzos a few times only to repeat this cycle.

Whether you abuse it or not you will eventually run out or have to come off of it. What then? All of your original stresses and anxiety will come back but it will be far worse than before. Sort that shit out and if you like to get fucked up, there are many other drugs out there.

I'm not trying to piss on your bonfire here; I thought the exact same thing as you. There is a bullshit benzo stigma but aside from that, any benzo dependent person will tell you the same thing: stay the fuck away from benzos if you have anxiety (especially if it is not debilitating). I've had benzos ruin my life several times and i've fucked up so many times on them I'm surprised I am still alive. And i still crave them for relief.

If a bunch of drug users warn you about how harmful benzos can be, what do you think your Dr will say? If your Dr cares about you, you won't get any benzos unless you are tapering. Benzodiazepines are not a sustainable solution for the long term, no matter how you look at it.

 

[dhopeless]

I had one week of heavy Alprazolam use back in April and i suffered some severe withdrawal symptoms!

Sweats,insomnia,terrible anxiety,nausea,loss of appetite,hallucinations (including closed eye visuals and audio hallucinations) amongst other things.

For this reason i will keep away from Alprazolam even though it can be a great 'situation' benzo,although i do realise that my misuse had some effects on the withdrawal symptoms i experienced.

As for the OP's question...i believe long term benzo uses causes more harm than good.

The same thing happened to me a few months ago. I was taking 2mg bars every day for a week. Then when I stopped I had horrible w/ds. I had to call my doctor and he called in some lorazepam for me, which helped a lot. Lorazepam is the ONLY benzo I can take as much as I want and never get addicted. I have used it daily for months at a time and then took a couple weeks off no problem. I recently had been needing it too much, so I had my doctor switch me over to klonopin, which isn't the best for as needed, but if i just take .5mgs at night, my anxiety levels are much better throughout the next day due to the long half life. I refuse to take more than 1mg a day, ever, because I used to take 4mgs a day and had to come off that AND SUBUTEX in jail COLD TURKEY! I am lucky to be alive. Facking jailers, I think denial of medication to an inmate is cruel and unusual.

To answer the OP's question, my favorite benzo is Valium. I love it because it hits you fast, so you can take it as needed for panic attacks, and it lasts a long time. The euphoria is nice too. It's the best of both worlds, imo, because what bothers me about klonopin is that it takes too long to kick in, and the problem with Ativan is it doesn't last long enough for me. And I will never ever take xanax again. I think it should be taken off the market, frankly. Valium is so much safer. I would say if you rarely need them, Ativan is the best choice for anxiety. If you're naturally stressed like me, I think Valium is the best to take, because it can be used tid and prn.