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Better medication for anxiety and sleep disorder.

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Hello, I will try to tell the story short. Basically I was drinking for 12 days and then i stopped. Took clonezapam about 1m.g. a day for one week after. I had it was not prescribed for me. Than I got fed up and stopped it for a week. Than after two weeks i started taking zopiclone to make me sleep couse i thought i ll sleep better, that was prescribed by the doctor. I took it for a few days and then it didn't work very well. So I started taking diazapam 5mg before sleep, as my anxiety was stable during the day but it was hard to sleep. I kept doing my day to day things going to work . After a while i felt much better and i started sleeping on my own sleep. And then for about a week i didn't take any medication and was feeling clean, relaxed more or less and focused. Then i was getting stressed and it looked like somehow it came back, like relapsed. Then I went to see gp and told i have anxiety problems, so he prescribed me fluoxutine. Over time that 6 weeks period i had memory problems, diziness, sweating when sleepin, focusing, some strange thoughts that won't make sense. But it was getting better and it was okay at some point and then it went back again. Today i took some clonezapam 0.5 mg before sleep as i work nights. And i took fluoxutine at 3 pm. noW. I feel better that last few days. I dont kno whether i should take clonezapam when needed or I should suffer and wait.
I do have some strange thoughts but in a way my head is blocked for a past week, it feels like it. It's just blank in there and fell like without drive to do anything but i keep pushing myself. Im going to see the doctor on monday, but for i while im thinking should i take clonezapam in case not to get stressed to much, or i should wait? I have never took any big doses of medicine during this period, just to help me sleep or to make me calmer. And clonezapam i had it in a draw in case i would get difficult problems. but i was not using it. And i dont want to get overmedicated. so donnot what to do really. Until monday when i go to gp. However my hands shiver and my head is like intence feels like shivering sometimes, when i try to sleep. Please help.


Category: Psychiatrist

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Category: Sexologist
Dr. Srikanth Reddy is online now

Expert:  Dr. Srikanth Reddy replied 4 Days.

Hello
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.
Kind regards
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.


Expert:  Dr. Srikanth Reddy replied 3 Days.

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.
Regards
Dr. Srikanth Reddy


Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
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