Hi,
I'm having an extreme panic disorder with agoraphobia, social phobia and some OCD related to my heart. I take a high dose of Klonopin (Clonazepam) 8 mg day divided into 16 doses of 0.5 mg for 1 hour and 0.25 the hour after and do this all day long + 1 mg of Xanax (Alprazolam)/day, 0.5 mg in the morning and 0.25 afternoon and 0.25 at night. I take the 8 mg of Klonopin since june 2009, I was previously on a low dose of Valium 20 mg day but I start having panic attacks again so my PDoc put me on the Klonopin, who I had already took in the past from 2005 until 2007 when I withdraw it with the help of the Valium...
Since 1 1/2, my panic increase from a normal situational state of panic with the usual panic attacks who happen at first at the gym because of the fast pulse rate and some weeks later happening while I had to drive my car. In 2009 and for half of 2010, I was still able to get out of the house and drive and see my friends and have a "normal" life, even if I had many panic attakcs a day, especially when I was out of the house.
In the middle of 2010, I start having agoraphobia and my panic disorder get into a newer level never reach before. I had to stop driving my car, taking a shower was almost impossible because I was feeling like I will faint (I actually faint 3 times around the same period of time), light up the first cigarette in the morning was and is still horrible and since then i'm homebound.
I start having what my PDoc call a cardiophobia problem, can take my pulse rate 1000 times a day, take my blood pressure 30 times and more a day. Of course, I was sent into Therapy, who didin't improve my state at all, did 3 Therapies in less than 1 year (12 weeks each) + 1 group therapy.
Also, in the middle of 2010, I start seeking for more tests, I first saw a neurologist who just told me to take some neurotin or topamax for my headache. I also saw 2 different Cardiologists, the first one for the slow pulse rate I had in the begining of 2010 until the middle of 2010, I had a holter 24 hours monitor who was perfect, had a stress-test with an electrocardiogram who was also perfect so the first Cardiologist just send me home with no answer about the low pulse rate.
Like I wrote before, in july 2010 my panic reach a new level and I start having once in a while strong chest pain on the left side, very fast pulse rate in the morning and late evening, unstable blood pressure (high when I was out of the house and normal-low at home), so I saw another Cardiologist and had other tests for my heart, holter monitor 24 hours, blood pressure 24 hours, stress-test on a treadmill, everything was ok apparently and he RX a first beta-blocker to take as needed before a stressfull event or daily if I wanted... I had to try 4-5 different beta-blockers before finding the good one to reduce my fast pulse rate, who is not working anymore. I ending on a low dose of Inderal 5 to 10 mg a day to control the fast heart beat, I still take 2.5 mg of Inderal, but it's just to give to me some peace of mind like "yeah, I take something for my heart and I will not die from it", but I know that that dose is so small that it have no effect on me.
In february 2011, the panic and anxiety reach a new level again, this time very debilitating level of anxiety. That's when my PDoc choose to add 0.5 mg of Xanax in the norming because it's the faster acting benzo med and it's seem that I need something who act fast soon after I get up. Now, I can't be in a car, even if I don't drive, if I really need to go somewhere like a Doc or PDoc, I need to take some Xanax and double my Inderal dose 1-2 hours before I leave the house, I start having IBS symptoms (bloating, intestine pain, severe constipation) all the time especially in the evening (me who had a gastric by-pass to loose weight and who had diarrhea up to 8 times a day before), the headache is now chronic and is worse when my blood pressure is on the low side with a pulsating veins that I can see on the left temple of my head, also and I can't take painkillers cause they make my heart race and increase my blood pressure. I start having also extreme jaw and teeth pain, neck-shoulder-upper back and left side chest pain all day long, I start having muscles twitching and spasm (especially in my arms, legs and in my buttocks, I have those muscles spasm all day long also who is a sign that I MAY have developped a high tolerance to the benzo meds cause they are normally good to relieve muscles spasms (it's seem that I have some paradoxical effects from the Klonopin), my blood pressure is unstable and can be low for 2-3 months and be bordeline 2-3 months and return to the low side, I have an irregular heart everyday, goes to the ER several times for tachycardia (supraventricular tachycardia episodes) but all the EKG + blood tests + X-ray of my lungs was ok, i'm all the time dizzy, I have exercise intolerance and can't do anything physical like just walking without having a very fast pulse rate and strong chest pain (the chest pain happen more often at rest and is apparently not related to my heart, that's what my Cardiologist said to me when I saw him again last march), my eyes hurt and burn, I have extreme jaw pain and teeth pain all the time, neck pain, back pain, poor memory, feel like I will become crazy, constant depersonalisation, derealisation, and the list goes on...
Since i'm on a high dose of benzo, I should not have those symptoms, that's why I wonder if I don't build up a tolerance to their effects? When the PDoc add the Xanax, I was feeling more normal and less anxious in the first 3 weeks but it's seem that I build up a tolerance to the Xanax faster and really don't want to increase it. Same for the Klonopin, I try to increase it with no improve on my anxiety so I reduce it to the initial 8 mg...
Since i'm now med sensitives and can't start the Paxil, who is the only one AD who sork to stop the panic disorder on me, and since I have a lot of cardiovascular symptoms, what I should do with all of this? Should I start a slow withdrawal schedules for the Xanax first with the help of Valium (Professor C Heather Ashton technic)? And when I will be off the Xanax, should I start to do the same with the Klonopin? My anxiety is very high, for me each day is like the last day I will live and I want to avoid an increase of anxiety...
Someone else have build-up a high dose tolerance of benzo here? And if so, how you can deal with that? Is it normal to have withdrawal symptoms even if i'm on high dose? What I can do to reduce those symptoms? Adding some neurotin or Lyrica?
Thanks for your help ;-)