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Benzos longterm for anxiety

Has anyone here taken benzos longterm for anxiety? What has been your experience from taking the benzodiazepines longterm to managing your anxiety and panic? W/D from these meds is a nightmare. Things are great until tolerance starts to creep in after longterm use. Many say the w/d is the worst imaginable...easier to get off heroin than benzos. I can tell you from personal experience that the w/d is horrendous.
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Avatar universal
Most benzos are given short term for anxiety, but there are benzos that are prescribed for a longer period of time.  Klonopin is a widely prescribed benzo that has a longer half life and can be used for an extended period of time in my opinion.  But, as with any medication like this, your body can build a tolerance to it and coming off of it can be a challenge.  In my experience, as long as I came off of it very slowly, I did not have that much trouble.  Have you ever thought of an AD like Zoloft or Lexapro?  SSRIs like these are prescribed long term and help with anxiety in my opinion.  

Also, the best way to confront this for the long term is through talk therapy.  Do you have access to counseling?  Remember to consult with your doctor before changing any medication regimine though....keep us posted!
Avatar universal
Hi !
    Hummmm... I don't think that a longterm treatment with a benzodiazepine is possible without built-up a tolerance and have addiction BUT I know some peoples who use them since more than 20 years and dont have tolerance and addiction to those meds and they take the same dose since all those years and it's working good for their anxiety! Everyone is different.

For me, it's another story... Since 2005, I use benzodiazepine to control my social phobia, I didn't had panic, OCD, agoraphobia or anything else before I start them. My first RX for a benzo was for 2 mg of Rivotril (Clonazepam aka Klonopin in the USA) daily divided in 4 doses of 0.5mg.

At first, it's working like a charm for my social phobia, for the first time of my life I was able to walk alone on a street and feel calm and normal. It was actually fun to be free of anxiety while I was alone outside and I was more open to the others around me and not shy at all. After 4 months at 2 mg a day, it's stop working and I start having what I call rebound anxiety, I had a lot of panic attacks for no reason, was not able to do public speech at school, wasn't able to walk alone in the streets or take the metro or the bus, so I called my Doc at the time and he said that I had rebound anxiety because my brain was used now to the med, so he increase my dose to 4 mg a day!!!

The panic attacks stop and I was feeling just ok, like before I started the benzo med... what I didn't know at the time is that I was already strongly addicted to the benzo med...

At the end of 2006, I called my Doc again and told him that it was not working on me anymore. He double my dose, so I was on 8 mg a day of Rivotril and he add the unfamous med call Neurontin (Gabapentin) on the top of it, saying it was working also on the gaba receptors... it was a disaster... My social phobia was worse than before I start the benzo meds... in fact I was experiencing agoraphobia. I wanted to stop them completly but was told by the Doc that I had to tapering them slowly. I succeed to decrease my dose to 4 mg of Rivotril in 6 months... but wasnt able to stop them completly. At the same time, I try severals antidepressants meds ... some of them, especially the older ones like the Nardil was making me a lot sleppy, did nothing for the anxiety itself, but had to reduce the Rivotril because of the sedation... 1 year later in the summer of 2007, I ask the Doc to have a long half-life benzo to be able to stop them completly, so I start with 40 mg of Valium + 2 mg of Rivotril each day and slowly decrease the Rivotril and stay at 40 mg of Valium and after 3 months I was only on the Valium BUT it was a nightmare!!! But nothing compare with the Xanax withdraw I had the year later!

The Valium have maybe a longer half-life but it's doing nothing for the anxiety, it's good to put you asleep that's it!!! I was able to reduce the Valium faster and at the end of the summer 2007, I was taking only a 20 mg dose of Valium daily.

I stay on 20 mg of Valium from the fall of 2007 until the spring of 2008 when I had again panic attacks and bad social phobia. The PDoc put me on the Xanax ... wrong decision!!! I was put on 6 mg of Xanax daily in april 2008... and at first it was working like a charm, panic stop, social phobia stop... but the Xanax have more side-effects than the Rivotril, more a drug like effect, euphoria...and the short half-life give a lot of rebound anxiety...so only after 1 month I was highly addicted to it...

The PDoc had to increase and increase the dose and I ending at the psychiatrict hospital because of my addiction from the Xanax, I was at 12 mg daily of Xanax... barely able to speak and open my mouth to articulate the words I wanted to say... I was like a vegetable...and it was not working at all for the panic or social phobia after 4 months... At the hospital, they cut half of my dose of Xanax and replace it with the Valium again, I was on 100 mg of Valium, who was too much because of the sedation effect + 6 mg of Xanax... and I withdraw faster the Xanax, I was exhausted and a lot anxious... the withdraw process from the Xanax was something I don't wish to my worse ennemy. Wasnt able to speak for 2 months, poor memory, panic attacks all the time, tremors, depression...

From September 2008 until April 2009, I was able to have a normal life on only 30 mg of Valium divided into 6 doses of 5 mg... and things get worse...

I subscribe to a gym, start having panic attacks because of my fast heart beat and because it was full of peoples and since I have social phobia, I wasnt feeling very well there. The Pdoc put me again on the Rivotril... what a mistake ... at first he put me on 4 mg day... and to my surprise, the panic stop... but 1 month after I was again addicted to it and had to increase my dose to 6 mg... than the 6 mg stop working and was put on 8 mg...

Since November 2009, i'm dealing with OCD (mainly cardiophobia), GAD (new for me), SAD, severe panic disorder with agoraphobia (can't get out of my house since 4 months now without experiencing bad panic attack, can't drive my car or just go by walk to the convinience store who is 5 minutes by walk from my house, each time I get of the house, my chronic symptoms increase to the point that I do panic, well I do panic attack in my shower now or just when I watch the TV... ), I also have bulimia and a list of chronic symptoms that I experience each day of my life since more than 1 year!

I'm obsess about my heart (can take up to 100 times a day my pulse rate and blood pressure), have chronic chest pain, eyes pain, chronic headache, fears of meds (antidepressants.. I need to be back on them but I can't deal with the side-effects... the problem is that I try all of them in the past and never had any kind of side-effects... I just take an advil and I fear that I will have a heart attack, that's insane) and the list goes on...

So overall, the Benzo meds are not god for longterm treatment for me, maybe not for you. I think that everyone with an anxiety disorder should be put on an antidepressant med, benzo meds can be add for 4-6 weeks at the begining of the treatment to decrease the anxiety but they sould be withdraw slowly after that 4-6 weeks period... Finding the good antidepressant is not always easy... And the newer ones like the Pristiq or the Lexapro are not necessary the ones with the less side-effects or the best!!! Sometimes, older meds work better (Nardil for social phobia) or Paxil for panic and agoraphobia...

Benzo meds tend to worse the anxiety in a longterm view... addiction problem worse the anxiety, skip dose worse the anxiety and give rebound anxiety, also some side-efffects like chronic headache, worse anxiety, more panic, hands tremor, poor memory ... are often well know with the use of those benzo meds in a longterm view....

For the Therapy... it's not working for everyone... I admit that talking with someone can help somewhat, I have my own Therapist and each week I see her and I feel great after the appointment for only 3-4 hours... but after the anxiety increase again and I feel like crap until I see her again... CBT therapy are also not working for everyone... gradual exposure therapy for panic disorder don't work also for everyone... Deep breathing don't work also for everyone!!!

I think a good antidepressant is the best to treat and keep under control the anxiety... And remember that one med can work very good for one person and can be a pain in the *** for someone else...
345079 tn?1299206076
I was on ativan for three almost 4 years and have been on klonopin for over 3 years and it will be long term. I have not had to increase it more than .5mg
1402011 tn?1291415382
It depends. My mom has been on a combination of Xanax and Klonopin for well over 20 years and has never touched her dose. I would say she has severe anxiety disorder but if it is any relief anxiety seems to get better as we age, or we just burn out. It's funny because some new doctors are shocked that she is on a benzo, but they forget SSRI's only came into good graces since 1998 and have way worst side effects than a benzo, people just abuse benzos more.

I on the other hand was on a benzo for about 5 years when it stopped working, went on Paxil, twice and had to stop because of the 60 lbs, high BP and absolute craving for alcohol it developed. I have been back on a benzo (Klonopin) now for about 18 months, .125 to start then up to .25 for about a year, and it has essentially stopped working. I take a .125 in the morning and at night and I suffer withdrawal symptoms between doses. I refuse to up my dose because we all know that game, and it doesn't end well.

So I guess the answer is if you have the makeup to sustain on the benzo it is the perfect drug, but if your like most people I read about it is going to wear off and your choices are to get off, suffer, or increase the dose (never a good idea).
345079 tn?1299206076
I am on Paxil and the benzo. Some doctors think its awful others say whatever works and since I have been tried on everything there is and benzos have worked the best we stick with what works. I am 34 and have had severe anxiety for 20 years. I am on disability its so severe. Without the benzos I would not function as well because the side effects of all the new meds are so much worse for me
Avatar universal
You're so right !!! Don't increase your dose because each time it's ending with worse anxiety than before you start the benzo... especialy with the Rivotril, I don't know why but that benzo med make me really depress and addicted.

I'm on disability also, since 3 years now... on therapy, some peoples told me that I had to start working again and that my anxiety will stop by itself because I will think of other things than my body sensation and panic attacks or my heart... but I can't... just type that message will make me tired for the rest of the day, I can't imagine going out of the house for 8 hours of work... will kill myself after 3 days or less...

I never sleep so much in the last 3 years... since 6 months it's so bad, I need to sleep at least 8 hours, if not I feel very bad all the day... and since 1 month, even if I sleep 8 hours in a row, I feel bad all the time... I can't deal with any kind of stress ( noise, peoples around me, TV, computer screen, phone call...) everything make me anxious to the point that it's ending in panic attacks... I also feel very tired physically and mentally... that's why I always think I have something wrong with my heart... because I can't do physical things... but I have the same kind of fatigue that happen when I do mental task, so sometimes I put the blame on the benzo meds and the fact that the benzo destroy my memory and decrease my cognitive abilities...

I write that benzo meds are not working anymore, but I continue to take my 8 mg a day divided into 16 dose of 0.5 mg of Rivotril... My PDoc say it's a very high dose but since i'm having severe anxiety with panic and OCD, he don't want that I decrease my dose and to be honnest, I try in the last months to cut a little bit of my dose each week, no more than 0.25 mg a week.... and I ending with worse anxiety and more panic, so I think it must work in a certain way and I can't imagine me now without the Rivotril, even if it's suck !!! I will never be able to manage my anxiety without the Rivotril.

Before the last summer, The Rivotril was for me like a security pill... It was working for at least prevent panic while I had to drive and I was able to go out of my house without feeling like I will die all the time and feeling tired to the point that I need 3 days to recover from a small venture out of the house....

Before I had to drive my car, I was taking my dose and I felt more secure and knowing that I will not have panic or fast heart beat for all the time, or a slow heart beat who can lead to heart attack, or anything else wrong when I will have to drive...BUT in the middle of June, I had a very frightning experience, I had to drive to my Doctor office and had nobody to come with me, so I had to take the car alone and I had the worse panic attack of my life, just had the time to stop my car at the right of the road and I faint... I wake up and call my best friend and I was not able to speak of breath... it last 30 minutes... black out, lost of vision, strong tinnitus, dizziness, fast heart beat, severe chest pain (it's when I start having chronic chest pain)...

Since then, the Rivotril is not working at all to prevent or control the panic or the fast heart beat and I stop driving because I know that NOW, the benzo are not doing anything to decrease my fears, high level if apprehensions, avoidance or panic... and I know that I can do a car crash anytime and I don't want to kill someone else because of my disease...

Now I take it because if I don't take it, if I forget a dose for example between 7 and 9 AM, if I forget the 8 AM dose, I have severe chest pain and waek blood pressure, slow or fast pulse rate, to the point that I feel like I will faint again. Even my first cigarette in the morning trigger a panic attack each morning... but I can't stop smoking...  I try often but I can't quit for now...

I feel stuck and addicted to a BAD med who don't work anymore... I hate that... I never felt that way on the Paxil or all the other antidepressants that I try...  For the Paxil, I was able to start it to the 20 mg dose without any side-effects with the exception of the usual weight gain, but the weight gain is nothing compare to the high anxiety level I have now... I was also able to stop it cold turkey without withdraw effect... or rebound anxiety...  That's suck because now I can't start it again... 1 mg make all my chronic symptoms 50 % worse and my anxiety increase to the point that I want to kill myself... Eventually I will have to start it again, will work on that with my Therapist in january, maybe she will help me to start it at 1 mg and increase very slowly.... it will take 6 months before I reach the 20 mg but I don't care... I know that I will feel better after that... if I don't start it, I will be stuck with severe anxiety and panic, OCD and agoraphobia for how many times? 1 year, 2 years, 3 years, 20 years??? I want to be useful for the society, I want to work, I want to have friends, I want to have someone to love, I don't want to ending in a Psychiatrict hospital or in a small appartement completly homebound...

Of course, I try all the others benzo meds in the last 6 months... I return on the Xanax for 2 weeks and had to take 10 to 12 mg a day to have the same amount of anxiety that I feel on the 8 mg of Rivotril. For the Ativan it was 16 -18 mg a day to have the same anxiety level than 8 mg of rivotril... I try also to mix the Xanax and the Rivotril but it was doing nothing more to relieve my anxiety, I was just more sedated. I try to add some Valium with the Rivotril, thinking that a longer half-life benzo will help me to cope with the rebound anxiety between each dose but it was doing nothing good, even with 1 hour with 0.5 mg of Rivotril and one hour with 10 mg of Valium (so around 4 mg of Rivotril with 80 mg of Valium a day). I try also to mix the Rivotril with some Bromazepam with the same result... I don't try the older or milder Benzo like the Librium or the Serax, since they worth nothing... I don't try also the Benzo normally Rx to treat insomnia cause they are weak in general... they knock you out but don't kill the anxiety... and since I already feel like a zombie, I don't want to feel worse....

I even try the Benzo who is only RX for seizure, its call Frisium.... apparently, when the regular 1-4 rings Benzo meds stop working, some people can react very well to the Frisium who is binding to different places on the Gaba-A receptors... but well, on me it was like sugar pill...

Overall, I think that I completly ****** up my Gaba-A system. Like my PDoc explain to me, my Gaba-a receptors change in some way and didn't recognise the Benzo meds when I take them, so they don't work very well anymore. Also, he explain that on some peoples, the Gaba system in the brains will decrease the amount of Gaba receptors they produce in the brain... so less Gaba-A receptors mean less effectiviness of the Benzo meds...

Anyway... first thing that I will eliminate from my life, when I will be stable on the Paxil, will be the Rivotril and all the benzo meds... will never touch them again!!!
Avatar universal
I would have to agree that an AD is much more suitable for a long term prescription. I also believe that counseling is the best therapy.  Medications can definitely be a great tool while you are learning about your anxiety in the long term, but they will not permanently 'cure' you of the root cause of your problems.  Keep on working through it and you will get out on the other end a more well rounded person because of this experience, in my opinion.  Keep us posted!
Avatar universal
Thanks everyone for your responses.

* Alisonj29 - I am also on disability due to my severe anxiety and panic. How long have you been on disability?

* txQC - Thanks for your long reply. Hang tough friend. Do you plan on just staying on the benzo for now?
345079 tn?1299206076
I have been on it for 7 years now :( Hoping that I can get a grasp and change that this year.
Avatar universal
Well, for now, I stay on my 8 mg of Rivotril daily, I plan to start the Paxil at a very low 1 mg, who is very hard for me, and increase it of 1 mg every week or two, if one week i'm too nervous or have more panic or heart related problems, I will increase of 1 mg every 2 weeks only... I will see how it's goes... I will do this until I reach the 15 mg, who normally work to stop the panic, agoraphobia.or any kind of other "out of control" fears... After, the goal will be to reduce the Benzo very slowly when I will be stable on the Paxil...

I just wait for the Ok from my Cardiologist... I call him this week.. i'm experiencing stronger chest pain than usual, more lower legs pain, more panic attacks than usual and low blood pressure...  not usual to have a drop of the blood pressure, especially the systolic one, when you have a panic attack or severe anxiety...
Avatar universal
I am bipolar 1 with ADHD and GAD and unable to take any antidepressants, even with a mood stabilizer, so my doc and I agreed on long term xanax. I take a scheduled dose. If I start experiencing withdrawal between doses (rare since I take it at the same times, and am allowed 4 doses per day, I go up on my dose for a few days. Usually when I have trouble, it's triggered anyway. After a week or so, I slowly taper back down. I just pick a relaxed time of day (in a relaxed week), and take 0.25mg less, and keep going until I'm where I want to be. This has worked even going way down from higher doses. Other than having to manage tolerance this way, I've had zero issues taking it long term.
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