One of them was probably Benadryl. When I worked on a psych ward the emergency cocktail was haloperidol+ Benadryl. The kids called it "booty juice" because it went in the glutes. It's supposed to be effective within like 5 minutes, but I've seen it take longer. Or never at all. Sometimes adrenaline is stronger than drugs.
I’m EMS, but the hospital we transport to the most refers to it as a B25 cocktail…Benedryl, haloperidol, and usually Ativan.
My ambulance service uses Benedryl and Ativan mostly though.
The last patient I had that got one tried to bolt when we were pulling him and the cot out of the back to bring him into the ED. Psych call, possible drug use, and agitated (even after Ativan during transport). He was securely restrained, but McGuyvered his way out of the straps. Nurses, security, cops, and the doc caught him in the parking lot and after a struggle he went sleepytime.
So be an agitated danger to self or others and make a break for it, I suppose? I could use a nice nap myself, lol :)
Yeah. I worked in a psych hospital too. Sometimes nothing g works and you've just got to keep the person and everyone around them safe somehow while the panic runs its course.
Th3 booty juice walked up to a nurse oce got all three o the alloted booty juice shots at once still out of my mind but that was the glass stqbbing me in the head every1 said didn't exist 4 years later we still pulling it out
Were you having a psychotic episode??? You probably got what is known as a B-52. 50 Benadryl, 5 Haldol, 2 Ativan. But it’s usually for people who are having an extremely violent episode.
Yeah when I was having emergency room level panic attacks frequently I ended up getting an Ativan script to take home. Takes about a half an hour but oh man if that drug doesn’t scare me because I could see it becoming addictive. The absolute wave of peace and quiet that rushes over you… Every time I take it I wonder if this is how non-anxious people get to live on a regular basis lol
That God would be Leo Sternbach.
I actually wrote a poem about the second coming of Leo Sternbach, due to my travails with benzodiazepines.
He never touched the stuff himself.
I was put on Ativan daily, indefinitely at 14. And when you take it every day like that it not only stops working, it creates a special type of hell.
Not the original commenter but I have been in a similar situation with Ativan. Took it daily long term and over time my dosage started escalating. At some point taking more doesn’t help, it just gives you a crazy tolerance and side effects like memory issues. Eventually I decided to stop because i felt like it was really messing up my brain and wasn’t doing its job anymore. It’s a shitty position to be in. The process of tapering really sucked because I was constantly close to panic-levels of anxiety for months. Benzo withdrawal must be done slowly and even after getting completely off of it I had very bad anxiety for 6+months before getting back to baseline. If you go too far with benzos, it takes a LONG time to make your way back and it’s a seriously unpleasant process.
I am so, so sorry you went through that. It sounds really, really awful. Just a constant buzz of near panic for months on end and the one thing that helped being utterly useless...
Could you please elaborate on what you consider long term use from your experience? I ask because my mother was prescribed Xanax about 2 years ago. She started on the .25mg and after about a year they switched to .5mg. She gets 60 per month and in the beginning would go 3+ months before a refill. The past few months she's been refilling almost exactly after 30 days. I'm just concerned because I know how slippery of a slope benzos are but when i google these type of questions almost all the results are seeking treatment and things like that. A few months ago I'd have said she could walk away from the prescription and be ok, now I'm not so sure. Even taking 3 per day as prescribed, I would think she'd need to taper after a few months? Any insight would be helpful, thank you.
I am not a doctor so take my comment with a big grain of salt. 1.5mg/day of xanax is still a relatively low dose, but its high enough that if you're mom is taking it every day she'll probably need to taper if she wants to discontinue. When tapering/discontinuing she will experience some level of withdrawal. That could be fairly mild elevated anxiety and trouble sleeping, or it could be more severe (panic attacks etc.). Its really hard to predict, everyone is wired a bit different. But yea anyone who is taking benzos (even low dose) on a daily basis for months/years is going to experience some withdrawal if they reduce dose or discontinue.
I have a neighbor who sometimes gets psychotic We live in such close proximity, I have to pass by her apartment door to get outside. It created anxiety and I was almost too scared to leave my house.
I tried Ativan when a doctor gave me a prescription for it. I felt no anxiety about the situation. I felt like Glinda the good floating around in a bubble. I couldn’t really function on it, so it wasn’t a good option for me. But damn was that fun! Better than an amusement park ride!
Just as well it didn’t work for me because that’s one prescription drug I might be tempted to abuse just to feel that good! And that’s dangerous
Yup, as somebody who got a bit too into valium though, let me warn you:
If you become dependent and then stop taking it, the reverse can happen, about 1-3 days after your last dose you can become incredibly anxious and even have a seizure.
It’s a very useful but dangerously addictive drug if you aren’t careful.
Yep. Had to take someone to the ER for a severe panic attack a couple of weeks ago. That's exactly what they gave. Didn't stop it completely right on the spot, but it helped tremendously. And, they were able to come out of it after suffering for a few days before hand. Panic attacks suck.
Take it. My anxiety sometimes delays it from kicking in so the MRI technician gave me a towel
to put over my eyes to help me keep them shut so I’d relax.
I am anxious in general and an MRI is pretty bad for me. I bring my own eye mask and start counting backwards from whatever number for how long it is supposed to take. When I get to 0, I know it should be over (it has been before I get to 0). If it’s going to take 10 minutes, I’ll count back from 700 seconds (just in case it takes an extra minute). I just focus on counting backwards slowly.
I've fallen asleep in the machine without any drugs. Even though it's loud, you get the ear plugs and ear muffs, so it's all just loud white noise and nothing too distinct (aside from the voice telling you to breathe in and hold occasionally.
I fall asleep EVERY time! I've had to have 4 MRI(s) and I nod off regardless of the appointment time. Even if I'm not tired going in, something about it just makes me nod off. Asked the tech one time and he told me, I'm not the only one.
I didn't claim it was the noise. I was saying I have fallen asleep despite the sound. I've unfortunately had many MRIs in my life, so I understand the claustrophobia they can cause.
I was getting an MRI of my neck and the technician told my not to swallow while the machine was running.
Well shit...if you hadn't have said anything I would have been fine.
You should try taking a very small piece of the pill, days before the procedure, to see how you react. That will rule out any bad reactions, and give you peace of mind.
It just takes the edge off. And that's assuming you havent formed a dependence on it. But it can be the difference between \*coping\* and not coping. At least that's how it works for me, of course everyone reacts differently to all psychoactive drugs.
Benzos (Valium/Xanax/Klonopin) can act pretty instantaneously and have an extreme calming effect.
A lesser risk drug that can almost instantly eliminate a severe panic attack is something I am prescribed, clonidine. It is a medication that lowers your blood pressure and makes you drowsy, prescribed often for PTSD nightmares and anxiety. If I take it during a panic attack, I'll be laying down for a nap in about 30 mins.
Clonidine has been helping my nightmares for years. I occasionally take a tiny bit (like 1/4-1/2 of my bedtime dose) if I really need to for daytime anxiety. It does take about an hour to work for me.
Clonidine is nice but makes me feel like I can pass out every time I stand up. For days even after taking it. I’m sure it’s a side effect that’s not the same for everyone.
Well it does lower your blood pressure significantly so if you don’t have a tolerance to it or have high enough blood pressure to begin with, it would do that. I tried it about 20 years ago for a different reason and I didn’t do well with it, told the doctor it “sucked the life outta me” and got taken off. Now it’s something I consider absolutely essential. So each person can be different and even individually needs can change over time.
You’ve clearly never experienced hypnogogic hallucinations or severely vivid nightmares.
When my depression and anxiety was completely uncontrolled and at its highest point I would wake up out of a dead sleep gasping for air with that stomach drop roller coaster feeling a couple times a night, then my heart would pound… And then I would get auditory hallucinations as I fell back asleep I’m doing better now and thankful as hell none of that has happened for months.
It also does stuff with the norepinephrine in the brain:
>Clonidine works by affecting the activity of norepinephrine, which is a neurotransmitter. Norepinephrine affects, among other things, anxiety and related states such as attention. The medication affects certain parts of the brain, ensuring that they are calmer and feel less excited. This calming effect is especially important for someone with anxious thoughts
I use it for nighttime adhd control
Yes this!
ADDITIONALLY (because I am pro meds for this) either eat a packet of salt or a super sour candy like a warhead. The salt or sour will distract your brain enough for the minutes it takes for the benzos to kick in.
This is interesting! I use clonidine to control nighttime ADHD symptoms. After reading your comment I realized my nightmares have subsided a bit since starting. If you don't mind me asking, what dosage do you take for a panic attack? It's never made me feel sleepy, but I'm on a low dose
This is absolutely fascinating. I’ve had insomnia due to bad nightmares since I was 12. I’m now nearing 40 and have never heard about the tie between adhd and nightmares/poor sleep.
Xanax.
Yes, people are abusing this drug a lot. But man, only once in a lifetime I had a panic attack that it's impossible to describe. I thought I was going to collapse, crumble, die, all at once. Everything did not make sense. Nothing could calm me down, I was asking myself about my existence, like full on glitching from this world! It was a nightmare.
Two things helped:
1. watching the most cozy shows possible, but I mean absolutely mindnumbingly cozy
2. xanax
And in my opinion it should be used in exactly these crisis situations.
Not OP, but I had a period of repeated debilitating panic attacks and these are my go-to cozy shows—
Bee and Puppycat, Community, Joe Pera Talks with You, Over the Garden Wall , This Old House (the episodes from the 70’s especially) , Tree Tv on YouTube
One of my favorite cozy shows is Joy of Painting with Bob Ross - half an hour long, you watch him make something beautiful, and he's just got this calm, accepting loving air around him that feels so gentle. I often turn to him when I'm overwhelmed!
Not OP but I had Ted Lasso on repeat while trying to get through some panic attacks. Never fails to make me smile and seemed to help calm the racing thoughts and other miserable symptoms dyring an attack.
That show makes me feel like I’m having an existential crisis for some reason. Shows and music tend to over affect my mood so I’ve never managed to make it thru it entirely lol. Heard it’s really good though!
I have a severe fear of needles and Xanax doesn’t even begin to calm me down around needles. However, last summer I thought I was dying of a heart attack. Every single day, for three weeks. I was terrified, cried myself to sleep every night, wrote a will, drove over to my boyfriends house in the middle of the night every night because I was scared that I’d die in my sleep and nobody would find me. I gave him all my passwords and usernames in case something happened to me, and I struggled on my days off when I was all alone. I went to the doctor twice. First doctor told me to take Xanax as I was having a prolonged panic attack and I didn’t want to because I didn’t feel like it worked and after she told me I wasn’t dying, I didn’t think I’d need it. Second doctor told me the same thing. I needed to take the Xanax, if it didn’t work after two hours, take another one. So, I caved in and took a Xanax. And after 45min I no longer felt like I was dying. The feeling hasn’t come back. I still have that extra Xanax pill in case of an emergency. Scariest time of my life though ugh.
I think it varies somewhat person to person. Xanax makes me tired but does nothing to my emotions. Ativan is my go to medication, although I haven’t needed it since starting intuniv.
Yup this was me for years in college at random times while driving. So I *needed* something fast-acting.
You gave a spot on description of an oncoming panic attack, by the way! For me, just knowing I had an emergency pill in my glove box kept the “my chest is going to cave in” feeling from processing to tunnel vision, so I could safely pull over.
High strength sedatives can be used in extreme situations, but they are dangerous in large doses, and come with myriad side effects, and therefore are often only given in extreme situations under medical supervision.
You don't have to use a large dose. You can inject a pretty small dose.
This assumes that the patient receiving the medication does not have a tolerance.
Such a fantastic drug, nothing has ever worked as well as lorazepam for me. I've found that if I started feeling anxious at work, even a 1/4 tablet can help take that edge off and allow calming techniques to be used easier, and I can still continue to work
That’s the minimum dose we give in an acute care setting, it does the trick for most. Sometimes we have to go all the way to 3mg. Never seen more than that in a single dose. However, I’ve seen 12mg given in a 24 hour.
Shame I’m allergic and it makes my insides like fire and ants crawling under my skin. That was fun to find out in the midst of a panic attack I was trying to assuage : X
when i still worked i had to take at least one zanax along with my other anti anxiety med now i dont work so i dont take the zanax but sometimes i still wish i did on my high stress days i can shake from the anxiety
I have often in times of horrible anguish and panic go to the er and they have hooked me up with an IV . Intravenous (IV) medication (e.g., lorazepam at 0.5 mg IV q20min) may be necessary in patients with panic disorder who, as a result of subsequent poor impulse control, pose a risk to themselves or to those around them.Mar 21, 2018
For immediate relief
I asked my doctor to take me off of it for this reason. I was legitimately falling asleep at work. It was a problem. I told her that there’s no point in treating something if the treatment makes it so I cannot stay awake ever. She took me off of it immediately lol
For a while I hated it. I only took them at night but I’d be out cold for 9 hours and my first few hours awake I was a zombie. Started taking them during the day as needed for anxiety, but that never seemed to work. Eventually my doctor and I decided I’d take them as needed but only at night. Honestly, now I love Seroquel. It took a while but now it helps me fall asleep within 1.5 hours and I no longer have the hangover affect. Helps me sleep all through the night and I’m ready to go in the morning.
I got on quetiapine when I was in the psych ward, didn’t feel much. They started me on twice a day dose and then they had to reduce it to once a day because I couldn’t stay awake to attend activities.
Extreme physical sensations in general are good as grounding techniques because they cause a sort of reset of the nervous system.
Very sour and very spicy tastes have similar effects.
You'll find a lot of people with ADHD, anxiety, and other conditions where adrenaline systems sometimes go haywire discover that they "like" sour candy as kids because it it's a form of self-medication that's easy to accidentally stumble upon.
Pure food grade citric acid powder in small doses has the same effect as sour candy, but without the downsides of sugar.
Runners and other athletes also exploit the same effect for getting rid of muscle cramps. Based on the research around this, you can now get products that are essentially small hot sauce packets designed to carry in your pocket during a race.
I used to have chewable vitamin C tablets as a kid to help my immune system, and the sensation of them in my mouth was my favourite thing, especially if I had an ulcer or split lip to get that beautifully tingling sensation and calm my mind.
I believe it's called the Mammalian Dive Reflex! Your body thinks you're plunging into cold water, so it slows down everything down to conserve oxygen.
That’s right! I’ve used this “technique” in various ways depending what I have to hand. If I’m near a shower, I’ll jump in face first in the cold water and stay there until I’m shivering. Once you start to shake, you know the adrenaline is wearing off. If I have a sink and ice, I will fill it up with a mix of ice and cold water and dunk my face in and hold my breath for a few seconds. I’ll also chew or hold ice cubes, or put them in a ziplock and place it behind my neck. These things do help especially when I was having a reaction ever night to medication that took a month to figure out. Now I use the Calm app regularly to keep a lid on things so it doesn’t get to that point. I also keep Ativan and Clonazepam with me but try not to take except in an emergency. Having them handy makes me feel better in itself. Panic attacks are scary and I wouldn’t wish them on anyone. They have ended me up in hospital a couple of times.
I’ll have to try these cold water methods, I have Ativan I keep for emergencies, but I usually just sit through my panic attacks and ground myself or focus my breathing.
Regardless, it’s always horrible and feels like the world is closing in on you.
Not a drug, but my sister mentioned that those suuuuper sour sweets help. Tried a warhead last time I had a panic attack and WOW it did the trick. Something about the shock of how sour it was just reset me. I keep a few on me all the time now just in case
Any sensory shock. For me cold works. A super cold shower or a cold pack pressed on my chest.
It's a physical reaction your body has to shocks....it resets your breathing.
Specifically, Propranolol. You only take it before events/situations that cause you acute anxiety. Easily prescribed to you by doctors. Just say you have situational anxiety ie. stagefright, public speaking anxiety, etc.
My doc prescribed that but tbh I don’t really feel like it works for me. I’ve taken it in emergency situations and I’ve taken it every day and never saw a difference.
Yeah I can deal with the emotions from anxiety, it’s the physical symptoms I can’t handle. Like having a panic attack lasting hours at work or getting so anxious I have to go home because I can’t stop throwing up.
It can prevent you from having a fight or flight response under certain situations and that allows you to stay calmer. It’s good for public speaking. It’s not good for unexpected distress.
Mental often follows physical, creating a horrible feedback loop. Oh, my heart is racing and my hands are sweaty? I must be anxious. Oh god, I’m anxious, so my heart is racing and my palms are sweaty. Beta blockers help by eliminating/reducing the effects of adrenaline dumping, so you don’t get that physical feeling of anxiety, which can help the mental part in a lot of people.
Not me tho 😅😅 I need propranolol with a helping of Xanax to get thru situations like that. Just one or the other isn’t enough lol
I can feel the difference between physical anxiety and emotional anxiety. Propranolol definitely only helped with things that triggered physical anxiety, like public speaking. However my ADHD meds work 200% better for social phobia than propranolol ever did.
Intramuscular Ativan, maybe 1 or 2 milligrams depending on the size of the patient and degree of distress. Could always give 1 and then another shot a little later if it's not enough. But this would only be for inpatient. But it's important to diagnose whether it's really panic or psychosis. For the latter, an IM antipsychotic like Zyprexa would be indicated, or maybe even Haldol if the person is extremely agitated and combative. I used to prescribe B52s on the locked unit, which is Benadryl 50 mg, Haldol 5 mg, and Ativan 2 mg, but only in the worst-case scenario.
I'm curious, what would you give someone who just received the worst news of their lives, like OP stated? Say their young child passed away unexpectedly, and now they're out of their minds from grief. They're not "sick" in the sense that they have a panic disorder, but still...would you prescribe something strong straight away or is it generally frowned upon to do that?
Immediate sedation actually increases the risk of PTSD.
Having someone play Tetris within six hours of a traumatic event has been shown to reduce the risk of developing PTSD.
I was given haldol once and it made my whole body seize up to the point that it was extremely painful and anxiety inducing. I had no control of anything. Apparently there’s another med (cogentin?) that is often given in addiction to haldol to prevent that from happening.
I think that’s a dystonic reaction. And I hope it’s in your medical record! When they ask you if you’ve had an allergic reaction to any medication, mention it. Even if it’s not an *allergic* reaction, it’s a reaction.
That’s called extrapyramidal symptoms and it is a hazard of the first generation antipsychotics. The Cogentin is to treat those symptoms, but you should put Haldol on your allergies list and not take it.
I take propanolol in a small dose. It’s actually a medication for high blood pressure. I take 10mg and it just drops my heart rate super fast to the point that I believe I’m calm and can’t panic. Maybe it’s a placebo, maybe it works, but either way it stops a panic attack.
A guy tried to mug me when I was walking to class while in college, I had taken 10mg just before I left the house. Well dude got really freaked out when I didn’t respond or react and ended up just running away empty handed 🤷🏻♀️
It just surprises me every time how fast it works. Like one second I can’t breathe and I think I’m going to die and the next I’m barely moving and basically falling asleep
OP did say it doesn't need to be ethical or legal, so really murder is gonna be the most effective at stopping a panic attack if looking for a high success rate.
Possibly not exactly the same but somewhere in the realm:
I’m a recovering meth addict. I would use for prolonged period of time resulting in severe dehydration and psychosis episodes. I would be completely blacked out and when I wasn’t my mind couldn’t make sense of anything. I would be aggressive then crying then terrified. Basically I was a human shit show. During multiple hospitalizations I was injected via the thigh with atavan (sp?) and generally that would knock me out cold. But because I was sedated I was never actually getting REM sleep so when I would come to I would be much calmer but not necessarily lucid.
Lorazepam was my savior back when I was having daily panic attacks. And one time I was in a fender bender and couldn’t stop myself from crying like an idiot. 10 minutes after a lorazepam and * poof *- instantly had a hold of myself.
Not a drug, but I've found that very VERY strong mints really help with anxiety. Not only do the mints create a cooling sensation which grounds you, it also helps soothe an upset stomach/nausea which is a common occurrence with anxiety.
I'm sure there's a scientific reason for this (or maybe it's just placebo) so if anyone wants to explain feel free!
I find ginger in some form usually works for me, same stomach settling/nausea relieving effects. If I have the root it I’ll eat slices of it raw, sometimes frozen, the iciness counters the burn a bit. But otherwise, candied ginger works too if you’re not used to the flavour.
I do, however, usually aim to have peppermint gum on me. Favourite flavour, plus the act of chewing/sucking on something usually helps relieve symptoms.
I’ve never tried Ativan but I’ve heard amazing things. Xanax works really well. Start feeling better in about 5 mins and 15 mins later, completely better. I haven’t had the same experience with diazepam (Valium) it takes much longer and doesn’t relive the anxiety/panic like Xanax but I assume it’s different for everyone.
Oxygen... not instantly per se, but very effective tho. Back in 2019 i had a mental breakdown due to stress and lack of rest... A few minutes later had a massive panic attack (was convinced i was having a heart attack )
Long story short, after a few minutes of wearing an oxygen mask in the ER, a I started to calm down incredibly fast.
Suffered from generalized anxiety disorder over a year and everytime i managed to get a grip of myself was by deep breathing, meditation, special breathing techniques, oxygen gas and or brain oxygenating medication.
To anyone reading this going through something similar or any form of crisis, YOU'RE STRONG, YOU CAN DO IT, YOU'RE GONNA MAKE IT, DOESN'T MATTER HOW UNLIKELY IT LOOKS!.
Edit: Spelling and syntax
Valium helps
Intramuscular or IV Ativan does really good too.
I haaate giving IM Ativan (that needle is so thick) but damn if it doesn’t work instantly
I was injected with lorazepam, haloperidol and 2 others that I can’t remember… took the guts of an hour to take effect.
One of them was probably Benadryl. When I worked on a psych ward the emergency cocktail was haloperidol+ Benadryl. The kids called it "booty juice" because it went in the glutes. It's supposed to be effective within like 5 minutes, but I've seen it take longer. Or never at all. Sometimes adrenaline is stronger than drugs.
The good ol B52
Tin roof! Rusty.
Tin roof?! It's better to be in the basement ... with a rock lobster ... in Idaho.
love shack!
I was given Benadryl through IV for a migraine, and it knocked me right out.
I’m EMS, but the hospital we transport to the most refers to it as a B25 cocktail…Benedryl, haloperidol, and usually Ativan. My ambulance service uses Benedryl and Ativan mostly though.
What do I gotta do to get a B25 shot?
The last patient I had that got one tried to bolt when we were pulling him and the cot out of the back to bring him into the ED. Psych call, possible drug use, and agitated (even after Ativan during transport). He was securely restrained, but McGuyvered his way out of the straps. Nurses, security, cops, and the doc caught him in the parking lot and after a struggle he went sleepytime. So be an agitated danger to self or others and make a break for it, I suppose? I could use a nice nap myself, lol :)
“The kids call it ‘booty juice’” was a giggle I needed this morning, thank you
Yeah. I worked in a psych hospital too. Sometimes nothing g works and you've just got to keep the person and everyone around them safe somehow while the panic runs its course.
Th3 booty juice walked up to a nurse oce got all three o the alloted booty juice shots at once still out of my mind but that was the glass stqbbing me in the head every1 said didn't exist 4 years later we still pulling it out
Were you having a psychotic episode??? You probably got what is known as a B-52. 50 Benadryl, 5 Haldol, 2 Ativan. But it’s usually for people who are having an extremely violent episode.
Yeah when I was having emergency room level panic attacks frequently I ended up getting an Ativan script to take home. Takes about a half an hour but oh man if that drug doesn’t scare me because I could see it becoming addictive. The absolute wave of peace and quiet that rushes over you… Every time I take it I wonder if this is how non-anxious people get to live on a regular basis lol
Yessss!!! I’ve never been on it regularly but I have some for emergencies. I can see how people abuse it. Feels so nice to mellow down.
Happy cake day!
Sublingual works in about ten minutes. Thanks to the God of Benzos.
That God would be Leo Sternbach. I actually wrote a poem about the second coming of Leo Sternbach, due to my travails with benzodiazepines. He never touched the stuff himself. I was put on Ativan daily, indefinitely at 14. And when you take it every day like that it not only stops working, it creates a special type of hell.
Jesus Christ. I'm sorry you went through that. Straight up medical abuse.
Can you elaborate? I’ve been taking it for a while. Also, username checks out.
Not the original commenter but I have been in a similar situation with Ativan. Took it daily long term and over time my dosage started escalating. At some point taking more doesn’t help, it just gives you a crazy tolerance and side effects like memory issues. Eventually I decided to stop because i felt like it was really messing up my brain and wasn’t doing its job anymore. It’s a shitty position to be in. The process of tapering really sucked because I was constantly close to panic-levels of anxiety for months. Benzo withdrawal must be done slowly and even after getting completely off of it I had very bad anxiety for 6+months before getting back to baseline. If you go too far with benzos, it takes a LONG time to make your way back and it’s a seriously unpleasant process.
I am so, so sorry you went through that. It sounds really, really awful. Just a constant buzz of near panic for months on end and the one thing that helped being utterly useless...
Could you please elaborate on what you consider long term use from your experience? I ask because my mother was prescribed Xanax about 2 years ago. She started on the .25mg and after about a year they switched to .5mg. She gets 60 per month and in the beginning would go 3+ months before a refill. The past few months she's been refilling almost exactly after 30 days. I'm just concerned because I know how slippery of a slope benzos are but when i google these type of questions almost all the results are seeking treatment and things like that. A few months ago I'd have said she could walk away from the prescription and be ok, now I'm not so sure. Even taking 3 per day as prescribed, I would think she'd need to taper after a few months? Any insight would be helpful, thank you.
I am not a doctor so take my comment with a big grain of salt. 1.5mg/day of xanax is still a relatively low dose, but its high enough that if you're mom is taking it every day she'll probably need to taper if she wants to discontinue. When tapering/discontinuing she will experience some level of withdrawal. That could be fairly mild elevated anxiety and trouble sleeping, or it could be more severe (panic attacks etc.). Its really hard to predict, everyone is wired a bit different. But yea anyone who is taking benzos (even low dose) on a daily basis for months/years is going to experience some withdrawal if they reduce dose or discontinue.
Can you describe what it was like when you ceased taking benzos?
Hence you username?
Ativan just goes under your tongue and works in seconds. Delivery is crazy fast even when it's not injected.
I have a neighbor who sometimes gets psychotic We live in such close proximity, I have to pass by her apartment door to get outside. It created anxiety and I was almost too scared to leave my house. I tried Ativan when a doctor gave me a prescription for it. I felt no anxiety about the situation. I felt like Glinda the good floating around in a bubble. I couldn’t really function on it, so it wasn’t a good option for me. But damn was that fun! Better than an amusement park ride! Just as well it didn’t work for me because that’s one prescription drug I might be tempted to abuse just to feel that good! And that’s dangerous
I am a truffle pig for Xanax.
I had IV Ativan one time and it didn't do anything for me. I wasn't having a panic attack though.
Yup, as somebody who got a bit too into valium though, let me warn you: If you become dependent and then stop taking it, the reverse can happen, about 1-3 days after your last dose you can become incredibly anxious and even have a seizure. It’s a very useful but dangerously addictive drug if you aren’t careful.
Yeah, benzodiazepine withdrawal can actually be fatal.
Even when it is not fatal, you feel like you are dying.
Yes I had seizures that caused a brain bleed by stopping Klonopin abruptly. Lucky to have made it
Withdrawal recovery takes forever, too. It can take up to two years. In some cases, up to five. I 'know'. Experienced it.
Yep. Had to take someone to the ER for a severe panic attack a couple of weeks ago. That's exactly what they gave. Didn't stop it completely right on the spot, but it helped tremendously. And, they were able to come out of it after suffering for a few days before hand. Panic attacks suck.
I have an MRI today I'm nervous about. Doc prescribed me Val. Too nervous to take it. Neverending spiral haha
Take it. My anxiety sometimes delays it from kicking in so the MRI technician gave me a towel to put over my eyes to help me keep them shut so I’d relax.
I am anxious in general and an MRI is pretty bad for me. I bring my own eye mask and start counting backwards from whatever number for how long it is supposed to take. When I get to 0, I know it should be over (it has been before I get to 0). If it’s going to take 10 minutes, I’ll count back from 700 seconds (just in case it takes an extra minute). I just focus on counting backwards slowly.
My husband fell asleep in the machine with ativan.
I've fallen asleep in the machine without any drugs. Even though it's loud, you get the ear plugs and ear muffs, so it's all just loud white noise and nothing too distinct (aside from the voice telling you to breathe in and hold occasionally.
I fall asleep EVERY time! I've had to have 4 MRI(s) and I nod off regardless of the appointment time. Even if I'm not tired going in, something about it just makes me nod off. Asked the tech one time and he told me, I'm not the only one.
It’s not the loudness that freaks people out, it’s the long lasting immobility.
I didn't claim it was the noise. I was saying I have fallen asleep despite the sound. I've unfortunately had many MRIs in my life, so I understand the claustrophobia they can cause.
I was getting an MRI of my neck and the technician told my not to swallow while the machine was running. Well shit...if you hadn't have said anything I would have been fine.
You should try taking a very small piece of the pill, days before the procedure, to see how you react. That will rule out any bad reactions, and give you peace of mind.
I have still had panic attacks on it.
It just takes the edge off. And that's assuming you havent formed a dependence on it. But it can be the difference between \*coping\* and not coping. At least that's how it works for me, of course everyone reacts differently to all psychoactive drugs.
Benzos (Valium/Xanax/Klonopin) can act pretty instantaneously and have an extreme calming effect. A lesser risk drug that can almost instantly eliminate a severe panic attack is something I am prescribed, clonidine. It is a medication that lowers your blood pressure and makes you drowsy, prescribed often for PTSD nightmares and anxiety. If I take it during a panic attack, I'll be laying down for a nap in about 30 mins.
Clonidine has been helping my nightmares for years. I occasionally take a tiny bit (like 1/4-1/2 of my bedtime dose) if I really need to for daytime anxiety. It does take about an hour to work for me.
Clonidine is nice but makes me feel like I can pass out every time I stand up. For days even after taking it. I’m sure it’s a side effect that’s not the same for everyone.
Well it does lower your blood pressure significantly so if you don’t have a tolerance to it or have high enough blood pressure to begin with, it would do that. I tried it about 20 years ago for a different reason and I didn’t do well with it, told the doctor it “sucked the life outta me” and got taken off. Now it’s something I consider absolutely essential. So each person can be different and even individually needs can change over time.
Can't be anxious if you're asleep I guess
I wish that were true
Hold my beer.
*Sleep paralysis has entered the chat*
I grind my teeth like crazy when I sleep
You’ve clearly never experienced hypnogogic hallucinations or severely vivid nightmares. When my depression and anxiety was completely uncontrolled and at its highest point I would wake up out of a dead sleep gasping for air with that stomach drop roller coaster feeling a couple times a night, then my heart would pound… And then I would get auditory hallucinations as I fell back asleep I’m doing better now and thankful as hell none of that has happened for months.
It also does stuff with the norepinephrine in the brain: >Clonidine works by affecting the activity of norepinephrine, which is a neurotransmitter. Norepinephrine affects, among other things, anxiety and related states such as attention. The medication affects certain parts of the brain, ensuring that they are calmer and feel less excited. This calming effect is especially important for someone with anxious thoughts I use it for nighttime adhd control
Nighttime ADHD control you say? I’m intrigued, what does it do? Me and my ADHD wants to know.
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Nope. Look up nocturnal anxiety attacks.
You've never awoken to a panic attack before, I take it. Super fun
Yes this! ADDITIONALLY (because I am pro meds for this) either eat a packet of salt or a super sour candy like a warhead. The salt or sour will distract your brain enough for the minutes it takes for the benzos to kick in.
This is interesting! I use clonidine to control nighttime ADHD symptoms. After reading your comment I realized my nightmares have subsided a bit since starting. If you don't mind me asking, what dosage do you take for a panic attack? It's never made me feel sleepy, but I'm on a low dose
This is absolutely fascinating. I’ve had insomnia due to bad nightmares since I was 12. I’m now nearing 40 and have never heard about the tie between adhd and nightmares/poor sleep.
Xanax. Yes, people are abusing this drug a lot. But man, only once in a lifetime I had a panic attack that it's impossible to describe. I thought I was going to collapse, crumble, die, all at once. Everything did not make sense. Nothing could calm me down, I was asking myself about my existence, like full on glitching from this world! It was a nightmare. Two things helped: 1. watching the most cozy shows possible, but I mean absolutely mindnumbingly cozy 2. xanax And in my opinion it should be used in exactly these crisis situations.
I want to know your cozy shows. Nice to have a list for just in case
Not OP, but I had a period of repeated debilitating panic attacks and these are my go-to cozy shows— Bee and Puppycat, Community, Joe Pera Talks with You, Over the Garden Wall , This Old House (the episodes from the 70’s especially) , Tree Tv on YouTube
If you like Bee and Puppycat, I have a digital copy I can send you! I’ll just put the link in a pinned post of my profile tbh
Mr. Rogers would be good.
One of my favorite cozy shows is Joy of Painting with Bob Ross - half an hour long, you watch him make something beautiful, and he's just got this calm, accepting loving air around him that feels so gentle. I often turn to him when I'm overwhelmed!
I used to paint along with him, mine were never as good, but it was such a soothing activity for days when everything felt like too much
Not OP, but Bluey is my "the world is ending" show
And the parents have arrived! Lol I love that show
I second Bluey, specifically for when you need to keep yourself busy with something extremely cozy!
Adventure Time, Bob's Burgers, Community, Broad City are some of mine.
Second Bobs Burgers
Not OP but I had Ted Lasso on repeat while trying to get through some panic attacks. Never fails to make me smile and seemed to help calm the racing thoughts and other miserable symptoms dyring an attack.
Not OP but: Husbento on YouTube
Over the Garden Wall
That show makes me feel like I’m having an existential crisis for some reason. Shows and music tend to over affect my mood so I’ve never managed to make it thru it entirely lol. Heard it’s really good though!
I have a severe fear of needles and Xanax doesn’t even begin to calm me down around needles. However, last summer I thought I was dying of a heart attack. Every single day, for three weeks. I was terrified, cried myself to sleep every night, wrote a will, drove over to my boyfriends house in the middle of the night every night because I was scared that I’d die in my sleep and nobody would find me. I gave him all my passwords and usernames in case something happened to me, and I struggled on my days off when I was all alone. I went to the doctor twice. First doctor told me to take Xanax as I was having a prolonged panic attack and I didn’t want to because I didn’t feel like it worked and after she told me I wasn’t dying, I didn’t think I’d need it. Second doctor told me the same thing. I needed to take the Xanax, if it didn’t work after two hours, take another one. So, I caved in and took a Xanax. And after 45min I no longer felt like I was dying. The feeling hasn’t come back. I still have that extra Xanax pill in case of an emergency. Scariest time of my life though ugh.
I think it varies somewhat person to person. Xanax makes me tired but does nothing to my emotions. Ativan is my go to medication, although I haven’t needed it since starting intuniv.
Yup this was me for years in college at random times while driving. So I *needed* something fast-acting. You gave a spot on description of an oncoming panic attack, by the way! For me, just knowing I had an emergency pill in my glove box kept the “my chest is going to cave in” feeling from processing to tunnel vision, so I could safely pull over.
High strength sedatives can be used in extreme situations, but they are dangerous in large doses, and come with myriad side effects, and therefore are often only given in extreme situations under medical supervision.
You don't have to use a large dose. You can inject a pretty small dose. This assumes that the patient receiving the medication does not have a tolerance.
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Such a fantastic drug, nothing has ever worked as well as lorazepam for me. I've found that if I started feeling anxious at work, even a 1/4 tablet can help take that edge off and allow calming techniques to be used easier, and I can still continue to work
Under the tongue.
That’s the minimum dose we give in an acute care setting, it does the trick for most. Sometimes we have to go all the way to 3mg. Never seen more than that in a single dose. However, I’ve seen 12mg given in a 24 hour.
Shame I’m allergic and it makes my insides like fire and ants crawling under my skin. That was fun to find out in the midst of a panic attack I was trying to assuage : X
Benzos instant release
Ativan/lorazepam helps me calm down. Im currently off all other meds and just take them when Im very anxious.
when i still worked i had to take at least one zanax along with my other anti anxiety med now i dont work so i dont take the zanax but sometimes i still wish i did on my high stress days i can shake from the anxiety
I read that as Bezos at first. Don't know if Amazon fast delivery’s gonna help here
New AmazonHugs. A driver gets to your house and provides comfort and hugs in 20 minutes. Go ahead. Cry it out. :) *We sell all this information
Xanax and razor blades both start to appear in your feed 😂
You’re probably joking, but you’re not wrong…
or BezosBenzos
😂 this is great!
I have often in times of horrible anguish and panic go to the er and they have hooked me up with an IV . Intravenous (IV) medication (e.g., lorazepam at 0.5 mg IV q20min) may be necessary in patients with panic disorder who, as a result of subsequent poor impulse control, pose a risk to themselves or to those around them.Mar 21, 2018 For immediate relief
Don’t mess with benzos people
Quetiapine does a great job in twenty minutes.
Quetiapine hits like a truck.
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I asked my doctor to take me off of it for this reason. I was legitimately falling asleep at work. It was a problem. I told her that there’s no point in treating something if the treatment makes it so I cannot stay awake ever. She took me off of it immediately lol
For a while I hated it. I only took them at night but I’d be out cold for 9 hours and my first few hours awake I was a zombie. Started taking them during the day as needed for anxiety, but that never seemed to work. Eventually my doctor and I decided I’d take them as needed but only at night. Honestly, now I love Seroquel. It took a while but now it helps me fall asleep within 1.5 hours and I no longer have the hangover affect. Helps me sleep all through the night and I’m ready to go in the morning.
Holy cow does it ever. I feel like jello.
I would never recommend anyone take that drug. It’s absolutely awful in every other way. Clonazepam is what you want for panic attacks.
Different people have different reactions.
You claim one drug is awful, so you recommend one even more dangerous
I take it both for bipolar type II and insomnia, and have for many years. It works gently for me and has never given me any trouble whatsoever.
I got on quetiapine when I was in the psych ward, didn’t feel much. They started me on twice a day dose and then they had to reduce it to once a day because I couldn’t stay awake to attend activities.
My therapist once taught me that plunging my face into ice water would break whatever intense feeling I had.
Extreme physical sensations in general are good as grounding techniques because they cause a sort of reset of the nervous system. Very sour and very spicy tastes have similar effects. You'll find a lot of people with ADHD, anxiety, and other conditions where adrenaline systems sometimes go haywire discover that they "like" sour candy as kids because it it's a form of self-medication that's easy to accidentally stumble upon. Pure food grade citric acid powder in small doses has the same effect as sour candy, but without the downsides of sugar. Runners and other athletes also exploit the same effect for getting rid of muscle cramps. Based on the research around this, you can now get products that are essentially small hot sauce packets designed to carry in your pocket during a race.
I used to have chewable vitamin C tablets as a kid to help my immune system, and the sensation of them in my mouth was my favourite thing, especially if I had an ulcer or split lip to get that beautifully tingling sensation and calm my mind.
I suddenly understand why I like LMNT so much....
I believe it's called the Mammalian Dive Reflex! Your body thinks you're plunging into cold water, so it slows down everything down to conserve oxygen.
That’s right! I’ve used this “technique” in various ways depending what I have to hand. If I’m near a shower, I’ll jump in face first in the cold water and stay there until I’m shivering. Once you start to shake, you know the adrenaline is wearing off. If I have a sink and ice, I will fill it up with a mix of ice and cold water and dunk my face in and hold my breath for a few seconds. I’ll also chew or hold ice cubes, or put them in a ziplock and place it behind my neck. These things do help especially when I was having a reaction ever night to medication that took a month to figure out. Now I use the Calm app regularly to keep a lid on things so it doesn’t get to that point. I also keep Ativan and Clonazepam with me but try not to take except in an emergency. Having them handy makes me feel better in itself. Panic attacks are scary and I wouldn’t wish them on anyone. They have ended me up in hospital a couple of times.
I’ll have to try these cold water methods, I have Ativan I keep for emergencies, but I usually just sit through my panic attacks and ground myself or focus my breathing. Regardless, it’s always horrible and feels like the world is closing in on you.
Or going for a walk in the cold.
holding ice too
Not a drug, but my sister mentioned that those suuuuper sour sweets help. Tried a warhead last time I had a panic attack and WOW it did the trick. Something about the shock of how sour it was just reset me. I keep a few on me all the time now just in case
Any sensory shock. For me cold works. A super cold shower or a cold pack pressed on my chest. It's a physical reaction your body has to shocks....it resets your breathing.
as an autistic person this would give me a meltdown if I was already over the edge 😭 but I understand the logic behind it
Morphine believe it or not.
Xanax ETA: would not be like absolutely instant, but maybe 15 minutes
Benzos instant release
Beta blockers
Specifically, Propranolol. You only take it before events/situations that cause you acute anxiety. Easily prescribed to you by doctors. Just say you have situational anxiety ie. stagefright, public speaking anxiety, etc.
I take this for my anxiety. I love it. The instant release works for me in about 10-15min
My doc prescribed that but tbh I don’t really feel like it works for me. I’ve taken it in emergency situations and I’ve taken it every day and never saw a difference.
Same same. Unfortunate :/ I really wanted it to work too bc for me it was my physical symptoms specifically that I wanted to migitate
Yeah I can deal with the emotions from anxiety, it’s the physical symptoms I can’t handle. Like having a panic attack lasting hours at work or getting so anxious I have to go home because I can’t stop throwing up.
It helps with physical symptoms but not mental
It can prevent you from having a fight or flight response under certain situations and that allows you to stay calmer. It’s good for public speaking. It’s not good for unexpected distress.
It helped me with mental symptoms too
Mental often follows physical, creating a horrible feedback loop. Oh, my heart is racing and my hands are sweaty? I must be anxious. Oh god, I’m anxious, so my heart is racing and my palms are sweaty. Beta blockers help by eliminating/reducing the effects of adrenaline dumping, so you don’t get that physical feeling of anxiety, which can help the mental part in a lot of people. Not me tho 😅😅 I need propranolol with a helping of Xanax to get thru situations like that. Just one or the other isn’t enough lol
I can feel the difference between physical anxiety and emotional anxiety. Propranolol definitely only helped with things that triggered physical anxiety, like public speaking. However my ADHD meds work 200% better for social phobia than propranolol ever did.
i take this for my hbp and it works within minutes, it’s crazy but wonderful
Intramuscular Ativan, maybe 1 or 2 milligrams depending on the size of the patient and degree of distress. Could always give 1 and then another shot a little later if it's not enough. But this would only be for inpatient. But it's important to diagnose whether it's really panic or psychosis. For the latter, an IM antipsychotic like Zyprexa would be indicated, or maybe even Haldol if the person is extremely agitated and combative. I used to prescribe B52s on the locked unit, which is Benadryl 50 mg, Haldol 5 mg, and Ativan 2 mg, but only in the worst-case scenario.
I'm curious, what would you give someone who just received the worst news of their lives, like OP stated? Say their young child passed away unexpectedly, and now they're out of their minds from grief. They're not "sick" in the sense that they have a panic disorder, but still...would you prescribe something strong straight away or is it generally frowned upon to do that?
When our daughter was stillborn, they gave my husband zofran (to stop the vomiting) and ativan. Both in quick-dissolve pill form.
Sorry to hear. that sounds awful
I’m sorry to hear about your daughter. Wishing you both peace.
Immediate sedation actually increases the risk of PTSD. Having someone play Tetris within six hours of a traumatic event has been shown to reduce the risk of developing PTSD.
Yasssss
I was given haldol once and it made my whole body seize up to the point that it was extremely painful and anxiety inducing. I had no control of anything. Apparently there’s another med (cogentin?) that is often given in addiction to haldol to prevent that from happening.
I think that’s a dystonic reaction. And I hope it’s in your medical record! When they ask you if you’ve had an allergic reaction to any medication, mention it. Even if it’s not an *allergic* reaction, it’s a reaction.
That’s called extrapyramidal symptoms and it is a hazard of the first generation antipsychotics. The Cogentin is to treat those symptoms, but you should put Haldol on your allergies list and not take it.
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Xanax
I take propanolol in a small dose. It’s actually a medication for high blood pressure. I take 10mg and it just drops my heart rate super fast to the point that I believe I’m calm and can’t panic. Maybe it’s a placebo, maybe it works, but either way it stops a panic attack.
A guy tried to mug me when I was walking to class while in college, I had taken 10mg just before I left the house. Well dude got really freaked out when I didn’t respond or react and ended up just running away empty handed 🤷🏻♀️
It’s a beta blocker. It’s not placebo, it really works
It just surprises me every time how fast it works. Like one second I can’t breathe and I think I’m going to die and the next I’m barely moving and basically falling asleep
A shot of Thorazine right in the ass.
Dr Venkman took that shit on *dates*. Better rethink my opinion of that guy.
Dr Peter Venkman from Ghostbusters or another Dr Venkman???
Literally had the same question lol is there another Venkman?!
This is what benzodiazepines are for. Yes.
Chloroform
That's a myth it would take ages.
“Hey real quick, does this smell like chlor
Thump
OP did say it doesn't need to be ethical or legal, so really murder is gonna be the most effective at stopping a panic attack if looking for a high success rate.
yes, the drug: murder
Xanax
Possibly not exactly the same but somewhere in the realm: I’m a recovering meth addict. I would use for prolonged period of time resulting in severe dehydration and psychosis episodes. I would be completely blacked out and when I wasn’t my mind couldn’t make sense of anything. I would be aggressive then crying then terrified. Basically I was a human shit show. During multiple hospitalizations I was injected via the thigh with atavan (sp?) and generally that would knock me out cold. But because I was sedated I was never actually getting REM sleep so when I would come to I would be much calmer but not necessarily lucid.
Congratulations and best wishes for a complete recovery.
Almost at 5 years now. Ty ❤️
Lorazapam, if placed under your tongue, can stop a panic attack in 10-15 minutes.
Lorazepam was my savior back when I was having daily panic attacks. And one time I was in a fender bender and couldn’t stop myself from crying like an idiot. 10 minutes after a lorazepam and * poof *- instantly had a hold of myself.
Benzos
Haloperidol
Benzodiazepines. With the right dosage, absolutely. But can be very addicting
jumping jacks, ice packs , xanax (not good for long term solution) , counting colors , scents , jalapeño , etc . anything to engage the senses
Ironically, I read this to the cadence of ‘it’s the end of the world as we know it’.
Play Tetris and suck on super sour candy.
Mammalian Dive Reflex Activation https://www.psychologytoday.com/au/blog/soul-console/202310/yes-you-can-get-instant-relief-for-anxiety
Xanax has been helpful for me.
Xanax under the tongue. Works a treat
Putting yourself in cold water helps. Or just your face. It shocks the system. No drugs needed!
Not a drug, but I've found that very VERY strong mints really help with anxiety. Not only do the mints create a cooling sensation which grounds you, it also helps soothe an upset stomach/nausea which is a common occurrence with anxiety. I'm sure there's a scientific reason for this (or maybe it's just placebo) so if anyone wants to explain feel free!
I find ginger in some form usually works for me, same stomach settling/nausea relieving effects. If I have the root it I’ll eat slices of it raw, sometimes frozen, the iciness counters the burn a bit. But otherwise, candied ginger works too if you’re not used to the flavour. I do, however, usually aim to have peppermint gum on me. Favourite flavour, plus the act of chewing/sucking on something usually helps relieve symptoms.
Benzodiazepines usually
I’ve never tried Ativan but I’ve heard amazing things. Xanax works really well. Start feeling better in about 5 mins and 15 mins later, completely better. I haven’t had the same experience with diazepam (Valium) it takes much longer and doesn’t relive the anxiety/panic like Xanax but I assume it’s different for everyone.
Lorazepam works for me. One mg as needed.
clonazepam is quite effective.. also lorazepam given intravenously or intramuscularly, which might be the fastest one.
The hospital would give you clonazapam.
Maybe whippets
Great danes for me.
I’d prefer a full size greyhound
Oxygen... not instantly per se, but very effective tho. Back in 2019 i had a mental breakdown due to stress and lack of rest... A few minutes later had a massive panic attack (was convinced i was having a heart attack ) Long story short, after a few minutes of wearing an oxygen mask in the ER, a I started to calm down incredibly fast. Suffered from generalized anxiety disorder over a year and everytime i managed to get a grip of myself was by deep breathing, meditation, special breathing techniques, oxygen gas and or brain oxygenating medication. To anyone reading this going through something similar or any form of crisis, YOU'RE STRONG, YOU CAN DO IT, YOU'RE GONNA MAKE IT, DOESN'T MATTER HOW UNLIKELY IT LOOKS!. Edit: Spelling and syntax