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PostPosted: Sat Dec 06, 2014 11:24 pm 
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Ok so I've been working with my psych/anesthesiologist on this but nothing seems to be helping me and it really is THAT bad. The only thing that even helped a little at preventing them (which is great rather then rescue meds for it when they happen) is Amitriptyline 100mg at bed-time. It was also used to get my sleep patterns in check again. But it has all of its own issues too it isn't perfect.

I was on Clonazepam for 14yrs and had to make the choice when I gave up the methadone & dilaudid for pain that I also had to give up the clonazepam too in order to get on Subutex and have my Dr' treat meet. Which I did willingly because I had no idea how much they were helping me and I was surely going to die from my opiate use after 10 years being prescribed what I was in the dosages I was.

What is killing me is at least once a day... ifI am lucky once every 2 days or other times multiple times in one day I get SEVERE anxiety/panic attacks. I am talking so bad that my blood pressure shoots up to 167/110 (that was todays numbers when i checked) & it feels like someone is sitting on my chest. My oxygen saturation drops to 86 and freely moves between 86 & 89 during the actual attacks which is a terrible oxygen saturation for a 29 year old male. I get sweaty, dizzy, and my muscles start to luck up like a borderline seizure. I have actually had seizures that landed me in the hospital from my panic attacks. And all of these symptoms and panic attacks started when I was much younger & weren't drug related. I was someone who had ADD for sure but didn't want to be drugged for it because I was always very intelligent and I thought they just wanted to dumb me down.

Nothing seems to help my panic attacks at all and when I get them it is like I feel like Im going to die. Its something that scares me a whole lot. I never abused my benzo medications given to me in the past before buprenorphine treatment. I was even prescribed MASSIVE amount while on huge doses of methadone & dilaudid and never abused them. I was given 4mg clonazepam a day and I was lucky if I used 1mg a day. My Dr tried Hydroxyzine as it worls for some and tried Promethazine & still no go. :( :( :(

I have given meditation a serious shot for 6 months (doesn't help with the panics out of nowhere either), I've tried medical acupuncture through my doctor, etc. I'm at a lose. The ONLY thing that has helped even a little which is better then nothing is 0.2mg of Clonidine (which yes I know is a blood pressure medication with it's own risks) but I am legally prescribed it for blood pressure problems to be take 0.2mg once a day at night preferably so I go to sleep after as it makes you groggy. The dropping of the blood pressure helps the anxiety attack go from a 10+ i feel like im dieing to like a 7.5 on a 1-10 scale. Better then nothing but nowhere near as good as even 1/2 a mg of a weak benzo in a small dose like lorazepam used to do for me.

Do any members or Dr's on this board have any advice or anything im missing or haven't tried? It's really messing with my school, professional, and home life with my daughter. Thank you!

-Jonathan


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PostPosted: Sun Dec 07, 2014 10:09 pm 
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Hey Jonathan,

I'm so sorry you are having such problems. Have you ever tried any of the depression meds like effexor, prozac, etc...? I know these can take a long time to take effect, but it might be something that with a little patience could work for you. This might be a silly question, because it sounds like you have tried everything, but you never know.

Honestly, I really think that I have heard of a few doctors who would allow patients to stay on low dose benzo's in extreme cases while taking suboxone. I can totally understand why they would be leary of it, but your case definitely sounds extreme. Is your sub prescriber aware how serious your anxiety is? Surely there is something out there that would be safe...

I'll see if I can dig up some answers for you.

Q

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PostPosted: Sun Dec 07, 2014 11:22 pm 
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JONATHAN...SORRY YOU ARE HAVING SO MUCH TROUBLE. I WAS JUST LIKE YOU AT ONE TIME AND COULD NOT CONVINCE DR.S TO GIVE ME ANY KIND OF MEDICATION FOR MY NERVES. I WAS BUYING IT AND DOING ALL KINDS OF THINGS TO GET IT AND I FINALLY JUST DECIDED TO QUIT TRYING TO GET IT. I DO KNOW SOME BUP DRS. THAT DO GIVE SOME ANXIETY MEDS...BUT MINE WOULD NOT.

I FOUND THAT WHEN I FINALLY GOT OFF THE XANAX MY ENTIRE LIFE CHANGED. ALL MY ANXIETY JUST LEFT ME AND I REALIZED THAT I HAD AN ADDICTION TO THE ANXIETY MEDS AS MUCH AS I HAD AN ADDICTION TO THE PAINKILLERS. I JUST QUIT TAKING MY BLOOD PRESSURE ALL THE TIME AND QUIT WORRYING ABOUT IT AND JUST DECIDED IF I DIED WITHOUT IT I WOULD JUST DIE. I KNOW THIS IS NOT WHAT YOU WANT TO HEAR...BUT I PROMISE YOU IT HELPED ME JUST TO QUIT EVERYTHING AND START OVER WITH JUST THE BUP.

GOOD LUCK TO YOU...

SLIPPER

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PostPosted: Mon Dec 08, 2014 10:26 am 
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I am a lot like you, and my doctor is just like your:( I used to get klonopin 2mg to take up to 2x daily for severe anxiety from my previous psychiatrist, who was much more relaxed. I didn't use it daily, maybe 3-4 times per week, so she rarely had to write me a new script. Anyway, when I moved and changed doctors, my new doctor freaked out when he heard about the klonopin and said NO WAY! I used a few different antidepressants to try and manage my anxiety, and in the meantime, made what I had left of the klonopin last for several months (I used it may 2x per week, only when I REALLY needed it). But when it ran out, it was only about a week, and I had an anxiety attack like you described, the hospital gave me a shot of Ativan right in the triage area to stabilize my vitals. Since then, as long as I take antidepressants (welbutrin works well for me), my doc is willing to give me #5 klonopin 0.5mg each month. Its been just enough for the past 3 years to keep me level, although there are days when I'm at home where the anxiety gets bad, and I avoid taking the klonopin because I'm afraid I'll run out before the month is over and I'll have a worse attack at work or while driving. For me, I need the suboxone (I've been on it for 10 years, since September 2004) so however I need to address my anxiety issues I'm willing to do in order to stay in my prescribing doctors good graces:)

I hope you're able to find something that works for you. Maybe your present you prescribing doc with a little research so that you're both able to come to some sort of compromise like my doc & I did to help your anxiety. Good luck!

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PostPosted: Wed Dec 10, 2014 1:04 am 
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Panic attacks are usually one of the most treatable conditions, using a moderate dose of an SSRI like Zoloft or citalopram. It takes a few weeks, but they almost always work...

Benzos are helpful if you can take them intermittently-- but if you take them daily they will likely make your anxiety worse in the long run. http://suboxonetalkzone.com/the-problem-with-benzodiazepines/


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PostPosted: Wed Dec 10, 2014 6:16 pm 
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Hi there!

I was just like you having panic attacks all the time. I now take a Beta Blocker called Propranolol and it has been a miracle. It is not addicting so my Sub doctor prescribes it with my meds.

It blocks Adrenaline so you are preventing a panic attack from coming on. I take 10mg 3 times a day and now they offer a time release med on this too.

I would at least ask your doctor about this. I do not know what I would do if I didn't have this med to keep my panic attacks at bay.


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PostPosted: Fri Dec 12, 2014 3:21 am 
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raudy1975 wrote:
Hi there!

I was just like you having panic attacks all the time. I now take a Beta Blocker called Propranolol and it has been a miracle. It is not addicting so my Sub doctor prescribes it with my meds.

It blocks Adrenaline so you are preventing a panic attack from coming on. I take 10mg 3 times a day and now they offer a time release med on this too.

I would at least ask your doctor about this. I do not know what I would do if I didn't have this med to keep my panic attacks at bay.


Oh my god I never thought of that! That absolutely would be a great off-label use for that medication. Is it rather safe? Because I have a "middle ground" right now that im using that has helped for panic attacks and that is using my blood pressure medication "clonidine". Im sure anyone who has gone through withdrawal, detox, or induction has had or heard of clonidine. It's a wonder drug for withdrawals & the fast onset & blood pressure dropping effect really has helped in my panic attacks when they aren't to severe.

I'm very familiar with how beta blockers work and it makes perfect since that blocking adrenaline similar to how I used clonidine to drop my blood pressure could help me get through the worst parts of a severe attack. I think the beta blocker idea your Dr has you on would work even better then the clonidine. Honestly how has it been working for you?? Was it a very noticeable difference? And is it something you take to prevent attacks or to stop an attack once it happens? Because I have got the frequency to be much less often I don't know if id need a scheduled around the clock med but if it works good I would try it. Everything in my life is getting back to normal and im happy besides the stop breathing swallow my tongue pass out and end up in the ER part.

admin1 wrote:
Panic attacks are usually one of the most treatable conditions, using a moderate dose of an SSRI like Zoloft or citalopram. It takes a few weeks, but they almost always work...

Benzos are helpful if you can take them intermittently-- but if you take them daily they will likely make your anxiety worse in the long run. http://suboxonetalkzone.com/the-problem-with-benzodiazepines/


Thank you so much for your input and I definitely know benzo medications are NOT the cure for long term anxiety problems. Being on them for 14 years I definitely know how understated the dangers of benzos used to be when they prescribed them like candy. In fact most benzo medications were never meant to be used chronically... Im a little foggy but I think 14 days was the standard they put out originally. It was used more for acute issues over chronic issue treatment.

I was ALWAYS against SSRI's but trust me my panic attacks ARE that bad that I tried a few (got serotonin syndrome from one and ended up in the ICU almost dead. Lucky me right? and it was ZOLOFT that did it) But me being me I was determined to find something to help prevent the panic attacks instead of control them after the fact.

And what I found that at least helped was Amitriptyline (Elavil) which is actually not an SSRI but a tricyclic anti-depressant that has been around for 50 years by now. I took low dose 10mg already to help with my pain meds (common with pain clinics) so my Dr. slowly worked me up to 100mg once at bed time. It cured my insomnia and the frequency of my attacks was a lot less but not enough less to not be a huge problem.

I could live with #5 1mg Klonopin a month just for the REALLY bad ones and I would get through. I know my Dr is very no no on that but im going to ask him reasonably how id abuse 5 pills a month. We are close enough I can ask him. Thank you! I appreciate it.

slipper wrote:
JONATHAN...SORRY YOU ARE HAVING SO MUCH TROUBLE. I WAS JUST LIKE YOU AT ONE TIME AND COULD NOT CONVINCE DR.S TO GIVE ME ANY KIND OF MEDICATION FOR MY NERVES. I WAS BUYING IT AND DOING ALL KINDS OF THINGS TO GET IT AND I FINALLY JUST DECIDED TO QUIT TRYING TO GET IT. I DO KNOW SOME BUP DRS. THAT DO GIVE SOME ANXIETY MEDS...BUT MINE WOULD NOT.

I FOUND THAT WHEN I FINALLY GOT OFF THE XANAX MY ENTIRE LIFE CHANGED. ALL MY ANXIETY JUST LEFT ME AND I REALIZED THAT I HAD AN ADDICTION TO THE ANXIETY MEDS AS MUCH AS I HAD AN ADDICTION TO THE PAINKILLERS. I JUST QUIT TAKING MY BLOOD PRESSURE ALL THE TIME AND QUIT WORRYING ABOUT IT AND JUST DECIDED IF I DIED WITHOUT IT I WOULD JUST DIE. I KNOW THIS IS NOT WHAT YOU WANT TO HEAR...BUT I PROMISE YOU IT HELPED ME JUST TO QUIT EVERYTHING AND START OVER WITH JUST THE BUP.

GOOD LUCK TO YOU...

SLIPPER


Thank you for the advice and I felt the same way. I have been off the Klonopin for over 9 months now and the rebound anxiety getting off of it was horrendous but then it leveled out and life had some color and a sparkle to it again. Im fine with not always taking benzos on a schedule. I just need them for severe attacks I get that effect me very physiologically causing ER trips and fire trucks before and stuff. It's always straight to IV Ativan before they can hardly get the line in me and then after 10 minutes my vitals normalize and my oxygen goes up. Then im embarrassed for wasting the ER's time.

Having asthma I think is what scares me to death because when they happen my breathing gets bad. On an o2 monitor ill sit at about 82' which is pretty bad.


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PostPosted: Fri Dec 12, 2014 7:44 am 
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Hi

I also have severe anxiety and the doctor gave me Xanax about 5 years ago. I took it only for panic attacks that were severe. When I get hit with a bad one I have to walk, can't sit still, have to keep moving. I would walk the parking lot at work for 20 minutes go back into the office and have to go back out again. Then learned to use the medication at the beginning of the attack. This was when I was on opiates at crazy high doses/

Fast forward and I have been on suboxone for14 months and take .5 mg xanax total a day, every day. My sub doc knows but won't write it, my PCP writes it.

So now the question...how did you guys get off? I am scared to get off but I want to cut back on the meds I take.

JonWrong, I feel for you as I know first hand how awful those anxiety/panic attacks are. I still use meditation but it's called 1 minute meditation and that's what I do - close my eyes and pull up a happy thought and focus on that. Sometimes it works sometimes it doesn't.

Sending good thoughts your way.

Em


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PostPosted: Sun Dec 14, 2014 1:20 am 
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Tiki wrote:
Hi

I also have severe anxiety and the doctor gave me Xanax about 5 years ago. I took it only for panic attacks that were severe. When I get hit with a bad one I have to walk, can't sit still, have to keep moving. I would walk the parking lot at work for 20 minutes go back into the office and have to go back out again. Then learned to use the medication at the beginning of the attack. This was when I was on opiates at crazy high doses/

Fast forward and I have been on suboxone for14 months and take .5 mg xanax total a day, every day. My sub doc knows but won't write it, my PCP writes it.

So now the question...how did you guys get off? I am scared to get off but I want to cut back on the meds I take.

JonWrong, I feel for you as I know first hand how awful those anxiety/panic attacks are. I still use meditation but it's called 1 minute meditation and that's what I do - close my eyes and pull up a happy thought and focus on that. Sometimes it works sometimes it doesn't.

Sending good thoughts your way.

Em


Thank you I really appreciate the empathy. In the world of sever opiate addiction the people you end up surrounding yourself with in the end aren't exactly the most empathetic people in the world. When it comes to being dope sick it turns into a savage every man for himself type of situation.

Which med are you asking how to get off of? The suboxone or the Xanax? If you genuinely only take .5mg a day you are actually in a pretty decent spot to taper off of it. That dose really isn't that high. That is actually what id consider a rather safe dosage of a benzo if you aren't the type of person to have a bad day and over indulge. Unfortunately I was getting 4mg a day of Clonazepam (Klonopin) and it is a long lasting benzo compared to say Xanax or Ativan which are better choices for acute panic attacks. I was getting the Clonazepam the way I was so I was dosed around the clock 24/7 in an attempt to prevent them. In the end it just made it worse tho.

If you need help getting off the anxiety meds your on & your on a very small dose of Xanax Id talk to your PCP about stopping the medication and working a taper plan. Usually... at least in my experience they switch you over to a benzo with a very long half life like Valium to ease you off of it in the most painless way possible. I know just about every jail I know of that has inmates come in on benzos get sent to medical and detoxed on Valium. Ive never been an inmate thank god but my dad is a corrections officer so I know a little bit about how that all works. But that is something you and your PCP have to discuss together because for all I know maybe he has his own way he tapers people from prior experience. Im not a doctor so I gave you all the knowledge I know personally at least.

If it is the suboxone you are talking about getting off of check out the taper/detox forum on this website. It has GREAT information and real life experiences of tapering off successfully with the least amount of being uncomfortable. Sorry I wrote so much but I just wanted to offer back some empathy and a helping hand.

-Jonathan


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PostPosted: Sun Dec 14, 2014 11:59 am 
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Jonathan

That's for the input. It is the Xanax I want to taper back. It was fine when I only took it for an attack but now I am in the habit of taking .25 mg during the day & .25 mg at bed. I have no desire to take more, never have.

I have used Rescue remedy, calms forte & magnesium for mild panic. Meditation can really help if you practice it every day. Music, calming music can help. If you can focus on the music & get your heart rate down you may be able to avoid a severe panic attack.

How are you doing today?


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PostPosted: Thu Dec 18, 2014 7:27 pm 
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Tiki wrote:
Jonathan

That's for the input. It is the Xanax I want to taper back. It was fine when I only took it for an attack but now I am in the habit of taking .25 mg during the day & .25 mg at bed. I have no desire to take more, never have.

I have used Rescue remedy, calms forte & magnesium for mild panic. Meditation can really help if you practice it every day. Music, calming music can help. If you can focus on the music & get your heart rate down you may be able to avoid a severe panic attack.

How are you doing today?


You know I had been doing great actually then all of the sudden on the 16th I had the mother of all panic attacks. Im talking worse then I've ever had! This lasted over 4 hours! I tried meditation, 3 showers, walking around the block, etc. I literally tried everything and anything knowing I was going to have to see my Dr' the next day and take a UA I didn't want to fold and take a Xanax or Klonopin but it got to the point where It was going to be try to take one of those and hold on and see if it goes away or go to the ER and have them dig around for 30min trying to get an IV in me (im a terribly terribly tough stick. It always ends in PICC lines or a central/external jugular) only to give me a benzo anyways. Generally 2mg IV Ativan (Lorazepam) so i gave in and took 2mg Xanax & held on for dear life while I meditated and tried controlling/counting my breathing and it subsided after 40 min.

This was by far the worst one i've experienced in 10+ years and I don't know what brought it on but it scared me half to death. I talked to my Dr' about the beta blocker option and because of my high blood pressure and hte fact my PCP gives me 0.1mg of Clonidine 1x a day at bedtime for the hypertension/high blood pressure he kind of told me to take it up with him this coming monday 12/22 & if I can't get him to do it then to phone in to his nurse and who would go ahead and do it himself if need be. I think he just wants to make sure my primary care physician is on the same page. Coordination of care is big when you have a Psych/addiction Dr, Primary, and a GI Dr.

I hope your holidays are looking good Tiki. How have you been feeling? This is historically always the hardest time of year for me!


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PostPosted: Sun Sep 13, 2015 7:07 pm 
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I know this topic is old, but maybe my experience will help someone else besides the OP looking for answers. gabapentin, brand name Neurontin, has worked WONDERS for me. I take 300mg/4x a day and it has eliminated 90% of my anxiety while also stabilizing my mood.


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