Anxiety about lack of anxiety medications

[angier29]

I've struggled with anxiety/insomnia for about 9 years.  I've been on remeron for 8 years, ambien for 4 years, and xanax .5mg BID for about a year and a half.  Although I've had some really terrible days, the combination of these medications was sufficient to allow me to recover, readjust my life, and go on.

Recently an event triggered a severe bout of anxiety/insomnia that I have not been able to recover from.  For about 5 weeks now, my anxiety occurs 24 hours a day and I'm sleeping under 3 hours a night.  I went to the doc and asked him to raise my xanax to TID so at least I had enough anxiety medication to get through the entire day.  He refused, stating that he hates xanax and would rather have me on klonopin.

I don't have any abstract objection to klonopin, and it would be helpful to have an anti-anxiety medication in my system round the clock.  However, I'm concerned that he's going to vastly underprescribe the klonopin and that it's going to be far less effective than the xanax in controlling extreme anxiety.  Although I'm barely making it through the day with 2x .5mg xanax, the alternative of 0 and some new less effective med seems far worse.  I understand that I am now physically and psychologically dependent on xanax and that there are risks elevating the dosage.  But allow me to say though sleeping 2.5 hours a night and thinking about your anxiety for 22 hours straight is not life.  I'd rather take the chance on more medications and taper back when I'm feeling better, if that becomes possible/appropriate.

At any rate, it doesn't look like he will concede to raising the xanax dosage and he might insist on having me try klonopin.  How do I approach this?  I will be in absolute full panic mode the first time I take .5mg of klonopin, wait for it to do nothing, while staring at an empty bottle of a medication that has actually worked for me for 2 years.

[angier29]

Remeron/Ambien is almost always enough to induce some form of sleep, though the length and quality of sleep is almost always a function of how anxious I am.  I've tried a variety of SSRIs and hated all of them; they all give me this extra amount of energy that makes going to sleep more difficult.  When I'm not anxious and slept ok, I don't have anything that I would personally identify as depression, so I'm really not convinced I need an SSRI but I will try one this time if doc requests it.  He said he hates xanax because he thinks it's a dangerous drug to raise the dosage on.  I told him that I've never had problems with tapering before, it's just that this level of stress has required me to depend more on it than usual.  I wouldn't mind trying klonopin, but in a perfect world I would still have xanax as a backup plan.  It doesn't seem like this doc will lake that arrangement; I so wish I didn't have to jump through these hoops to appease this twit... but he's probably one of the more benzo friendly guys around here so I have to take what I can get I guess.

[allmymarbles]

Another suggestion. To help you sleep try taking Benadryl.

[allmymarbles]

I can understand why he dislikes Xanax. It is seriously addictive. My doctor was even more careful than yours and I appreciate him. Due to anxiety and panic attacks caused by inhaled steroids (which caused an adrenal malfunction) I was given a prescription for .25 mg of Xanax to be taken ONLY when I was on the verge of a panic attack. By experimenting I found that often only half a tablet would do the trick.

Now I don't use the Xanax at all. I take ashwagandha to relax me and it works very well. Also no side effects. And no addiction.