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 Post subject: Depression, Anxiety
PostPosted: Fri Dec 24, 2010 9:09 am 
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Hi All,

I have been having trouble with my anxiety and depression lately since starting on Suboxone a month ago, and I'm stumped on what I should do. Anti-depressants seem to have minimal or adverse effects on me, and the supposed axiolytic and anti-depressant potential of Buprenorphine has faded for me.

I've been through fluoxetine (Prozac), venlafaxine (Effexor XR), Paxil, Abilify, Seroquel, etc. and I have given them all a fair amount of time to kick in and work, but no luck. My former psychiatrist prescribed me 0.5mg clonazepam with the Effexor XR as needed, 30/month, and I found some refuge in that medication I can say. Although a rather low dose, it almost always brought relief when I was too anxious to fall asleep, or when I was very worked up about something that was going on in my life. Sometimes I would have to take a second one, but that was very seldom. I eventually ran out of the clonazepam and Effexor came with some uncomfortable side effects, so I ended up on Paxil 20mg for quite a while. Eventually, I switched doctors a couple months after arriving at college this fall and encountering some very paralyzing anxiety.

I went to see the new doctor a few times actually before the school year, and he just saw me once a month, keeping an eye on me. I would have breakdowns sometimes, which caused him to put me on Abilify 15mg to calm me down. Well, it calmed me down, but I was pretty much dead on it, so I stopped taking it after a few days. He raised my Paxil from 20mg to 30mg and that's all I was taking for a couple months or so until, as I mentioned above, I ran in to some very uncomfortable situations and anxiety during my first semester of college.

I went to go see him as an anxious mess. I pretty much just poured out exactly what I was feeling around that time and what things were going on in my life, and he evaluated me accordingly. He told me I could either try a sedative (benzo) to kill the anxiety, or a stimulant like adderall or ritalin to help get my thoughts in order and stimulate my brain to think more confidently and productively. We were both afraid of course that the stimulant would simply make my anxiety worse, so I chose the benzo. He wrote me for 1mg clonazepam 2x/day. I had grown to love my clonazepam from my previous doctor, so you can imagine how excited I was to receive this kind of a script. Not that I had any intentions in abusing it, I can't get high off klonopin, only Xanax. Anyway, I gave the klonopin a try for a couple of weeks but I think the dose was too high and it ended up just sedating me quite a bit and making me feel quite depressed, much different than the more positive results I experienced from the clonazepam 0.5mg PRN. I called him and he agreed to let me try the adderall XR 20mg. I gave it a try for a week and it felt like a miracle. I was immediately productive, confident, and felt like a new person. After just a couple of days though, my tolerance was somehow already through the roof, and the 20mg dose no longer had an effect for much longer than an hour or two, and it was a rather weak effect at that. After the week of addy, he switched me to Vyvanse 50mg for a couple weeks, and I had much better luck with it. It lasted all day long, unlike the addy, and the strength of it seemed to be much more consistent, even after a few days or a week of using it. However, after 2 weeks of the Vyvanse, the effect reached a low and due to the stimulants in my system over the previous 3 weeks from the adderall and vyvanse, my appetite had plummeted, leaving me extremely weak from under-eating.

Long story short, I failed a couple mandatory drug screens at the end of October that my doc requires for him to continue writing me medication, and to this day he will not see me as a patient again until I have fully completed a drug treatment/rehab program. My suboxone doctor is a behavioral health doctor, so he can help manage my psychiatric meds rather than me searching for an entirely new doctor, but unfortunately since he is the one that prescribes me Suboxone, he is very afraid of writing me a benzo while I'm on Suboxone, no matter the dosage. It's unfortunate, because I've been experiencing a lot of RLS and nervous twitches/habits over the past month, and after taking 0.25mg of my last clonazepam pill the other day, those symptoms were alleviated.

I informed him of that result, and how low of a dosage it required, but he still refused to write me even a 0.25mg 2x/day. I understand where he's coming from because of the respiratory depression and stuff, but I'm in quite a bind at the moment regarding my depression and anxiety treatment, and I'm not really sure what to do. I mean, I'm sure I could negotiate with him for a benzo once I'm off Suboxone, but I'm pretty confident that's going to be a very long time. Anyway, that's my story and I'm beginning to ramble but thanks for reading and any advice would be greatly appreciated.





Thanks!
Caleb


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PostPosted: Fri Dec 24, 2010 9:30 am 
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I think you posted this at another spot in the forum? I replied to you there...maybe you can check it out over there.

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