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Question
Posted by: Brian | 2010/12/20

tapering off benzodiazipines.

Hi Doc
I was diagnosed with major depressive disorder, Anxiety disorder(with panic attacks and derealization) and some OCD traits about 2 months ago. I am on 2 AD''s, Mirtrazipine (30mg) for the depression and Luvox(50mg) for the OCD. I am also on Alzam and am trying to wean myself off them as I believe that benzos can be very addictive. So far the AD''s mainly adressed the more physical symptoms of my ilness (I sleep better, have more energy and have a normal appetite). My irrational and obsessive thinking is still a major problem and leads to extreme anxiety almost daily. I was initially on 0.5mg Alzam 4 times a day but have since tappered slowly off to 0.25mg 3 times a day. What worries me is that I have been using benzos daily for more than 2 months now and am concerned that I might build up tollerance to the drug and become addicted. The benzos seem to be helping me when my brain goes into overload with irrational and intrusive thoughts and I do not feel ready yet to cope without them yet. I have been on the AD''s for about 7 weeks now and still waiting for the full effect, like I said mainly the psychological aspects. I also went for CBT and I daily practice mindfulness and progressive relaxation therapy.
Is it still OK to be on the benzos for a few weeks and slowly continue tappering off them at 0.25mg per week without getting any withdrawal symptoms such as rebound anxiety and insomnia.

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Our expert says:
Expert ImageCyberShrink

Actually, I'd think either of those AD's could help depression, anxiety symptoms, and OCD features. And CBT style counselling ( Cognitive-Behaviour Therapy ) could also be very helpful in increasing your own skills at preventing, limiting and controlling such symptoms. ( including sorting ou the irrational thinking, something it's especally good at ). Bezo's are sedative tranquillizers, and really don't help sort out unhelpful habits of thought.
It is indeed wise to be cautious aboput using benzo's in significant amounts over extended time, but don't worry too greatly, or this'll add to your anxiety ! While they are useful, don't withdraw this source of help until you have, such as by CBT, controlled those sources of anxiety. Don't rush too much to wean yourself off them. The "2 months" is a guidelines, not a law or constitutional amendment
"Mindfulness" isnt a core part of CBT, which should also go beyond relaxation to identifying and dealing with the triggers for the anxiety and obsessive concerns, and direct ways of dealing better with them.


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Our users say:
Posted by: cybershrink | 2010/12/21

Actually, I'd think either of those AD's could help depression, anxiety symptoms, and OCD features. And CBT style counselling ( Cognitive-Behaviour Therapy ) could also be very helpful in increasing your own skills at preventing, limiting and controlling such symptoms. ( including sorting ou the irrational thinking, something it's especally good at ). Bezo's are sedative tranquillizers, and really don't help sort out unhelpful habits of thought.
It is indeed wise to be cautious aboput using benzo's in significant amounts over extended time, but don't worry too greatly, or this'll add to your anxiety ! While they are useful, don't withdraw this source of help until you have, such as by CBT, controlled those sources of anxiety. Don't rush too much to wean yourself off them. The "2 months" is a guidelines, not a law or constitutional amendment
"Mindfulness" isnt a core part of CBT, which should also go beyond relaxation to identifying and dealing with the triggers for the anxiety and obsessive concerns, and direct ways of dealing better with them.


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