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Avatar universal

I just want the panic to stop!

So, I am on Klonopin .5 mg 3x a day, and taking Ativan when needed. I typically need (not want) 1-3 mg of Ativan a day. I haven't been on this high of a dose of benzos until several weeks ago. Right now, I absolutely need them, and all my doctors agree that it's my best option for now. My brain doesn't seem to work right, and just won't produce enough GABA. I really just want to stop the Ativan altogether, but at this point, it's unrealistic, unless the Klonopin is increased.

So, I've been really trying to let my brain produce its own GABA, by supplementing with L-Theanine (suntheanine brand). I've been taking 2-3 times the recommended dose with no noticeable benefits. It's supposed to help people, but I am guessing it only helps people who can actually produce sufficient amounts of the neurotransmitter (not me).

So, I went to the health food store and bought the most potent Valerian and Passion Flower they had, hoping to not need an extra Ativan tonight. The reason why I went to the store, is because I felt that something was coming on, looked at the Ativan, and thought, let's try something different.

Well, I had high hopes, but I got home, and it didn't work. I took double the amount of all the herbs, and took some L-Theanine. I started to feel tired and drowsy. The herbs were having an effect. However, the panic feelings were still present, but I was trying to ignore them. As I felt the need to drift off to sleep, my perceptions seemed to change, I felt a little spooked with an adrenaline rush, and then the underlying panic came out of its cage.

When I panic, I am surprisingly calm; in fact, I only will say a few words. I find myself touching my face repeatedly, as if it was the natural thing to do. If it's not as severe, I'll pace in circles touching my face over and over. If it's more severe, I'll lay face first on the ground. I need someone's presence when it happens, but the room needs to be quiet, and they can't talk to me as conversation is an extremely irritating stimuli. Tonight, I had the feeling of doom, and my blood pressure and heart escalated as it usually does (145/95 102 bpm). This was actually a good reading for me, as I've seen my blood pressure go much, much higher than that, and heart rate nearly double that speed. I feel the need for emergency attention every time. Unfortunately, this is an uncontrollable feeling for me. It really feels like I am dying. I put on my shoes, grabbed my keys, and thought about driving myself to an emergency room (I was in no condition to be driving), since only my little brother is home. I had thoughts of calling 911, but I've done that before (recently), so I resisted.

So, doing what a responsible person would do, I took the Ativan out of necessity (the attacks don't stop without it), and I was feeling better in about 40 minutes. Unfortunately, I don't always get complete relief from these drugs, but they make me well enough to stay home, and usually rid or lessen the feeling of doom.

I am on so many pharmaceuticals right now, and really wish I didn't need all these addictive anxiety pills on top of it. I have anxiety without depression, and it is terrible. What I went through today was nothing compared to some previous attacks, but a friendly reminder to listen to my body right now. I am told that after my underlying cause is treated, the anxiety, should go away, but sometimes I wonder if it will ever go away or if my brain is just stuck in its GABA deficient state. Unfortunately, I haven't found an anti-depressant that works at all for me. All they do is make anxiety worse. The more weeks I stay on them, the more they amplify the anxiety. I wish there was a better solution, that wasn't as addictive, but I haven't found one yet. Atleast the benzos give me a feeling of normalcy.

People claim that it impairs your ability to drive, it makes you less sharp, harder to concentrate, fatigue, etc. Well, in my case, all of those claims are a bunch of bogus. It does the exact opposite of every one of those side effects for me.

If I have a several day stretch where I am doing good, I sometimes try to cut back on my medication. My doctors know that I have a need for these drugs right now, and for that reason they encourage that I should take what I need. Unfortunately, those days of courage and optimism always seem to bite me in the butt.

I feel sorry for those on here that have panic attacks, and are told that it is all because of negative thinking, etc. I know there are a lot of other people out there with severe panic like me who have almost no control over what their body and brain is doing. I have so little control that I wouldn't accept that what I was experiencing was a form of panic attacks for a long time. I see a psychiatrist and a therapist now, and sure it does help me cope with the stress caused by my situation, but the attacks will stop when they decide to.
12 Responses
Avatar universal
I really don't think it's a good idea to be taking these supplements along with your meds.
Have you thought about taking an antidepressant? Many of these have antianxiety effects to them. Remar
Avatar universal
Thanks for your response. I have tried Several antidepressants, and I couldn't tolerate them. The neurologist wants to do a 3 day EEG, and the psychiatrist didn't want to prescribe me anything else until I got the EEG done. There is no way I am doing an EEG right now, because that involves stopping benzos. I refuse to do that at this point due to severity of symptoms, and next appointment I will opt for more symptomatic treatment. If I have enough benzos in my bloodstream, I mentally act and feel normal. If I don't have enough, I am in a state with an extreme feeling of doom. I physically feel like I am going to die. It's not because of an addiction, it's because I have a GABA deficiency. I went on the benzos because of those feelings. I do not feel depressed, and my mood is stable.

You would think all these benzos could curb the panic, but nope.
Avatar universal
It's highly unlikely you have a GABA deficiency.  There's no evidence people with anxiety or depression have any more of less serotonin or GABA than anyone else.  Just the way it is.  Nobody knows why this occurs, and why it's worse in some than others.  The major source of current research on anxiety is the amygdala, part of the primitive brain.  

More likely is the GABA isn't working properly, though why nobody knows.  There are two ways to get at GABA.  One is to try and soak the neurons in it longer, just as ssris do with serotonin.  That's what your benzos are essentially doing, though their mechanism is a little different.  They're not making more GABA.  Since they are much stronger at this than the valerian and passionflower, with the amount of benzos you're taking, these herbs can only make things worse or do nothing.  If you weren't taking medication, they might help over the long term to rebalance our system, but they can only do that if you're not on medication.  Since you are on medication, and appear to need its superior strength at this point until you find a therapist who can help you demystify the anxiety -- and I admit I never have -- then all you're doing by taking the additional GABA potentiators, valerian and passionflower, is risking overdose.  Theanine works differently, as it's a pseudo-amino acid, but I have to tell you, these remedies are pretty hit or miss, and are generally used in combination or they don't work well.  I would stop taking the natural relaxants at least until you improve to the point where you're not taking so many benzos at high doses.  

The natural way to make more GABA is to take taurine, which is the amino acid the body uses to produce GABA in the first place.  B6 is also essential to this process, but be careful as you don't want to overdose on that, either.  You can also take GABA in supplement form, though most believe the body doesn't absorb it well.  Tyrosine, another amino acid, also helps to make GABA, but as it also helps to make norepinephrine along with phenalynine, it can be stimulating.  But again, as you're taking as many benzos as you are, I wouldn't recommend doubling up on the process.  The logical next step would be ssris or tricyclics, but you've said they didn't agree with you.  So for now it's therapy and the benzos, I guess, and if you ever decide to try the natural route, it's a heavy commitment.  it will involve not taking the meds, changing your diet, exercise, relaxation practice, etc.  It's hard, time consuming, and works on building the body up, not sedating it.  And it probably works no more of the time than meds.

There are some natural remedies you can take that might help without conflicting with what you're taking.  These are the adaptogens, such as eleuthero and ashwagandha, and holy basil, which helps control cortisol levels.  You can also try homeopathic remedies while taking meds, though many practitioners don't believe they work well with meds in the system.  I have found some helpful, some not.  

For a good book on this, read Natural Highs, by Hyla Cass, a psychiatrist at UCLA.  It will at least show you how the natural remedies are used in combination and much of what's available.  But again, it's problematic to use them at the same time you're taking so much medication.  I hope this gets better for you.
Avatar universal
Saw psychiatrist. She upped my dose to 1 mg of klonopin 3x a day. I haven't upped my dose yet (still taking half that), but know I probably should. She wants to get me stable where I don't need to keep supplementing with Ativan.

I wish I didn't need the benzos, but I know I do. The panic and feelings of doom can still be pretty intense. When I'm not having an episode, I usually feel and act psychologically normal. No depression with any of this... just my happy otherwise stable normal self.

I am told (and hoping) this will go away as my underlying condition (Lyme Disease) gets treated.  The neuropsychological stuff got really bad (which wasn't unexpected) after starting antibiotics, and I am hoping I can taper off of this stuff as I recover.

It's been a tough year for me. I woke up very ill one morning last year, and struggled for a diagnosis for 9 months. I never knew what panic disorder was before this (I thought it was hyperventilation). It's by far the worst symptom I have.
1042487 tn?1275283499
I agree with Paxiled. Effects are mainly produced by the allosteric modification of a specific kind of neurotransmitter receptor, the GABAA receptor, which increases the conductance of this inhibitory channel; this results in the various therapeutic effects as well as adverse effects of benzodiazepines. GABA controls the excitability of neurons by binding to the GABAA receptor. The GABAA receptor is a protein complex located in the synapses of neurons. All GABAA receptors contain an ion channel that conducts chloride ions across neuronal cell membranes and two binding sites for the neurotransmitter gamma-aminobutyric acid (GABA), while a subset of GABAA receptor complexes also contain a single binding site for benzodiazepines. Binding of benzodiazepines to this receptor complex promotes binding of GABA, which in turn increases the conduction of chloride ions across the neuronal cell membrane. This increased conductance raises the membrane potential of the neuron resulting in inhibition of neuronal firing. I hope this will help your in your reflexion about ''i do not produce enought GABA''...

The views range from benzodiazepines being not effective long-term, that they should be reserved for treatment resistant cases or that they are as effective in the long-term as the main alternative agents, selective serotonin reuptake inhibitors.I would try Cymbalta or Lexapro for a more long term use if i were you. Have you heard of Buspirone (Buspar) ? It is used primarily as an anxiolytic, but also to a lesser extent as an antidepressant. If your problem is only anxiety i would strongly sugest you Buspar for a long term use... Benzos are definitly not used for long term uses.

Best Regards,
M4
Avatar universal
Thanks for all the science. I wasn't trying to get into too much science debate by calling it a deficiency.... all I was trying to say is that my brain doesn't work right, and GABAergic drugs are the only solution I have found that work for the panic and feeling of dying.

Right now, I am not interested in modifying drugs, etc, because:

a) I don't expect to be on them long term
b) They work, and have absolutely no side effects
c) I honestly wouldn't be able to live at home without them

If this type of severe panic with the feeling of doom sticks around (I hope this isn't the case), I may then consider an alternative route. I've tried SSRIs and SNRIs with no success. They stimulated me... as if I drank 100 cups of coffee. I couldn't drive a car while taking them. I had a panic attack with blood pressure 200/160 and pulse 200 on those when I showed up to the hospital. My blood pressure was already quite high before the attack (145/95). Go ahead and call panic attacks not dangerous if you will, but I'm smart enough to know that is not a safe range for blood pressure and pulse, and there is no way that could be good for your body. I either couldn't stay on the medication long enough to stand those "temporary" side effects, or the side effects wouldn't go away.

On the benzos, my blood pressure is usually around 115/65 now, but strange enough with benzos and beta blockers, it used to be high all the time, every day, with heart rate hovering about 100 bpm. Catecholamines have been checked multiple times and (strangely?) they are as normal as can be. My PCP thought I may have had primary hypertension at one point, but it was probably just part of the disease process.

I understand why some are against the use of benzos, but I think for cases like mine, they are needed.
1042487 tn?1275283499
I totally agree with you on the benzos being an heavy benzo user myself... But i overuse them only untill i get my Cymbalta which will help me deal with my anxiety and depression and will still have my bromazepam with me in case of a panic attack.
Question is: do you wanna spend your life on benzos and increase dose in case of tolerence ( i take 2 6mg of bromazepam to get the same effect now... ) and i had a 2 week withdrawal prior... take care with those...

But knowledge is power and the more we share and the more we know about it the better we feel. Don't be scared to talk about it to your friends or post often here. I'm always here to help and so are many other members. I can help you with the more technical and psychological side of it if you want well anyway if you have other question jus pm me...
Avatar universal
Like I said, I haven't increased the dose of Klonopin yet. I've been getting by by taking Ativan when needed, which seems to be most of the day. I've been trying to take Ativan .5 mg at a time to get a total of about 1.5 mg a day, but some evenings, I need an extra kick. The dosing of Klonopin hasn't been sufficient since I started it, and Ativan's half-life was too short to get rid of the feeling that I am about to die; a very unpleasant feeling.

Right now, I am under control 98% of the time, but I have to keep Ativan in my pocket at all times. During attacks I have some repetitive automatisms (touching my face repetitively), and I often won't speak or listen well during more severe attacks, but other than that, since I have the feeling of doom, racing heart, etc, I fit the clinical picture of a panic attack. My mom describes it as a catatonia-like state when it happens, but I've looked up catatonia, and I don't think it's true catatonia. I remember everything that happens. I really haven't observed what others are like when they have panic attacks, but it would be nice to see what it looks like. I usually just sit, pace, or if it's more severe lay face first on the ground feeling everything is going to end. The feeling of doom is awful, and feels all-too-real. I feel like I lose touch with the world for a little bit (extreme dizziness, and an extreme and strange altered mental state). If I say much at all, I often repetitively ask if someone can take me to the hospital. I think often I feel to scared to talk or respond to someone. My family is supportive and tells me "You are just having an episode, you are fine. It wil alll end in about 30 minutes.", but it never feels fine. It's not a feeling that I can just get used to. Once the meds kick in, everything is back to normal, and I am able to do things like laugh and make jokes again. It seems to take exactly 35 minutes for the Ativan to get me out of that altered state (which I am told is panic of course).

So, does this sound like a typical panic attack, or is there such thing as a "typical panic attack". Usually nothing provokes the attacks. I think there may be a connection to being tired. Occasionally a strange bodily sensation (such as a skipped heart beat, flutter, or PVC) can trigger a panic attack.

I never had problems like this when I was a kid (I am 23 now), but strangely, when I was a kid, I have suffered and was treated for depression. I think the depression was a teenage thing, and I see no relation to that and what is going on now. The depression was more situational, and this anxiety/panic happened when I suddenly became very ill last year. It took me a long time accept that I had panic attacks, because they were strange, unprovoked, and felt 100% physical. Nothing about panic attacks felt like it was possibly coming from the brain. Even though it is classified as a mental disorder, in my case, I believe it is a physical disorder of the brain caused by the Lyme infection.
Avatar universal
So, I upped the dose of Klonopin today to 1 mg. It sedated me quite a bit, and I am still quite sedated (more than I would like to be), but here is the weird thing: It seems to be causing anxiety. Is this possible? I felt relaxed the first hour or two when I felt the sedation. Now it's uncomfortable. I don't like feeling like this.

I think I will back down on the dose for now. I'd rather be doing the weak dose of Klonopin, and using Ativan as needed. Ativan has always worked great, but now I am wondering if Klonopin was helping or somehow contributing to anxiety even on the smaller dose.

I don't want to take an Ativan to get rid of the anxious feeling since I am already so sedated, but I'm wondering if that's what I need to feel normal.
1042487 tn?1275283499
Anxiety is all about being overreactive and your brain is overreactive so sedation is your short term solution untill you find to root to your problem. Talk therapy might help alot aswell as physical activity and healthy diet. Those are the 3 main options i sugest to everyone and they definitly work well...
Avatar universal
Well, I eventually had to take an Ativan on top of the Klonopin, and rather than sedating me more, it made me feel better, and able to think much clearer. I believe the larger dose of Klonopin caused an all day mild headache. Back to .5 mg of Klonopin, and calling psychiatrist tomorrow.

I would think these medications would essentially be the same on how are bodies respond to them. I always respond positively to a somewhat large dose of Ativan in severe situations, but Klonopin does not have a positive response to a larger dose. Does your body have to adjust before you see positive benefits of larger doses of Klonopin? Is my body addicted to Ativan? If it was just addiction, wouldn't a larger dose of Klonopin eliminate the need for the Ativan? I was thinking that maybe the sedative effects were causing the anxiety, but after taking Ativan, that didn't seem to be the case.

Aren't the pharmodynamics of these drugs essentially the same? There has to be an explanation for what I experience. I was expecting a positive reaction, but something about these drugs works on my brain differently. I by no means experienced a psychological reaction. It was the drugs.
Avatar universal
Well, I think I am going to stop visiting the forums a while. I need to find something else to do. I'm just wasting my time venting in self-pity, and I need to find some other activities to keep myself occupied. I have to focus less on myself, and just live the best I can right now. Life isn't fair, but that's ok. I'm just a little frustrated that I feel sick most of the time. I'm getting all the professional help I need for the psych stuff, and getting treated for the underlying condition (Lyme disease), and I am hoping this will soon all go away.

I'm much better than I was a month ago and I can function most days, but since I have temporarily moved in with my parents, I haven't been working or doing many activities. I think I am going to volunteer for something or do community service or something. Something simple, but enough to keep me occupied without over doing it.

Thanks for all the support I have been getting here. I just want my life back.
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