Your doctor took you off Xanax because it is not indicated as a long term treatment for anxiety due to it's long half-life Klonopin is a wiser choice for long term treatment even tho i'm against the idea of using a benzo as a long term treatment or chronic use. Long-term treatments includes antidepressants like Lexapro ( SSRI ) or Cymbalta, Effexor ( SNRI ). Canadian Psychiatric Association (CPA) recommends benzodiazepines alprazolam, bromazepam, lorazepam, and diazepam only as a second-line choice, if the treatment with two different antidepressants was unsuccessful.
Although they are second-line agents, benzodiazepines can be used for a limited time to relieve severe anxiety and agitation. CPA guidelines note that after 4-6 weeks the effect of benzodiazepines may decrease to the level of placebo, and that benzodiazepines are less effective than antidepressants in alleviating ruminative worry, the core symptom of GAD. However, in some cases a prolonged treatment with benzodiazepines as the add-on to an antidepressant may be justified.
You must now that there are many natural anti-anxiety medications/supplements available at your local food supplements store. Ask me if you want to know all the possibilities.
Therapy with a qualified psychotherapist is to be considered to address the problem to the root.
Can't add anything informative re medications to the post by M4, but will share my experience of some 30 yrs.
I believe doctors have tried every antidepressant in the book on me....finally in combination with Xanax. When my HMO forced me to change doctors I was immediately switched to Klonopin, which I take to this day.
I have a great deal of difficulty tolerating the antidepressants. The last one that worked, tho' it caused a great deal of nausea, was Effexor. It carried me through anal cancer treatment, then it suddenly caused a horrible rash on my face...an acne-like condition.
I was taking Klonopin @ the same time. Within a couple of months of looking and feeling awful, the weight gain began. Fifty pounds later, when dermatologist said I had to take an antibiotic to get rid of acne, I was at rock bottom. The antibiotic caused serious diarrhea and cramps. Bottom line: I took myself off Effexor and continued taking 2 Klonopin tabs daily. Haven't shed weight, but sure feel better.
Doctors are careful about anti-anxiety drugs that are habit forming. My doc has had me try three more antidepressants ...all with very poor results. I don't know much about Valium, but can tell you that Klonopin can be used long term. I often cut back, but will take full dose to get out of apt. At 75 I don't care if the world disapproves of me.
I see my doc now every couple of months: Medicare won't cover visits, and probably won't cover the Klonopin next year. So I pay $75 for visit, and will deal will medicine issue when it comes. Stay strong; you know what has worked and what hasn't.
Good luck Ann
Before discussing the benzos...are you in therapy? If not, that is something to consider, b/c while meds are a valuable tool, therpay is also helpful b/c it teaches you coping techniques.
Contrary to some people's belief, Klonopin is a great choice for long-term use, and unlike short-acting benzos like Ativan and Xanax...it doesn't have the same tolerance issues where you would need a frequent dose adjustment. once you find a dose that works for you, you shouldn't need to increase the dose but rarely.
The problem is...you went from a high dose of Xanax to a low dose of Klonopin (comparably), and the transition from one med to the next was handled very poorly. Klonopin has to build up in the plasma to acheive a therapeutic level. You were basically d/c'd cold turkey off the Xanax b/c the Klonopin still hadn't reached a steady state in your system, not to mention the dose was too low for you. When you finally got to a higher dose, it was starting to become effective. I understand that you said it took away the anxiety but not "completely". While that would be nice...that's a lofty goal. These meds tend to work well for a lot of people, but it doesn't mean you will be "anxiety'FREE". That's where therapy could be of real benefit for you.
Personally, I feel you need to have a sit down with your doc. Is the doc Rx-ing the Klonopin a psychiatrist? That would be preferable, and also he/she can recommend a good therapist.
If you are going to look into another med, it would most likely have to be Valium b/c, similar to Klonopin, it is indicated for long term use. Just be sure that if a change is made, that you request that the doc properly transition you from one to the next.
Lastly...the statement that "xanax is the most addictive" isn't actually true. Depends on the med and depends on the person. LOTS of people out there have developed problems with the other meds as well. As far as the research goes....it would be a tad skewed b/c Xanax is the most commonly prescribed benzo by a LARGE margin.
Best of luck to you...please let us knwo the outcome of your doc appt.
I would say none are a good choice. I don't know. I took valium for almost a year, and not all that much but it seemed to be turning my brain to mush and causing even more anxiety towards the end. I had to come off of it because I couldn't remember one thing to the next and was starting to feel depressed.I would say benzos are to be avoided unless it's a situational thing ie, some sort of traumatic event. I was separating from my husband and it was beneficial while I took it, but eventually it turned on me. Everyone reacts differently to benzos but Valium would be the weakest, but longest acting. It depends on what your anxiety is caused by and how long it lasts. Is it all day, low level, or a few hours, minutes a day? Have you tried other means to help your anxiety? Trust me, benzos don't work forever and you will develop tolerance and then have rebound anxiety to deal with. I am two weeks off of valium and feel like a veil has lifted and I can think again and feel much more stable. To come off benzos, I used fish oil, light box therapy, I took Kava-kava and some St. John's Wort and I used melatonin for sleep. I use these all to some degree anyway but I know they helped with the withdrawal, esp the Melatonin which allowed me to sleep properly. Good Luck!
Woozy..sorry you had such a bad experience, but as I have said numerous times, we must all be careful when using such strong statements as "benzos are to be avoided". You even stated that everyone is different, and that is so true. While obviously, it would be great if no one EVER needed this kind of med...the truth is...many do..and they have been a Godsend for a lot of people.
Also to say that benzos don't work forever is inaccurate. Klonopin is a wonderful choice for long-term treatment, as it doesn't share the tolerance issues that Xanax, and Ativan have, and it is very appropriate as a long-term medication. We have several patients at the facility where I work that have taken Klonopin for years, most have NEVER needed a dose increase, and one required one, about 2 years ago. I agree that if at all possible, the short-acting benzos, like Ativan and Xanax should be reserved for short-term courses when needed, due to the tolerance problems.
Again, with the nature of this forum, and with so many people being so reluctant to try any type of med, I think we just need to be cautious as to the statements we make. In the very least, be sure to make it clear that the remark is your opinion and based on YOUR experiences, which can differ from someone else's. Also, many people lump all benzos into the same category erroneously, when in fact they differ from med to med quite significantly. They sometimes get a bad rap unnecessarily. Anyone considering adding a benzo to their medication regimen should do so after weiging the options and after educating themselves on the risks vs benefits. Wanting to read about others' experiences is of course very valuable, but not if that person is going to make a decision about their own treatment plan based on the experiences of someone else.