I made this account specifically to reply to this comment.

I take Klonopin. It is the ONLY thing that works for me. I have tried nearly everything. Every form of therapy you can think of, basically every class of drug to treat anxiety...

But Klonopin (benzos) are the only things that allow me to function enough to work and provide for myself. If I didn't have Klonopin, I would be without a job and would be homeless. I would literally be unable to function outside of the house (by function, I mean interact with people, work, go to the grocery store...), until I were forcibly removed because I haven't paid rent in months.

So if this attitude you and others share continues to embed itself into the minds of doctors, then people like me will be left without proper care. And what that means is that people like me will be unable to work, and unable to slog through the process of acquiring disability (and trust me, it's hard as hell), so we will be homeless or forced to burden our families with our care. It's not some abstract issue, one that can be handwaved away, one that you can distance yourself from by saying "the drug is bad so it should not be used with regularity; those who need it with regularity can instead be treated in other ways". There are zero other ways, in my case, and I am sure in many others' cases too.

Sorry if I seem accusatory, but people's insistence that these drugs be given only for short periods of time is in effect an insistence that I be left without any options after that short period of time expires.

We have to look at both benefits and harms. Benxodiazepines have caused absolutely immense harm, because they have a cluster of very nasty properties.

Tolerance and physical dependence develop rapidly. For most patients, the actual effect of the drug disappears within a few weeks unless the dose is increased. The most common withdrawal symptom is rebound anxiety, so you'll feel worse after stopping the drug than before you started. Benzodiazepines are respiratory depressants and tolerance of this effect develops more slowly; higher doses present a substantial risk of overdose, particularly when combined with alcohol. Paradoxical effects are remarkably common, with a significant proportion of patients developing impulsivity, aggression and mania.

I accept that long-term prescription of benzodiazepines may be a reasonable option for some treatment-resistant patients as a last resort, but America is grossly over-prescribing benzodiazepines with disastrous consequences. Here in the UK, benxodiazepines are some of the most strictly controlled prescription drugs and new prescriptions for more than 14 days are rare.

Thanks for your comment. I was appalled that the article didn't mention the implications of being prescribed benzodiazepines (both culturally, behaviorally, and physically). I wish in America these consequences were taken more seriously AND that people were more educated about it, but it almost seems like a long-running joke from the 50s -- "Oh, just take a valium! You'll be fine!" and etc. I really wonder how long until that is not socially acceptable...

I actually have the exact opposite experience. I was on klonopin a long time, and it does get addictive. My doctor thought it was the best way for me to function with anxiety. After a couple years, I got a new doctor, who was far more cautious with medication. I got off it, which was incredibly hard. In fact I don't think I could have done it if the resulting agoraphobia hadn't prevented me from leaving the apartment to try to get more.

It took a very long time in what was the psychological equivalent of someone going through physical therapy to learn how to walk again, but I was able to identify and work through the underlying causes of my anxiety. I'm doing better now without the medication.

To be clear, I am NOT saying medication is bad or unnecessary. Some people do need these medications long term. But benzos really need to be prescribed with the same responsibility as opioids, because the risk of addiction and withdrawl is very real.

As with everything there are exceptions to the general rule and it appears that you are one of those exceptions.

My point was more that prescribing a strong benzo like Xanax is done too easily. There are people, like yourself, who need such medicine long term but with doctors handing them out to almost anyone who has a little bit of anxiety opens them up to abuse which then makes it harder for people like you to get medicine they really need.

They're both benzos, but xanax ain't klonopin. It has a half-life around 12 hours while klonopin is about 30 hours. You can get interdose withdrawal with xanax, while it's less likely with klonopin.

You should try meditating a few hours a day.

Do you meditate a few hours a day?

I have started to take a more active role in my wife's ongoing treatment for this very reason. While I generally like her doctor, his willingness to bounce from drug-to-drug in an effort to treat her depression and anxiety is incredibly troubling for me as someone who grew up in a society where medication was seen as a last resort in the treatment cycle.

She has now been on Xanax, Cymbalta, Lyrica, Klonopin, Ativan .... I could go on. Every time she begins a new medicine or comes off an existing one is a trying time for both of us as the side effects (both mental and physical) can be incredibly brutal.

> I have started to take a more active role in my wife's ongoing treatment

You might be interested in the English NICE website, which sets out some evidence based standards for treatment of various disorders.

Here's what they say for general anxiety:

Recommendations for treatment: https://www.nice.org.uk/guidance/cg113

Quality recommendations: https://www.nice.org.uk/guidance/qs53

Pathways: https://pathways.nice.org.uk/pathways/generalised-anxiety-di...

Over what kind of time period is that? You're definitely not supposed to change drugs every few months.

For me the scattershot approach is most alarming; it would be far better if there were some kind of in-vitro test to see what would be best rather than "suck it and see". I've seen a few other people have problems with that.

From what I heard, it is this way because there is currently no better way of determining which psychiatric drug will work best besides going for trial and error.

It's been over 2-3 years, but I would say on average her regime changes every 3-4 months. We saw another specialist recently who introduced us to a test that does a genetic screen to help identify what medicine should theoretically be the most effective. Here's hoping it works!

EDIT: the service is called GeneSight: https://genesight.com/

What non-medication treatments have you been trying, if any? And which had the most positive effect, in your estimation? To be clear, I'm asking this purely out of curiosity, not because I think medication is a bad solution or anything like that!

Not contradicting your statements, but I thought I would offer a single anecdata point for a different perspective.

I take Alprazolam (generic for Xanax) in a low dose (0.25mg) 2 or 3/day. This makes the difference between my being able to work and not, so in my case it is certainly effective and beneficial. I haven't noticed adverse side effects at this low dose level.

After over two years of use, I haven't felt any need to escalate the dose. I have only one experience stopping (as an experiment). Disabling anxiety returned in less than five days and persisted without change for 3 weeks. Stopping was otherwise not difficult, certainly not "seriously horrible". Resumption of the med after four weeks off returned me to manageable anxiety levels in two days.

I've considered the tradeoffs inherent in long-term use and have decided for now to continue. Things that could change my mind about this: absence of relapse into disabling anxiety after an experimental stop; unambiguous demonstration of damage caused by long-term use; appearance of a better alternative.

Check with your doctor before using this med. There are contraindications and adverse interactions with other meds.

Further, anxiety is highly idiosyncratic, therefore YMMV. My mother was essentially disabled by chronic anxiety for her last 3 decades, and I suspect I'm predisposed to chronic anxiety. Others will of course present differently and need a different treatment plan.

> After over two years of use

That's not how short acting benzodiazepines like Xanax are intended to be used (Klonopin is more likely for longer term use). Most psychiatrists would be getting you onto a regular antidepressant regimen within a few weeks of the onset of generalized anxiety.

Agreed. I seem to be an edge case. Klonopin adversely interacts with an antidepressant I take, otherwise it would be the choice for management of long term anxiety.

Aside from being a terrible experience, death is also a possible side effect of benzodiazepene withdrawal.

I wonder why drugs like propranalol and gabapentin aren't used more as first line treatments for anxiety. Propranalol is particularly effective in treating anxiety without the potential for abuse.

Propranolol is one of the most common pharmaceutical treatments in the UK, alongside SSRIs and SNRIs. It's more common for social anxiety or phobia than generalised anxiety. It's a particularly popular choice for the treatment of young people, because of the suicide risk associated with SSRIs.

Pregabalin is growing in popularity as a second-line treatment if SSRIs or SNRIs are ineffective or poorly tolerated. Some caution is necessary here, due to the uncertainty over dependency, the potential for abuse and possible risks of suicidality. It doesn't appear to be more effective than the common SSRI treatments, although it may be better for treating psychosomatic symptoms.

I was given Gabapentin when I started having seizures. My seizures became worse. We didn't know why, so months go by. Until one day I had enough and stopped it - no more seizures since then (and they were calling this treatment resistant epilepsy.) It took me about a MONTH of insane withdrawal effects and maybe 3 months to come back to baseline again.

I've had benzos, painkillers to help with the after seizure care, and their withdrawals were absolutely nothing compared to the gaba/prega. Most medications give you maybe a week at max of physical withdrawals, not a month...

However, it's absolutely great for anxiety! I would really exercise caution to everybody. If you don't believe me, Google first hand accounts on Reddit, Bluelight etc.

I would never touch it again.

Medication isn't indicated as a first line treatment for anxiety. An evidence-based talking therapy is. That would be something like 12 to 14 weeks of cognitive behaviour therapy; one hour per week; face to face with a therapist; not in group sessions.

If that doesn't work or if the anxiety is particularly severe (anxiety disorders can be debilitating and cause years lost to disability) medication might be indicated.

> propranalol

I've noticed an atypical anti-anxiety benefit from metropolol (which I take for the usual bp/heart effects). It's not an anxiolytic; it won't do much to stop stop a panic attack that has already started. What it does is reduce the slope of increasing anxiety, which means more time before a minor/moderate anxiety can grow into a full panic. Very occasionally this has let me avoid a panic attack.

Is there a tipping point as to how much you can take and quit without experiencing withdrawal effects? I'd think it would affect everyone individually, but it would be interesting if there was a safe amount of time.

It depends on the benzo I think. Klonopin and Xanax have shorter half lifes so you would need to take them more consistently for a longer period of time to get addicted, but they may be more psychologically addictive since they drop off faster. I took an insane amount of Valium (longer half life) and blacked out for two weeks but didn't have any physical withdrawals at the end of it that I noticed. I took 6mg of Xanax once and had an acute anxiety/panic attack coming down from them. Also, people I knew taking Xanax for anxiety took a dose of 0.25 mg which was laughable to me as someone who abused it. I don't really understand how you could get addicted to that dosage or have serious withdrawals from it.

Just smoke some weed on the weekend, works better than antidepressants.

Sadly, you need the right strain - if you live in a state where cannabis is legal, you're lucky.

I have 3 different types right now, only one is actually good for anxiety and stress, the other 2 make my thoughts race. And I can't choose what I buy, the dealers tend to go for high THC content because it gets you high. I suggested the lower THC plants and they said I'm crazy.

While I am generally pro-legalization and believe cannabis has medicinal benefits, I would caution anyone with anxiety to do their own research before trying this and be careful with dosage. THC can be harmful to people with severe anxiety or who are predisposed to things like schizophrenia. It's pretty irresponsible, IMO, to casually prescribe drugs when you don't even know the difference between a benzo and an SSRI.

Agreed.

I used to smoke weed every day for years but had to stop around the age of 24 due to ever-increasing paranoia and anxiety. It was really messing with my head and negatively affecting my life.

I can smoke fine these days but there is always that slight sense of anxiety and negative introspection when I do. It's not a pleasant feeling at all, so I I generally avoid weed these days.

Strange really as I do LSD and MDMA maybe once or twice a year for special occasions and have no problems.

That said I am definitely pro-legalisation. I just think people need to be educated about it. Legalisation proponents with genuinely good arguments can often find themselves drowned out by by those that refuse to acknowledge any potential downsides to their favourite recreactional drug, which is a shame.

Came here to say basically this. It can take months or years to taper down. I've seen a lot of people prescribed a lot of benzos (Klonopin specifically but also others. I think there are rules about how Xanax can be prescribed in my home state) , even when my peers and I were younger. It seems to me that these drugs are surprisingly accessible to people with the right resources. Unless there is no other way you can function taking Klonopin for long term

To my untrained eye being prescribed any benzo for extended daily use seems like it should be an exceptional treatment, but maybe I'm wrong.

Oh my god this is such a true statement!!!

Unless you want to be curled up on a couch for 5 days and sleepless with your muscles and forehead visibly spasming every 15 seconds, DON'T take any benzos, and DON'T quit them cold turkey.

I had the misfortune of experiencing this first hand, but others have had it much worse, going into seizures and dying after trying to quit benzos for years.

There are definitely other treatment options. Don't mess with benzos unless you absolutely cannot bear an acute situation!!!

Good luck to everyone who is truly suffering out there! You can make it through !! :)