Hi All,
I'm new here, but I have been diagnosed with panic disorder since age 17, which I've had now for 15 years. My father had a severe anxiety disorder, agoraphobia, which is almost always attached and diagnosed now as 'Panic Disorder with Agoraphobia" combining the anxiety disorder with the social phobia. I definitely inherited the disorder from my father, though he worked through his agoraphobia with a behavioral psychologist in in 1966. He still is prescribed
Valium (diazepam) 10mg tablets to take as needed; however, he doesn't use them on a daily basis. Which I hope I can get to some day. My symptoms are classic, and probably similar to others: shaking, sweating, feeling that I have a "choking" feeling, dry heaving, a terrible fear - but not of anything in particular, just a paralyzing fear, and the overwhelming need to get to a "safe" place - home or at least back to the town, sometimes, even just heading back in the direction to home. That is a classic reaction that makes the anxiety stronger. I'm working on pulling over to a parking lot and breathing through the panic - using my
Xanax, which is fast-acting, and not falling into the "trap" of wanting to drive home as that tells my brain that the "fear" is justified. It's so scary knowing how to try and fix a panic problem, but just not being able to and not being able to even overcome those fearful feelings. But, slowly but surely, I know that I will at the least be able to control my anxiety, instead of it controlling me.
I was initially prescribed Xanax (alprazolam) 0.5mg BID. Over the years, I've utilized benzodiazepine "rotation" where every 6 months - 2 years, I rotate to use a different mediction in the same class. I stayed on
Ativan (lorazepam) 1-2mg TID-QID the longest, for about 5 years, and Tranxene (clorazepate) 30mg QID for several years, and Valium (diazepam) 10mg TID. For the past year, I've rotated back to Xanax (alprazolam), but I take a large dose: 2mg TID, which will most likely become 2mg TID-QID this month. I use either the 2mg tablets or we may consider the
alprazolam concentrated solution liquid. From a serious case of pilonidal disease, I had surgery many times and ended up having V-Y reconstructive flap surgery as the wound from the pilonidal excision never healed past 2 inches x 1 inch x 1 inch deep. This ended up damaging my sacral and peri-rectal nerves and left me with neuropathy, for which I take opioid pain medication (since the age of 19, which is 13 years in August). I also use a tricyclic anti-depressant called Pamelor (nortriptyline) 25mg BID, which helps with the nerve pain and the panic disorder. And, to add to my anxiety disorder, while recovering in the Rochester Methodist Hospital, I lost one of my bestfriends to cancer, and could not fly back for her funeral. She passed away while I was in the operating room. I miss her tremendously. I am working on my coping skills for the panic with a psychologist and my medications are titrated wonderfully by a very skilled psychiatric APRN.
I never had any success with SSRI's being prescribed:
Paxil (paroxtetine),
Prozac (fluoxetine),
Zoloft (sertraline), or
Lexapro (escitalopram). And, some are contraindicated with even for some types of anxiety with depression. I never stayed on an SSRI for any longer than 4 months, as I had luck with the Pamelor.
My question for those with panic disorder or GAD (generalized anxiety disorder), have you been successful in reducing your dependence on benzodiazepines? Has this been accomplished through therapy and behavioral techniques, or has the disorder and anxiety diminished over the years?
I would love to reduce my dosage back to somewhere in the range of Xanax 1mg TID-QID (1/2 of my current dosage), which I would be thrilled to accomplish. I have always been more successful in controllling my panic attacks with the shorter to medium acting benzodiazepines: Xanax, Ativan, Tranxene. Valium and Librium (chlordiazepoxide, which I used once for a short period) have worked to control the anxiety, but the response to a panic attack or anticipatory anxiety is not great at all. I have never used
Klonopin (clonazepam), as my psychiatrist and APRN really don't prefer to use that for anxiety disorders.
I would love to hear from other people with anxiety and panic about your medications and how you have progressed.
I also want to say to those posts where I have seen people who have been using a benzodiazepine and are stopping it or weaning off, stopping a benzodiazepine without a correct, slow taper is dangerous - without a doubt. The withdrawal of especially short acting benzodiazepines can cause seizures within 24 hours. The withdrawal symptoms can begin and progress quickly from mild shakiness, tremor, a common symptom is not being able to even simply sign your name. Severe symptoms include hallucinations, delusions, these can turn into delerium tremens (DT's - similar to alcohol withdrawal). Please see a doctor for a taper regimen or if you are actively in withdrawal, definitely have someone transport you to a physician who prescribed the doses or, if you have been buying them or using them, please let an ER doctor know. I can't, of course, say that all will not be non-judgmental; however, they will be able to reverse your withdrawal symptoms, and that is the most important part. You want to be able to ensure that you are safe and your body is being given the correct doses of a medication to halt withdrawal. Which, too, means please be honest when letting a physician know how much you have been using. If it has been 6mg of Xanax per day with two 30mg
Restoril (temazepam) sleeping pills at night or Halcion (triazolam - the shortest acting of the benzodiazepines) 0.25mg at night, please let them know. This way, the correct calculation of a long-acting benzodiazepine can be made - a 1mg change in Xanax can result in a 5-10mg change in Valium. Overall, please be safe!
Thank you so much for letting me share my long story and for listening, and thank you, in advance, for any responses.
Ben
Lexapro and Anxiety Attacks advice please! 
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