![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by aphex on October 23, 2003, at 10:42:03
I'm a 24 y/o male. On the week of September 15th, I was diagnosed with Generalized Anxiety Disorder. I also have compulsive habits, including substance abuse. I've always been extra anxious, and felt physical symptoms of panic almost everytime I went to work or school, or into a social situation. Just about 3 years ago I started drinking sometimes when I got home to cope with the stress I couldn't cope with when I was going to work/school etc.
I had been seeing just a psychologist for half a year, and was against medication because I had tried Effexor and didn't like it. When I saw my psychiatrist, he suggested I research 4 medications, and see which one sounds best. Gabitril sounded best to me, since I read some about it being a "benzodiazepine alternative", and my psychiatrist is very against prescribing benzos. In January I had a PNR prescription for alprazolam, and that made me feel and function like I hadn't in years, so I figured since I coudn't try therapy with a benzo, the Gabitril is the best choice.
I've been on it for a month, and I started to feel beneficial effects(with some side effects) after 2 weeks when I had just started the full dose. Then a week later, I felt no effects at all, except for minor side effects. The anxiety came back even worse than I had ever experienced it, since I was no longer using alcohol and other compulsive habits to deal with stress, and the medication stopped working.
My question is whether or not the Gabitril is a good choice, and if it is common for it to work, then stop work, then work again once I have been on a constant stream of it long enough. Also, how common is it for doctors to be very against benzos? Should I just ask the doctor about Paxil?
Posted by Viridis on October 23, 2003, at 13:35:02
In reply to Gabitril vs. benzodiazepines for GAD, posted by aphex on October 23, 2003, at 10:42:03
The anti-benzo mindset is very common, and sad, since these are very effective meds for many people. The concern seems to be dependency, but if anything, Paxil and many other antidepressants have a worse record for discontinuation problems than benzos (plus all the side effects of ADs).
Based on my experience, I'd recommend you try Klonopin (clonazepam). It seems to be the "gold standard" for panic attacks especially, and I've found it extremely effective at a low dose with no side effects after the first week or two.
If your pdoc is so set against benzos, I'd look for another doctor. There's no justification for benzophobia in a situation like this, and a doctor who's so set in his/her ways that they won't try a safe, well-established drug like Klonopin is really doing you a disservice.
Posted by aphex on October 23, 2003, at 14:12:42
In reply to Re: Gabitril vs. benzodiazepines for GAD » aphex, posted by Viridis on October 23, 2003, at 13:35:02
> If your pdoc is so set against benzos, I'd look for another doctor. There's no justification for benzophobia in a situation like this, and a doctor who's so set in his/her ways that they won't try a safe, well-established drug like Klonopin is really doing you a disservice.Here's a catch-22 situation: Because of my anxiety, I find it so difficult to get a full time job, and get "real" insurance. I am a student at a state college, so I have health insurance through them, but I can only see the school's psychiatrist.
I felt the same way when I was diagnosed and asked about benzos. What if this is a medication that can help me like it has helped thousands? How can a doctor categorically denying the benifit of a class of drugs really be acting benificial to his patients?
For now, I'm going to ask about getting off the Gabitril, and trying Paxil. It seems that is my only option.
Posted by DoYouKnowHim? on October 24, 2003, at 2:52:50
In reply to Re: Gabitril vs. benzodiazepines for GAD, posted by aphex on October 23, 2003, at 14:12:42
i presume the reason your doc wont prescribe you benzos is because you mentioned you had a past "substance abuse" issue.
benzos really a get a bad wrap and it is undeserved. they are a wonderful med for people who use them for the right reasons. most of the horror stories that are publicized are dealing with people who use benzos for recreational use, and not medicinal.
i would talk it over with your school doc again. see if he/she would consider changing mind.
in the meantime, i would recommend going to the campus library and checking out "beyond anxiety" by edmund bourne. it covers all issues and treatments about all forms of anxiety like none other in the world.
Posted by aphex on October 24, 2003, at 7:48:47
In reply to Re: Gabitril vs. benzodiazepines for GAD, posted by DoYouKnowHim? on October 24, 2003, at 2:52:50
> i presume the reason your doc wont prescribe you benzos is because you mentioned you had a past "substance abuse" issue.
I understand the substance abuse issue as a reason, but my main concern with that is how is a person supposed to get better without effective medication with their treatment? I felt anxious all of the time, and all that was available to me was alcohol.
But, I realize the main reason my pdoc can't prescribe benzos: He's only available at the schools counceling center a few hours a week. Benzos need much closer monitoring than that, its hard to get an appointment when I need one, and he's not available over the phone. So I will have to explore other options. Thanks for the book suggestion, I'll check it out.
Posted by Viridis on October 25, 2003, at 1:42:08
In reply to Re: Gabitril vs. benzodiazepines for GAD, posted by aphex on October 23, 2003, at 14:12:42
Could you see a regular doctor and explain the situation? Many will not agree to prescribe benzos, but some will, if they have any common sense (older doctors especially, since they've been around and know what really works). I would stick with clonazepam (Klonopin) -- a request for Xanax can be interpreted as "drug-seeking behavior", even if it isn't.
Generic clonazepam is quite cheap (around $20/month, depending on the dose etc.) -- you just have to find a doctor who will prescribe it.
Good luck!
Posted by DoYouKnowHim? on October 26, 2003, at 3:04:52
In reply to Re: Gabitril vs. benzodiazepines for GAD » aphex, posted by Viridis on October 25, 2003, at 1:42:08
I agree, you ought to try for the Generic clonazepam. it is cheap and extremely effective.
thats a bummer about the school doc, but God always makes a way where there seems to be no way. if you dont have the money right now for an outside doc, perhaps you can go through a church counseling center and explain your situation (and maybe pay them over a period of time).
surely, somebody, somewhere can help you. i am pulling for you.
Michael
Posted by aphex on October 27, 2003, at 21:15:46
In reply to Re: Gabitril vs. benzodiazepines for GAD, posted by DoYouKnowHim? on October 26, 2003, at 3:04:52
Thanks so much. I'm learning now that my best plan is to find a full time job. I'm not too busy with classes right now, and although it is a huge challenge for me at this point, it would be good for many reasons, including having more options when it comes to mental health.
If I had taken care of this a couple of years ago on my parents insurance, I'd have been well on the way to being better now. I figure, I have to take more responsibilities if I want more options.
-Paul
Posted by DoYouKnowHim? on October 29, 2003, at 1:40:40
In reply to Re: Gabitril vs. benzodiazepines for GAD, posted by aphex on October 27, 2003, at 21:15:46
It might be tougher to find a job than a pdoc to prescribe you Klonopin with the way the market is now, but I wish you the best of luck.
You should NOT beat yourself up for taking care of this under your parents' insurance a few years back. That is in the past and there is nothing you can do about it. Let it go ...
Again, check out that book "Beyond Anxiety" by Bourne.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.