Posted by viridis on January 7, 2003, at 2:31:42
In reply to Should I ask my doc to prescribe a benzo?, posted by Caleb462 on January 7, 2003, at 0:31:25
If you have a long history of anxiety, then a benzo seems like a very reasonable approach, and certainly much safer than antipsychotics (and possibly ADs). I doubt some casual drug use would be enough to prevent prescription, but it all depends on the doctor -- some will avoid benzos at all costs, whether you've ever used illegal drugs at all, while others are much more reasonable.
One thing my psychiatrist mentioned is that people who ask for Xanax are often perceived as "drug seekers". This benzo in particular has a reputation (although probably largely undeserved) for abuse liability. It also has a short half-life, which means that it generally requires fairly frequent dosing to maintain a steady antianxiety effect (and this does, at least theoretically, increase the chances of dose escalation etc.). It does work very well though.
I'm a big fan of Klonopin (clonazepam). It works very well for my anxiety, lasts a long time, has worked consistently for me at the same dose for quite a long time, and seems to be viewed as safer than most of the other benzos by many doctors. You might try an approach like "The prescriptions I've tried aren't working...I've heard that this drug called clonazepam can be very useful for anxiety, and it sounds like it could work for me". This is honest without suggesting that you're just looking for benzos in general, and by proposing one that's generally perceived as unlikely to be abused you might (if you have a sensible doctor) be able to get a prescription. If not, I'd seriously consider another doctor, ideally a psychiatrist experienced with anxiety disorders (I'm not sure what kind of doctor you're seeing, but I think that GPs are less likely than psychiatrists to prescribe benzos, especially for long-term use).
All of the benzos can cause fatigue, and Klonopin does have a reputation for inducing depression in some people. But if you're like me and the depression is mainly the result of anxiety, I doubt this will be a problem. I had some side effects (drowsiness and clumsiness, mainly) for the first week or two that I took Klonopin, but those quickly disappeared, and I don't have any side effects at all now. I'd recommend that you try it if you can.
I know how hard it can be to talk to doctors, but just remember that the main objective for you (and your doctor) should be to find the best treatment with the fewest side effects. You shouldn't be uncomfortable or embarrassed about trying to achieve this goal, and if your doctor makes you feel that way, then maybe he or she isn't the best doctor for you.
poster:viridis
thread:134772
URL: http://www.dr-bob.org/babble/20030106/msgs/134784.html