Alternative to Benzodiazipines

April 20, 2005 9:28 AM

I am under a tremendous amount of stress lately due to factors with my health, job, and homelife. I have tried all sorts of natural ways to control this but with no luck. My doctor has prescribed Ativan, which works, but gives me an endless headache. A past experience with Xanax proved similar. Buspar did nothing. I am already on an anti-depressant. Is anyone aware of any other prescription drug that I could suggest to my doctor as an alternative to the benzos?
posted by jswanson19 to health & fitness (13 comments total)

I don't want to sound like a finger-waver, but if the stress is external (i.e. you don't have a strong biochemical predisposition to anxiety), you might get further by learning a meditation technique.

Check out the book The Relaxation Response for a totally non-religious take on the subject. It'll take some time before you see the full rewards, but benzos are strongly habit forming, and Xanax can cloud both memory and judgement.
posted by curtm at 9:50 AM on April 20, 2005

I'ts not prescription, but sometimes a little benedryl will take the edge off anxiety. Unfortunately it also tends to knock you out.

Or maybe try a beta-blocker (like propranolol). They reduce the physical symptoms of anxiety (racing heart, etc.), and are often used for stage-fright type situations. They can aggravate depression, though, so that's something to watch out for since you're on an anti-depressant.
posted by nixxon at 9:58 AM on April 20, 2005

How long has this been going on? I know some prescription drugs can take six weeks or more to build up in your system and really start kicking in.

Also, I hope you're doing something to attack the causes of the stress too. If you can't change the stressors, you can do something about how you respond. Curtm suggests meditation. There's also therapy. Cognitive behavioral therapy is all about learning coping techniques and things that will help you deal, rather than about talking about the stressful things in your life and working towards a psychoanalytic understanding. You might check it out.
posted by croutonsupafreak at 9:59 AM on April 20, 2005

jswanson19, have you tried yoga as a stress-reliever? An hour of yoga a few times a week does wonders for the body. As well, meditation suggested by curtm will also help.
posted by seawallrunner at 10:20 AM on April 20, 2005

Have a drink. Alcohol acts on the same GABA receptors as benzodiazepines.

That said, booze and pills are at best band-aids for stress and anxiety. Either change the external stressors (change jobs) or learn better management techniques - meditation, cued relaxation, whatever you find works for you.

Best of luck.
posted by symbebekos at 12:23 PM on April 20, 2005

I feel for you. Here's some info on the benzos and their alternatives given from a patient perspective: http://www.crazymeds.org/benzo.html

I'd especially recommend eating well, meditating, and getting as much therapy from a psychoanalyst as possible.
posted by _sirmissalot_ at 12:26 PM on April 20, 2005

Have a drink.

This is bad advice. If you are suffering from severe anxiety (as opposed to just needing to unwind a bit), alcohol actually increases your anxious feelings due to the rebound effect. Lots of anxious people self-medicate with booze and it just makes things worse and worse.

I would in fact recommend staying completely away from alcohol while you are in this weakened state--not to mention that you can die from mixing benzos and booze. You need to take it easy on your body so that it can help you fight this.
posted by _sirmissalot_ at 12:36 PM on April 20, 2005

Sirmissalot: I said have A drink, not ten. Jswanson is looking for an alternative to Ativan, and that's what alcohol is - an alternative. He's already getting a rebound effect from the benzo. - terrible headaches. No doctor would recommend alcohol as a treatment for any problem, except to clean a cut. It's more of a home remedy.

That said, the thing to do in this situation is to take steps to address the root causes of the stress, not treat the symptoms with addictive substances.
posted by symbebekos at 12:53 PM on April 20, 2005

The SSRIs, SNRIs (Prozac, celexa,lexapro, zoloft,wellbutrin,effexor,etc.)and like drugs are very dose sensitive--I assume this is what you are taking--A small change in the dosage can make a big difference in efficacy and side effects--if you are still feeling anxious you should have the medication evaluated--if modifying the dosage does not work then one of the other antidepressants should be tried-- many of the newer antidepressants are the preferred treatment for anxiety. The side effects from the benzodiazepine you are taking is rather unusual--it may not be the result of the benzo--if it is you may be to far into the benzos for your own good--they are very useful but only over a short period of time and when used sparingly--you might also try one of the other benzos--clonazepam come to mind as it is longer acting--if these symptoms have been around for a while and not responding to treatment you really should see a psychiatrist (perhaps you are) as they are much more familiar with the drugs and the importance of titrating the drug(s)--most of the other advice is very good--exercise good diet, sleep, dealing forthrightly with the external stressors, etc. Let it be said--alcohol is never,never,never a good solution to managing any anxiety or depression--nothing wrong with having an occasional drink (2-3) a week to celebrate the week end or a good meal--alcohol is never an appropriate medical treatment. CrazyMeds is an excellent website--Take Care Frank
posted by rmhsinc at 2:23 PM on April 20, 2005

Sorry, alcohol can be effective in managing cdertain cardiovascular risks but not the brain Frank
posted by rmhsinc at 2:37 PM on April 20, 2005

You might want to check to be sure you don't have a heart valve issue. I have mitral valve prolapse, which is known to cause anxiety at the drop of a hat. Stimulants such as caffeine make this feeling worse with MVP, and can actually cause panic attacks. It might be why you are having difficulty controlling your stress.

That said, I have tried benzos and also anti-depressants for stress/anxiety, and I was not pleased with the results. I have bipolar disorder and OCD, and so I have tried a lot of things. I have found that anti-psychotics such as Geodon or Seroquel are calming, and on a low dose I do not feel tired during the day (after the first few days of taking it). It might be worth checking them out. I am currently on Geodon, and have not noticed any side effects besides it taking me a little longer to wake up in the morning. It does not cause weight gain (some of them do, particularly Zyprexa). Check with your doctor.
posted by veronitron at 7:35 PM on April 20, 2005

A good aerobic exercise on a regular basis can work wonders. Something you enjoy - for me it has been road biking.

While a medication can jumpstart an exit out of a particular rut, learning some life-long and healthy coping skills can provide benefits the medications can't.
posted by jazzkat11 at 8:34 PM on April 20, 2005

For health/stress relaxation I find that nothing works better than swimming. There is something very comforting about being in the water, it might be a back to the womb thing.
posted by jonah at 9:12 PM on April 20, 2005