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Any ideas for a replacement for diazepam?

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barefoot

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For the last few years (roughly four, I think) I have taken 5mg diazepam for incidents of acute anxiety when I really need some help to down regulate.

I get a prescription for 28 tablets, which lasts me around 6 months.

I don’t have any dependency issues or any other problems using it. I use it sensibly and not very often (hence 28 tablets last me six months!) and they work well for me. My therapist knows when and how I take it and is supportive of me taking it as I do.

However, my GP has said that he doesn’t want to prescribe them to me any more...even though he said I am clearly not addicted...

A couple of months ago he prescribed me Propranolol but when I collected it from the pharmacy, the pharmacist said I needed to take it consistently every day (I don’t want/need to take an anxiety med every day) and she flagged that a very common side effect is sleep disturbance/nightmares. Since I am currently attending a sleep clinic for Parasomnias including night terrors, that just seemed nuts to me. Plus, the pharmacist said the propranolol was for physical symptoms of anxiety and wouldn’t help for “mental calming” in the way that diazepam does.

So, for all these reasons, I haven’t taken it and don’t intend to.

My therapist did suggest Gabapentin but my GP said he couldn’t prescribe that because it’s not licensed for anxiety. And when I mentioned it to the sleep doctor a few weeks ago, she said Gabapentin/pregabalin wasn’t recommended for people with parasomnias anyway as they can increase them. She thought it was ridiculous that GP had given me Propranolol given how common the sleep disturbance side effects are. And she didn’t understand why my GP won’t just let me keep using the diazepam as I am as it helps me and I am not dependent.

I am switching GPs (not just because of this) and have an appointment with a new one next week. I have about ten diazepam left, so there is no urgency but I want to start the conversation now to see what she thinks. I don’t want to run out then she won’t give me any and then I am stuck when I next need some help.

Ideally, I just want her to be happy to continue to prescribe me diazepam in the same way I currently use it. Fingers crossed!

I’m curious to know whether there is anything else I could take instead, which my GP may be happier to precribe.

My criteria are:
- something I can just take as and when for acute anxiety attack. I don’t need or want to take something consistently everyday/long term.
- something that calms me mentally so not something that’s just targeting and relieving physical symptoms of anxiety
- something that won’t create/exacerbate sleep disturbances

(ETA: I know pretty much anything could potentially have sleep disturbance side effects and that we all react differently to meds and that I won’t know any drug’s impact on me til I try it etc...so I just mean l don’t want something that is widely known to commonly cause sleep disturbances)

Any ideas?? (I’m in the UK if that’s relevant)

Many thanks in advance.
 
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I switched to lorazepam, it's much lighter than diazepam (the "high"), I need less dosage for it to work - a quarter is often enough to calm down acute anxiety - and it's great for sleep (occasionally).

My pdoc said it's one benzo docs aren't usually afraid to prescribe because it doesn't really have the "high" to it, making it easier for folks not to get addicted.
For me, since I use them like you (occasionally and sparingly) it's a great med for anxiety, has really saved my butt on more than one occasion.

I didn't like propranolol that much, and needed too much of it to calm down. Pdoc refused me gabapentin for the same reasons.
 
The brain melts? Wait...I think I’ve been doing it wrong! ?

When I take a Valium, I don’t feel a real high...I just feel much calmer and much more....unconcerned, I suppose.

Inner peace sounds good to me. Will do some research and may raise it with the new GP if she doesn’t want to prescribe more diazepam either.
 
Beta-blockers?

Propranolol is a beta blocker and that wasn’t suitable. So, I think I assumed (probably incorrectly - I don’t know much at all about meds - that all beta blockers would be similar ie I wouldn’t be able to just take them as and when and they would work on the physical symptoms of anxiety rather than “mental calm”?
 
I don't know about Propranolol...
The beta-blocker I took you could either take constantly or as-needed.
Actors and musicians take them just for stage fright.
Uni students take them just for exams.
 
I think the reason actors, musicians and students take beta blockers is cos they certainly don't give you that woolly-fuzzy-drowsy feeling mentally. Which, when you're performing on stage or need to write an exam, is not exactly helpful.

So they don't sort of have the same soothing effect of drinking a bottle of wine ;)
But beta-blockers don't "just" address the physical sides of anxiety.
And they're maybe/ probably not all the same?

But yeah, they wouldn't produce that woozy-calm a benzo does.
I still found them very helpful.
 
Hmm...I like the woozy calm of a benzo! Ha!
But, seriously, the diazepam doesn’t make me feel very fuzzy/drowsy....just calm. So perhaps a beta blocker wouldn’t feel so different.

Will definitely find out more and discuss with my GP. Thanks for the idea.
 
Hmm...I like the woozy calm of a benzo! Ha!
Haha, me too :laugh:

But I found it helpful to have both benzos and beta-blockers, cos I was always super wary about the addictive potential of benzos, and I had massive panic attacks daily, so using beta-blockers for a lot of them and keeping benzos for emergencies worked well for me.

:hug:
 
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