Benzos are a short term solution to a long term problem. Not good, 'eh?
Hydroxyzine!
Sorry for the length, I have a difficult time keeping things short. The following is solid info, I think a lot of members would back up what I have to say.
I'm presuming OP is having emotional issues that they would like addressed with a benzo, if it is for physical purposes such as muscle spasms or seizures this is not for the OP.
Anxiety and benzos:
Please consider the very serious downsides of benzos taken for more than a couple of months, you become a slave to them, they are the absolute worst class of drugs to be addicted to when the time comes to discontinue them, right up there with alcohol and barbs and way, way worse than opioid addiction - I know this from my own history and that of millions of others.
If you do go with a benzo it definitely should be done at the exact same time you're making progress with CBT (cognitive behavioral therapy). The benzo should be used solely for the purpose of facilitating the therapy - in office and out in the 'real world'. After a couple months you can discontinue the benzo and go about your life with a new tool kit and many ways to reduce your anxiety if it flares up.
There are non-dependency forming compounds that you can use after the discontinuation of benzos, ask your psych about these.
Continuing benzo therapy for more than two months hasn't been shown to do much. There's one significant exception but that's for people like myself, which I doubt you are like b/c you're not addicted to them, and won't be, right?
They are not "fun" drugs. If you find they are you likely have some sort of anxiety at the moment, but it well could be normal, a bad day of anxiety inducing events and almost anyone would feel better with 0.25-mg Xanax, just as they would likely enjoy the relief of some ethanol. That doesn't make it wise to use them for everyday anxiety, just as drinking to relieve anxiety daily is a terrible idea, although billions of people do it daily it doesn't mean their life is better for it.
Klonopin is the benzo you would want for GAD w/ Panic. Maybe Ativan (lorazepam), but most people find Klonopin (clonaZEPAM) to be the best. Really any should do for the two months you're using them, I suggest Klonopin b/c it is easy to dose, once a day or 2x/day, last a long time, doesn't give rebound anxiety like Xanax.
In my experience Xanax acerbates anxiety by adding rebound anxiety to the mix - for many - none of this info would cover everyone of course.
I empathize deeply with anyone suffering from GAD and or PD w/ or w/o agoraphobia as I have all of them to a life-limiting extent, very life limiting - as in I'm around 50 years old and retired b/c I can't deal with the work place well enough and happen to be well enough off that I can do so. But I'd really rather be part of the 99% crowd (which I am technically) - and work, have a social life and enjoy my free time.
If I could go back, I would have denied them except for a low dose two month supply (0.5- to 1-mg Klonopin), at 1.0-mg it's a moderate to high dose (eq. to 20-mg valium) so maybe 0.25-mg 2xday would be good, much more and you're asking for problems at the end of two months and the sedation might well be too much.
Because I didn't start my CBT for several years after being prescribed Klonopin I'm left with a terrible benzo dependency. I can't taper completely off after 16 years on this stuff - which was about 15 years and 10 months too long.
Don't let the hype here or anywhere else fool you that benzos are the best thing ever. Those folks usually come back a few months to years later regretting it terribly, many begging for advice on how to relieve the god awful, potentially fatal withdrawals.
Re-uptake inhibitors may be better for you. SSRIs and other re-uptake inhibitors, approved as anti-depressants, one of them is FDA approved for GAD.
They didn't do shit for me but they work for a lot of people. I tired them back in the day when Paxil was the SSRI of the week (ca. 2000), and it bombed terribly for me. The newer genration re-uptaker inhibitors I have heard better results from, but as I mentioned only one of them is US FDA approved for GAD, one of the newer ones.
They too cause dependency in a very fucked up way, look into SSRI discontinuation syndromes and you'll see that clearly.
I favor the hydroxizine / propranolol route and it I were a psych I'd be one of the "bitch" psychs who would only prescribe benzos, in most cases, in low dose, two week supplies and under the condition that the patient work with a therapist. Two months max for daily dosing. I wouldn't push re-uptake inhibitors. I'd offer them but leave the decision to try them to the patient.
I read two good papers yesterday, case reports of success in treating both GAD and PD with hydroxizine alone. One guy had a case so bad he was hospitalized briefly until the hydroxizine he was taking relieved his symptoms enough he was able to go about life with just that compound.
Non-dependency forming, cheap, reliable, anyone will prescribe it and it fucking works! It's a WHO essential drug so should be available in most countries. It is damn inexpensive, to buy and to use.
Hydroxyzine does more for my anxiety these days than 50-mg of Valium.
I'm a pathetic benzo addict who struggles with an addiction to a medication that isn't enjoyable in the least, benzos loose their very subjective "enjoyable" effects quickly unless you increase dose consistently and that is really bad.
I'm also a heroin and buprenorphine addict, but that's a different tale.
I urge you to talk to a psychiatrist about the protocol above for using benzos concomitantly (at the same time) with therapy, and find the therapist that suits you, you can use hydroxizine or maybe a benzo prn until you get into therapy.
FWIW - GPs/PCPs (regular physicians, internists) should not prescribe benzos for psych disorders. Many do, but the younger ones are less inclined as pharma therapy becomes more a part of medical education. Younger physicians tend to be more aware of the proper use of pharmaceuticals - when, how and why they should be used.
By presenting to your psych the case for a benzo prescribed for daily use short term along with therapy you'll likely impress your psych with your knowledge that benzos are not the long term solution, but rather that CBT - addressing the emotional issues that cause you distress - is the true and genuine solution.
That is how we beat abnormal anxiety. Everyday anxiety need not be treated, it's life and there are many things people can do to reduce anxiety in their lives. Not everyone who has a panic attack here or there or who gets very anxious has a disorder.
They may be having a difficult time coping, that's why I and may other advocate CBT as a first line treatment, it works for both reducing everyday anxiety as well as anxiety disorders and can sort out which one a person has and focus on addressing it specifically. Thus reducing the use of medications for disorders that can be sorted out with therapy. This saves many people a lot of time, money and heartache.
Best wishes, PM me if you have ?s, I know anxiety very well, I've embraced it as a part of my life and learned to work with it, however I am left with a horrid addiction to benzos. I can help advise on proper use and tapering, but tapering should not be needed. I have a lot of knowledge of these issues, both the clinical and pharmacological properties of benzos.
I'm a former pharmaceutical chemist with treatment resistant GAD/ PD and agoraphobia. I don't get out much so I'm here a lot. Mostly not logged in but I am reading most days.
Bet wishes, I'm a kind person, sorry if I came off as harsh here, but my warnings are not useless. I promise you that.
thanks
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