To think the GP could just cough up the good stuff?

[Pantone363]

Longstanding and boring OCD diagnosis, successfully treated with private CBT and a maintenance SSRI dose. At its worse upwards of 5 panic attacks a day. Currently about 4 a year (go me).

So I have the SSRI meds and when I have a panic attack I have a 2.5mg diazepam that I can take if I feel I can't handle the panic. I haven't taken one for over 9 mths. Mostly just knowing I have them is comforting and I work through the panic. For those of you know don't know 2.5mg is a minuscule amount.

Last week I lost my handbag which had my last 4 tablets. Repeat prescription refused and doctor asked to see me first (my old GP has retired).

Basically GP refused to prescribe and looked aghast that I expected her to. Asked if I had tried breathing exercises and basically said she wouldn't give me any as they are addictive and uneccesary.

I understand that but I was basically asking for 5 tablets at a tiny dose which would last over a year! Hardly a drug habit. DPS threw his neck out last year and the GP handed him a script for 5mg diaz about 12 tablets! My friend got some for a fear of flying!

So AIBU a to think the doc should just cough up the good stuff and not fob me off with breathing exercises (which I'm well versed with and do not work by the point I would take the Diaz)

[Timri]

Farfrom that's disgusting!!
I'd be asking to be referred to the pain specialist, or be making weekly appointments saying you can't cooe with the pain!!

OP YANBU, to be honest I'm sure a lot of these Doctors are on power trips, and feel the need to change things just because they can

[FarFromAnyRoad]

Thanks Paris - it bloody is, isn't it. I suppose I could have protested a little louder but I didn't want to look like some desperate slavering addict so I guess I'll just see how I cope and then do what I do not know.........go back and look like a desperate slavering addict I suppose

[spillyobeans]

I had really bad panic disorder a couple of years ago and was on antidepressants and had a small amount of diazapam same dose and also found the idea of having them if i needed them very comforting so when id finished my prescription it was scary but i worked through it. I found when i did go to docs asking for it made them not want to give it to you but if i was struggling etc and explained my ssymptomsthen they would prescribe them - i think they are keen to see diazapam as a short term fix and your antidepressants and cbt should be the long term 'management'. But no harm in seeing a couple of other doctors and just saying exactly how you feel, some doctors can be great others really not! ( i have long term intertiall cystitis, so utis almost every month and went into the docs pretty much crying and asking to be refered to a specialist and the doctors response was "have you tried eating yogurt?" )

[FarFromAnyRoad]

Yes Timri this new GP is young, bouncy and enthusiastic so I'm guessing he's still full of ideals about all manner of things. I just wish he'd practice them on someone else! I will just keep going back - I don't care - it's not like I have anything else to do because the buggering pain makes it almost impossible for me to work!

[AliceScarlett]

I'm a bit confused, panics attacks are acute, how does the Diaz kick in in time to have any impact?

[Goldmandra]

I've had one GP refuse to give me any for muscle spasm then her DH working for another practice that covers when ours is closed gave me a prescription for thirty without question.

I hope a different GP decides to trust you

[Fromparistoberlin73]

Far from

Don't give up - science is a wonderful thing and it has created a drug that helps you function as a human being - that gp can fuck right off - good luck xx

I am pissed off with the NHS right now due to - ah I can't be areas to go I to it but GP are very fallible and we do to tend to stick up for ourselves as see them as authority figures IFSWIM x

[spillyobeans]

alicescarlette they act very quickly, so as soon as you sense a panic attack coming on you can take one - wont stop it or prevent it but makes it alot more managable and a hell of alot less scary as you feel like you can regain controlnof yourself.

[straighttalker]

YABU.

2.5mg is a homeopathic dose (i.e. you might as well suck on a polo). It's not helping you - you're using it as a crutch. It sounds like you've done very well with CBT and SSRIs and they will help you in the long-term, benzodiazepines won't.

I think it is reasonable for the GP to wean you off a medication a) you're not using b) even if you did use clearly wouldn't help you beyond a placebo effect.

Like many medical staff, I've seen sufficiently negative side-effects and consequences from benzodiazepine prescription that I now honestly believe they should be restricted to procedural sedation, epileptic attacks and relief of muscle spasms.

Not likely to be a popular viewpoint I realise but there you go.

[AliceScarlett]

Mm very quickly won't be less than 15min if taken orally... So I can't see how that would have an impact on a panic attack. A psychological impact yes but not a chemical one... Which it is supposedly meant to have.

OP you sound like you're very much in control of them and use them sensibly so YANBU.

[meandjulio]

Alice from my experience (well not mine, a relative's) Diaz kicks in pretty bloody fast. My relative also gets a small amount prescribed, always has some as a backup and their intake amounts to about 15 tablets a year at the outside, most years much less than this.

OH I think you should go back and discuss it with the GP again. I wouldn't necessarily take sheaves of paper, but ask them why they are so against this treatment which you have found helpful. You could drop a few lines such as this 'I know that the NICE guideline for OCD says to avoid anti-anxiety drugs for the core symptoms of OCD without other problems because of the dependency problems for daily use over 4 weeks, but what is the evidence about the kind of occasional use I have had in the past? Would you consider contacting a consultant for an opinion about this?'

[LeoandBoosmum]

I thought 2.5mg was a biggish dose tbh. I get nowhere near that to try to help manage anxiety (and doc won't let me have anti-d's at the same time).

[spillyobeans]

Alice...im speaking from personal experience and mine was that it did act that fast ( as in within 5-10 mins) and i stated i found it didnt stop or prevent a panic attack but made it managable and lessend the severity of the symptoms of a panic attack.

I felt a very 'sedated' feeling, im sure there is a psychological element, as with other drugs, including antidepressants, but i definitely felt the physiological effects too.

Actually, i remember getting prescribed a dose of 2.5mg and was accidentally given a bigger dose by pharmacy. The effect was very quick and very strong - i felt as though i was knocked out! I only realised the wrong dose after and went to the pharmacy for an exchange. So, from personal experience i can tell you that the effects are definitely not all psychological.

[spillyobeans]

Also op - you said you found private cbt helpfull in past, perhaps say to doc about being put on waiting list for nhs cbt as you found it helpfull and if they are not willing to try a prolonged course of diazapam. You may suprise yourself how well you do without it ( although very hard to contemplate i know!). But yes, see another doctor and just keep doing so untill they take you seriously and sugest a plan of action so to speak

[CrohnicallyInflexible]

alice sometimes panic attacks can last for a heck of a long time! It's not the case that once the acute attack is over, that's it, you're back to normal. I realise I am probably atypical, but I can struggle on and keep a full panic attack (hyperventilating etc) from developing, but that means that I have a racing heart, sweaty, shaky, feeling sick etc for a long, long time. And even after the worst is over, it takes a long time for my heart rate to return to normal, during that time I am anxious about the fact I have had an attack and very susceptible to having another.

Diazepam kicks in within 5-10 minutes for me. It helps the physical symptoms, but also has a sedating effect so instead of being hyper and flappy, I can relax and do something like watching TV that helps to break the cycle of anxiety.

It's not just a psychological effect, I know the drug (yes, even 2mg) has an effect on me. I remember one occasion where I was too worked up before I took my tablet, and my digestive system must have temporarily shut down. It didn't work. But after an hour or so, when I had calmed down a little, it did kick in. If it was a placebo effect, it would have happened when I took the tablet or not at all- why would it kick in an hour later?

[TheHappinessTrap]

I have such a poor opinion of gp's. I'm sure this is wrong but I feel they should work to help me in ways I want to be helped. I hardly ever go but when I do, maybe once a year, I've exhausted everything I can do myself in terms of diet, excercise, supplements, whatever. I never find them helpful or when they are it's with random stuff I didn't go in for, like one woman who volunteered to tell me that I had acne rosacea and it could be treated, turned my life around. Nurses have always been amazing but gp's come across as control freaks in my opinion.

[meandjulio]

'Wean her off' a drug that s/he uses 4 x a year?

[ememem84]

I sympathise with you here. You haven't needed them for a while but I assume that just having them makes things easier to cope with?

My gp prescribed something for me - I think it's Valium but actually not sure off top of head would have to check- for my flight anxiety. I carry them with me in my hand luggage. Have used one. Once but not on a plane. At home. Wanted to make sure I didn't have a bad reaction to it while flying.

Never needed them in plane but just having them makes it easier.

[jusdepamplemousse]

I have to take diazepam to fly and some GPs are v difficult about it but I do see why. You have to be v v v reasonable about it but v v v insistent and tell them you'd like to see another GP if necessary as they haven't offered a valid alternative. And even though it was true it was a massive red flag going in saying you'd lost the last ones. Honestly if you didn't say that you may well have been prescribed what you needed. But that's addict/messer talk 101. NOT saying you are at all btw, you just unwittingly spoke a commonly given line.

But I recently got sent home from (albeit minor) surgery without any painkillers so I wonder is there an nhs wise push to reduce dispense of drugs generally? That seemed a bit extreme to me.

[spillyobeans]

Chronically - hit the nail on the head.

Its so hard for people to understand what true anxiety is like if you have never experienced it , having a panic attack and then starting off a cycle of fearing the next...its actually so debilitating.

Ive suffered anorexia and depression in the past....neither even compares to true anxiety/panic disorder. And im not saying that lightly.

[Chimchar]

Well done Panetone on your cbt. You sound like you're in control, which is a good place to be!

I've been doing it too for anxiety amongst other things and have found it really useful. I'm also doing mindfulness which is proving very beneficial.

I have a stash of 2.5 mg diazies. Exactly the same as you....I know I have them. I don't use them, but I know, if it all gets too much, and I start that vicious panic cycle, then it will give me some head space. Just knowing I have them is enough. I know I won't be able to get any more...my Gp gave them to me very reluctantly in a sort of urgent situation.

It is good to be in a thread where people understand how fucking terrible panic attacks can be.

[AliceScarlett]

chronically Good point about the after effects.

[Pantone363]

I'm busy right now but yes it's the cycle that they stop, one panic attack may only last a short time but you can have multiple attacks in one day. The Diaz calms down the physical effects which tend to feed the what if what if what if thinking.

I can't get any from my mum, she doesn't live near and won't send them in the post (fair enough!)

[Fromparistoberlin73]

I would take some of the advice on here , quote the NICE guidelines too. Well you know what you need to do next time you visit your mum

Just seems there is no consistency in how this is prescribed

[ApeMan]

Doctors should not prescribe addictive drugs they consider to be unnecessary.

That's about it, really.