Tranquilizers and me

I’ve had problems with anxiety for my entire life. When I was diagnosed with bipolar, I was also diagnosed with Generalized Anxiety Disorder (GAD). Later I was diagnosed with Obsessive Compulsive Disorder (OCD). I also have panic attacks, but I don’t quite meet the criteria for Panic Disorder. I don’t meet those requirements since the worry about future panic attacks does not cause me trouble in the present.

Based on these diagnoses, my first (well second, the first retired shortly after I met him) psychiatrist prescribed a benzodiazepine (tranquilizer). There are many benzos, the one she put me on was Klonopin, or clonazepam, which is the generic name.

I was instructed to take it PRN (as needed), and I did so. I took it maybe 3 or 4 times a week and it was a wonderful med. Since I didn’t take it all the time, there was no problem with withdrawals.

The I went inpatient for the first time. They told me that I should take the Klonopin every time the prescription allowed. After all, I was anxious and in an unfamiliar place, so why not? I was naive about benzos at the time, so I didn’t refuse this.

Then I got out of the hospital and tried to go back to taking the Klonopin PRN. That did not work. I had withdrawals whenever I skipped a dose. Nasty withdrawals that got worse fast if I held off a dose. I didn’t like this, but I did have anxiety, so I should be taking an anxiety med, shouldn’t I? So I just kept taking it.

There was a problem though, I built up a tolerance to the med. It got less effective the longer I took it. It was a small dose, so we just increased it. Over and over. Eventually I was at the maximum dose and it still kept getting less and less effective.

What to do? She switched me to Xanax, or alprazolam. That was great at first, it was effective. But again, tolerance built up. At some point it too was ineffective. But I could not stop taking it. This irked me greatly.

At some point another problem became evident. My mind was slower and cloudier than it normally was. My mother said that, “The sparkle is gone from your eyes.” My mental life just wasn’t what it used to be. That irked me even more than the withdrawals.

What to do? I couldn’t stop taking it, but I had to. So I went to my psychiatrist and asked what I could do. This was a new Dr. and he said that he preferred his clients not to use benzos for exactly the same reason that I didn’t want to be taking it.

We came up with a plan to titrate (slowly change) off the Xanax. It would take six weeks. It was miserable. I couldn’t sleep, I had the shakes, and it felt like my skeleton was trying to crawl out of my body. And then I hit the first week when I took none. The misery went up massively.

It took another six weeks of no Xanax before I started feeling close to normal again. I still couldn’t sleep. Three months and I was off the Xanax, but I still couldn’t sleep. Normally I sleep well, I’m one of the lucky people with bipolar who only has sleep problems during mania. Not anymore.

I complained about this, and was put on Remeron, or mirtazapine. Remeron is an antidepressant that causes such drowsiness that it is used as a sleeping pill. I’ve never known anyone to take it as an antidepressant, it’s just too sedating. It only sort of worked and gave me horrible hangovers. I could sleep a little at night, but then in the day I couldn’t stay awake.

After about nine months, my life started coming together. I could sleep, the “sparkle” was back and I was thinking clearly. Was it worth getting off the benzos? I think so, but it was not easy.

Would I ever take a benzo again? Never on a regular basis, but maybe for a one-time event like dental work. It’s not really an issue around here though, doctors, even psychiatrists, are so scared of the DEA that they will not prescribe benzos (and will only prescribe pain meds for very short periods of time, even after surgery). This happened after a local clinic was shut down for over prescribing meds that could be (and were being) abused. Everyone who worked there, not just the medical staff, went to prison. It seems that they were all in on it. They were an extreme case, they really were supporting drug abuse, but now everyone is paying the price. Worst off were their legitimate patients who saw them for non-drug-abuse purposes. No local doctor or clinic would take them Even in nearby cities. They were pariahs. It’s like they were radioactive. It was a very big clinic too, lots of people were affected. One person I know had to keep going to the ER to get prescriptions for her insulin. That stigma and discrimination has passed and those patients can find doctors now, but still no benzos and pain meds for only a short period of time.

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