Talking to Your Psychiatrist – How To Guide

psych
I get really bad doctor anxiety and have trouble saying what I want to say at appointments. I find writing things down as I think of them days in advance helps. Here are some pointers on making appointments with your psychiatrist effective for both of you.

Be honest. This is important. Don’t lie to your psychiatrist. Don’t exaggerate. Don’t hide symptoms. Don’t be embarrassed. He’s probably heard it all before.

If you think a medication is or isn’t working, tell you psychiatrist this and why. It’s important to be informed on your medications. It’s important not to control your medications, because the psychiatrist is the one with the MD and training, but if something isn’t working, you have the right to say so.

Psychiatrists don’t often offer therapy much anymore*, but they do need to know about your life and general health. A psychiatrist is trained in diagnosing mental illness and treating it with psychotropic drugs, or a referral for therapy or other care, like a medical doctor would diagnose a physical illness and treat it with the appropriate care or medication.

Don’t focus so much on your diagnosis, focus on your symptoms(1). The diagnosis is generally used in communication with insurance companies and too many people get caught up in the diagnosis hype. Treating symptoms is most important. Right now, the DSM has just changed over to the DSM 5(2), and things are confusing. It can take a while to reach a diagnosis, so focus on eliminating the symptoms and getting better.

Be reasonable with your psychiatrist. There is no magic pill (I’ve been told this by so many doctors) and you have to work at it, too. Mood trackers, therapy, keep track of medications, go to all appointments. Don’t stop a medication unless you’re having a side effect that could kill you. Some medications require blood tests – get them done. Work with your psychiatrist.

A psychiatrist is a doctor and is going to have good and bad days. There are good and bad psychiatrists out there, trust me, I’ve had a couple of bad ones. Fortunately, right now, I like my psychiatrist. It’s not always easy to change doctors, especially if you’re in a country like Canada (where I am) and there’s a doctor shortage. A psychiatrist should always remain professional and never be rude to you.

*A psychiatrist is a doctor trained in psychiatry with an M.D. A psychologist is more often referred to as a therapist and you spend more time working on issues with them. Very few psychiatrists offer 50 minute appointments with a couch, a notepad and psychotherapy anymore, unfortunately.

 

Signs of a good psychiatrist:

  •  They listen to your concerns and don’t ask the same questions over and over.  They will ask relevant questions, about your mood, your current situation, and current meds.

I had a psychiatrist that asked me, every appointment, if I had quit smoking “dope” yet. I had never smoked “dope” in the entire time I saw him.

  •  They respect your concerns, needs and what you say.
  •  They stop medications if they don’t work, or if the side effects get bad.  I had a psychiatrist bitch at me when I had to stop lithium due to diabetes insipidus. He said I “complained too much”. Same one that accused me of smoking dope. I had two doctors telling me I couldn’t take lithium, and that psychiatrist was being a jackass, he had never heard of the condition. Fortunately, he retired. (Note: I only stayed with him because of how hard it is to find a doctor in this area)
  • A good psychiatrist respects your wishes with medications and doesn’t intimidate you about them. You should be able to be open about medications – you live with the side effects of them and you also pay for them one way or another.
  •  No psychiatrist should tell you you’re going to fail or never get better. If they feel that way, they should refer you.
  •  They should schedule appointments appropriately. Some people need to be seen every few months, some need to be seen more often.
  •  They should have open time to see a patient in crisis. Sometimes they can’t get you in that afternoon, but they should be able to get you in fast.
  • Keeping you waiting for hours in the waiting room is not good. They should also return phone calls in good time. It’s disrespectful and unprofessional not to.
  • You should feel comfortable and not threatened with the doctor.(3)

(1) Talking to a Psychiatrist
(2) DSM5 HomePage
(3) Makings of a Good Psychiatrist on Shrink Wrap

Be Nice To Yourself and Don’t Buy Supplements Online

Buying supplements online seems like a good idea, a cheap way to get supplements we want or can’t get in our country. I’m Canadian and some stuff just isn’t available here. I admit, I used to be a bit of a diet pill junky, or collector. I’d buy the stupid things and take a couple, get sick, and throw them all out when I got busted by my mom. I did that for 8 years. I wasted a lot of money. I admit, I still scour the Internet for diet pills. Bad habit. I don’t use them anymore, but I find them interesting.

simpsons

I am a very pro-treatment and pro-medication kind of gal. I’ve never found that naturopaths or homeopaths have worked for me, but I know those they’ve worked very well for. I’ve tried over the counter stuff for my bipolar disorder and it hasn’t worked. If it’s worked for you, great. Feel free to share experiences. I won’t deny that over the counter stuff works, it has helped me with other problems (pain, PMS, cramps. I hate painkillers, for example). I also won’t deny that it isn’t as tightly regulated as it should be, and that it can be dangerous. People need to see their doctors before taking it and follow precautions, especially if they mix it with meds. These are medications, too, just not as tightly regulated.

People are wary of prescription drugs. In the US, in one year, they spent $26.7 billion(1) on non-prescription supplements. I’m making a guess at this, but there is less guilt in taking something over the counter, less embarrassment than asking your doctor? It seems the world is split, some avoid prescription meds, and some overuse them. The happy medium isn’t big enough!

The FDA and a subsection (Dietary Supplement Health and Education Act DSHEA) have found:
– Some supplements found in stores and online can cause heart, kidney and liver problems with no warnings.
– There is little to no quality control and toxic substances such as pesticides, heavy metals or (for some strange reason) even prescription drugs are being sold with no knowledge to the customer.
– China is a major supplier of raw ingredients, which are often contaminated, have never had their factories inspected by the FDA.
Many products also exaggerate their claims, meaning, they say the supplement can prevent, treat or cure a disease. This is harmful advice, and this is illegal.
Consumers of the products often have no idea
A lot of the users of the supplements don’t know what they’re getting. It’s like a surprise, but it can hurt or kill you! A lot of vitamins and supplements purchased online contain very little nutritional value and can kill you, your kids or your pet. Seriously, if they get into them. There are a few reasons why buying online is a bad idea(2).

counterfeit

1. A medication can be “counterfeit” and dangerous. (I’m picturing a pill in fake Adidas with an Ak-47)
2. The product has probably expired, if it is real, and the seller has repackaged it for resale.
And for the best one 3. It’s stolen. No quality control.

If you can’t get it at home, don’t order it online. This includes even Amazon.

Counterfeit?
Counterfeit basically means “fake”, or “ripped off”. This is different from medications where there is a brand name and a generic, because the generic actually has real ingredients in it. A counterfeit mediction just looks real. It doesn’t act real. It’s never going to have as much active ingredient as it claims, and if you check out the link to where I’m getting this info, you’re literally paying a lot for a little bit of sawdust, according to the FDA.

roundup

Note: The criminals rarely get charged because it’s too hard to figure out who to charge, where it began and so on. Sad. This is costing a lot of money, $600 billion, to be, well, estimated, which is almost as much as terrorism costs. Cheap is so tempting, but it’s not legit.

Expired
All medications expire and can do weird things after they do. They can become more potent, less potent, or make you change colours and see things (or make you see yourself change colour?) It’s a bad idea to take that expired cough syrup. You’ll probably cough it back up into the toilet, for example, if you’re lucky. Generally a medication or supplement is good for 6-12 months after being filled at the pharmacy. Sometimes longer. Selling an expired product is illegal, its dangerous, because the product may or may not work, it could make you sick, and all the criminal has to do is slap a new date on the package.

expired

They can get any amount of $ they want. The pills aren’t counterfeit. If someone complains it doesn’t work, the “seller” and throw them a few good pills, or ignore it. Nobody knows exactly how effective this stuff is anyways. It’s a dangerous game when you buy online. Here’s a link on expired medications: http://www.rxlist.com/script/main/art.asp?articlekey=87599

As for stolen, well, that’s self explanatory. You could get a good product once, a bad product another time. Hit or miss.

When In Doubt
If you’re going to use supplements:
1. Don’t buy them online. Go to a local health food store.
2. See your doctor and pharmacist. Check for interactions. Get that physical every year, or every other year. Some doctors are very open to supplements. I know many that have a few concoctions for PMS and cramps!
3. Don’t take anything for weight loss, sexual ehancement or building muscle.
4. If it’s from the US, or you’re living in the US, it has a “USP Verified”(3) mark on the bottle. Their website is linked below with everything they verify.
5. You CAN overdose. More is not better.
6. If something feels wrong, tell your doctor. If it’s really wrong, go to an emergency clinic, or the ER.

Safely Buying Supplements
1. Buy from the manufacturer or a reputable operation in your own country. Try not to cross borders. Do not import things illegal in your country. (For example, ephedra, easy to get OTC in Canada, is illegal in most USA States)
2. Reputable companies supply a lot more information, ingredients, quality control info, and websites with more info, and even have phone numbers.
3. Avoid really cheap stuff.
4. Avoid sites like ebay and amazon, this is your health!

1. http://www.consumerreports.org/cro/2012/05/dangerous-supplements/index.htm
2.http://www.garyshealthtips.com/why-you-should-never-buy-supplements-on-amazon-or-ebay-a-must-read-by-former-fda-special-agent-gary-collins/wn

3. http://www.usp.org/usp-verification-services/usp-verified-dietary-supplements

I suck. And I’ll start updating more, too.

August 1 2008 I had been discharged from my longest hospitalization.

form1

October 7th, 2013 I was hospitalized until October 24th because the stress of life, the universe and everything kicked in and I broke down. Of course, no beds on my Dr’s unit, so he loopholed me through PERT – Psychiatric Emergency Resource Team. They had an emergency room physician come in and put me on a Form 1. 72 hour involuntary hold. Dr N, my pdoc, was not impressed. He took me off it when I was transferred to Unit B, the ward he works on. I was a danger to myself. What crap.

I had a panic attack when they handed me the Form 42 (copy of the Form 1). PERT is just seclusion rooms. Luckily, I wasn’t locked in. They nurse gave me some Ativan and a heated blanket. I slept. BF showed up. He brought McDonalds. My friends took my car back to the apartment. The next day I was transferred to Unit B, where my pdoc works. I had a private room. It was BF’s birthday. He saw me anyways. I owed him big for that!  They tried to give me Ritalin at 10pm, night meds. I refused it. They charted I was “refusing meds”.  My pdoc laughed the next day, thankfully, saying it was good I knew to refuse Ritalin at 10pm! He then told them to NEVER give it to me after 4pm.

Pdoc was good to me. Saw me daily. I had a pass for Canadian Thanksgiving. It sucked, my dad was drunk and being an ass. It was a short pass, thankfully, I had BF with me. “Oh, back so soon.” Oh, yes. BF went for his MRI results: No change in the tumor since his diagnosis a year ago!! MRI’s are yearly, now. At the best cancer centre in Canada, only 45 min away from us. He had a seizure last night. His neurologist is still working on the meds. Less bad, shorter seizures, but still minor seizures. No unconsciousness, no disorientation, but still.

So, we had a lot of groups. I met a couple cool people. I had a day pass, I went to the barn, went riding.

sparkle

That’s me on Sparkle. She’s a five year old, gigantic Thoroughbred filly. Her registered name is “Sparkle Tangerine”. I did some walk, trot, canter and a small jump. She was very good. Look how tiny I am on her!  I was exhausted when I got back.

I did all the groups. I got so sick of the religious crap from a lot of patients. There wasn’t a lot of super craziness like I’ve seen. No restraints used, no chemical restraints used. A few “code whites” (unmanageable or violent patient) called. I was going to go long term, but the beds weren’t available. Dr N saw staying on the ward was getting hard on me, and we agreed on discharge for the 24th. I start outpatient therapy next Tuesday for anxiety, stress. CBT, that sort of thing. One on one. The only cost is parking.

I now take Geodon (aka Zedox), Lexapro (Cipralex), Ritalin, Topamax, Clonazepam, mostly at lower doses, managing. and my normal meds for my health. I was diagnosed with endometriosis yesterday. BLAH. I start birth control (I’ve had a tubal ligation!!) after my period to try to ease the pain. If not, we do more drastic things. It’s not the worst thing in the world. The ultrasound could have shown a million WORSE things. (Endo is not detected on most ultrasounds) I’ve decided on rotator cuff surgery. Dr N was great to me in the hospital. I thanked him before I left, for his patients. The rec therapists were great. One I’ve known since 2002. We even had a ball pit!

That’s my life for now.

The Stigma of Bipolar Disorder

This is based on personal experience and the experience of others. If you want to add your own experience, please do so in the comments. Bipolar disorder has a stigma attached to it, and it needs to go away! The more that speak up, the better!

Mental illness has carried a stigma (a mark of disgrace or infamy; a stain or reproach, as one’s reputation) not only with family, friends, and the general population, but also with doctor’s, nurses and pharmacists, for as long as it has been around. Which is a very long time. They don’t throw us in snake pits anymore or burn us as witches, but the effects still hurt.

Bipolar disorder is a disease of the mind. The current theory is that it is a chemical imbalance with serotonin, dopamine and GABA. In a nutshell, a typical bipolar person swings between depression and mania, of varying degrees. We are said to be more likely to do stupid things in a manic or mixed episode, but everybody does something stupid. I am pro-medication and pro-treatment, and yes, bipolar disorder can be controlled with proper medication, exercise, diet and a good support system. We aren’t all raving lunatics. (Look at the state of the world today, we’re the sane ones!)

(1) We often get told we’re overreacting. Duh, that’s a symptom. One of my favourite things I hear is “Everybody has mood swings sometimes”. These aren’t mood swings they are mood episodes. Everybody’s mood swings, but not to the extent of that of a bipolar person. Our mood swings/episodes can be set off/triggered, but a lot of the time, they just come out of nowhere. Most people have a reason for having a mood swing, like losing someone close to them, a change in health, or circumstances.

People hear “bipolar disorder” and either don’t know wtf it means and you have to explain “It’s manic depression” and they assume you’re crazy, batshit, bonkers. I had a girlfriend ask if I was dangerous to other people. It didn’t work out. I’m not a “sociopath” (the accepted name nowadays is “Antisocial personality disorder) and there are very few bipolar people that fit the criteria for a serial killer!

I rarely get told I’m normal, maybe its the tattoos and sometimes crazy hair, but people with mental illness hate being told “You seem so normal.” Do you have any idea how much work it is to seem so normal? It’s a daily job. We aren’t “What You See Is What You Get”, nor is anyone. Don’t even get me started on asking if it’s “that time of the month”, either!

When I took Lithium, the second I said “Lithium” to a doctor of any kind, except a psychiatrist, because they’re more understanding (or should be) they’d immediately snap into attention and ask if I was bipolar. Lithium is often used to augment antidepressants and has a stigma attached. They would treat me differently. When I used to self harm, and needed medical attention, I was treated like a criminal in the ER.

Here’s a story. I used to be a competitive horseback rider but one day my horse refused a jump, I fell off, came down hard on it, and took the impact with my right upper arm and shoulder, protecting my head and neck, even though I was wearing a helmet. I thought nothing was wrong, so I put the fence back together, got on the horse, and finished my lesson. The next day I couldn’t grip with my right arm, and went to the ER. I had a fractured humerus and a shattered shoulder.

The doctor’s prescribed NSAID’s. I couldn’t take them at the time because they interact badly with Lithium. So I went without painkillers for a week until I saw an orthopedic surgeon. It was Sunday, my appointment was Tuesday. I didn’t want to wait in the ER because I needed a better painkiller, so I went to a walk-in clinic. I had been popping Tylenol 1’s (tylenol with 8mg codeine) but the pain didn’t fade. I was wearing a sling, so I gathered my meds (key note: when you see a doctor, always bring your medications or proof of medications, it makes life a lot easier) and my mom took me to a clinic because I hurt too much to drive.

The doctor was fine until he saw my medications and reason I was there. He made me submit to a drug test and yelled at me to see my GP (general practicioner). It was a Sunday. I told him the drug test would show benzos, as I take Xanax, and opiates, as I had been taking over the counter tylenol with codeine. He basically accused me of drug seeking and he yelled at me when the hospital was too busy to send my file. He did not touch my arm. “Hmm, you’re bipolar, so you must abuse substances”. He eventually gave me 10 Tylenol 3’s, and I left crying, from the pain and how I was treated.

I’ve had “friends” make jokes about self harm and suicide. I’ve had my parents not understand that my moods were cycling and the meds weren’t working. I was even fired by a psychiatrist once because I made a shitty attempt at suicide. I’ve been told to pull myself up by the bootstraps (whatever the hell that means) and get my shit together.

I’ve included these links below because I find they are helpful in explaining your diagnosis, and how you should be treated.

  1. http://bipolar.about.com/od/stigma/a/10-bad-things-not-to-say.htm

  2. http://bipolar.about.com/od/stigma/a/dont-challenge-bipolar-diagnosis.htm

  3. http://bipolar.about.com/u/ua/stigma/hurtfulthings.htm

  4. http://www.news-medical.net/news/20120913/Stigma-impacts-functioning-in-bipolar-disorder.aspx

  5. http://www.psychologytoday.com/blog/bipolar-you/201002/dispelling-stigma-revealing-your-bipolar-truth

  6. http://www.crazyboards.org

 Don’t let others get you down! You are a person too, probably a better person!

Scary Side Effects Part 3 – Antidepressant Induced Mania?

In the 1980’s, bipolar disorder was called manic depression and was a feared word. It was changed to bipolar (two poles) later in the 1980’s and diagnosed more and more. But often, the patient will present with depression symptoms, and get prescribed an antidepressant, which can cause horrible hypomanic, mixed, and even full blown manic episodes. This can be because we go to the doctor when we feel down, not up. After years and years of being bipolar, I know when to see a doctor for mania. (Also called “insight”)

 Mania can feel great, but it can also be dangerous. Impulsivity, people giving away all their money. Then comes the inevitable crash. Many bipolar suicides are accidental during a mixed or manic state. Some may say that antidepressant induced mania is just a side effect, it isn’t indicative of bipolar disorder. There are a lot of controversies about it.

 Some people put on antidepressants are bipolar, but it can have the same effect on somebody who isn’t bipolar. Their moods start cycling(1) and they start showing clinical features and meeting the diagnostic criteria of bipolar disorder. Is this a lasting effect? It can be. The criteria for bipolar disorder is one manic episode, although most have several.

 The findings of this study confirm that treatment-induced mania is a clinical phenomenon that belongs within the bipolar spectrum rather than a coincidental treatment complication, and that it should be placed under ‘bipolar disorders’ in future classification systems.” (1)

Statistics

Thirty-five percent of the patients had a manic episode rated as likely to have been antidepressant-induced. No variable was a predictor of vulnerability to antidepressant-induced mania. Cycle acceleration was likely to be associated with antidepressant treatment in 26% of the patients assessed. Younger age at first treatment was a predictor of vulnerability to antidepressant-induced cycle acceleration. Forty-six percent of patients with antidepressant-induced mania, but only 14% of those without, also showed antidepressant-induced cycle acceleration at some point in their illness. (2)

 Antidepressants can be devastating to someone with bipolar disorder. It can send the patient into a mixed or manic state. Some people are able to tolerate antidepressants such as tricyclics, MAOI’s, or Wellbutrin, but SSRI’s and SNRI’s have a tendency to push you over the edge. However, this may not be true at all!

 

Myth or Mania? Controversy

Sometimes the myth is just an incorrect use of language. Many people have detected a temporal association between the use of tricyclic antidepressants and mania in patients with bipolar disorder, but no mechanism is indicated. There is an assumption the association could extend to all antidepressants despite chemical and pharmacological transformations.(3) 

This association between mania and SSRI’s hasn’t been found. Studies find that the switch rate is no different than that of normal bipolar disorder when the patient is on an SSRI or SNRI.

 Revisiting the Controversy

Mania is likely to be antidepressant-induced and not attributable to the expected course of illness in one-third of treatment-refractory bipolar patients, and rapid cycling is induced in one-fourth. Antidepressant-induced mania may be a marker for increased vulnerability to antidepressant-induced cycle acceleration. Antidepressant-induced cycle acceleration (but not antidepressant- induced mania) is associated with younger age at first treatment and may be more likely to occur in women and in bipolar II patients.”(4)

 

Conclusion

Antidepessants can make a bipolar patient exhibit signs of mania. When the antidepressant is stopped, the mania generally goes away. Antidepressants are often prescribed for those that are bipolar, for the symptoms during depression. (I take Luvox for Pure-O OCD). However, a mood stabilizer with an antidepressant effect such as Lamictal or Lithium would be more effective than adding on antidepressants.

 

There are controversies, so keep that in mind. Also, with any medication and diagnosis: YMMV (your mileage may vary)

 

 

  1. http://psychcentral.com/news/2011/10/13/antidepressant-induced-mania-similar-to-bipolar-disorder/30300.html

  2. http://www.ncbi.nlm.nih.gov/pubmed/7625459

  3. http://thelastpsychiatrist.com/2005/07/do_antidepressants_induce_mani.html

  4. http://ajp.psychiatryonline.org/article.aspx?articleID=171161

How Meds Are Named

You’ve seen them out there, the meds with the silly names: Abilify, Geodon (Zeldox in Canada), Elavil, Viibryd. Effexor, Xanax, Depakote (called “Epival” in Canada) but how do they come up with these names? It doesn’t seem to make much sense!

 Actually, it makes perfect sense. A drug on the market has 4 names(1): a chemical name, a company name, a generic name, and a brand name. The examples I listed are brand names.

The chemical name is a scientific name given by the meds structure and rarely heard of for consumers. A company developing that specific drug will use the chemical name before giving it a generic name.

The generic name is given to identify a drug during its (useful) clinical lifetime. This is it’s “INN”.(2) It includes pharmaceutical substances or active ingredients. It has a unique name that is used worldwide.

When a company patents a drug, its trademark name is made, which is owned by the company and only they can use it. This goes away when the patent expires and you can get a generic. Some drugs, like Depakote/Epival, have more than one brand name. (3)

There are naming rules for medications! They sway away from h, j & k because of pronunciation problems. In English, it could make sense, but it could potentially be insulting in another language.

The Greek and Latin roots are studied when naming a drug. A brand name is often more catchy than the generic name, and also easier to pronounce. All of the meds I take, except for Abilify, are generic. Generics tend to cost less and have more companies competing to make the best generic. Contrary to popular belief, generics are pretty much exactly the same as the brand-name drug. The name can’t have any connotations of “promising to be better” in it, either.(4)

For example, Geodon (Geo-don) means “down to earth”. It can get really confusing!

 

  1. http://www.ucb.com/rd/info-centre/drug-naming

  2. International Non-proprietary Name

  3. http://cen.acs.org/articles/90/i3/Drug-Names-Come.html

  4. http://insidemystory.com/2012/08/02/choosing-a-name/

  5. https://www.msu.edu/~defores1/gre/roots/gre_rts_afx2.htm?…

 

Medications Part 3 – Benzo Comparisons

Benzodiazepine’s (shortened to benzo’s, otherwise known as tranquilizers) are one of the most prescribed drugs in the US. I’ve been taking benzo’s since I was 17 years old, that was the first med my psychiatrist put me on: Clonazepam (Klonopin for those in the US) I’m going to compare a few of them, explain the difference between dependence and addiction, and go through discontinuation, or withdrawal, symptoms.

Benzo’s are highly abused, especially Xanax, since it has a euphoric feel to it at first. I take Xanax (alprazolam) twice daily (.5mg twice a day) A year go, I was taking 0.5mg 4 times a day, or more. I slowly tapered down to 0.5mg twice a day and now I want to just have it around for anxiety or panic attacks, like before going to the dentist, or getting on a plane. I’m not saying this is for everybody: Some people need to be on benzo’s full time. I’m just setting a baseline for myself. Benzo’s are also good for seizure control, but you still need an anticonvulsant for regular maintenance.

Benzo’s are prescribed for a variety of reasons: Anxiety, insomnia, alcohol withdrawal, seizure control, muscle relaxation, something to calm you down before a procedure (like surgery, or the dentist).(1) They are CNS(1) (central nervous system- brain and spinal cord) depressants, but that doesn’t mean they’ll make you depressed. It is a physiological depressant, not a psychological one(2).

There are many benefits to taking a benzo, such as quick relief for anxiety. There are short term and long term benefits, anxiety and insomnia being a short term benefit. Valium is commonly used to help an alcoholic to get off of alcohol without horrible side effects. Librium is used for other drugs, as well, as it’s long acting and less harsh on the system to withdraw from. They are far less toxic than other medications.

There are risks to taking benzos, though. Some people have an opposite reaction and get very angry. They can be sedating (well, they are tranquilizers) and you shouldn’t drive until you know how it effects you. They can cause addiction, physical dependence and are not easy medications to get off of(4). It hasn’t been declared if it is safe to take them during pregnancy ornot. They also show up on a drug test.

Image

There are many different benzo’s to try, here are the4 most commonly used today:

Valium (diazepam): Treats anxiety disorders, muscle spasms and alcohol withdrawal symptoms(5) and sometimes used in the treatment of seizures. It has a long half life (up to 200 hours, with 6-8 at the beginning and slowly tapering down) so it’s one of the easiest benzos to discontinue, although it still sucks. Discontinuing a benzo should only be done with a doctors supervision.

Ativan (Lorazepam): Used mainly to treat panic or anxiety attacks. Comes in sublingual (under the tongue) form so it works faster. Kicks in pretty fast. Has a half life of 12 hours. (6)

Xanax (Alprazolam): Has the shortest half life of about 6-8 hours, and produces a euphoric feeling at first. Often given before surgery, or for insomnia, but most commonly used for panic attacks. (7) I sometimes take a pill, and ignore the taste, and dissolve it under my tongue if I get really panicky.

Klonopin (Clonazepam): A long acting benzo which is great for anxiety and panic disorders, and in higher doses, it helps with seizure control as well. (Also the first benzo I ever took!) It has a long half life of 18-20 hours, but it’s still not fun to come off of.(8)

Benzo’s are abused(9) and that is why some psychiatrists don’t prescribe them to people with an alcohol or drug background, or at all. I saw one psychiatrist and her first thing on the agenda was to get me completely off of Valium. Over my dead body. I fired her and went back to my (just retired and waiting for a referral) psychiatrist. But psychostimulant’s were perfectly fine, to her. Derp?

To someone not taking benzo’s on a regular basis, yes, they can be abused. They can be abused if they’re taken on a regular basis, too. They are a scheduled drug and if you get caught with them you better have them in the original prescription bottle or have a prescription/doctor’s note with you. They are scheduled because of their tendency to be abused. I crossed the Canada/US border with a bottle of Valium, no problem, it had everything on the label.

Some people start abusing benzos because they like the way they make them feel, their doctor has prescribed them for a good reason, and they get hooked after a while, and start taking more.(10) The more you take, the more you need, and if you find yourself without, well, you’ll go through withdrawal. Many people mix benzos and alcohol (sometimes even as a date rape drug!) which is combining two CNS depressants, and that has bad news written all over it. It greatly impairs your ability to think, as well as stand up. Thousands of people go to emergency rooms in the US every year for mixing benzos and alcohol.

Benzodiazepine withdrawal can be hell on earth. Many healthcare providers will switch you over to Vaium, because of the long half life (it gradually leaves your system, slowly, rather than Xanax, which is quickly out of the system causing you to crave it). The most common, and the most likely, side effects from withdrawal are: perceptual distortions, abnormal skin sensations, difficulty waking, anxiety, tension, agitation, restlessness and insomnia.

Some less common effects are: feelings of unreality, extreme depression, depersonalization, paranoid thoughts, headache, and seizures. Rare withdrawal symptoms are: psychosis, confusion and fits.

  1. http://www.webmd.com/mental-health/benzodiazepine-abuse
  2. http://medical-dictionary.thefreedictionary.com/Central+Nervous+System+Depressants
  3. http://www.benzo.org.uk/lader1.htm
  4. http://en.wikipedia.org/wiki/Benzodiazepine
  5. http://www.emedicinehealth.com/drug-diazepam/article_em.htm
  6. http://www.emedicinehealth.com/drug-lorazepam_oral/article_em.htm
  7. http://www.emedicinehealth.com/drug-alprazolam/article_em.htm
  8. http://www.emedicinehealth.com/drug-clonazepam//article_em.htm
  9. http://www.webmd.com/mental-health/benzodiazepine-abuse
  10. http://www.narconon.org/drug-abuse/effects-of-benzodiazepine.htm
  11. A very useful tool for comparing benzos: http://www.psychresidentonline.com/Benzodiazepine%20Comparison.htm