Thank you for your query at DoctorSpring.com
I have gone through your question in detail and I can understand what you are going through.
I totally agree with your GP that you have an anxiety disorder and it definitely needs to be treated. However I disagree on the fact the fluoxetine should be the first choice. In-fact fluoxetine is effective but there is a lot of activating effect initially which you may notice as an increased anxiety. I would suggest that escitalopram or paroxetine to be better options than fluoxetine.
However now that you have already started fluoxetie, let us stick to it for at-least 3-4 weeks and discard it only if its not effective.
Coming to your 'question proper', yes you can take clonazepam 0.5mg -1mg when ever you require and this wont be classified as overdosing. Clonazepam is routinely prescribed along with fluoxetine during the initial weeks until the body adapts to fluoxetine.
Also I would suggest you to consider cognitive behavioural therapy for your anxiety disorder which can always work good with medications. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.
Hope this helps.
In case you have any further query, do let me know.
Dr. Srikanth Reddy MD
Patient replied :
Hello, Thank you very much for quick response. I would definatley try cognitive behaviuor therapy, and how can I get it in NHS. Few things about clonezapam another concern is that the GP don't know Im taking it, becouse I had it from before as i said. I just don''t want to use it like for a week everyday or when needed and then suffer withdrawls not understanding wheather it is from medication(clonezapam) or from my anxiety disorder in general. Is it posibble to get withdrwals after using it for a week e.g.( couse i have maybe 5 tablets 2mg each), or I just worry too much?:) Anyway I was thinking to see gp wheather he could prescribe something maybe similar to clonezapam to take on daily basis or when needed, and he could then monitor how it works on me. I just don't want to be told off for self medicating, becouse it was not prescribed. Couse we left it as i should come and se gp after three weeks of taking fluoxutine. However he adviced to come anytime if i need anything. But sadly it is weekend. And another thing is it better to take clonezapam eg. when you feel i m getting more anxious or just wait until it really might get worse when my head is about to explode and i starting shivering? I understand ligicaly these things, worries happening in me is only temporary thing and i will get through them. I try to keep myself positive. Thanks for your help.
Thank you for your follow up,
You may get a slight withdrawal if you use the medicine daily for 7 days. You need to taper it gradually like 0.25mg and the taking it on alternate day and then stoping it.
NHS does provide CBT, but then your GP will have to guide you regarding the procedures on obtaining it.
If at all you need to use clonazepam, use it only when symptoms become intolerbale.
You can request your doctor to prescribe you either klonopin or xanax or etizolam which ever he is comfortable with.
Dr. Srikanth Reddy