General Question

silky1's avatar

Why would a psych doctor at a mental health facility tell you they don't prescribe the drug xanax or valium?

Asked by silky1 (1507points) July 13th, 2010

It’s not like I went in asking for them they are a part of my medical history.

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27 Answers

dpworkin's avatar

Because benzodiazapenes are highly addictive, and are not really as useful as CBT in treating anxiety.

Neizvestnaya's avatar

Maybe the director of that particular facility doesn’t favor those drugs as treatment, they do happen to be two of the most abused prescriptions the public has.

tinyfaery's avatar

To stop drug seekers from trying to get a fix

stardust's avatar

Could you give some more information? Did you need a prescription re-fill or something? Was it a psychologist as opposed to a psychiatrist? The former don’t always prescribe. @dpworkin ‘s right – they are highly addictive, so that might have a huge bearing on the decision.

Dr_Lawrence's avatar

@stardust Psychologists are not licensed to prescribe drugs. They do refer patients to physicians, when medications seem indicated.

silky1's avatar

I did actually see a psychiatrist.

mass_pike4's avatar

Because they are both depressants. I’m positive that prescribing depressants at a “mental health facility” is not the best option

silky1's avatar

I understand that but these are my prescribed medications from another psychiatrist. The only reason i left that doctor is because my insurance no longer covered my visits. Aren’t they supposed to continue what works for you?

jca's avatar

there are many meds they can choose from to try.

watch out with xanax. it is highly addictive. i have a friend who ended up going to detox to get off xanax. she got so she could not sleep without it, and was calling the doctor for more prescriptions, and going to the pharmacy at midnight because that’s when the new day started when she could fill the prescription. she has since told the doctor she will never take it again.

Neizvestnaya's avatar

From what I’ve personally observed, Xanax is an expensive but easy to get on the street garbage drug. A friend of mine was addicted to them and pretty darn useless and often publicly embarassing because of them. Be careful you don’t turn into a mumbling, bumbling, passing out at the wrong times participant in life.

jaytkay's avatar

The other answers sound more likely, but another idea – maybe they prescribe the generic versions instead of brand name?

Xanax is a brand name for generic alprazolam
Valium is a brand name for generic diazepam

jazmina88's avatar

they would like to find natural ways for you to cope and deal with stress, instead of relying on another rx. I do love valium when stessed, but I dont take it often. Only during a meltdown.

janbb's avatar

I was just speaking to a friend who has a sister with serious mental illness right now. He was telling me what a runaround she is getting with her treatment right now because of insurance and other issues and how no doctor is taking charge of her care. Each new place she goes to changes her medication so she is not on anything long enough to know if it will be effective. It seems like our mental health care system is as broken as the rest of the health care system. I would try another facility if you can to see if someone will prescribe what is working for you – in addition to trying some newer therapeutic techniques perhaps.

JLeslie's avatar

A lot of doctors won’t prescribe it because it is so addictive, as others mentioned above. You probably need to either find another doctor, or try what this new doctor suggests. If you take benzos daily you might want to give an alternative drug or therapy a try, because the withdrawal is pretty sucky, and that means every time you are running low on medication in your blood stream you are feeling anxious, rebound anxiety. It is a viscious cycle. The drug makes you better, but it makes you worse. I think benzos are fantastic for short term. Terrified of flying take one before a flight. Or, getting through a very traumatic event like a close loved one dying, maybe take it for a month or two. But, as a daily remedy for ongoing mental health trouble it is not ideal in my opinion. But I am not a medical professional, its just my opinion.

JLeslie's avatar

May I ask, are you being treated for an addiction aside from the benzos? Or, is your diagnosis something unrelated?

wundayatta's avatar

I have an idea. Why don’t you ask the shrink?

Just saying.

Flavio's avatar

I am a psychiatrist and I do work in an inpatient psychiatrist hospital and I never prescribe either xanax (alprazolam) or valium (diazepam). As others mentioned above, alprazolam is highly addictive and, I find, causes more hurt than help. Diazepam is an OK long-term benzo, but there are cleaner, better ones.

I only prescribe benzodiazepines for two reasons:
1) the patient is at acute risk for withdrawal from and alcohol or benzo addiction. If this is the case, I use ativan (lorazepam) or librium (chlordiazepoxide). I prefer the latter.

2) very short-term treatment for agitation or anxiety. I use it in acute settings as a temporary measure until the other meds (anti-depressants, mood stabilizers, anti-psychotics, etc kick in). in this case I use the short-acting ativan (lorazepam) on a “as needed” basis usually in 0.5 to 1 mg increments up to 6–8total mg per day OR I use the longer acting Klonapin (clonazepam) usually no more than 1–3mg per day.

I HATE discharging people on these meds because they are so addictive. I will never discharge someone with lorazepam (unless they have a flight or something) and I will rarely, begrudgingly discharge someone on clonazepam provided I know the outpatient psychiatrist they will follow up with and can have a conversation about my reasoning with him/her.

If I admit someone who regularly takes a benzodiazepine as an outpatient, I wont continue it and I wont discharge them with it. I think it’s bad clinical practice to prescribe alprazolam ever. I can understand the justification for diazepam, but I think clonazepam is better because it’s longer acting and easier to dose. Nonetheless, I think these meds require extreme caution and cannot be taken lightly.

sleepdoc's avatar

All of this class of medications (benzodiazepenes) have the potential for addiction and abuse (which is not the same thing as addiction). Many mental health professionals want to help people to develop healthy coping strategies for their anxiety, stress, etc. If one gets in the habit of using a medication like this to “self medicate” they are less likely to work at getting the healthy coping skills they need. The reason being taking the pill is easy and it makes them in most cases feel good. Trying to understand and cope with your emotions is typically less easy to do and takes effort and many times failure. The pills pretty much always works. The down side is for many it puts them in a state of not having to deal with anything in their life but that only lasts as long as the dose. FWIW

silky1's avatar

My motto and I’m sticking to it is if ain’t broke then don’t fix it. If this medication works for me then that’s what I should get.

wundayatta's avatar

I know people who live for klonazepam. For me, though, it really sucks. One pill made me so sleepy, I couldn’t drive. It was really hard jamming with the other musicians that night, and forget sitting up in the circle.

We cut it down to half a pill, but that was still too much. So we did a quarter pill. It’s three years later, and I have all those quarter pills still sitting around. I gave the whole pills to a friend who loves the stuff. Funny, she comes from a family full of people with addictions.

FWIW

JLeslie's avatar

I get sleepy with klonopon also. Xanax is best for me. Only once in my life did I take it daily, for about 6 weeks after a traumatic event. Since then I have taken a few here and there, maybe two or three during a really bad week, but I have gone years taking nothing. About 3 years ago I was a nervous wreck because my thyroid was soooo out of whack and I asked the doctor for 10 pills until my numbers would start to move again (thyroid medication takes a while to kick in) and she gave me a really really hard time about prescribing Xanax. The way I began to insist probably looked like I was desperate. I told her she can check every pharmacy in town, my insurance, I had not had a Xanax in over 10 years more or less. She finally wrote the script. I just wanted something I knew would work, and I knew I did not have negative side effects from. Frustrating.

silky1's avatar

So you know exactly what I’m talking about. It’s crazy. It seems as though the medications that work are the ones they don’t want to prescribe.

JLeslie's avatar

@silky1 But, you probably will get addicted if you are not already. I am very gun shy of addiction. I don’t drink, don’t smoke, never toked, never took a pill to get hi ever in my life. I personally would prefer to try less addictive drugs if I had to take an antianxiety medication long term. But, I do understand where you are coming from. Obviously, I don’t know your entire medical and psychiatric history.

soarwing11's avatar

I’m a pharmacy tech and I agree that the most likely reason is that alprazolam (Xanax) and diazepam (Valium) are addictive. But then again, these drugs are schedule IV, whereas drugs like Vicodin (hydrocodone/acetaminophen) and Tylenol (acetaminophen) with codeine are schedule III, and thus rated by the Feds as more addictive than Xanax or Valium. Perhaps you could ask your doctor about BuSpar (busPIRone), as it shows very little potential for abuse. It is available in tablets: 5, 10, 15, 30 mg. BuSpar might not work for you, however.

silky1's avatar

I do in fact take BuSpar also. They are very mild and sometimes the headache I get from them is to much to bare. Thanks for the input.

JLeslie's avatar

@silky1 Do you take BuSpar when you don’t have bensos available? The reason I ask is because many people get headaches coming down from Xanax and other bensos. It might not be the BuSpar, it might be the lack of Xanax.

AlaskanNobody's avatar

I understand your frustration and dilemma. I had had the same thing happened when I moved from Alaska to Texas – the doctors in Texas lived in the Dark Ages and assumed that my medications, which I’d taken for years without any dose creepage or anything negative, were “bad” for me. I had to fight like hell to get them refilled. If it ain’t broke, don’t fix it! If I were you, I’d pay cash and continue to see my regular doctor who did prescribe for me but ask them if you can only see him quarterly with refills that last that long. These people who ASSUME you are an “addict” versus being “physically dependent” don’t know the difference, and don’t know what they’re talking about and this can include doctors! I finally found a small town doctor, two hours away from Houston, who would continue my Alaskan medications, which had been carefully chosen over a number of years, and after trying other alternatives. The ones I had WORKED… I did not want to go through the painful “search and rescue” mission again to find things that worked, and did no harm in other ways, about other medical conditions. It was hell for two months! But, things were righted by an old doctor, who didn’t care what all the new stuff said; he had 50 years of direct patient experience with old and new drugs and felt the new ones were far more dangerous. I personally agree! My health was too precious to me! Best of luck!

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