Symptoms of stress such as insomnia, nervousness, sweating, anxiety, tension headaches, loss of appetite and fear are like the red light warning indicators on the dashboard of your car. These symptoms tell us that something in our lives is out of balance and needs to be set straight. Perhaps we need to leave a situation or confront an abusive child or say no to someone's unreasonable demands. Whatever the situation, the symptoms of anxiety represent our body's attempt to get our mind's attention and make a change. When one takes anti-anxiety medications, the brain temporarily shuts off the warning light on the dashboard without discovering the source of the problem. If we disregard our car engine's warning light and continue driving we risk destroying our engine. If we disregard the stress symptoms and "disconnect" with Xanax, Ativan or similar medications without uncovering and correcting the source of such feelings we run the risk of more serious physical or mental illness.
Anti-anxiety medications(like Xanax, Valium, Klonopin and Ativan) are very effective at relieving the uncomfortable symptoms of stress and anxiety. They absolutely work.
Not all anti-anxiety medications are chemically alike therefore they work differently in the body and brain. Ativan, Xanax and Valium are rapidly taken up in the brain and often create a mild "buzz." They also wear off rapidly in a few hours leaving the person's brain in a state of mild withdrawal which is experienced as anxiety. Ironically, the cure becomes the disease and patients often find themselves reaching for another pill to find relief.
Clonazepam(Klonopin) is different chemically from the above meds and has a slow onset and offset, often lasting for 8 or 12 hours. Since the onset is slow, patients often can't "feel" the effect but the brain receptors that cause anxiety are effectively "comforted."
I do not prescribe the short acting medications like Xanax(Alprazolam:generic), Ativan(Lorazepam:generic) but do prescribe Klonopin(Clonazepam:generic) at the lowest effective dose for short periods of time for situational stress or for international travel, not to exceed 30 tablet every 6 months. I do not prescribe these medications for chronic use.
If you feel you must have these medications on a more regular basis, I will refer you to a qualified psychiatrist. Long term use of these medications (benzodiazepines) results in physical and psychological dependence. If you have been taking these medications from a previous doctor, you cannot stop them "cold turkey" without risking withdrawal seizures and severe anxiety. I will help you "detox" off these medications slowly.
These medications in the elderly are associated with an increased risk of falls, confusion and memory loss. They may often mask or aggravate depression or dementia.
I do prescribe hydroxyzine, a mild non-addictive anti-histamine with sedating properties that is often effective for situational symptoms of anxiety.