can diazapam stop Anti D from working

[Turnaround00]

Hi

So I have been taking 2 mgs of diazapam every few days for about a year,
I have now hit rock bottom and my usual anti depressant isnt working now since I decided to go back on anti depressants about 4 months ago.

I know 2 mg isnt much but I was taking one everytime I felt panicky in work etc so I oculd take two 2mgs a days for 3/4 days then none for a few days etc.

Im worried my body now does not know how to fight the panic itself and cant rely on the anti D either so am now trying pregabalin but am still taking anti D too until I stabalise on something else.

Its all very shit

[panic_down_under]

I have now hit rock bottom and my usual anti depressant isnt working now since I decided to go back on anti depressants about 4 months ago.

I know 2 mg isnt much but I was taking one everytime I felt panicky in work etc so I oculd take two 2mgs a days for 3/4 days then none for a few days etc.

I think there are two issues here. Firstly, to answer the question in the subject, yes, benzodiazepines may reduce the effectiveness of antidepressants by inhibiting the growth of new brain cells (http://www.americanscientist.org/issues/feature/depression-and-the-birth-and-death-of-brain-cells/99999) (neurogenesis), the mechanism which produces the therapeutic response (see: Boldrini M (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374628/), 2014; Nochi R (https://www.ncbi.nlm.nih.gov/pubmed/23963779), 2013; Sun Y (https://www.ncbi.nlm.nih.gov/pubmed/23639432), 2013; Wu X (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(09)00106-1/abstract), 2009; Stefovska VG (https://www.ncbi.nlm.nih.gov/pubmed/18991352), 2008).

The second issues is that there is growing evidence antidepressants become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control. They may also produce more severe, and/or different, initial side-effects. Two studies, Amsterdam JD (https://www.ncbi.nlm.nih.gov/pubmed/27805299), 2016 and Amsterdam, 2009 (http://www.karger.com/Article/FullText/226611) found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Amsterdam JD (http://www.ncbi.nlm.nih.gov/pubmed/18694599), 2009; Leykin Y (http://www.ncbi.nlm.nih.gov/pubmed/17469884), 2007).


Im worried my body now does not know how to fight the panic itself and cant rely on the anti D either so am now trying pregabalin but am still taking anti D too until I stabalise on something else.

What is the antidepressant you're currently on, how much are you taking and how long have you been at this dose? Also, how many times have you been on antidepressants in the past and which one/s were they.

[snowghost57]

I don't like to give any suggestions when it comes to medication, that's a physicians job. I would be careful with the diazepam as it is very addictive, (even when taken as prescribed) I don't rely on medication, I was given tools by my CBT therapist to cope with anxiety.

[Turnaround00]

Thank yo both very much. Very interesting panicdown under thank you.
I am on prozac 20 mgs since early March so long enough to have a therapeutic affect by now. I have been on that before too, as well as sertraline and paroxetine and duloxetine and possibly another one or two. Been on them about 15 years now but only ever tampered with the diazapam in the last year when a doc prescribed it when I was struggling in work/Uni with panic. At the time I had come off duloxetine as I thought I would be fine as felt fine (usual thing that happens every few years when I feel good I taper off then relapse). They all stopped the panic attacks before but maybe my life been more hectic at the last couple of years has a part in it too.
I did increase to 40 mgs of prozac after about week 6 (doc advised). Then after about 5 weeks on the 40mg I became even more anxious so was told to go back down to 20mgs and I really can't say it has done anything at all for me and am still on it now until I stabalise.
Hoping the pregabailn will save me but I am also really pushing myself the last few days going out for walks etc. I am just still struggling when I have to talk to people. I can cope if its just passing someone saying hello and little chat but in a room with someone is a problem. Like I feel I can't leave and just get all squirmy on the chair then eventually just leave the room like at the doc's yesterday. I get dizzy nad feels like my brain is moving then I have to run.....

[panic_down_under]

I am on prozac 20 mgs since early March so long enough to have a therapeutic affect by now.

Yes, while Prozac can take longer to kick-in than other antidepressants because of its long half-life, if 20mg was going to be effective there would have been some indication by now.


I did increase to 40 mgs of prozac after about week 6 (doc advised). Then after about 5 weeks on the 40mg I became even more anxious so was told to go back down to 20mgs and I really can't say it has done anything at all for me and am still on it now until I stabalise.

Because of that long half-life it takes about 40 days for Prozac plasma levels to stabilize to a steady-state after a dose increase (or decrease) at which point side-effects, including heightened anxiety, tend to diminish, but it seems to have had the opposite effect on you. Maybe it took that long for plasma levels to cross your anxiety tipping point.

[Turnaround00]

Thank you. Its a pain really and cant help but worry that I won't get better.
I am hopeful that the pregabalin saves the day. Just not sure it will do much if I stay on 75mg bd but to be fair it has already settled me a bit so perhaps a large dose won't be needed....

[panic_down_under]

Its a pain really and cant help but worry that I won't get better..

Don't despair. You still have a lot of med options, and also therapy which can be very effective for the issues you've mentioned. Your GP can provide more information on this.

[Turnaround00]

Thank you
I am currently trying to decide on a CBT online course to buy as there doesn't seem to be anything readily available on the NHS and I can't sit around and wait for a magic fix

[panic_down_under]

I am currently trying to decide on a CBT online course to buy as there doesn't seem to be anything readily available on the NHS

I thought GPs in most NHS trusts could prescribe the online FearFighter (http://www.nhs.uk/Conditions/online-mental-health-services/Pages/fearfighter.aspx) program.

Back in the first decade of the century there was a concerted push in Britain to make CBT the first line treatment for anxiety and depression with plans to train an extra 10,000 therapists. Then the GFC pole-axed the economy and it seems to have been greatly scaled back. :weep:


I can't sit around and wait for a magic fix

If only there was one! :(

[Turnaround00]

Thanks.
Fearfighter is th eone I want to do and saw that it costs over 100 if you can't get it on the NHS. Says it is onlu available in certain areas but I have rang and left a message with them so waiting to hear back to see if it is free but am not very hopeful...

Yes, I wish 15 years ago doctors/people and I knew more about anxiety then as I would have refused medicationa and got my ass to a therapist to deal with it then and there. Such is life though

---------- Post added at 23:27 ---------- Previous post was at 22:59 ----------

Found these which all look good

turn2me.org - This site has online sessions you can join most days and seems to be skype counselling too at a reduced fee.

https://www.nopanic.org.uk/ - This looks good. You pay 15 pounds to sign up then you get a mentor for 6 weeks who does CBT over the phone with you. Apparently its good and they push you out of your comfort zone. I am on a waiting list but should get a call in a week.

DARE: The new way to end anxiety and panic attacks

This is a book but once you nuy book you get access to an app and audio and a facebook group page where you can all help eachother as you all read and try practice the techniques in the book. Has some really good reviews and is affordable at 12 pounds on amazon

[panic_down_under]

Yes, I wish 15 years ago doctors/people and I knew more about anxiety then as I would have refused medicationa and got my ass to a therapist to deal with it then and there. Such is life though

Indeed, but be aware that therapy is not necessarily a cure, nor does it work for everyone. The success rate is about the same as for meds. While cognitive/behavioural/mindfulness therapies can be at least as effective as antidepressants, they are still only classed as treatments. This isn't a commentary on them per se, but on human nature. The techniques taught need continual application and we tend to slip back into old habits over time.

[Turnaround00]

I agree. I think that it is very easy to slip back into old habits, especially when feeling well again. When I feel well I feel like I am in control and nothing can stop me and I leave anxiety at the door and move on.
This time I am going to try and keep cbt techniques going so that when anxiety does show its face again I won't be so alarmed and hopefully remember to take it easy and do the steps

[BellaLune]

If you contact your local branch of MIND they often offer reduced price therapies, my local is £15 per hour max, they negotiate if you are very low income or unwaged too so often it is less and sometimes even free.

There is the possibility of a waiting list because it's popular but it's always worth asking and the waiting lists are usually much shorter than anything within the NHS.

[MyNameIsTerry]

If you contact your local branch of MIND they often offer reduced price therapies, my local is £15 per hour max, they negotiate if you are very low income or unwaged too so often it is less and sometimes even free.

There is the possibility of a waiting list because it's popular but it's always worth asking and the waiting lists are usually much shorter than anything within the NHS.

MIND are also the IAPT funded provider in many areas so offer it free throug referral or self referral. So, I would check that first as that would mean making the decision to go private for the same service you could wait a little longer for.

But good to know they offer discounted private therapy. AnxietyUK do the same.

---------- Post added at 01:56 ---------- Previous post was at 01:53 ----------


Back in the first decade of the century there was a concerted push in Britain to make CBT the first line treatment for anxiety and depression with plans to train an extra 10,000 therapists. Then the GFC pole-axed the economy and it seems to have been greatly scaled back. :weep:

They did, they brought in IAPT. This brought us a quicker referral but meant we now saw therapists trained to deliver CBT only with no requirement for any medical background.

It was criticised for introducing a stripped down form of CBT. You will hear even therapists comment about offering only the ERP elements to clients.

It's been a double-edged sword. Personally, I believe it was a plaster to address a service gap rather than a service designed to meet customer needs.

[panic_down_under]

I believe it was a plaster to address a service gap rather than a service designed to meet customer needs.

How unusual for governments....NOT!! Sigh!