Aa
clonazepam and nervous system?
I will ask the question about clonazepam. I have what I consider anxiety attacks but electrophysilogist says they aren't classic panic attacks but wired up nervous system from ANS.
My primary care gave this med to me a couple years ago but I have been afraid to use it since its addictive Also he only gave me three of them prescribed as follows-take 1 tab 3x a day as needed. Hence a one day supply. I was afraid to even start them because if they work and give some relief it would be terrible if that's all he gave.
Anyway do others use this med and do u find it beneficial and worth the risk? I see him this week and if anybody can give me their thoughts I may bring this up with him again. My anxiety is terrible but I deal with it. I can't take ssris and that type of stuff as its deadly to me. Learned that the hard way.
Beema
My primary care gave this med to me a couple years ago but I have been afraid to use it since its addictive Also he only gave me three of them prescribed as follows-take 1 tab 3x a day as needed. Hence a one day supply. I was afraid to even start them because if they work and give some relief it would be terrible if that's all he gave.
Anyway do others use this med and do u find it beneficial and worth the risk? I see him this week and if anybody can give me their thoughts I may bring this up with him again. My anxiety is terrible but I deal with it. I can't take ssris and that type of stuff as its deadly to me. Learned that the hard way.
Beema
Your concerns about benzodiazepines are valid; some people do develop addiction issues with them. I think it's important, though, to make a distinction between addiction and physiological dependence. Addiction is a type of pathology. Addiction leads to drug-seeking behavior where a person wants (and feels they need) a drug, and often greater and greater quantities of a drug, in order to feel a certain way. Addiction is often paired with behaviors such as lying, stealing, prioritizing the drug over friend/family relationships, etc. I think addiction often has both physiological and psychological, as well as behavioral components.
Physiological dependence, as I understand it, is an issue of when your body's physiology changes to accommodate the presence of a drug in your system, such that sudden removal of the drug will cause withdrawal symptoms. (Whereas slowly tapering off the drug allows the physiology to return to normal and operate as it did without the drug.) The body may also develop a tolerance to the drug such that, much like is possible in addiction, it takes greater and greater amounts to achieve the desired effect. A person on a high dose of prednisone (a steroid) of a length of time will become physiologically dependent on the steroid, and in order for their doctor to safely discontinue the drug from their regimen, it has to be slowly tapered down (even if it was abruptly started at a high dose). But I don't know that it would be technically correct to call a person "addicted" to prednisone. If you do take it away too quickly, you're not going to find the person on a street corner hustling for more of it, or "fiending" for their "prednisone fix." They may get ill, but there's not that compulsion to get more of the drug or the behavioral disorders attendant with addiction. I hope that makes sense.
With benzodiazepines, you have a gray area, to be sure. There are people who VERY MUCH get addicted to them, particularly the more "popular ones" (of which, I wouldn't say either clonazepam or librium is one). There are also people who are on them for *years* and develop a physiological dependence without ever showing any sign of addiction. I've been taking some form of benzodiazepine almost constantly since 1999; lorazepam until last year and now lately switched to clonazepam. I didn't have issues with needing more and more of it to get relief; in fact, a few years ago I was able to reduce my dose to 1/3 of what it had been and still get relief (slowly tapering down, of course, to avoid withdrawal effects because I do have a "dependence" on it) of my symptoms. In general, I think at this stage in my life I require a relatively tiny dose, perhaps because as mentioned elsewhere in this thread, people with dysautonomia can sometimes do well with "mini" doses of things for whatever reason. (I have my theories about why, but I am SO not a pharmacologist, so I'll leave that alone.) As far as what happens when it is suddenly withdrawn ... for me because I take it daily (rather than PRN) and have done so for so long, it does cause a bad withdrawal reaction. We would never intentionally do that, and both times it occurred were mistakes. You live and you learn, and I know to keep a closer eye on things now.
I recently had an immediate family member who had been on a benzo for years taper off it completely without issue. They also never showed any signs of addiction (vs. dependence).
On the other hand, I would be lying if I said I hadn't read horror stories online about people who had hellish experiences with benzo addiction. Like anything else, I suppose it depends very much on the individual. We have several forum members here who take them with good success (I suspect we're all on quite relatively low doses, but I'm not sure), but we're not representative of everyone.
In the end, I think it's just one of those decisions you have to weigh out for yourself. In my life, it's one of the meds I would have a very hard time agreeing to discontinuing. It has made such a dramatic difference in symptoms that just were not manageable otherwise and has improved my quality of life to such a degree, that I'm fine if I'm on it for the rest of my days on this earth. I very much know what addiction feels like, because I was very VERY badly addicted to cigarettes before I quit. I honestly don't think I ever would have successfully quit if I hadn't had a cancer scare, and it was still probably the hardest thing I've ever done in my life. When I was off my benzo (at the time, lorazepam, and a high dose of it then too), I felt absolutely *horrid*, yes. But I wasn't craving lorazepam at all. My body nor mind never really even made that connection. I don't "fiend" for my next dose if I'm late taking it or miss one. (Even though that's one of the short-acting ones.) I've had leeway to take extra mg of my benzo PRN, and only did so maybe 3-4x a year on average the whole decade+ I've been on it. I guess knowing those things, and comparing the feelings between the cigarette addiction and the benzo dependence reassures me that, at least in my mind, me being dependent on this to treat legitimate medical symptoms is no different than a diabetic being dependent on insulin.
If you think the medication might give you relief from your symptoms and improve your quality of life, it might be worth a try. But I think it is realistic to consider the implications of physiological dependence on a drug. I also think it is wise to start with the lowest dose possible and raise it only if necessary. (I started clonazepam at 1/2 of a 0.5 mg pill per day which seems sufficient if I'm not under excess environmental stress.) If you are concerned about dependence and/or addiction, definitely discuss it with your doctor. You may also want to consider family history, as I think addiction has been found to have a hereditary component (as far as putting a person at higher risk goes)? You could probably ask for more information about that in our Substance Abuse Community and they'd be happy to answer your questions.
Physiological dependence, as I understand it, is an issue of when your body's physiology changes to accommodate the presence of a drug in your system, such that sudden removal of the drug will cause withdrawal symptoms. (Whereas slowly tapering off the drug allows the physiology to return to normal and operate as it did without the drug.) The body may also develop a tolerance to the drug such that, much like is possible in addiction, it takes greater and greater amounts to achieve the desired effect. A person on a high dose of prednisone (a steroid) of a length of time will become physiologically dependent on the steroid, and in order for their doctor to safely discontinue the drug from their regimen, it has to be slowly tapered down (even if it was abruptly started at a high dose). But I don't know that it would be technically correct to call a person "addicted" to prednisone. If you do take it away too quickly, you're not going to find the person on a street corner hustling for more of it, or "fiending" for their "prednisone fix." They may get ill, but there's not that compulsion to get more of the drug or the behavioral disorders attendant with addiction. I hope that makes sense.
With benzodiazepines, you have a gray area, to be sure. There are people who VERY MUCH get addicted to them, particularly the more "popular ones" (of which, I wouldn't say either clonazepam or librium is one). There are also people who are on them for *years* and develop a physiological dependence without ever showing any sign of addiction. I've been taking some form of benzodiazepine almost constantly since 1999; lorazepam until last year and now lately switched to clonazepam. I didn't have issues with needing more and more of it to get relief; in fact, a few years ago I was able to reduce my dose to 1/3 of what it had been and still get relief (slowly tapering down, of course, to avoid withdrawal effects because I do have a "dependence" on it) of my symptoms. In general, I think at this stage in my life I require a relatively tiny dose, perhaps because as mentioned elsewhere in this thread, people with dysautonomia can sometimes do well with "mini" doses of things for whatever reason. (I have my theories about why, but I am SO not a pharmacologist, so I'll leave that alone.) As far as what happens when it is suddenly withdrawn ... for me because I take it daily (rather than PRN) and have done so for so long, it does cause a bad withdrawal reaction. We would never intentionally do that, and both times it occurred were mistakes. You live and you learn, and I know to keep a closer eye on things now.
I recently had an immediate family member who had been on a benzo for years taper off it completely without issue. They also never showed any signs of addiction (vs. dependence).
On the other hand, I would be lying if I said I hadn't read horror stories online about people who had hellish experiences with benzo addiction. Like anything else, I suppose it depends very much on the individual. We have several forum members here who take them with good success (I suspect we're all on quite relatively low doses, but I'm not sure), but we're not representative of everyone.
In the end, I think it's just one of those decisions you have to weigh out for yourself. In my life, it's one of the meds I would have a very hard time agreeing to discontinuing. It has made such a dramatic difference in symptoms that just were not manageable otherwise and has improved my quality of life to such a degree, that I'm fine if I'm on it for the rest of my days on this earth. I very much know what addiction feels like, because I was very VERY badly addicted to cigarettes before I quit. I honestly don't think I ever would have successfully quit if I hadn't had a cancer scare, and it was still probably the hardest thing I've ever done in my life. When I was off my benzo (at the time, lorazepam, and a high dose of it then too), I felt absolutely *horrid*, yes. But I wasn't craving lorazepam at all. My body nor mind never really even made that connection. I don't "fiend" for my next dose if I'm late taking it or miss one. (Even though that's one of the short-acting ones.) I've had leeway to take extra mg of my benzo PRN, and only did so maybe 3-4x a year on average the whole decade+ I've been on it. I guess knowing those things, and comparing the feelings between the cigarette addiction and the benzo dependence reassures me that, at least in my mind, me being dependent on this to treat legitimate medical symptoms is no different than a diabetic being dependent on insulin.
If you think the medication might give you relief from your symptoms and improve your quality of life, it might be worth a try. But I think it is realistic to consider the implications of physiological dependence on a drug. I also think it is wise to start with the lowest dose possible and raise it only if necessary. (I started clonazepam at 1/2 of a 0.5 mg pill per day which seems sufficient if I'm not under excess environmental stress.) If you are concerned about dependence and/or addiction, definitely discuss it with your doctor. You may also want to consider family history, as I think addiction has been found to have a hereditary component (as far as putting a person at higher risk goes)? You could probably ask for more information about that in our Substance Abuse Community and they'd be happy to answer your questions.
You guys make me smile so much. Having kind of a dark day today and I needed this. Sorry, probably shouldn't be smiling at the problems of others ... but misery really does love company sometimes, you know? I'm putting my responses to everyone below by name because I need organization today to keep my head on straight. It's one of *those* days. (I'll explain in a minute when I start my own thread about what's up with me yesterday/today.)
Thank you for posting the last few days. Just reading 2 things in your posts was very validating for me!
1) That "electrophysilogist says they aren't classic panic attacks but wired up nervous system from ANS."
I have had anxiety and panic throughout my life, but I really believe that it is what you wrote above! I have never heard someone else say it. When you tell you doc that you have anxiety, they don't consider it a symptom of your illness, they think it is the CAUSE of all of your symptoms. This is so frustrating. I am a clinical psychologist and see no shame in anxiety or depression, but it infuriates me that most docs who can not figure out what is wrong with us, just write it off as an axiety or depressive disorder.
2) I can't take meds as I have become sensitve and very reactive to 99% of them.
I am the same way...always have been!! I tell the doctors and they don't believe me. I tell them to give me the lowest dose of any med or a child's dose. I wonder if this is typical for people with Dysautonomia. I always wondered why I couldn't drink alcohol without feeling really ill right away. I just learned why from reading about dysautonomia...alcohol diates the blood vessels and we already have ours dialated too much, so it makes our symptoms much worse.
I hope you have a good day today,
Shari
1) That "electrophysilogist says they aren't classic panic attacks but wired up nervous system from ANS."
I have had anxiety and panic throughout my life, but I really believe that it is what you wrote above! I have never heard someone else say it. When you tell you doc that you have anxiety, they don't consider it a symptom of your illness, they think it is the CAUSE of all of your symptoms. This is so frustrating. I am a clinical psychologist and see no shame in anxiety or depression, but it infuriates me that most docs who can not figure out what is wrong with us, just write it off as an axiety or depressive disorder.
2) I can't take meds as I have become sensitve and very reactive to 99% of them.
I am the same way...always have been!! I tell the doctors and they don't believe me. I tell them to give me the lowest dose of any med or a child's dose. I wonder if this is typical for people with Dysautonomia. I always wondered why I couldn't drink alcohol without feeling really ill right away. I just learned why from reading about dysautonomia...alcohol diates the blood vessels and we already have ours dialated too much, so it makes our symptoms much worse.
I hope you have a good day today,
Shari
Aw Surgi, that would be nice. But I'm afraid God will have me do the same thing I did in some of the theatre musicals I did in college....mouth the words. Not a good singer, but I can fake it pretty well. :) But am looking forward to that glorified body!! I also lose my voice when singing, but had thyroid cancer and that seemed to make it worse. And I notice if I'm anemic or have not eaten enough salt and drank enough water, I get even more dizzy than usual.
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