Agoraphobia Support Group

I always feel better and more confident when I do exposures when I have taken my Klonopin. However, I'm scared I'll never be able to do without it. I asked my therapist about recovery, and he said that recovery can be done, it's just more difficult when meds are involved sometimes. The other day I went out on no klonopin and I had 2 panic attacks when I was out doing errands. On the days I prepare beforehand and take my benzo, I do really well...not perfect, but I don't fully panic to the max. Am I halting my recovery by doing this? Any thoughts on this? I struggle with this everyday with these meds. ...to take or not to take. I have a love hate relationship with this little klonopin pill!

Whatever you feel comfortable with.

If you want to not take it and continue to do exposure the frequency of the attacks should lessen.

It's just do you want to or are you ready to go through that right now?

For many recovery isn't an option without these pills. Perhaps your brain (subconcious mind) hasn't adjusted to the exposure/experience and you need more of this exposure before you leave without taking a pill. If you have a pill on you (and you haven't taken any before hand) do you feel less fearful?

I think the meds or not meds question is such a personal one. It's so different for each person. I have overcome my panic/agor before without using meds and did fine... and it didn't take long with small amounts of exposure to get much better. But that was then....... this time around life is a little different and I'm just not making the progress I want to be making. So I finally gave in to taking small doses of ativan when I need to for bad panic. I have always had a huge fear of meds so this was a big step for me. But, after talking to my dr and several people I decided if taking a pill is what I need to get better then that's what I'll do, because the alternative just isn't working for me ! I would like to think that down the road I'll be just fine without having the security of a benzo on hand. But I'm also good with the idea of having to have it forever. If taking a benzo is the difference between life as it is now for me or regaining my life and independence , then I will take that pill every day if need be . It's like a friend of mine told me..... if that pill were for any other disease of disorder you wouldn't think twice about taking it.

It's just my opinion, and I know so many people have their own opinion on the med topic. I say do whatever makes life tolerable for you.

From what I've read, benzo type medicines don't allow you to feel the anxiety sensations to learn how to deal with them so you can feel dependant on them unless they're short term and you use them to get good experiences and then don't need them anymore...that's what I understand. A daily ssri won't be addicting but ask your doctor for reassurance about your medicine choices too of course.

Benzo meds don't allow you to feel the anxiety sensations , but isn't that the point? If the panic overwhelms and keeps you from getting out or doing certain things in life, then a benzo sure is a great answer if you choose to take that route. Taking small doses allows it to just take the edge off to be able to do things that normally panic would stop some people from doing. Sometimes experiencing the anxiety leads to so many set backs that recovery is impossible. That's the case when med help is something to consider I think.

And yes of course you always want to go with what the doctor thinks is best for you as far as meds.... you can't get the meds without your doctor.

ssri's are good for some but not for everyone. I had a HORRIBLE experience with an ssri which led to my current set back with my agor and panic. But for some people ssri's have helped them make great progress..... That's why medication decisions are so personal and different for each person.

Post edited by: Conn65, at: 06/22/2012 10:49 PM

When I was seeing my therapist she was hesitant to put me on meds while we were doing exposure therapy because she felt I wouldn't credit myself completely for the success and would not be able to build up the confidence necessary to fully recover. I think it's very individualistic though

Thank you all for responding.

TennisP, I went down the SSRI route....never again. Had too many bad reactions. I'm only on a small dose of Paxil that does nothing for me I think. I agree that the benzo meds don't allow you to feel the sensations, but the same holds true for SSRIs when they work for people. when Paxil used to work for me, it killed a lot of the sensations. It pooped out on me though, so the benzo is the only medication that works right now.

I don't fully credit myself when I do exposures on my benzo...exactly Salishgrl! This is what worries me. I'm going to discuss this with my therapist next week.

I agree, these meds are available for a reason. I'm pushing myself too hard. I've only been doing CBT for 4 months, so I can't be expected to be doing exposures I guess without my meds right now. I need to be more patient. Once I tackle exposures anxiety free with the benzo, then I can work on eliminating the benzo. One step at a time I guess.

Banaberry,, I always have benzos on me when I am out. It doesn't seem to help me though . I guess it's because my benzo klonopin takes at least a 1/2 hr to work.

Just sharing what I have read multiple sources.... you gotta do what works for you based on what your doctor also agrees with...

It's just so important to know the skills to self calm/self soothe so that way you don't have to rely on medicine for life that's what I mean...

I used to see a naturopath dr and he refused to write prescriptions for benzos because he knows they can become habit forming.... right now I'm trying an ssri so hopign in a few more weeks to see more progress,

I hope the best for you an yes it takes time to change...I remember in the winter months just stepping outside my front door was so anxiety producing and now I'm walking around some outside and looking for interesting things to see etc to keep me int he logical part of the brain...that's the key....stay focused on the moment and don't add fear to sensations if they pop up !

I just lost the text I was going to post. I forgot to to bookmark it, pissed at myself . So, here are some references:

An in-depth paper using studies and analysis for possible effective treatments agoraphobia

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215519/

Meta-Analysis on Benzos. and their cognitive effects on the brain

http://www.sciencedirect.com/science/article/pii/ S08876177030009

Professor Ashtons site on benzodiazpines: how they work with illustration and her method of getting of benzos after tolerance has built:

http://www.benzo.org.uk/manual/bzcha01.htm

Also, I think I stated in the op. that people have to weigh the pro's and con's of long term benzo use. Basically using the persons quality of life. If the person suffers from agoraphobia to the point where they seclude themselves in their house or room 24/7; than I would argue that indefinite use of a benzodiazepine is warranted. If they improve the persons symptoms and quality if life. If a person has a strong issue with panic disorder in certain social environments; Than alprazolam, clonazepam,or another benzo prn may be the answer. There are also other medications either still under trial or in use that can help. The voltage calcium channel blockers- pregabalin and gabapentin. Although the require a titration down to ween off. It is nowhere as serious as benzos.

In regards to benzo withdrawal from daily use resulting in dependency:

Because the brain will start to try and achieve a state of homeostasis, the neurons basically overreact. The reduction in glutamate due to the longterm up-regulation of GABA due to benzo. use is now effectively reversed. The neurons will release a flood of glutamate into the synapse for reuptake. The effects of to much active glutamate in the brain and the depletion of GABA produces protracted withdrawl. It can include- insomnia, depersonalization (feeling outside of yourself), extreme paranoia, involuntary muscle spams and twitching, and grand-mal seizures. These can all strat to happen once the blood plasma level of the medication starts to reduce due to stopping the medication cold turkey around 24 hrs in.

Than their are other therapies besides medications that can be used. Exposure ,CBT, ACT, Psychotherapy, supplementation along with diet, exercise, and sleep

The Mayo Clinics page on agoraphobia:

http://www.mayoclinic.com/health/agoraphobia/ds00894/ dsection

Others:

http://www.cnn.com/HEALTH/library/agoraphobia/DS00894.html

http://allpsych.com/journal/phobias.html

http://agoraphobia.medicalassistanthq.com/agoraphobia-

Post edited by: gofobroke, at: 06/23/2012 01:46 PM

Post edited by: gofobroke, at: 06/23/2012 01:47 PM