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Family Physician
Family Physician, Doctor
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Experience:  Emergency Medicine and Family Practice for over 26 years
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If you become too tolerant of a pain narcotic or anxiety medication

Resolved Question:

If you become too tolerant of a pain narcotic or anxiety medication and stop taking it, will you one day eventually be able to take it again successfully?
Submitted: 1 year ago.
Category: Medical
Expert:  Family Physician replied 1 year ago.
The tolerance that develops to opiates (pain medications) and benzodiazepines such as clonazepam does gradually go away with time.

After the dose has been stopped or reduced, the higher dose taken would be more effective than it had been when the higher dose was being used regularly for weeks or months.

There are other medications that are useful for essential tremor including propranolol and primidone. Your doctor may need to add one of these other medications OR switch you to one of these for routine use which would allow you to use the clonazepam on a "as needed" basis for times when the tremor was much worse.
http://www.essentialtremor.org/Medications
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12663
Experience: Emergency Medicine and Family Practice for over 26 years
Family Physician and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

I just got diagnosed with Essential tremors and am taking 60mg of Inderal 3 times a day, but even at 180 mg total (plus 30 mg of lisinopril), I don't notice the tremors completely stopping. They're still there. I'm afraid to increase the amount of Inderal because I've been checking my blood pressure and pulse rate daily, and it's perfect right now.


The neurologist really wants me to stick with Inderal, and increase the dosage because I did suggest Primidone. The physician assistant said they like to stay with one drug at a time. I even asked if I could just stop taking the Inderal and take Primidone for a month to see if it helps more, but the physician assistant doesn't want me to change yet.


 


Anyway, I'm making an appointment with the physician assistant today. It's so embarrassing and hard to accept. I deteriorated very quickly in January for no reason and could barely communicate, talk, write, and all of my appendages were shaking in a strange pattern. I'm glad it's not MS, but there aren't any great medications for it either.


 


What do you think of Primidone? I do have a nausea issue...


 


Thanks again, this is all new to me and people at school where I teach were saying I was on cocaine or was crazy. It was really humiliating, so I saw an attorney today about discrimination and harrassment. He recommended I stop hiding my medical condition so I will disclose to them that I have the Essential Tremor condition. Today was a good day though and no one would notice that I had the condition....it's weird.


 


Again,if you think I should try the Primidone since I don't want my blood pressure lowering more, please let me know so that I can discuss it at my next appointment. Embarassed

Expert:  Family Physician replied 1 year ago.
Personally, I find that many people do better with 2 medications at lower doses than a single medication at a higher dose.

I can not legally or ethically give you medical advice (medication to use at what dose), but I do believe that discussing this with the neurologist directly (rather than the PA) may be your best option.
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12663
Experience: Emergency Medicine and Family Practice for over 26 years
Family Physician and 3 other Medical Specialists are ready to help you
Customer: replied 1 year ago.
Relist: Incomplete answer.
A neurologist would be a better choice to answer this question.
Customer: replied 1 year ago.

Hi,


 


Guess what?! After sending an emailing the rules of HIPAA and HHS to the pain management doctor just yesterday (Monday), I received a call early this morning (in less than 24 hours) saying that the doctor reviewed my file (after two months), they added the addendum, and are emailing and mailing me my records today.


 


I still might add my own addedum if I disagree.


 


Like I said, you were so helpful and better than an attorney!


 


Off to the psychiatrist to find out how to slowly get off of Clonazepam in case I need it to work with another tremor episode.


 


Thank you again!

Expert:  Family Physician replied 1 year ago.
Thank you very much for the update - It sounds like things may be working out for you.
Family Physician, Doctor
Category: Medical
Satisfied Customers: 12663
Experience: Emergency Medicine and Family Practice for over 26 years
Family Physician and 3 other Medical Specialists are ready to help you

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