[jawngee]

I can relate to this. I took klonopin for 10+ years, just recently weaned myself off of it (six months and counting).

My first panic attack happened about two weeks after 9/11 on the F train. Top 3 most terrifying moments of my life.

I did CBT, talk therapy, all kinds of anti-depressant medications (the worst being Effexor XR, that shit should be illegal) until finding klonopin to be the most effective. Marijuana was helpful too, though it had its moments of making things worse, but for the most part A+++ rating, would smoke again.

My anxiety manifested itself in some pretty severe panic attacks, extreme hypochondria and some pretty intense derealization. I miss the derealization though, but it took awhile for me to appreciate it instead of fearing it. The hypochondria I don't miss at all. The panic attacks still happen from time to time (mostly when the lights in the room suddenly change) but I'm so used to them now they don't really phase me. And I'm so practiced at having them, nobody standing around me is ever aware that I'm having a sudden bout of tachycardia and growing concerns that my heart is about to explode in my chest.

I noticed the klonopin was making me kind of a zombie, putting a mega-kabosh on the creative output, so I decided to taper my way to freedom. The first two weeks without it were pretty painful, but now it's relatively smooth sailing.

I'm not sure what happened that I got to this point now. I did move to a foreign country (Vietnam) so I'm sure the slower pace has had something to do with it, despite how much I've grown to dislike living here.

As for what caused it, all of my therapists think I have PTSD from my high school days (I was in a pretty violent anti-racist skinhead group back in the day), but I personally think it has to do with all the MDMA I chewed in the post-skinhead rave days. I guess I'll never know.

[refurb]

Honestly benzodiazepines should almost never be taken long-term for anxiety. They are fantastic drugs for short-term use, but in the long-term they tend to only make things worse.

You don't have to take them for very long to have withdrawal symptoms after stopping. The effects of stopping can include crippling anxiety. Not exactly the best thing for someone having bad anxiety in the first place.

[foobarqux]

There is a meta-study by Kripke which concludes that even very rare use of benzos triples your likelihood of death, controlling for other factors.

[jawngee]

That was actually refuted by the guys Kripke cited:

http://www.researchgate.net/publication/264345529_Reply_to_E...

[vellum]

Full pdf here: http://www.antonpottegaard.dk/publications/letters/[l002%20-...

[foobarqux]

That's interesting, thanks. Were you already familiar with the original study?

[hga]

Absolutely. I myself use clonazapam (generic Klonopin) on an "as needed" basis, because you get tolerant to a particular dosage within a few weeks, and then you either increase step by step to the limits your doctor sets, or when you can mentally afford it, you wean yourself off, which is no fun at all. Good in its niche for anxiety, but not real solution.

I have eventually crippling genetic anxiety and "depression of a bi-polar nature" (it's most like bipolar depression, but I never go manic unless I'm prescribed the wrong drug (which is not uncommon in general)). A low dose of the now generic Seroquel, an atypical antiphychoic, was a life saver, without it I'd only get 4 hours of sleep a night when I need 8. I also take a stiff dose of now generic Lexapro, which is laser precise in its action.

It took years for me and my doctors to figure out this regimen that seems to be as good as possible unless and until an anti-anxiety wonder drug is developed.

[throwawayokay]

I've been on meds for about 15 years, with one year off. The last 11 years I've been on 75mg of Effexor, and it's been a miracle drug for me, with the only side effect being a mildy suppressed libido. And 75mg is a pretty low dose, less than half what is normal for treating depression.

I'm not keen on being a slave to meds, so I'm currently weaning myself off 1mg a day (Effexor is notoriously bad to quit cold turkey). I did this a couple years ago and got to 30mg before I felt like I was experiencing anxious symptoms. These days I'm married, I meditate, and am all around less of a spazz.

"I'm so practiced at having them, nobody standing around me is ever aware that I'm having a sudden bout of tachycardia and growing concerns that my heart is about to explode in my chest"

Believe me, I recall that sensation, and I don't miss it. If I need to take meds for the rest of my life to avoid those types of experiences, so be it. When I was preoccupied with dealing with that level of anxiety, I was missing out on more than I realized.

[hvs]

Effexor XR was very helpful for both myself and family members. Just because something doesn't work for you doesn't mean it should be "illegal".

[kirsebaer]

MDs should warn patients about long-term benzo use. These drugs are only approved for a few weeks of use. I have talked with many MDs who are in denial about benzodiazepine addiction and adverse-effects. These MDs write prescriptions without properly informing their patients.

[UrMomReadsHN]

Not sure if you are replying to the right comment. Effexor XR is an SNRI, not a benzo.

[A_COMPUTER]

For some people it is not only ineffective, it results in suicide. I was almost one of those people. I don't know if it should be illegal, but I'm just throwing that out there.

[killface]

that's true of nearly every anti-depressant, though. it's called suicidal ideation: http://en.wikipedia.org/wiki/Suicidal_ideation#Prescription_...

[hga]

Exactly. I have a friend who took another anti-depressant in a long search for one that worked that gave her suicidal ideation, which prompted her to go off it immediately.

As I explain the state of the art of these drugs to people, we know that if you poke at the brain with sticks who's ends are shaped in various ways, certain classes of effects will result. But everything beyond that is pure theory/search for a rational mechanism to e.g. explain this to people who aren't comfortable with pragmatic reality.

[rhino369]

Zoloft worked great for me with Kolonpin as a backup if I had an anxiety attack. But once Zoloft started working, I didn't have to use it.

I took Zoloft for about 8 months and then weaned off and I feel back to normal.

Pot and Kolonpin (and other benzos) are really only for temporary treatment. I'd recommend taking SSRIs but you have to wait for the 6 week ramp up period to see if it works. If it doesn't, you have to change SSRIs.

[foobarqux]

Can you talk more about your experience with Effexor?

[jawngee]

I was on 150mg a day (worked up to that from a low dosage).

After awhile, I was getting these insane headaches, like stabbed in the brain with a rusty knife type headache. Those lasted a few weeks.

And then came the brain shivers. Moving my eyes, or rapidly turning my head, would cause an electric shock sensation that, from what I've read, was similar to what people having a stroke experience. Like lightning in your head. It wasn't painful like the headaches, but it was well beyond annoying, if not completely frightening. I'd sometimes lose my balance and fall over.

I then made the mistake of quitting cold turkey. This was my first AD and my psychiatrist hadn't informed me of how bad an idea that was, and I was stupid for not reading the insert when taking it. After a few days of hell, I went back on it and tapered off.

I understand if it is effective for a lot of people, but I certainly know I'm not alone in my experiences with it.

Zoloft was much softer, but really didn't do much for me.

[hga]

As I like to say, cold turkey is for turkeys, but you self corrected quickly enough, and if you restarted at a lower dose then those two days of pain were not wasted. I'll sometimes trade off more pain for faster withdrawal in some stages when I wean myself off my benzodiazepam.

But there's no grand insight into your experience with Effexor, besides confirming that this isn't cookie cutter science/medicine, you try different drugs out until you find the best balance between side effects and desired action. And try to keep you shit together with what turn out to be bad choices, e.g. (generic) Paxil made me hypomanic.

[cbd1984]

It would be great if there were better ways to get the active ingredients in marijuana into people without hoping the plant has them in the right ratios, doesn't have the chemicals that cause bad side-effects, and doesn't need to be smoked (which hurts the lungs) or eaten in a fatty solution (which causes weight gain, which hurts everything else).

[chillingeffect]

With a name like "cbd" () I'm not sure if you're playing naive or if it's a coincidence :) but your concerns are exactly what the medical marijuana establishment has been able to address over the last decade now that it's legal in some states.

Simply extracting the active ingredients of medical grade by heating the cannabis in 1/4 teaspoon of olive oil will only give the patient about 9 calories.

() Cannabidiol (CBD) is one of at least 85 active cannabinoids identified in cannabis. It is a major phytocannabinoid, accounting for up to 40% of the plant's extract. (wikipedia)

[TheSisb2]

From what I've heard "vaporizing" allows you better control consumption without any (minimal) smoke. Probably the safest and healthiest method to consume a desired amount.

[GuiA]

Won't speak for other potentially negative effects, but there is no smoke (not even minimal) in vaporizing, as no combustion occurs.

[cbd1984]

That doesn't solve the problem of getting a known dose with minimal bad chemicals.

[killface]

Known dose, sure. A lot of medical shops are posting independent lab measurements of all of the independent cannabinoids (most importantly: thc, cbd, cbn, cbg). So if you had a mg-accurate scale, and a bit of math, and assuming 100% uptake in a vaporizer, that's nearly a solved problem. With vaporizing the dried flowers, there is literally nothing else in there -- it's not an extract or anything where there could be latent glycols or butane or whatever.

So really, the problem _is_ solved :) It's just that the threshold and effective doses for cannabis mean that mg-specific dosing really isn't that useful.