Benzodiazepines: Problems with doctor

[jkb]

I was wondering if anyone knew if dropping down off a benzoid at .5mgs a month is safe with no other medication added. As well as what am i to be expected?, How should i do this decrease? (wasn't given directions..just told to do it how i want), Is this safe? And finally how to handle my gad/pa's/agora..

One final question..can another med not be added in while being on a benzoid? Or does one have to completely get off it and then add in a new med?

I am taking..alprozalam.

TYIA for any replies.

 

[David Baxter PhD]

Re: Benzodiazepines

I was wondering if anyone knew if dropping down off a benzoid at .5mgs a month is safe with no other medication added. As well as what am i to be expected?, How should i do this decrease? (wasn't given directions..just told to do it how i want), Is this safe? And finally how to handle my gad/pa's/agora..

I'm not sure if I understand the question. if you are asking about decreasing your dose by 0.5 mg per month as a way of tapering off, that's probably a safe rate of decrease to minimize withdrawal. As to what to expect, it depends partly on what the current dose is and how long you've been taking it but best guess would be some rebound anxiety and insomnia for a while.

One final question..can another med not be added in while being on a benzoid? Or does one have to completely get off it and then add in a new med?

It depends on what the medication is that you are trying to add. You can certainly add an SSRI while taking the benzodiazepine, because it's in a different family chemically entirely. On the other hand, you would need to be more careful about adding in, e.g., one of the atypical antipsychotics.

 

[jkb]

Re: Benzodiazepines

TY for replying

Here is the issues..putting it in point form:

-i am on 4mgs a day, sometimes an extra .25mg depending on the anx.
-been on this dose for? a year? i believe..maybe less..8mths.
-been on the med for 15 yrs.
-my anx./agora etc was doing good/better and then it started up again...about 3 mths ago. not sure if it is external stressors or the med not working.
-called my dr. beg. of feb to tell her this. Asked what to do, increase?? a new med??
-nothing happened..well it did..long story but won't go into that right now...
-was told by her/receptionist that you can't add in another med, that the xanax has to be out of me before trying any type of new med.
-i am scared, don't understand..how am i supp. to drop down, with no other med/hlep when my anxiety/agora is not in control at all. It has risen due to the above problems..or whatever is going on with my doctor. I am not geting any real explainations..
-was finally given a referal to the ROH anxiety program, but that could be up to a 6mth wait..so what am i supp. to do until then, let alone how am i supp. to deal with the anxiety/agora .?? and NOW withdrawal ??
-been searching for a new doctor..very hard..
-i don't understand this all..even my pharmiscist didn't
-i havent dropped yet...i don't know what is right..if this is right and why am i not able to try a new med to help me..aka i don't see how i am going to make any appt's with my anx. already being sky high and then going off the xanax with nothing?
-is this ethical? aka proper ?

sorry for long post.

ty for listening.

 

[David Baxter PhD]

Re: Benzodiazepines

What is the situation with your current doctor? Can you not get appointment at all with him/her? I'm not sure you should be taking advice from his receptionist as necessarily definitive.

 

[foghlaim]

Re: Benzodiazepines

I'm not sure you should be taking advice from his receptionist as necessarily definitive.

i agree with david...


you do have to ask your doc on this.

if you cannot get apt.. maybe copying what u have wrote, as is.. put in envelope and either hand it in or post it in to the doc.. along with a note of course..

an option maybe??

 

[jkb]

Re: Benzodiazepines

Ty for your replies and suggestions ..much appreciated..

As for getting an appt. with her..i don't think so.

I had to write this out abit at a time cause it is causing me anxiety/stress..when going back through it all...and i don't know why since i am just writting..

what has been going on/transpired to answer your q about the curent situation with my doctor.

The story:


-phoned beg. feb as noted in last post , stating exactly that to the nurse.(about how meds or ? isn't working since i am exp. more anxiety..and not getting farther..)
-nurse said she would talk to dr. and call back.
-i didn't hear for days so i called back.
-receptionist said a letter was being sent out and was not willing to further the conversation. I asked what? what letter? about what? i'm confused.. She said you will just have to sit back and wait to get it.
-waited and waited for i believe approx. almost a week and half. NO letter was sent to me, i never recieved one.
-more scared/flustered i called back saying i haven't recieved this letter..i want to talk to dr.? blank . i want to know what this letter is about.
-long story shortendied up getting it faxed to my rental office for i did not want to wait till gosh knows when to get it. In the first letter it said she no longer wanted to deal with my anxiety/agora etc.., that she no longer felt comfortable prescribing me my med and i had 2 choices to go to the ER when i ran out or to accept a referal or she would stop my meds asap.
-i replied back saying fine..i acept of course..never have denied further help nor meds (as also mentioned inthat letter by her)...and that i was wanting clarifcation on whether she was my gp still and why is it that we could not after all this time working "together", try a med adjustment or add in something...and that i was shocked. etc.
.-got a letter sent back to me saying that i was a burden to the staff for calling abut questions, that they have 3000 patients and do not have the time to be my support people (they meaning the nurse and receptionist), and that how she has wanted me off of the xanax for a long time now ( absolutely untrue..never been a meention of this with her not to mention if this were the case why did she up my dose ..) and how she said that the xanax was causing increased anxiety., and if i did not comply with her rule of me getting to an appt. that she would make to someone..that i would be left to fend for myself.
-replied back, since i then and still do feel like a huge burden etc.., that i didn't understand this all..that none of my questions were being answered (is she my gp, why can't we try new meds or an increase, etc..) and how once again i don't? deny help, and i do not see where i have been such a burden, but i am sorry. I also stated in there that i had spoken to 2 other shrinks and pharmaists , and both siad yes you can add in another med..., that my increase in anxiety/gad/agora was not likely at all caused by the med since i have ben on it for a long time, and if this were to happen it would of happened along time ago etc. i had done this research etc for my knoledge and that i was still lost and very confused.
-no reply
-got a call late in the month by her saying that she had set up a appt. for detox at the QCH, that this was the only way, that i would thank her in years from now, she had to go due to patients waiting for her, she said good luck, i will be thinking of you , gotta go bye. click
-i started crying..for i had no idea and still don't as to why this..why she had done this..the reasons etc...and i got very freaked out. i began calling places, cmha, um tons of places and they did not understand this at all..not at all...once agian. Esp. since I do not abuse my medication at all, never have never would.(all documented) i do not drink or use drugs. Pharmicist at this time didn't understand either. Started a process of calling the college of phys. to talk with them about this.
-I did not go. I did not go due to fact taht nothing was explained, i had /have the right to know about any treatments pre arranged, and i didn't agree after hearing all i haad from other professionals etc. For i was told i have the right to know about my treatment and why.
-I even tried to contact this psychiatrist or ? /doctor about why this was neccessary and for further info..I was denied answers.
-I was then adviced to stop contact with her/my doctor..and to search/seek out a nother doctor or shrink since i was getting no answers and i feel/felt that i was bieng mistreated. I have and am seeking one out..yet it is next to imp. to find one..
-Finally last week I called the ROH intake office for the anxiety program to talk again and to gain possibly further resourses etc..she knew who i was and she knew my doctor. She gave me a nuber to call..another resourse..
-the next day, got a call from the doctors officce and that is when i was told by the rec. all i had just wrote in my last post that i had to get off sanax in that way, that the ROH had called them saying i was talking with them, that she was putting in a referal, and if id id not go nor drop my? meds as stated, that that was it, she would stop all. and they were calling in to pharm to change my perscription.... i said but what about my anx..how do i cope? ..but nothing..nothing at all but this is the way it is.
-crying and crying i have..anx. been way up..scared to.
-called pharm. again..talked as last post..and he said even last night not to go down like that..under my circ. and maybe try if i want a cut of .25mgs, till i can get further answers, and that i could call them? if i wanted anytime..and he still did not undrestand any of this..since i amvery much agora and anx. is up
-this all has caused me intense anxiety..i have had nightmares..i don't like nor feel like i ambeing teated right..and i feel like some animal in a cage being teased and played with..being given ultimatiums, not getting answers, nor help..and all the while i sit here..more scared then i ever have not knowing what is going to come..
-I will be writing this weekend a letter with the fact only..and trying last time..i can't do anything more..she doesn't seem like she wants anything to do with me..this is stressful..and traumatic..or so it feels..
i am gonna take today off..or try to and keep calm....this has? been a long battle...and one i think wasn't isn't nec. to begin with..

all i wanted from the beg. was help..not this disaster..and not to mention how this has and is impacting my health/anxiety.....

that was hard to write out..i feel on edge..gonna break and calm

i haven't cried as much as i have had over the last month and a half ever..nor has my anxiety been this bad ever ...

i hate this ..

ty for listening.

 

[jkb]

Re: Benzodiazepines

i know why i am scared..exp. more stress re this all..it is due to the fact taht she left me way back in '01/beg of '02 for no reason..and left me..and i did exp. some traumatic things due to this..i did go back to her..about a year later..we talked..she said she wuld never do this to e again..there is where the fears lie..where all this stress is mounting..feelings of anxiety.

It took me all day to just write point form a letter and fax it..how silly is that..

I am really worried what is to come..if i did wrong I don't think i did at all..but it feels like it since every time i try to talk to her..i feel that things get worse..not better..

i will be a mess until i hear..sometime tom. hopefully what she says..about the points i made..and what she will do next..worried that things will become worse.. unsure of how much worse it can get..

sorry for writting again..had to let it out.

I am going to try and forget it for now..and do some breathing and watch a funny movie or something.

 

[Cat Dancer]

Re: Benzodiazepines

I'm really sorry about all the stress you're going through. I dont' understand either why your doctor is doing this. I hope you can find a new doctor.

 

[Peanut]

Re: Benzodiazepines

jkb, who is she from your last post? ?Are you talking about your doctor? ?

I didn't respond earlier because I can't think of any advice, but the experience with your doctor sounds awful. ? I can see why you're upset, I would be too. ?It doesn't sound like your doctor is handling this well (or doesn't know how to handle it). ? ?Maybe you could see a psychiatrist who might be better at this sort of thing than your general doctor? ?Also, maybe you should get a new gp, one that you can rely on more and who might have a fresh perspective on your situation. ?Anyway...I just wanted to say that I'm sorry that you have to go through this.

 

[foghlaim]

Re: Benzodiazepines

Hi Jkb,

It took me all day to just write point form a letter and fax it..how silly is that..

i don't think that it is silly,? but i used to..(and i could use other words to describe how i thought about it taking so long) *s*
i find it very difficult to write sometimes,, (well actually nearly all the time). ?i get distracted with diff thoughts running thru my head, even now here this min.. it's taking a bit of time.
i do find it extremely frustrating that it can take me so long to say a few words.
i have to think of it this way,? ?does it matter how long it takes really? as long as i get what i wanted to say said.

remember you? did get it done and faxed.
i think u did good!

enjoy the movie..

 

[jkb]

Re: Benzodiazepines

Thank you all for your kind words and support ..means alot

Update..
-i hadn't heard back from the office so i called at 1:20pm to say /ask if they recieved the fax.
-nurse said let me check I'l call you back.
-called back and said that yes she did but is to busy to reply and will if a report is neccessary.

Really nice..really nice..what does that mean? What am i supose to do? Handle this? I hope that she does call back at some point..but i just don't know..i don't.


i am telling you this..i have tried..tried many of times to talk..and this was the last..what more can ido? my letter was not rude..not rude at all..it was point form..just as stated basically as i have written. I honestly do not feel i am being treated right..and furthmore..i can't see myself dropping down/with nothing..and trying to function/deal with her/this i mean and my agora/anx/gad...

i am just shocked..but i guess in a way i am not..

To answer your q'sToeless ..she is yes my doctor..

i have been seeking a doctor/new one for over 3 weeks now and it is next to imp. since so far with all my calls no one is accepting new patients.. I was told by the college of physicains that there is def. a shortage of doctors here..big time.

As for shrinks..you ned a referal by a gp to see one. I have as well been calling around to find one..not that i know of how i'd see anyone with this anx..but i have been calling and no..either they are booked or need a referal. Plus..supp. my doc. has finally or is putting in referal as stated before, into the ROH anx. to see one..yet that can be quite a wait..

I don't know what i am going to do..if i can't find a doc or she doesn't call back and help or....anyhow that is what has happened..

 

[foghlaim]

Re: Benzodiazepines

JKB, i was just wondering about a social worker,\ or a community welfare office, don't know what these ppl are called over where u live.
over here, we can use our C.W.O to find out info, apply for medi cards.. and to find out who the social worker for our area is.
i'm thinking that if you feel you are getting no help from your G.P. that maybe your social worker can find you another one and or a therapist.
it might be worth checking out. ???

 

[jkb]

Re: Benzodiazepines

Thanks Notsure for your reply?

Well have heard nothing at all today from th doctors office....yet i think she isn't working today if i recall..she works p/t..so who knows if i will hear something..or not tom..been trying to let it go for today..and just be..just getting run down/tired from oh 40 days now of all this ....

Umm as for a social worker i'd have to find one..so we 'll see..and from my understanding a therapist can't refer. I do have to try again and make an appt. with mine though..

soemthing interesting is that i found out that one of the pharmacists sent in a letter of convern to my doctor last week..on friday..so i guess i am not that 'out of my mind' aka not believing that what she has done is right etc...

anyhow..guess i'll see..and will be trying to find a new doc..just really hard..

thanks again

 

[jkb]

Re: Benzodiazepines

My day..


I didn't hear anything so i caled the office and only was able to talk to the nurse. This is what happened:

-a. said that there is no way that can add in another med.
-b. would NOT explain to me why u can't add in another med of any type..just said u can't...and she wouldn't
-c. said i will not exp. any withdrawl...don't worry
-d. would not allow me to speak or anything with her.
e. I have no choice
f. that what she is doing med wise is the only way and i should be just fine and that i don't know this yet..and who knows about even adding or putting me on any other med afer i supp. get 'off' xanax with nothing and with my agora etc being as bad as it is.
g. doesn't even have my right med start/aka what i am on now written write!!!..even though through various faxes over the last month and a half i have stated what i take ..and in my last fax as well.
h. the only 'good' thing i was told by the pharmacist (talked to him) is that she deccided to decrease my drop of it..by reducing it by .25mgs..
i. pharm read the fax to me from the doctor and she has been getting this 'medical info' from another psychiatrist...the one that denied me answers (have never met her or talked to her) (umm i wrote about that in one of my posts here)..now how can a shrink make a decision on MY meds without talkeing to me? or is that the way it goes? I'm honestly asking..
I have been given and denied on top of all even .25mgs IF a bad attack happens in which i can't calm myself down...doesn't happen alot but still..i also was for so long alloted and allowed to take just a tad more aka that .25mgs if i hd to do soemthing outside my safe zone..or when going about my baby steps..

What is gonna happen to me?

Isn't she putting my life on hold? My well being? My chance to keep on going with this agora/anx disorder etc?..

I feel like my life is eing taken away from me..not cuz the xanax is being cut out..cuz i'm being denined the med help I KNOW i need to help me get back on my feet witht he agora..to help ease the panic so i can concentrate on other tools..

For correct me if i'm wrong but isn't that the first step when dealing with Agora/GAD with pa's? is to settle the anxiety/panic and then move forth into further cbt/exposure etc?

What do i do??

Is this right? Is this really proper treatment?

Sorry i am blown away..i am sad..i am scared..mad..tired..and feel like..i don't know..gonna go calm..

 

[^^Phoenix^^]

Re: Benzodiazepines

Hi
I don't know much about the meds, and what is good paired with what, etc. However, I feel angry when I hear that your questions are not being answered by the people administering the drugs. Perhaps a letter? Explaining your concern and requesting advice about the meds you are taking? I know you have tried, however - perhaps persistant faxes and telephone calls fuel the 'hysterical client' image, which is why the nurse is reluctant to be open with you. If you are under any treatment from them, you have a right to know, why and how each med affects you. But the nurses will have lots of experiance with a lot of clients facing similar stressers. And 'over experiance' can encourage indifferance. Just try to stay relaxed when you speak to them and if you don't like the answers they give, go over their head some how.
Anyway, you do have the right to answers.
x

 

[jkb]

Re: Benzodiazepines

ty for replying..

i don't know if what is going on is right..if what she has done is right..

i have tried so many times to brng up my points..and nothing..here is the last fax i had sent to? her..maybe i wrote wrong i don't know..:

I?m not understanding a few things and hope that you can clear this up for me.
- - my anx./agora etc was doing good/better and then it started up again...about 3 or so mths ago. not sure if it is external stressors or the med not working/needs adjustment.?
- called you at the . beg. of feb to tell you this. Asked what to do, increase? a new med??
- was told by you that you can?t add in another med, that the xanax has to be out of me before trying any type of new med. How is this so? I have spoken to a few professionals to gain further knowledge about this all and was told that this isn?t true at all hence why I am asking you. I have gained info saying that it is either the external stressors as mentioned in my previous letters to you, or the dose or med has conqued out.
- I don?t understand..how am I suppose. to drop down, with no other anti anxiety med when my anxiety/agora is not in control. I am not getting any real explanations.
- what am i suppose. to do until the appt. let alone how am i suppose. to deal with the anxiety/agora .?? and NOW withdrawal ?? I don?t see how i am going to make any appt?s with my anx. already being high and then going off the xanax with nothing? Let alone trying to do baby steps here and keep trying to move forward as you wanted me to and as i want to.
- you know i do not abuse medications, nor drugs nor alcohol in any way.
- are you saying that my only option you are giving me is to wean off the xanax and if i don?t or can?t or run into problems with the weaning, since increased anxiety and other symptoms can occur while doing this, that you will stop my medication treatment?
- All i wanted from day one, the beg. of feb. was to try something new or to try an increase,
I am not trying to fight..or be rude or anything like this..I am simply looking for concrete answers that I feel were never given to me from day one.

i don't understand how she is giving my pharmicist these "supposed' answers..and not me..how she can and is allowed to talk witht heiis shrink ...without me knowing..and who knows if she knows what she is doing..

i feel..lost and scared..

it seems like i have no voice..and now i suffer..cuz of her..and what prob isn't the right move..

i don't know..

 

[^^Phoenix^^]

Re: Benzodiazepines

What happened in the end about the referal? I does just sound like the clinic that you have been refering to has got the wrong impression of what you expect from them and perhaps a clean break is best for you. There is no use banging your head against that brick wall when you can get answers from this referal.
Let me know

 

[David Baxter PhD]

Re: Benzodiazepines

I'm also a bit confused, jkb. Are you able to get out to appointments? Or was this doctor prescribing over the phone? What was your arrangement with her?

 

[jkb]

Re: Benzodiazepines

What happened in the end about the referal? I does just sound like the clinic that you have been refering to has got the wrong impression of what you expect from them and perhaps a clean break is best for you. There is no use banging your head against that brick wall when you can get answers from this referal.
Let me know

I'm not sure wht you mean about this referal..
This has all been going on with my GP over he last month and a half. All the faxes, phone calls etc. The only referal now that is supposedly happening is the one to the ROH anx. clinc to see a shrink in which there is a wait time..

My gp has ben denying me answers, not willing to talk to me , and changing my meds..making me drop off the xanax from what i was told by the pharm. , via this shrink she has been speaking to, whom i have never talked to nor met..

my concern lies in all that i have written..finding a new doctor has been more then hard..since there is a shortage here in Ottawa..i have been calling and will cont. to do so..but now with this sudden dec. to drop my med down/take me off etc..i haven't a clue as to how i will manage to get out when that is my problem in the first place..and now this all with her has caused me an increase in anxiety and has made it increasingly harder for me to get out to do my baby steps, aka work on the agora etc..since this has become one nightmare..


ty for replying.

 

[jkb]

Re: Benzodiazepines

I'm also a bit confused, jkb. Are you able to get out to appointments? Or was this doctor prescribing over the phone? What was your arrangement with her?

No..not now i am not able to get out..the last time i was outside was a month ago..my agora has increased due to external stressors and now all that i have written about..my anxiety has risen.

The last time i saw her was about a year ago..when the increase of .25mgs - .5mgs? was impliented..and did help me..for i was making a lot of progress with the agora..i was getting out..even going to stores for the first time in a year ..and then i had a relapse...

Since then..well now yes all this that i have writen about has been over the phone. Her changing my meds..or should i say her making me wean off them yes..without being allowed to talk to her or anything..just through the nurse and the recept. at the office.

I have been given no choice here..not even to come in..if i could..furthmore in the letter she wrote to my pharm. she said she refused to prescribe anything else and that she was getting these 'directions' from this shrink as mentioned..

Hence..now i have to wean off..with no help..and try and make this appt. at the ROH when it does come..with nothing..when i think and feel that i do need help med wise..

We've had no ral arragement..the only one that was given to me..was that she would refer me to the ROH , that i had to get off the xanax, and if id idn't? do either then i was on my own..so i guess that is the arrangement..one ididn't have a voice in..well re; meds etc..or an explanation etc.

i am not understanding any of her doings..re: my meds..why she wont talk to me, and why she is talking with a shrink about me (one that isn't associated at all with the ROH or one that i have ever encountered or will), as i have stated..i just really don't understand it all...

I fear what is going to happen to me.now with all of what has gone on...I do not want to end up even worse..hence why i called her in the first place, at the beg. of Feb.


ty