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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have severe anxiety and have xanax and klonopin but they

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I have severe anxiety and have xanax and klonopin but they don't seem to control it...any suggestions on something different I can try
Dr. Z :


Dr. Z :

I believe I can help you with your concern

Dr. Z :

I am so sorry that you have been experiencing this severe anxiety, I can imagine how distressing and debilitating it can be for you

Dr. Z :

Usually Xanax and Klonopin are best to use "as needed" because the medication can be very physically addicting and using it on a regular basis can increase this physical addictiveness of the medication.

Dr. Z :

May I ask, have you ever tried Lexapro?

Dr. Z :

It is also a SSRI antidepressant like Celexa, Prozac, and Paxil, but Lexapro is usually more effective and has less side effects.

Customer: Have not tried lexapro since I don't like anti depressants ...I'd rather a fat acting medicine I can take when the anxiety hits rather than something every day
Dr. Z :

Well if that is your preference then the Klonopin and Xanax are the best for that, but that means you would have to take a constant supply of this medication as it does not accumulate in your system like other medications.

Dr. Z :

Since you do not want to take medication everyday, are you using a therapeutic techniques at all to help with your anxiety too? Because the use of Cognitive Behavioral Therapy (CBT) and the medication is considered the best approach to treat severe anxiety

Customer: Right now I'm prescribed .5 xanax twice a day as needed and 1 mg klonopin twice a day as needed...should those doses be increased?
Customer: ive tried CBT and it hasn't history consists of years if sexual abuse and a rape in my late teens
Dr. Z :

If you are still having severe anxiety with these dosages, then yes these medications can definitely be increased, I would think about favoring the Klonopin over the Xanax as Klonopin has a much longer half-life and stays in your system longer. But your body may get used to these medications over time which means you would have to use more. This is the problem with these medications and why they should not be used as long-term

Customer: are there other anxiety meds I could try? Not anti depressants though
Dr. Z :

I am so sorry to hear about your history of sexual abuse. These medications will not cure you from that trauma, only therapy will. I would like to recommend looking at Dialectical Behavioral Therapy (DBT). This has a higher success rate treating anxiety from sexual abuse trauma than just CBT.

Customer: how do I get that type of family dr of 20 years has never suggested it
Dr. Z :

Well I would like to recommend Buspar. It is a great anti-anxiety medication with mild tranquilizer effect. It works similar as anti-depressant by increasing Serotonin, but it is considered chiefly an anti-anxiety medication.

Customer: ok...I could try that
Dr. Z :

Well I can look in your area for you if you like and try to find a therapist that specializes in DBT for you. Also here is a good website on it and a book I would like to recommend for you too.

Customer: i live in Marquette Michigan and the wait time to see any type of psychologist here is 6 months
Dr. Z :

Well a Master's level therapist can provide DBT too, and they usually have shorter wait times, but give me a few minutes to compile a list for you

Customer: I need someone who can prescribe and monitor my meds which is why I'm looking for a family doctor is upset that I don't want to stay on antidepressants
Dr. Z :

Oh okay, well this is a therapist that uses DBT and does not prescribe medications at all. You can try to find a psychiatrist in your area and practice the DBT therapy with the website I gave you and the books too if you like. Still here is the name of the only DBT therapist I found in your area

Customer: Thanks but I need someone to monitor my meds as well as provide therapy
Dr. Z :

In addition to Buspar, you can also try the use of Beta Blockers. They are used for hypertension, but have been used off-label for anxiety. They treat the physiological symptoms of anxiety well

Dr. Z :

I understand, most psychiatrists do not provide DBT therapy, as this is a more novel type of therapy

Customer: Tried those and I have low blood pressure so those make me dizzy... My blood pressure is typically anywhere from 50/70 to 65/90
Dr. Z :

I understand, I just wanted to give you all of your options. I think using Buspar and raising your Xanax and Klonopin would be the best medical approach for you at this time.

Dr. Z :

Here is also a link of different medications to try to help treat anxiety as well

Customer: Ok thank you
Dr. Z :

Anytime, I am always happy to help. Is there anything else I can assist you with?

Customer: I think that's it...thank you
Dr. Z :

You are most welcome, I hope that your anxiety goes away swiftly with these medications. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Dr. Z :

Before you sign off though, I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much

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