xanax and BPD?

[SlyQQ]

Not sure was coming of heroin as well but was off before she started benzos ( almost killed her when she started again ( DONT DO BENZOS AND HEROIN !) eventually dumped the xanax and rivotil for effexor and seroquel stupid psyche didnt even no crossover between suboxone an seroquel never met a decent psyche yet my ex could really hold her drugs though so was probably higher

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[notdownyet]

 

Been there big time 5 xanax an two to three rivotil a day

disadvantages

1 addictive but coming off fairly  managable

2 use over time makes them worthless making you lift and lift dosage

eventually becoming more addictive an worthless

3 REDUCES inhibitions big problems with impulse control!

4 Basically is good for Sporadic use to handle very stressfull

circumstances

Was that 5mg?

I Agree with all this.

My BPDw was on the 5mg dose of diazepam.

During her worst mania, she took a full strip; so that’s 14x5mg + alcohol + zopiclone, over a few hours.

I’m surprised that she’s still here.

On an average day, it would be 4 – 6 tablets.  Bearing in mind, that these tablets have a very long half life, so could be in the system for days.

She’s now had her supply cut off.  Believe me, it was a battle to stop the Dr’s from giving them and for her to stop demanding/taking them.

[Deeno02]

Mine was on it. Including some meds for Fibromyalgia too. Didnt make a ___ of difference. Think she may be addicted to them. Had to do a few "Emergency" Xanax refills with her Doctor. Glad Im not around that crap anymore.

[waverider]

I Agree with all this.

My BPDw was on the 5mg dose of diazepam.

During her worst mania, she took a full strip; so that’s 14x5mg + alcohol + zopiclone, over a few hours.

I’m surprised that she’s still here.

On an average day, it would be 4 – 6 tablets.  Bearing in mind, that these tablets have a very long half life, so could be in the system for days.

She’s now had her supply cut off.  Believe me, it was a battle to stop the Dr’s from giving them and for her to stop demanding/taking them.

We are on 16x 5mg diazapam at the moment as a consequence of coming off 8 x 2mg xanax +8 x 5mg diazapam.  This was on top of 100-120mg oxycodene (now on methadone to come off that), seroquel, effexor, largactyl, epilim, amilsulpride, No Doz caffeine pills, panadol codeine, ibruprophen This all used to be washed down each day with an enormous amount of beer and wine. Chain drinking from wake up until fall over... .I too think it is a miracle she is still alive.

She needed a short stay in a detox center to change from xanax to diazapam. They work on 10mg diazapam approx equals 1mg xanax. difference being kick in kick out, makes diazapam then an easier med to withdraw from slowly. It took national restrictions being brought in to accept (with a lot of kicking and screaming) she had to come off it as no GP is allowed to prescribe it ongoing anymore without strict permits. Its now on a par with opiates as a restricted med.

Recovering from breast cancer and continuing to chain smoke

These are all being reduced slowly. Alcohol has been gone now for coming up 2 years. She has a GP who provides weekly counselling sessions, not just meds, and also in the same health center a mental health therapist/nurse who home visits each week or two. No formal BPD therapy. Its hard to get here and she is not functional enough to reliably turn up at a structured course yet.

Various individual Ts have come and gone and made zero impact.

TBH me being here has had the greatest impact

[waverider]

Actually death by diazapam overdosing is rare. Panadol and xanax are very high risk of accidental death by overdosing.especially if combined with alcohol  and opiate painkillers

[SlyQQ]

If your p is not on seroquel suboxone might be worth considering waverider my partner could do a couple of bottles of vodka an be ready to kick on did thousands odf dollars in heroin in one day off an on plus almost every other med under the sun bar lithium but she was considering it am in australia to so maybe we have some similar background stuff none of the psyche drugs really helped with BPD 

[notdownyet]

We are on 16x 5mg diazapam at the moment as a consequence of coming off 8 x 2mg xanax +8 x 5mg diazapam.  This was on top of 100-120mg oxycodene (now on methadone to come off that), seroquel, effexor, largactyl, epilim, amilsulpride, No Doz caffeine pills, panadol codeine, ibruprophen This all used to be washed down each day with an enormous amount of beer and wine. Chain drinking from wake up until fall over... .I too think it is a miracle she is still alive.

She needed a short stay in a detox center to change from xanax to diazapam. They work on 10mg diazapam approx equals 1mg xanax. difference being kick in kick out, makes diazapam then an easier med to withdraw from slowly. It took national restrictions being brought in to accept (with a lot of kicking and screaming) she had to come off it as no GP is allowed to prescribe it ongoing anymore without strict permits. Its now on a par with opiates as a restricted med.

Recovering from breast cancer and continuing to chain smoke

These are all being reduced slowly. Alcohol has been gone now for coming up 2 years. She has a GP who provides weekly counselling sessions, not just meds, and also in the same health center a mental health therapist/nurse who home visits each week or two. No formal BPD therapy. Its hard to get here and she is not functional enough to reliably turn up at a structured course yet.

Various individual Ts have come and gone and made zero impact.

TBH me being here has had the greatest impact

That's one difficult situation.  Even if you took the drugs and alcohol out of the equation, I’m sure it wouldn’t be plain sailing.

It sounds like there’s progress being made, which is a positive.  I hope it feels that way for you both.

[waverider]

That's one difficult situation.  Even if you took the drugs and alcohol out of the equation, I’m sure it wouldn’t be plain sailing.

It sounds like there’s progress being made, which is a positive.  I hope it feels that way for you both.

Huge progress has been made, but it has been a long hard process with lots of misleading blind alleys. Having obvious substances at hand to do serious harm/fatality out of a tantrum is like walking on a knife edge.

[maxsterling]

Good discussion.  I think additional worry here is that Xanax will not solve all dysregulated states, and when dysregulated she will take an overdose in desperation.  I think she has done it before (long before I met her), and there have been a few times where she has instructed me to hide her medicines from her.

She did get a refill script for Xanax.  But when I went to fill it, they said they could not fill it for a few more days because the time was too close to her last script.  She said she had 5 pills left, and 4 days until it could be filled.  I'm not sure how many they dispense her per day, but I think around 2 pills.  She did also make mention that they helped her tremendously at first, but less over the course of the week.  I wonder if this all has to do with her taking them too often.

[waverider]

She did get a refill script for Xanax.  But when I went to fill it, they said they could not fill it for a few more days because the time was too close to her last script.  She said she had 5 pills left, and 4 days until it could be filled.  I'm not sure how many they dispense her per day, but I think around 2 pills.  She did also make mention that they helped her tremendously at first, but less over the course of the week.  I wonder if this all has to do with her taking them too often.

Yes this was the first flag to me that repeat scripts were being turned down by pharmacy as too soon. You are then fed BS excuses (lost pills, unexpected serious stress that need extra pills, last bottle was short etc) to try and talk the pharmacist around. Next thing you know you are piggy in the middle.

At my lowest I sunk to knowingly telling fibs to get excess meds to avoid the fall out

If one pill works then 2 must be better right, 3 will make them feel great? Meds are design to clip the peaks of anxiety/panic. They are not designed to totally eliminate it, and even make someone feel good. This is what someone with no regulation skills will fail to grasp.

[maxsterling]

If one pill works then 2 must be better right, 3 will make them feel great? Meds are design to clip the peaks of anxiety/panic. They are not designed to totally eliminate it, and even make someone feel good. This is what someone with no regulation skills will fail to grasp.

I think that is what my wife has trouble with.  It's not just the emotional issues, but all issues.  Same goes for her pain.  She wants something to make it all go away.  I don't live in her skin, so I don't know how much pain she is in.  But at near 40 years old, I expect some pain and live with some pain.  I wonder if she just can't do that.  I also just started taking meds for adult ADHD.  I'm on a low dose, just to see if they can help.  So far, so good.  But I am carefully evaluating how they are working.  I would worry if my ADHD problem completely went away.  I'd also worry if I was taking Xanax and all my anxiety went away.  We feel sadness and anxiety for biological reasons.  Taking that all away is not good.

I think that is where validation could help.  I try to tell my wife when she is feeling bad that most healthy people feel bad in similar situations.  Example - most people feel anxious when starting a new job.  If they didn't there would be something wrong with them.  I think that helps sometimes, but when the anxiety is acute, she seems to have zero control and a full blown panic attack ensues.

[Haye]

Anti-psychotics like seroquel are used here where I live to treat BPD patients. Not as effective as sedatives, but does not create similar addiction. It's very effective to stop obsessive thinking and help one to sleep. Some get side effects yes, mostly they are something like increasing appetite. My SO is anorectic so the tiny rise of appetite was only good. Seroquel helped my SO hugely; at the point when he was doing very badly he took a long effect one (prolong) and some faster when needed. It is however not as fast working as sedatives, i.e. when he really falls down the med is needed asap, waiting for 30min-1hour for it to cull the anxiety/suicide thoughts was too slow.

He is now taking benzo 5mg when needed, which is maybe once or twice a month so not much risk for an addiction. I give him something like 6 tablets to hold, enough for 2-3 days, to make sure he doesn't combine a pack or two with some other stuff to end his days. The rest are hidden carefully. My SO however is not easily addicted and is okey living with some amounts of anxiety etc. In truth the problem was to get him understand he doesn't have to endure all bad thoughts and feelings in his head.

I understand you don't want to get involved with her medications, Max. I really do. But sometimes we the nons are the only ones that can make a change, be it about descriptions or how she is treated otherwise. I have met my SO's psychiatrics and explained what is truly going on... .In my experience healthcare persons only listen closely when there's an extremely worried (desperate, frustrated and sad) loved one demanding more attention to the patient's case. It's like my bi-polar mom once said: "They don't listen to us crazy ones. They just don't. Beacuse why would anyone believe anything the crazy ones say". (she was hospitalized, suicidal thoughts in mania state, the personnel there marked here as depressed and suicidal and fed her uplifting medicine, only elevating her mania :O. No matter how much she protested... .Me they believed, however. So stupid).

[SlyQQ]

A Dilemma A Dilemma “We can prescribe antipsychotics, but patients with BPD do not have true psychosis. We can prescribe antidepressants, but patients with BPD do not have classic depression. We can prescribe mood stabilizers, but the affective instability of BPD is not the same as the symptoms of bipolar disorder.” -Paris 2008 (p. 113) Benzodiazepines Benzodiazepines z Alprazolam has shown worsening of symptoms and an increase in severe behavioral dyscontrol z Benzodiazepines can be disinhibiting and impair already-precarious cognitive functions and should be used with caution NOTE: Patients with BPD often want to use meds to eliminate - rather than regulate - feeling states (particularly anxiety). b palmer mayo clinic 2012 worth looking at

[waverider]

A Dilemma

A Dilemma

“We can prescribe antipsychotics, but patients with BPD

do not have true psychosis. We can prescribe

antidepressants, but patients with BPD do not have

classic depression. We can prescribe mood

stabilizers, but the affective instability of BPD is not

the same as the symptoms of bipolar disorder.”

-Paris 2008 (p. 113)

Benzodiazepines

Benzodiazepines

z

Alprazolam has shown worsening of

symptoms and an increase in severe

behavioral dyscontrol

z

Benzodiazepines can be disinhibiting and

impair already-precarious cognitive functions

and should be used with caution

NOTE: Patients with BPD often want to use

meds to eliminate - rather than regulate -

feeling states (particularly anxiety).

b palmer mayo clinic 2012 worth looking at

Pretty much what psychiatrist told us also. psychosis linked to BPD is not true psychosis, which is more an ongoing state than a pwBPD experiences.

The swings in and out of the various states often means the meds are often like shutting the gate after the horse has bolted. You are either treating a state that may or may not be about to be an issue, or they may be coming down out of the state already even before drug kicks in. Either way they will often have the drug in their system when they dont actually need it.

This in real terms means that taking say benzos when no impending need, simply dopes them out, bringing with it other problems. Then when a crisis hits the amount may not be enough.

With other medical conditions meds are gradually introduced to deal with conditions slowly until an appropriate containment level is reached. If the condition swings wildly, as in BPD, then their are obvious difficulties in matching this balance. Leading to over medicating and under medicating cycles.

Next thing you know they are taking uppers to counter the sedatives, the blood pressure tabs to counter the uppers and so on. Meds treating the side effects of meds until you have no idea what is working and what isn't

[notdownyet]

I honestly have to question the wisdom of prescribing (and possibly the existence of) benzodiazepines, in a lot of instances.  Particularly the likes of xanax, lorazepam etc.

It's just a quick fix solution, to an on-going long term problem, for BPD’s.  Where do you draw the line when prescribing?  when the symptoms have “gone away”.  Not to mention the potential long term damage benzo's can cause.

In a lot of cases, it's simply just exchanging one mental health problem for another.

Here in the UK, they give them out like sweets.  You can even get them if you're nervous about flying!

[notdownyet]

Benzodiazepines can be disinhibiting and

impair already-precarious cognitive functions

and should be used with caution

NOTE: Patients with BPD often want to use

meds to eliminate - rather than regulate -

feeling states (particularly anxiety).

b palmer mayo clinic 2012 worth looking at

This is what my BPDw experienced - worsening of some BPD traits, particularly around compulsive, impulsive and aggressive behaviours.

As it says above, the user’s just conditioning themselves into not managing/regulating their own feelings, by relying on an external force to do that for them.

I guess that fits into the whole BPD ethos, of looking for the both the problems and solutions, outside of themselves.

[waverider]

Often Xanax is initially prescribed for debilitating panic disorder before BPD is diagnosed as the real issue. pwBPD tend to catastrophize everything so symptoms can be seen more severe than they really are. They dont panic a bit, they panic a lot as nothing is done in small measures. The driving force is not always the same as that which drives someone with panic disorder as a specific disorder.

Once on the med the role is played to stay on it.

My partner could go from regulated to total meltdown as soon as she walked through docs door, to recovery as soon as she left. All the doc ever saw was a woman who was in a permanent state of meltdown. ie the Panic was triggered by a need to get the med and fear of not getting it, rather than real panic disorder.

[notdownyet]

My partner could go from regulated to total meltdown as soon as she walked through docs door, to recovery as soon as she left. All the doc ever saw was a woman who was in a permanent state of meltdown. ie the Panic was triggered by a need to get the med and fear of not getting it, rather than real panic disorder.

Tell me about it.  My BPDw did exactly the same.

My BPDw, knew how to play the theatrics in a such a subtle way, that all the GP's at the practice would fall for it.  She actually prided herself in being able to dupe them.

Fortunately, my BPDw's come down from her grandiosity.

In the end I wrote a letter to the prescribing Dr, detailing her tactics and the end results.  Didn’t work though.  Even the multiple OD admissions on her record didn’t stop them prescribing.

She even pulled the same trick with her p – who’s’ a consultant p at that – this time with zopiclone (benzo supply was cut off by the p, after her last OD) and managed to get some.

Amazing how BPD’s can focus their self-control, when after something they desire.

[waverider]

Amazing how BPD’s can focus their self-control, when after something they desire.

This is their survival trigger being activated. To them it feels like life or death. Most of us can excel ourselves when faced with this mode. Luckily for us we have a working executive ability to asses reality  better and do not go into this mode very often, or never. pwBPD are never far from it.

[SlyQQ]

My ex BPD partner only did a bit of dr shopiing though one of her similar friends was good at it I guess mine just reached for a needle when it got to that stage

[waverider]

Mine worked the system so that she was getting up in the middle of the night when I was asleep calling the home visiting after hours service, where by nature they sent a different duty doc each time and still used hand written scripts. Then she would modify the these scripts to add repeats in.

Guess which muggins was the one who was having pharmacies rejecting suss scripts and believing she was being hard done too. As she abused the pharmacies for making outrageous claims.

Eventually was reported to police and ended up in court with a charge of passing false/doctored scripts. These were for panadene forte (strong ibruprohen/codeine).

The excess use of ibruprophen eventually caused a ruptured stomach ulcer leading to emergency surgery when we were on hols once.

The point being it is not always the specific med it is the pursuit of the magic pill attitude. Once it starts, it becomes transferable to different pills and harder to stop.