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  • BDD Moderators: Keif’ Richards | negrogesic

Advice on panic attack medications

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Panic247

Greenlighter
Joined
Jan 22, 2017
Messages
9
I'm new to this forum, so I apologize in advance if this post is in the wrong place.

I've had anxiety/panic attacks for over 20 years, and have been on a plethora of medications to try and treat it. Essentially, I have severe hypochondria, which is worsened by the pains that come along with the panic attacks. I've been on dozens of different medications that "require several weeks for symptoms to improve", but nothing ever helps with the anxiety/panic attacks even after 6-8 months of taking said medications. I could list the meds, but I'm here to ask about the fast-acting medications.

I've been taking Lorazepam on and off for about 10 years, and have been prescribed 1mg tablets the entire time. This is the only medication that I can take and notice a positive change in the attacks, but the 1mg dose only works about 60% of the time. I've bumped it up to 1.5mg, and that seems to get me to the 75% success mark.

I am seeing a new counselor/psychiatrist soon, so before I see her I have a couple of questions:

1. Is there a better, fast-acting medication out there that would better fit my condition? My main issue is the hypochondria, because even the slightest twinge of pain anywhere on my body send me into the darkness.

2. Should I up the Lorazepam dosage to 2mg? I've never done more than 1.5 so not sure if upping the dosage more would do me any good.

I don't take Lorazepam every day, because I don't like to rely on medication to get me through the darkness. I may take it 1-3 times a week, but that varies. Any advice would be appreciated, as I am certain the new counselor will want to get me on yet another long-acting medication.

Thank you!
 
Everyone is different. My experiences with Lorazepam have been pretty mild, it's never helped much. Alprazolam (Xanax) is your best bet for fast-acting, IMO. It is arguably the strongest benzo and most popular for anxiety/panic attacks. Clonazepam (Klonopin) is also a great choice. It has a slower onset, but lasts alot longer.
 
I got panic attacks and took Xanax for it. However I kept young the dose and eventually I found myself taking it for breakfast lunch and dinner. And also while it helped me in the short term I felt like I was feeling more and more helpless over my panic attacks.

Have you tried therapy? I think you'd benefit from CBT because it sounds like your thinking is a big player in your anxiety. Perhaps you could take the lorazepam before therapy so your less anxious then use that time to work with a therapist in challenging your beliefs.
 
Thank you for all of the input, I appreciate it! So what is CBT? I've had numerous attempts at therapy, from stress reduction classes, to yoga, to one-on-one with counselors, but I've not heard of CBT. With Zanax, does that get rid of the pain associated with the panic attacks, or does it just make you loopy? The thing with the Lorazepam is that the only things I notice are that my eyes get heavy (like when I smoke weed), and I don't get so focused on my rapid heart rate and breathing.

Thank you again.
 
Cognitive behavioral therapy. Youd work with your therapist even fill out worksheets

A example with be
Thought: my chest hurts im having a heart attack i am going to sie.
Evidence: chest pain pccurs in some people having a heart attack
Evidence suggests this isnt a heart attack: i jist ate a greasy meal then layes down which can cause acid reflux that feels like a burning in chest.
Everytime ive had this happen i was not having a heart attack

Behavior i normal would go type in chedt pain on wevmd and look for evidence to support i am indeed dying
Is this behavior adaptive or maladaptive

Is there something i can do that is more adaptive instead of what i typical do which hasnt been working so well.
 
Both xxanax and lorazepam work by interacting with a receptor site called benzodiazepine receptor which then influences the activity of gaba a a1 and a5 receptors making you drowsy and amnesia a2/3 and a4 making your muscles relax

It helpa prevent the effects of chemicals like noradrenaline triggering the fight or flight response

However over the long term your body adapts and it can beco e completely ineffective and sensitize you panic attacks making it worse.

Its closer to alcohol it makes you both calmer and meased up thats why its not really a long term solution if u need it daily
 
Xanax imo is WAY better, stronger, and more effective in every way for panic attacks.. Way better than lorazepam! It isn't my preffered benzo because I like the long acting ones much better, like klonopin and valium, to name a couple. They are great for general anxiety/social anxiey and panic disorder too, well klonopin is a bit better to me, than valium, for panic disorder.. but its still better for just general anxiety, as if you don't chew or swallow the pill crushed up/parachute it, it takes like 40 mins at least to really kick in, when swallowed whole.. when chewed, about 10-15 mins for me it kicks in around then.. I always chew my klonopin, I am and have been on it for like 5+ years or so, and other benzos too.. Xanax, which is great, for people who have more panic attacks, and less prolonged, 24/7 anxiety non stop, not being able to sleep.. that's how I am, plus I was so quiet and shy, and had the hardest time engaging in conversation with people I didn't know very well, and had this thing where I had trouble looking people in the eyes.. and as you can imagine, would get judged by other people, in high school, because of it.. it sucked so bad, I hated my life like that.. but I am so happy since finding the right benzo for me..

I think you should stick with whatever works for you though, because for me... Ativan has NEVER once worked, at all.. even the first time I took some.. like over 8-10mg, when I found it in a relatives medicine cabinet, who had no idea it was even there and didn't take them.. having only taken one of the strongest "common" benzos around, Xanax, at the time, the Ativan taken in 1mg tablets throughout the day, 1 like every 30 mins, after I still kept feeling absolutely nothing, with like no tolerance to benzos at that time.. that was years before I was getting scripted benzos and taking them regularly. But I have friends who hate Xanax, and love Ativan! it is weird, with benzos especially, everybody works extremely different, and their bodies all react differently to each medication, that's a benzo.

So I would ask the new doc, to up you to 2mg of Ativan if possible, and see if that helps at all.. If not, I would then try Xanax, if you solely struggle from panic disorder.. if you also have really bad general anxiety disorder/social anxiety disorder, then klonopin or valium are both wonderful benzos too.. I like Xanax.. it works great.. the thing I don't like about Xanax, is that it makes me so care-free I feel like I can take more, and more.. when I was planning on saving them to take daily.. and it doesn't last very long at all, like 4-5 hrs TOPS.. for most people.. usually 1mg gets me through like 2-3 hrs or so.. then its done, and I really want more.. so its a bit more addicting ime, than Ativan or klonopin, again though.. Ativan has never worked for me.. taking 10mg with no tolerance, normally would have people nodding off, super faded, and totally out of it.. it literally did like the slightest bit of difference though.. then I tried it numerous more times, when given some for free or something.. still it didn't work at all.. idk why, that is benzos for you though! Good luck, I hope you get your panic disorder issues taken care of asap.
 
Wow, that was exactly what I was looking for! Based on the description of Cognitive behavioral therapy, I've done the logging before with some success, so maybe the new counselor can work with me on improving that. With the meds, I only take my Lorazepam a couple times per week, so my concern for addiction increases if Zanax works better. Interesting points to think about.

Thank you all again for the help, you have given me a ton of info going into this session with the new counselor. Any further input is always appreciated.
 
One other quick question. It was mentioned that the benzos are chewed, I swallow the pill whole. Is there a reason why people chew the benzo? I assume it would lead to a faster acting time, but does it cause them to work better? Would chewing it lead to issues with your teeth or mouth (increased cavities, canker sores, etc.)? I just got a refill of my Lorazepam to get me until I see my counselor and have not needed any for the last few days, but if chewing them is more effective and I don't have to use as much then that may help me short-term.

Thanks
 
unfortunately the only tried and true way to beat the battle against anxiety disorders is CBT ...and its a very hard thing to do as it requires you to confront your fears regularly .. which is easier said that done ;)
that being said, i take klonopin (i actually asked for it over valium and xanax, said a friend used it and it worked wonders for them)... ive done more than a few benzos in my day (was waaaay too into xanax in my younger days)..
ive always found klonopin to be the best for actually treating my anxiety (not seeking abuse).. but its different for everyone, they say. if youre working with a Dr ... its best to just see if you can give as many benzos as you can a try to see which suites you best :) goodluck and remember youre not alone with your problems.. there are many of us!
 
Yep, therapy is where it's at. Taking benzos can help in the immediate sense to quell the panic, but it's only masking the symptoms, not treating the cause. CBT will help you rewire the kind of negative thought patterns that contribute to the panic attacks. Otherwise you're just going to end up in a situation where the second you feel your heart start to beat faster for any reason, it spirals out into panic. Ask me how I know -_-
 
Another thing that helps me is mindful breathing you can either count like one two three one two three four or focus on the air hitting your lips or nose and leaving really focusing on the sensation
 
Mindful breathing works wonders. Exhaling for a couple of beats longer than your inhale is the trick, as exhalation actually slows your heart rate down via vagal nerve activity
 
I prefer Valium for anxiety attacks, but everyone is different. I would say that it's likely you've got a tolerance going and that's why you're elevated dose works well for you. Probably a jump to 2mg would work better, but your doctor might not write that much for you.
 
Hi I'm new to this and know how you feel with panic attacks. My doc has basically told me that he doesn't like prescribing valium or xanax so I don't know where to turn. I have been buying them when the attacks got very bad but I thought my doc would be able to help.
 
Doctor in the majority of cases are not supposed to just you on Xanax or valium for the long .
 
Rotten robbie said:
Hi I'm new to this and know how you feel with panic attacks. My doc has basically told me that he doesn't like prescribing valium or xanax so I don't know where to turn. I have been buying them when the attacks got very bad but I thought my doc would be able to help.
Click to expand...

Every doctor has different views on scripting benzos to their patients. None of mine, but my first psych/sub doctor, who was a shitty doctor regardless, have had a problem scripting me klonopin.. The doctor I first received klonpin from was open to me trying just about any of the benzos out there, mainly the 4 most prescribed.. Ativan(joke of a benzo ime, but some swear by it, I just got no relief whatsoever from it, the numerous times I tried it in various small to large doses.), Valium(tied with kpin for the best, at combating general/social anxiety, insomnia, and panic disorder, best for general anxiety throughout the day though..), Xanax(good benzo, great for panic attacks, probably the best for them.. but not so good for insomnia, and 24/7 anxiety issues.. they wear off too quickly, and have a very short half-life/duration of action.), and then Klonopin, which I am currently taking for my anxiety both social/general anxiety disorder, insomnia, and occasional real bad panic attacks and its definitely the best, longest lasting, and best tasting(tastes like candy mints!) but i have to chew it or parachute it... especially if i am having a panic attack, it takes sooo long to kick in when just swallowed whole.. and i don't believe chewing it, is really any worse for you than swallowing it whole.. they both seem to last just as long when done both ways, except, chewing/parachuting/crushing and swallowing pill in powder form, it kicks in way quicker.. like 10-20 mins MAX.. usually like 5-10 mins i start feeling it, if chewed and taken correctly that way, i chew it between my front teeth, so none will get stuck in my molars or other "bigger" teeth in the back of my mouth.

The thing is though, if you don't absolutely believe there is anything else out there that can help your anxiety, and have tried other meds, non-benzo or non-narcotic to get rid of your issues, benzo addiction is scary! You need to make sure you stick to the prescribed amount from your doc, or less than that.. it is hard for me to do, especially now, after building a huge tolerance to benzodiazepines.. it sucks... but kpin, still is a very solid benzo, and works/has worked like a charm for me, for over 5 years.. it is just fucked that, if anything ever happens like I take a few extra when I am having a bad day and can not get an early refill, I either have to take like a fraction of my normal dose.. or run out, and wing it, borrowing them from friends who also get klonopin or other benzos like it, or having to get them off the street, which are both.. ime.. not very reliable! So if you don't try anything else, but a different doctor, and do get benzos, be very careful.. i highly suggest, trying something less addicting and habit forming before resorting to benzos... but if you must take them, like myself(nothing else worked for me, believe me, i tried lots of other meds, non-narcotic, like SSRIs or anti-depressants, which did next to nothing at all for me, before hopping right on klonopin..), be very careful, how you take them.. and certain ones, specifically the shorter acting, more powerful ones like Xanax, be very careful.. they can be like the "crack of benzos", as in you may take one.. then just compulsively take another, and another... etc.. and then not remember even doing it the next day...
 
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I'm trying to find other ways to get help because the doc only prescribed sleeping pills for 2 days that justhe kept me awake. I'll have to keep trying
 
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